Robust and resource-efficient production process suitable for large-scale production of baculovirus through high cell density seed train and optimized infection strategy

The aim of this study was the development of a scalable production process for high titer (108 pfu/mL and above) recombinant baculovirus stocks with low cell line-derived impurities for the production of virus-like particles (VLP). To achieve this, we developed a high cell density (HCD) culture for low footprint cell proliferation, compared different infection strategies at multiplicity of infection (MOI) 0.05 and 0.005, different infection strategies and validated generally applicable harvest criteria of cell viability ≤ 80%. We also investigated online measurable parameters to observe the baculovirus production. The infection strategy employing a very low virus inoculum of MOI 0.005 and a 1:2 dilution with fresh medium one day after infection proved to be the most resource efficient. There, we achieved higher cell-specific titers and lower host cell protein concentrations at harvest than other tested infection strategies with the same MOI, while saving half of the virus stock for infecting the culture compared to other tested infection strategies. HCD culture by daily medium exchange was confirmed as suitable for seed train propagation, infection, and baculovirus production, equally efficient as the conventionally propagated seed train. Online measurable parameters for cell concentration and average cell diameter were found to be effective in monitoring the production process. The study concluded that a more efficient VLP production process in large scale can be achieved using this virus stock production strategy, which could also be extended to produce other proteins or extracellular vesicles with the baculovirus expression system.

Prognostic value of EndoPredict test in patients with hormone receptor-positive, human epidermal growth factor receptor 2-negative primary breast cancer screened for the randomized, double-blind, phase III UNIRAD trial

BACKGROUND

The purpose of this study was to evaluate the prognostic value of the multigene EndoPredict test in prospectively collected data of patients screened for the randomized, double-blind, phase III UNIRAD trial, which evaluated the addition of everolimus to adjuvant endocrine therapy in high-risk, hormone receptor-positive, human epidermal growth factor receptor 2 (HER2)-negative early breast cancer.

PATIENTS AND METHODS

Patients were classified into low or high risk according to the EPclin score, consisting of a 12-gene molecular score combined with tumor size and nodal status. Association of the EPclin score with disease-free survival (DFS) and distant metastasis-free survival (DMFS) was evaluated using Kaplan-Meier estimates. The independent prognostic added value of EPclin score was tested in a multivariate Cox model after adjusting on tumor characteristics.

RESULTS

EndoPredict test results were available for 768 patients: 663 patients classified as EPclin high risk (EPCH) and 105 patients as EPclin low risk (EPCL). Median follow-up was 70 months (range 1-172 months). For the 429 EPCH randomized patients, there was no significant difference in DFS between treatment arms. The 60-month relapse rate for patients in the EPCL and EPCH groups was 0% and 7%, respectively. Hazard ratio (HR) supposing continuous EPclin score was 1.87 [95% confidence interval (CI) 1.4-2.5, P < 0.0001]. This prognostic effect remained significant when assessed in a Cox model adjusting on tumor size, number of positive nodes and tumor grade (HR 1.52, 95% CI 1.09-2.13, P = 0.0141). The 60-month DMFS for patients in the EPCL and EPCH groups was 100% and 94%, respectively (adjusted HR 8.10, 95% CI 1.1-59.1, P < 0.0001).

CONCLUSIONS

The results confirm the value of EPclin score as an independent prognostic parameter in node-positive, hormone receptor-positive, HER2-negative early breast cancer patients receiving standard adjuvant treatment. EPclin score can be used to identify patients at higher risk of recurrence who may warrant additional systemic treatments.

Chemotherapy is not needed when complete evacuation of gestational choriocarcinoma leads to hCG normalization

BACKGROUND

The standard treatment for gestational choriocarcinoma is chemotherapy.

OBJECTIVE

To describe the risk of recurrence with expectant management of gestational choriocarcinoma that has reached a normal human chorionic gonadotropin level after tumor removal without adjuvant chemotherapy.

METHODS

A retrospective multicenter international cohort study was conducted from 1981 to 2017 involving 11 gestational trophoblastic disease reference centers with patient's follow-up extended until 2023. Clinical and biological data of included patients were extracted from each center's database. The inclusion criteria were i) histological diagnosis of gestational choriocarcinoma in any kind of placental tissue retrieved, ii) spontaneous normalization of human chorionic gonadotropin level following choriocarcinoma retrieval, iii) patient did not receive any oncological treatment for the choriocarcinoma, iv) and at least 6 months of follow-up after the first human chorionic gonadotropin level normalization.

RESULTS

Among 80 patients with retrieved gestational choriocarcinoma and whose human chorionic gonadotropin level normalized without any other oncological therapy, none had a recurrence of choriocarcinoma after a median follow-up of 50 months. The median interval between choriocarcinoma excision and human chorionic gonadotropin level normalization was 48 days. The International Federation of Gynecology and Obstetrics/World Health Organization risk score was ≤6 in 93.7% of the cases.

CONCLUSIONS

This multicenter international study reports that selected patients with gestational choriocarcinoma managed in gestational trophoblastic disease reference centers did not experience any relapse when the initial tumor evacuation is followed by human chorionic gonadotropin level normalization without any additional treatment. Expectant management may be a safe approach for highly selected patients.

A straightforward method for determination of the sevoflurane metabolite hexafluoroisopropanol in urinary occupational medical samples by headspace-gas chromatography mass spectrometry

Biological monitoring of the unmodified sevoflurane and its metabolite hexafluoroisopropanol (HFIP) in urine samples was proposed to determine the individual exposure levels of the medical staff. In this study, a method for simultaneous determination of both compounds in urine using static headspace-gas chromatography-mass spectrometry (HS-GC-MS) was developed. The method is linear over a broad concentration range from 1 to 1000 µg/L (r2 > 0.999) and shows high precision. Limits of quantification (LOQ) are 0.6 µg/L for sevoflurane and 3 µg/L for HFIP, representing an excellent sensitivity without the necessity of analyte enrichment. The method was successfully applied in a German pilot-study to monitor both compounds in samples from medical personnel working in operating theatres. Urinary concentrations of HFIP ranged between < LOQ and 145 µg/L, while sevoflurane was below the LOD in all samples.

Moving adsorption belt system for continuous bioproduct recovery utilizing composite fibrous adsorbents

A continuous protein recovery and purification system based on the true moving bed concept is presented. A novel adsorbent material, in the form of an elastic and robust woven fabric, served as a moving belt following the general designs observed in known belt conveyors. The composite fibrous material that forms the said woven fabric showed high protein binding capacity, reaching a static binding capacity equal to 107.3 mg/g, as determined via isotherm experiments. Moreover, testing the same cation exchange fibrous material in a packed bed format resulted in excellent dynamic binding capacity values (54.5 mg/g) even when operating at high flow rates (480 cm/h). In a subsequent step, a benchtop prototype was designed, constructed, and tested. Results indicated that the moving belt system could recover a model protein (hen egg white lysozyme) with a productivity up to 0.5 mg/cm²/h. Likewise, a monoclonal antibody was directly recovered from unclarified CHO_K1 cell line culture with high purity, as judged by SDS-PAGE, high purification factor (5.8), and in a single step, confirming the suitability and selectivity of the purification procedure.

A new benchmark of soft X-ray transition energies of Ne , CO 2 , and SF 6 : paving a pathway towards ppm accuracy

ABSTRACT

A key requirement for the correct interpretation of high-resolution X-ray spectra is that transition energies are known with high accuracy and precision. We investigate the K-shell features of Ne , CO 2 , and SF 6 gases, by measuring their photo ion-yield spectra at the BESSY II synchrotron facility simultaneously with the 1s-np fluorescence emission of He-like ions produced in the Polar-X EBIT. Accurate ab initio calculations of transitions in these ions provide the basis of the calibration. While the CO 2 result agrees well with previous measurements, the SF 6 spectrum appears shifted by ∼ 0.5 eV, about twice the uncertainty of the earlier results. Our result for Ne shows a large departure from earlier results, but may suffer from larger systematic effects than our other measurements. The molecular spectra agree well with our results of time-dependent density functional theory. We find that the statistical uncertainty allows calibrations in the desired range of 1-10 meV, however, systematic contributions still limit the uncertainty to ∼ 40-100 meV, mainly due to the temporal stability of the monochromator energy scale. Combining our absolute calibration technique with a relative energy calibration technique such as photoelectron energy spectroscopy will be necessary to realize its full potential of achieving uncertainties as low as 1-10 meV.

Uncovering a Role for the Dorsal Hippocampal Commissure in Recognition Memory

The dorsal hippocampal commissure (DHC) is a white matter tract that provides interhemispheric connections between temporal lobe brain regions. Despite the importance of these regions for learning and memory, there is scant evidence of a role for the DHC in successful memory performance. We used diffusion-weighted magnetic resonance imaging (DW-MRI) and white matter tractography to reconstruct the DHC in both humans (in vivo) and nonhuman primates (ex vivo). Across species, our findings demonstrate a close consistency between the known anatomy and tract reconstructions of the DHC. Anterograde tract-tracer techniques also highlighted the parahippocampal origins of DHC fibers in nonhuman primates. Finally, we derived diffusion tensor MRI metrics from the DHC in a large sample of human subjects to investigate whether interindividual variation in DHC microstructure is predictive of memory performance. The mean diffusivity of the DHC correlated with performance in a standardized recognition memory task, an effect that was not reproduced in a comparison commissure tract—the anterior commissure. These findings highlight a potential role for the DHC in recognition memory, and our tract reconstruction approach has the potential to generate further novel insights into the role of this previously understudied white matter tract in both health and disease.

Bridging the age gap in breast cancer: cluster randomized trial of two decision support interventions for older women with operable breast cancer on quality of life, survival, decision quality, and treatment choices

BACKGROUND

Rates of surgery and adjuvant therapy for breast cancer vary widely between breast units. This may contribute to differences in survival. This cluster RCT evaluated the impact of decision support interventions (DESIs) for older women with breast cancer, to ascertain whether DESIs influenced quality of life, survival, decision quality, and treatment choice.

METHODS

A multicentre cluster RCT compared the use of two DESIs against usual care in treatment decision-making in older women (aged at least ≥70 years) with breast cancer. Each DESI comprised an online algorithm, booklet, and brief decision aid to inform choices between surgery plus adjuvant endocrine therapy versus primary endocrine therapy, and adjuvant chemotherapy versus no chemotherapy. The primary outcome was quality of life. Secondary outcomes included decision quality measures, survival, and treatment choice.

RESULTS

A total of 46 breast units were randomized (21 intervention, 25 usual care), recruiting 1339 women (670 intervention, 669 usual care). There was no significant difference in global quality of life at 6 months after the baseline assessment on intention-to-treat analysis (difference -0.20, 95 per cent confidence interval (C.I.) -2.69 to 2.29; P = 0.900). In women offered a choice of primary endocrine therapy versus surgery plus endocrine therapy, knowledge about treatments was greater in the intervention arm (94 versus 74 per cent; P = 0.003). Treatment choice was altered, with a primary endocrine therapy rate among women with oestrogen receptor-positive disease of 21.0 per cent in the intervention versus 15.4 per cent in usual-care sites (difference 5.5 (95 per cent C.I. 1.1 to 10.0) per cent; P = 0.029). The chemotherapy rate was 10.3 per cent at intervention versus 14.8 per cent at usual-care sites (difference -4.5 (C.I. -8.0 to 0) per cent; P = 0.013). Survival was similar in both arms.

CONCLUSION

The use of DESIs in older women increases knowledge of breast cancer treatment options, facilitates shared decision-making, and alters treatment selection. Trial registration numbers: EudraCT 2015-004220-61 (https://eudract.ema.europa.eu/), ISRCTN46099296 (http://www.controlled-trials.com).

Toward adequate control of internal interfaces utilizing nitrile-based electrolytes

Methods to control internal interfaces in lithium ion batteries often require sophisticated procedures to deposit coating layers or introduce interphases, which are typically difficult to apply. This particularly holds for protection from parasitic reactions at the current collector, which reflects an internal interface for the electrode composite material and the electrolyte. In this work, electrolyte formulations based on aliphatic cyclic nitriles, cyclopentane-1-carbonitrile and cyclohexane-1-carbonitrile, are introduced that allow for successful suppression of aluminum dissolution and control of internal interfaces under application-relevant conditions. Such nitrile-based electrolytes show higher intrinsic oxidative and thermal stabilities as well as similar capacity retentions in lithium nickel-manganese-cobalt oxide LiNi_3/5Mn_1/5Co_1/5O₂ (NMC622)||graphite based full cells compared to the state-of-the-art organic carbonate-based electrolytes, even when bis(trifluoro-methane)sulfonimide lithium salt is utilized. Moreover, the importance of relative permittivity, degree of ion dissociation, and viscosity of the applied electrolyte formulations for the protection of current collector interfaces is emphasized.

Demographics, natural history and treatment outcomes of non-molar gestational choriocarcinoma: a UK population study

OBJECTIVE

To investigate the demographics, natural history and treatment outcomes of non-molar gestational choriocarcinoma.

DESIGN

A retrospective national population-based study.

SETTING

UK 1995-2015.

POPULATION

A total of 234 women with a diagnosis of gestational choriocarcinoma, in the absence of a prior molar pregnancy, managed at the UKs two gestational trophoblast centres in London and Sheffield.

METHODS

Retrospective review of the patient's demographic and clinical data. Comparison with contemporary UK birth and pregnancy statistics.

MAIN OUTCOMES

Incidence statistics for non-molar choriocarcinoma across the maternal age groups. Cure rates for patients by FIGO prognostic score group.

RESULTS

Over the 21-year study period, there were 234 cases of non-molar gestational choriocarcinoma, giving an incidence of 1:66 775 relative to live births and 1:84 226 to viable pregnancies. For women aged under 20, the incidence relative to viable pregnancies was 1:223 494, for ages 30-34, 1:80 227, and for ages 40-45, 1:41 718. Treatment outcomes indicated an overall 94.4% cure rate. Divided by FIGO prognostic groups, the cure rates were low-risk group 100%, high-risk group 96% and ultra-high-risk group 80.5%.

CONCLUSIONS

Non-molar gestational choriocarcinoma is a very rare diagnosis with little prior detailed information on the demographics and natural history. The data in this study give age-related incidence data based on a large national population study. The results also demonstrated the widely varying natural history of this rare malignancy and the marked correlation of disease incidence with rising maternal age.

TWEETABLE ABSTRACT

National gestational choriocarcinoma database indicates a close association between increasing maternal age and incidence.

Fluorine and Lithium: Ideal Partners for High-Performance Rechargeable Battery Electrolytes

Further enhancement in the energy densities of rechargeable lithium batteries calls for novel cell chemistry with advanced electrode materials that are compatible with suitable electrolytes without compromising the overall performance and safety, especially when considering high-voltage applications. Significant advancements in cell chemistry based on traditional organic carbonate-based electrolytes may be successfully achieved by introducing fluorine into the salt, solvent/cosolvent, or functional additive structure. The combination of the benefits from different constituents enables optimization of the electrolyte and battery chemistry toward specific, targeted applications. This Review aims to highlight key research activities and technical developments of fluorine-based materials for aprotic non-aqueous solvent-based electrolytes and their components along with the related ongoing scientific challenges and limitations. Ionic liquid-based electrolytes containing fluorine will not be considered in this Review.

Methodology paper: a novel phantom setup for commissioning of scanned ion beam delivery and TPS

BACKGROUND

Commissioning of treatment planning systems (TPS) and beam delivery for scanned light ion beams is an important quality assurance task. This requires measurement of large sets of high quality dosimetric data in anthropomorphic phantoms to benchmark the TPS and dose delivery under realistic conditions.

METHOD

A novel measurement setup is described, which allows for an efficient collection of a large set of accurate dose data in complex phantom geometries. This setup allows dose measurements based on a set of 24 small volume ionization chambers calibrated in dose to water and mounted in a holder, which can be freely positioned in a water phantom with various phantoms mounted in front of the water tank. The phantoms can be scanned in a CT and a CT-based treatment planning can be performed for a direct benchmark of the dose calculation algorithm in various situations.

RESULTS

The system has been used for acceptance testing in scanned light ion beam therapy at Heidelberg Ion Beam Therapy Center for scanned proton and carbon ion beams. It demonstrated to be useful to collect large amounts of high quality data for comparison with the TPS calculation using various phantom geometries.

CONCLUSION

The setup is an efficient tool for commissioning and verification of treatment planning systems. It is especially suited for dynamic beam delivery, as many data points can be obtained during a single plan delivery, but can be adapted also for other dynamic therapies, like rotational IMRT.

Perceived fatigue and cognitive performance change in multiple sclerosis: Uncovering predictors beyond baseline fatigue

BACKGROUND

Fatigue is a common and disabling symptom in multiple sclerosis (MS) with a variety of direct and indirect influences, but remains poorly understood. Perceived fatigue and cognitive performance fatigability may only be weakly correlated and may have independent predictors. We adopted a multifactorial approach, utilising a measure of concurrent cognitive performance change in order to examine the clinical, psychological, and cognitive factors influencing perceived and cognitive performance fatigability in MS.

METHODS

Individuals with adult-onset MS were identified from a regional patient database and invited to complete an assessment battery during a home visit. Baseline perceived fatigue was measured using the Modified Fatigue Impact Scale, Fatigue Assessment Instrument, and a Visual Analogue Scale (VAS). The Conners Continuous Performance Test 3 (CCPT3) and VAS were administered before and after our intervention of roughly 2.5 hours of assessment, which represented a period of cognitive effort. The differences in scores formed measures of cognitive performance fatigability and perceived fatigue change, respectively. We examined differences across baseline fatigue, fatigue change and performance change classifications, using regression analysis to uncover predictors of perceived fatigue and performance change.

RESULTS

The sample comprised 61 participants who were recruited from an existing cohort of MS patients. Positive relationships with depression and emotion-focused coping, and a negative one with sleep, each predicted baseline perceived fatigue with the model explaining 53.5% of variance. Increased perceived fatigue change was not associated with baseline fatigue, cognitive impairment, disease variables or levels of disability, but was linked with higher anxiety, lower self-efficacy and gender. Most CCPT3 performance change variables did not show significant correlations with baseline clinical, psychological, or fatigue variables. However, two variables were predicted by positive relationships with estimated intelligence, whilst a negative relationship with self-efficacy and a positive one with post-intervention fatigue predicted one each.

CONCLUSION

Fatigue in MS is a multifactorial construct, with perceived fatigue and cognitive performance fatigability largely influenced by indirect psychological and cognitive factors. Future studies need to take these influences into account when developing fatigue assessment tools. Further, targeting influential fatigue drivers such as psychological variables may improve the burden of fatigue and quality of life of people with MS.

Trichinella spiralis in a South American sea lion (Otaria flavescens) from Patagonia, Argentina

Trichinella spp. from a sylvatic cycle has been found in several animal species such as pumas (Puma concolor), armadillos (Chaetophractus villosus), rats (Rattus norvegicus), and wild boars (Sus scrofa) in Argentina. Moreover, Trichinella infection has been detected in a wide range of marine mammals around the world, including polar bears (Ursus maritimus) and walruses (Odobenus rosmarus). Until the present time, Trichinella spp. infection has not been detected in marine mammals of South America. Samples from four South American sea lions (Otaria flavescens) found dead in Rio Negro, Argentina, were analyzed by artificial digestion, and in the case of one animal, Trichinella larvae were identified at the species level by nested multiplex PCR as Trichinella spiralis. This is the first report of a Trichinella species infecting marine mammals from South America.

Robotic-assisted laparoscopic repair of rectovesical fistula after Hartmann's reversal procedure

The case is of a 59-year-old male with history of severe ischemic colitis following emergent intervention for a ruptured infrarenal aortic aneurysm who subsequently underwent left hemicolectomy, partial proctectomy, and Hartmann colostomy. The patient later underwent reversal of the Hartmann colostomy with diverting ileostomy. The surgery was complicated by a right ureteral and posterior bladder injury that resulted in a large rectovesical fistula involving the right hemitrigone and right ureteral orifice. An attempt to repair the rectovesical fistula at an outside facility was unsuccessful. Then, he underwent a robotic-assisted laparoscopic repair of rectovesical fistula, including simple prostatectomy, excision of rectovesical fistulous tract, rectal closure, peritoneal and omental flap interposition, bladder neck reconstruction, vesicourethral anastomosis and right ureteral reimplantation. There were no intraoperative or postoperative complications, and the patient was discharged at postoperative day 4; cystoscopy at 6-week follow-up demonstrated a successful closure of the fistula, at which time the ureteral stents were removed.

Understanding transport mechanisms in ionic liquid/carbonate solvent electrolyte blends

To unravel mechanistic details of the ion transport in liquid electrolytes, blends of the ionic liquid (IL) 1-butyl-1-methylpyrrolidinium bis(trifluoromethylsulfonyl)imide (Pyr14TFSI), ethylene carbonate (EC) and dimethyl carbonate (DMC) with the conducting salts lithium hexafluorophosphate (LiPF6) and lithium bis(trifluoromethylsulfonyl)imide (LiTFSI) were investigated as a function of the IL concentration. Electrochemical impedance, Pulsed Field Gradient Nuclear Magnetic Resonance (PFG NMR) and Raman spectroscopy supported by Molecular Dynamics (MD) simulations allowed the structural and dynamic correlations of the ion motions to be probed. Remarkably, we identified that though the individual correlations among different ion types exhibit a clear concentration dependence, their net effect is nearly constant throughout the entire concentration range, resulting in approximately equal transport and transference numbers, despite a monitored cross-over from carbonate-based lithium coordination to a TFSI-based ion coordination. In addition, though dynamical ion correlation could be found, the absolute values of the ionic conductivity are essentially determined by the overall viscosity of the electrolyte. The IL/carbonate blends with a Pyr14TFSI fraction of ∼10 wt% are found to be promising electrolyte solvents, with ionic conductivities and lithium ion transference numbers comparable to those of standard carbonate-based electrolytes while the thermal and electrochemical stabilities are considerably improved. In contrast, the choice of the conducting salt only marginally affects the transport properties.

Disposable microfluidic micromixers for effective capture of Cryptosporidium parvum oocysts from water samples

Background

Protecting drinking water supplies from pathogens such as Cryptosporidium parvum is a major concern for water utilities worldwide. The sensitivity and specificity of current detection methods are largely determined by the effectiveness of the concentration and separation methods used. The purpose of this study is to develop micromixers able to specifically isolate and concentrate Cryptosporidium, while allowing in situ analysis.

Results

In this study, disposable microfluidic micromixers were fabricated to effectively isolate Cryptosporidium parvum oocysts from water samples, while allowing direct observation and enabling quantification of oocysts captured in the device using high quality immunofluorescence microscopy. In parallel, quantitative analysis of the capture yield was carried out by analyzing the waste from the microfluidics outlet with an Imaging Flow Cytometer. At the optimal flow rate, capture efficiencies up to 96% were achieved in spiked samples.

Conclusions

Scaled microfluidic isolation and detection of Cryptosporidium parvum will provide a faster and more efficient detection method for Cryptosporidium compared to other available laboratory-scale technologies.

A step towards understanding the beneficial influence of a LIPON-based artificial SEI on silicon thin film anodes in lithium-ion batteries

In this work, we present a comprehensive study on the influence of lithium phosphorus oxynitride (LIPON) as a possible "artificial SEI layer" on the electrochemical performance of pure silicon (Si) thin film electrodes for a possible application in microbatteries or on-chip batteries. Si thin film anodes (140 nm) with and without an additional amorphous LIPON surface layer of different thicknesses (100-300 nm) were prepared by magnetron sputter deposition. The LIPON surface coating was characterized thoroughly by means of electrochemical impedance spectroscopy, Raman spectroscopy, X-ray photoelectron spectroscopy and atomic force microscopy. In situ electrochemical dilatometry and ex situ cross-section analysis of the electrodes after cycling could prove that the LIPON coating greatly diminishes the volume expansion of the Si electrode and, therefore, significantly improves the cycling stability and capacity retention. Furthermore, the LIPON coating remarkably reduces parasitic electrolyte decomposition reactions that originate from the Si volume expansion and contribute to the overall electrode volume expansion, as observed by the enhanced Coulombic efficiency over ongoing charge/discharge cycling. Overall, this article focuses on the preparation of optimized Si-based thin film electrodes in combination with LIPON solid electrolyte coatings for use in high-energy lithium ion batteries.

Antibodies to Factor XII Are Distinct from Antibodies to Prothrombin in Patients with the Anti-phospholipid Syndrome

Patients with the anti-phospholipid syndrome (APS) have antiphospholipid antibodies (aPA) which are often targeted towards phospholipid binding proteins such as β2-glycoprotein I and prothrombin. Antibodies to factor XII (FXIIabs) have also been identified in some patients with APS. Factor XII (FXII) is a member of the kringle family of proteins which include plasminogen and prothrombin. Antibodies to prothrombin have been associated with myocardial infarction and have been shown to cross react with plasminogen.

Sixteen patients with APS and FXIIabs were investigated for the presence of antibodies to prothrombin, by enzyme linked immunosorbent assay in a calcium (Ca++) independent assay. All sixteen showed different antibody binding patterns than those observed for antibodies to FXII.

Eight patients were further investigated using surface plasmon resonance (SPR) for antibody binding to covalently bound FXII and to covalently bound prothrombin in both Ca++ dependent and independent systems. Of three patients demonstrating antibody binding to FXII by SPR, none demonstrated antibody binding to prothrombin in a Ca++ independent system with one demonstrating antibody binding to prothrombin that was Ca++ dependent. Of five patients who did not bind FXII by SPR, one demonstrated antibody binding to prothrombin in a Ca++ independent system while two demonstrated antibody binding to prothrombin in a Ca++ dependent system. Antibodies to FXII in patients with APS appear to be distinct from antibodies to prothrombin.

Antibodies to Factor XII Associated with Lupus Anticoagulant

Falsely low levels of factor XII (FXII) have been documented in patients who are lupus anticoagulant positive (LA+). In addition, we have previously noted a surprisingly high incidence (20.9%) of apparently true FXII deficiency in patients who were LA+. We have hypothesised that this may be partly due to the presence of antibodies to FXII.

The aim of the present study was to investigate whether LA+ patient plasmas contain antibodies directed either against FXII or FXII in association with phospholipids. Plasma samples from 60 blood donors, all LA negative, and 51 LA+ patients were tested using ELISA assays employing purified FXII, phosphatidylserine (PS) and phosphatidylethanolamine (PE). We have identified seven patients whose plasma contained either IgG or IgM that reacted with purified FXII in the absence of PS or PE. When PS was included in the assay system four additional patient plasmas were shown to contain either IgG or IgM that reacted with FXII. The plasma of one patient contained IgG that reacted with FXII both in the presence and absence of PS. There was no reactivity to FXII with either IgG or IgM when PE was included in the assay system. Affinity purified IgG from three patients whose plasma reacted with FXII in the ELISA assay in the absence of PS, gave a positive reaction in an immunoblot assay. These results suggest that FXII antibodies are present in a significant proportion of LA+ patients and may lead to an erroneous diagnosis of FXII deficiency.

Factor XII Determinations in the Presence and Absence of Phospholipid Antibodies

Factor XII (FXII) levels were determined in plasma samples from 29 normal donors, 10 patients with inherited FXII deficiency (all lupus anticoagulant [LA] negative) and 67 LA positive patients, using clotting (FXIIct), chromogenic substrate (FXIIcs) and immunochemical (FXIIag) assays. Excellent correlations were obtained in the three FXII assays with the LA negative samples and between the FXIIcs and FXIIag assays in the LA positive samples. Correlations between both the FXIIcs and FXIIag with FXIIct in the LA positive patients were poor. Of 67 LA positive samples studied, 25 (37.3%) showed lower values in the FXIIct assay; 13 (19.4%) of these patients were pseudo FXII deficient with values of FXII below the lower limit of normal.

These results indicate that a diagnosis of FXII deficiency can be made inappropriately in the presence of phospholipid antibodies and that such a diagnosis should not be made by FXIIct assay alone.

Trichinellosis surveillance in wildlife in northeastern argentine patagonia

Trichinellosis is a food-borne parasitic disease produced by different nematodes of the genus Trichinella. In Argentina, it is an endemic zoonosis and an important public health problem. The infection has been detected in domestic and wild animals. Trichinella spp. muscle larvae have anaerobic metabolism, which allows their survival in decaying tissues. The aim of this study was to evaluate the presence of Trichinella spp. in carnivorous and/or scavenger wild vertebrates - birds, mammals and reptiles - in northeastern Argentine Patagonia. Skeletal muscle samples from 141 animals, which were found killed on northeastern Argentine Patagonia roads, were analyzed by the artificial digestion method. None of the 141 samples were positive for larvae of Trichinella. These results suggest that Trichinella does not use these species to complete its cycle in this region of the continent and the absence of a significant alteration in the study area makes it difficult to transmit parasitic diseases. However, due to the limited number of samples assessed for some species, this could not be confirmed. The relevance of this study resides in the fact that it is the first systematic study in South America that considers birds, reptiles and mammals as potential hosts for Trichinella.

Timing of post 131I ablation diagnostic whole body scan in differentiated thyroid cancer patients

Ziel: Beantwortung der Frage, ob drei Monate nach 131I-Ablation als zu früh für eine diagnostische Radioiod-Ganzkörperszintigraphie (dxWBS) bei Patienten mit einem differenzierten Schilddrüsenkarzinom (DTC) anzusehen sind. Patienten, Material, Methode: Daten von 462 DTC-Patienten, die in unserem Klinikum behandelt worden waren, wurden analysiert. Alle Patienten wurden thyreoid ektomiert. Von 129 Patienten waren folgende Daten verfügbar a) eine dxWBS mit gleichzeitiger TSH-stimulierter Thyreoglobulin-Messung, die innerhalb von vier Monaten (max. 120 Tage) nach 131I-Ablation durchgeführt wurde ohne weitere therapeutische Maßnahmen zwischen Ablation und dxWBS, b) eine zweite dxWBS oder 131I-Therapie (rxWBS), die innerhalb von 1,5 Jahren nach Ablation durchgeführt wurde. Ergebnisse: Bei 25/129 Patienten stimmten die Ergebnisse der initialen und weiteren Scans nicht überein: Bei 15 von 54 Patienten (27%) mit einem positiven initialen dxWBS widersprachen diese Ergebnisse dem zweiten dxWBS oder rxWBS. Neue Läsionen wurden bei 10/74 (14%) Patienten mit einem initial negativen dxWBS entdeckt. Eine Diskordanz zwischen dem ersten und weiteren in der Nachsorge gemessenen stimulierten Tg-Werten wurde in 5/129 (4%) der Patienten gefunden: Bei 2/90 (2%) Patienten mit einer negativen ersten stimulierten Tg-Bestimmung wurde nachfolgend ein positives Ergebnis gefunden. Bei 3/29 (10%) Patienten mit einer positiven ersten Bestimmung wurde bei der zweiten Untersuchung ein negatives Ergebnis festgestellt. Schlussfolgerung: Weniger als vier Monate nach 131I-Ablation ist zu früh für eine diagnostische Radioiod-Ganzkörperszintigraphie mit zeitgleich TSH-stimulierter Tg-Messung. Die Ermittlung des richtigen späteren Zeitpunkts erfordert weitere Untersuchungen.

Das Zeitintervall zwischen 131I Ablation und diagnostischer Ganzkörperszintigraphie bei Patienten mit differenziertem Schilddrüsenkarzinom Weniger als vier Monate nach Ablation dürfte zu früh sein

Determining oxidative stability of battery electrolytes: validity of common electrochemical stability window (ESW) data and alternative strategies

Galvanostatic and potentiodynamic measurements reveal an oxidative stability of common LiPF6 salt/carbonate solvent based electrolytes > 5 V vs. Li/Li⁺.

New amidinate complexes of indium(iii): promising CVD precursors for transparent and conductive In2O3 thin films

Heteroleptic and homoleptic In(iii)-amidinate complexes as promising CVD precursors for In₂O₃ thin films.

Patients with high-risk differentiated thyroid cancer have a lower I-131 ablation success rate than low-risk ones in spite of a high ablation activity

OBJECTIVE

To examine success rates in strictly defined high-risk differentiated thyroid cancer (DTC) patients who received a high-activity (≥5550 MBq) adjuvant postoperative I-131 therapy and compare these to the rates found in highest risk and low-risk patients.

DESIGN

Retrospective database study.

PATIENTS

We examined 377 patients with DTC who received I-131 ablation. Patients with distant metastases were classified as very high risk. Patients with primary tumours >4 cm, extensive extrathyroidal invasion (pT4a or pT4b in accordance with the 7th edition of the TNM system), and patients with ≥5 lymph node metastases or any lateral compartment lymph node metastases were considered high risk. All other patients were considered low risk.

MEASUREMENTS

Ablation success rate at first TSH-stimulated follow-up.

RESULTS

The ablation success rate was 72·6% in low-risk patients, 51·7% in high-risk patients and 13·8% in highest risk patients (all differences P < 0·001). In none of the groups, a significant difference in the initial I-131 activity was found between patients with successful and unsuccessful ablation (low risk: P = 0·16, high risk: P = 0·91 and highest risk: P = 0·48). Furthermore, there was no difference in ablation success between patients who received <5550 MBq and those who received ≥5550 Mbq (low risk: P = 0·31, high risk: P = 0·69 and highest risk: P = 0·22).

CONCLUSIONS

Patients with high-risk DTC have a significantly reduced I-131 ablation success rate compared to low-risk ones in spite of high initial I-131 activities. As successful ablation is prognostically important, efforts should be made to improve outcome in these patients.

Readiness-to-change as a moderator of a web-based brief intervention for marijuana among students identified by health center screening

INTRODUCTION

Electronic screening and brief intervention has been identified as a low cost strategy to address marijuana use among students, however there is little known about who may be most responsive to this intervention approach. This study examined whether readiness-to-change moderated the influence of a web-based intervention on frequency of use at 3-month outcomes.

METHODS

One-hundred twenty-three students who smoked marijuana at least monthly were identified by screening in a student health center. Baseline and 3-month outcome assessments were conducted on-line. Participants were randomly assigned to either eCHECKUP TO GO-marijuana or a control condition after completing marijuana measures and the Readiness-to-Change Questionnaire (RTCQ). Negative binomial regression analyses were conducted to examine whether the effect of the intervention on marijuana use at 3-month outcomes was moderated by the Action and Problem Recognition dimensions of the RTCQ, adjusting for baseline use.

RESULTS

Analyses showed a significant Intervention × Action interaction. Probing of interaction effects showed that among those with high scores on the Action scale participants in the intervention group reported significantly fewer days of use than those in the control condition at follow-up (IRR=0.53, 95%CI: 0.94, 2.08). The Problem Recognition dimension did not moderate the influence of the intervention on outcomes.

CONCLUSION

These results suggest that this eSBI may bolster change efforts among students who have begun taking steps toward changing their marijuana use.

Tackling agricultural diffuse pollution: What might uptake of farmer-preferred measures deliver for emissions to water and air?

Mitigation of agricultural diffuse pollution poses a significant policy challenge across Europe and particularly in the UK. Existing combined regulatory and voluntary approaches applied in the UK continue to fail to deliver the necessary environmental outcomes for a variety of reasons including failure to achieve high adoption rates. It is therefore logical to identify specific on-farm mitigation measures towards which farmers express positive attitudes for higher future uptake rates. Accordingly, a farmer attitudinal survey was undertaken during phase one of the Demonstration Test Catchment programme in England to understand those measures towards which surveyed farmers are most receptive to increasing implementation in the future. A total of 29 on-farm measures were shortlisted by this baseline farm survey. This shortlist comprised many low cost or cost-neutral measures suggesting that costs continue to represent a principal selection criterion for many farmers. The 29 measures were mapped onto relevant major farm types and input, assuming 95% uptake, to a national scale multi-pollutant modelling framework to predict the technically feasible impact on annual agricultural emissions to water and air, relative to business as usual. Simulated median emission reductions, relative to current practise, for water management catchments across England and Wales, were estimated to be in the order sediment (20%)>ammonia (16%)>total phosphorus (15%) ≫ nitrate/methane (11%)>nitrous oxide (7%). The corresponding median annual total cost of the modelled scenario to farmers was £3 ha(-1)yr(-1), with a corresponding range of -£84 ha(-1)yr(-1) (i.e. a net saving) to £33 ha(-1)yr(-1). The results suggest that those mitigation measures which surveyed farmers are most inclined to implement in the future would improve the environmental performance of agriculture in England and Wales at minimum to low cost per hectare.

Mechanistic insights into lithium ion battery electrolyte degradation – a quantitative NMR study

Water as the main driving force of LiPF₆ degradation increases the reaction rate and determines the composition of degradation products.

The truth about the 1st cycle Coulombic efficiency of LiNi1/3Co1/3Mn1/3O2 (NCM) cathodes

High voltage issues of the NCM cathode could be attributed predominantly to structural instabilities and unexpected negligible electrolyte oxidation.

Nanoporous polymer foams derived from high molecular PS-b-P4VP(PDP)xfor template-directed synthesis approaches

Various nanoporous block copolymers derived from supramolecular complexes PS-b-P4VP(PDP) are presented as templates for template-directed synthesis approaches.

A rare cause of ulnar nerve entrapment at the elbow area illustrated by six cases: The anconeus epitrochlearis muscle

Ulnar nerve entrapment is the second most common compressive neuropathy after carpal tunnel syndrome. The accessory anconeus epitrochlearis muscle - present in 4% to 34% of the general population - is a known, but rare cause of ulnar nerve entrapment at the elbow. The aim of this article was to expand our knowledge about this condition based on six cases that we encountered at our hospital between 2011 and 2015. Every patient had a typical clinical presentation: hypoesthesia or sensory deficit in the fourth and fifth fingers; potential intrinsics atrophy of the fourth intermetacarpal space; loss of strength and difficulty with fifth finger abduction. Although it can be useful to have the patient undergo ultrasonography or MRI to aid in the diagnosis, only electromyography (EMG) was performed in our patients. EMG revealed clear compression in the ulnar groove, with conduction block and a large drop in nerve conduction velocity. Treatment typically consists of conservative treatment first (splint, analgesics). Surgical treatment should be considered when conservative treatment has failed or the patient presents severe neurological deficits. In all of our patients, the ulnar nerve was surgically released but not transposed. Five of the six patients had completely recovered after 0.5 to 4years follow-up. Ulnar nerve entrapment at the elbow by the anconeus epitrochlearis muscle is not common, but it must not be ignored. Only ultrasonography, MRI or, preferably, surgical exploration can establish the diagnosis. EMG findings such as reduced motor nerve conduction velocity in a short segment of the ulnar nerve provides evidence of anconeus epitrochlearis-induced neuropathy.