The Indian Ocean experiment: widespread air pollution from South and Southeast Asia

The Indian Ocean Experiment (INDOEX) was an international, multiplatform field campaign to measure long-range transport of air pollution from South and Southeast Asia toward the Indian Ocean during the dry monsoon season in January to March 1999. Surprisingly high pollution levels were observed over the entire northern Indian Ocean toward the Intertropical Convergence Zone at about 6 degrees S. We show that agricultural burning and especially biofuel use enhance carbon monoxide concentrations. Fossil fuel combustion and biomass burning cause a high aerosol loading. The growing pollution in this region gives rise to extensive air quality degradation with local, regional, and global implications, including a reduction of the oxidizing power of the atmosphere.

Phase II clinical trial of pasireotide long-acting repeatable in patients with metastatic neuroendocrine tumors

Pasireotide long-acting repeatable (LAR) is a novel somatostatin analog (SSA) with avid binding affinity to somatostatin receptor subtypes 1, 2, 3 (SSTR1,2,3) and 5 (SSTR5). Results from preclinical studies indicate that pasireotide can inhibit neuroendocrine tumor (NET) growth more robustly than octreotide in vitro. This open-label, phase II study assessed the clinical activity of pasireotide in treatment-naïve patients with metastatic grade 1 or 2 NETs. Patients with metastatic pancreatic and extra-pancreatic NETs were treated with pasireotide LAR (60 mg every 4 weeks). Previous systemic therapy, including octreotide and lanreotide, was not permitted. Tumor assessments were performed every 3 months using Response Evaluation Criteria in Solid Tumors (RECIST) criteria. The primary endpoint was progression-free survival (PFS). The secondary endpoints included overall survival (OS), overall radiographic response rate (ORR), and safety. Twenty-nine patients were treated with pasireotide LAR (60 mg every 4 weeks) and 28 were evaluable for response. The median PFS was 11 months. The most favorable effect was observed in patients with low hepatic tumor burden, normal baseline chromogranin A, and high tumoral SSTR5 expression. Median OS has not been reached; the 30-month OS rate was 70%. The best radiographic response was partial response in one patient (4%), stable disease in 17 patients (60%), and progressive disease in ten patients (36%). Although grade 3/4 toxicities were rare, pasireotide LAR treatment was associated with a 79% rate of hyperglycemia including 14% grade 3 hyperglycemia. Although pasireotide appears to be an effective antiproliferative agent in the treatment of advanced NETs, the high incidence of hyperglycemia raises concerns regarding its suitability as a first-line systemic agent in unselected patients. SSTR5 expression is a potentially predictive biomarker for response.

A multi-institutional, phase II open-label study of ganitumab (AMG 479) in advanced carcinoid and pancreatic neuroendocrine tumors

The IGF pathway has been implicated in the regulation of neuroendocrine tumor (NET) growth, and preliminary studies suggested that ganitumab (AMG 479), a human MAB against IGF1R, may have antitumor activity in this setting. We performed a two-cohort phase II study of ganitumab in patients with metastatic progressive carcinoid or pancreatic NETs (pNETs). This open-label study enrolled patients (≥18 years) with metastatic low- and intermediate-grade carcinoid or pNETs. Inclusion criteria included evidence of progressive disease (by Response Evaluation Criteria in Solid Tumors (RECIST)) within 12 months of enrollment, ECOG PS 0-2, and fasting blood sugar <160  mg/dl. Prior treatments were allowed and concurrent somatostatin analog therapy was permitted. The primary endpoint was objective response. Secondary endpoints included overall survival (OS), progression-free survival (PFS), and safety. Sixty patients (30 carcinoid and 30 pNETs) were treated with ganitumab 18  mg/kg every 3 weeks, among whom 54 patients were evaluable for survival and 53 patients for response. There were no objective responders by RECIST. The median PFS duration was 6.3 months (95% CI, 4.2-12.6) for the entire cohort; 10.5 months for carcinoid patients, and 4.2 months for pNET patients. The OS rate at 12 months was 66% (95% CI, 52-77%) for the entire cohort. The median OS has not been reached. Grade 3/4 AEs were rare and consisted of hyperglycemia (4%), neutropenia (4%), thrombocytopenia (4%), and infusion reaction (1%). Although well tolerated, treatment with single-agent ganitumab failed to result in significant tumor responses among patients with metastatic well-differentiated carcinoid or pNET.

Genotoxic analysis in aquatic environment under influence of cyanobacteria, metal and radioactivity

The micronucleus (MN) and nuclear abnormality (NA) tests were employed to evaluate the genotoxic potential of the Lucrecia dam (RN, Brazil) located in a semi-arid region and influenced by crop irrigation and irregular rainfall. The analyses of these water samples demonstrated the presence of several cyanobacteria as well as metals and radioactivity. The Nile Tilapia (Oreochromis niloticus) was used for micronucleus and nuclear abnormality assays and analysis of metal concentrations in gills and liver samples. Genotoxic assays in source water fish showed a significant increase in the frequency of nuclear damage (MN and NA) in relation to the negative control group. In conclusion, the results obtained with water surface and biological samples from the Lucrecia dam suggest that this important water resource contains a number of chemical and microbiological pollutants with genotoxic potential and that these substances may be compromising the species inhabiting this ecosystem. Particular care must be taken to prevent further degradation of this water supply. Capsule: A battery of assay was successfully applied to assess the water quality of Lucrecia dam from a Northeastern region of Brazil.

Vincristine-induced acute neurotoxicity versus Guillain?Barr� syndrome: a diagnostic dilemma

We report the case of a patient with acute lymphoblastic leukaemia who, after the initiation of treatment with vincristine (VCR), developed a fulminant motor polyradiculoneuropathy resembling an axonal variant of Guillain-Barré syndrome (GBS). This report shows that differentiating between axonal GBS and VCR-induced acute neurotoxicity may be a challenge for clinicians.

Cloning and spatiotemporal expression of RIC-8 in Xenopus embryogenesis

RIC-8 is a highly conserved protein that promotes G protein signaling as it acts as a Guanine nucleotide Exchanging Factor (GEF) over a subset of Gα subunits. In invertebrates, RIC-8 plays crucial roles in synaptic transmission as well as in asymmetric cell division. As a first step to address further studies on RIC-8 function in vertebrates, here we have cloned a ric-8 gene from Xenopus tropicalis (xtric-8) and determined its spatiotemporal expression pattern throughout embryogenesis. The xtric-8 transcript is expressed maternally and zygotically and, as development proceeds, it shows a dynamic expression pattern. At early developmental stages, xtric-8 is expressed in the animal hemisphere, whereas its expression is later restricted to neural tissues, such as the neural tube and the brain, as well as in the eye and neural crest-derived structures, including those of the craniofacial region. Together, our findings suggest that RIC-8 functions are related to the development of the nervous system.

Sall2 is required for proapoptotic Noxa expression and genotoxic stress-induced apoptosis by doxorubicin

The Sall2 transcription factor is deregulated in several cancers; however, little is known about its cellular functions, including its target genes. Recently, we demonstrated that p53 directly regulates Sall2 expression under genotoxic stress. Here, we investigated the role of Sall2 in the context of cellular response to genotoxic stress. In addition, we further examined the Sall2-p53 relationship during genotoxic stress in primary mouse embryo fibroblasts (MEFs), which are derived from Sall2 knockout mice separately, or in combination with the p53ERTAM knock-in mice. We found that the levels of Sall2 mRNA and protein are dynamically modulated in response to doxorubicin. At early times of stress, Sall2 is downregulated, but increases under extension of the stress in a p53-independent manner. Based on caspase-3/7 activities, expression of cleaved poly (ADP-ribose) polymerase, expression of cleaved caspase-3 and induction of proapoptotic proteins, Sall2 expression was correlated with cellular apoptosis. Consequently, Sall2-/- MEFs have decreased apoptosis, which relates with increased cell viability in response to doxorubicin. Importantly, Sall2 was required for apoptosis even in the presence of fully activated p53. Searching for putative Sall2 targets that could mediate its role in apoptosis, we identified proapoptotic NOXA/PMAIP1 (phorbol-12-myristate-13-acetate-induced protein 1). We demonstrated that Sall2 positively regulates Noxa promoter activity. Conserved putative Sall2-binding sites at the NOXA promoter were validated in vitro by electrophoretic mobility shift assay and in vivo by ChIP experiments, identifying NOXA as a novel Sall2 target. In agreement, induction of Noxa protein and mRNA in response to doxorubicin was significantly decreased in Sall2-/- MEFs. In addition, studies in leukemia Jurkat T cells support the existence of the Sall2/Noxa axis, and the significance of this axis on the apoptotic response to doxorubicin in cancer cells. Our study highlights the relevance of Sall2 in the apoptotic response to extended genotoxic stress, which is important for understanding its role in normal physiology and disease.

Aggressive coseasonal immunotherapy in mountain cedar pollen allergy

Ninety adults with "mountain cedar" pollen allergy were started on coseasonal immunotherapy regimens in December 1979. At season's end, there were 20 whose starting antigen dose was based on serial dilution end point titration (SDET), 1:2,500 or 1:12,500 weight by volume (w/v); 28 in a "traditional" group started at 1:62,500 w/v; and 28 who had been double-blind placebo control subjects. Injections twice weekly were pushed aggressively toward maintenance. The SDET group received 11 times more antigen than the traditional group; both showed a trend for fewer symptoms than the placebo group. As compared with the other groups, SDET subjects had substantially blunted total and specific IgE responses in season, lower specific IgE level at season's end and less shift of skin end point toward higher dilutions. The findings demonstrate that substantial immunologic effects are possible in the first months of aggressive coseasonal immunotherapy.

Mutagenic potential assessment associated with human exposure to natural radioactivity

Lucrécia city, known to harbor a high cancer rate, is located in a semiarid region characterized by the presence of mineral reservoirs, facing a high exposure to metal and natural radioactivity. The present study aimed to assess the environmental scenario at a semiarid region located in Northeastern Brazil. Metal concentration, alpha and beta radiation, and cyanobacteria content in tap water along with indoor radon and gamma emitters (U, K and Th) concentrations were measured. In addition, mutagenic and nuclear instability effects were assessed using buccal micronucleus cytome assay. The study included five samplings corresponding to a period between 2007 and 2009. Drinking water from Lucrécia city presented levels of Mn, Ni and Cr along with cyanobacteria in concentrations one to four times higher than regulatory guidelines considered. Furthermore, high levels of all the tested radionuclides were found. A high percentage of the houses included in this study presented indoor radon concentrations over 100 Bq m^-3. The mean annual effective dose from Lucrécia houses was six times higher than observed in a control region. The levels of exposure in most of the Lucrécia houses were classified as middle to high. A significant mutagenic effect, represented as an increase of micronuclei (MN) frequency and nuclear abnormalities as nuclear buds (NB), binucleated cells (BN), and pyknotic cells (PYC) were found. The results obtained highlight the role of high background radioactivity on the observed mutagenic effect and could help to explain the exacerbated cancer rate reported in this locality.

Unexpected Anisotropy of the Electron and Hole Landé g-Factors in Perovskite CH3NH3PbI3 Polycrystalline Films

In this work, we studied, at low temperature, the coherent evolution of the localized electron and hole spins in a polycrystalline film of CH3NH3PbI3 (MAPI) by using a picosecond-photo-induced Faraday rotation technique in an oblique magnetic field. We observed an unexpected anisotropy for the electron and hole spin. We determined the electron and hole Landé factors when the magnetic field was applied in the plane of the film and perpendicular to the exciting light, denoted as transverse ⟂ factors, and when the magnetic field was applied perpendicular to the film and parallel to the exciting light, denoted as parallel ∥ factors. We obtained |ge,⟂|=2.600 ± 0.004, |ge,∥|=1.604 ± 0.033 for the electron and |gh,⟂|=0.406 ± 0.002, |gh,∥|=0.299 ± 0.007 for the hole. Possible origins of this anisotropy are discussed herein.

Outcome of bilateral hip hemiarthroplasty for displaced fracture of the hip

Our aim was to evaluate the outcome in patients with bilateral non-simultaneous hip fracture treated with hemiarthroplasty at our institution between 1997 and 2003. We looked for any important modification factor that could change the devastating functional and social results. Twenty-two patients with a mean age of 79 at the initial fracture and 82 at the subsequent fracture were evaluated; all were Garden grade III-IV. The second fracture happened a mean of 28 months after the first one. The outcome measurement was the incidence of hip pain, recovery of pre-injury level of ambulation and activities of daily living at a minimum follow-up of one year. Following the first hemiarthroplasty patients deteriorated in their walking capacity and other activities of daily life, and this happened to an even greater extent after the second operation. With respect to walking ability (measured in metres) we concluded that it improved if a modular hemiarthroplasty was used after both fractures (p<0.05) and that worse functional outcomes were observed when different kinds of hemiarthroplasties were used in the same patient.;

Occurrence of 15 Haplotypes of Linepithema micans (Hymenoptera: Formicidae) in Southern Brazil

The ant genus Linepithema is widely known, thanks to the pest species Linepithema humile (Mayr), which is easily mistaken for Linepithema micans (Forel) due to their morphological similarity. Like L. humile, L. micans is associated to the main grapevine pest in Brazil, Eurhizococcus brasiliensis (Wille), also known as ground pearl. Therefore, the present study uses mtDNA fragments to expand the knowledge of haplotype diversity and distribution of L. micans in the state of Rio Grande do Sul (Brazil), to understand the genetic differences of the populations identified in this study. We identified 15 haplotypes of L. micans spread across different localities. Twelve of these haplotypes were new for the species. The high haplotype diversity uncovered in Rio Grande do Sul (Brazil) for this species was predictable, as L. micans is in its native environment. Additional studies that take gene flow into account may reveal interesting aspects of diversity in these populations.

Electrical tuning of helical edge states in topological multilayers

Mainstream among topological insulators, GaSb/InAs quantum wells present a broken gap alignment for the energy bands which supports the quantum spin Hall insulator phase and forms an important building block in the search of exotic states of matter. Such structures allow the band-gap inversion with electrons and holes confined in adjacent layers, providing a fertile ground to tune the corresponding topological properties. Using a full 3D eight-band [Formula: see text] method we investigate the inverted band structure of GaSb/InAs/GaSb and InAs/GaSb/InAs multilayers and the behavior of the helical edge states, under the influence of an electric field applied along the growth direction. By tuning the electric field modulus, we induce the change of the energy levels of both conduction and valence bands, resulting in a quantum spin Hall insulator phase where the helical edge states are predominantly confined in the GaSb layer. In particular, we found that InAs/GaSb/InAs has a large hybridization gap of about [Formula: see text] and, therefore, are promising to observe massless Dirac fermions with a large Fermi velocity. Our comprehensive characterization of GaSb/InAs multilayers creates a basis platform upon which further optimization of III-V heterostructures can be contrasted.

[Clinical mycology and antifungals in the pediatric population]

Infections caused by Candida spp. and Aspergillus spp. account for 90% of all fungal infections and are the most significant causes of human morbidity and mortality. Candida albicans causes between 50 and 60% of all nosocomial fungal infections. The wet mount test and culture are the screening methods used in leading clinical laboratories for the detection of Candida spp. However, yeasts should be strictly classified mainly based on their physiological and biochemical characteristics, through a series of morphological and biochemical laboratory tests. As a result of the increase in systemic fungal infections and the spread of antifungal medications, it was necessary to establish standardized in vitro sensitivity tests as a guideline for the therapeutic decision-making process. Among antifungal agents available today we find antimycotics such as amphotericin B, 5-fluorocytosine (5-FC), fluconazole, voriconazole, posaconazole, and ravuconazole. Additionally, there is the recently developed group of echinocandines, which includes caspofungin, micafungin and anidulafungine.

P4169The crucial role of the bystander in out-of-hospital cardiac arrest resuscitation

Background

Out-of-hospital cardiac arrest (OHCA) is a major public health concern in France, given that there are 61.5 cases per 100,000 inhabitants a year. The impact of bystander action, performed before the arrival of emergency medical services (EMS), on survival has never been studied in France.

Purpose

Determine whether bystander cardiopulmonary resuscitation (CPR), performed before the arrival of EMS, was correlated with an increased 30-day survival rate after an OHCA.

Methods

24,885 out-of-hospital cardiac arrests witnessed in France from 1 January 2012 to 1 May 2018 were analysed to determine whether CPR, performed before the arrival of EMS, was correlated with survival. Data from the Electronic Registry of Cardiac Arrests was used. The association between the effect of CPR performed before the arrival of EMS and 30-day survival rate was studied, using propensity analysis (which included variables such as age and sex of the patient, location, cause, and year of cardiac arrest, initial cardiac rhythm, EMS response time and no-flow time).

Results

CPR was performed before the arrival of EMS in 14,904 cases (59.9%) and was not performed in 9,981 cases (40.1%). The 30-day survival rate was 10.2% when CRP was performed by bystanders versus 3.9% when CRP was not performed before the EMS arrival (p<0.001). CPR performed by bystanders was associated with an increased 30-day survival rate (odds ratio 1.269; 1.207 to 1.334).

The effect of bystander CPR on survival

Conclusion

Bystander CPR performed before the arrival of EMS was associated with an increased 30-day survival rate after an out-of-hospital cardiac arrest in France.

[Fungemia caused by Rhodotorula mucilaginosa in relation to total parenteral nutrition]

BACKGROUND

Fungal infections are nowadays more common in clinical practice. The most frequently isolated fungi are Candida and Cryptococcus. Infection due to Rhodotorula mucilaginosa is very uncommon. We describe here our experience with R. mucilaginosa fungemia, with emphasis on total parenteral nutrition related episodes.

METHOD

A retrospective review identified 3 patients with R. mucilaginosa, and predisposing conditions, clinical features, treatment used and outcome were analyzed. The case definition includes the repeated isolation of R. mucilaginosa in several blood-cultures and/or the isolation of R. mucilaginosa in one single blood culture together with its isolation in any other site.

RESULTS

Three patients were identified. In all of them there are some defects in immune response (skin anergy in two, immunosuppressive therapy in the remaining patient), had an iv line placed, under antibiotic therapy and total parenteral nutrition. All factors could have been related to the development of R. mucilaginosa infection.

CONCLUSION

Although its pathogenic role is controversial, in two or our patients R. mucilaginosa infections correlates well with clinical signs and symptoms of invasive infections (fever, hemodynamic changes). The treatment is still not clear.

Occurrence of tar balls on the beaches of Fernando de Noronha Island, South Equatorial Atlantic

This work reports on the widespread occurrence of tar balls on a pebble beach of Sueste Bay on Fernando de Noronha Island, a Brazilian national marine park and a preserve in the South Equatorial Atlantic. Environmental regulations preclude regular visitors to the Sueste Bay beach, and the bay is a pristine area without any possible or potential sources of petroleum in the coastal zone. In this work, these tar balls were observed for the first time as they occurred as envelopes around beach pebbles. They are black in color, very hard, have a shell and coral fragment armor, and range in average size from 2 to 6 cm. The shape of the majority of the tar balls is spherical, but some can also be flattened ellipsoids. The polycyclic aromatic hydrocarbon analyses of the collected samples revealed the characteristics of a strongly weathered material, where only the most persistent compounds were detected: chrysene, benzo(b,k)fluoranthene, dibenzo(a,h)antracene and benzo(a)pyrene.

Genetic diversity of the forage peanut in the Jequitinhonha, São Francisco, and Paranã River valleys of Brazil

Arachis pintoi and A. repens are legumes with a high forage value that are used to feed ruminants in consortium systems. Not only do they increase the persistence and quality of pastures, they are also used for ornamental and green cover. The objective of this study was to analyze microsatellite markers in order to access the genetic diversity of 65 forage peanut germplasm accessions in the section Caulorrhizae of the genus Arachis in the Jequitinhonha, São Francisco and Paranã River valleys of Brazil. Fifty-seven accessions of A. pintoi and eight of A. repens were analyzed using 17 microsatellites, and the observed heterozygosity (H_O), expected heterozygosity (H_E), number of alleles per locus, discriminatory power, and polymorphism information content were all estimated. Ten loci (58.8%) were polymorphic, and 125 alleles were found in total. The H_E ranged from 0.30 to 0.94, and H_O values ranged from 0.03 to 0.88. By using Bayesian analysis, the accessions were genetically differentiated into three gene pools. Neither the unweighted pair group method with arithmetic mean nor a neighbor-joining analysis clustered samples into species, origin, or collection area. These results reveal a very weak genetic structure that does not form defined clusters, and that there is a high degree of similarity between the two species.

Mapping of surface radiogenic heat production from in situ gamma spectrometry and chemical data of exhumed mantle peridotites at the St. Peter and St. Paul archipelago (equatorial Atlantic)

This work presents the first mapping of the radiogenic heat production (RHP) and the respective radiogenic heat flow (RHF) of the Saint Peter and Saint Paul Archipelago (SPSPA) located at 1°N in the Equatorial Atlantic Ocean. Using radiogenic heat producing elements (RPE) we inferred a radiogenic heat production ranging 0.08-0.68 μW/m³ (Median: 0.21 μW/m³ and Geometric mean: 0.25 μW/m³) by whole-rock chemical analysis and between 0.08 and 0.48 μW/m³ (Median: 0.19 μW/m³; Geometric mean: 0.19 μW/m³) by in situ Gamma radiation spectrometry. The mean of radiogenic heat production of mylonite rocks from SPSPA (0.22 μW/m³) is significantly higher than predicted values for ultramafic rocks as those largely outcropping in the SPSPA. This is probably due to the pervasive alteration of these rocks and the incorporation of little magma fractions during mylonitization. By converse, the average surface radiogenic heat flow (49.7 μW/m²) is lower than that predicted for the oceanic lithosphere, suggesting that the upper mantle contribution to the heat flow is also low in the SPSPA region. Based on the acquired data and the peculiar tectonics of the SPSPA we propose that the lithospheric mantle around the SPSPA area is colder than that surrounding the Equatorial Atlantic region.