[Cryptococcal meningitis associated with hydrocephalus in an immunocompetent patient].

Cryptococcal meningitis is an infrequent infection with high morbidity and mortality. Its presentation in immunocompetent patients is rare. We present the case of a 67-year-old male who was admitted for subacute symptoms of gait disturbance and urinary incontinence. Neurological examination revealed inability to stand and memory impairment. Cranial imaging showed obstructive tetraventricular hydrocephalus with areas of gliosis in the cerebellar peduncles. Endoscopic treatment of hydrocephalus was performed and cerebrospinal fluid samples taken revealing the growth of Cryptococcus neoformans. The patient improved with the endoscopic treatment and after completing intravenous antifungal therapy with liposomal amphotericin B and fluconazole for ten weeks. Antifungals are used to treat cryptococcal meningitis in immunocompetent patients. On rare occasions, it presents with hydrocephalus, a situation that requires surgical treatment using cerebrospinal fluid diversions or endoscopic techniques.

Usefulness of extended inflammatory parameters related to neutrophil activation reported by Sysmex XN-1000 hematology analyzer for predicting complicated acute appendicitis. Comparison with canonical inflammatory laboratory tests.

AIM: Accurate diagnosis of complicated appendicitis is of importance to ensure that patients receive early and effective treatment, minimizing the risk of postoperative complications to promote successful recovery. Biochemical markers are a promising tool to identify complicated appendicitis. We aimed to evaluate the potential role of novel parameters related with neutrophil activation, known as "Extended Inflammation Parameters" (EIP), included in blood cell count reported by Sysmex XN-Series analyzers, compared to other canonical biomarkers in identifying complicated appendicitis. METHOD: Prospective observational study including patients with confirmed diagnosis of acute appendicitis. C-reactive protein (CRP), procalcitonin, cell blood count, including white blood cell (WBC), absolute neutrophil (ANC) and immature granulocyte (IG) count and EIP (neutrophil reactivity [NEUT-RI] and granularity intensity [NEUT-GI]) were analyzed before surgery. Their accuracy to diagnose complicated appendicitis was tested in an ROC curve analysis. RESULTS: Our population study included 119 patients, and appendicitis was complicated in 58 (48.7%). NLR, CRP and procalcitonin levels, ANC and IG count and NEUT-RI and NEUT-GI were higher in patients with complicated appendicitis. Regarding accuracy for complicated appendicitis, CRP was the biomarker with the highest performance (ROC AUC: 0.829), with an optimal cutoff of 73.1 mg/L (sensitivity: 63.8%, specificity: 88.5%). NEUT-RI and NEUT-GI achieved both significant but poor accuracy, with ROC AUC of 0.606 and 0.637, respectively. CONCLUSIONS: Novel laboratory tests reported by Sysmex XN-Series analyzers have poor accuracy for identifying complicated appendicitis. In this study, CRP was the biomarker with the highest performance and may be useful as predictor of the severity of acute appendicitis.

Reliability of a point of care testing blood gas analyzer for measurement of lactate levels in cerebrospinal fluid.

Analysis of cerebrospinal fluid (CSF), including lactate, is key for diagnosis of acute meningitis. Since blood gas analyzers (BGA) enable rapid and safe blood-lactate measurements, we evaluated the reliability of RAPIDPoint 500 BGA to provide a fast and accurate measure of CSF lactate. In this study, CSF lactate levels were measured by a reference assay and on RAPIDPoint 500 BGA. Comparability was evaluated through difference analysis, using Bland Altman test, and linear regression analysis, using the Passing Bablok test. Agreement rate according to CSF lactate (≥3.5 and <3.5 mmol/L) was calculated using kappa (κ) statistic. Population study included 98 CSF samples. Concerning difference analysis, according to Bland-Altman test, bias was 0.13 mmol/L (CI 95%: -0.26 to 0.52 mmol/L. In regression analysis, according to Passing-Bablok equation a systematic difference between both assays was found. In concordance analysis, the interrate realibility was very high (κ: 0.964). According to our resuls, although a systematic difference was detected when lactate levels were measured on RAPIDPoint 500 BGA, the results from Bland-Altman test and the high agreement rate support that this POCT analyzer could be useful for a early and safe detection of patients with high probability of increased CSF lactate level.

Meningitis criptocócica asociada a hidrocefalia en un paciente inmunocompetente / Cryptococcal meningitis associated with hydrocephalus in an immunocompetent patient

La meningitis criptocócica es una infección infrecuente y con alta morbimortalidad, cuya presentación en pacientes inmunocompetentes es excepcional. Presentamos el caso de un varón de 67 años que ingresó por un cuadro subagudo de alteración de la marcha e incontinencia urinaria. El examen neurológico reveló incapacidad para mantenerse en pie y deterioro de la memoria. Las pruebas de imagen craneales mostraron hidrocefalia tetraventricular obstructiva con áreas de gliosis en los pedúnculos cerebelosos. Se realizó tratamiento endoscópico de la hidrocefalia, con toma de muestras de líquido cefalorraquídeo en las que se observó crecimiento de Cryptococcus neoformans. El paciente mejoró con el tratamiento endoscópico y tras completar la terapia antifúngica intravenosa con anfotericina B liposomal y fluconazol durante diez semanas. La meningitis criptocócica en pacientes inmunocompetentes se trata con antifúngicos. En raras ocasiones se presenta con hidrocefalia, situación que requiere tratamiento quirúrgico mediante derivaciones del líquido cefalorraquídeo o técnicas endoscópicas. (AU)

Cryptococcal meningitis is an infrequent infection with high morbidity and mortality. Its presentation in immuno-competent patients is rare.We present the case of a 67-year-old male who was admitted for subacute symptoms of gait disturbance and urinary incontinence. Neurological examination revealed inability to stand and memory impairment. Cranial im-aging showed obstructive tetraventricular hydrocephalus with areas of gliosis in the cerebellar peduncles. Endo-scopic treatment of hydrocephalus was performed and cerebrospinal fluid samples taken revealing the growth of Cryptococcus neoformans. The patient improved with the endoscopic treatment and after completing intravenous antifungal therapy with liposomal amphotericin B and flu-conazole for ten weeks.Antifungals are used to treat cryptococcal meningitis in immunocompetent patients. On rare occasions, it presents with hydrocephalus, a situation that requires surgical treat-ment using cerebrospinal fluid diversions or endoscopic techniques. (AU)

Structure, Spin Correlations, and Magnetism of the S = 1/2 Square-Lattice Antiferromagnet Sr2CuTe1-xWxO6 (0 ≤ x ≤ 1).

Quantum spin liquids are highly entangled magnetic states with exotic properties. The S = 1/2 square-lattice Heisenberg model is one of the foundational models in frustrated magnetism with a predicted, but never observed, quantum spin liquid state. Isostructural double perovskites Sr2CuTeO6 and Sr2CuWO6 are physical realizations of this model but have distinctly different types of magnetic order and interactions due to a d10/d0 effect. Long-range magnetic order is suppressed in the solid solution Sr2CuTe1-xWxO6 in a wide region of x = 0.05-0.6, where the ground state has been proposed to be a disorder-induced spin liquid. Here, we present a comprehensive neutron scattering study of this system. We show using polarized neutron scattering that the spin liquid-like x = 0.2 and x = 0.5 samples have distinctly different local spin correlations, which suggests that they have different ground states. Low-temperature neutron diffraction measurements of the magnetically ordered W-rich samples reveal magnetic phase separation, which suggests that the previously ignored interlayer coupling between the square planes plays a role in the suppression of magnetic order at x ≈ 0.6. These results highlight the complex magnetism of Sr2CuTe1-xWxO6 and hint at a new quantum critical point between 0.2 < x < 0.4.

On the Origin of the Non-Arrhenius Na-ion Conductivity in Na3 OBr.

The sodium-rich antiperovskites (NaRAPs) with composition Na3 OB (B=Br, Cl, I, BH4 , etc.) are a family of materials that has recently attracted great interest for application as solid electrolytes in sodium metal batteries. Non-Arrhenius ionic conductivities have been reported for these materials, the origin of which is poorly understood. In this work, we combined temperature-resolved bulk and local characterisation methods to gain an insight into the origin of this unusual behaviour using Na3 OBr as a model system. We first excluded crystallographic disorder on the anion sites as the cause of the change in activation energy; then identified the presence of a poorly crystalline impurities, not detectable by XRD, and elucidated their effect on ionic conductivity. These findings improve understanding of the processing-structure-properties relationships pertaining to NaRAPs and highlight the need to determine these relationships in other materials systems, which will accelerate the development of high-performance solid electrolytes.

Noncovalent bonding assessment by pair distribution function.

Noncovalent interactions are essential in the formation and properties of a diverse range of materials. However, reliably identifying noncovalent interactions remains challenging using conventional methods such as X-ray diffraction, especially in nanocrystalline, poorly crystalline or amorphous materials which lack long-range lattice periodicity. Here, we demonstrate the accurate determination of deviations in the local structure and tilting of aromatic rings during the temperature-induced first order structural transition in the 1 : 1 adduct of 4,4'-bipyridinium squarate (BIPY:SQA) from the low temperature form HAZFAP01 to high temperature HAZFAP07 by X-ray pair distribution function. This work demonstrates how pair distribution function analyses can improve our understanding of local structural deviations resulting from noncovalent bonds and guide the development of novel functional materials.

Multiple Local Symmetries Result in a Common Average Polar Axis in High-Strain BiFeO_{3}-Based Ceramics.

For the first time, the origin of large electrostrain in pseudocubic BiFeO_{3}-based ceramics is verified with direct structural evidence backed by appropriate simulations. We employ advanced structural and microstructural characterizations of BiFeO_{3}-based ceramics that exhibit large electrostrain (>0.4%) to reveal the existence of multiple, nanoscale local symmetries, dominantly tetragonal or orthorhombic, which have a common, averaged direction of polarization over larger, meso- or microscale regions. Phase-field simulations confirm the existence of local nanoscale symmetries, thereby providing a new vision for designing high-performance lead-free ceramics for high-strain actuators.

Fabrication of Super-Sized Metal Inorganic-Organic Hybrid Glass with Supramolecular Network via Crystallization-Suppressing Approach.

Metal coordination compound (MCC) glasses [e.g., metal-organic framework (MOF) glass, coordination polymer glass, and metal inorganic-organic complex (MIOC) glass] are emerging members of the hybrid glass family. So far, a limited number of crystalline MCCs can be converted into glasses by melt-quenching. Here, we report a universal wet-chemistry method, by which the super-sized supramolecular MIOC glasses can be synthesized from non-meltable MOFs. Alcohol and acid were used as agents to inhibit crystallization. The MIOC glasses demonstrate unique features including high transparency, shaping capability, and anisotropic network. Directional photoluminescence with a large polarization ratio (≈47 %) was observed from samples doped with organic dyes. This crystallization-suppressing approach enables fabrication of super-sized MCC glasses, which cannot be achieved by conventional vitrification methods, and thus allows for exploring new MCC glasses possessing photonic functionalities.

On the Origin of the Non-Arrhenius Na-ion Conductivity in Na3OBr.

The sodium-rich antiperovskites (NaRAPs) with composition Na3OB (B=Br, Cl, I, BH4, etc.) are a family of materials that has recently attracted great interest for application as solid electrolytes in sodium metal batteries. Non-Arrhenius ionic conductivities have been reported for these materials, the origin of which is poorly understood. In this work, we combined temperature-resolved bulk and local characterisation methods to gain an insight into the origin of this unusual behaviour using Na3OBr as a model system. We first excluded crystallographic disorder on the anion sites as the cause of the change in activation energy; then identified the presence of a poorly crystalline impurities, not detectable by XRD, and elucidated their effect on ionic conductivity. These findings improve understanding of the processing-structure-properties relationships pertaining to NaRAPs and highlight the need to determine these relationships in other materials systems, which will accelerate the development of high-performance solid electrolytes.

Pair distribution function analysis of the reassembly step of the assembly-disassembly-organisation-reassembly (ADOR) process.

An in situ pair distribution function study assessing the reassembly of three IM-12 (UTL) intermediate materials to the corresponding fully connected materials. A greater level of atomic change is observed at higher temperatures for the reassembly of the fully disconnected intermediate, IPC-1P, compared to the two partially connected intermediates of IPC-2P and IPC-6P.

Glassy behaviour of mechanically amorphised ZIF-62 isomorphs.

Zeolitic imidazolate frameworks (ZIFs) can be melt-quenched to form glasses. Here, we present an alternative route to glassy ZIFs via mechanically induced amorphisation. This approach allows various glassy ZIFs to be produced in under 30 minutes at room temperature, without the need for melt-quenching.

Aneurisma de arteria braquial inducido por el uso de muleta / Crutch-induced brachial artery aneurysm

Introducción: el uso de muletas de forma prolongada como desencadenante de aneurisma de arteria braquial es raro pero potencialmente vital. Caso clínico: presentamos a una paciente de 84 años, con historia de poliomielitis y uso prolongado de muleta en brazo derecho. Se diagnostica de isquemia crítica secundaria a oclusión de aneurisma de arteria braquial y lesiones por embolización distal. A pesar de realizarse injerto venoso, la paciente presenta mala evolución con amputación de antebrazo. Discusión: es de vital importancia el reconocimiento y tratamiento de esta patología.(AU)

Introduction: the prolonged use of crutches resulting in a brachial aneurysm is rare but potentially vital. Case report: we present an 84-year-old patient with a history of poliomyelitis and prolonged use of a crutch in her right arm. She was diagnosed with critical ischemia secondary to occlusion of brachial artery aneurysm and distal embolization lesions. Despite having performed a venous graft, the patient presented a poor evolution which resulted in a forearm amputation. Discussion: it's of vital importance to recognize and treat this pathology.(AU)

Testing the Factorial Validity of the Classroom Engagement Inventory with Spanish Students.

INTRODUCTION: The purpose of the study was to test the factorial validity of Classroom Engagement Inventory of Wang, Bergin and Bergin with Spanish high school students. METHODS: In this study, 546 students participated (mean = 13.27, standard deviation = 0.629), from several high schools in Andalusia. To analyze the psychometric properties of the scale, several analyses were carried out. RESULTS: The results offered support for the five-factor structure. The analysis of invariance with respect to gender showed that the factor structure of the questionnaire was invariant. The Cronbach alpha values were higher than 0.70 in the subscales. DISCUSSION: The results of this study demonstrated the reliability and validity of the Spanish version of the Classroom Engagement Inventory with high school students.

Transparent and luminescent glasses of gold thiolate coordination polymers.

Obtaining transparent glasses made of functional coordination polymers (CPs) represents a tremendous opportunity for optical applications. In this context, the first transparent and red-emissive glasses of gold thiolate CPs have been obtained by simply applying mechanical pressure to amorphous powders of CPs. The three gold-based CP glasses are composed of either thiophenolate [Au(SPh)] n , phenylmethanethiolate [Au(SMePh)] n or phenylethanethiolate [Au(SEtPh)] n . The presence of a longer alkyl chain between the thiolate and the phenyl ring led to the formation of glass with higher transparency. The glass transitions, measured by thermomechanical analysis (TMA), occurred at lower temperature for CPs with longer alkyl chains. In addition, all three gold thiolate glasses exhibit red emission at 93 K and one of them, [Au(SMePh)] n , remains luminescent even at room temperature. An in-depth structural study of the amorphous gold thiolates by XRD, PDF and EXAFS analysis showed that they are formed of disordered doubly interpenetrated helical chains. These d10 metal-based compounds represent the first examples of transparent and luminescent CP glasses.