SLESIS-R: an improved score for prediction of serious infection in patients with systemic lupus erythematosus based on the RELESSER prospective cohort.

OBJECTIVE: To develop an improved score for prediction of severe infection in patients with systemic lupus erythematosus (SLE), namely, the SLE Severe Infection Score-Revised (SLESIS-R) and to validate it in a large multicentre lupus cohort. METHODS: We used data from the prospective phase of RELESSER (RELESSER-PROS), the SLE register of the Spanish Society of Rheumatology. A multivariable logistic model was constructed taking into account the variables already forming the SLESIS score, plus all other potential predictors identified in a literature review. Performance was analysed using the C-statistic and the area under the receiver operating characteristic curve (AUROC). Internal validation was carried out using a 100-sample bootstrapping procedure. ORs were transformed into score items, and the AUROC was used to determine performance. RESULTS: A total of 1459 patients who had completed 1 year of follow-up were included in the development cohort (mean age, 49±13 years; 90% women). Twenty-five (1.7%) had experienced ≥1 severe infection. According to the adjusted multivariate model, severe infection could be predicted from four variables: age (years) ≥60, previous SLE-related hospitalisation, previous serious infection and glucocorticoid dose. A score was built from the best model, taking values from 0 to 17. The AUROC was 0.861 (0.777-0.946). The cut-off chosen was ≥6, which exhibited an accuracy of 85.9% and a positive likelihood ratio of 5.48. CONCLUSIONS: SLESIS-R is an accurate and feasible instrument for predicting infections in patients with SLE. SLESIS-R could help to make informed decisions on the use of immunosuppressants and the implementation of preventive measures.

Interpretation of the LHCb P_{c} States as Hadronic Molecules and Hints of a Narrow P_{c}(4380).

Three hidden-charm pentaquark P_{c} states, P_{c}(4312), P_{c}(4440), and P_{c}(4457) were revealed in the Λ_{b}^{0}→J/ψpK^{-} process measured by LHCb using both run I and run II data. Their nature is under lively discussion, and their quantum numbers have not been determined. We analyze the J/ψp invariant mass distributions under the assumption that the crossed-channel effects provide a smooth background. For the first time, such an analysis is performed employing a coupled-channel formalism with the scattering potential involving both one-pion exchange as well as short-range operators constrained by heavy quark spin symmetry. We find that the data can be well described in the hadronic molecular picture, which predicts seven Σ_{c}^{(*)}D[over ¯]^{(*)} molecular states in two spin multiplets, such that the P_{c}(4312) is mainly a Σ_{c}D[over ¯] bound state with J^{P}=1/2^{-}, while P_{c}(4440) and P_{c}(4457) are Σ_{c}D[over ¯]^{*} bound states with quantum numbers 3/2^{-} and 1/2^{-}, respectively. We also show that there is evidence for a narrow Σ_{c}^{*}D[over ¯] bound state in the data which we call P_{c}(4380), different from the broad one reported by LHCb in 2015. With this state included, all predicted Σ_{c}D[over ¯], Σ_{c}^{*}D[over ¯], and Σ_{c}D[over ¯]^{*} hadronic molecules are seen in the data, while the missing three Σ_{c}^{*}D[over ¯]^{*} states are expected to be found in future runs of the LHC or in photoproduction experiments.

H2 production pathways in nutrient-replete mixotrophic Chlamydomonas cultures under low light. Response to the commentary article "On the pathways feeding the H2 production process in nutrient-replete, hypoxic conditions," by Alberto Scoma and Szilvia Z. Tóth.

BACKGROUND: A recent Commentary article entitled "On the pathways feeding the H2 production process in nutrient-replete, hypoxic conditions" by Dr. Scoma and Dr. Tóth, Biotechnology for Biofuels (2017), opened a very interesting debate about the H2 production photosynthetic-linked pathways occurring in Chlamydomonas cultures grown in acetate-containing media and incubated under hypoxia/anoxia conditions. This Commentary article mainly focused on the results of our previous article "Low oxygen levels contribute to improve photohydrogen production in mixotrophic non-stressed Chlamydomonas cultures," by Jurado-Oller et al., Biotechnology for Biofuels (7, 2015; 8:149). MAIN BODY: Here, we review some previous knowledge about the H2 production pathways linked to photosynthesis in Chlamydomonas, especially focusing on the role of the PSII-dependent and -independent pathways in acetate-containing nutrient-replete cultures. The potential contributions of these pathways to H2 production under anoxia/hypoxia are discussed. CONCLUSION: Despite the fact that the PSII inhibitor DCMU is broadly used to discern between the two different photosynthetic pathways operating under H2 production conditions, its use may lead to distinctive conclusions depending on the growth conditions. The different potential sources of reductive power needed for the PSII-independent H2 production in mixotrophic nutrient-replete cultures are a matter of debate and conclusive evidences are still missing.

Low oxygen levels contribute to improve photohydrogen production in mixotrophic non-stressed Chlamydomonas cultures.

BACKGROUND: Currently, hydrogen fuel is derived mainly from fossil fuels, but there is an increasing interest in clean and sustainable technologies for hydrogen production. In this context, the ability of some photosynthetic microorganisms, particularly cyanobacteria and microalgae, to produce hydrogen is a promising alternative for renewable, clean-energy production. Among a diverse array of photosynthetic microorganisms able to produce hydrogen, the green algae Chlamydomonas reinhardtii is the model organism widely used to study hydrogen production. Despite the well-known fact that acetate-containing medium enhances hydrogen production in this algae, little is known about the precise role of acetate during this process. RESULTS: We have examined several physiological aspects related to acetate assimilation in the context of hydrogen production metabolism. Measurements of oxygen and CO2 levels, acetate uptake, and cell growth were performed under different light conditions, and oxygenic regimes. We show that oxygen and light intensity levels control acetate assimilation and modulate hydrogen production. We also demonstrate that the determination of the contribution of the PSII-dependent hydrogen production pathway in mixotrophic cultures, using the photosynthetic inhibitor DCMU, can lead to dissimilar results when used under various oxygenic regimes. The level of inhibition of DCMU in hydrogen production under low light seems to be linked to the acetate uptake rates. Moreover, we highlight the importance of releasing the hydrogen partial pressure to avoid an inherent inhibitory factor on the hydrogen production. CONCLUSION: Low levels of oxygen allow for low acetate uptake rates, and paradoxically, lead to efficient and sustained production of hydrogen. Our data suggest that acetate plays an important role in the hydrogen production process, during non-stressed conditions, other than establishing anaerobiosis, and independent of starch accumulation. Potential metabolic pathways involved in hydrogen production in mixotrophic cultures are discussed. Mixotrophic nutrient-replete cultures under low light are shown to be an alternative for the simultaneous production of hydrogen and biomass.

Relevance of nutrient media composition for hydrogen production in Chlamydomonas.

Microalgae are capable of biological H2 photoproduction from water, solar energy, and a variety of organic substrates. Acclimation responses to different nutrient regimes finely control photosynthetic activity and can influence H2 production. Hence, nutrient stresses are an interesting scenario to study H2 production in photosynthetic organisms. In this review, we mainly focus on the H2-production mechanisms in Chlamydomonas reinhardtii and the physiological relevance of the nutrient media composition when producing H2.

The value of 6-month interval imaging after benign radiologic-pathologic concordant minimally invasive breast biopsy.

BACKGROUND: Current National Comprehensive Cancer Network guidelines recommend repeat imaging 6-12 months after a benign radiologic-pathologic concordant image-guided breast biopsy. We hypothesized that interval imaging <12 months after benign concordant biopsy has a low cancer yield and increases health care costs. METHODS: An institutional review board-approved retrospective chart review identified 689 patients who underwent image-guided breast biopsy at Bryn Mawr Hospital between January and December 2010. Charts were evaluated for documentation of radiologic-pathologic concordance. RESULTS: Of 689 patients, 188 (27 %) had malignant pathology, 3 (0.4 %) had nonbreast pathology, and 498 (72.3 %) had benign pathology. Of 498 patients with benign findings, 44 (8.8 %) underwent surgical excision as a result of discordance, atypia, papillary lesion, or other benign finding. Of the remaining 454 patients who did not undergo excision, 337 (74.2 %) had documented radiologic-pathologic concordance. Interval imaging <12 months after benign biopsy was obtained in 182 (54.0 %) concordant patients. Five (2.7 %) patients had suspicious [American College of Radiology Breast Imaging-Reporting and Data System (BI-RADS) 4] findings on follow-up imaging. Only one breast cancer was identified, representing 0.5 % (95 % confidence interval 0-3.4) of all benign concordant patients undergoing interval imaging. The cost of detecting a missed cancer with interval imaging after benign concordant biopsy was $41,813.77 in this cohort. CONCLUSIONS: Interval imaging performed <12 months after benign concordant breast biopsy demonstrated a low yield for the detection of breast cancer and resulted in increased health care costs. Our data support the policy for discontinuation of routine interval imaging after benign concordant biopsy.

Surprises in threshold antikaon-nucleon physics.

Low energy KN interactions are studied within unitary chiral perturbation theory at next-to-leading order with ten coupled channels. We pay special attention to the recent precise determination of the strong shift and width of the kaonic hydrogen 1s state by the DEAR Collaboration that has challenged our theoretical understanding of this sector of strong interactions. We typically find two classes of solutions, both of them reproducing previous data, that either can or cannot accommodate the DEAR measurements. The former class has not been previously discussed.

Minimum distance probability discriminant analysis for mixed variables.

Minimum distance probability (MDP) is a robust discriminant algorithm based on a distance function. In this article, we generalize the use of MDP to the case of mixed (continuous and categorical) variables by means of the individual-score (IS) distance. This distance assumes an underlying parametric model and is based on the score transformation of the data. We have adapted it to the usual case of ignoring the distribution of the whole set of observed variables, but assuming that some knowledge about the marginal distributions is available. Finally, MDP with IS distance (IS-MDP) is compared with other discriminant methods (including those designed for mixed data) in several examples and simulations. IS-MDP is shown to be the most efficient method according the leave-one-out criterion.