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The proton dissociation processes of two tridentate salicylidene aminoguanidine Schiff bases (SISC, Pro-SISC-Me), the solution stability and electrochemical properties of their Cu(II), Fe(II) and Fe(III) complexes were characterized using pH-potentiometry, cyclic voltammetry and UV-visible, 1H NMR and electron paramagnetic resonance spectroscopic methods. The structure of the proline derivative (Pro-SISC-Me) was determined by X-ray crystallography. The conjugation of L-proline to the simplest salicylidene aminoguanidine Schiff base (SISC) increased the water solubility due to its zwitterionic structure in a wide pH range. The formation of mono complexes with both ligands was found in the case of Cu(II) and Fe(II), while bis complexes were also formed with Fe(III). In the complexes these tridentate ligands coordinate via the phenolato O, azomethine N and the amidine N, except the complex [Fe(III)L2]+ of Pro-SISC-Me in which the (O,N) donor atoms of the proline moiety are coordinated beside the phenolato O, confirmed by single crystal X-ray crystallographic analysis. This binding mode yielded a stronger Fe(III) preference for Pro-SISC-Me over Fe(II) in comparison to SISC. This finding is also reflected in the lower redox potential value of the iron-Pro-SISC-Me complexes. The ligands alone were not cytotoxic against human colon cancer cell lines, while complexation of SISC with Cu(II) resulted in moderate activity, unlike the case of its more hydrophilic counterpart.
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Complejos de Coordinación , Bases de Schiff , Complejos de Coordinación/química , Complejos de Coordinación/farmacología , Cristalografía por Rayos X , Compuestos Férricos , Compuestos Ferrosos , Guanidinas , Humanos , Ligandos , Oxidación-Reducción , Prolina , Bases de Schiff/química , Bases de Schiff/farmacologíaRESUMEN
BACKGROUND: Cerebral palsy (CP) causes motor, cognitive and sensory impairment at different extents. Many recent rehabilitation developments (therapies) have focused solely on the upper extremities (UE), although the lower extremities (LE) are commonly affected. Hand-arm Bimanual Intensive Therapy Including Lower Extremities (HABIT-ILE) applies the concepts of motor skill learning and intensive training to both the UE and LE. It involves constant stimulation of the UE and LE, for several hours each day over a 2-week period. The effects of HABIT-ILE have never been evaluated in a large sample of young children. Furthermore, understanding of functional, neuroplastic and biomechanical changes in infants with CP is lacking. The aim of this study is to carry out a multi-center randomized controlled trial (RCT) to evaluate the effects of HABIT-ILE in pre-school children with unilateral CP on functional, neuroplastic and biomechanical parameters. METHODS: This multi-center, 3-country study will include 50 pre-school children with CP aged 1-4 years. The RCT will compare the effect of 50 h (two weeks) of HABIT-ILE versus usual motor activity, including regular rehabilitation. HABIT-ILE will be delivered in a day-camp setting, with structured activities and functional tasks that will be continuously progressed in terms of difficulty. Assessments will be performed at 3 intervals: baseline (T0), two weeks later and 3 months later. Primary outcomes will be the Assisting Hand Assessment; secondary outcomes include the Melbourne Assessment-2, executive function assessments, questionnaires ACTIVLIM-CP, Pediatric Evaluation of Disability Inventory, Young Children's Participation and Environment Measure, Measure of the Process of Care, Canadian Occupational Performance Measure, as well as neuroimaging and kinematics measures. DISCUSSION: We expect that HABIT-ILE will induce functional, neuroplastic and biomechanical changes as a result of the intense, activity-based rehabilitation process and these changes will impact the whole developmental curve of each child, improving functional ability, activity and participation in the short-, mid- and long-term. Name of the registry: Changes Induced by Early HABIT-ILE in Pre-school Children With Uni- and Bilateral Cerebral Palsy (EarlyHABIT-ILE). TRIAL REGISTRATION: Trial registration number: NCT04020354-Registration date on the International Clinical Trials Registry Platform (ICTRP): November 20th, 2018; Registration date on NIH Clinical Trials Registry: July 16th, 2019.
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Parálisis Cerebral/terapia , Modalidades de Fisioterapia , Parálisis Cerebral/fisiopatología , Preescolar , Evaluación de la Discapacidad , Mano/fisiopatología , Humanos , Lactante , Extremidad Inferior/fisiopatología , Destreza Motora/fisiología , Plasticidad Neuronal , Prevención Secundaria , Encuestas y Cuestionarios , Extremidad Superior/fisiopatologíaRESUMEN
Achieving good quality Ohmic contacts to van der Waals materials is a challenge, since at the interface between metal and van der Waals material different conditions can occur, ranging from the presence of a large energy barrier between the two materials to the metallization of the layered material below the contacts. In black phosphorus (bP), a further challenge is its high reactivity to oxygen and moisture, since the presence of uncontrolled oxidation can substantially change the behavior of the contacts. Here we study three of the most commonly used metals as contacts to bP, chromium, titanium, and nickel, and investigate their influence on contact resistance against the variability between different flakes and different samples. We investigate the gate dependence of the current-voltage characteristics of field-effect transistors fabricated with these metals on bP, observing good linearity in the accumulation regime for all metals investigated. Using the transfer length method, from an analysis of ten devices, both at room temperature and at low temperature, Ni results to provide the lowest contact resistance to bP and minimum scattering between different devices. Moreover, we observe that our best devices approach the quantum limit for contact resistance both for Ni and for Ti contacts.
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BACKGROUND: Toxin-producing Clostridium difficile is the most common cause of nosocomial diarrhea in geriatric units. AIM: The purpose of study was to check the impact of intensive staff education on rate of Clostridium difficile-associated disease in hospitalized geriatric patients. METHODS: The sampling frame was all patients suffering from diarrhea checked for Clostridium difficile toxin during the years 2017-2018. Clostridium difficile-positive patients were compared to a similar number of Clostridium difficile toxin-negative patients. The data were compared to our previous study, followed by medical staff's educational program for Clostridium difficile control and prevention. RESULTS: Among 217 patients with diarrhea, 60 (27.6%) were positive for Clostridium difficile toxin. The study group tended to be of older age (p = 0.06), and showed higher rate of functional impairment (p < 0.001) and mortality (p < 0.001) than Clostridium difficile toxin negative patients. The rate of Clostridium difficile toxin-positive patients did not significantly differ between the previous and current studies (20.0% and 27.6%, respectively). CONCLUSIONS AND DISCUSSION: In spite of findings, that patients tended to be older, with high rate of mortality, the rate of Clostridium difficile did not change from the previous study.
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Clostridioides difficile , Infecciones por Clostridium , Infección Hospitalaria , Anciano , Infecciones por Clostridium/epidemiología , Infección Hospitalaria/epidemiología , Diarrea/epidemiología , HumanosRESUMEN
BACKGROUND AND AIMS: To examine antimicrobial resistance of commonly isolated pathogens in elderly hospitalized patients. METHODS: Data regarding all clinically significant isolates from blood and urine cultures of patients admitted to a multilevel geriatric hospital during March 2015 to April 2016 were collected. Antimicrobial susceptibility testing was performed according to Clinical and Laboratory Standard Institute guidelines. RESULTS: Escherichia coli, Proteus mirabilis, and Klebsiella pneumoniae were the most common isolates, with proportions of extended spectrum beta-lactamase positivity of 60, 40, and 61% respectively. Adjusted logistic regression models indicated that resistance of Escherichia coli to ceftriaxone [odds ratio (OR) 2.8, 95% confidence interval (CI) 1.5-5.1], ceftazidime (OR 2.8, 95% CI 1.5-5.1), ciprofloxacin (OR 2.2, 95% CI 1.2-4.0), amoxicillin/clavulanic acid (OR 2.3, 95% CI 1.2-4.3), and trimethoprim/sulfamethoxazole (OR 2.4, 95% CI 1.4-4.3) was significantly higher in skilled nursing wards than in acute geriatric wards. Resistance of Proteus mirabilis to ceftriaxone (OR 3.1, 95% CI 1.5-6.4) and Klebsiella pneumoniae to ciprofloxacin (OR 3.2, 95% CI 1.3-7.9) was significantly higher in skilled nursing wards than in acute wards. CONCLUSIONS AND DISCUSSION: Antimicrobial resistance was found to be high in a multilevel geriatric hospital, especially in skilled nursing wards. These findings call for rethinking of the empirical antimicrobial therapy and of the efforts for prevention of nosocomial infection.
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Antibacterianos/uso terapéutico , Farmacorresistencia Bacteriana/fisiología , Escherichia coli/efectos de los fármacos , Klebsiella pneumoniae/efectos de los fármacos , Proteus mirabilis/efectos de los fármacos , Anciano , Antibacterianos/farmacología , Infección Hospitalaria/prevención & control , Escherichia coli/aislamiento & purificación , Femenino , Geriatría , Hospitales Especializados , Humanos , Klebsiella pneumoniae/aislamiento & purificación , Masculino , Proteus mirabilis/aislamiento & purificación , Estudios Retrospectivos , beta-Lactamasas/sangre , beta-Lactamasas/orinaRESUMEN
INTRODUCTION: Mandibular two-implant overdentures are considered the minimum standard of care for edentulous patients and provide an excellent performance, as well as satisfaction to the patients. Dental schools are required to promote the teaching of current treatment options in order to enable students to master state-of-the-art procedures. AIMS: The purpose of this study was to examine how the theoretical and practical aspects of mandibular two-implant overdentures are taught in dental schools in North America. METHODS: Data were collected via an online questionnaire that included questions regarding the theoretical and clinical courses, surgical procedure and imaging method. RESULTS: Of 75 schools, 36 responded to the survey. Almost all the schools teach the subject theoretically, but it is not mandatory for students to perform in most of the schools. Only a minority (23%) of the mandibular dentures made by students are implant-supported. Almost all of the schools (94%) use two implants to support overdentures, and Locator abutment is used almost exclusively. The prevalent imaging for the surgical procedure is CT scans, although 30% of the schools use panoramic radiograph. None of the schools loads the implants immediately after surgery. CONCLUSION: Some clear trends are apparent in the current survey: the use of two implants, no use of bar connectors and delayed loading of the implants. It is likely that graduates will not have sufficient clinical skills and will need continuing education to be familiar with the required procedures, both surgical and prosthetic.
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Prótesis Dental de Soporte Implantado , Prótesis de Recubrimiento , Educación en Odontología , Humanos , Mandíbula , América del Norte , Facultades de Odontología , Encuestas y CuestionariosRESUMEN
Admission policies for higher education are aimed at achieving efficient allocation of resources for both faculty and students, in an attempt to minimize dropout. Methods: The characteristics of dropout students at the School of Dental Medicine at the Hebrew University from 2001 to 2013 were assessed in a retrospective study. Data were collected from dental school records, followed by an online questionnaire Results: Between 2001 and 2013, 268 out of 925 students left and did not return the following year, reflecting a dropout rate of 29%. A total 98 dropouts responded to the survey. The academic achievements of the dropouts were higher than average. The primary reason for quitting dental school was attraction to a different professional field (70%) and lack of interest in dentistry (11%). Almost all the dropouts left in the first three years: 80% of them transferred to medical school, 17% transferred to a profession other than medicine, and 4% continued their dental studies in another institution. Conclusion: Dropout was clearly not due to academic reasons, but rather attributable to pursuit of medical studies. The present findings imply that the admission process failed to identify students who do not intend to graduate. It is likely that changing the structure of the program by admitting students only to a 3 to 4 year program of dental school, following pre-med studies, may have a positive effect on reducing the dropout rate.
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Educación en Odontología , Abandono Escolar/estadística & datos numéricos , Estudiantes de Odontología/estadística & datos numéricos , Adulto , Femenino , Humanos , Israel , Masculino , Estudios Retrospectivos , Facultades de Odontología , Encuestas y Cuestionarios , Adulto JovenRESUMEN
BACKGROUND: Hyperhidrosis is a disorder that can impair quality of life. Localized treatments may be cumbersome and ineffective, and no systemic treatments have proven to be significantly beneficial. OBJECTIVES: To evaluate the effectiveness and tolerance of low-dose oxybutynin for hyperhidrosis. METHODS: We conducted a prospective, randomized, placebo-controlled trial. From June 2013 to January 2014, 62 patients with localized or generalized hyperhidrosis were enrolled. Oxybutynin was started at a dose of 2·5 mg per day and increased gradually to 7·5 mg per day. The primary outcome was defined as improvement of at least one point on the Hyperhidrosis Disease Severity Scale (HDSS). Dermatology Life Quality Index (DLQI) and tolerance were also reported. RESULTS: Most patients (83%) in our study had generalized hyperhidrosis. Oxybutynin was superior to placebo in improving the HDSS: 60% of patients treated with oxybutynin, compared with 27% of patients treated with placebo, improved at least one point on the HDSS (P = 0·009). The mean improvement in quality of life measured by DLQI was significantly better in the oxybutynin arm (6·9) than in the placebo arm (2·3). The most frequent side-effect was dry mouth, which was observed in 43% of the patients in the oxybutynin arm, compared with 11% in the placebo arm. CONCLUSIONS: Treatment with low-dose oxybutynin is effective in reducing symptoms of hyperhidrosis in generalized or localized forms. Side-effects were frequent but minor and mainly involved dry mouth.
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Hiperhidrosis/tratamiento farmacológico , Ácidos Mandélicos/administración & dosificación , Antagonistas Muscarínicos/administración & dosificación , Adolescente , Adulto , Relación Dosis-Respuesta a Droga , Femenino , Humanos , Masculino , Ácidos Mandélicos/efectos adversos , Persona de Mediana Edad , Antagonistas Muscarínicos/efectos adversos , Satisfacción del Paciente , Estudios Prospectivos , Calidad de Vida , Resultado del Tratamiento , Xerostomía/inducido químicamente , Adulto JovenRESUMEN
OBJECTIVE/BACKGROUND: Despite being an important risk factor for venous thromboembolism, the role of the prothrombin G20210A mutation in patients with arterial disease remains unclear. The aim of this review was to evaluate the association of prothrombin G20210A and lower extremity peripheral arterial disease (PAD). METHODS: This was a systematic review and meta-analysis of case-control studies. A systematic review of electronic databases, including MEDLINE and Embase, was conducted to assess the prevalence of prothrombin G20210A in patients with lower extremity PAD. The main outcome was the prevalence of prothrombin G20210A in patients with lower extremity PAD. The random effects model odds ratio (OR) was used as the primary outcome measure. RESULTS: The initial electronic search identified 168 relevant abstracts of which five studies evaluating 1,524 cases of PAD and 1,553 controls were included. Prothrombin G20210A was found in 70 of 1,524 patients with lower extremity PAD and 44 of 1,553 of the controls (random effects OR 1.68, 95% confidence interval [CI] 0.8-3.2). In those with critical limb ischemia (CLI), the prevalence of prothrombin G20210A was 23 of 302 compared with 31 of 1,253 of the controls (OR 3.2, 95% CI 1.6-6.1). CONCLUSION: Despite finding no significant association between lower extremity PAD and prothrombin G20210A, the meta-analysis suggests that the prevalence of prothrombin G20210A is significantly elevated in those with atherosclerotic occlusive disease of the lower extremities presenting with CLI. Well-designed prospective cohort studies evaluating the role of prothrombin G20210A as a predictor of disease progression or adverse vascular events are highly needed.
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Isquemia/genética , Extremidad Inferior/irrigación sanguínea , Mutación , Enfermedad Arterial Periférica/genética , Protrombina/genética , Trombofilia/genética , Distribución de Chi-Cuadrado , Enfermedad Crítica , Frecuencia de los Genes , Predisposición Genética a la Enfermedad , Humanos , Isquemia/diagnóstico , Oportunidad Relativa , Enfermedad Arterial Periférica/diagnóstico , Fenotipo , Medición de Riesgo , Factores de Riesgo , Trombofilia/sangre , Trombofilia/complicaciones , Trombofilia/diagnósticoRESUMEN
Cyanobacterial blooms in freshwater sources are a global concern, and gaining insight into their causes is crucial for effective resource management and control. In this study, we present a novel computational framework for the causal analysis of cyanobacterial harmful algal blooms (cyanoHABs) in Lake Kinneret. Our framework integrates Convergent Cross Mapping (CCM) and Extended CCM (ECCM) causal networks with Bayesian Network (BN) models. The constructed CCM-ECCM causal networks and BN models unveil significant interactions among factors influencing cyanoHAB formation. These interactions have been validated by domain experts and supported by evidence from peer-reviewed publications. Our findings suggest that Microcystis flos-aquae levels are influenced not only by community structure but also by ammonium, phosphate, oxygen, and temperature levels in the weeks preceding bloom occurrences. We demonstrated a non-parametric computational framework for causal analysis of a multivariate ecosystem. Our framework offers a more comprehensive understanding of the underlying mechanisms driving M. flos-aquae blooms in Lake Kinneret. It captures complex interactions and provides an explainable prediction model. By considering causal relationships, temporal dynamics, and joint probabilities of environmental factors, the proposed framework enhances our understanding of cyanoHABs in Lake Kinneret.
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Background: Since administration of COVID-19 vaccines, there has been growing evidence of thrombotic and thrombocytopenic events following vaccination. However, there remains limited data on long-term management of these adverse hematologic events. Key Clinical Question: We report on 9 patients presenting with thrombocytopenia following COVID-19 vaccination, with 4 subsequently diagnosed with vaccine-induced thrombocytopenia and thrombosis (VITT) and 5 with immune thrombocytopenia. Clinical Approach: A retrospective chart review was completed for adults >18 years of age presenting to a tertiary care center with new-onset thrombocytopenia occurring 4 to 42 days following COVID-19 vaccination. Presenting symptoms, laboratory investigations, and response to treatment are described. Conclusion: Two of 4 patients with VITT developed refractory thrombocytopenia successfully treated with intravenous immunoglobulin, corticosteroids, and plasma exchange therapy. Patients with VITT remained on anticoagulation for at least 9 months due to persistently positive diagnostic tests. Four of 5 patients with immune thrombocytopenia received intravenous immunoglobulin and corticosteroids with good recovery. Patients who received a subsequent COVID-19 mRNA vaccine had no adverse hematologic effects.
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Virtual reality dental training simulators, unlike traditional human-based assessment, have the potential to enable consistent and reliable assessment. The purpose of this study was to determine whether a haptic simulator (IDEA Dental(®) ) could provide a reliable and valid assessment of manual dexterity. A total of 106 participants were divided into three groups differing in dental manual dexterity experience: (i) 63 dental students, (ii) 28 dentists, (iii) 14 non-dentists. The groups, which were expected to display various performance levels, were required to perform virtual drilling tasks in different geometric shapes. The following task parameters were registered: (i) Time to completion (ii) accuracy (iii) number of trials to successful completion and (iv) score provided by the simulator. The reliability of the tasks was calculated for each parameter. The simulator and its scoring algorithm showed high reliability in all the parameters measured. The simulator was able to differentiate between non-professionals and dental students or non-professionals and dentists. Our study suggests that for improved construct validity, shorter working times and more difficult tasks should be introduced. The device should also be designed to provide greater sensitivity in measuring the accuracy of the task.
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Simulación por Computador , Instrucción por Computador/métodos , Educación en Odontología/métodos , Tecnología Educacional/instrumentación , Destreza Motora/fisiología , Estudiantes de Odontología , Interfaz Usuario-Computador , Análisis de Varianza , Competencia Clínica , Femenino , Humanos , Masculino , Reproducibilidad de los Resultados , Análisis y Desempeño de TareasRESUMEN
The usefulness of anticoagulation in patients with suspected non-massive pulmonary embolism (PE) is uncertain. We recently published a decision analysis model suggesting a benefit for preemptive anticoagulation in patients with an intermediate or high probability of PE, even with short diagnostic delays (0-3 h). In case of a low probability of PE, the decision to treat or not could partly rely on the expected diagnostic delay. Once the diagnosis is confirmed, achieving rapidly therapeutic anticoagulation levels decreases future thrombotic complications.
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Anticoagulantes/uso terapéutico , Embolia Pulmonar/tratamiento farmacológico , Embolia Pulmonar/prevención & control , Humanos , Embolia Pulmonar/diagnósticoRESUMEN
D-dimer containing species are soluble fibrin degradation products derived from plasmin-mediated degradation of cross-linked fibrin, i.e., 'D-dimer'. D-dimer can hence be considered a biomarker of in vivo activation of both coagulation and fibrinolysis, the leading clinical application in daily practice of which is ruling out venous thromboembolism (VTE). D-dimer has been further evaluated for assessing the risk of VTE recurrence and helping define optimal duration of anticoagulation treatment in VTE, for diagnosing disseminated intravascular coagulation (DIC), and for screening those at enhanced risk of VTE. D-dimer assays should however be performed as intended by regulatory agencies, as their use outside these indications might make them a laboratory-developed test (LDT). This narrative review is aimed at: (1) reviewing the definition of D-dimer, (2) discussing preanalytical variables affecting D-dimer measurement, (3) reviewing and comparing the assays performance and some postanalytical variables (e.g., different units and age-adjusted cutoffs), and (4) discussing the interest of D-dimer measurement across different clinical settings, including pregnancy, cancer, and coronavirus disease 2019 (COVID-19).
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COVID-19 , Coagulación Intravascular Diseminada , Tromboembolia Venosa , Embarazo , Femenino , Humanos , Productos de Degradación de Fibrina-Fibrinógeno/metabolismo , Productos de Degradación de Fibrina-Fibrinógeno/uso terapéutico , Tromboembolia Venosa/diagnóstico , Tromboembolia Venosa/tratamiento farmacológico , COVID-19/diagnóstico , Coagulación Intravascular Diseminada/diagnóstico , Pruebas de Coagulación SanguíneaRESUMEN
Previous research suggests that parental psychopathology predicts suicidal behavior among offspring; however, the more fine-grained associations between specific parental disorders and distinct stages of the pathway to suicide are not well understood. We set out to test the hypothesis that parental disorders associated with negative mood would predict offspring suicide ideation, whereas disorders characterized by impulsive aggression (for example, antisocial personality) and anxiety/agitation (for example, panic disorder) would predict which offspring act on their suicide ideation and make a suicide attempt. Data were collected during face-to-face interviews conducted on nationally representative samples (N=55 299; age 18+) from 21 countries around the world. We tested the associations between a range of parental disorders and the onset and persistence over time (that is, time since most recent episode controlling for age of onset and time since onset) of subsequent suicidal behavior (suicide ideation, plans and attempts) among offspring. Analyses tested bivariate and multivariate associations between each parental disorder and distinct forms of suicidal behavior. Results revealed that each parental disorder examined increased the risk of suicide ideation among offspring, parental generalized anxiety and depression emerged as the only predictors of the onset and persistence (respectively) of suicide plans among offspring with ideation, whereas parental antisocial personality and anxiety disorders emerged as the only predictors of the onset and persistence of suicide attempts among ideators. A dose-response relation between parental disorders and respondent risk of suicide ideation and attempt was also found. Parental death by suicide was a particularly strong predictor of persistence of suicide attempts among offspring. These associations remained significant after controlling for comorbidity of parental disorders and for the presence of mental disorders among offspring. These findings should inform future explorations of the mechanisms of intergenerational transmission of suicidal behavior.
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Salud Global/estadística & datos numéricos , Encuestas Epidemiológicas/estadística & datos numéricos , Padres/psicología , Psicopatología/estadística & datos numéricos , Ideación Suicida , Intento de Suicidio/psicología , Adolescente , Adulto , Trastornos de Ansiedad/epidemiología , Trastornos de Ansiedad/psicología , Salud de la Familia , Humanos , Trastornos del Humor/epidemiología , Trastornos del Humor/psicología , Prevalencia , Factores de RiesgoRESUMEN
Although fetal fluids, amnion (AM) and allantois (AL), have been studied at the end of pregnancy in the bitch, little is known about their composition during gestation. The aim of this study was to characterize and compare the biochemical parameters of fetal fluids collected from healthy pregnant bitches in mid pregnancy. Fetal fluids were collected from 26 pregnant bitches between 35 and 62 days from ovulation based on ultrasonography. A total of 149 samples were analyzed; 94 samples of known origin (61 a.m. and 33 AL) from 17 dams, which included 17 paired samples (AM and AL from the same fetus; 34 samples), and 55 of unknown origin from nine dams. Reference ranges were formulated for 22 biochemical parameters in AM and AL based on the samples of known origin (n = 94). All parameters (creatinine, albumin, GGT and urea) significantly different between AM and AL were included (by mixed model ANOVA) in the analysis and an algorithm to predict the origin of the fluid was developed (by logistic regression). Overall, of the 94 samples, 79 samples (84%) were correctly identified by the algorithm. For the 33 allantois samples, and for the 61 amnion samples, 23 (69.7%) and 56 (91.8%) were correctly identified by the algorithm, respectively. Based on the algorithm, 31 of the unknown samples (58%) were classified as amnion and 22 samples (42%), as allantois fluid. For all the unknown samples, the average certainty was 86% (compared to 81% for the samples whose fluid type was known), showing the degree of precision of the classification.
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Líquido Amniótico , Líquidos Corporales , Alantoides , Líquido Amniótico/química , Animales , Líquidos Corporales/química , Perros , Femenino , Embarazo , UreaRESUMEN
Juvenile idiopathic epilepsy (JIE) is a self-limiting neurological disorder with a suspected genetic predisposition affecting young Arabian foals of the Egyptian lineage. The condition is characterized by tonic-clonic seizures with intermittent post-ictal blindness, in which most incidents are sporadic and unrecognized. This study aimed to identify genetic components shared across a local cohort of Arabian foals diagnosed with JIE via a combined whole genome and targeted resequencing approach: Initial whole genome comparisons between a small cohort of nine diagnosed foals (cases) and 27 controls from other horse breeds identified variants uniquely shared amongst the case cohort. Further validation via targeted resequencing of these variants, that pertain to non-intergenic regions, on additional eleven case individuals revealed a single 19bp deletion coupled with a triple-C insertion (Δ19InsCCC) within the TRIM39-RPP21 gene readthrough that was uniquely shared across all case individuals, and absent from three additional Arabian controls. Furthermore, we have confirmed recent findings refuting potential linkage between JIE and other inherited diseases in the Arabian lineage, and refuted the potential linkage between JIE and genes predisposing a similar disorder in human newborns. This is the first study to report a genetic variant to be shared in a sub-population cohort of Arabian foals diagnosed with JIE. Further evaluation of the sensitivity and specificity of the Δ19InsCCC allele within additional cohorts of the Arabian horse is warranted in order to validate its credibility as a marker for JIE, and to ascertain whether it has been introduced into other horse breeds by Arabian ancestry.
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OBJECTIVES: The prognosis of patients in whom pulmonary embolism (PE) is suspected but ruled out is poorly understood. We evaluated whether the initial assessment of clinical probability of PE could help to predict the prognosis for these patients. DESIGN: Retrospective analysis of data obtained during a prospective multicentre management study. SETTING: Six general and teaching hospitals in Belgium, France and Switzerland. SUBJECTS: In 1334 patients in whom PE was ruled out, 3-month mortality data were available (hospital readmission status was unknown for three patients) and clinical probability was evaluated with the revised Geneva score (RGS). MAIN OUTCOME MEASURES: Three-month mortality and readmission rates. RESULTS: Three-month mortality and readmissions rates were 3% and 19%, respectively and differed significantly depending on the RGS-determined PE probability group (P<0.001). When compared with patients presenting with a low probability, the risk of death after 3 months was higher in cases of intermediate or high RGS-based probability {odds ratio: 8.7 [95% confidence interval (CI): 2.7-28.5] and 22.6 (95%CI: 2.1-241.2), respectively}. The readmission risk increased with PE probability group (P<0.001). The main causes of death were cancer, respiratory failure and cardiovascular failure. In total, 86% of patients with low RGS-based probability were alive and had not been readmitted to hospital, whereas other patients had a twofold increased risk of death or readmission during the 3-month follow-up. The simplified Geneva score, calculated a posteriori, gave similar results. CONCLUSIONS: Initial assessment of clinical probability may help to stratify prognosis of patients in whom PE has been ruled out. Patients with a low probability of PE have a good prognosis. Whether patients with higher probability might benefit from more vigilant care should be evaluated.
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Técnicas de Apoyo para la Decisión , Embolia Pulmonar/diagnóstico , Adulto , Anciano , Bélgica/epidemiología , Enfermedades Cardiovasculares/mortalidad , Métodos Epidemiológicos , Femenino , Francia/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Neoplasias/mortalidad , Readmisión del Paciente/estadística & datos numéricos , Pronóstico , Insuficiencia Respiratoria/mortalidad , Suiza/epidemiologíaRESUMEN
Low intrinsic noise, high bandwidth, and high accuracy vector magnetometers are key components for many ground or space geophysical applications. Here, we report the design and the test of a 4He vector optically pumped magnetometer specifically dedicated to these needs. It is based on a parametric resonance magnetometer architecture operated in the Earth magnetic field with closed-loop compensation of the three components of the magnetic field. It provides offset-free vector measurements in a ±70 µT range with a DC to 1 kHz bandwidth. We demonstrate a vector sensitivity up to 130 fT/âHz, which is about ten times better than the best available fluxgate magnetometers currently available for the same targeted applications.
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In this paper a study on the ion transmission ratio of a nanoporous alumina sample is presented. The sample was investigated by scanning transmission ion microscopy (STIM) with different beam sizes. The hexagonally close-packed Al(2)O(3) nanocapillary array, realized as a suspended membrane of 15 microm thickness, had pore diameters of approximately 215 nm and spacing of approximately 450 nm. When the proton beam size was limited to a single domain, a peak transmission ratio of 19% was observed as is expected from the geometry (approximately 19-20%). This result points out an almost perfectly parallel alignment of the capillaries within one domain. However, for larger beam scanning areas (sampling multiple domains) the transmission ratio was reduced to 5%. The STIM analysis over an area larger than the typical domain size revealed an overall capillary angular spread of approximately 2 degrees.