Investigating the potential for microbially induced carbonate precipitation to treat mine waste

In this study, the feasibility of promoting microbially induced carbonate precipitation (MICP) in mine waste piles by using an environmental bacterial enrichment is explored, with goals to reduce metals and acid leaching. MICP has been explored for remediation applications and stabilization of mine waste. Here, we utilize a native bacterial enrichment to promote MICP on seven mine waste samples with variability in acid production and extent of toxic metal leaching. During fifteen applications of MICP solutions and bacteria on waste rock in bench-scale columns, calcium carbonate formed on grain surfaces within all waste samples, though microscopy revealed uneven distribution of CaCO3 coating. The effluent from acid-producing wastes increased in pH during MICP treatment. MICP performance was evaluated with humidity cell and synthetic precipitation leaching procedure (SPLP) tests. Leaching tests revealed reductions in Cd, Pb and Zn concentrations in leachate of all but one sample, mixed results for Cu, and As increasing in all but one leachate sample after treatment. MICP technology has potential for coating mine waste and reducing release of acid and some metals. This study provides a laboratory assessment of MICP feasibility for stabilizing mine waste in situ and mitigating release of toxic metals into the environment.

[Potential effect of the stimulus threshold level of the nociceptive flexion reflex (NFRT) on mortality and delirium incidence in the critically ill patient: a retrospective cohort analysis]

BACKGROUND

Mortality and delirium in critically ill patients are affected by the provided analgesics and sedatives. The deeper the sedation and the higher the dose of analgesics applied, the more difficult it is to assess pain and the depth of sedation. Therefore, instrumental measurement methods, such as the measurement of the stimulus threshold of the nociceptive flexion reflex (NFRT), are becoming increasingly more important.

OBJECTIVE

The aim of the present study is to investigate a potential association between the level of the nociceptive flexion reflex, mortality, and the occurrence of delirium.

MATERIAL AND METHODS

By retrospectively analyzing a pilot data set of 57 ICU patients from the interdisciplinary surgical ICU of Ulm University Hospital surveyed between 11/2018 and 03/2020, a possible association between the NFRT, mortality, and the occurrence of delirium was calculated in an adjusted logistic regression model. Depending on the cut-off value, the stimulus threshold corridors result in the following comparison pairs: < 20 mA vs. 20-40 mA/20-50 mA/20-60 mA, > 40 mA vs. 20-40 mA, > 50 mA vs. 20-50 mA and > 60 mA vs. 20-60 mA. Results are presented as odds ratios (OR) adjusted for age, sex, height, TISS-28, SAPS II, RASS, BPS, and applied analgesics. Pain assessment was performed, in addition to the Behavioral Pain scale, ≥ 3 times daily by measuring NFRT.

RESULTS

A statistically nonsignificant tendency for an increase in mortality incidence occurred with an NFRT > 50 mA, versus a stimulus threshold corridor of 20-50 mA (OR 3.3, CI: 0.89-12.43, p = 0.07). A trend toward a reduction in delirium incidence occurred at an NFRT < 20 mA, versus a stimulus threshold corridor of 20-40 mA (OR 0.40, CI: 0.18-0.92, p = 0.03).

CONCLUSION

Based on the level of the NFRT, no recommendation can be made at this point to adjust the analgesic regimen of critically ill patients, who are unable to communicate. The observation of a tendency towards an increase in mortality at high stimulus thresholds or a reduction in the occurrence of delirium at low stimulus thresholds of the NFRT must be verified in standardized studies.

Investigation of an immobilization process for PFAS contaminated soils

A two-phased bench-scale study was conducted to evaluate various sorbents for possible use as chemical stabilizing agents, along with cement solidification, for possible use in an in-situ solidification/stabilization (immobilization) treatment process for per- and polyfluoroalkyl (PFAS) contaminated soils. The first phase involved sorption experiments for six selected PFAS compounds diluted in a water solution, using five selected sorbents: granular activated carbon (GAC), activated carbon-clay blend, modified clay, biochar, iron (Fe)-amended biochar, and Ottawa sand as a control media. The second phase involved chemical stabilization treatment (via sorption), using the most effective sorbent identified in the first phase, followed by solidification of two soils from PFAS-contaminated sites. Physical solidification was achieved by adding cement as a binding agent. Results from the first phase (sorption experiments) indicated that GAC was slightly more successful than the other sorbents in sorption performance for a 3000 μg/L solution containing a mixture of the six selected PFAS analytes (500 μg/L concentration each of shorter- and longer-chain alkyl acids), and was the only sorbent used in the second phase of this study. While the GAC, activated carbon-clay blend, and modified clay sorbents showed similar sorption performance for the longer chain analytes tested, both the activated carbon-clay blend and modified clay, exhibited slightly less sorptive capacity than GAC for the shorter-chain alkyl acids. Immobilization effectiveness was evaluated by soil leachability testing using Environmental Protection Agency (EPA) Method 1312, Synthetic Precipitation Leaching Procedure (SPLP) on the samples collected from two PFAS-contaminated sites. For the majority of the PFAS soil analytes, the addition of GAC sorbent (chemical stabilization) substantially reduced the leachability of PFAS compounds from the contaminated soil samples, and the addition of cement as a physical binding agent (solidification) further decreased leachability for a few of the PFAS compounds. Overall immobilization of PFAS analytes that were detectable in the leachate from two PFAS contaminated soils ranged from 87.1% to 99.9%. Therefore, it is reasonable to consider that the laboratory testing results presented here may have application to further pilot or limited field-scale studies within a broader suite of PFAS-contaminated site treatment options that are currently available for treating PFAS contaminated soils.

Heart Rate Variability Reflects Similar Cardiac Autonomic Function in Explosive and Aerobically Trained Athletes

Autonomic cardiac function can be indirectly detected non-invasively by measuring the variation in microtiming of heart beats by a method known as heart rate variability (HRV). Aerobic training for sport is associated with reduced risk for some factors associated with cardiovascular diseases (CVD), but effects on autonomic function in different athlete types are less known. To compare cardiac autonomic modulation using a standard protocol and established CVD risk factors in highly trained intercollegiate athletes competing in aerobic, explosive, and cross-trained sports. A total of 176 college athletes were categorized in distinct sports as explosive (EA), aerobic (AA), or cross-trained (mixed) athletes. Eight different HRV measures obtained at rest were compared across training type and five health factors: systolic (SBP), diastolic blood pressure (DBP), body weight (BW), sex, and race. All athletic types shared favorable HRV measures that correlated with low CVD risk factors and indicated normal sympathovagal balance. A significant correlation was reported between DBP and pNN50 (% RR intervals > 50 ms) (β = -0.214, p = 0.011) and between BW and low-frequency (LF) power (β = 0.205, p = 0.006). Caucasian and African American athletes differed significantly (p < 0.05) with respect to four HRV variables: pNN50, HF power, LF power, and LF/HF ratios. Explosive, aerobic and mixed athletes had similar cardiovascular and autonomic HRV results in all eight HRV parameters measured. All athletes reported LF and pNN50 values that were significantly correlated with two CVD risk factors: DBP and BW. Compared with Caucasian teammates, African American athletes demonstrated lower LF/HF and higher pNN50, indicating an even more favorable resting sympathovagal activity and healthy CV function.

Development of a PET/EPRI combined imaging system for assessing tumor hypoxia

Precise quantitative delineation of tumor hypoxia is essential in radiation therapy treatment planning to improve the treatment efficacy by targeting hypoxic sub-volumes. We developed a combined imaging system of positron emission tomography (PET) and electron para-magnetic resonance imaging (EPRI) of molecular oxygen to investigate the accuracy of PET imaging in assessing tumor hypoxia. The PET/EPRI combined imaging system aims to use EPRI to precisely measure the oxygen partial pressure in tissues. This will evaluate the validity of PET hypoxic tumor imaging by (near) simultaneously acquired EPRI as ground truth. The combined imaging system was constructed by integrating a small animal PET scanner (inner ring diameter 62 mm and axial field of view 25.6 mm) and an EPRI subsystem (field strength 25 mT and resonant frequency 700 MHz). The compatibility between the PET and EPRI subsystems were tested with both phantom and animal imaging. Hypoxic imaging on a tumor mouse model using 18F-fluoromisonidazole radio-tracer was conducted with the developed PET/EPRI system. We report the development and initial imaging results obtained from the PET/EPRI combined imaging system.

The Challenges of PFAS Remediation

Many military bases and their surrounding communities are impacted by contamination with per- and polyfluoroalkyl substances (PFAS) from Aqueous Film-Forming Foams (AFFFs). Soil sorption technologies provide a promising solution to immobilize PFAS in the soil and prevent groundwater and drinking water contamination. This article is the result of a collaborative effort between Battelle and the U.S. EPA's review of the most promising technologies.

Mesenchymal stem cells in peripheral blood of severely injured patients

PURPOSE

Mesenchymal stem cells (MSCs) are primarily stromal cells present in bone marrow and other tissues that are crucial for tissue regeneration and can be mobilized into peripheral blood after different types of organ damage. However, little is known about MSC appearance in blood in the setting of polytrauma.

METHODS

We conducted a monocentered and longitudinal observational clinical study in 11 polytraumatized patients with an injury severity score (ISS) ≥ 24 to determine the numbers of MSCs in peripheral blood. Blood was collected from healthy volunteers and patients after polytrauma in the emergency room and 4, 12, 24, 48 h, 5 and 10 day later, and cells carrying MSC-surface markers (negative for CD45, positive for CD29, CD73, CD90, CD105, and CD166 in different combinations also employing the more stringent markers STRO1 and MSCA1) were detected and characterized using flow cytometry. Relative numbers of MSC-like cells were correlated with clinical parameters to evaluate if specific injury patterns had an influence on their presence in the blood cell pool.

RESULTS

We were able to detect MSC marker-positive cells in both cohorts; however, the percentage of those cells present in the blood of patients during the first 10 day after injury was mostly similar to healthy volunteers, and significantly lowers starting at 4 h post trauma for one marker combination when compared to controls. Furthermore, the presence of a pelvis fracture was partly correlated with reduced relative numbers of MSC-like cells detectable in blood.

CONCLUSIONS

Polytrauma in humans was associated with partly reduced relative numbers of MSC-like cells detected in peripheral blood in the time course after injury. Further studies need to define if this reduction was due to lower mobilization from the bone marrow or to active migration to the sites of injury.

Complement C5a-Induced Changes in Neutrophil Morphology During Inflammation

The complement and neutrophil defence systems, as major components of innate immunity, are activated during inflammation and infection. For neutrophil migration to the inflamed region, we hypothesized that the complement activation product C5a induces significant changes in cellular morphology before chemotaxis. Exposure of human neutrophils to C5a dose- and time-dependently resulted in a rapid C5a receptor-1 (C5aR1)-dependent shape change, indicated by enhanced flow cytometric forward-scatter area values. Similar changes were observed after incubation with zymosan-activated serum and in blood neutrophils during murine sepsis, but not in mice lacking the C5aR1. In human neutrophils, Amnis high-resolution digital imaging revealed a C5a-induced decrease in circularity and increase in the cellular length/width ratio. Biomechanically, microfluidic optical stretching experiments indicated significantly increased neutrophil deformability early after C5a stimulation. The C5a-induced shape changes were inhibited by pharmacological blockade of either the Cl-/HCO3--exchanger or the Cl^- -channel. Furthermore, actin polymerization assays revealed that C5a exposure resulted in a significant polarization of the neutrophils. The functional polarization process triggered by ATP-P2X/Y-purinoceptor interaction was also involved in the C5a-induced shape changes, because pretreatment with suramin blocked not only the shape changes but also the subsequent C5a-dependent chemotactic activity. In conclusion, the data suggest that the anaphylatoxin C5a regulates basic neutrophil cell processes by increasing the membrane elasticity and cell size as a consequence of actin-cytoskeleton polymerization and reorganization, transforming the neutrophil into a migratory cell able to invade the inflammatory site and subsequently clear pathogens and molecular debris.

Percutaneous left atrial appendage occlusion for stroke prevention in patients with atrial fibrillation and contraindication for anticoagulation

BACKGROUND

Stroke, as the third cause of death in developed countries, is a public health issue. Atrial fibrillation is an important cause of ischemic stroke and its prevention is efficient with oral anticoagulation. However, oral anticoagulation can be contraindicated because of hemorrhagic risk related to these treatments. Percutaneous left atrial appendage occlusion is a new alternative of oral anticoagulation for patients with atrial fibrillation and high risk of cardio-embolic stroke but contraindicated for oral anticoagulation.

METHODS

We describe in this paper the procedure of left atrial appendage occlusion with the Amplatzer cardiac plug device, used in our center in Grenoble university hospital, for the first three patients who have been treated with this device. These three patients (one man and two women) have all atrial fibrillation with neurological complication of this arrhythmia, as ischemic stroke. Oral anticoagulation is indicated to prevent another ischemic stroke. However, they all have a high risk of cerebral bleeding for different reasons (cavernomatosis, history of intracerebral hemorrhage and aneurysm of the polygon of Willis). Consequently, they have a high risk of cardio-embolic complication but contraindication for oral anticoagulation. They have been treated by left atrial appendage occlusion with Amplatzer cardiac plug device by percutaneous and trans-septal access. Then, they have been followed by neurologist and cardiologist, with clinical and paraclinical evaluation by echocardiography.

RESULTS

Our three first patients have been successfully implanted, without periprocedural complication. No latest adverse event was observed, and particularly no cardiac or neurologic adverse event.

CONCLUSION

The technique of left atrial appendage occlusion is a very interesting and promising technique for ischemic stroke prevention in patient with high risk of cardio-embolic complication because of atrial fibrillation, but high risk of bleeding and contraindication for oral anticoagulation. Because of frequency of both atrial fibrillation and contraindication for oral anticoagulation, occlusion of the left atrial appendage should become an interesting alternative for many patients. However, it remains an invasive procedure and efficacy and indications need to be evaluated in further clinical trials. Risk/benefit ratio must be carefully assessed and compared to that of the new anticoagulant drugs.

EUROPattern Suite technology for computer-aided immunofluorescence microscopy in autoantibody diagnostics

Antinuclear autoantibodies (ANA) are highly informative biomarkers in autoimmune diagnostics. The increasing demand for effective test systems, however, has led to the development of a confusingly large variety of different platforms. One of them, the indirect immunofluorescence (IIF), is regarded as the common gold standard for ANA screening, as described in a position statement by the American College of Rheumatology in 2009. Technological solutions have been developed aimed at standardization and automation of IIF to overcome methodological limitations and subjective bias in IIF interpretation. In this review, we present the EUROPattern Suite, a system for computer-aided immunofluorescence microscopy (CAIFM) including automated acquisition of digital images and evaluation of IIF results. The system was originally designed for ANA diagnostics on human epithelial cells, but its applications have been extended with the latest system update version 1.5 to the analysis of antineutrophil cytoplasmic antibodies (ANCA) and anti-dsDNA antibodies.

Environmental impact of the use of contaminated sediments as partial replacement of the aggregate used in road construction

The Indiana Harbor Canal (IHC) is a waterway extensively polluted with heavy metals and petroleum. Since there are limited disposal options for the petroleum-contaminated sediments (PCSs) of the canal, the environmental impact of IHC dewatered sediment when used as partial replacement of the aggregate used in hot mix asphalt (HMA) for road construction was investigated. In order to assess the long term migration of the target contaminants into the environment, the TCLP, SPLP, and a Constant pH leaching test were applied to a HMA mixture containing 10% of dewatered PCS, a conventional HMA, and the dewatered PCS. None of the heavy metals significantly leached from any of the tested materials in any of the conducted tests. Despite the presence of PAHs in the PCS, these were not found in any of the leachate samples. Finally, among the measured VOCs, only acetone and 2-butanone were found to leach from the asphalt mixtures and the sediment in the Constant pH experiment. It was concluded that it may be environmentally safe to replace the aggregates of the HMA used in road construction in the studied proportions with dewatered PCS based upon leaching levels as compared to TCLP regulated levels. This could be a viable, beneficial use option for the PCS, and therefore, for the canal remediation.

A Case of Autoimmune Hepatitis Treated with Rituximab

Autoimmune hepatitis (AIH) is a form of chronic hepatitis of unknown etiology. It was first described in the 1950s as a form of chronic hepatitis noted in younger women. It was later termed lupoid hepatitis due to its association with autoantibodies before being named AIH in 1965. Corticosteroids and azathioprine have been the standard therapy for AIH, but due to treatment failures and toxicities from these medications, new medications are being investigated as possible treatment options. Rituximab has been used in various autoimmune disorders with good success. We report the case of a 34-year-old Caucasian woman with a history of B cell lymphoma and concurrent AIH treated with rituximab. The diagnosis of AIH was made by classic serological and histological features. The patient was initially treated with steroids but had a progression of her disease as well as suffering toxicities from the steroids. She was then given eight weeks of rituximab with good improvement in both laboratory and histological findings.

[Recurrent tumors in the oral and maxillofacial region. Results and treatment strategies in 20 years]

SUBJECT MATTER: Following clinical diagnosis of a recurrent tumor, curative treatment is seldom available. Depending on the size of the recurrent tumor and the patient's general health condition, extensive surgical resections and reconstructions are avoided in favor of nonsurgical treatment modalities with palliative intent. According to the literature, location of the tumor, tumor size and R-1 and R-2 resection rates are the most frequent reasons for the development of recurrent tumors.

PATIENTS AND METHODS

In a retrospective evaluation, a population of 1000 patients who had been treated for primary head and neck cancer during the period from 1979 to 1996 were analyzed descriptively. Survival probabilities of patients with recurrent tumors were calculated according to the Kaplan-Meier product-limit method, and different treatment concepts were compared and analyzed with the log-rank test for significant differences.

RESULTS

The largest proportion of primary tumors involved the floor of the mouth (n=369, 36.9%). A total of 198 patients (19.8%) developed recurrent cancer; 79.8% of patients experienced recurrent cancer within 2 years following primary treatment. Within the group of T1/T2 tumors the incidence of recurrent tumors was 28.9%, whereas the incidence in the T3/T4 group was 44.6%. Tumor infiltration of the resection margins was detected in 12.9%.

CONCLUSIONS

In line with the literature, tumor infiltration of the resection margins is a relevant prognostic factor; therefore, intraoperative frozen section must be recommended. Treatment with curative intention, in particular extensive surgical resections, is seldom possible and always requires a very intensive discussion with the patient.

Phenylalanine kinetics in healthy volunteers and liver cirrhotics: implications for the phenylalanine breath test

Expired 13CO2 recovery from an oral l-[1-13C]phenylalanine ([13C]Phe) dose has been used to quantify liver function. This parameter, however, does not depend solely on liver function but also on total CO2 production, Phe turnover, and initial tracer distribution. Therefore, we evaluated the impact of these factors on breath test values. Nine ethyl-toxic cirrhotic patients and nine control subjects received intravenously 2 mg/kg of [13C]Phe, and breath and blood samples were collected over 4 h. CO2 production was measured by indirect calorimetry. The exhaled 13CO2 enrichments were analyzed by isotope ratio mass spectrometry and the [13C]Phe and l-[1-13C]tyrosine enrichments by gas chromatography-mass spectrometry. The cumulative 13CO2 recovery was significantly lower in cirrhotic patients (7 vs. 12%; P < 0.01), in part due to lower total CO2 production rates. Phe turnover in cirrhotic patients was significantly lower (33 vs. 44 micro mol. kg(-1). h(-1); P < 0.05). When these extrahepatic factors were considered in the calculation of the Phe oxidation rate, the intergroup differences were even more pronounced (3 vs. 7 micro mol. kg(-1). h(-1)) than those for 13CO2 recovery data. Also, the Phe-to-Tyr conversion rate, another indicator of Phe oxidation, was significantly reduced (0.7 vs. 3.0 micro mol. kg(-1). h(-1)).

Low-level phenomenal vision despite unilateral destruction of primary visual cortex

GY, an extensively studied human hemianope, is aware of salient visual events in his cortically blind field but does not call this "vision." To learn whether he has low-level conscious visual sensations or whether instead he has gained conscious knowledge about, or access to, visual information that does not produce a conscious phenomenal sensation, we attempted to image process a stimulus s presented to the impaired field so that when the transformed stimulus T(s) was presented to the normal hemifield it would cause a sensation similar to that caused by s in the impaired field. While degradation of contrast, spatio-temporal filtering, contrast reversal, and addition of smear and random blobs all failed to match the response to a flashed bar s(f), moving textures of low contrast were accepted to match the response to a moving contrast-defined bar, s(m). Orientation and motion direction discrimination of the perceptually matched stimuli [s(m) and T(s(m))] was closely similar. We suggest that the existence of a satisfactory match indicates that GY has phenomenal vision.

CD64 surface expression on neutrophils is transiently upregulated in patients with septic shock

OBJECTIVE

To clarify the changes in total leukocyte counts, CD64 neutrophil receptor expression and serum granulocyte colony-stimulating factor (G-CSF) concentrations in critically ill patients without infection and sepsis and in patients with septic shock.

DESIGN

Prospective study.

SETTING

Intensive care unit (ICU) and research laboratory of a university hospital.

PATIENTS

Eleven critically ill patients without infections and 22 patients with proven infections in septic shock for the first time and of at least 3 days' duration.

MEASUREMENTS AND RESULTS

Over a 6month period, a longitudinal analysis of expression of the monomeric Fc receptor type I (CD64, FcgammaRI) on neutrophils was performed by flow cytometric analysis on a daily basis in all postoperative/post-traumatic patients admitted to the ICU until discharge from the ICU or death. Out of 273 patients, 11 patients without sepsis had organ failure and 22 patients with proven infections had septic shock for the first time and of at least 3 days' duration. Ten out of the 22 patients survived, 12 died. CD64 expression was greater in patients with septic shock than in patients without sepsis. Moreover, CD64 expression was only initially and transiently elevated in most survivors (9/10) and non-survivors (8/12) of septic shock. In survivors, G-CSF serum concentrations were markedly decreased in the 2nd week.

CONCLUSIONS

Decreased neutrophil CD64 expression in an acutely ill population with septic shock may reflect the development of a non-responsive state as well as the early downregulation of neutrophil activation prior to the resolution of an ongoing infection.

Electron spin relaxation of triarylmethyl radicals in fluid solution

Electron spin relaxation times of a Nycomed triarylmethyl radical (sym-trityl) in water, 1:1 water:glycerol, and 1:9 water:glycerol were measured at L-band, S-band, and X-band by pulsed EPR methods. In H(2)O solution, T(1) is 17+/-1 micros at X-band at ambient temperature, is nearly independent of microwave frequency, and exhibits little dependence on viscosity. The temperature dependence of T(1) in 1:1 water:glycerol is characteristic of domination by a Raman process between 20 and 80 K. The increased spin-lattice relaxation rates at higher temperatures, including room temperature, are attributed to a local vibrational mode that modulates spin-orbit coupling. In H(2)O solution, T(2) is 11+/-1 micros at X-band, increasing to 13+/-1 micros at L-band. For more viscous solvent mixtures, T(2) is much shorter than T(1) and weakly frequency dependent, which indicates that incomplete motional averaging of hyperfine anisotropy makes a significant contribution to T(2). In water and 1:1 water:glycerol solutions continuous wave EPR linewidths are not relaxation determined, but become relaxation determined in the higher viscosity 1:9 water:glycerol solutions. The Lorentzian component of the 250-MHz linewidths as a function of viscosity is in good agreement with T(2)-determined contributions to the linewidths at higher frequencies.

Differences in the expression of CD64 and mCD14 on polymorphonuclear cells and on monocytes in patients with septic shock

The present study was performed to clarify the time course of the expression of CD64, the Fc gamma receptor type I (FcgammaR1), and membrane-bound CD14 (mCD14), one of the major receptors for endotoxin, on polymorphonuclear leukocytes (PMN) and monocytes in 22 postoperative/post-traumatic patients with septic shock. Therefore, the expression of CD64 and mCD14, and serum concentrations of granulocyte colony-stimulating factor (G-CSF) and interferon-gamma (IFN-gamma) were determined by flow cytometric analysis and enzyme-linked immunosorbent assay (ELISA), respectively, from the first day of septic shock onwards over a period of 14 days. When compared to the values of 12 healthy controls, CD64 expression was elevated significantly on PMN and monocytes of the patients, whereas the expression of mCD14 was decreased significantly at all days. The initially increased expression of CD64 on PMN and monocytes decreased within the first days of septic shock. The already initially decreased mCD14 expression decreased further on PMN, but not on monocytes. Serum concentrations of G-CSF and IFN-gamma during the study period were significantly higher than those of the control group. The differences in the kinetics of CD64 and mCD14 expression in patients with septic shock may be explained by different regulatory effects of cytokines, such as G-CSF and IFN-gamma.

[Hematopoietic stem cell transplantation in pediatric onco-hematology]

Hematopoietic stem cell transplantation (HSCT) represents today an important therapeutic choice for several disorders of childhood: hematologic, metabolic and neoplastic pathologies can be treated with this strategy. The aim of this paper is to resume the latest history of HSCT, paying attention to the main changes and controversies, and its efficacy as far as concerns the major indications in pediatric oncohematology.

A geometric view on early and middle level visual coding

As opposed to dealing with the geometry of objects in the 3D world, this paper considers the geometry of the visual input itself, i.e. the geometry of the spatio-temporal hypersurface defined by image intensity as a function of two spatial coordinates and time. The results show how the Riemann curvature tensor of this hypersurface represents speed and direction of motion, and thereby allows to predict global motion percepts and properties of MT neurons. It is argued that important aspects of early and middle level visual coding may be understood as resulting from basic geometric processing of the spatio-temporal visual input. Finally, applications show that the approach can improve the computation of motion.

Dissociation of LPS-induced monocytic ex vivo production of granulocyte colony-stimulating factor (G-CSF) and TNF-alpha in patients with septic shock

Over a 6 month period, in 192 patients admitted to the intensive care unit (ICU), a longitudinal analysis of whole blood lipopolysaccharide (LPS)-induced ex vivo cytokine production was performed on a daily basis until discharge from the ICU or death. Twenty-one patients with proven infections were in septic shock for the first time and for at least 3 days' duration. Ex vivo LPS-inducible release of granulocyte colony-stimulating factor (G-CSF) was upregulated and that of TNF-alpha was downregulated in patients with septic shock, regardless whether they survived or died. In conclusion, LPS-induced ex vivo TNF-alpha and G-CSF cytokine release by monocytes is regulated differentially in patients with septic shock. Since upregulation of LPS-induced production of G-CSF occurred earlier in survivors than in non-survivors, rapidly elevated and sustained G-CSF responsiveness may contribute to survival in septic shock.

Allogeneic bone marrow transplantation in hematologic disorders of childhood: new trends and controversies

Bone marrow transplantation (BMT) represents an important therapeutic choice for several kinds of disorders: hematologic, metabolic and neoplastic pathologies can be treated with this strategy. The aim of this article is to describe the main indications for allogeneic BMT in haematologic disorders of childhood and possible problems related to this procedure. We consider only hematologic aspects, paying particular attention to unusual disorders of infancy as myelodysplastic syndromes and aplastic anemia. We also consider quality of life after a BMT in patients with sickle cell anemia and thalassemia major and compare this with quality of life of patients receiving chronic periodic blood transfusions.

How honeybees make grazing landings on flat surfaces

Freely flying bees were filmed as they landed on a flat, horizontal surface, to investigate the underlying visuomotor control strategies. The results reveal that (1) landing bees approach the surface at a relatively shallow descent angle; (2) they tend to hold the angular velocity of the image of the surface constant as they approach it; and (3) the instantaneous speed of descent is proportional to the instantaneous forward speed. These characteristics reflect a surprisingly simple and effective strategy for achieving a smooth landing, by which the forward and descent speeds are automatically reduced as the surface is approached and are both close to zero at touchdown. No explicit knowledge of flight speed or height above the ground is necessary. A model of the control scheme is developed and its predictions are verified. It is also shown that, during landing, the bee decelerates continuously and in such a way as to keep the projected time to touchdown constant as the surface is approached. The feasibility of this landing strategy is demonstrated by implementation in a robotic gantry equipped with vision.

A geometric framework for nonlinear visual coding

It is argued that important aspects of early and middle level visual coding may be understood as resulting from basic geometric processing of the visual input. The input is treated as a hypersurface defined by image intensity as a function of two spatial coordinates and time. Analytical results show how the Riemann curvature tensor R of this hypersurface represents speed and direction of motion. Moreover, the results can predict the selectivity of MT neurons for multiple motions and for motion in a direction along the optimal spatial orientation. Finally, a model based on integrated R components predicts global-motion percepts related to the barber-pole illusion.

Comparison between the oral and intravenous L-[1-13C]phenylalanine breath test for the assessment of liver function

To simplify the L-[1-13C]phenylalanine breath test which is used to assess liver function the tracer is usually given orally, and CO2 production rate is estimated. In 12 healthy volunteers and 10 liver cirrhotics we compared the oral approach with i.v. tracer administration combined with measurement of individual CO2 production rate. The 13CO2/12CO2 enrichment was assessed by isotope-ratio mass spectrometry. After i.v. [1-13C]phenylalanine application exhaled 13C recovery per minute peaked within 10 minutes (controls: 0.17 +/- 0.06%; cirrhotics: 0.05 +/- 0.02%, p < 0.01). The oral approach yielded comparable separation between 30-60 minutes, with average peak values being 0.18 +/- 0.03% and 0.06 +/- 0.03% (p < 0.01), respectively. Variable gastrointestinal resorption kinetics after oral application probably causes this difference.

Intrinsic two-dimensional features as textons

We suggest that intrinsic two-dimensional (i2D) features, computationally defined as the outputs of nonlinear operators that model the activity of end-stopped neurons, play a role in preattentive texture discrimination. We first show that for discriminable textures with identical power spectra the predictions of traditional models depend on the type of nonlinearity and fail for energy measures. We then argue that the concept of intrinsic dimensionality, and the existence of end-stopped neurons, can help us to understand the role of the nonlinearities. Furthermore, we show examples in which models without strong i2D selectivity fail to predict the correct ranking order of perceptual segregation. Our arguments regarding the importance of i2D features resemble the arguments of Julesz and co-workers regarding textons such as terminators and crossings. However, we provide a computational framework that identifies textons with the outputs of nonlinear operators that are selective to i2D features.

Determination of 13CO2/12CO2 ratio by IRMS and NDIRS

Breath tests using 13C-labelled substrates require the measurement of 13CO2/12CO2 ratio in breath gas samples. Next to isotope ratio mass spectrometry (IRMS), which is very sensitive but also complex and expensive, alternatively isotope selective nondispersive infrared spectrometry (NDIRS) can be used to determine the 13CO2/12CO2 ratio in expired breath. In this study we compared NDIRS- with IRMS-results to investigate whether the less expensive and very simply to operate NDIRS works as reliable as IRMS. For this purpose we applicated 1- 13C-Phenylalanine to patients with advanced liver cirrhosis and healthy volunteers and took duplicated breath samples for IRMS and NDIRS at selected time points. Our data show a good correlation between these two methods for a small number of samples as required for simple breath tests. Longer series, where repeated measurements are required on the NDIRS instrument lead to a decreasing correlation. This indicates the superiority of IRMS concerning 13CO2-kinetics over longer time periods.