Measurement of Algal Photosynthesis Using a Clark-Type O2 Electrode.

The Clark-type electrode can be used to assess the rates of photosynthesis by detecting changes in O2 concentration in a culture. This chapter describes a method for a liquid phase measurement of light and dissolved inorganic carbon-dependent photosynthesis using the model green alga Chlamydomonas reinhardtii. The technique can be used to evaluate the presence or efficiency of carbon-concentrating mechanisms.

Measurements of Oxygen Evolution in Photosynthesis.

This chapter compares two different techniques for monitoring photosynthetic O2 production; the wide-spread Clark-type O2 electrode and the more sophisticated membrane inlet mass spectrometry (MIMS) technique. We describe how a simple membrane inlet for MIMS can be made out of a commercial Clark-type cell and outline the advantages and drawbacks of the two techniques to guide researchers in deciding which method to use. Protocols and examples are given for measuring O2 evolution rates and for determining the number of chlorophyll molecules per active photosystem II reaction center.

Technical Note: Individuals identified by radiographic comparison: A sample of demographics and the region of body used for identification in Clark County, Nevada, USA (2017-2020).

Radiographs regularly aid in identifications by comparing antemortem and postmortem images. The forensic community has widely accepted this method because radiographic images are low in cost, easily transferable, and generally believed to be uncomplicated to assess. However, there is a dearth of diverse, modern radiographic datasets as well as a deficiency in assessing population frequencies of nonmetric traits via radiographs. Further, radiographic comparisons, although typically required as a core competency of practicing forensic anthropologists, do not have standard training and education requirements. To understand the diversity and representation within an opportunistic dataset, we provide a case study of the demographics of decedents identified via radiographic comparison at the Clark County Office of the Coroner/Medical Examiner (CCOCME) in Las Vegas, NV, USA from 2017 to 2020. Additionally, we examined each region of the body used to make radiographic identifications. The sample was majority Caucasian and male, with a mean and median age at death of 64.9 years and 67.0 years, respectively. Our results indicated that this sample was not representative of the greater Clark County population. The most common body region used for comparisons was the chest, followed by the head and neck, pelvis, dentition, and the extremities. Thus, large generalizations made from these types of datasets must be implemented with caution due to the relative lack of diversity and representation. As well, current discussions regarding training and education of forensic anthropologists as they relate to radiographic comparisons are explored.

Paired acoustic recordings and point count surveys reveal Clark's nutcracker and whitebark pine associations across Glacier National Park.

Global declines in tree populations have led to dramatic shifts in forest ecosystem composition, biodiversity, and functioning. These changes have consequences for both forest plant and wildlife communities, particularly when declining species are involved in coevolved mutualisms. Whitebark pine (Pinus albicaulis) is a declining keystone species in western North American high-elevation ecosystems and an obligate mutualist of Clark's nutcracker (Nucifraga columbiana), an avian seed predator and disperser. By leveraging traditional point count surveys and passive acoustic monitoring, we investigated how stand characteristics of whitebark pine in a protected area (Glacier National Park, Montana, USA) influenced occupancy and vocal activity patterns in Clark's nutcracker. Using Bayesian spatial occupancy models and generalized linear mixed models, we found that habitat use of Clark's nutcracker was primarily supported by greater cone density and increasing diameter of live whitebark pine. Additionally, we demonstrated the value of performing parallel analyses with traditional point count surveys and passive acoustic monitoring to provide multiple lines of evidence for relationships between Clark's nutcracker and whitebark pine forest characteristics. Our findings allow managers to gauge the whitebark pine conditions important for retaining high nutcracker visitation and prioritize management efforts in whitebark pine ecosystems with low nutcracker visitation.

Transformation of phenylarsenic chemical warfare agents and their effect on bacterial communities in Baltic Sea sediment.

During the World Wars large quantities of phenylarsenic chemical warfare agents (CWAs) were dumped in the Baltic Sea. Many transformation products of these chemicals have been identified, but the pathways that produce the found chemicals has not been investigated. Here we studied the biotic and abiotic transformation of phenylarsenic CWAs under oxic and anoxic conditions and investigated how the sediment bacterial communities are affected by CWA exposure. By chemical analysis we were able to identify seventeen CWA-related phenylarsenicals, four of which (methylphenylarsinic acid (MPAA), phenylthioarsinic acid (PTAA), phenyldithioarsinic acid (PDTAA) and diphenyldithioarsinic acid (DPDTAA)) have not been reported for marine sediments before. For the first time PTAA was verified from environmental samples. We also observed equilibrium reactions between the found transformation products, which may explain the occurrence of the chemicals. 16S rRNA-analysis showed that bacterial communities in sediments are affected by exposure to phenylarsenic CWAs. We observed increases in the amounts of arsenic-resistant and sulphur-metabolising bacteria. Different transformation products were found in biotic and abiotic samples, which suggests that bacteria participate in the transformation of phenylarsenic CWAs. We propose that methylated phenylarsenicals are produced in microbial metabolism and that chemical reactions with microbially produced sulphur species form sulphur-containing transformation products.

Clark's nutcracker forest community visitation: Whitebark pine maintains a keystone seed disperser.

Clark's nutcrackers (Nucifraga columbiana) are obligate seed dispersers for whitebark pine (Pinus albicaulis), but they frequently use other conifer seed resources because of annual variability in cone production or geographic variation in whitebark pine availability. Whitebark pine is declining from several threats including white pine blister rust, leading to potential population declines in the nutcracker and the pine. We hypothesize that where there are few additional seed resources, whitebark pine becomes the key and limiting resource supporting nutcracker populations. We investigated how nutcrackers use coniferous forest community types within Yellowstone National Park to determine potential seed resources and the importance of whitebark pine. We established sites representing five forest community types, including whitebark pine, lodgepole pine (P. contorta), Engelmann spruce (Picea engelmannii), limber pine (P. flexilis), and Douglas-fir (Pseudotsuga menziesii). Each transect annually generated nutcracker point counts, conifer cone production indices, community composition data, and seed resource use observations. We compared hierarchical distance sampling models, estimating nutcracker density and its relationship to forest community type, seed harvesting time-period, year, study site, and cone seed energy. We found cone production varied across years indicating annual variability in energy availability. Nutcracker density was best predicted by forest community type and survey time-period and was highest in whitebark pine stands during the mid-harvesting season. Nutcracker density was comparatively low for all other forest community types. This finding underscores the importance of whitebark pine as a key seed resource for Clark's nutcracker in Yellowstone National Park. The decline of whitebark pine potentially leads to a downward spiral in nutcrackers and whitebark pine, arguing for continued monitoring of nutcrackers and implementation of restoration treatments for whitebark pine.

Correlation Analyses between Histological Staging and Molecular Alterations in Tumor-Derived and Cell-Free DNA of Early-Stage Primary Cutaneous Melanoma.

Here, we investigate the correlation and statistical analyses between histological staging and molecular alterations in tumor-derived (tdDNA) and cell-free DNA (cfDNA) obtained from early-stage primary cutaneous melanoma (PCM) patients using digital PCR (dPCR) for the detection of the BRAF p.V600E somatic pathogenic variant. In the prospective study, a total of 68 plasma and paired tdDNA samples, and in the retrospective cohort, a total of 100 tdDNA samples were analyzed using dPCR and reverse hybridization StripAssay. The Breslow depth (BD) and Clark level were applied to categorize the study population. Our results demonstrate that dPCR is a highly sensitive and specific method for the detection of BRAF p.V600E somatic variants in cfDNA samples from PCM patients. A strong correlation was detected between BD and cfDNA concentration in all mutant and negative cases, between the tdDNA concentration and the tumor-derived variant allele frequency (VAF) of BRAF p.V600E, between the tdVAF and the cfVAF in all cases, and between the cfDNA and cfVAF in mutant cases. The tdVAF and cfVAF of BRAF p.V600E and cfDNA concentration were the highest in Clark's V category. The cfDNA concentration was statistically significantly higher in Clark's III, IV, and V groups compared to cases with a better prognosis. It can also be explained by the fact that cases with a more advanced stage classification release more cfDNA into the peripheral circulation.

PRAME-negativity in sclerosing nevi with pseudomelanomatous features supports classification as an indolent lesion.

BACKGROUND: Some dysplastic nevi, termed sclerosing nevi with pseudomelanomatous features, may have florid fibroplasia associated with features that cause melanoma to be a prominent consideration in the differential diagnosis. PRAME (PReferentially expressed Antigen in MElanoma) immunohistochemistry (IHC) has been shown to be a useful marker in the distinction of melanoma and nevus. PRAME expression in such sclerosing nevi with pseudomelanomatous features has not been evaluated to our knowledge. METHODS: Thirty-two sclerosing nevi with pseudomelanomatous features were stained with PRAME IHC, with positive labeling defined as staining of >75% of the cytomorphologically atypical lesional cells. RESULTS: All 32 cases had variable cytologic atypia, bridging of elongated rete, fibroplasia, and a vertically oriented trizonal appearance. Some cases (23/32) had centrally located flattening of the rete ridge pattern bilaterally flanked by fibroplasia associated with elongated rete. PRAME labeling was negative (<1% labeling) in 28/32 cases. Four cases, also interpreted as having negative labeling with PRAME, showed only weak nuclear positivity of <50% of the melanocytes within the pseudomelanomatous foci. p16 staining was positive in 28/28 lesions. CONCLUSIONS: Rare sclerosing nevi with pseudomelanomatous features (4/32; ~13%) had weak PRAME labeling of 25%-50% of atypical foci. Twenty-eight of 32 lesions had virtually no labeling with PRAME. PRAME results support classifying sclerosing nevi with pseudomelanomatous features as indolent lesions.

Invasive Cutaneous Melanoma: Evaluating the Prognostic Significance of Some Parameters Associated with Lymph Node Metastases.

Background and Objectives: This study aimed to assess the clinical-pathological profile of patients with invasive cutaneous melanomas and to identify the parameters with a prognostic role in the lymph nodal spread of this malignant tumor. Materials and Methods: We performed a retrospective study on patients with invasive cutaneous melanomas who underwent surgery in the "Pius Brînzeu" County Clinical Emergency Hospital from Timișoara, Romania, and were evaluated for the status of loco-regional lymph nodes. We selected and analyzed some parameters searching for their relationship with lymph node metastases. Results: We identified 79 patients with invasive cutaneous melanomas (29 men and 50 women, mean age 59.36 years). A percentage of 58.3% of melanomas had Breslow tumor thickness >2 mm; 69.6% of melanomas showed a Clark level IV-V. Tumor ulceration was present in 59.5% of melanomas. A mitotic rate of ≥5 mitoses/mm2 was observed in 48.1% of melanomas. Tumor-infiltrating lymphocytes (TILs), non-brisk, were present in 59.5% of cases and 22.8% of patients had satellite/in-transit metastasis (SINTM). Tumor regression was identified in 44.3% of cases. Lymph nodes metastases were found in 43.1% of patients. Statistical analysis showed that lymph node metastases were more frequent in melanomas with Breslow thickness >2 mm (p = 0.0002), high Clark level (p = 0.0026), mitotic rate >5 mitoses/mm2 (p = 0.0044), ulceration (p = 0.0107), lymphovascular invasion (p = 0.0182), SINTM (p = 0.0302), and non-brisk TILs (p = 0.0302). Conclusions: The Breslow thickness >2 mm, high Clark level, high mitotic rate and ulceration are the most important prognostic factors for lymph nodal spread in cutaneous melanomas. However, some melanomas without these clinical-pathological features can have an unexpected, aggressive evolution, which entails the necessity of close and prolonged clinical follow-up of patients, including those with lesions considered without risk.

Microbial Biosensor for Characterization of a Microorganism: A Review focusing on the Biochemical Activity of Microbial Cells.

Express assessment of the biochemical activity of microorganisms is important in both applied and fundamental research. A laboratory model of a microbial electrochemical sensor formed on the basis of the culture of interest is a device that provides rapidly information about the culture and is cost effective, simple to fabricate and easy to use. This paper describes the application of laboratory models of microbial sensors in which the Clark-type oxygen electrode was used as a transducer. The formation of the models of the reactor microbial sensor (RMS) and the membrane microbial sensor (MMS) and the formation of the response of biosensors are compared. RMS and MMS are based on intact or immobilized microbial cells, respectively. For MMS, the response of biosensor is caused both by the process of transport of substrate into microbial cells and by the process of the initial metabolism of substrate; and only initial substrate metabolism triggers the RMS response. The details of the application of biosensors for the study of allosteric enzymes and inhibition by substrate are discussed. For inducible enzymes, special attention is paid to the induction of microbial cells. This article addresses current problems related to implementation of the biosensor approach and discusses the ways how to overcome these problems.

Constructing Causal Life-Course Models: Comparative Study of Data-Driven and Theory-Driven Approaches.

Life-course epidemiology relies on specifying complex (causal) models that describe how variables interplay over time. Traditionally, such models have been constructed by perusing existing theory and previous studies. By comparing data-driven and theory-driven models, we investigated whether data-driven causal discovery algorithms can help in this process. We focused on a longitudinal data set on a cohort of Danish men (the Metropolit Study, 1953-2017). The theory-driven models were constructed by 2 subject-field experts. The data-driven models were constructed by use of the temporal Peter-Clark (TPC) algorithm. The TPC algorithm utilizes the temporal information embedded in life-course data. We found that the data-driven models recovered some, but not all, causal relationships included in the theory-driven expert models. The data-driven method was especially good at identifying direct causal relationships that the experts had high confidence in. Moreover, in a post hoc assessment, we found that most of the direct causal relationships proposed by the data-driven model but not included in the theory-driven model were plausible. Thus, the data-driven model may propose additional meaningful causal hypotheses that are new or have been overlooked by the experts. In conclusion, data-driven methods can aid causal model construction in life-course epidemiology, and combining both data-driven and theory-driven methods can lead to even stronger models.

Acute toxicity of organoarsenic chemical warfare agents to Danio rerio embryos.

During the 20th century, thousands of tons of munitions containing organoarsenic chemical warfare agents (CWAs) were dumped into oceans, seas and inland waters around the world. As a result, organoarsenic CWAs continue to leak from corroding munitions into sediments and their environmental concentrations are expected to peak over the next few decades. There remains, however, a lack of knowledge about their potential toxicity to aquatic vertebrates, such as fish. The aim of this study was to fill in this gap in research, by investigating the acute toxicity of organoarsenic CWAs on fish embryos, using the model species, Danio rerio. To estimate the acute toxicity thresholds of organoarsenic CWAs (Clark I, Adamsite, PDCA), a CWA-related compound (TPA), as well as four organoarsenic CWA degradation products (Clark I[ox], Adamsite[ox], PDCA[ox], TPA[ox]), standardized tests were performed following the OECD no. 236 Fish Embryo Acute Toxicity Test guidelines. Additionally, the detoxification response in D. rerio embryos was investigated by analysing the mRNA expression of five genes encoding antioxidant enzymes (CAT, SOD, GPx, GR and GST). During the 96 h of exposure, organoarsenic CWAs induced lethal effects in D. rerio embryos at very low concentrations (classified as 1st category pollutants according to GHS categorization), and were therefore deemed to be serious environmental hazards. Although TPA and the four CWA degradation products caused no acute toxicity even at their maximum solubility, the transcription of antioxidant-related genes was altered upon exposure to these compounds, indicating the need for further testing for chronic toxicity. Incorporating the results of this study into ecological risk assessments will provide a more accurate prediction of the environmental hazards posed by CWA-related organoarsenicals.

COVID-19 and oil market risks: Evidence from new datasets.

We evaluate the predictive value of the newly constructed six COVID-19 indices for oil market risks from 31st December, 2019 (when COVID-19 started) to 28th December, 2021. We show that, on average, higher values of the COVID-19 indices appear to have heightened oil market risks albeit with the converse for Vaccine index regardless of the choice of oil price proxy. The predictive value of the indices is sustained over multiple out-of-sample forecasts and we attribute the outcome to the increased uncertainties associated with the pandemic. Therefore, measures aimed at mitigating these uncertainties can help moderate the oil market risks.•Testing the predictive value of the newly constructed COVID-19 measures for the out-of-sample forecasting of oil market risks.•Increased uncertainties associated with the pandemic tend to raise the level of oil market risks.•Measures aimed at mitigating these uncertainties can help moderate the oil market risks.

The enigmatic figure of Leon Pierce Clark and his contribution to epilepsy.

Leon Pierce Clark (1870-1933) was a prominent American neurologist and psychiatrist and an enigmatic figure. He made enduring contributions to status epilepticus and to epilepsy. In the 1910s and 1920s, his chief focus was on the psychological mechanisms of epilepsy and on the personality of those with idiopathic epilepsy which he interpreted from a psychoanalytical perspective. He also described the epileptic voice sign, wrote psychobiographies of among others Abraham Lincoln and Napoleon Bonaparte, and published a book of poetry. He held many important positions in American professional societies and yet was embroiled in controversy.

Comparative evaluation of efficacy of Halstead technique, Clark and Holmes technique, Gow Gates technique, and Sargenti technique for mandibular anesthesia.

Aim: This study aimed to evaluate the inferior alveolar nerve block, that is, the Halstead technique, Clark and Holmes technique, Gow Gates technique, and Sargenti technique, for mandibular anesthesia. Methodology: This prospective, double-blinded, in-vivo study was conducted amongst 100 patients, requiring mandibular anesthesia. These patients were divided into four groups. Parameters assessed were time required for appearance of subjective and objective symptoms and signs, positive aspiration, need for supplementary anesthesia, and ease of administration. Results: The means for subjective symptoms for the four techniques, that is, Halstead technique, Clark and Holmes technique, Gow Gates technique, and Sargenti technique, were 78.44, 120.76, 176.6, and 203.08, respectively. The means for objectives symptoms for the four techniques, that is, Halstead technique, Clark and Holmes technique, Gow Gates technique, and Sargenti technique, were 110.6, 269.8, 287.48, and 154.08, respectively. Halstead technique had statistically significant (P < 0.05) faster objective signs than all the other techniques. Supplementary block if required was noted for all four techniques. Conclusion: The Clark and Holmes technique showed maximum complications, while Gow Gates technique was most difficult to administer. The Angelo Sargenti technique gave good results, same as standard Halstead technique.

Anticipative information in a Brownian-Poisson market.

The anticipative information refers to some information about future events that may be disclosed in advance. This information may regard, for example, financial assets and their future trends. In our paper, we assume the existence of some anticipative information in a market whose risky asset dynamics evolve according to a Brownian motion and a Poisson process. Using Malliavin calculus and filtration enlargement techniques, we derive the information drift of the mentioned processes and, both in the pure jump case and in the mixed one, we compute the additional expected logarithmic utility. Many examples are shown, where the anticipative information is related to some conditions that the constituent processes or their running maximum may verify, in particular, we show new examples considering Bernoulli random variables.

Episignature Mapping of TRIP12 Provides Functional Insight into Clark-Baraitser Syndrome.

Clark-Baraitser syndrome is a rare autosomal dominant intellectual disability syndrome caused by pathogenic variants in the TRIP12 (Thyroid Hormone Receptor Interactor 12) gene. TRIP12 encodes an E3 ligase in the ubiquitin pathway. The ubiquitin pathway includes activating E1, conjugating E2 and ligating E3 enzymes which regulate the breakdown and sorting of proteins. This enzymatic pathway is crucial for physiological processes. A significant proportion of TRIP12 variants are currently classified as variants of unknown significance (VUS). Episignatures have been shown to represent a powerful diagnostic tool to resolve inconclusive genetic findings for Mendelian disorders and to re-classify VUSs. Here, we show the results of DNA methylation episignature analysis in 32 individuals with pathogenic, likely pathogenic and VUS variants in TRIP12. We identified a specific and sensitive DNA methylation (DNAm) episignature associated with pathogenic TRIP12 variants, establishing its utility as a clinical biomarker for Clark-Baraitser syndrome. In addition, we performed analysis of differentially methylated regions as well as functional correlation of the TRIP12 genome-wide methylation profile with the profiles of 56 additional neurodevelopmental disorders.

An Uncommon Presentation of Constriction Band Syndrome: A Case Report and Review of Literature.

One of the rarer manifestations of constriction band syndrome (CBS) is peripheral nerve palsy. We report a 6-year-old child presenting with motor deficits of the median, ulnar and radial nerves and atrophy of the biceps and brachialis atrophy due to CBS. We were unable to find any similar reports in the literature. He had a constriction ring at the upper arm that had undergone multiple z-plasty by another surgeon. On examination, he had medical research council (MRC) grade 1 elbow flexion, weak flexion of fingers and absent extension of fingers and wrist. We used a pedicled pectoralis major myocutaneous flap to restore elbow flexion and the patient achieved M4 flexion of the elbow. Level of Evidence: Level V (Therapeutic).

Analysis of facial proportions in skeletal Class II subjects treated with Clark's twin block appliance, followed by nonextraction fixed mechanotherapy: A retrospective longitudinal study.

INTRODUCTION: This study aimed to determine the influence of Clark's twin block (CTB) appliance therapy on achieving golden proportion in post-treatment facial profiles in skeletal Class II patients. METHODS: A retrospective longitudinal study was conducted on a sample of 44 skeletal Class II subjects treated with CTB, followed by nonextraction mechanotherapy. Ricketts' 13 dentoskeletal ratios were measured on pre- and post-treatment lateral cephalograms. Paired Student's t test was used to analyze the existence of golden proportion in the values of the pre- and post-treatment ratios. The influence of pretreatment variables was tested on post-treatment ratio 4 using simple and multiple linear regression analyses. RESULTS: A statistically significant difference in pre- and post-treatment values was found for ratios 4 (P = 0.02), 9 (P = 0.04), 10 (P < 0.001), and 13 (P = 0.01). Ratios 4, 9, and 13 moved closer to the golden proportion, whereas ratio 10 moved away from the golden proportion after CTB therapy. Simple linear regression analysis showed a statistically significant association of post-treatment ratio 4 with pretreatment ratios 1, 4, 8, 9, and 12. Multiple linear regression analysis showed a statistically significant association of post-treatment ratio 4 with pretreatment ratios 4 and 12. CONCLUSIONS: Treatment with CTB appliance may well move various facial ratios in individual patients toward the published Ricketts ideals. Ricketts' published golden proportion may be used as one guide when planning for attempted dentofacial change in individual patients.

A Method of Conservative Management of Giant Omphalocele Useful in Preventing Rupture of Sac.

BACKGROUND: Omphalocele consists of congenital malformation of anterior abdominal wall defects occurring at the midline with herniation of the viscera through this defect. Giant omphaloceles constitute a challenging situation as such conservative management has been advocated as an effective method of treatment. This study aimed to compare the conventional method of dressing the omphalocele sac using gauze, an escharotic agent, and a crepe bandage to our improvised method of the usage of a sterilization wrap over the escharotic agent with a crepe bandage. METHODS: This was a retrospective comparative review of 7 babies with giant omphalocele that was treated with topical honey and the non-adherent sterilization wrap covering (group B) and compared with 6 babies that had honey, sofratulle ,and dry gauze covering (group A) that was initially done in our center. RESULTS: All of the babies who were in group B had an uneventful epithelization of the sac with no rupture; also, no death occurred in this group. However, three in group A had sacs that ruptured before epithelization. Two of these died from complications of sepsis following rupture of the sac, one had a small point on the sac which was ruptured and it healed with a dressing left in place for a week. CONCLUSION: The use of Kimberley-Clark sterilization wrap prevents rupture of the sac while using the escharotic agent, thereby reducing mortality. We advocate that gauze should not make any contact with the omphalocele sac.

CONTEXTE: Omphalocele consiste en une malformation congénitale deanomalies de la paroi abdominale antérieure survenant à la ligne médiane avechernie des viscères à travers ce défaut. Omphalocèles géantsconstituent une situation difficile en tant que telle gestion conservatricea été préconisé comme une méthode de traitement efficace. Cette étudevisant à comparer la méthode conventionnelle d'habillage dusac omphalocèle utilisant de la gaze, un agent escharotique et un pansement en crêpeà notre méthode improvisée d'utilisation d'une enveloppe de stérilisation sur leagent escharotique avec un pansement en crêpe. MÉTHODES: Il s'agissait d'une revue comparative rétrospective de 7 bébés atteints deomphalocèle géant qui a été traité avec du miel topique et le revêtement d'enveloppement de stérilisation non adhérent (groupe B) et comparé à 6bébés qui avaient du miel, de la sofratulle et de la gaze sèche couvrant (groupe A)cela a d'abord été fait dans notre centre. RÉSULTATS: Tous les bébés qui étaient dans le groupe B ont eu une situation sans incident.épithélisation du sac sans rupture; de plus, aucun décès n'est survenu dans cegroupe. Cependant, trois dans le groupe A avaient des sacs qui se sont rompus avantépithélisation. Deux d'entre eux sont morts de complications de la septicémiesuite à la rupture du sac, on avait une petite pointe sur le sac quia été rompu et il a guéri avec un pansement laissé en place pendant une semaine. CONCLUSION: L'utilisation de l'emballage de stérilisation Kimberley-Clark prévientrupture du sac lors de l'utilisation de l'agent escharotique, réduisant ainsimortalité. Nous préconisons que la gaze ne devrait pas entrer en contact avecle sac omphalocèle. MOTS-CLÉS: Omphalocèle géant, Enveloppe de stérilisation Kimberly.