Polarized thermal emission from dust in a galaxy at redshift 2.6.

Magnetic fields are fundamental to the evolution of galaxies, playing a key role in the astrophysics of the interstellar medium and star formation. Large-scale ordered magnetic fields have been mapped in the Milky Way and nearby galaxies1,2, but it is not known how early in the Universe such structures formed3. Here we report the detection of linearly polarized thermal emission from dust grains in a strongly lensed, intrinsically luminous galaxy that is forming stars at a rate more than 1,000 times that of the Milky Way at redshift 2.6, within 2.5 Gyr of the Big Bang4,5. The polarized emission arises from the alignment of dust grains with the local magnetic field6,7. The median polarization fraction is of the order of 1%, similar to nearby spiral galaxies8. Our observations support the presence of a 5-kiloparsec-scale ordered magnetic field with a strength of around 500 µG or lower, oriented parallel to the molecular gas disk. This confirms that such structures can be rapidly formed in galaxies, early in cosmic history.

Very-high-frequency oscillations in the main peak of a magnetar giant flare.

Magnetars are strongly magnetized, isolated neutron stars1-3 with magnetic fields up to around 1015 gauss, luminosities of approximately 1031-1036 ergs per second and rotation periods of about 0.3-12.0 s. Very energetic giant flares from galactic magnetars (peak luminosities of 1044-1047 ergs per second, lasting approximately 0.1 s) have been detected in hard X-rays and soft γ-rays4, and only one has been detected from outside our galaxy5. During such giant flares, quasi-periodic oscillations (QPOs) with low (less than 150 hertz) and high (greater than 500 hertz) frequencies have been observed6-9, but their statistical significance has been questioned10. High-frequency QPOs have been seen only during the tail phase of the flare9. Here we report the observation of two broad QPOs at approximately 2,132 hertz and 4,250 hertz in the main peak of a giant γ-ray flare11 in the direction of the NGC 253 galaxy12-17, disappearing after 3.5 milliseconds. The flare was detected on 15 April 2020 by the Atmosphere-Space Interactions Monitor instrument18,19 aboard the International Space Station, which was the only instrument that recorded the main burst phase (0.8-3.2 milliseconds) in the full energy range (50 × 103 to 40 × 106 electronvolts) without suffering from saturation effects such as deadtime and pile-up. Along with sudden spectral variations, these extremely high-frequency oscillations in the burst peak are a crucial component that will aid our understanding of magnetar giant flares.

A candidate super-Earth planet orbiting near the snow line of Barnard's star.

Barnard's star is a red dwarf, and has the largest proper motion (apparent motion across the sky) of all known stars. At a distance of 1.8 parsecs1, it is the closest single star to the Sun; only the three stars in the α Centauri system are closer. Barnard's star is also among the least magnetically active red dwarfs known2,3 and has an estimated age older than the Solar System. Its properties make it a prime target for planetary searches; various techniques with different sensitivity limits have been used previously, including radial-velocity imaging4-6, astrometry7,8 and direct imaging9, but all ultimately led to negative or null results. Here we combine numerous measurements from high-precision radial-velocity instruments, revealing the presence of a low-amplitude periodic signal with a period of 233 days. Independent photometric and spectroscopic monitoring, as well as an analysis of instrumental systematic effects, suggest that this signal is best explained as arising from a planetary companion. The candidate planet around Barnard's star is a cold super-Earth, with a minimum mass of 3.2 times that of Earth, orbiting near its snow line (the minimum distance from the star at which volatile compounds could condense). The combination of all radial-velocity datasets spanning 20 years of measurements additionally reveals a long-term modulation that could arise from a stellar magnetic-activity cycle or from a more distant planetary object. Because of its proximity to the Sun, the candidate planet has a maximum angular separation of 220 milliarcseconds from Barnard's star, making it an excellent target for direct imaging and astrometric observations in the future.

Age-associated systemic factors change central and peripheral immunity in adult male mice.

Aging coincides with major changes in brain immunity that aid in a decline in neuronal function. Here, we postulate that systemic, pro-aging factors contribute to immunological changes that occur within the brain during aging. To investigate this hypothesis, we comprehensively characterized the central and peripheral immune landscape of 20-month-old male mice using cytometry by time-of-flight (CyTOF) and investigated the role of age-associated circulating factors. We found that CD8+ T cells expressing programmed cell death protein 1 (PD1) and tissue-resident memory CD8+ T cells accumulated in the aged brain while levels of memory T cells rose in the periphery. Injections of plasma derived from 20-month-old mice into 5-month-old receiving mice decreased the frequency of splenic and circulating naïve T cells, increased memory CD8+ T cells, and non-classical, patrolling monocytes in the spleen, and elevated levels of regulatory T cells and non-classical monocytes in the blood. Notably, CD8+ T cells accumulated within white matter areas of plasma-treated mice, which coincided with the expression of vascular cell adhesion molecule 1 (VCAM-1), a mediator of immune cell trafficking, on the brain vasculature. Taken together, we here describe age-related immune cell changes in the mouse brain and circulation and show that age-associated systemic factors induce the expansion of CD8+ T cells in the aged brain.

Cannabis use frequency and pain interference among people with HIV.

Cannabis is often used by people with HIV (PWH) for pain, yet study results are inconsistent regarding whether and how it affects pain. This study examines whether greater cannabis use frequency is associated with lower pain interference and whether cannabis use modifies the association of pain severity and pain interference among 134 PWH with substance dependence or a lifetime history of injection drug use. Multi-variable linear regression models examined the association between past 30-day cannabis use frequency and pain interference. Additional models evaluated whether cannabis use modified the association between pain severity and pain interference. Cannabis use frequency was not significantly associated with pain interference. However, in a model with interaction between cannabis use frequency and pain severity, greater cannabis use frequency attenuated the strength of the association between pain severity and pain interference (p = 0.049). The adjusted mean difference (AMD) in pain interference was +1.13, + 0.81, and +0.05 points for each 1-point increase in pain severity for those with no cannabis use, 15 days of use, and daily use, respectively. These findings suggest that attenuating the impact of pain severity on pain-related functional impairment is a potential mechanism for a beneficial role of cannabis for PWH.

Thoracic Aortic Aneurysm and Dissection: Review and Recommendations for Evaluation.

ABSTRACT: Aortic dissection and rupture (collectively termed "sudden aortic death") are commonly encountered by forensic pathologists, with an estimated incidence at autopsy between 0.6% and 7.7%. Despite this, there is no standard of practice for the evaluation of sudden aortic death at autopsy.Recent studies have shown 20% of patients with thoracic aortic aneurysm or dissection (TAAD) have an identifiable genetic syndrome, and 19% will have an affected first-degree relative. The past 2 decades have seen identification of new culprit genes and syndromes, which can have subtle or nonexistent external phenotypes. A high index of suspicion is warranted to identify possible hereditary TAAD (H-TAAD), allowing family members to obtain screening to avoid catastrophic vascular events. Forensic pathologists need broad knowledge of the spectrum of H-TAAD and awareness of the relative significance of hypertension, pregnancy, substance use, and microscopic changes of aortic architecture.This article reviews the common subtypes of H-TAAD, including Marfan syndrome, vascular Ehlers-Danlos, Loeys-Dietz, and familial thoracic aortic aneurysm and dissection. Recommendations for the evaluation of sudden aortic death at autopsy are presented, including (1) performance of a complete autopsy, (2) documentation of aortic circumference and valve morphology, (3) notifying family of the need for screening, and (4) preservation of a sample for potential genetic testing.

Enhancement of Arthrospira sp. culturing for sulfate removal and mining wastewater bioremediation.

Sulfate content in mining wastewater can reach concentrations over 2,000 mg·L-1, which is considered as a pollutant of concern. In this article, two cyanobacteria species were cultured using highly sulfated wastewater (3,000 mg·L-1) as the culture medium. This investigation aimed to analyze the sulfate bioremediation potential of microalgae while enhancing the uptaking of this pollutant through the design of a novel nutritional medium. The results obtained show the suitability of Arthrospira maxima as a bioremediation organism of sulfated wastewater. The appropriateness of this organism is based on its great growth performance when cultured in this residue, 2.16 times higher than the initial value. Moreover, the initially obtained sulfate reduction, 23.3%, was significantly enhanced to a final removal of 73% (2,247 mg·L-1). In addition, scanning electron microscopy and energy-dispersive X-ray spectroscopy were used to evaluate sulfur crystallization. To the best of our knowledge, there are no previous works focused on microalgal sulfate removal that have reached such an uptaking rate. Accordingly, this study presents the highest performance on sulfate microalgal bioremediation published to date. Our findings suggest that A. maxima can be cultured for sulfated wastewater bioremediation while showing a removal yield that is theoretically sufficient for industrial applications.

To the best of our knowledge, this is the first study focused on the bioremediation potential of Arthrospira genre (Spirulin) for highly sulfated wastewaters depuration. Moreover, according to the available data, our study achieved the highest sulfate removal rate by using microalgae as a bioremediation organism. Thus, we strongly believe that our investigation provides up-to-date data in terms of mining wastewaters bioremediation, which can cause a strong impact on how these residues are managed.

Thyroid-stimulating hormone is associated with trabecular bone score and 5-year incident fracture risk in euthyroid postmenopausal women: the OsteoLaus cohort.

Thyroid-stimulating hormone (TSH) excess or deficiency influences bone density and fracture risk. Nevertheless, does TSH in the reference range influence bone health? In euthyroid postmenopausal women, TSH levels in the reference range were positively associated with trabecular bone score and negatively with incident fractures, without affecting BMD. PURPOSE: Subclinical hyperthyroidism is associated with low bone mineral density (BMD) and increased fracture risk. In healthy postmenopausal women, association between thyroid-stimulating hormone (TSH) in the normal range and BMD is contradictory. Trabecular bone score (TBS), an index of bone micro-architecture, is often decreased in secondary osteoporosis (OP). The aim was to determine the association between thyroid hormones (TSH, fT4) and BMD, TBS, and the incident 5-year OP fractures, in euthyroid post-menopausal women. METHODS: We assessed 1475 women of the CoLaus/OsteoLaus cohort. We evaluated BMD at lumbar spine, femoral neck and total hip, lumbar spine TBS, and vertebral fracture with DXA. Incident major OP fractures were evaluated 5 years later by questionnaire and DXA. Women with anti-osteoporotic, antidiabetic, thyroid-modifying, hormone replacement, or systemic corticoid treatment were excluded. RESULTS: Five hundred thirty-three women (age 68.4 ± 7.3 years, BMI 25.9 ± 4.6 kg/m2, TSH 2.03 ± 0.87 mU/l, fT4 15.51 ± 1.85 pmol/l) met the inclusion criteria. There was no significant association between TSH or fT4 and BMD measures at any site. A positive association was found between TSH and TBS (ß = 0.138, p < 0.01), even after adjusting for age, BMI, and duration of menopause (ß = 0.086, p < 0.05). After a 5-year follow-up, women with incident major OP fractures had lower TSH levels (1.77 ± 0.13 vs. 2.05 ± 0.04 mU/l, p < 0.05) than women without fractures, while no difference was found for fT4. CONCLUSION: In euthyroid postmenopausal women, TSH levels were positively associated with TBS and negatively with incident fractures, without affecting BMD. Further studies are needed to evaluate the influence of thyroid hormones on TBS.

A singular value decomposition entropy approach to assess the impact of Covid-19 on the informational efficiency of the WTI crude oil market.

This work investigates the impact of the Covid-19 outbreak on crude oil market efficiency. The approach is based on the singular value decomposition (SVD) entropy. Iso-distributional surrogate data test was used to contrast the results against random patterns, and phase randomization based on Fourier transform was used to assess nonlinearities. The analysis considered the WTI market and focused on the Covid-19 pandemic period January 2020-November 2021 and contrasted with the long preceding period from January 2000 to date. It was found that the crude oil market was informationally efficient most of the time with small sporadic deviations from efficiency in the pre-Covid-19 years. The Covid-19 period exhibited the largest deviations from efficiency, mainly in the first months of the outbreak, accompanied by a marked reduction of nonlinear components. The analysis was conducted for different scales, and the results showed that the deviations from efficiency were more pronounced for quarterly scales. For the sake of comparison, the analysis was also carried out on the trading volume dynamics and the results showed that the market activity is not fully random. The dynamics of the trading volume exhibited significant deviations from the randomness behavior when the crude oil market was efficient, and a behavior that was consistent with nonlinear patterns. The opposite behavior was noted for stages when the crude oil market showed strong deviations from efficiency. Overall, the findings of this study suggest an increasing opportunity for crude oil price predictions and abnormal returns during the Covid-19 pandemic.

Sex differences in treatment strategy for coronary artery aneurysms: Insights from the international Coronary Artery Aneurysm Registry.

INTRODUCTION: Sex disparities exist in coronary artery disease (CAD) in terms of risk profile, clinical management and outcome. It is unclear if differences are also present in coronary aneurysms, a rare variant of CAD. METHODS: Patients were selected from the international Coronary Artery Aneurysm Registry (CAAR; ClinicalTrials.gov: NCT02563626), and differences between groups were analysed according to sex. The CAAR database is a prospective multicentre registry of 1565 patients with coronary aneurysms (336 females). Kaplan-Meier method was used for event-free survival analysis for death, major adverse cardiac events (MACE: composite endpoint of death, heart failure and acute coronary syndrome) and bleeding. RESULTS: Female patients were older, were more often hypertensive and less frequently smoker. They were treated conservatively more often compared to male patients and received significantly less frequently aspirin (92% vs 88%, p = 0.002) or dual antiplatelet therapy (DAPT) (67% vs 58%, p = 0.001) at discharge. Median DAPT duration was also shorter (3 vs 9 months, p = 0.001). Kaplan-Meier analysis revealed no sex differences in death, MACE or bleeding during a median follow-up duration of 37 months, although male patients did experience acute coronary syndrome (ACS) more often during follow-up (15% vs 10%, p = 0.015). CONCLUSIONS: These CAAR findings showed a comparable high-risk cardiovascular risk profile for both sexes. Female patients were treated conservatively more often and received DAPT less often at discharge, with a shorter DAPT duration. ACS was more prevalent among male patients; however, overall clinical outcome was not different between male and female patients during follow-up.

Reference Protocol to Assess Analytical Performance of Higher Order Structural Analysis Measurements: Results from an Interlaboratory Comparison.

Measurements of protein higher order structure (HOS) provide important information on stability, potency, efficacy, immunogenicity, and biosimilarity of biopharmaceuticals, with a significant number of techniques and methods available to perform these measurements. The comparison of the analytical performance of HOS methods and the standardization of the results is, however, not a trivial task, due to the lack of reference protocols and reference measurement procedures. Here, we developed a protocol to structurally alter and compare samples of somatropin, a recombinant biotherapeutic, and describe the results obtained by using a number of techniques, methods and in different laboratories. This, with the final aim to provide tools and generate a pool of data to compare and benchmark analytical platforms and define method sensitivity to structural changes. Changes in somatropin HOS, induced by the presence of zinc at increasing concentrations, were observed, both globally and at more localized resolution, across many of the methods utilized in this study and with different sensitivities, suggesting the suitability of the protocol to improve understanding of inter- and cross-platform measurement comparability and assess analytical performance as appropriate.

Host traits, lifestyle and environment are associated with human skin bacteria.

BACKGROUND: The human skin offers diverse ecosystems for microbial symbionts. However, the factors shaping skin-microbiome interactions are still insufficiently characterized. This contrasts with the broader knowledge about factors influencing gut microbiota. OBJECTIVES: We aimed to investigate major patterns of association of host traits, lifestyle and environmental factors with skin bacteria in two German populations. METHODS: This is a cross-sectional study with 647 participants from two population-based German cohorts, PopGen (n = 294) and KORA FF4 (n = 353), totalling 1794 skin samples. The V1-V2 regions of the 16S ribosomal RNA (rRNA) gene were sequenced. Associations were tested with two bacterial levels, community (beta diversity) and 16S rRNA gene amplicon sequence variants (ASVs). RESULTS: We validated known associations of the skin microbiota with skin microenvironment, age, body mass index and sex. These factors were associated with beta diversity and abundance of ASVs in PopGen, which was largely replicated in KORA FF4. Most intriguingly, dietary macronutrients and total dietary energy were associated with several ASVs. ASVs were also associated with smoking, alcohol consumption, skin pH, skin type, transepidermal water loss, education and several environmental exposures, including hours spent outdoors. Associated ASVs included members of the genera Propionibacterium, Corynebacterium and Staphylococcus. CONCLUSIONS: We expand the current understanding of factors associated with the skin bacterial community. We show the association of diet with skin bacteria. Finally, we hypothesize that the skin microenvironment and host physiology would shape the skin bacterial community to a greater extent compared with a single skin physiological feature, lifestyle and environmental exposure.

Phylogeographic review of Y chromosome haplogroups in Europe.

The Y chromosome has been widely explored for the study of human migrations. Due to its paternal inheritance, the Y chromosome polymorphisms are helpful tools for understanding the geographical distribution of populations all over the world and for inferring their origin, which is really useful in forensics. The remarkable historical context of Europe, with numerous migrations and invasions, has turned this continent into a melting pot. For this reason, it is interesting to study the Y chromosome variability and how it has contributed to improving our knowledge of the distribution and development of European male genetic pool as it is today. The analysis of Y lineages in Europe shows the predominance of four haplogroups, R1b-M269, I1-M253, I2-M438 and R1a-M420. However, other haplogroups have been identified which, although less frequent, provide significant evidence about the paternal origin of the populations. In addition, the study of the Y chromosome in Europe is a valuable tool for revealing the genetic trace of the different European colonizations, mainly in several American countries, where the European ancestry is mostly detected by the presence of the R1b-M269 haplogroup. Therefore, the objective of this review is to compile the studies of the Y chromosome haplogroups in current European populations, in order to provide an outline of these haplogroups which facilitate their use in forensic studies.

Development of sacral/buttock retiform purpura as an ominous presenting sign of COVID-19 and clinical and histopathologic evolution during severe disease course.

Retiform purpura has been described as a relatively frequent cutaneous finding in patients with coronavirus disease 2019 (COVID-19). The etiology is hypothesized to be related to thrombotic vasculopathy based on lesional biopsy specimen findings, but the pathogenesis of the vasculopathy is not completely understood. Here, we present a case of a retiform purpuric patch on the sacrum/buttocks in a hospitalized patient prior to subsequent diagnosis of COVID-19 and an eventual fatal disease course. Two lesional biopsy specimens at different time points in the disease course revealed thrombotic vasculopathy, despite therapeutic anticoagulation. Detailed histopathologic evaluation using immunohistochemical markers suggest the etiology of the vasculopathy involves both persistent complement activation and platelet aggregation, which possibly promote ongoing thrombus formation. This case highlights that sacral/buttock retiform purpuric patches may be a presenting sign of infection with SARS-CoV-2 virus and may represent an ominous sign supporting a future severe disease course. In addition, biopsy specimen findings at separate time points demonstrate that cutaneous vasculopathy may persist despite adequate systemic anticoagulation, possibly due to the combination of persistent complement and platelet activation. Finally, occlusive thrombi in sacral/buttock retiform purpuric patches may contribute to future ulceration and significant cutaneous morbidity in patients who survive COVID-19.

Sulfadiazine removal using green zero-valent iron nanoparticles: A low-cost and eco-friendly alternative technology for water remediation.

In this work, the effectiveness of green zero-valent iron nanoparticles (gnZVIs) for the removal of the antibiotic sulfadiazine (SDZ) from water via adsorption and reduction was tested. Additionally, the effectiveness of this material as a catalyst for the Fenton and photo-Fenton processes was also investigated. This represents the first study concerning the use of gnZVIs for the degradation of a sulfonamide antibiotic. The results obtained indicate that gnZVIs were able to remove up to 58% of SDZ via adsorption and up to 69% via adsorption plus reduction using a SDZ/Fe3+ molar ratio of 1:61.6. Furthermore, gnZVIs showed strong effectiveness as a catalyst for the Fenton and photo-Fenton reactions, with complete SDZ removal in 8 h and 5 min, respectively, using a SDZ/Fe3+/H2O2 molar ratio of 1:38.4:38.4. These results demonstrate that the use of gnZVIs constitutes an attractive and potential alternative technology for water remediation, reducing environmental impact and operational costs.

Sulfadiazine, sulfamethazine and sulfachloropyridazine removal using three different porous materials: Pine bark, "oak ash" and mussel shell.

This work focuses on studying the efficacy of three different by-products to adsorb three antibiotics (sulfadiazine, SDZ; sulfamethazine, SMT; sulfachloropyridazine, SCP). These antibiotics can be considered pollutants of the environment when they reach water, as well as in cases where they are spread on soils through irrigation or contained in sewage sludge or livestock manure. In this study, batch-type adsorption/desorption experiments were performed for each of the three sulfonamides, adding 7 different concentrations of the antibiotics, going from 1 to 50 µmol L-1, and with contact time of 24 h. The results indicate that pine bark is the most efficient bioadsorbent among those studied, as it adsorbs up to 95% of the antibiotics added, while desorption is always less than 11%. However, for "oak ash" and mussel shell the adsorption is always lower than 45 and 15%, respectively, and desorption is high, reaching up to 49% from "oak ash" and up to 81% from mussel shell. Adsorption data showed good fitting to the Linear and Freundlich models, with R2 values between 0.98 and 1.00 in both cases. Kd and KF adsorption parameters showed similar values for the same sorbent materials but were much higher for pine bark than for the other two bioadsorbents. The Freundlich's n parameter showed values in the range 0.81-1.28. The highest KF values (and therefore the highest adsorption capacities) were obtained for the antibiotic SCP in pine bark. Pine bark showed the highest capacity to adsorb each of the antibiotics, increasing as a function of the concentration added. When the concentration of sulfonamide added was 50 µM, the amounts adsorbed were 780 µmol kg-1 for SDZ, 890 µmol kg-1 for SMT, and 870 µmol kg-1 for SCP. "Oak ash" and mussel shell have low adsorption capacity for all three sulfonamides, showing values always lower than 150 µmol kg-1 (oak ash) and 20 µmol kg-1 (mussel shell) when a concentration of 50 µmol L-1 of antibiotic is added. The results of this study could aid to make an appropriate management of the by-products studied, in order to facilitate their valorization and recycling in the treatment of environmental compartments polluted with sulfonamide antibiotics.

A Clinico-Pathologic Approach to the Differential Diagnosis of Pericardial Tumors.

PURPOSE OF REVIEW: Tumors of the pericardium are rare, but a wide variety of congenital, infectious, inflammatory, and neoplastic processes have been reported. Pericardial tumors can be categorized as non-neoplastic or neoplastic. Neoplastic lesions can be further divided into benign or malignant, with malignancies being either primary or secondary (metastatic). Clinical, radiographic, and pathologic features of the most common entities are discussed. RECENT FINDINGS: Metastatic neoplasms involving the heart and pericardium are far more common than primary pericardial neoplasms. Of primary pericardial malignancies, mesothelioma is the most common; notably, cytology of effusion fluid is relatively insensitive to the diagnosis. The prognosis for most malignancies of the pericardium, primary or secondary, is poor. Increasingly, clinically recognized diseases that involve the pericardium include Erdheim-Chester and IgG4-related disease. This article provides a comprehensive review of the most recent literature to develop a structured framework to the differential diagnosis of pericardial tumors.

Environmental relevance of adsorption of doxycycline, enrofloxacin, and sulfamethoxypyridazine before and after the removal of organic matter from soils.

In this work batch-type experiments were used to study the adsorption of the antibiotics doxycycline (DC), enrofloxacin (ENR), and sulfamethoxypyridazine (SMP) in cultivation soils, before and after the removal of soil organic matter. Organic matter removal by calcination resulted not only in C and N removal, but also in increased soil pH, exchangeable basic cations and surface area values. The results indicate a very different behavior depending on the type of antibiotic, showing the adsorption sequence DC > ENR > SMP. Specifically, DC adsorption was very high in untreated soil samples (with organic matter), and was still high (although decreased) after the removal of soil organic matter. Furthermore, the adsorption behavior of DC was clearly dependent on the pH of the medium. Regarding ENR, it also showed high adsorption, although to a lesser extent than DC. However, when soil organic matter was removed, ENR adsorption significantly decreased in all soil samples. As regards SMP, it was adsorbed to a much lesser extent, and the removal of soil organic matter caused an additional drastic decrease in adsorption, reaching negligible values in some samples. Desorption followed the reverse sequence of adsorption, specifically in the order DC < ENR < SMP. In the case of DC, desorption was negligible, both in samples with and without organic matter, while for ENR and SMP, desorption clearly increased for soil samples where organic matter was removed. These results may be of relevance as regards environmental quality and public health, especially to facilitate a correct use of soils and organic amendments in areas that receive the application of substances containing the investigated antibiotics.

Antiphospholipid Syndrome: A Seronegative Case at Ho Teaching Hospital, Ghana.

Antiphospholipid syndrome is a systemic autoimmune disease characterized by thrombosis and/or pregnancy morbidity in the presence of persistently positive antiphospholipid antibodies. The finding of individuals who present a clinical picture highly suggestive of antiphospholipid syndrome, but who are persistently negative for "criteria" of antiphospholipid antibodies has led physicians to refer to this patient population as having "seronegative" Antiphospholipid syndrome. We present a case of a 35-years old patient with strong clinical suspicion of antiphospholipid syndrome, with a history of recurrent pregnancy loss and one episode of deep vein thrombosis, but serologically negative, who was admitted and successfully managed and discharged.

Le syndrome des antiphospholipides est une maladie autoimmune systémique caractérisée par une thrombose et/ou une morbidité de la grossesse en présence d'anticorps antiphospholipides positifs persistants. La découverte d'individus qui présentent un tableau clinique hautement évocateur du syndrome des antiphospholipides, mais qui sont constamment négatifs pour les « critères ¼ des anticorps antiphospholipides a conduit les médecins à qualifier cette population de patients de syndrome des antiphospholipides « séronégatifs ¼. Nous présentons le cas d'une patiente de 35 ans avec une forte suspicion clinique de syndrome des antiphospholipides, avec des antécédents de fausses couches à répétition et un épisode de thrombose veineuse profonde, mais sérologiquement négative, qui a été admise et prise en charge avec succès et sortie de l'hôpital.

Online audio-visual information on oral cancer for Spanish-speaking laypersons. A cross-sectional study.

BACKGROUND: Lack of knowledge and awareness of oral cancer seem to be the main causes of diagnostic delay. Online resources are often used by patients to obtain health/medical information. However, there are no reports on the quality and usefulness of oral cancer audio-visual resources in Spanish. The aims of this investigation were to disclose the type of information about oral cancer available, and whether it may be useful to shorten the patients' oral cancer appraisal time-interval. MATERIAL AND METHODS: Cross-sectional study undertaken at three video-sharing sites on October, 13th 2019. KEYWORDS: "Cáncer oral"; "cáncer de boca". The first 100 results in each viewing list were retrieved by three reviewers. Demographical data was recorded, and interaction indexes, viewing rates, comprehensiveness, and usefulness were calculated for each video. The presence of non-scientifically supported information was also assessed. A descriptive analysis was undertaken, and relationships between variables were explored using the Spearman correlation test. RESULTS: A total of 127 videos were selected. They were produced mainly by mass-media (46.5%; n=59) and their length ranged from 0.28 to 105.38 minutes (median 4.15 minutes; IQR: 2.34-9.67). The most viewed video (10,599,765 views; visualization rate 726,508.9) scored 0 both in usefulness and comprehensiveness. The most useful video gathered 44,119 views (visualization rate 2.033.13). A highly significant positive correlation (0.643; p<0.001) could be observed between usefulness and comprehensiveness of the videos, together with negative correlations between the visualization rate and usefulness (-0.186; p<0.05), and visualization rate and comprehensiveness (-0.183; p<0.05). CONCLUSIONS: Online audio-visual material about oral cancer in Spanish is incomplete, of limited usefulness, and often includes non-scientifically supported information. Most of these resources are produced by mass media and healthcare professionals, with minor contributions from educational and healthcare institutions. Visualization rates negatively correlated with the usefulness and comprehensiveness of the contents in these digital objects.