Improved algorithm with adaptive regularization for tomographic reconstruction of gas distributions using DOAS measurements.

Differential optical absorption spectroscopy (DOAS) is notably well suited for the retrieval of UV-absorbing trace gases present in the atmosphere. We combine multi-axis DOAS observations to perform a tomographic reconstruction of the distribution of gases emitted from different sources. We use a new algorithm based on a regularized minimization approach embedding key physical aspects of the solution to constrain the inversion. In this work, we take into account that the spatial sampling of the plume being scanned by the instruments is not homogeneous. Therefore, we introduce an adaptive approach with a locally tuned regularization weight according to the uncertainty levels introduced by the sampling scheme. We tested our approach on reconstructions of simulated gas distributions and different configurations applicable to multi-axis DOAS. Finally, our approach is applied to experimental data for the retrieval of the distribution of ${\rm NO}_2$NO2 within a plume cross section emitted from a group of stacks.

Joint Theoretical and Experimental Study on the La Doping Process in In2O3: Phase Transition and Electrocatalytic Activity.

In2O3 and La3+-doped In2O3 nanostructures were synthesized through a facile and fast chemical route based on the microwave-assisted hydrothermal method combined with rapid thermal treatment in a microwave oven. The presence of the La3+ doping process modifies the size and morphology of the In2O3 nanostructures and also stabilizes the rhombohedral (rh) In2O3 phase with respect to the most stable cubic (bcc) polymorph. X-ray diffraction (XRD) patterns and Rietveld refinements, Raman, UV-vis, and energy dispersive X-ray (EDX) spectroscopies, transmission electron (TEM) and field-emission scanning electron (FE-SEM) microscopies, as well as PL emissions have been performed. To complement and rationalize the experimental results, first-principle calculations, based on density functional theory, are carried out to obtain the formation energies of the In2O3 and bcc- and rh-In2O3-doped phases, their geometry and electronic properties. Theoretical results are able to explain the relative stabilization of the rh-phase with respect to the bcc-phase based on the analysis geometry changes and the electronic redistribution induced by the La3+ doping process. In addition, Wulff construction is employed to match the theoretical and experimental morphologies of the cubic phase. The synthesized samples were applied for the O2 evolution reaction (OER). The La3+-doped In2O3 film presents superior electrocatalytic activity, with an onset potential lower than the undoped In2O3 film that can be associated with the increase in electron density caused by the La3+ doping process. This study provides a versatile strategy for obtaining In2O3 and La3+-doped In2O3 nanostructures for practical applications.

Intravenous thrombolysis in wake-up stroke: real-world data from the Austrian Stroke Unit Registry.

BACKGROUND AND PURPOSE: Data on real-world experience with intravenous thrombolysis (IV tPA) in wake-up stroke (WUS) are limited. The aim of this study was to examine the efficacy and safety of IV tPA in patients with WUS included in the Austrian Stroke Unit Registry. METHODS: Data from a large nationwide stroke unit registry including initial stroke severity, vascular risk factors, comorbidities, treatment with IV tPA, symptomatic intracerebral haemorrhage (sICH) and functional outcome were extracted and analysed. Patients with WUS were compared with patients with known-onset stroke (KOS) regarding the frequency of IV tPA treatment, neurological improvement (National Institutes of Health Stroke Scale score ≥4), sICH and 3-month functional outcome by modified Rankin Scale score using standard statistical tests. RESULTS: A total of 107 895 stroke patients entered the analysis, including 12 534 with WUS and 91 899 with KOS. Altogether, 904 (7.2%) patients with WUS received IV tPA as compared with 16 694 (18.2%) patients with KOS. Patients with WUS who received IV tPA treatment had twofold higher initial National Institutes of Health Stroke Scale score (median 8 vs. median 4) as compared with patients with KOS. There was no statistical difference in functional outcome by modified Rankin Scale score 0-1 at 3 months between patients with WUS and patients with KOS treated with IV tPA (adjusted odds ratio, 1.08; 95% confidence interval, 0.9-1.31). Also, the rate of sICH did not differ (4.1% vs. 4%, P = 0.852). CONCLUSIONS: In this large non-randomized comparison, the safety and efficacy of IV tPA in patients with WUS in the real-world setting seems to be comparable to patients with KOS.

Effect of Mercaptosuccinic Acid Stabilizer Agent on the Optical Properties of Colloidal CdTe Quantum Dots.

In the present work, we report on the positive effect of mercaptosuccinic acid (MSA) stabilizer agent on the optical features of colloidal CdTe quantum dots (QDs). With this aim, we performed some spectroscopic measurements such as steady-state absorption and fluorescence, fluorescence quantum yield and time-resolved photoluminescence for five MSA-capped CdTe QD samples with different synthesis times. The first general aspect to highlight is that the QDs' average size increased with synthesis time (from 30 to 150 min) while the size dispersion decreased due to the Ostwald ripening mechanism. Second, comparing the optical properties of CdTe QDs obtained from the same synthesis route, we show that MSA stabilizer agent enhanced the optical properties of CdTe QDs as compared with other widely used stabilizer agents such as GSH and TGA. We ascribe this outcome to reduction of the number of surface defects of the CdTe QDs because the MSA stabilizer agent decreases the growth rate of nanocrystals, causing an improvement in their surface quality. In the light of Fermi's golden rule, we observed that for longer synthesis time the optical properties of CdTe QDs increases due to the enhancement of the direct radiative recombination rate of electrons and holes and decrease in the decay rate for core states. Finally, we investigated the pH-dependent fluorescence and demonstrated the similar behaviour in acidic range between MSA-capped CdTe and mercaptocarboxylates-capped CdTe.

Familial hypercholesterolaemia in patients with ischaemic stroke or transient ischaemic attack.

BACKGROUND AND PURPOSE: Identification of patients with familial hypercholesterolaemia (FH) is a prerequisite for the appropriate management of their excess cardiovascular risk. It is currently unknown how many patients with acute ischaemic stroke or transient ischaemic attack (TIA) are affected by FH and whether systematic screening for FH is warranted in these patients. METHODS: The prevalence of a clinical diagnosis of FH was estimated in a large representative series of patients with acute ischaemic stroke or TIA (ABCD2 score ≥ 3) using the Dutch Lipid Clinic Network Algorithm (DLCNA; possible FH ≥3, probable/definite FH ≥6). RESULTS: Out of 1054 patients included in the present analysis, 14 had probable/definite FH (1.3%; 95% confidence interval 0.6-2.0) and 107 possible FH (10.2%; 8.4-12.0) corresponding to an overall prevalence of potential FH of 11.5%. Prevalences were even higher in patients with stroke/TIA manifestation before age 55 in men or 60 in women (3.1%, 0.6-5.6; and 13.1%, 8.3-17.9) and those with a prior history of cardiovascular disease (2.6%, 0.9-4.3; and 15.1%, 11.3-18.9). Of note, in two-thirds of our patients with probable/definite and possible FH, stroke or TIA was the initial clinical disease manifestation. CONCLUSIONS: The frequency of potential FH, based on clinical criteria, in patients with acute ischaemic stroke or TIA was 11.5% and that of probable/definite FH (1.3%) was similar to recently reported counts for patients with acute coronary syndrome (1.6%). FH screening using the DLCNA is feasible in clinical routine and should be considered as part of the usual diagnostic work-up.

Heritable symbionts in a world of varying temperature.

Heritable microbes represent an important component of the biology, ecology and evolution of many plants, animals and fungi, acting as both parasites and partners. In this review, we examine how heritable symbiont-host interactions may alter host thermal tolerance, and how the dynamics of these interactions may more generally be altered by thermal environment. Obligate symbionts, those required by their host, are considered to represent a thermally sensitive weak point for their host, associated with accumulation of deleterious mutations. As such, these symbionts may represent an important determinant of host thermal envelope and spatial distribution. We then examine the varied relationship between thermal environment and the frequency of facultative symbionts that provide ecologically contingent benefits or act as parasites. We note that some facultative symbionts directly alter host thermotolerance. We outline how thermal environment will alter the benefits/costs of infection more widely, and additionally modulate vertical transmission efficiency. Multiple patterns are observed, with symbionts being cold sensitive in some species and heat sensitive in others, with varying and non-coincident thresholds at which phenotype and transmission are ablated. Nevertheless, it is clear that studies aiming to predict ecological and evolutionary dynamics of symbiont-host interactions need to examine the interaction across a range of thermal environments. Finally, we discuss the importance of thermal sensitivity in predicting the success/failure of symbionts to spread into novel species following natural/engineered introduction.

Neuromielitis óptica: asociación con espasmos tónicos paroxísticos dolorosos / Neuromyelitis optica: association with paroxysmal painful tonic spasms

Introducción: Los espasmos tónicos paroxísticos dolorosos (ETPD) fueron descriptos inicialmente en la esclerosis múltiple (EM) pero serían más frecuentes en la neuromielitis óptica (NMO). El objetivo es comunicar su presencia en una serie de casos de NMO y su espectro (NMOSD), determinar la frecuencia y las características clínicas. Métodos y pacientes: Se evaluaron retrospectivamente historias clínicas de pacientes con NMO/NMOSD en 2 centros de la Ciudad de Buenos Aires (Hospital Durand y Hospital Álvarez) durante el periodo 2009-2013. Resultados: De 15 pacientes con NMOSD (7 con NMO definida y 8 con NMO limitada), 4 presentaron ETPD (26,66%). En los pacientes con NMO definida la frecuencia fue del 57,14% (4/7). De 9 (9/15) pacientes con mielitis longitudinal extensa (LETM) 44,44% presentó ETPD. Edad: media 35 años (rango: 22-38 años). Cien por cien sexo femenino. Tiempo desde el diagnóstico de NMO: media 7 meses (rango: 1-29 meses) y con respecto a la última recaída de LETM: media 30 días (rango: 23-40 días). El 100% presentó LETM (cervicodorsal 75% y dorsal 25%) en resonancia magnética (RM). El 100% presentó control de los espasmos y el dolor con carbamazepina (uno asociado a gabapentin) sin una respuesta adecuada a pregabalina, gabapentin y fenitoína. Conclusiones: Los ETPD son frecuentes en la NMO. Aparecen aproximadamente al mes de una recaída de LETM con lesiones cervicodorsales extensas en RM. Tienen excelente respuesta a carbamazepina y poca o nula a pregabalina y gabapentin. Estos resultados deberán ser confirmados con estudios prospectivos con mayor número de pacientes

Introduction: Paroxysmal painful tonic spasms (PPTS) were initially described in multiple sclerosis (MS) but they are more frequent in neuromyelitis optica (NMO). The objective is to report their presence in a series of cases of NMO and NMO spectrum disorders (NMOSD), as well as to determine their frequency and clinical features. Patients and Methods: We conducted a retrospective assessment of medical histories of NMO/NMOSD patients treated in 2 hospitals in Buenos Aires (Hospital Durand and Hospital Álvarez) between 2009 and 2013. Results: Out of 15 patients with NMOSD (7 with definite NMO and 8 with limited NMO), 4 presented PPTS (26.66%). PPTS frequency in the definite NMO group was 57.14% (4/7). Of the 9 patients with longitudinally extensive transverse myelitis (LETM), 44.44% (9/15) presented PPTS. Mean age was 35 years (range, 22-38 years) and all patients were women. Mean time between NMO diagnosis and PPTS onset was 7 months (range, 1-29 months) and mean time from last relapse of LETM was 30 days (range 23-40 days). LETM (75% cervicothoracic and 25% thoracic) was observed by magnetic resonance imaging (MRI) in all patients. Control over spasms and pain was achieved in all patients with carbamazepine (associated with gabapentin in one case). No favourable responses to pregabalin, gabapentin, or phenytoin were reported. Conclusions: PPTS are frequent in NMO. Mean time of PPTS onset is approximately one month after an LETM relapse, with extensive cervicothoracic lesions appearing on the MRI scan. They show an excellent response to carbamazepine but little or no response to pregabalin and gabapentin. Prospective studies with larger numbers of patients are necessary in order to confirm these results

Carcinoma de mama triple negativo. Heterogeneidad inmunofenotípica y en el comportamiento farmacocinético / Triple-negative breast carcinoma: heterogeneity in immunophenotypes and pharmacokinetic behavior

Objetivos. Valorar, mediante resonancia magnética (RM), las características morfocinéticas, farmacocinéticas y de difusión de las neoplasias de mama con fenotipo triple negativo y analizar si hay relación entre estos parámetros y el tiempo hasta la progresión. Material y métodos. Estudio retrospectivo y observacional de una serie consecutiva de 100 pacientes con diagnóstico histológico de cáncer de mama, fenotipo triple negativo, entre enero de 2005 y diciembre de 2010 en nuestro centro. Se revisaron los estudios de RM de extensión locorregional y se recogieron las características anatomopatológicas y el seguimiento de las pacientes hasta agosto de 2014. Resultados. Las características más frecuentes por RM de estos tumores fueron: lesiones tipo masa de morfología redondeada (47,3%), bordes bien delimitados (53,7%), patrón de captación 'en anillo' (46,2%), curvas de tipo 3 (50,5%), hiperintensidad de señal intratumoral en las secuencias potenciadas en T2, valores altos de ADC (coeficiente de difusión aparente) (1,04 × 10−3 mm2/s) y una permeabilidad capilar aumentada (Kep) (0,94 min−1). No se evidenció ninguna relación estadísticamente significativa entre las características morfocinéticas o farmacocinéticas y el tiempo hasta la progresión. Se halló elevada presencia del componente in situ en las piezas quirúrgicas, aunque su representación era baja. En el seguimiento, un 25% presentaron metástasis, con predilección por órganos viscerales y baja supervivencia. Conclusión. Las neoplasias con fenotipo triple negativo mostraron mayoritariamente en la RM lesiones de tipo masa, de morfología redondeada, bordes bien delimitados y patrón de captación "en anillo". No se evidenció ninguna relación estadísticamente significativa entre las características morfocinéticas o farmacocinéticas y el tiempo hasta la progresión (AU)

Objectives. To evaluate the morphokinetic, pharmacokinetic, and diffusion characteristics of triple-negative breast cancers on magnetic resonance (MR) imaging and to analyze whether there is a relation between these parameters and the time to progression. Material and methods. This was a retrospective observational study of a consecutive series of 100 patients with histologically confirmed triple-negative breast cancer studied at our center between January 2005 and December 2010. We reviewed the findings on MR locoregional extension studies, the histological findings, and the follow-up of patients until August 2014. Results. The most common MR findings for these tumors were a rounded mass (47.3%), well-defined borders (53.7%), ring enhancement (46.2%), type 3 curves (50.5%), hyperintensity within the tumor on T2-weighted sequences, high ADC values (1.04 × 10-3 mm2/s), and increased capillary permeability (Kep) (0.94 min-1). No significant association was observed between the morphokinetic or pharmacokinetic characteristics and the time to progression. The in situ component in the surgical specimens was high, although its expression was low. During follow-up, 25% of patients had metastases, with a predilection for the visceral organs, and survival was low. Conclusion. Tumors with the triple-negative phenotype mostly presented in MR as rounded tumors with well-defined borders and ring enhancement. We found no significant association between the morphokinetic or pharmacokinetic characteristics and the time to progression (AU)

Study of IRF6 and 8q24 region in non-syndromic oral clefts in the Brazilian population.

OBJECTIVES: We investigated the association between non-syndromic oral cleft and variants in IRF6 (rs2235371 and rs642961) and 8q24 region (rs987525) according to the ancestry contribution of the Brazilian population. SUBJECTS AND METHODS: Subjects with oral cleft (CL, CLP, or CP) and their parents were selected from different geographic regions of Brazil. Polymorphisms were genotyped using a TaqMan assay and genomic ancestry was estimated using a panel of 48 INDEL polymorphisms. RESULTS: A total of 259 probands were analyzed. A TDT detected overtransmission of the rs2235371 G allele (P = 0.0008) in the total sample. A significant association of this allele was also observed in CLP (P = 0.0343) and CLP + CL (P = 0.0027). IRF6 haplotype analysis showed that the G/A haplotype increased the risk for cleft in children (single dose: P = 0.0038, double dose: P = 0.0022) and in mothers (single dose: P = 0.0016). The rs987525 (8q24) also exhibited an association between the A allele and the CLP + CL group (P = 0.0462). These results were confirmed in the probands with European ancestry. CONCLUSIONS: The 8q24 region plays a role in CL/P and the IRF6 G/A haplotype (rs2235371/rs642961) increases the risk for oral cleft in the Brazilian population.

Triple-negative breast carcinoma: heterogeneity in immunophenotypes and pharmacokinetic behavior.

OBJECTIVES: To evaluate the morphokinetic, pharmacokinetic, and diffusion characteristics of triple-negative breast cancers on magnetic resonance (MR) imaging and to analyze whether there is a relation between these parameters and the time to progression. MATERIAL AND METHODS: This was a retrospective observational study of a consecutive series of 100 patients with histologically confirmed triple-negative breast cancer studied at our center between January 2005 and December 2010. We reviewed the findings on MR locoregional extension studies, the histological findings, and the follow-up of patients until August 2014. RESULTS: The most common MR findings for these tumors were a rounded mass (47.3%), well-defined borders (53.7%), ring enhancement (46.2%), type 3 curves (50.5%), hyperintensity within the tumor on T2-weighted sequences, high ADC values (1.04 × 10(-3) mm2/s), and increased capillary permeability (Kep) (0.94 min(-1)). No significant association was observed between the morphokinetic or pharmacokinetic characteristics and the time to progression. The in situ component in the surgical specimens was high, although its expression was low. During follow-up, 25% of patients had metastases, with a predilection for the visceral organs, and survival was low. CONCLUSION: Tumors with the triple-negative phenotype mostly presented in MR as rounded tumors with well-defined borders and ring enhancement. We found no significant association between the morphokinetic or pharmacokinetic characteristics and the time to progression.

Neuromyelitis optica: association with paroxysmal painful tonic spasms. / Neuromielitis óptica: asociación con espasmos tónicos paroxísticos dolorosos.

INTRODUCTION: Paroxysmal painful tonic spasms (PPTS) were initially described in multiple sclerosis (MS) but they are more frequent in neuromyelitis optica (NMO). The objective is to report their presence in a series of cases of NMO and NMO spectrum disorders (NMOSD), as well as to determine their frequency and clinical features. PATIENTS AND METHODS: We conducted a retrospective assessment of medical histories of NMO/NMOSD patients treated in 2 hospitals in Buenos Aires (Hospital Durand and Hospital Álvarez) between 2009 and 2013. RESULTS: Out of 15 patients with NMOSD (7 with definite NMO and 8 with limited NMO), 4 presented PPTS (26.66%). PPTS frequency in the definite NMO group was 57.14% (4/7). Of the 9 patients with longitudinally extensive transverse myelitis (LETM), 44.44% (9/15) presented PPTS. Mean age was 35 years (range, 22-38 years) and all patients were women. Mean time between NMO diagnosis and PPTS onset was 7 months (range, 1-29 months) and mean time from last relapse of LETM was 30 days (range 23-40 days). LETM (75% cervicothoracic and 25% thoracic) was observed by magnetic resonance imaging (MRI) in all patients. Control over spasms and pain was achieved in all patients with carbamazepine (associated with gabapentin in one case). No favourable responses to pregabalin, gabapentin, or phenytoin were reported. CONCLUSIONS: PPTS are frequent in NMO. Mean time of PPTS onset is approximately one month after an LETM relapse, with extensive cervicothoracic lesions appearing on the MRI scan. They show an excellent response to carbamazepine but little or no response to pregabalin and gabapentin. Prospective studies with larger numbers of patients are necessary in order to confirm these results.

Small-vessel occlusion versus large-artery atherosclerotic strokes in diabetics: Patient characteristics, outcomes, and predictors of stroke mechanism.

INTRODUCTION: Diabetes mellitus exerts a detrimental effect on cerebral vasculature affecting both macrovasculature and microvasculature. However, although ischaemic stroke is typically included among macrovascular diabetic complications, it is frequently omitted from microvascular diabetic complications. We aimed to compare the proportion of large-artery atherosclerotic and small-vessel occlusion strokes among diabetic stroke patients, explore their differences and outcomes, and assess potential mechanisms which may determine why some diabetic patients suffer large-artery atherosclerotic stroke whereas others suffer small-vessel occlusion stroke. METHODS: We pooled data of diabetic patients from four prospective ischaemic stroke registries (Acute Stroke Registry and Analysis of Lausanne (ASTRAL), Athens, Austrian, and Helsinki Stroke Thrombolysis Registries). Stroke severity and prognosis were assessed with National Institutes of Health Stroke Scale (NIHSS) and ASTRAL scores, respectively; functional outcome with three-month modified Rankin score (0-2 considered as favourable outcome). Logistic-regression analysis identified independent predictors of large-artery atherosclerotic stroke. RESULTS: Among 5412 patients, 1069 (19.8%) were diabetics; of them, 232 (21.7%) had large-artery atherosclerotic and 205 (19.2%) small-vessel occlusion strokes. Large-artery atherosclerotic stroke had higher severity than small-vessel occlusion stroke (median NIHSS: 6 vs. 3, p < 0.001), worse prognosis (median ASTRAL score: 23 vs. 19, p < 0.001), and worse three-month outcome (60.3% vs. 83.4% with favourable outcome, p < 0.001). In logistic-regression analysis, peripheral artery disease (odds ratio: 4.013, 95% confidence interval: 1.667-9.665, p < 0.01) and smoking (odds ratio: 1.706, 95% confidence interval: 1.087-2.675, p < 0.05) were independently associated with large-artery atherosclerotic strokes. CONCLUSION: In the diabetic stroke population, small-vessel occlusion and large-artery atherosclerotic strokes occur with similar frequency. Large-artery atherosclerotic strokes are more severe and have worse outcome than small-vessel occlusion strokes. The presence of peripheral artery disease and smoking independently predicted large-artery atherosclerotic stroke.

A facultative endosymbiont in aphids can provide diverse ecological benefits.

Ecologically important traits of insects are often affected by facultative bacterial endosymbionts. This is best studied in the pea aphid Acyrthosiphon pisum, which is frequently infected by one or more of eight facultative symbiont species. Many of these symbiont species have been shown to provide one ecological benefit, but we have little understanding of the range of effects that a single strain can have. Here, we describe the phenotypes conferred by three strains of the recently discovered bacterium known as X-type (Enterobacteriaceae), each in their original aphid genotype which also carries a Spiroplasma symbiont. All comparisons are made between aphids that are coinfected with Spiroplasma and X-type and aphids of the same genotype that harbour only Spiroplasma. We show that in all cases, infection with X-type protects aphids from the lethal fungal pathogen Pandora neoaphidis, and in two cases, resistance to the parasitoid Aphidius ervi also increases. X-type can additionally affect aphid stress responses--the presence of X-type increased reproduction after the aphids were heat-stressed. Two of the three strains of X-type are able to provide all of these benefits. Under benign conditions, the aphids tended to suffer from reduced fecundity when harbouring X-type, a mechanism that might maintain intermediate frequencies in field populations. These findings highlight that a single strain of a facultative endosymbiont has the potential to provide diverse benefits to its aphid host.

Neonatal oxytocin administration and supplemental milk ameliorate the weaning transition and alter hormonal expression in the gastrointestinal tract in pigs.

The aim of this study was to investigate the influences of milk supplementation during lactation, over 1 wk after weaning, and oxytocin administration for the first 14 d of life on the pigs' response to weaning. Pigs from 20 litters were allocated to each of these 3 treatments in a randomized factorial design. Oxytocin was administered subcutaneously daily from 0 to 14 d of age at a rate of 10 I.U. per kg. The milk supplement consisted of a mixture of 25% skim milk powder offered either during lactation between 10 and 20 d of age or for the first week after weaning as a transitional diet along with dry pellets. Pigs were weaned at 21 d of age. Growth rate was measured from birth to slaughter at 140 d of age and feed intake of supplemental milk or feed from 10 to 56 d of age. Organ weights (heart, liver, stomach, and kidneys) and the gene expression of ghrelin, leptin, and glucagon-like peptides (glucagon-like peptide-1 and glucagon-like peptide-2) were measured in the stomach, ileum, and duodenum at 10, 21, and 28 d of age. Milk supplementation after weaning resulted in immediate feed intake and partially alleviated the depression in growth rate over the first 7 d postweaning (P < 0.001), but milk supplementation during lactation had no effects (P > 0.1). However, effects were only transient and disappeared once the milk liquid diet was removed. Neonatal oxytocin administration reduced weight loss over the first 2 d after weaning (P = 0.03), without affecting feed intake (P > 0.1), hence possibly reducing weaning stress. Seven days after weaning, oxytocin-treated pigs had greater stomach ghrelin and leptin expression (both P = 0.02), and pigs supplemented with milk after weaning had greater stomach leptin and glucagon-like peptide-2 expression (P = 0.02 and P = 0.05, respectively). Hence, neonatal oxytocin administration or postweaning milk supplementation are both effective means of enhancing gastric leptin expression and reducing weight loss at weaning, likely improving gut health during this critical period.

Protection against a fungal pathogen conferred by the aphid facultative endosymbionts Rickettsia and Spiroplasma is expressed in multiple host genotypes and species and is not influenced by co-infection with another symbiont.

Many insects harbour facultative endosymbiotic bacteria, often more than one type at a time. These symbionts can have major effects on their hosts' biology, which may be modulated by the presence of other symbiont species and by the host's genetic background. We investigated these effects by transferring two sets of facultative endosymbionts (one Hamiltonella and Rickettsia, the other Hamiltonella and Spiroplasma) from naturally double-infected pea aphid hosts into five novel host genotypes of two aphid species. The symbionts were transferred either together or separately. We then measured aphid fecundity and susceptibility to an entomopathogenic fungus. The pathogen-protective phenotype conferred by the symbionts Rickettsia and Spiroplasma varied among host genotypes, but was not influenced by co-infection with Hamiltonella. Fecundity varied across single and double infections and between symbiont types, aphid genotypes and species. Some host genotypes benefit from harbouring more than one symbiont type.

Etiology of first-ever ischaemic stroke in European young adults: the 15 cities young stroke study.

BACKGROUND AND PURPOSE: Risk factors for IS in young adults differ between genders and evolve with age, but data on the age- and gender-specific differences by stroke etiology are scare. These features were compared based on individual patient data from 15 European stroke centers. METHODS: Stroke etiology was reported in detail for 3331 patients aged 15-49 years with first-ever IS according to Trial of Org in Acute Stroke Treatment (TOAST) criteria: large-artery atherosclerosis (LAA), cardioembolism (CE), small-vessel occlusion (SVO), other determined etiology, or undetermined etiology. CE was categorized into low- and high-risk sources. Other determined group was divided into dissection and other non-dissection causes. Comparisons were done using logistic regression, adjusting for age, gender, and center heterogeneity. RESULTS: Etiology remained undetermined in 39.6%. Other determined etiology was found in 21.6%, CE in 17.3%, SVO in 12.2%, and LAA in 9.3%. Other determined etiology was more common in females and younger patients, with cervical artery dissection being the single most common etiology (12.8%). CE was more common in younger patients. Within CE, the most frequent high-risk sources were atrial fibrillation/flutter (15.1%) and cardiomyopathy (11.5%). LAA, high-risk sources of CE, and SVO were more common in males. LAA and SVO showed an increasing frequency with age. No significant etiologic distribution differences were found amongst southern, central, or northern Europe. CONCLUSIONS: The etiology of IS in young adults has clear gender-specific patterns that change with age. A notable portion of these patients remains without an evident stroke mechanism according to TOAST criteria.

A non-compulsory stewardship programme for the management of antifungals in a university-affiliated hospital.

Antimicrobial stewardship programmes promote excellence in the use of antimicrobials by selecting the appropriate antimicrobial agent and the correct dose, route of administration and duration of treatment. However, there is limited experience with such programmes targeting antifungal treatments. We present the results of a non-compulsory programme for the control of antifungals. For 12 months, prescriptions of oral voriconazole or intravenous voriconazole, caspofungin and liposomal amphotericin B were reviewed, and non-compulsory recommendations were made. The incidence and outcome of fungal infections were examined. The results for the dispensed defined daily doses (DDDs) and expenditure on antifungals were compared with those for the previous 12 months. The number of antifungal treatments reviewed was 662. A recommendation to change treatment was made in 29% of the cases, including a change from intravenous to oral treatment (15%), cessation of antifungal treatment (8%), and a change to fluconazole (6%). The DDDs of intravenous voriconazole and caspofungin were reduced by 31.4% and 20.2%, respectively. The DDDs of oral voriconazole and dispensed vials of liposomal amphotericin B were increased by 8.2% and 13.9%, respectively. Expenditure on antifungals was reduced by US$370681.78 (11.8% reduction). The programme was not related to significant increases in the incidence of candidaemia, percentage of persistent/relapsing candidaemia cases, percentage of fluconazole-resistant Candida species, incidence of infections by filamentous fungi, or 12-month mortality in patients with filamentous fungal infections. In conclusion, a stewardship programme targeting antifungals achieved a reduction in antifungal expenditure without reducing the quality of care provided.

Bone marrow-derived mesenchymal stromal cells and platelet-rich plasma on a collagen matrix to improve fascial healing.

OBJECTIVE: To demonstrate improved healing of a midline laparotomy after application of mesenchymal stromal cells and platelet-rich plasma on a collagen matrix and introduce a potential cellular-based therapy for the prevention of incisional hernia formation. BACKGROUND: Up to 10 % of laparotomies are complicated by postoperative incisional hernias. Despite continuous improvements in surgical technique and technology, hernia rates have remained constant. Cell-based therapies focused on augmentation of the body's natural healing properties could reduce hernia formation. METHODS: Midline laparotomies were performed on 42 Lewis rats. Three groups were studied: (1) primary repair only, (2) primary repair with CollaTape™ (CoTa) overlay and platelet-rich plasma (PRP), and (3) primary repair with CoTa overlay and PRP and bone marrow-derived mesenchymal stromal cells (BM-MSCs). Abdominal wall fascia was recovered at 4 and 8 weeks in each group. Biomechanical testing and histological evaluation was performed. RESULTS: At 4 weeks, there was a twofold increase in tensile strength between groups 1 and 2 and a fourfold increase between groups 1 and 3 (p < 0.001). Group 3 had a 320 % increase in total energy absorption at 4 weeks compared to group 1 and a 142 % increase at 8 weeks (p < 0.001). Vascularization and collagen abundance were significantly increased in group 3 at both time points. CONCLUSION: The addition of BM-MSCs, PRP, and CoTa led to a marked improvement in abdominal wall strength and energy absorption. Histologic evaluation confirmed increased vascularity and collagen abundance consistent with the biomechanical findings. Application of this therapy may ultimately reduce incisional hernia formation.

An integer-based score to predict functional outcome in acute ischemic stroke: the ASTRAL score.

OBJECTIVE: To develop and validate a simple, integer-based score to predict functional outcome in acute ischemic stroke (AIS) using variables readily available after emergency room admission. METHODS: Logistic regression was performed in the derivation cohort of previously independent patients with AIS (Acute Stroke Registry and Analysis of Lausanne [ASTRAL]) to identify predictors of unfavorable outcome (3-month modified Rankin Scale score >2). An integer-based point-scoring system for each covariate of the fitted multivariate model was generated by their ß-coefficients; the overall score was calculated as the sum of the weighted scores. The model was validated internally using a 2-fold cross-validation technique and externally in 2 independent cohorts (Athens and Vienna Stroke Registries). RESULTS: Age (A), severity of stroke (S) measured by admission NIH Stroke Scale score, stroke onset to admission time (T), range of visual fields (R), acute glucose (A), and level of consciousness (L) were identified as independent predictors of unfavorable outcome in 1,645 patients in ASTRAL. Their ß-coefficients were multiplied by 4 and rounded to the closest integer to generate the score. The area under the receiver operating characteristic curve (AUC) of the score in the ASTRAL cohort was 0.850. The score was well calibrated in the derivation (p = 0.43) and validation cohorts (0.22 [Athens, n = 1,659] and 0.49 [Vienna, n = 653]). AUCs were 0.937 (Athens), 0.771 (Vienna), and 0.902 (when pooled). An ASTRAL score of 31 indicates a 50% likelihood of unfavorable outcome. CONCLUSIONS: The ASTRAL score is a simple integer-based score to predict functional outcome using 6 readily available items at hospital admission. It performed well in double external validation and may be a useful tool for clinical practice and stroke research.

Acercamiento epidemiológico de la enfermedad arterial periférica en la República Argentina. Resultado de Encuesta nacional multicéntrica / Aproximaçâo epidemiológica da doença arterial periférica na República Argentina. Resultado de uma pesquisa nacional multicéntrica / Epidemiological analysis of peripheral arterial disease in Argentina. Results of a multicenter national survey

Objetivo: conocer la prevalencia de la enfermedad vascular periférica (Enfermedad Arterial Periféricay Enfermedad Cerebro Vascular extra craneana) en distintos puntos de la República Argentina, a través de una encuesta a representantes del CACCVE (Colegio Argentino de CirujanosCardiovasculares y Endovasculares).Material y métodos: mediante una encuesta que se detalla a continuación, se solicitó conocer en porcentajes distintos aspectos de los pacientes atendidos en 2009-2010 a distintos centros de atención vascular: Edad; Sexo; Grupo Étnico (Blanca, Mestiza, Criolla, Aborigen, etc.); Hábitos(Tabaquismo, Sedentarismo, Personalidad); Factores de Riesgo Asociados (Hipertensión Arterial,Diabetes, Dislipidemia, Coronariopatías, Insuficiencia Renal Crónica, Enfermedades Broncopulmonares);Estudios solicitados (Análisis Clínicos, Ecodoppler, Índice Tobillo-Brazo); Medicación (Vasodilatadores, anti agregantes, anti neuríticos y analgésicos); Estadificación (Fontaine, Rutherford, TASC, TASC II); Enfermedad Carotidea (ACAS, NASCET). Resultados: se evaluaron 9500 consultas de pacientes con patología arterial, en CABA, Pcia. Bs. As., Córdoba Capital, Ciudad de Tucumán, Ciudad de Bariloche (Río Negro) y Ciudad de Río Grande (Tierra del Fuego) Se observan diferencias con respecto a la metodología diagnóstica, manejo de factores de riesgo asociados y tratamiento médico con respecto a Guías Internacionales. Se discute sobre grupo etario sobre el que basamos nuestros tratamientos. Conclusión: en muchos aspectos se aplican guías de procedimiento internacionales, sin evaluar previamente sobre nuestras realidades, intentamos mostrar la prevalencia de la Enfermedad ArterialPeriférica considerándolo esencial para optimizar los programas de atención primaria tanto como el tratamiento médico y quirúrgico para esta enfermedad.

Objetivo: conhecer a prevalência da doença vascular periférica (Doença Arterial Periférica e Doença Cérebro Vascular extra craneana) em diferentes pontos da República Argentina, a travésde uma pesquisa realizada com representantes do CACCVE (Colégio Argentino de Cirurgiões Cardiovasculares e Endovasculares).Material e métodos: Utilizando uma pesquisa apresentada em detalhes em continuação, solicitou-se conhecer em porcentagens, diversos aspectos dos pacientes atendidos no período 2009-2010 em diferentes centros de atendimento vascular: Idade; Sexo; Grupo Étnico (Branco, Preto, Pardo, Indígena, etc.); Hábitos (Tabaquismo, Sedentarismo, Personalidade ); Fatores de Risco Associados (Hipertensão Arterial, Diabetes, Dislipidemia, Coronariopatias, Insuficiência RenalCrônica, Doenças Broncopulmonares); Exames solicitados (Análises Clínicas, Ecodoppler, Índice Tornozelo Braquial); Medicação (Vasodilatadores, antiagregantes, anti neuríticos e analgésicos); Classificação (Fontaine, Rutherford, TASC, TASC II); Doença Carotídea (ACAS, NASCET). Resultados: Avaliaram-se 9500 consultas de pacientes com patología arterial, em CABA, Província de Bs. As., Córdoba Capital, Cidade de Tucumán, Cidade de Bariloche (Rio Negro) e Cidade de Rio Grande (Terra do Fogo). Observam-se diferenças relacionadas à metodologia diagnóstica, manejo de fatores de risco associados e tratamento médico com respeito a Guias Internacionais.Discute-se sobre grupo etário no qual baseamos nossos tratamentos. Conclusão: Em muitos aspectos aplicam-se guias de procedimento internacionais, sem avaliar previamente sobre nossas realidades. Tentamos mostrar a prevalência da Doença Arterial Periféricaconsiderando-a essencial para otimizar os programas de atendimento primário como também o tratamento médico e cirúrgico para esta doença.

Objective: to collect information on the prevalence of peripheral vascular disease (Peripheral Arterial Disease and Extra-cranial Cerebrovascular Disease) in different regions of Argentina through a survey of CACCVE (Colegio Argentino de Cirujanos Cardiovasculares y Endovasculares) representatives.Material and Methods: the following survey was distributed to know the percentage of certain different criteria in the patients followed-up between 2009-2010 at different vascular centers: age; gender; ethnic group (Caucasian, Mestizos, Creole, Indigenous, etc.); Habits (Smoking,Sedentarism, Personality ); Associated Risk Factors (Arterial Hypertension, Diabetes, Dyslipidemia, Coronary Disease, Chronic Renal Failure, Bronchopulmonary Disease); Tests indicated (Clinical Laboratory, Ecodoppler, Ankle Arm Index); Medication ( vasodilators, antiagreggants, antineuritics and pain medication); Staging (Fontaine, Rutherford, TASC, TASC II); Carotiddisease (ACAS, NASCET). Results: 9,500 patients with arterial disease were followed in the city of Buenos Aires, the province of Buenos Aires, the capital city of Cordoba, city of Tucumán, City of Bariloche (Rio Negro) andCity of Rio Grande (Tierra del Fuego). Differences are seen in the diagnostic methodology, management of concomitant risk factors and medical treatment according to the internationalguidelines. Also the age group for treatment indication is taken into consideration. Conclusion: In many cases international operating guidelines are applied disregarding the local reality, we tried to indicate the prevalence of Peripheral Arterial Disease as we consider this information to be essential in order to optimize primary care programs both for the medical and surgical treatment of this disease.