A unique anatomic variant: Left anterior choroidal artery arising proximal to fetal posterior communicating artery.

Anomalous vascular variants pose unique challenges in clinical management, especially in the context of neuroendovascular intervention. We present a case report detailing an extremely rare anatomic variant involving the left anterior choroidal artery, which arises proximal to the fetal posterior communicating artery. Our patient presented with confusion and speech abnormalities following a benzodiazepine overdose. Subsequent computed tomography of the head revealed an aneurysm originating from the left supraclinoid carotid artery. This aneurysm was located 2 mm more proximal to the origin of the left posterior communicating artery and was initially misidentified as originating from the left posterior communicating artery due to its proximity. Further diagnostic cerebral angiography revealed an extremely rare anatomical variant where the left anterior choroidal artery anomalously arose proximal to a fetal posterior communicating artery, with the aneurysm being correctly identified as arising from the left anterior choroidal artery. The patient underwent successful detoxification and has since shown remarkable improvement, with plans for elective endovascular flow diversion treatment under dual antiplatelet therapy. Considering the critical role of the anterior choroidal artery in supplying vital cerebral structures, awareness of such variants is paramount to prevent inadvertent vascular injury and optimize patient outcomes. This case highlights the necessity of meticulous pre-procedural imaging and multidisciplinary collaboration in managing neurovascular anomalies effectively.

Bronchopulmonary dysplasia in adults: Exploring pathogenesis and phenotype.

This review highlights both the longstanding impact of bronchopulmonary dysplasia (BPD) on the health of adult survivors of prematurity and the pressing need for prospective, longitudinal studies of this population. Conservatively, there are an estimated 1,000,000 survivors of BPD in the United States alone. Unfortunately, most of the available literature regarding outcomes of lung disease due to prematurity naturally focuses on pediatric patients in early or middle childhood, and the relative amount of literature on adult survivors is scant. As the number of adult survivors of BPD continues to increase, it is essential that both adult and pediatric pulmonologists have a comprehensive understanding of the pathophysiology and underlying disease process, including the molecular signaling pathways and pro-inflammatory modulators that contribute to the pathogenesis of BPD. We summarize the most common presenting symptoms for adults with BPD and identify the critical challenges adult pulmonologists face in managing the care of survivors of prematurity. Specifically, these challenges include the wide variability of the clinical presentation of adult patients, comorbid cardiopulmonary complications, and the paucity of longitudinal data available on these patients. Adult survivors of BPD have even required lung transplantation, indicating the high burden of morbidity that can result from premature birth and subsequent lung injury. In addition, we analyze the disparate symptoms and management approach to adults with "old" BPD versus "new" BPD. The aim of this review is to assist pulmonologists in understanding the underlying pathophysiology of BPD and to improve clinical recognition of this increasingly common pulmonary disease.

Protection of Messenger RNA Vaccines Against Hospitalized Coronavirus Disease 2019 in Adults Over the First Year Following Authorization in the United States.

BACKGROUND: Coronavirus disease 2019 (COVID-19) messenger RNA (mRNA) vaccines were authorized in the United States in December 2020. Although vaccine effectiveness (VE) against mild infection declines markedly after several months, limited understanding exists on the long-term durability of protection against COVID-19-associated hospitalization. METHODS: Case-control analysis of adults (≥18 years) hospitalized at 21 hospitals in 18 states 11 March-15 December 2021, including COVID-19 case patients and reverse transcriptase-polymerase chain reaction-negative controls. We included adults who were unvaccinated or vaccinated with 2 doses of a mRNA vaccine before the date of illness onset. VE over time was assessed using logistic regression comparing odds of vaccination in cases versus controls, adjusting for confounders. Models included dichotomous time (<180 vs ≥180 days since dose 2) and continuous time modeled using restricted cubic splines. RESULTS: A total of 10 078 patients were included, 4906 cases (23% vaccinated) and 5172 controls (62% vaccinated). Median age was 60 years (interquartile range, 46-70), 56% were non-Hispanic White, and 81% had ≥1 medical condition. Among immunocompetent adults, VE <180 days was 90% (95% confidence interval [CI], 88-91) versus 82% (95% CI, 79-85) at ≥180 days (P < .001). VE declined for Pfizer-BioNTech (88% to 79%, P < .001) and Moderna (93% to 87%, P < .001) products, for younger adults (18-64 years) (91% to 87%, P = .005), and for adults ≥65 years of age (87% to 78%, P < .001). In models using restricted cubic splines, similar changes were observed. CONCLUSIONS: In a period largely predating Omicron variant circulation, effectiveness of 2 mRNA doses against COVID-19-associated hospitalization was largely sustained through 9 months.

Risk factors for oral epithelial dysplasias to become malignant: clinical implications.

There is a lack of effective clinical management of oral epithelial dysplasias to reduce their risk of malignant transformation and considerable gaps in knowledge regarding the most effective means of treating such lesions. A retrospective cohort of biopsy-confirmed oral epithelial dysplasias consecutively diagnosed in the period 1995-2014 and followed-up until 2017 was identified from pathology department files. Demographic, clinical and follow-up information was collected. Multivariate Cox proportional-hazards models were performed to evaluate sociodemographic, clinical and pathological factors associated with progression to oral squamous cell carcinoma. The study included 144 oral epithelial dysplasias, of which 42% progressed to oral cancer at the end of follow-up (21 years). Clinical aspect of the lesion was described for 77 (53.5%) of the patients. Treatment, age, grade of the lesion and diagnostic period were independent prognostic factors for progression. When considering only patients with described clinical aspect, only treatment and grade of the lesion were independently associated with cancer. The results from this non-selected retrospective cohort of oral epithelial dysplasias underscore the existing limitations of the current standard-of-care of the patients and provide novel insights on the management of these lesions with and without described clinical aspect. Well-designed, robust prospective studies, a homogenized staging system and multidisciplinary treatment guidelines are warranted.

Will Africans take COVID-19 vaccination?

The economic and humanistic impact of COVID-19 pandemic is enormous globally. No definitive treatment exists, hence accelerated development and approval of COVID-19 vaccines, offers a unique opportunity for COVID-19 prevention and control. Vaccine hesitancy may limit the success of vaccine distribution in Africa, therefore we assessed the potentials for coronavirus vaccine hesitancy and its determinants among Africans. An online cross-sectional African-wide survey was administered in Arabic, English, and French languages. Questions on demographics, self-reported health status, vaccine literacy, knowledge and perception on vaccines, past experience, behavior, infection risk, willingness to receive and affordability of the SARS-COV-2 vaccine were asked. Data were subjected to descriptive and inferential statistics. A total of 5,416 individuals completed the survey. Approximately, 94% were residents of 34 African countries while the other Africans live in the Diaspora. Only 63% of all participants surveyed were willing to receive the COVID-19 vaccination as soon as possible and 79% were worried about its side effects. Thirty-nine percent expressed concerns of vaccine-associated infection. The odds of vaccine hesitancy was 0.28 (95% CI: 0.22, 0.30) among those who believed their risk of infection was very high, compared to those who believed otherwise. The odds of vaccine hesitancy was one-fifth (OR = 0.21, 95% CI: 0.16, 0.28) among those who believed their risk of falling sick was very high, compared to those who believed their risk of falling very sick was very low. The OR of vaccine hesitancy was 2.72 (95% CI: 2.24, 3.31) among those who have previously refused a vaccine for themselves or their child compared to counterparts with no self-reported history of vaccine hesitancy. Participants want the vaccines to be mandatory (40%), provided free of charge (78%) and distributed in homes and offices (44%). COVID-19 vaccine hesitancy is substantial among Africans based on perceived risk of coronavirus infection and past experiences.

Estudio del aclaramiento de la infección por el VPH de alto riesgo después de una conización / Study of high-risk HPV infection clearance after conization

Objetivo: Evaluar el porcentaje de aclaramiento de la infección por el virus del papiloma humano (VPH) de alto riesgo en las mujeres sometidas a una conización cervical, así como analizar los genotipos de VPH más prevalentes en nuestro medio. Material y métodos: Estudio longitudinal, observacional, retrospectivo, descriptivo y analítico. Se revisaron las conizaciones realizadas en el Área 7 del Hospital Clínico San Carlos de Madrid entre octubre de 2015 y octubre de 2016. Resultados: De 291 conizaciones practicadas durante 12 meses, se realizó determinación de VPH-AR pre-conización a 138 pacientes. En 247 pacientes la indicación del tratamiento escisional fue por resultado de biopsia HSIL/CIN 2-3, y en 44 por LSIL/CIN una persistente más de dos años. Sesenta y una de las 138 mujeres presentaron uno o varios VPH-AR distintos al 16/18/31 antes de la conización (61/138), mientras que en 77 pacientes se diagnosticaron VPH-AR 16/18/31 (77/138). Si desglosamos, el VPH 16 estuvo presente en 58/138 de los casos, el VPH 31 en 15/138 y el VPH 18 en 4/138. En el primer control post-conización, en 126 pacientes la determinación de VPH-AR fue negativa (126/138). El VPH 16 se aclaró en 49 pacientes (49/58), el VPH 31 en 15 (15/15) y el VPH 18 en uno (1/4). Conclusiones: El genotipo 16 fue el VPH-AR más frecuente en mujeres conizadas en nuestro estudio, seguido por el 31 y el 18. Tras la conización cervical, se consigue un aclaramiento de la infección por VPH-AR en un 91,4% de las pacientes.(AU)

Objective: To evaluate the percentage of clearance of high-risk HPV infection in women undergoing cervical conization, as well as to analyse the most prevalent HPV genotypes in our environment. Material and methods: Longitudinal, observational, retrospective, descriptive and analytical study. The conizations performed in Area 7 of the Hospital Clínico San Carlos in Madrid between October 2015 and October 2016 were reviewed. Results: Of 291 conizations over 12 months, pre-conization HPV-AR determination was made in 138 patients. In 247 patients the indication for excisional treatment was the result of biopsy HSIL/CIN 2-3, and in 44 for persistent LSIL/CIN 1 for more than 2 years. Sixty-one of the 138 women had one or more HPV-AR other than 16/18/31 prior to conization (61/138), while 77 patients were diagnosed with HPV-AR 16/18/31 (77/138). If we break it down, HPV 16 was present in 58/138 of cases, HPV 31 in 15/138 and HPV 18 in 4/138. In the first post-conization control, in 126 patients the determination of HPV-AR was negative (126/138). Clearance of HPV 16 was achieved in 49 patients (49/58), HPV 31 in 13 (13/15) and HPV 18 in 1 (1/4). Conclusions: Genotype 16 was the most common HPV-AR in conized women in our study, followed by 31 and 18. After cervical conization, a clearance of HPV-AR infection was achieved in 91.4% of patients.(AU)

Epidemiology of human papillomavirus-related oropharyngeal cancer in a classically low-burden region of southern Europe.

The incidence of human papillomavirus (HPV)-related oropharyngeal cancer is increasing in some regions. Nevertheless, the epidemiology of this disease has not been extensively investigated in southern Europe. We conducted a retrospective cohort study of patients diagnosed with primary oropharyngeal cancer from 1991 to 2016. Cancer tissues underwent histopathological evaluation, DNA quality control, HPV-DNA detection and p16INK4a immunohistochemistry. Data were collected from medical records. Factors associated with HPV positivity and time trends were evaluated with multivariable Bayesian models. The adjusted prevalence of HPV-related cases in 864 patients with a valid HPV-DNA result was 9.7%, with HPV-DNA/p16INK4a double positivity being considered. HPV-related oropharyngeal cancer was likely to occur in non-smokers and non-drinkers, to be located in the tonsil or diagnosed at advanced stages. Time-trend analysis showed an increasing risk of HPV-related oropharyngeal cancer in the most recent periods (5-year period increase of 30%). This increase was highest and with a clear increasing trend only in the most recent years (2012-2016). The prevalence of HPV-related oropharyngeal cancer started to sharply increase in the most recent years in our setting, as occurred two decades ago in areas where most oropharyngeal cancer cases are currently HPV-related. Our results provide a comprehensive assessment of the epidemiological landscape of HPV-related oropharyngeal cancer in a region of southern Europe.

A rapid and convenient screening method for detection of restricted monensin, decoquinate, and lasalocid in animal feed by applying SERS and chemometrics.

The surface-enhanced activities of size- and shape-controlled gold nanoparticles (AuNPs) with superior chemical stability were investigated to explore a possible development of a simple and non-destructive spectroscopic method to help the regulatory agency's analytical services for rapid detection and characterization of selected antimicrobials in animal feeds. Feed samples spiked at different concentration ranges of antimicrobials were evaluated using AuNPs as a surface-enhanced Raman spectroscopy (SERS) agent. The collected SERS spectra were mathematically preprocessed for further analysis. The classification models obtained 100% predictive accuracy with zero or little misclassification. The first two canonical variables (p = 0.001) could explain >95% of the variability in preprocessed spectral data. Most chemometric models for predicting MON, DEC, and LAS concentrations showed a high predictive accuracy (r2 > 0.90), lower predictive error (<20 mg/kg), and satisfactory regression quality (slope close to 1.0). The statistical results showed no statistically significant difference between the reference and SERS predicted values (p > 0.05). The findings and implications from the study indicate that SERS would be a powerful and efficient technique possessing a great potential serving as an excellent monitoring and screening tool for antimicrobial contaminated samples in the on-site analysis.

Thermal Control of Spin Excitations in the Coupled Ising-Chain Material RbCoCl_{3}.

We have used neutron spectroscopy to investigate the spin dynamics of the quantum (S=1/2) antiferromagnetic Ising chains in RbCoCl_{3}. The structure and magnetic interactions in this material conspire to produce two magnetic phase transitions at low temperatures, presenting an ideal opportunity for thermal control of the chain environment. The high-resolution spectra we measure of two-domain-wall excitations therefore characterize precisely both the continuum response of isolated chains and the "Zeeman-ladder" bound states of chains in three different effective staggered fields in one and the same material. We apply an extended Matsubara formalism to obtain a quantitative description of the entire dataset, Monte Carlo simulations to interpret the magnetic order, and finite-temperature density-matrix renormalization-group calculations to fit the spectral features of all three phases.

Correction to: Human Papillomavirus and Factors Associated with Recurrence in Sinonasal Inverted Papillomas from Poland and Spain.

The original version of this article unfortunately contained a mistake. Three values in Table 1 were incorrect. In "months of recurrence", range row, the intervals should be in numbers. They should read as 3-83 instead of Mar-83, 9-83 instead of Sep-83 and 3-36 instead of Mar-36. The corrected Table 1 is given below. The original article has been corrected.

Human Papillomavirus and Factors Associated with Recurrence in Sinonasal Inverted Papillomas from Poland and Spain.

Sinonasal inverted papilloma (SNIP) is a benign but locally aggressive tumor that has a tendency for recurrence and malignant transformation. The role of human papillomavirus (HPV) in SNIP is controversial. To determine the HPV-DNA prevalence and type distribution in SNIP in two different geographic areas and assess the association between SNIP recurrence and HPV infection, as well as additional potential etiologic factors. Two retrospective cohorts of SNIP patients from Poland and Spain were evaluated. Demographic, tobacco/alcohol use, clinical, and follow-up data were collected. All samples were subject to histopathologic evaluation, DNA quality control, and HPV-DNA detection by PCR. HPV-DNA positive samples and a random sample of HPV-DNA negative cases were further subject to p16INK4a analysis. Proportional-hazards models were used to evaluate the risk of recurrence by selected variables. Seventy-nine SNIP patients (46 from Spain diagnosed between 1995 and 2014, and 33 from Poland diagnosed between 2012 and 2017) were included in the study. HPV-DNA was detected in four patients (5.1%), two from each region, and all four were positive for the HPV11 subtype. Seventeen patients (21.5%) experienced recurrence, with a median time to recurrence of 14 months. No association was identified between lesional HPV-DNA positivity, toxic habits, Krouse stage, or malignant transformation and a higher risk of recurrence. The low prevalence of HPV-DNA in SNIPs suggests that HPV is not a main etiology for development of these lesions. With a lack of association between the evaluated factors and recurrence, further research with larger number of patients and additional biomarkers is warranted to further understand predisposing risk factors.

Diagnóstico citológico de «células glandulares atípicas» como predictor de enfermedad ginecológica oncológica / Cytological diagnosis of "atypical glandular cells" as a predictor of gynaecological oncological disease

Objetivos: Evaluar la incidencia en nuestro medio de citologías con resultado de atipia de células glandulares (ACG), así como analizar la conducta llevada a cabo ante estos resultados, el diagnóstico final y su relación con enfermedad ginecológica oncológica. Material y métodos: Estudio longitudinal, observacional, retrospectivo y descriptivo. Se revisaron las citologías realizadas en el Área 7 del Hospital Clínico San Carlos de Madrid, entre mayo de 2006 y agosto de 2016, seleccionando las informadas como ACG. Resultados: De 162.988 citologías realizadas durante 10 años y 3 meses, 40 fueron informadas como ACG. Desglosándolas, 11 fueron informadas como ACG-H, 6 como ACG-NOS, 22 como ACG endocervicales y una como ACG endometrial. El 75% de las pacientes con ACG presentaron enfermedad: 25% benigna, 15% displasia cervical y el 35% neoplasia. Si se desglosan y revisan los resultados, de 22 pacientes con ACG endocervicales, una presentó neoplasia, 4 displasia cervical, 9 enfermedad benigna y 8 negativas. De 11 ACG-H, 10 desarrollaron neoplasias y una fue negativa. De entre las 6 ACG-NOS, en 2 se encontraron neoplasias, en 2 displasia cervical, en una enfermedad benigna y una fue negativa. La citología ACG endometrial presentó un adenocarcinoma de endometrio. Conclusión: La incidencia en nuestro medio de citología con resultado de ACG es muy baja (0,025%). La probabilidad de presentar enfermedad detrás de esta alteración citológica es alta, lo que debe llevar a realizar un estudio exhaustivo de estas pacientes de acuerdo con las normas dictadas por las sociedades científicas, dado que un porcentaje no desdeñable puede traducir la existencia de enfermedad severa neoplásica no solo cervical, también endometrial u ovárica

Objectives: To evaluate the incidence of cytology reporting atypical glandular cells (AGC) in an area of Madrid, as well as to analyse the action taken on these results, the final diagnosis, and its relationship with gynaecological-oncological disease. Material and methods: A longitudinal, observational, retrospective and descriptive study was carried out on the cytology analysis performed in Area 7 of the HCSC of Madrid, between May 2006 and August 2016, was revised, selecting those reported as AGC. Results: Of the 162,988 cytologies performed during a period of 10 years and 3 months, 40 were reported as AGC. These included 11 reported as AGC-H, 6 AGC-NOS, 22 endocervical AGC, and one endometrial AGC. Of the 75% of patients with AGC that had a disease, 25% were benign, 15% with cervical dysplasia, and 35% with a neoplasm. On analysing the results of 22 patients with endocervical AGC, one had a neoplasm, 4 an intracervical neoplasm, 9 with benign disease, and 8 negative. Of the 11 AGC-H, 10 developed neoplasms and one was negative. Among the 6 AGC-NOS, 2 neoplasms were found as cervical intraepithelial neoplasia, one benign, and one negative. Endometrial AGC cytology showed an endometrial adenocarcinoma. Conclusion: The incidence of cytology in our area with AGC result is very low (0.025%). The probability of having an underlying cytological alteration is high, which in turn should lead to an exhaustive study of these patients according to the recommendations of the scientific societies, since a non-negligible percentage can translate into the existence of severe malignant diseases, not only cervical, but also endometrial or ovarian

Differences in binding kinetics, bond strength and adduct formation between Pt-based drugs and S- or N-donor groups: A comparative study using mass spectrometry techniques.

Pt-S and Pt-N interactions resulting from the coordination of cisplatin, oxaliplatin and carboplatin to two synthetic peptides that differ from each other in one amino acid (Met or His) have been thoroughly studied in this work. The degree of Pt-binding was determined by inductively coupled plasma mass spectrometry after the separation of the Pt-complexes from the unreacted drugs by size exclusion chromatography. Cisplatin and oxaliplatin showed high affinity for the peptides from the first hours of incubation, although the peptides required longer incubation times to obtain the same platination degrees with cisplatin than with oxaliplatin. Once the reactions reached their maximum binding degrees, the complexes with oxaliplatin began to dissociate, revealing binding reversibility, while a pseudo steady-state was observed for cisplatin until the last day of incubation. Conversely, the equilibrium was not reached for carboplatin and the His-peptide after 30 days, showing a binding degree of 16%, versus 78% for the Met-peptide. The S-donor group also presented an important influence on the reactivity and the adduct formation. The reaction rate for the Met-peptide was faster than the hydrolysis of oxaliplatin and carboplatin, and all the drugs, except oxaliplatin, were able to coordinate up to 3 different donor groups, which were identified by nanospray mass spectrometry. Since structural characterization of metal-complexes often represents an analytical challenge during electrophoretic separations, the strength of Pt-Met and Pt-His bonds was also evaluated under these conditions. The nature of the electrophoretic agents and the incubation times used were the parameters that most affected the stability. Higher Pt losses were found for the Met-peptide (35-90%) than for the His-peptide (16-48%), indicating that Pt-Met bonds were kinetically preferred while Pt-His interactions were thermodynamically favored.

Early Craniectomy Improves Intracranial and Cerebral Perfusion Pressure after Severe Traumatic Brain Injury.

After traumatic brain injury, decompressive craniectomy (DC) is a second-tier, late therapy for refractory intracranial hypertension. We hypothesize that early DC, based on CT evidence of intracranial hypertension, improves intracranial pressure (ICP) and cerebral perfusion pressure (CPP). From September 2008 to January 2015, 286 traumatic brain injury patients requiring invasive ICP monitoring at a single Level I trauma center were reviewed. DC and non-DC patients were propensity score matched 1:1, based on demographics, hemodynamics, injury severity score (ISS), Glasgow Coma Scale (GCS), transfusion requirements, and need for vasopressor therapy. Data are presented as M ± SD or median (IQR) and compared at P ≤ 0.05. The study population was 42 ± 17 years, 84 per cent male, ISS = 29 ± 11, GCS = 6(5), length of stay (LOS) = 32(40) days, and 28 per cent mortality. There were 116/286 (41%) DC, of which 105/116 (91%) were performed at the time of ICP placement. For 50 DC propensity matched to 50 non-DC patients, the midline shift was 7(11) versus 0(5) mm (P < 0.001), abnormal ICP (hours > 20 mm Hg) was 1(10) versus 8(16) (P = 0.017), abnormal CPP (hours < 60 mm Hg) was 0(6) versus 4(9) (P = 0.008), daily minimum CPP (mm Hg) was 67(13) versus 62(17) (P = 0.010), and daily maximum ICP (mm Hg) was 18(9) versus 22(11) (P < 0.001). However, LOS [33(37) versus 25(34) days], mortality (24 versus 30%), and Glasgow Outcome Score Extended [3.0(3.0) versus 3.0(4.0)] did not improve significantly. Early DC for CT evidence of intracranial hypertension decreased abnormal ICP and CPP time and improved ICP and CPP thresholds, but had no obvious effect on the outcome.

Does Vasopressin Exacerbate Cerebral Edema in Patients with Severe Traumatic Brain Injury?

Arginine vasopressin (AVP) is often used as an alternative pressor to catecholamines (CATs). However, unlike CATs, AVP is a powerful antidiuretic that could promote edema. We tested the hypothesis that AVP promoted cerebral edema and/or increased requirements for osmotherapy, relative to those who received CATs, for cerebral perfusion pressure (CPP) management after traumatic brain injury (TBI). This is a retrospective review of 286 consecutive TBI patients with intracranial pressure monitoring at a single institution from September 2008 to January 2015. Cerebral edema was quantitated using CT attenuation in prespecified areas of gray and white matter. RESULTS: To maintain CPP >60 mm Hg, 205 patients required no vasopressors, 41 received a single CAT, 12 received AVP, and 28 required both. Those who required no pressors were generally less injured; required less hyperosmolar therapy and less total fluid; and had lower plasma Na, lower intracranial pressure, less edema, and lower mortality (all P < 0.05). Edema; daily mean, minimum, and maximum Na levels; and mortality were similar with AVP versus CATs, but the daily requirement of mannitol and 3 per cent NaCl were reduced by 45 and 35 per cent (both P < 0.05). In patients with TBI who required CPP therapy, AVP reduced the requirements for hyperosmolar therapy and did not delay resolution or increase cerebral edema compared with CATs.

Cationic imprinting of Pb(II) within composite networks based on bovine or fish chondroitin sulfate.

Imprinting chondroitin sulfate (CS)/silica composites with Pb(II) and Cu(II) cations was explored with CS of bovine and different fish species origin. The process was based on the assumption that particular arrangements of the linear CS chains in aqueous solution, induced so as to accommodate cross complexation with the cations, would be embodied into a tridimensional matrix created through an organoalkoxysilane sol-gel scheme. The presence of Cu(II) in the synthesis of the composites did not result in the production of significantly stronger Cu(II)-oriented binding arrangements, and therefore, the imprinting was not successful. Inversely, for Pb(II), the materials obtained exhibited a "memory" effect for the Pb(II) ions, expressed in the observation of stronger (13%-44%) binding as compared to the nonimprinted counterparts, and increased selectivity (1.5-2 folds) against Cd(II). The imprinting features observed were dependent on the CS source. However, it was not possible to identify, among a set of their properties (carboxylate and sulfate abundance, percent of disulfated units, 4S/6S ratio, and molecular weight), any that correlated directly with the observed imprinting features. The augmented selectivity provided by the cation-imprinting process may be advantageous in areas such as analytical separation, remediation, purification, sensing, and others, particularly in those cases where a certain cation is of special interest within a mixture of them.