Chronic Hyponatremia and Brain Structure and Function Before and After Treatment.

RATIONALE & OBJECTIVE: Hyponatremia is the most common electrolyte disorder and is associated with significant morbidity and mortality. This study investigated neurocognitive impairment, brain volume, and alterations in magnetic resonance imaging (MRI)-based measures of cerebral function in patients before and after treatment for hyponatremia. STUDY DESIGN: Prospective cohort study. SETTING & PARTICIPANTS: Patients with presumed chronic hyponatremia without signs of hypo- or hypervolemia treated in the emergency department of a German tertiary-care hospital. EXPOSURE: Hyponatremia (ie, plasma sodium concentration [Na+]<125mmol/L) before and after treatment leading to [Na+]>130mmol/L. OUTCOMES: Standardized neuropsychological testing (Mini-Mental State Examination, DemTect, Trail Making Test A/B, Beck Depression Inventory, Timed Up and Go) and resting-state MRI were performed before and after treatment of hyponatremia to assess total brain and white and gray matter volumes as well as neuronal activity and its synchronization. ANALYTICAL APPROACH: Changes in outcomes after treatment for hyponatremia assessed using bootstrapped confidence intervals and Cohen d statistic. Associations between parameters were assessed using correlation analyses. RESULTS: During a 3.7-year period, 26 patients were enrolled. Complete data were available for 21 patients. Mean [Na+]s were 118.4mmol/L before treatment and 135.5mmol/L after treatment. Most measures of cognition improved significantly. Comparison of MRI studies showed a decrease in brain tissue volumes, neuronal activity, and synchronization across all gray matter after normalization of [Na+]. Volume effects were particularly prominent in the hippocampus. During hyponatremia, synchronization of neuronal activity was negatively correlated with [Na+] (r=-0.836; 95% CI, -0.979 to-0.446) and cognitive function (Mini-Mental State Examination, r=-0.523; 95% CI, -0.805 to-0.069; DemTect, r=-0.744; 95% CI, -0.951 to-0.385; and Trail Making Test A, r=0.692; 95% CI, 0.255-0.922). LIMITATIONS: Small sample size, insufficient quality of several MRI scans as a result of motion artifact. CONCLUSIONS: Resolution of hyponatremia was associated with improved cognition and reductions in brain volumes and neuronal activity. Impaired cognition during hyponatremia is closely linked to increased neuronal activity rather than to tissue volumes. Furthermore, the hippocampus appears to be particularly susceptible to hyponatremia, exhibiting pronounced changes in tissue volume. PLAIN-LANGUAGE SUMMARY: Hyponatremia is a common clinical problem, and patients often present with neurologic symptoms that are at least partially reversible. This study used neuropsychological testing and magnetic resonance imaging to examine patients during and after correction of hyponatremia. Treatment led to an improvement in patients' cognition as well as a decrease in their brain volumes, spontaneous neuronal activity, and synchronized neuronal activity between remote brain regions. Volume effects were particularly prominent in the hippocampus, an area of the brain that is important for the modulation of memory. During hyponatremia, patients with the lowest sodium concentrations had the highest levels of synchronized neuronal activity and the poorest cognitive test results.

Towards nanotube-based sensors for discrimination of drug molecules.

The proper detection of drug molecules is key for applications that have an impact in several fields, ranging from medical treatments to industrial applications. In case of illegal drugs, their correct and fast detection has important implications that affect different parts of society such as security or public health. Here we present a method based on nanoscale sensors made of carbon nanotubes modified with dopants that can detect three types of drug molecules: mephedrone, methamphetamine and heroin. We show that each molecule produces a distinctive feature in the density of states that can be used to detect it and distinguish it from other types of molecules. In particular, we show that for semiconducting nanotubes the inclusion of molecules reduces the gap around the Fermi energy and produces peaks in the density of states below the Fermi energy at positions that are different for each molecule. These results prove that it is possible to design nanoscale sensors based on carbon nanotubes tailored with dopants, in such a way that they might be able to discriminate between different types of compounds and, especially, drug molecules whose proper recognition has important consequences in different fields.

Data Augmentation Effects on Highly Imbalanced EEG Datasets for Automatic Detection of Photoparoxysmal Responses.

Photosensitivity is a neurological disorder in which a person's brain produces epileptic discharges, known as Photoparoxysmal Responses (PPRs), when it receives certain visual stimuli. The current standardized diagnosis process used in hospitals consists of submitting the subject to the Intermittent Photic Stimulation process and attempting to trigger these phenomena. The brain activity is measured by an Electroencephalogram (EEG), and the clinical specialists manually look for the PPRs that were provoked during the session. Due to the nature of this disorder, long EEG recordings may contain very few PPR segments, meaning that a highly imbalanced dataset is available. To tackle this problem, this research focused on applying Data Augmentation (DA) to create synthetic PPR segments from the real ones, improving the balance of the dataset and, thus, the global performance of the Machine Learning techniques applied for automatic PPR detection. K-Nearest Neighbors and a One-Hidden-Dense-Layer Neural Network were employed to evaluate the performance of this DA stage. The results showed that DA is able to improve the models, making them more robust and more able to generalize. A comparison with the results obtained from a previous experiment also showed a performance improvement of around 20% for the Accuracy and Specificity measurements without Sensitivity suffering any losses. This project is currently being carried out with subjects at Burgos University Hospital, Spain.

Gastrointestinal nematodes and mineral deficiencies in yearling cattle in Santiago del Estero, northern Argentina.

The aims were to study the epidemiology and the effect of gastrointestinal nematodes (GINs) on yearling cattle in a semiarid region in Argentina and to evaluate the mineral serum levels. Ten- to twelve-month-old calves were monitored between November and April 2019. Animals were divided into three groups: untreated control (CONG; n = 20); group treated with moxidectin (MXD, 200 µg/kg) every 30-40 days (MXDG; n = 20); group equally MXD treated and mineral supplementation administered in November and January (MMG; n = 20). Individual GIN egg counts (epg) and fecal cultures were made every 30-40 days. Animal live weight gain was determined. On 7-11-18, 25-1-19, and 3-4-19, serum levels of Se, Cu, Zn, Mg, and Ca were determined by atom absorption spectrophotometry. At the start of the trial, epg values were low (x̄ = 5.5), which increased only in CONG towards the end of the assay (x̄ = 229). In both GMXD and MMG, epg remained very low (x̄ = 4.1). Cooperia spp. (81%) prevailed over Haemonchus spp. (9%) and Oesophagostomum spp. (9%). Deficiency of Se ranged between marginal and important, except for MMG, although mean values were always below normal. Cu was marginally deficient in CONG and MXDG on the first two sampling dates, whereas MMG had normal values after treatment. Mg had low values in the three groups (x̄ = 1.5 mg/dl), whereas Ca and Zn exhibited normal values. Live weight gain (LWG) was higher in MMG than in MXDG, with significant differences (p < 0.05) by mid-January and then, when epg increased, dewormed groups showed higher LWG (p < 0.034) than CONG. A negative effect of GINs on LWG was observed, as well as low to marginal levels of Se, Cu, and Mg.

The impact of prehospital tranexamic acid on mortality and transfusion requirements: match-pair analysis from the nationwide German TraumaRegister DGU®.

BACKGROUND: Outcome data about the use of tranexamic acid (TXA) in civilian patients in mature trauma systems are scarce. The aim of this study was to determine how severely injured patients are affected by the widespread prehospital use of TXA in Germany. METHODS: The international TraumaRegister DGU® was retrospectively analyzed for severely injured patients with risk of bleeding (2015 until 2019) treated with at least one dose of TXA in the prehospital phase (TXA group). These were matched with patients who had not received prehospital TXA (control group), applying propensity score-based matching. Adult patients (≥ 16) admitted to a trauma center in Germany with an Injury Severity Score (ISS) ≥ 9 points were included. RESULTS: The matching yielded two comparable cohorts (n = 2275 in each group), and the mean ISS was 32.4 ± 14.7 in TXA group vs. 32.0 ± 14.5 in control group (p = 0.378). Around a third in both groups received one dose of TXA after hospital admission. TXA patients were significantly more transfused (p = 0.022), but needed significantly less packed red blood cells (p ≤ 0.001) and fresh frozen plasma (p = 0.023), when transfused. Massive transfusion rate was significantly lower in the TXA group (5.5% versus 7.2%, p = 0.015). Mortality was similar except for early mortality after 6 h (p = 0.004) and 12 h (p = 0.045). Among non-survivors hemorrhage as leading cause of death was less in the TXA group (3.0% vs. 4.3%, p = 0.021). Thromboembolic events were not significantly different between both groups (TXA 6.1%, control 4.9%, p = 0.080). CONCLUSION: This is the largest civilian study in which the effect of prehospital TXA use in a mature trauma system has been examined. TXA use in severely injured patients was associated with a significantly lower risk of massive transfusion and lower mortality in the early in-hospital treatment period. Due to repetitive administration, a dose-dependent effect of TXA must be discussed.

[Seroprevalence and risk factors associated with Neospora caninum in dairy farms from the Province of Salta, Argentina]. / Prevalencia sérica de Neospora caninum y factores de riesgo asociados a su transmisión en tambos de la provincia de Salta, Argentina.

The objective of this work was to determine the seroprevalence of Neospora caninum in cattle in Valle de Lerma, province of Salta, Argentina, and the risk factors associated with the disease. Serum samples were taken from 40 cows in each dairy herd, which were analyzed by indirect ELISA to detect antibodies against N. caninum. Chronic and acute infections were discriminated by measuring the avidity of these antibodies. All the herds exhibited at least one seropositive animal, the mean being 35.3 ± 14.9% of positive animals. Specific antibodies were also detected in dogs present in 9of the herds, which showed a seropositivity value of 71.7% ± 19.9%. Among the seropositive animals, 56.3% showed acute infections. A negative association was found between seroprevalence and the avidity index of specific antibodies, indicating that the presence of animals with acute infections is associated with higher seroprevalence. Fields with grazing showed more recent infections. These results show for the first time the importance of this parasite in this particular region and the need to promote the development of control programs considering the different risk factors that affect the epidemiological situation of the disease.

The CECAM electronic structure library and the modular software development paradigm.

First-principles electronic structure calculations are now accessible to a very large community of users across many disciplines, thanks to many successful software packages, some of which are described in this special issue. The traditional coding paradigm for such packages is monolithic, i.e., regardless of how modular its internal structure may be, the code is built independently from others, essentially from the compiler up, possibly with the exception of linear-algebra and message-passing libraries. This model has endured and been quite successful for decades. The successful evolution of the electronic structure methodology itself, however, has resulted in an increasing complexity and an ever longer list of features expected within all software packages, which implies a growing amount of replication between different packages, not only in the initial coding but, more importantly, every time a code needs to be re-engineered to adapt to the evolution of computer hardware architecture. The Electronic Structure Library (ESL) was initiated by CECAM (the European Centre for Atomic and Molecular Calculations) to catalyze a paradigm shift away from the monolithic model and promote modularization, with the ambition to extract common tasks from electronic structure codes and redesign them as open-source libraries available to everybody. Such libraries include "heavy-duty" ones that have the potential for a high degree of parallelization and adaptation to novel hardware within them, thereby separating the sophisticated computer science aspects of performance optimization and re-engineering from the computational science done by, e.g., physicists and chemists when implementing new ideas. We envisage that this modular paradigm will improve overall coding efficiency and enable specialists (whether they be computer scientists or computational scientists) to use their skills more effectively and will lead to a more dynamic evolution of software in the community as well as lower barriers to entry for new developers. The model comes with new challenges, though. The building and compilation of a code based on many interdependent libraries (and their versions) is a much more complex task than that of a code delivered in a single self-contained package. Here, we describe the state of the ESL, the different libraries it now contains, the short- and mid-term plans for further libraries, and the way the new challenges are faced. The ESL is a community initiative into which several pre-existing codes and their developers have contributed with their software and efforts, from which several codes are already benefiting, and which remains open to the community.

Rapid response infrastructure for pandemic preparedness in a tertiary care hospital: lessons learned from the COVID-19 outbreak in Cologne, Germany, February to March 2020.

The coronavirus disease (COVID-19) pandemic has caused tremendous pressure on hospital infrastructures such as emergency rooms (ER) and outpatient departments. To avoid malfunctioning of critical services because of large numbers of potentially infected patients seeking consultation, we established a COVID-19 rapid response infrastructure (CRRI), which instantly restored ER functionality. The CRRI was also used for testing of hospital personnel, provided epidemiological data and was a highly effective response to increasing numbers of suspected COVID-19 cases.

Effect of gastrointestinal nematodes on serum copper and phosphorus of growing beef calves in northwestern Argentina.

The aim of this work was to study the effect of gastrointestinal nematodes (GINs) on copper (Cu) and phosphorus (P) in blood of beef cattle in two ranches (R1 and R2) located in northwestern Argentina. In 2015-2016 (R1) and 2016-2017 (R2), in each ranch, 22 weaned female calves were divided into two groups: calves treated systematically with 200 mcg/kg moxidectin every 45-50 days (TG) and untreated calves (UTG). The following parameters were measured: number of fecal eggs (epg), fecal cultures, serum Cu and P levels, and live weight gain (LWG). Differences between groups were compared using analysis of variance and Tukey test. GIN infections in both ranches were subclinical and moderate, showing the highest epg (R1 = 907 ± 754; R2 = 1049 ± 1040) by mid-winter. Epg values of TG groups were always negligible (> 93% of moxidectin efficacy). The dominant nematode genera were Cooperia and Haemonchus. The average serum Cu values (µg/dl) indicated low (R1 = 49.7 ± 18) and severe (R2 = 27.2 ± 14) deficiency. The effect of treatments was evident in both ranches from late winter, with TG showing significantly (p < 0.01) higher serum levels in winter, spring, and early autumn (R1 = 65.1, 50.9, and 60.3; R2 = 48.0, 25.7, and 22.4) than UTG (R1 = 44.3, 33.9, and 32.9; R2 = 25.5, 18.2, and 16.4). There were no differences in serum P levels between groups. LWG of TG increased significantly (p < 0.008) (27.2% in R1 and 38.6% in R2), with respect to those of UTG. This study showed a negative effect of GIN on serum Cu values in moderately infected growing calves.

Multifunctional nanostructured Co-doped ZnO: Co spatial distribution and correlated magnetic properties.

In this report we present a systematic structural and magnetic analysis of Co-doped ZnO nanoparticles prepared via a microwave-assisted hydrothermal route. The structural data confirm the incorporation of Co ions into the wurtzite ZnO lattice and a Co concentration mainly near/at the surface of the nanoparticles. This Co spatial distribution is set to passivate the surface of the ZnO nanoparticles, inhibiting the nanoparticle growth and suppressing the observation of a ferromagnetic phase. Based on experimental and theoretical results we propose a kinetic-thermodynamic model for the processes of nucleation and growth of the Co-doped ZnO nanoparticles, and attribute the observed ferromagnetic order to a ferromagnetism associated with specific defects and adsorbed elements at the surface of the nanoparticle. Our findings give valuable contribution to the understanding of both the doping process at the nanoscale and the nature of the magnetic properties of the Co-doped ZnO system.

Managing Malnourishment in Pregnancy after Bariatric Surgery.

BACKGROUND: Little information exists to guide monitoring and treatment of malnourishment during pregnancy after bariatric surgery. Here we present a case with severe deficiencies and recommendations for testing and treatment. CASE: Our patient underwent a duodenal switch procedure resulting in significant weight loss and numerous deficiencies. She then experienced a neonatal demise with multiple congenital abnormalities, including diaphragmatic hernia, possibly related to severe vitamin A deficiency. After high doses of oral and parenteral replacement, pancreatic enzymes, and total parenteral nutrition, she delivered an anatomically normal but growth-restricted neonate in a subsequent pregnancy. CONCLUSION: Bariatric procedures may result in nutritional deficiencies that affect pregnancy outcome. Women with severe deficiencies require pre-pregnancy counselling, monitoring, aggressive treatment, and a multidisciplinary approach to care.

Synthesis and Single-Molecule Conductance Study of Redox-Active Ruthenium Complexes with Pyridyl and Dihydrobenzo[b]thiophene Anchoring Groups.

The ancillary ligands 4'-(4-pyridyl)-2,2':6',2''-terpyridine and 4'-(2,3-dihydrobenzo[b]thiophene)-2,2'-6',2"-terpyridine were used to synthesize two series of mono- and dinuclear ruthenium complexes differing in their lengths and anchoring groups. The electrochemical and single-molecular conductance properties of these two series of ruthenium complexes were studied experimentally by means of cyclic voltammetry and the scanning tunneling microscopy-break junction technique (STM-BJ) and theoretically by means of density functional theory (DFT). Cyclic voltammetry data showed clear redox peaks corresponding to both the metal- and ligand-related redox reactions. Single-molecular conductance demonstrated an exponential decay of the molecular conductance with the increase in molecular length for both the series of ruthenium complexes, with decay constants of ßPY =2.07±0.1 nm(-1) and ßBT =2.16±0.1 nm(-1) , respectively. The contact resistance of complexes with 2,3-dihydrobenzo[b]thiophene (BT) anchoring groups is found to be smaller than the contact resistance of ruthenium complexes with pyridine (PY) anchors. DFT calculations support the experimental results and provided additional information on the electronic structure and charge transport properties in those metal|ruthenium complex|metal junctions.

[Rice fortification to correct micronutrient deficiency in children 6-59 months old]. / Fortificación del arroz para corregir la deficiencia de micronutrientes en niños de 6 a 59 meses de edad.

OBJECTIVE: To carry out a systematic review of the literature on the effectiveness of fortified rice consumption in terms of increasing levels of iron and other micro-nutrients in children aged 6-59 months, with a view to evaluating its usefulness as a public health intervention. METHODS: A search was conducted in MEDLINE, Embase, Cochrane Library, and LILACS databases. The review included randomized clinical trials (RCTs) that assessed the consumption of fortified rice, compared with a placebo or other forms of intervention, in terms of enhanced levels of iron and other micronutrients. The CONSORT® checklist was used to assess methodological quality. The risk of bias in the studies was assessed using the Cochrane® Collaboration methodology. RESULTS: Seven RCTs were included in the review. All the studies showed significant improvements in indicators of nutritional iron status in the intervention groups, without reporting adverse effects. There was no evidence of improvement in vitamin A levels or in anthropometric indicators of weight and height as a secondary result of the intervention. The included studies showed moderate methodological quality. CONCLUSIONS: Rice fortification was an effective intervention strategy to correct iron deficiency in children under age 5. For implementation as a public health measure, local studies are needed to assess its effectiveness in long-term and large-scale interventions.

A hybrid PCA-CART-MARS-based prognostic approach of the remaining useful life for aircraft engines.

Prognostics is an engineering discipline that predicts the future health of a system. In this research work, a data-driven approach for prognostics is proposed. Indeed, the present paper describes a data-driven hybrid model for the successful prediction of the remaining useful life of aircraft engines. The approach combines the multivariate adaptive regression splines (MARS) technique with the principal component analysis (PCA), dendrograms and classification and regression trees (CARTs). Elements extracted from sensor signals are used to train this hybrid model, representing different levels of health for aircraft engines. In this way, this hybrid algorithm is used to predict the trends of these elements. Based on this fitting, one can determine the future health state of a system and estimate its remaining useful life (RUL) with accuracy. To evaluate the proposed approach, a test was carried out using aircraft engine signals collected from physical sensors (temperature, pressure, speed, fuel flow, etc.). Simulation results show that the PCA-CART-MARS-based approach can forecast faults long before they occur and can predict the RUL. The proposed hybrid model presents as its main advantage the fact that it does not require information about the previous operation states of the input variables of the engine. The performance of this model was compared with those obtained by other benchmark models (multivariate linear regression and artificial neural networks) also applied in recent years for the modeling of remaining useful life. Therefore, the PCA-CART-MARS-based approach is very promising in the field of prognostics of the RUL for aircraft engines.

Redox control of thermopower and figure of merit in phase-coherent molecular wires.

We demonstrate how redox control of intra-molecular quantum interference in phase-coherent molecular wires can be used to enhance the thermopower (Seebeck coefficient) S and thermoelectric figure of merit ZT of single molecules attached to nanogap electrodes. Using first principles theory, we study the thermoelectric properties of a family of nine molecules, which consist of dithiol-terminated oligo (phenylene-ethynylenes) (OPEs) containing various central units. Uniquely, one molecule of this family possesses a conjugated acene-based central backbone attached via triple bonds to terminal sulfur atoms bound to gold electrodes and incorporates a fully conjugated hydroquinonecentral unit. We demonstrate that both S and the electronic contribution Z el T to the figure of merit ZT can be dramatically enhanced by oxidizing the hydroquinone to yield a second molecule, which possesses a cross-conjugated anthraquinone central unit. This enhancement originates from the conversion of the pi-conjugation in the former to cross-conjugation in the latter, which promotes the appearance of a sharp anti-resonance at the Fermi energy. Comparison with thermoelectric properties of the remaining seven conjugated molecules demonstrates that such large values of S and Z el T are unprecedented. We also evaluate the phonon contribution to the thermal conductance, which allows us to compute the full figure of merit ZT = Z el T/(1 + κ p/κ el), where κ p is the phonon contribution to the thermal conductance and κ el is the electronic contribution. For unstructured gold electrodes, κ p/κ el â‰«âƒ’ 1 and therefore strategies to reduce κ p are needed to realize the highest possible figure of merit.

A wireless portable high temperature data monitor for tunnel ovens.

Tunnel ovens are widely used in the food industry to produce biscuits and pastries. In order to obtain a high quality product, it is very important to control the heat transferred to each piece of dough during baking. This paper proposes an innovative, non-distorting, low cost wireless temperature measurement system, called "eBiscuit", which, due to its size, format and location in the metal rack conveyor belt in the oven, is able to measure the temperature a real biscuit experience while baking. The temperature conditions inside the oven are over 200 °C for several minutes, which could damage the "eBiscuit" electronics. This paper compares several thermal insulating materials that can be used in order to avoid exceeding the maximum operational conditions (80 °C) in the interior of the "eBiscuit. The data registered is then transmitted to a base station where information can be processed to obtain an oven model. The experimental results with real tunnel ovens confirm its good performance, which allows detecting production anomalies early on.

[SOP Leading symptom: flank pain]. / SOP Leitsymptom Flankenschmerzen.

In addition to triggers such as ureteral stones or pyelonephritis, the common symptom of flank pain can be associated with a whole range of conditions. This SOP is intended to give doctors in the emergency department an overview of the possible causes. Based on medical history, clincal examination including sonography and laboratory diagnostics, important differential diagnoses are addressed and an imaging algorithm is presented.

Selective Sensing of DNA Nucleobases with Angular Discrimination.

The fast and precise selective sensing of DNA nucleobases is a long-pursued method that can lead to huge advances in the field of genomics and have an impact on aspects such as the prevention of diseases, health enhancement, and, in general, all types of medical treatments. We present here a new type of nanoscale sensor based on carbon nanotubes with a specific geometry that can discriminate the type of nucleobase and also its angle of orientation. The proper differentiation of nucleobases is essential to clearly sequence DNA chains, while angular discrimination is key to improving the sensing selectivity. We perform first-principle and quantum transport simulations to calculate the transmission, conductance, and current of the nanotube-based nanoscale sensor in the presence of the four nucleotides (A, C, G, and T), each of them rotated 0, 90, 180, or 270°. Our results show that this system is able to effectively discriminate between the four nucleotides and their angle of orientation. We explain these findings in terms of the interaction between the phosphate group of the nucleotide and the nanotube wall. The phosphate specifically distorts the electronic structure of the nanotube depending on the distance and the orientation and leads to nontrivial changes in the transmission. This work provides a method for finer and more precise sequential DNA chains.