Lymphocyte subsets early predict mortality in a large series of hospitalized COVID-19 patients in Spain.

The role of lymphocytes and their main subsets as prognostic factors of death in SARS-CoV-2-infected patients remains unclear, with no information obtained from patients outside China. We aimed to assess whether measuring lymphocyte subpopulations added clinical value to the total lymphocyte counting regarding mortality when they were simultaneously tested at hospital admission. Peripheral blood was analysed in 701 polymerase chain reaction (PCR)-confirmed consecutive patients by lysed-no washed flow cytometry. Demographic and clinical features were registered in electronic medical records. Statistical analysis was performed after a 3-month follow-up. The 112 patients who died were older and had significantly higher frequencies of known co-morbidities than survivor COVID-19 patients. A significant reduction in total lymphocytes, CD3+ , CD4+ , CD8+ and CD19+ counts and CD3+ percentage was found in the group of deceased patients (P < 0·001), while the percentage of CD56+ /CD16+ natural killer (NK) cells was significantly higher (P < 0·001). Multivariate logistic regression analysis showed a significantly increased risk of in-hospital death associated to age [odds ratio (OR) = 2·36, 95% confidence interval (CI) = 1·9-3·0 P < 0·001]; CD4+  T counts ≤ 500 cells/µl, (OR = 2·79, 95% CI = 1·1-6·7, P = 0·021); CD8+  T counts ≤ 100 cells/µl, (OR = 1·98, 95% CI = 1·2-3·3) P = 0·009) and CD56+ /CD16+ NK ≥ 30%, (OR = 1·97, 95% CI = 1·1-3·1, P = 0·002) at admission, independent of total lymphocyte numbers and co-morbidities, with area under the curve 0·85 (95% CI = 0·81-0·88). Reduced counts of CD4+ and CD8+ T cells with proportional expansion of NK lymphocytes at admission were prognostic factors of death in this Spanish series. In COVID-19 patients with normal levels of lymphocytes or mild lymphopenia, imbalanced lymphocyte subpopulations were early markers of in-hospital mortality.

Effect of the cap layer growth temperature on the Sb distribution in InAs/InSb/InAs sub-monolayer heterostructures for mid-infrared devices.

Sub-monolayer (SML) deposition of InSb within InAs matrix by migration enhanced epitaxy tends to form type II SML nanostructures offering efficient light emission within the mid-infrared (MIR) range between 3 and 5 µm. In this work, we report on the Sb distribution in InSb/InAs SML nanostructures with InAs cap layers grown at temperatures lower than that associated with the under-grown InSb active layer. Analysis by transmission electron microscopy (TEM) in 002 dark field conditions shows that the reduction in the growth temperature of the InAs cap layer increases the amount of Sb deposited in the layers, in good agreement with the x-ray diffraction results. TEM micrographs also show that the layers are formed by random InSbAs agglomerates, where the lower cap temperature leads to a more continuous InSb layer. Quantitative atomic column resolved high angle annular dark field-scanning (S)TEM analyses also reveal atomic columns with larger composition of Sb for the structure with the lowest InAs cap layer temperature. The dependence of the Sb distribution on InAs cap growth temperature allows tuning the corresponding emission wavelength in the MIR range, as shown by the photoluminescence emission spectra.

Investigation on Sb distribution for InSb/InAs sub-monolayer heterostructure using TEM techniques.

InSb/InAs sub-monolayer (SML) nanostructures such as SML quantum dots offer sharper emission spectra, a better modal gain and a larger modulation bandwidth compared to its Stranski-Krastanov counterpart. In this work, the Sb distribution of SML InSb layers grown by migration enhanced epitaxy has been analyzed by transmission electron microscopy (TEM) techniques. The analysis of the material by diffraction contrast in 002 dark field conditions and by atomic column resolved high angle annular dark field-scanning TEM reveal the presence of a low Sb content InSbAs continuous layer with scarce Sb-rich InSbAs agglomerates. The intensity profiles obtained by both techniques point to Sb segregation during growth. This segregation has been quantified using the Muraki segregation model obtaining a high segregation coefficient R of 0.81 towards the growth direction. The formation of a continuous InSbAs wetting layer as a result of a SML deposition of Sb on the InAs surface is discussed.

Influence of the crosstalk on the intensity of HAADF-STEM images of quaternary semiconductor materials.

The influence of the neighbouring atomic-columns in determining the composition at atomic column scale of quaternary semiconductor compounds, using simulated HAADF-STEM images is evaluated. The InAlAsSb alloy, a promising material in the photovoltaic field, is considered. We find that the so called 'crosstalk' effect plays an important role for the aimed compositional determination. The intensity transfer is larger from neighbouring atomic columns with higher average Z, and towards atomic columns with smaller Z. Our results show that in order to obtain precise information on the column composition, the HAADF-STEM intensities of both columns need to be taken into account simultaneously.

Structural characterization of bulk and nanoparticle lead halide perovskite thin films by (S)TEM techniques.

Lead halide (APbX3) perovskites, in polycrystalline thin films but also perovskite nanoparticles (NPs) has demonstrated excellent performance to implement a new generation of photovoltaic and photonic devices. The structural characterization of APbX3 thin films using (scanning) transmission electron microscopy ((S)TEM) techniques can provide valuable information that can be used to understand and model their optoelectronic performance and device properties. However, since APbX3 perovskites are soft materials, their characterization using (S)TEM is challenging. Here, we study and compare the structural properties of two different metal halide APbX3 perovskite thin films: bulk CH3NH3PbI3 prepared by spin-coating of the precursors in solution and CsPbBr3 colloidal NPs synthetized and deposited by doctor blading. Both specimen preparation methods and working conditions for analysis by (S)TEM are properly optimized. We show that CH3NH3PbI3 thin films grown by a one-step method are composed of independent grains with random orientations. The growth method results in the formation of tetragonal perovskite thin films with good adherence to an underlying TiO2 layer, which is characterized by a photoluminescence (PL) emission band centered at 775 nm. The perovskite thin films based on CsPbBr3 colloidal NPs, which are used as the building blocks of the film, are preserved by the deposition process, even if small gaps are observed between adjacent NPs. The crystal structure of CsPbBr3 NPs is cubic, which is beneficial for optical properties due to its optimal band gap. The absorption and PL spectra measured in both the thin film and the colloidal solution of CsPbBr3 NPs are very similar, indicating a good homogeneity of the thin films and the absence of aggregation of NPs. However, a particular care was required to avoid long electron irradiation times during our structural studies, even at a low voltage of 80 kV, as the material was observed to decompose through Pb segregation.

Choosing a career in oncology: results of a nationwide cross-sectional study.

BACKGROUND: Little information is currently available concerning young medical students desire to pursue a career in oncology, or their career expectations. METHODS: This project is a cross-sectional epidemiological study. A voluntary and anonymous questionnaire was distributed to all young oncologists studying in France between the 2nd of October 2013 and the 23rd of February 2014. RESULTS: The overall response rate was 75.6%. A total of 505 young oncologists completed the questionnaire. The main determining factors in the decision to practice oncology were the cross-sectional nature of the field (70.8%), the depth and variety of human relations (56.3%) and the multi-disciplinary field of work (50.2%). Most residents would like to complete a rotation outside of their assigned region (59.2%) or abroad (70.2%) in order to acquire additional expertise (67.7%). In addition, most interns would like to undertake a fellowship involving care, teaching and research in order to hone their skills (85.7%) and forge a career in public hospitals (46.4%). Career prospects mainly involve salaried positions in public hospitals. Many young oncologists are concerned about their professional future, due to the shortage of openings (40.8%), the workload (52.8%) and the lack of work-life balance (33.4%). CONCLUSIONS: This investigation provides a comprehensive profile of the reasons young oncologists chose to pursue a career in oncology, and their career prospects.

Noise exposure and oxidative balance in auditory and extra-auditory structures in adult and developing animals. Pharmacological approaches aimed to minimize its effects.

Noise coming from urban traffic, household appliances or discotheques might be as hazardous to the health of exposed people as occupational noise, because may likewise cause hearing loss, changes in hormonal, cardiovascular and immune systems and behavioral alterations. Besides, noise can affect sleep, work performance and productivity as well as communication skills. Moreover, exposure to noise can trigger an oxidative imbalance between reactive oxygen species (ROS) and the activity of antioxidant enzymes in different structures, which can contribute to tissue damage. In this review we systematized the information from reports concerning noise effects on cell oxidative balance in different tissues, focusing on auditory and non-auditory structures. We paid specific attention to in vivo studies, including results obtained in adult and developing subjects. Finally, we discussed the pharmacological strategies tested by different authors aimed to minimize the damaging effects of noise on living beings.

Atom-scale compositional distribution in InAlAsSb-based triple junction solar cells by atom probe tomography.

The analysis by atom probe tomography (APT) of InAlAsSb layers with applications in triple junction solar cells (TJSCs) has shown the existence of In- and Sb-rich regions in the material. The composition variation found is not evident from the direct observation of the 3D atomic distribution and because of this a statistical analysis has been required. From previous analysis of these samples, it is shown that the small compositional fluctuations determined have a strong effect on the optical properties of the material and ultimately on the performance of TJSCs.

Assessment of Hippocampal-Related Behavioral Changes in Adolescent Rats of both Sexes Following Voluntary Intermittent Ethanol Intake and Noise Exposure: A Putative Underlying Mechanism and Implementation of a Non-pharmacological Preventive Strategy.

Ethanol (EtOH) intake and noise exposure are particularly concerning among human adolescents because the potential to harm brain. Unfortunately, putative underlying mechanisms remain to be elucidated. Moreover, implementing non-pharmacological strategies, such as enriched environments (EE), would be pertinent in the field of neuroprotection. This study aims to explore possible underlying triggering mechanism of hippocampus-dependent behaviors in adolescent animals of both sexes following ethanol intake, noise exposure, or a combination of both, as well as the impact of EE. Adolescent Wistar rats of both sexes were subjected to an intermittent voluntary EtOH intake paradigm for one week. A subgroup of animals was exposed to white noise for two hours after the last session of EtOH intake. Some animals of both groups were housed in EE cages. Hippocampal-dependent behavioral assessment and hippocampal oxidative state evaluation were performed. Results show that different hippocampal-dependent behavioral alterations might be induced in animals of both sexes after EtOH intake and sequential noise exposure, that in some cases are sex-specific. Moreover, hippocampal oxidative imbalance seems to be one of the potential underlying mechanisms. Additionally, most behavioral and oxidative alterations were prevented by EE. These findings suggest that two frequently found environmental agents may impact behavior and oxidative pathways in both sexes in an animal model. In addition, EE resulted a partially effective neuroprotective strategy. Therefore, it could be suggested that the implementation of a non-pharmacological approach might also potentially provide neuroprotective advantages against other challenges. Finally, considering its potential for translational human benefit might be worth.

Interval gastric cancer: A call to attentiveness and action.

INTRODUCTION AND AIMS: Endoscopy is the most effective method for identifying gastric adenocarcinoma (GAC). Interval gastric cancer (IGC) is GAC that is diagnosed 2-3 years after a normal endoscopy. Its characteristics are unknown in the Colombian environment. The clinical, histopathologic, and endoscopic characteristics were evaluated, along with the presentation rate, proton pump inhibitor (PPI) use, and IGC survival rate, and compared with other types of GAC. METHODS: A retrospective, analytic study was conducted on a prospective cohort. It evaluated 513 patients with GAC treated at our institution, within the time frame of January 2012 and June 2018. The patients had endoscopic diagnosis of GAC and endoscopy within the past three years that was negative for tumor. RESULTS: A total of 513 patients diagnosed with GAC were evaluated. Forty-two of the patients had IGC (8.2%): 9 early lesions and 33 advanced lesions (79%). The IGCs were smaller (31 vs. 41 mm; P < .01), as well as flatter and more depressed (P < .01). There was no association with PPI use, but there was an association with a history of gastrectomy and anastomosis (P = .02), as well as the absence of red flags (P < .003). The most frequent locations were the gastric body (52%) and the antrum (26%). Overall two-year survival was similar between IGC and GAC (37.1 vs. 39.3%, P = .72). CONCLUSION: A total of 8.2% of recently diagnosed GAC were cases of IGC. The presence of anastomosis and the absence of red flags were related to IGC. Overall survival was poor and there were no differences from the other types of GAC detected.

The Impact of Diet and Photoperiodism on the Life History of Thanatophilus sinuatus (Coleoptera: Silphidae).

The forensically important genus Thanatophilus Leach, 1815 (Coleoptera: Silphidae) is a widespread group of carrion beetles that occupies the Holarctic and Afrotropical realms. It has recently received more recognition, as its species are frequently detected on large carrion, including humans, and can be useful in estimating the time of colonization (TOC) and the post-mortem interval (PMI). The immature stages of Thanatophilus sinuatus (Fabricius, 1775) were reared on three different meat diets (pork liver, pork muscle, and chicken muscle). Diet influence on some of the essential life history traits of the species was examined for different populations. Our findings indicated an accelerated development on pork muscle followed closely by pork liver and a prolonged development on chicken muscle. The diet significantly affected the size, and the body condition (weight/ size) as both pork muscle and liver produced individuals in better physical condition (larger and heavier). The impact of two cyclic photoperiod regimes (16 h Light (L): 8 h Dark (D) and 12 h L: 12 h D) was further evaluated and indicated no significant variability.

PPARα polymorphisms association with total cholesterol and LDL-C levels in a Mexican population.

OBJECTIVE: Peroxisome proliferator-activated receptor alpha (PPARα) is a nuclear transcription factor with a role in gene expression changes associated to lipid metabolism. PPARα polymorphic variants have been previously correlated to serum lipid profile but in Mexico, there is no previous report about that association. For this reason, the aim of this study was to investigate the relationship between PPARα polymorphic variants and lipids level in serum in a Mexican population. PATIENTS AND METHODS: Two-hundred and forty women from the Northeast region of Mexico were included in the study. Anthropometric characteristics and serum lipid profile (such as triglycerides, total cholesterol, LDL cholesterol and HDL cholesterol) were evaluated. Genomic DNA extraction and purification were made from blood samples. Real-time PCR and TaqMan probes were used for genotyping of rs1800206 and rs4253778 single nucleotide polymorphisms (SNPs). RESULTS: Linear regression analysis (adjusted by age and body mass index (BMI)) showed a significant statistical association of rs4253778 with total cholesterol (p=0.034) and LDL cholesterol (p=0.037). Any significant association was found between rs1800206 and lipid levels. CONCLUSIONS: These results suggested that rs4253778 (C allele) is associated with high levels of total cholesterol and LDL in a Mexican women population.

The CORCOBIA study: Cut-off points of Alzheimer's disease CSF biomarkers in a clinical cohort.

INTRODUCTION: The analysis of the core biomarkers of Alzheimer's Disease (AD) in the cerebrospinal fluid (CSF) is recommended in the clinical units where it is available. Because of the absence of universal validated values, the determination of specific cut-off points for each center and its population is recommended. The main objective of the CORCOBIA study was to determine the cut-off points of core AD CSF biomarkers for several centers (Parc de Salut Mar, Barcelona and Hospital General de Granollers), which work with the same reference laboratory (Laboratori de Referència de Catalunya). METHODS: Prospective study including cognitively unimpaired individuals (CU, n = 42), subjects with amnestic mild cognitive impairment (aMCI, n = 35) and patients with dementia due to Alzheimer's Disease (AD, n = 48), in whom clinical and neuropsychological assessment, neuroimaging, APOE genotyping and lumbar puncture to analyse amyloid beta peptides (Aß42, Aß40), total tau (tTau) and phosphorylated Tau (pTau181) using the Lumipulse G600II (Fujirebio) was performed. The values of sensitivity (SE), specificity (SP), predictive values and area under the curve (AUC) were calculated, determining the cut-off point according to the Youden index by comparing the CU and AD groups. RESULTS: The resulting cut-offs and their AUC were the following: Aß42 750 pg/mL (AUC 0.809); Aß42/Aß40 0.062 (AUC 0.78); pTau181 69.85 pg/mL (AUC 0.81); tTau 522.0 pg/mL (AUC 0.79); Aß42/tTau 1.76 (AUC 0.86); Aß42/pTau181 10.25 (AUC 0.86). CONCLUSIONS: The determination of cut-off points of core AD CSF biomarkers for the participating centers allows a better diagnostic accuracy. The ratio CSF Aß42/pTau181 shows the highest AUC and better balance between sensitivity and specificity.

Narcolepsy and opioid-free anesthesia: a review and case report. / Narcolepsia y anestesia libre de opioides: revisión y caso clínico.

INTRODUCTION: Narcolepsy is the second most common sleep disorder. It is characterised by excessive daytime sleepiness together with other symptoms such as cataplexy, sleep paralysis, and hallucinations. The pathophysiology and treatment of this disease, together with its associated syndromes, can severely interfere with anaesthesia. METHODOLOGY: Due to the lack of quality evidence on which to base a high grade of recommendation for anaesthesia in these patients, we performed a non-systematic, narrative review of the literature in Pubmed. We used the descriptors narcolepsy, anesthesia, surgery, perioperative, opioid, obstructive, apnea and sleep both individually and with AND and OR connectors. CONCLUSION: The recommendation to avoid opioids and the stability of opioid-free anaesthesia (OFA) make this approach an option to consider in these patients. We describe a case in which it was used safely.

[Perioperative management of the patient with chronic spinal cord injury using bilateral diaphragmatic pacemaker. Clinical case].

Patients with chronic spinal cord injury suffer from a number of pathophysiological alterations that can lead to important morbidity and mortality in the perioperative period. The diaphragmatic pacemaker is a device that enables pulmonary ventilation in patients with high cervical cord injuries and provides them with a better quality of life when compared to mechanical ventilation. We present here the clinical case of a patient with chronic spinal cord injury who used a diaphragmatic pacemaker, and who was scheduled for percutaneous nephrolithotomy and double-J stent implantation. The anesthesiologist should know the pathophysiological situation of these patients in order to provide a safe perioperatory care.

Developmental models of the carrion beetle Thanatophilus rugosus (Linnaeus, 1758) (Coleoptera: Silphidae).

Coleoptera are currently considered a fundamental tool to help solve criminal investigations, allowing forensic entomologists to estimate post-mortem intervals and obtain other ecology-related information. Thanatophilus rugosus (Linnaeus, 1758) is an important necrophagous beetle distributed through most of the Palaearctic region, where it is readily found on human bodies and animal carcasses. In this study, the new thermal summation models for all the developmental stages of Thanatophilus rugosus are provided. Beetles were reared at six different constant and ecologically relevant temperatures (12, 14, 16, 18, 20, and 22 °C), and their developmental times were measured. Thermal summation constants were calculated for each developmental stage (egg, three larval instars, post-feeding stage, and pupa).

Morphological evolution of InAs/InP quantum wires through aberration-corrected scanning transmission electron microscopy.

Evolution of the size, shape and composition of self-assembled InAs/InP quantum wires through the Stranski-Krastanov transition has been determined by aberration-corrected Z-contrast imaging. High resolution compositional maps of the wires in the initial, intermediate and final formation stages are presented. (001) is the main facet at their very initial stage of formation, which is gradually reduced in favour of [114] or [118], ending with the formation of mature quantum wires with {114} facets. Significant changes in wire dimensions are measured when varying slightly the amount of InAs deposited. These results are used as input parameters to build three-dimensional models that allow calculation of the strain energy during the quantum wire formation process. The observed morphological evolution is explained in terms of the calculated elastic energy changes at the growth front. Regions of the wetting layer close to the nanostructure perimeters have higher strain energy, causing migration of As atoms towards the quantum wire terraces, where the structure is partially relaxed; the thickness of the wetting layer is reduced in these zones and the island height increases until the (001) facet is removed.

Blocking of indium incorporation by antimony in III-V-Sb nanostructures.

The addition of antimony to III-V nanostructures is expected to give greater freedom in bandgap engineering for device applications. One of the main challenges to overcome is the effect of indium and antimony surface segregation. Using several very high resolution analysis techniques we clearly demonstrate blocking of indium incorporation by antimony. Furthermore, indium incorporation resumes when the antimony concentration drops below a critical level. This leads to major differences between nominal and actual structures.

Management of Stage I twin-to-twin transfusion syndrome: an international survey.

OBJECTIVE: To determine practice patterns for evaluation and treatment of Stage I twin-to-twin transfusion syndrome (TTTS) among international physicians. METHODS: An e-mail cross-sectional survey of members from the IFMSS, NAFTNet and SMFM societies and participants at a Eurofoetus-sponsored TTTS meeting was undertaken between May 2008 and November 2008. Questionnaires consisted of physician demographics and their recommendations for managing Stage I TTTS. Alternative therapies to expectant management were assessed based on the following special circumstances of the patient: residence more than 200 miles from the center, severe symptoms, or a cervical length of

Chorioamnion plugging and the risk of preterm premature rupture of membranes after laser surgery in twin-twin transfusion syndrome.

OBJECTIVE: To examine the incidence of preterm premature rupture of membranes (PPROM) in pregnancies affected by twin-twin transfusion syndrome (TTTS) treated with laser photocoagulation where an absorbable gelatin sponge was used as a chorioamnion sealant of the fetoscopic access port. METHOD: A retrospective review was undertaken of consecutive cases undergoing fetoscopic directed laser surgery for TTTS between October 2006 and November 2008 at Texas Children's Fetal Center, in which an absorbable gelatin sponge, used as a chorioamnion 'plug', was placed at the conclusion of the intervention as a possible prophylactic measure to prevent PPROM. We excluded cases that had a failure of plug placement and those in which it was not attempted. PPROM was defined as rupture of membranes before 34 weeks' gestation. A comparison was performed between the PPROM group and a no-PPROM group to determine risk factors and outcomes. RESULTS: Successful plug placement occurred in 79 of 84 cases (94%) in which it was attempted after laser surgery, with a rate of PPROM of 34% in these patients. PPROM occurred at an average gestational age of 26.5 +/- 3.6 weeks, with an average procedure-to-PPROM interval of 5.2 +/- 3.5 weeks. There were no statistically significant differences between the PPROM group and the no-PPROM group in maternal demographics or preoperative parameters including: amniotic fluid volumes in the recipient twin's gestational sac, volume of amnioreduction, and location of the placenta. The procedure-to-delivery interval for the total cohort (n = 79) was 9.2 +/- 4.7 weeks, without a significant difference between the two groups (P = 0.08). However, after exclusion of one PPROM outlier, the PPROM group had an average procedure-to-delivery time 2 weeks shorter than the group with no PPROM (P = 0.03). The live birth rates were similar in the PPROM and no-PPROM groups, at 77 and 73%, respectively. However, the average recipient's weight in the PPROM group was significantly lower than in the no-PPROM group (1321 +/- 493 vs. 1705 +/- 576 g; P = 0.02). CONCLUSION: The rate of PPROM and the mean gestational age at delivery in pregnancies in which an absorbable gelatin sponge was used as a sealant of the fetoscopic port following laser photocoagulation for TTTS were comparable to those that have been reported by other laser centers where membrane sealants were not used. A randomized controlled trial should be considered to evaluate the effect of chorioamnion plugging.