Prediction of Flux and Rejection Coefficients in the Removal of Emerging Pollutants Using a Nanofiltration Membrane.

The removal of three emerging pollutants: carbamazepine, ketoprofen, and bisphenol A, has been studied using the nanofiltration flat sheet membrane NF99HF. The removal efficiencies of the membrane have been evaluated by two system characteristic parameters: permeate flux and rejection coefficient. The influence of two operating variables has been analysed: operating pressure and feed concentration. Before and after the tests with emerging pollutants, the membrane has been characterized by determining its water permeability coefficient and its magnesium chloride rejection coefficient to find out if the removal of emerging pollutants causes membrane fouling. The results show that operating pressure has significant separation effects, obtaining the highest efficiencies at a pressure of 20 bar for pollutant concentrations between 5 and 25 mg/L. Moreover, rejection of ketoprofen was found to be dependent on electrostatic repulsion, while rejection of bisphenol A was significantly affected by adsorption onto the membrane. Finally, the experimental data have been fitted to the solution diffusion model and to the simplified model of Spiegler-Kedem-Katchalsky to predict the behaviour of the nanofiltration membrane in the removal of the tested pollutants. Good agreement between the experimental and predicted carbamazepine and bisphenol A data has been obtained with each model, respectively.

Ultrafiltration Membranes Modified with Reduced Graphene Oxide: Effect on Methyl Green Removal from Aqueous Solution.

In this work, three types of ultrafiltration membranes with different characteristics (GR60PP, RC70PP and GR80PP) have been tested for the removal of the dye methyl green. The tests were first carried out with the three membranes without any modification and then with the membranes' surfaces modified with reduced graphene oxide (rGO). The modification was achieved through physical treatment. The CR70PP membrane did not support the modification treatment and was discarded. The other membranes were initially characterized with distilled water tests to study the permeability to the solvent, and later, the permeate fluxes and the values of rejection coefficients were obtained at different working pressures with a fixed dye initial concentration. In addition, SEM images and SEM-EDX spectra of the native and modified membranes were obtained before and after the dye tests. The GR60PP membrane has shown the best results in relation to the modification because it has increased its rejection levels. On the opposite, the GR80PP membrane performs better without surface modification, achieving the highest rejection values and the highest permeate fluxes in its native form.

Usefulness of open data to determine the incidence of COVID-19 and its relationship with atmospheric variables in Spain during the 2020 lockdown.

The SARS-CoV-2 pandemic and the spread of the COVID-19 disease led to a lockdown being imposed in Spain to minimise contagion from 16 March 2020 to 1 May 2020. Over this period, measures were taken to reduce population mobility (a key factor in disease transmission). The scenario thus created enabled us to examine the impact of factors other than mobility (in this case, meteorological conditions) on the incidence of the disease, and thus to identify which environmental variables played the biggest role in the pandemic's evolution. Worthy of note, the data required to perform the study was entirely extracted from governmental open data sources. The present work therefore demonstrates the utility of such data to conduct scientific research of interest to society, leading to studies that are also fully reproducible. The results revealed a relationship between temperatures and the spread of COVID-19. The trend was that of a slightly lower disease incidence as the minimum temperature rises, i.e. the lower the minimum temperature, the greater the number of cases. Furthermore, a link was found between the incidence of the disease and other variables, such as altitude and proximity to the sea. There were no indications, however, in the study's data, of a relationship between incidence and precipitation or wind.

Ibuprofen Removal by Graphene Oxide and Reduced Graphene Oxide Coated Polysulfone Nanofiltration Membranes.

The presence of pharmaceutical products, and their metabolites, in wastewater has become a focus of growing environmental concern. Among these pharmaceutical products, ibuprofen (IBU) is one of the most consumed non-steroidal anti-inflammatory drugs and it can enter the environment though both human and animal consumption, because it is not entirely absorbed by the body, and the pharmaceutical industry wastewater. Nanofiltration has been described as an attractive process for the treatment of wastewater containing pharmaceutical products. In this paper, the modification of a polysulfone nanofiltration membrane by coating with graphene oxide (GO) and reduced graphene oxide (RGO) has been carried out. The morphology and elemental composition of the active layer of unmodified and modified membranes were analyzed by scanning electronic microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDX), respectively. Initial characterization membranes was carried out, studying their water permeability coefficient and their permeate flux and rejection coefficients, at different applied pressures, using magnesium chloride solutions. The behavior of both pristine and coated membranes against ibuprofen solutions were analyzed by studying the permeate fluxes and the rejection coefficients at different pressures and at different contaminant concentrations. The results have shown that both GO and RGO coated membranes lead to higher values of ibuprofene rejection than that of uncoated membrane, the latter being the one that presents better results in the studies of permeability, selectivity, and fouling.

Toxoplasma gondii infection in hospitalized people living with HIV in Spain, 1997 to 2015.

Toxoplasma gondii infection was one of the most frequent AIDS-defining conditions in HIV-infected individuals until the advent of combination antiretroviral therapy. We aimed to assess the clinical load, coinfection, and mortality, as well as time trends for people living with HIV and hospitalized with Toxoplasma gondii infection, in Spain from 1997 to 2015. Retrospective observational analysis using the Spanish National Registry of Hospital Discharges. Information was retrieved for the study period using the International Classification of Diseases, 9th revision. There were 66,451,094 hospital admissions in Spain from 1997 to 2015, including 472,269 (0.71%) in people living with HIV. Toxoplasma gondii infection was registered in 9006 of these (overall prevalence 1.91%), making it the fifth most common opportunistic infection in hospitalized HIV-positive patients. Prevalence of Toxoplasma gondii infection declined in this group from 4.2% in 1997 to 0.8% in 2015 (p < 0.001), while mean age increased, from 35 years in 1997 to 44 years in 2015. The overall in-hospital mortality rate declined from 13.5% in 1997 to 8.9% in 2015, and it was higher in the concomitant presence of bacterial pneumonia (28.9% vs. 10.2%, p < 0.001), cryptosporidiosis (26.9% vs. 11.5%; p = 0.03), cytomegalovirus disease (18.2% vs. 11.2%, p < 0.001), Pneumocystis jiroveci pneumonia (31.5% vs. 10.5%, p < 0.001), leukoencephalopathy (19.8% vs. 11.78% p < 0.001), and wasting syndrome (29.3% vs 10.9%; p < 0.001). Toxoplasma gondii infection prevalence has significantly declined among hospitalized HIV-infected patients in Spain during the last two decades, coinciding with the widespread use of combination antiretroviral therapy.

Screening ultrafiltration membranes to separate lactose and protein from sheep whey: application of simplified model.

Several studies demonstrated that protein from whey milk could be a new strategy to reduce energy intake and increase satiety. Sheep whey has high protein content, but it is also rich in lactose. The aim of this study was to screening different ultrafiltration membranes to separate protein and lactose from sheep whey in one step. Protein was recovered in the concentrate feed, and lactose passed through three membranes and was recovered in the permeate feed. Membranes with different chemical composition and molecular weight cut-offs were assayed, and the influence of operating pressure and lactose concentration feed in the permeate flux and lactose rejection coefficients were studied. Lactose separation was not affected by pressure in GR60PP or GR90PP, and 85% and 80%, respectively of the lactose was separated into permeate feed. When the feed concentration increased, lactose separation remained stable in all three membranes, being GR60PP the most efficient, as 90% of the disaccharides were separated. In all cases 100% of the protein was recovered. Finally, the Spiegler-Kedem-Katchalsky model perfectly fitted the results obtained about lactose rejection coefficients.

Adding access blood flow surveillance reduces thrombosis and improves arteriovenous fistula patency: a randomized controlled trial.

PURPOSE: Stenosis is the main cause of arteriovenous fistula (AVF) failure. It is still unclear whether surveillance based on vascular access blood flow (QA) enhances AVF function and longevity. METHODS: We conducted a three-year follow-up randomized, controlled, multicenter, open-label trial to compare QA-based surveillance and pre-emptive repair of subclinical stenosis with standard monitoring/surveillance techniques in prevalent mature AVFs. AVFs were randomized to either the control group (surveillance based on classic alarm criteria; n = 104) or to the QA group (QA measured quarterly using Doppler ultrasound [M-Turbo®] and ultrasound dilution [Transonic®] added to classic surveillance; n = 103).The criteria for intervention in the QA group were: 25% reduction in QA, QA<500 mL/min or significant stenosis with hemodynamic repercussion (peak systolic velocity [PSV] more than 400 cm/sc or PSV pre-stenosis/stenosis higher than 3). RESULTS: At the end of follow-up we observed a significant reduction in the thrombosis rate in the QA group (0.025 thrombosis/patient/year in the QA group vs. 0.086 thrombosis/patient/year in the control group [p = 0.007]). There was a significant improvement in the thrombosis-free patency rate (HR, 0.30; 95% CI, 0.11-0.82; p = 0.011) and in the secondary patency rate in the QA group (HR, 0.49; 95% CI, 0.26-0.93; p = 0.030), with no differences in the primary patency rate between the groups (HR, 0.98; 95% CI, 0.57-1.61; p = 0.935).There was greater need for a central venous catheter and more hospitalizations associated with vascular access in the control group (p = 0.034/p = 0.029).Total vascular access-related costs were higher in the control group (€227.194 vs. €133.807; p = 0.029). CONCLUSIONS: QA-based surveillance combining Doppler ultrasound and ultrasound dilution reduces the frequency of thrombosis, is cost effective, and improves thrombosis free and secondary patency in autologous AVF.

The impact of access blood flow surveillance on reduction of thrombosis in native arteriovenous fistula: a randomized clinical trial.

PURPOSE: The usefulness of access blood flow (QA) measurement is an ongoing controversy. Although all vascular access (VA) clinical guidelines recommend monitoring and surveillance protocols to prevent VA thrombosis, randomized clinical trials (RCTs) have failed to consistently show the benefits of QA-based surveillance protocols. We present a 3-year follow-up multicenter, prospective, open-label, controlled RCT, to evaluate the usefulness of QA measurement using Doppler ultrasound (DU) and ultrasound dilution method (UDM), in a prevalent hemodialysis population with native arteriovenous fistula (AVF). METHODS: Classical monitoring and surveillance methods are applied in all patients, the control group (n = 98) and the QA group (n = 98). Besides this, DU and UDM are performed in the QA group every three months. When QA is under 500 ml/min or there is a >25% decrease in QA the patient goes for fistulography, surgery or close clinical/surveillance observation. Thrombosis rate, assisted primary patency rate, primary patency rate and secondary patency rate are measured. RESULTS: After one-year follow-up we found a significant reduction in thrombosis rate (0.022 thrombosis/patient/year at risk in the QA group compared to 0.099 thrombosis/patient/year at risk in the control group [p = 0.030]). Assisted primary patency rate was significantly higher in the QA group than in control AVF (hazard ratio [HR] 0.23, 95% confidence interval [CI] 0.05-0.99; p = 0.030). In the QA group, the numbers unddergoing angioplasty and surgery were higher but with no significant difference in non-assisted primary patency rate (HR 1.41, 95% CI 0.72-2.84; p = 0.293). There was a non-significant improvement in secondary patency rate in the QA group (HR 0.510, 95% CI 0.17-1.50; p = 0.207). CONCLUSIONS: The measurement of QA combining DU and UDM shows a reduction in thrombosis rate and an increased assisted primary patency rate in AVF after one-year follow-up. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02111655.

Effect of diabetes mellitus on Corvis ST measurement process.

PURPOSE: Diabetes mellitus (DM) affects corneal biomechanical parameters. We compared analyses using ORA (Ocular response analyser) and Corvis ST to determine the influence of disease duration, hyperglycaemia and haemoglobin A1c (HbA1c) levels on these parameters. METHODS: This observational, cross-sectional, observer-masked study assessed one eye of 94 consecutive DM patients and 41 healthy subjects. Two DM groups were analysed: the uncontrolled DM group (n = 54) (HbA1c ≥ 7%) and the controlled DM group (n = 40) (HbA1c < 7%). Central corneal thickness (CCT) was measured by ultrasonic pachymetry and intraocular pressure (IOP) by Goldmann applanation tonometry. ORA and Corvis ST analyses were performed to evaluate the changes. RESULTS: Most of the Corvis ST parameters [Deformation amplitude (DA), A1 and A2 times, A1 velocity] in the uncontrolled DM group eyes were found to be significantly different to controls and controlled DM group eyes (p = 0.005, p = 0.001, p < 0.0001, p = 0.002, respectively). DA on the Corvis ST was correlated with blood glucose concentration (p = 0.004) and HbA1c percentage (p = 0.002). ORA corneal hysteresis was significantly lower in diabetic patients with elevated HbA1c than in control subjects (p = 0.001) and was affected by disease duration (p = 0.037), whereas the corneal resistance factor remained unaltered. CONCLUSIONS: A poor glucose control in DM affects corneal biomechanics measured by ORA and Corvis ST, which may cause high IOP measurements independent of CCT. The measurement of the corneal biomechanics should be taken into consideration in the clinical practice.

Estimation of parameters in sewage sludge by near-infrared reflectance spectroscopy (NIRS) using several regression tools.

Sewage sludge application to agricultural soils is a common practice in several countries in the European Union. Nevertheless, the application dose constitutes an essential aspect that must be taken into account in order to minimize environmental impacts. In this study, near infrared reflectance spectroscopy (NIRS) was used to estimate in sewage sludge samples several parameters related to agronomic and environmental issues, such as the contents in organic matter, nitrogen and other nutrients, metals and carbon fractions, among others. In our study (using 380 biosolid samples), two regression models were fitted: the common partial least square regression (PLSR) and the penalized signal regression (PSR). Using PLSR, NIRS became a feasible tool to estimate several parameters with good goodness of fit, such as total organic matter, total organic carbon, total nitrogen, water-soluble carbon, extractable organic carbon, fulvic acid-like carbon, electrical conductivity, Mg, Fe and Cr, among other parameters, in sewage sludge samples. For parameters such as C/N ratio, humic acid-like carbon, humification index, the percentage of humic acid-like carbon, the polymerization ratio, P, K, Cu, Pb, Zn, Ni and Hg, the performance of NIRS calibrations developed with PLSR was not sufficiently good. Nevertheless, the use of PSR provided successful calibrations for all parameters.

Synthesis and photophysical properties of stilbeneoctasilsesquioxanes. Emission behavior coupled with theoretical modeling studies suggest a 3-D excited state involving the silica core.

A set of stilbene-substituted octasilicates [p-RStil(x)Ph(8-x)SiO(1.5)](8) (R = H, Me, MeO, Cl, NMe(2) and x = 5.3-8) and [o-MeStilSiO(1.5)](8) were prepared. Model compounds were also prepared including the corner and half cages: [p-MeStilSi(OEt)(3)], [p-Me(2)NStilSi(OSiMe(3))(3)], and [p-Me(2)NStilSi(O)(OSiMe)](4). These compounds were characterized by MALDI-TOF, TGA, FTIR, and (1)H NMR techniques. Their photophysical properties were characterized by UV-vis, two-photon absorption, and cathodoluminescence spectroscopy (on solid powders), including studies on the effects of solvent polarity and changes in concentration. These molecules are typically soluble, easily purified, and robust, showing T(d(5%)) > 400 degrees C in air. The full and partial cages all show UV-vis absorption spectra (in THF) identical to the spectrum of trans-stilbene, except for [o-MeStilSiO(1.5)](8), which exhibits an absorption spectrum blue-shifted from trans-stilbene. However, the partial cages show emissions that are red-shifted by approximately 20 nm, as found for stilbene-siloxane macrocycles, suggesting some interaction of the silicon center(s) with the stilbene pi* orbital in both the corner and half cages. In contrast, the emission spectra of the full cages show red-shifts of 60-100 nm. These large red-shifts are supported by density functional theoretical calculations and proposed to result from interactions of the stilbene pi* orbitals with a LUMO centered within the cage that has 4A(1) symmetry and involves contributions from all Si and oxygen atoms and the organic substituents. Given that this LUMO has 3-D symmetry, it appears that all of the stilbene units interact in the excited state, consistent with theoretical results, which show an increased red-shift with an increase in the functionalization of a single corner to functionalization of all eight corners with stilbene. In the case of the Me(2)N- derivatives, this interaction is primarily a charge-transfer interaction, as witnessed by the influence of solvent polarity on the emission behavior. More importantly, the two-photon absorption behavior is 2-3 times greater on a per p-Me(2)Nstilbene basis for the full cage than for the corner or half cages. Similar observations were made for p-NH(2)stilbenevinyl(8)OS cages, where the greater conjugation lengths led to even greater red-shifts (120 nm) and two-photon absorption cross sections. Cathodoluminescence studies done on [p-MeStilSiO(1.5)](8) or [p-MeStilOS](8) powders exhibit essentially the same emissions as seen in solution at high dilution. Given that only the emissions are greatly red-shifted in these molecules, whereas the ground-state UV-vis absorptions are not changed from trans-stilbene, except for the ortho derivative, which is blue-shifted 10 nm. It appears that the interactions are only in the excited state. Theoretical results show that the HOMO and LUMO states are always the pi and pi* states on the stilbene, which show very weak shifts with increasing degrees of functionalization, consistent with the small changes in the UV-vis spectra. The band gap between the lowest unoccupied 4a1 symmetry core state localized inside the silsesquioxane cage and the highest occupied state (pi state on stilbene), however, is markedly decreased as the number of stilbene functional groups is increased. This is consistent with the significant red-shifts in the emission spectra. The results suggest that the emission occurs from the 4a1 state localized on the cage. Moreover, for the compounds [p-RStil(6-7)Ph(2-1)OS](8), the emissions are blue-shifted compared to those of the fully substituted compounds, suggesting the molecular symmetry is reduced (from cubic), thereby reducing the potential for 3-D delocalization and raising the energy of the LUMO. The implications are that these octafunctional molecules exhibit some form of 3-D interaction in the excited state that might permit their use as molecular transistors as well as for energy collection and dispersion as molecular antennas, for example, and for nonlinear optical applications.

Fluoride rearrangement reactions of polyphenyl- and polyvinylsilsesquioxanes as a facile route to mixed functional phenyl, vinyl T10 and T12 silsesquioxanes.

Polyphenylsilsesquioxane [PhSiO(1.5)](n) (PPS) and polyvinylsilsesquioxane [vinylSiO(1.5)](n) (PVS) are polymeric byproducts of the syntheses of the related T(8) octamers [PhSiO(1.5)](8) and [vinylSiO(1.5)](8). Here we demonstrate that random-structured PPS and PVS rearrange in the presence of catalytic amounts of Bu(4)N(+)F(-) in THF to form mixed-functionality polyhedral T(10) and T(12) silsesquioxane (SQ) cages in 80-90% yields. Through control of the initial ratio of starting materials, we can statistically tailor the average values for x for the vinyl(x)Ph(10-x)T(10) and vinyl(x)Ph(12-x)T(12) products. Metathetical coupling of x approximately = 2 vinyl cages with 4-bromostyrene produces SQs with an average of two 4-bromostyrenyl substituents. These products can be reacted via Heck coupling with vinylSi(OEt)(3) to produce SQs with vinylSi(OEt)(3) end-caps. Alternately, Heck coupling with the originally produced x approximately = 2 vinyl SQs leads to "beads on a chain" SQ oligomers joined by conjugated organic tethers. The functionalized T(10) and T(12) cages, metathesis, and Heck compounds were characterized by standard analytical methods (MALDI-TOF MS, (1)H and (13)C NMR spectroscopy, TGA, and GPC). MALDI confirms the elaboration of the cages after each synthetic step, and GPC verifies the presence of higher molecular weight SQ oligomers. TGA shows that all of these compounds are thermally stable in air (>300 degrees C). The UV-vis absorption and emission behavior of the Heck oligomers reveals exceptional red-shifts (> or = 60 nm) compared to the vinylSi(OEt)(3) end-capped model compounds, suggesting electronic interactions through the SQ silica cores. Such phenomena may imply 3-D conjugation through the cores themselves.

Correlación clínica y anatomopatológica de los fallecidos en una unidad de cuidados intensivos pediátricos / Clinical correlation and anatomopatológica of the dead in a unit of pediatric intensive cares

Se realizó un estudio transversal, retrospectivo de 98 pacientes fallecidos en el período de Enero del 2001 a Mayo del 2006 en la Unidad de Cuidados Intensivos del Hospital Pediátrico de Centro Habana, a los cuales se les realizó necropsia. Se enunciaron las causas de muerte y se analizaron las coincidencias y los errores diagnósticos. Predominaron los fallecidos menores de un año del sexo masculino. Las causas de muerte más frecuentes fueron las congénitas/genéticas. La coincidencia diagnóstica fue alta para las causas básicas y directas de muerte, no hubo significación estadística para la relación entre la coincidencia diagnóstica y la edad. Se demostró relación significativa entre la edad y la causa básica de muerte con una fuerza de asociación débil, predominando los errores menores y una baja frecuencia de error tipo I. No se demostró relación significativa entre la presencia de errores diagnósticos y la estadía (AU)

Identidad deportiva en atletas adolescentes de la ESPA Provincial de Santiago de Cuba / Sports identity in adolescent athletes from the Provincial School for athletes training and perfection (ESPA) in Santiago de Cuba

Se realizó un estudio a atletas del deporte tenis de mesa, utilizándose latécnica de muestreo intencional. Parte de determinar las insuficiencias que semanifiestan en el desarrollo reflexivo de los mismos acerca de cómo seperciben y proyectan a sí mismo en relación a su identificación y autoafirmación en la actividad deportiva, como resultado de un diagnostico con la utilizacióndel método de observación al entrenamiento y la entrevista individual a los atletas. Se caracteriza por crear espacios de comunicación, considerandotalleres para dialogar con técnicas reflexivas la esencia de nuestro deportecubano, teniendo en cuenta en su especialización deportiva nuestros principios para la orientación ideológica en sus actuaciones, así como los fines denuestra actividad deportiva que contribuyen al desarrollo de la orientación de una Identidad como componente de la personalidad del atleta para formar valores, actitudes, expresar sus sentimientos y su disposición combativa(AU)

Weekly administration of high-dose sodium ferric gluconate is safe and effective in peritoneal dialysis patients.

This report describes the safety and efficacy of high-dose sodium ferric gluconate in 18 peritoneal dialysis (PD) patients. Nine patients received low-dose (125 mg) and 9 patients received high-dose (250 mg) sodium ferric gluconate once per week for 8 or 4 weeks, respectively, followed by a maintenance dose once every 4 weeks. Patients in both groups had low iron saturation before treatment (hemoglobin [Hgb] < 11 g/dl, transferrin saturation [TSAT] approximately 20%, and serum ferritin < 250 ng/ml). After treatment, TSAT and ferritin significantly increased in both the low-dose (ferritin 465 +/- 292 ng/ml and TSAT 33.5 +/- 6.9%) and high-dose (ferritin 622 +/- 339 ng/ml and TSAT 35.0 +/- 25.7%) groups compared to baseline. Hemoglobin levels also increased in both groups, but this was not statistically significant. No adverse reactions or transferrin oversaturation with high-dose sodium ferric gluconate were observed. In conclusion, high-dose sodium ferric gluconate was safe, convenient, and effective in treating iron deficiency in PD patients.

Caring for the renal failure patient: optimizing iron therapy.

The effectiveness of anemia management in patients with end stage renal disease (ESRD) has increased over the past 4 years. However, approximately 26% of treated patients still do not meet the minimum hemoglobin (Hgb) value of 11 g/dl that is recommended by the K/DOQI Clinical Practice Guidelines (National Kidney Foundation [NKF], 2001). One of the main obstacles to good patient outcome may be iron deficiency, which is common in both the predialysis and dialysis period. Since iron is needed for Hgb synthesis, iron depletion exacerbated anemia and reduces the response to recombinant erythropoietin (rEPO) therapy. Health care providers can significantly improve patient outcome by addressing iron deficiency more rigorously. A good starting point is the establishment of an iron deficiency management protocol that includes early evaluation of iron status and aggressive iron therapy. Iron therapy, in turn, can be optimized by administering safe and effective iron supplements and by implementing maintenance iron regimens to prevent the recurrence of iron deficiency. By making these simple improvements to their treatment approach, clinicians can enhance the effectiveness of anemia management in patients with ESRD.

Receiver operating characteristic analysis of the performance of basal serum hormone profiles for the diagnosis of polycystic ovary syndrome in epidemiological studies.

OBJECTIVE: We have used receiver operating characteristic (ROC) analysis to determine the diagnostic performance of several serum parameters, in order to evaluate their potential usefulness in establishing the diagnosis of polycystic ovary syndrome (PCOS) in epidemiological studies. DESIGN: Prospective study. METHODS: One hundred and fourteen women reporting spontaneously for blood donation were included in the study. Menopausal and oral contraceptive-treated women were excluded. Serum samples were obtained at the moment of donation, independently of fasting, time of day or day of menstrual cycle. Measurements included total testosterone, sex hormone-binding globulin (SHBG), dehydroepiandrosterone sulfate (DHEAS), LH, FSH and estradiol. The free testosterone (FT) concentration and the free androgen index (FAI) were calculated from testosterone and SHBG levels. ROC curves were calculated for all these serum determinations. RESULTS: Eight patients were diagnosed with PCOS, according to the presence of oligomenorrhea, hirsutism, acne and/or hyperandrogenemia, and exclusion of non-classic congenital adrenal hyperplasia, hypothyroidism and hyperprolactinemia. Of the parameters studied SHBG, FAI, FT and DHEAS were considered adequate measures for the diagnosis of PCOS. For example, serum SHBG levels showed an area under the ROC curve of 0.875+/-(S.E.(w))0.045 (95% confidence interval 0.800-0.929). A SHBG decision threshold <37 nmol/l had a sensitivity of 87.5%, a specificity of 86.8%, a positive likelihood ratio of 6.63, and a negative likelihood ratio of 0.14, for the diagnosis of PCOS. CONCLUSIONS: Our present results strongly suggest that decreased SHBG levels, and increased FAI, free testosterone concentration and DHEAS concentrations, are highly effective as single analytical procedures in epidemiological studies for the detection of PCOS in women of reproductive age.

Overexpression, purification, crystallization and data collection of 3-methylaspartase from Clostridium tetanomorphum.

3-Methylaspartase (E.C. 4.3.1.2) catalyses the reversible anti elimination of ammonia from L-threo-(2S,3S)-3-methylaspartic acid to give mesaconic acid as well as a slower syn elimination from the (2S,3R)-epimer, L-erythro-3-methylaspartic acid. The anti-elimination reaction occurs in the second step of the catabolic pathway for glutamic acid in Clostridium tetanomorphum. The reverse reaction is of particular interest because the addition of ammonia to substituted fumaric acids is highly stereoselective and gives highly functionalized amino acids. The mechanism of the transformation is unusual and of considerable interest. 3-Methylaspartase from C. tetanomorphum has been overexpressed and purified from Escherichia coli. Crystals of the enzyme have been obtained by sitting-drop vapour diffusion. Two native data sets have been collected, one in-house on a rotating-anode generator to 3.2 A and one at the European Synchrotron Radiation Facility to 2.0 A. A 2.1 A data set has been collected on a crystal of selenomethionine protein. Combining the data sets identify the space group as P2(1)2(1)2, with unit-cell parameters a = 110.3, b = 109.9, c = 67.2 A, alpha = beta = gamma = 90 degrees. The asymmetric unit contains two monomers with 42% solvent. A self-rotation function indicates the presence of a twofold axis, consistent with a biological dimer.

Screening for mutations in the steroidogenic acute regulatory protein and steroidogenic factor-1 genes, and in CYP11A and dosage-sensitive sex reversal-adrenal hypoplasia gene on the X chromosome, gene-1 (DAX-1), in hyperandrogenic hirsute women.

Abstract Abnormalities in adrenal and/or ovarian steroidogenesis are found in most patients with hirsutism. The rate-limiting step in the synthesis of steroids in the ovary and the adrenal is the conversion of cholesterol into pregnenolone by cholesterol side-chain cleavage enzyme (P450scc), encoded by the gene CYP11A, after cholesterol is introduced into the mitochondria by the steroidogenic acute regulatory protein (StAR). DAX-1 is a repressor of StAR gene expression, and steroidogenic factor-1 (SF-1) is a regulator of CYP11A, DAX-1, and StAR gene. Mutations in any of these factors resulting in gain of function, or loss of repression, of StAR or P450scc might contribute to the steroidogenic abnormalities present in hirsute patients. In the present study we have screened, using heteroduplex analysis, the genes encoding StAR and SF-1 as well as DAX-1 and CYP11A for mutations in genomic DNA from 19 women presenting with hirsutism and increased serum androgen levels. When variants were found, analysis was extended to a larger group of hyperandrogenic patients and nonaffected women. Two variants were identified in the SF-1 gene. A G-->C change in exon 6, resulting in an Arg(365)Pro mutation, was found in 1 of 45 patients, but not in controls. Also, a Gly(146)Ala missense mutation, resulting from a G-->C change in exon 4, was found in 2 of 48 patients and in 2 of 50 nonaffected individuals. We identified a C-->T base pair change at position -33 of the StAR gene. Three of 48 patients and 3 of 43 controls presented this variant. No mutations were found in coding regions of the StAR gene. Analysis of CYP11A-coding regions identified a G-->A change in exon 3, resulting in a Val(179)Ile missense mutation. This mutation was found in 1 of 29 patients studied and was not present in 50 controls. Finally, analysis of DAX-1 showed no variant in any of the women studied. In conclusion, mutations in StAR, SF-1, CYP11A, and DAX-1 are seldom found in hirsute patients and do not explain the steroidogenic abnormalities found in these women.