Search

In recent years, there has been a significant increase in the power consumption of data centers. As a result, server rack architecture has shifted from using 12 V to higher voltage levels of 48–60 V. The conventional power delivery system in use involves two stages of dc–dc conversion, utilizing an unregulated first-stage converter followed by a regulated converter. Among the first-stage converter topologies, the 4-to-1 switched tank converter (STC) is highly employed due to its high efficiency and power density. However, the STC has the drawback of generating a large inrush current during the startup phase. To address this issue, typically an auxiliary element such as a buck converter, a hot-swap controller, or an eFuse is employed. Additionally, achieving the zero-current switching condition in both resonant tanks is challenging when a mismatch in the resonant frequencies is considered. This article proposes a novel control technique to mitigate the large inrush that does not involve the use of any additional element, boosting the power density. It also presents a strategy to minimize the mismatch in the resonant frequencies in an STC. The experimental results obtained from a 600-W prototype validate the effectiveness of these approaches.

During last decade biomedical devices have become more and more performing, covering an increasing number of usages. In particular, subcutaneous devices represent one of the most invasive yet innovative application; their battery management is one of the most challenging topics because, once implanted, they can be handled only through surgery, so wireless charge is the only way to feed subcutaneous systems with appreciable energy in a controlled manner. But differently from conventional consumer devices, in this scenario the energy delivered necessarily runs into human body and tissues, so the main challenge consists in maximizing the “energy delivered versus energy dissipated in tissues” ratio, in order to guarantee human safety first while also conveying an appreciable amount of energy to the implanted device. After analyzing the state-of-the-art of the principal techniques, this article proposes a novel architecture for low-power wireless charging, based on a Wiegand sensor used as a transducer in order to fulfill all the requirements from both electrical and medical points of view; such architecture is implemented inside an IC prototype in 0.35- $\mu \text{m}$ lithography that acts as an ultralow-power DC–DC buck converter and battery manager.

Observational studies suggest that physical activity can reduce the risk of mental health and substance use disorders. However, it is unclear whether this relationship is causal or explained by confounding bias (e.g., common underlying causes or reverse causality). We investigated the bidirectional causal relationship of physical activity (PA) and sedentary behaviour (SB) with ten mental health and substance use disorders, applying two-sample Mendelian Randomisation (MR). Genetic instruments for the exposures and outcomes were derived from the largest available, non-overlapping genome-wide association studies (GWAS). Summary-level data for objectively assessed PA (accelerometer-based average activity, moderate activity, and walking) and SB and self-reported moderate-to-vigorous PA were obtained from the UK Biobank. Data for mental health/substance use disorders were obtained from the Psychiatric Genomics Consortium and the GWAS and Sequencing Consortium of Alcohol and Nicotine Use. MR estimates were combined using inverse variance weighted meta-analysis (IVW). Sensitivity analyses were conducted to assess the robustness of the results. Accelerometer-based average PA was associated with a lower risk of depression (b = −0.043, 95% CI: −0.071 to −0.016, effect size[OR] = 0.957) and cigarette smoking (b = −0.026; 95% CI: −0.035 to −0.017, effect size[β] = −0.022). Accelerometer-based SB decreased the risk of anorexia (b = −0.341, 95% CI: −0.530 to −0.152, effect size[OR] = 0.711) and schizophrenia (b = −0.230; 95% CI: −0.285 to −0.175, effect size[OR] = 0.795). However, we found evidence of reverse causality in the relationship between SB and schizophrenia. Further, PTSD, bipolar disorder, anorexia, and ADHD were all associated with increased PA. This study provides evidence consistent with a causal protective effect of objectively assessed but not self-reported PA on reduced depression and cigarette smoking. Objectively assessed SB had a protective relationship with anorexia. Enhancing PA may be an effective intervention strategy to reduce depressive symptoms and addictive behaviours, while promoting sedentary or light physical activities may help to reduce the risk of anorexia in at-risk individuals.

Triticum turgidumssp. dicoccoides(wild emmer wheat) was one of the first plants that gave rise to domestic wheat forms in southwest Asia. The details of the domestication of emmer and its early dispersal routes out of southwest Asia remain elusive, especially with regard to its dispersal to the east. In this study, we combine whole genome data from a selection of specimens of modern wild T. turgidumssp. dicoccoidesand domestic T. turgidumssp. dicoccum(emmer wheats) with a previously published 3,000 year old sample, to explore the phylogenetic relationships between wild and domestic populations of emmer, and especially the early dispersal routes south and eastwards to Africa and Asia, respectively. Our data confirm a marked differentiation between landraces from Europe, the Caucasus and Iran, and those from Africa, the Arabian Peninsula and India, the first group being more closely related to wild emmer from the northern and eastern Fertile Crescent. Gene flow is detected between wild emmer from the western Fertile Crescent and the second group of domestic emmer. These results support a dispersal route from southwest Asia to Africa, the Arabian Peninsula and India. We also observe a lower genetic variability in the wild emmer from the northern and eastern compared with that of the western Fertile Crescent. It is possible that the ancestors of domestic emmer that spread into Egypt still remain to be surveyed and analysed. Investigating the genetic content of ancient samples from Europe, the Caucasus or Iran would be very valuable to determine whether the two distinct types of germplasm arose during history or were already present during the early phases of dispersal.

Adverse childhood experiences (ACEs) are linked to poorer mental health outcomes, and growing evidence implicates biological and genetic pathways from early adversity to psychopathology. However, little is known about the relationship of ACEs and their underlying biological and genetic mechanisms with older people’s mental health responses to the COVID-19 pandemic. We tested the associations of ACEs, hair cortisol, C-reactive protein (CRP), and polygenic scores (PGS) with depression, anxiety, and loneliness among older adults during the COVID-19 pandemic, accounting for the potential interplay of ACEs with biological and genetic risk markers. Data were drawn from the English Longitudinal Study of Ageing, a prospective cohort study of older adults living in England. Retrospective information on ACEs were collected in 2006/7, while CRP and hair cortisol were measured at wave 6 (2012/13). Psychological distress was assessed before the pandemic (2018–19) and at two COVID-19 assessments in 2020 (June-July and November-December). Associations were tested on 2050 participants using linear/logistic regression models adjusted for pre-pandemic outcome measures and mixed-effect models to assess changes before and during the pandemic. The results showed that ACEs were associated with higher levels of depression (OR = 2.55[95%CI:1.81,3.59]) anxiety (OR = 1.84[95%CI:1.13,3.01]), and loneliness (b = 0.28[95%CI:0.14,0.42]) during the pandemic. Hair cortisol was related to an increased risk of depression (OR = 1.15[95%CI:1.04,1.26]), and CRP was associated with greater loneliness scores (b = 0.16[95%CI:0.03,0.30]). The relationship between cortisol and psychological distress was larger among participants with ACEs (e.g., ORdepression= 1.07[95%CI:1.00,1.14]). Further, individuals with high CRP experienced greater increases in feelings of loneliness from before to during the pandemic, compared to those with lower CRP levels (interaction effect=0.23; 95%CI:0.1–0.37). Individuals with 2+ ACEs experienced greater increases in depressive symptoms compared to those with none (interaction effect=2.09; 95%CI:1.1–3.98). Higher levels of hair cortisol were also related to worse changes in depressive symptoms across timepoints (interaction effect=1.84;95%CI:1.41–2.41). These results highlight the lasting impact of biosocial vulnerabilities on older adults’ mental health responses to new environmental stressors. They also implicate biological mechanisms in the pathophysiology of later-life psychological distress.

Adverse childhood experiences (ACEs) are associated with depression and systemic inflammation in adults. However, limited longitudinal research has tested these relationships in children and young people, and it is unclear whether inflammation is an underlying mechanism through which ACEs influence depression. We examined the longitudinal associations of several ACEs across different early-life periods with longitudinal patterns of early-life inflammation and depression in young adulthood and assessed the mediating role of inflammation. The data came from the Avon Longitudinal Study of Parents and Children (N= 3931). ACEs from the prenatal period through to adolescence were operationalised using cumulative scores, single adversities, and dimensions derived through factor analysis. Inflammation (C-reactive protein) was measured on three occasions (9–18 years) and depressive symptoms were ascertained on four occasions (18–23 years). Latent class growth analysis was employed to delineate group-based trajectories of inflammation and depression. The associations between ACEs and the inflammation/depression trajectories were tested using multinomial logistic regression analysis. Most types of ACEs across all early-life periods were associated with elevated depression trajectories, with larger associations for threat-related adversities compared with other ACEs. Bullying victimisation and sexual abuse in late childhood/adolescence were associated with elevated CRP trajectories, while other ACEs were unrelated to inflammation. Inflammation was also unrelated to depression and did not mediate the associations with ACEs. These results suggest that ACEs are consistently associated with depression, whereas the associations of inflammation with ACEs and depression are weak in young people. Interventions targeting inflammation in this population might not offer protection against depression.

All crops are the product of a domestication process that started less than 12,000 years ago from one or more wild populations1,2. Farmers selected desirable phenotypic traits (such as improved energy accumulation, palatability of seeds and reduced natural shattering3) while leading domesticated populations through several more or less gradual demographic contractions2,4. As a consequence, the erosion of wild genetic variation5is typical of modern cultivars, making them highly susceptible to pathogens, pests and environmental change6,7. The loss of genetic diversity hampers further crop improvement programmes to increase food production in a changing world, posing serious threats to food security8,9. Using both ancient and modern seeds, we analysed the temporal dynamics of genetic variation and selection during the domestication process of the common bean (Phaseolus vulgaris) in the southern Andes. Here, we show that most domestic traits were selected for before 2,500 years ago, with no or only minor loss of whole-genome heterozygosity. In fact, most of the changes at coding genes and linked regions that differentiate wild and domestic genomes are already present in the ancient genomes analysed here, and all ancient domestic genomes dated between 600 and 2,500 years ago are highly variable (at least as variable as modern genomes from the wild). Single seeds from modern cultivars show reduced variation when compared with ancient seeds, indicating that intensive selection within cultivars in the past few centuries probably partitioned ancestral variation within different genetically homogenous cultivars. When cultivars from different Andean regions are pooled, the genomic variation of the pool is higher than that observed in the pool of ancient seeds from north and central western Argentina. Considering that most desirable phenotypic traits are probably controlled by multiple polymorphic genes10, a plausible explanation of this decoupling of selection and genetic erosion is that early farmers applied a relatively weak selection pressure2by using many phenotypically similar but genetically diverse individuals as parents. Our results imply that selection strategies during the past few centuries, as compared with earlier times, more intensively reduced genetic variation within cultivars and produced further improvements by focusing on a few plants carrying the traits of interest, at the cost of marked genetic erosion within Andean landraces.

ABSTRACTBackgroundIn Italy vaccine hesitancy worsened after a failure to vaccinate episode that took place in Friuli Venezia-Giulia Region until early 2017 which undermined herd immunity by leaving unprotected more than 5,444 children.MethodsBetween May and June 2017, 2,557 parents were surveyed at the local vaccination clinic where they were invited within the subsequent extraordinary vaccination campaign. The aim of the survey was to evaluate whether the multi-channel extraordinary vaccination campaign had reached the target population and to know parental beliefs and trusted sources of information after the failure to vaccinate event.ResultsWhile 279 parents were non-hesitant (10.9%) and 1,491 hesitant acceptors (58.3%), just 38 (1.5%) refused to have their children revaccinated. Overall, the most consulted sources of information were print media (18.8%), physicians (16.0%), relatives and friends (12.1%). The majority of parents considered vaccination as a fundamental practice (73.9%), but many were worried about potential side effects (38.8%) or doubtful about the effectiveness of some vaccines (11.0%). According to parents, 19.7% of them (57) changed their opinion about vaccines after the Codroipo case.ConclusionsAfter the Codroipo case, most parents chose to have their children re-vaccinated and just a little proportion refused the re-administration of vaccines. More studies are needed to confirm the importance of a coherent multi-channel communication strategy using both traditional and new media in order to counteract vaccine hesitancy.

An updated taxonomic and nomenclatural framework is essential to develop most biological research. To stabilize the application of Hypericumnames and avoid future problems, we critically reviewed the protologues, the main Floras in which the studied names are listed, and the types of 84 names described for non‐Andean South America (Argentina, Brazil, Paraguay, Uruguay). Application of the term holotype is corrected to lectotype for 18 names, and type is corrected to lectotype for six names (“inadvertent lectotypifications”). For H. nudicaulethe term type is corrected to neotype, for H. paraguensethe term lectotype is corrected to neotype, and for H. polyanthemumthe term isotype is corrected to neotype (“inadvertent neotypifications”). For 24 names, lectotypifications are provided, including one re‐lectotypification (H. brasiliensevar. angustifolium) and 19 second‐step lectotypifications. Neotypes are designated for four names (H. cyathifolium, H. lorentzianum, H. meridionale, H. sellowianum). Five new synonyms are proposed (H. campestresubsp. pauciflorum, H. campestresubsp. tenue, H. rigidumsubsp. bracteatum, H. rigidumsubsp. meridionale, H. rigidumsubsp. sellowianum), and two superfluous names are detected for the first time (H. bolivianum, H. connatumvar. obscurum).

Hypothalamic-pituitary-adrenal (HPA)-axis hyperactivity and inflammation are thought to be prominent in the aetiology of depression. Although meta-analyses have confirmed this relationship, there is considerable variability in the effect sizes across studies. This could be attributed to a differential role of such biological systems in somatic versus cognitive-affective depressive symptoms which remains largely unexplored. Furthermore, most longitudinal research to date has focused on transient rather than persistent depressive symptoms. In the current study, we investigated the associations of hair cortisol and plasma C-reactive protein (CRP) with the longitudinal persistence and dimensions (cognitive-affective versus somatic) of depressive symptoms over a 14-year period using Trait‐State‐Occasion (TSO) structural equation modelling. The data came from a large sample of older adults from the English Longitudinal Study of Ageing. Depressive symptoms were assessed from wave 1 (2002–03) to wave 8 (2016–17). Hair cortisol (N= 4761) and plasma CRP (N= 5784) were measured in wave 6 (2012–13). Covariates included demographic, socioeconomic, lifestyle, chronic disease, and medication data. Our results revealed that higher cortisol and CRP levels were significantly associated with persistent depressive symptoms across the study period. Notably, both biomarkers exhibited stronger relationships with somatic than with cognitive-affective symptoms. The associations with somatic symptoms were also independent of relevant confounding factors. In contrast, their associations with cognitive-affective symptoms were weak after adjustment for all covariates. These distinct associations reveal the importance of considering symptom-specific effects in future studies on pathophysiological mechanisms. Ultimately, this will have the potential to advance the search for biomarkers of depression and facilitate more targeted treatments.

Purpose: The effect of combined lifestyle interventions (LSI) including dietary and physical activity on metabolic health, energy metabolism and VO2max in diabetic patients has provided mixed results. We evaluated the impact of 1-year caloric restriction (CR), and 12-week supervised structured exercise training (SSET) on metabolic health, RMR and VO2max in obese adults with type 2 diabetes. Methods: After 1-month education for LSI, 33 participants had anthropometric, biochemical and metabolic assessments. They then started CR based on RMR, and 3-month SSET during the months 1–3 (Early-SSET) or 4–6 (Late-SSET). Reassessments were planned after 3, 6 and 12 months. Using a per-protocol analysis, we evaluated parameter changes from baseline and their associations for the 23 participants (11 Early-SSET, 12 Late-SSET) who completed the study. RMR was adjusted (adjRMR) for age, sex, fat-free mass (FFM) and fat mass (FM). Results: Compared with baseline, after 6 months we found significant increases in VO2max (+?14%) and HDL-cholesterol (+?13%), and reduction in body mass index (-?3%), FM (-?8%) and glycated hemoglobin (HbA1c, -?7%). Training-related caloric expenditure negatively correlated with changes in body weight (p?<?0.001), FM (p?<?0.001) and HbA1c (p?=?0.006). These results were confirmed at the 12-month follow-up. Pooling together all follow-up data, adjRMR changes correlated with changes in glycemia (r?=?0.29, p?=?0.02), total-cholesterol (r?=?0.29, p?=?0.02) and VO2max (r?=?-?0.26,p?=?0.02). No significant differences emerged between the Early- and Late-SSET groups. Conclusions: Combined intervention with SSET and CR improved metabolic control. Changes in metabolic health and fitness correlated with changes of adjRMR, which was reduced improving fitness, glycemia and cholesterolemia. Clinical trial registry: Trial registration number: NCT03785379. URL of registration: http://clinicaltrials.gov.

Intraprocedural aneurysm sac embolization (embo-EVAR) during endovascular abdominal aneurysm repair (EVAR) using coils and fibrin glue is a technique for preventing type II endoleak (EII). Our aim is to evaluate feasibility, safety and clinical outcome of this promising approach.

ABSTRACTMycoplasma bovisis a major bovine pathogen associated with bovine respiratory disease complex and is responsible for substantial economic losses worldwide. M. bovisis also associated with other clinical presentations in cattle, including mastitis, otitis, arthritis, and reproductive disorders. To gain a better understanding of the genetic diversity of this pathogen, a multilocus sequence typing (MLST) scheme was developed and applied to the characterization of 137 M. bovisisolates from diverse geographical origins, obtained from healthy or clinically infected cattle. After in silicoanalysis, a final set of 7 housekeeping genes was selected (dnaA, metS, recA, tufA, atpA, rpoD, and tkt). MLST analysis demonstrated the presence of 35 different sequence types (STs) distributed in two main clonal complexes (CCs), defined at the double-locus variant level, namely, CC1, which included most of the British and German isolates, and CC2, which was a more heterogeneous and geographically distant group of isolates, including European, Asian, and Australian samples. Index of association analysis confirmed the clonal nature of the investigated M. bovispopulation, based on MLST data. This scheme has demonstrated high discriminatory power, with the analysis showing the presence of genetically distant and divergent clusters of isolates predominantly associated with geographical origins.

Purpose: To describe perforation of a Dacron aortic graft due to a post-thoracotomy dislocated rib fracture in a young Marfan patient.Case Report: Six months after a successful open repair of a type II dissecting thoracoabdominal aortic aneurysm (TAAA), a 40-year-old woman with Marfan syndrome underwent elective repair of a post-thoracotomy dislocated rib fracture. During the procedure, the graft ruptured; 2 TAG stent-grafts were emergently implanted to reline the existing aortic graft. The fractured rib was then resected. The postoperative course was uneventful, without residual leak at computed tomography at 3 days. At 18 months, the patient is well, without need of further operations.Conclusion: Early correction of any dislocated rib fracture close to a thoracic aortic graft should be considered, especially if the graft is not wrapped by the aneurysm sac. In these patients, in-graft endovascular relining associated with repair of the rib fracture may be a feasible and effective alternative to redo thoracotomy and surgical graft repair. Prior to attempting rib resection, appropriate thoracic endografts should be on hand in case an endovascular bailout is needed.

The novel benzopyranopyrrolidine, S33138 [N-[4-[2-[(3aS,9bR)-8-cyano-1,3a,4,9b-tetrahydro[1]benzopyrano[3,4-c]pyrrol-2(3H)-yl)-ethyl]phenylacetamide], is a preferential antagonist of cloned human D(3) versus D(2L) and D(2S) receptors. In mice, S33138 (0.04-2.5 mg/kg i.p.) increased levels of mRNA encoding c-fos in D(3) receptor-rich Isles of Calleja and nucleus accumbens more potently than in D(2) receptor-rich striatum. Furthermore, chronic (3 weeks) administration of S33138 to rats reduced the number of spontaneously active dopaminergic neurones in the ventral tegmental area (0.16-10.0 p.o.) more potently than in the substantia nigra (10.0). In primates treated with 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine, antiparkinson actions of the D(3)/D(2) agonist, ropinirole, were potentiated by low doses of S33138 (0.01-0.16 p.o.) but diminished by a high dose (2.5). Consistent with antagonism of postsynaptic D(3)/D(2) sites, S33138 attenuated hypothermia and yawns elicited by the D(3)/D(2) agonist 7-OH-DPAT [(+)-7-dihydroxy-2-(di-n-propylamino)-tetralin] in rats, and it blocked (0.01-0.63, s.c.) discriminative properties of PD128,907 [(+)-(4aR,10bR)-3,4, 4a,10b-tetrahydro-4-propyl-2H,5H-[1]benzopyrano-[4,3-b]-1,4-oxazin-9-ol; trans-N-[4-[2-(6-cyano-1,2,3,4-tetrahydroisoquinolin-2-yl)ethyl]cyclohexyl]-4-quinolininecarboxamide]. Suggesting antagonist properties at D(3)/D(2) autoreceptors, S33138 prevented (0.16-2.5 s.c.) the inhibitory influence of PD128,907 upon dopamine release in frontal cortex, nucleus accumbens, and striatum and abolished (0.004-0.25 i.v.) its inhibition of ventral tegmental dopaminergic neuron firing. At higher doses, antagonist actions of S33138 (0.5-4.0 i.v.) at alpha(2C)-adrenoceptors were revealed by an increased firing rate of adrenergic perikarya. Finally, antagonism of 5-hydroxytryptamine (5-HT(2A) and 5-HT(7)) receptors was shown by blockade of 1-[2,5-dimethoxy-4-iodophenyl]-2-aminopropane-induced head twitches (0.63-10.0 s.c.) and 5-carboxytryptamine-induced hypothermia (2.5-20.0 i.p.), respectively. In conclusion, S33138 displays modest antagonist properties at central alpha(2C)-adrenoceptors, 5-HT(2A) and 5-HT(7) receptors. Furthermore, in line with its in vitro actions, it more potently blocks cerebral populations of D(3) versus D(2) receptors.

We evaluated whether the increased immunogenicity provided by an MF59-adjuvant influenza vaccine translates into increased protection among the elderly. Residents of 25 long-term care facilities received either the adjuvant or a non-adjuvant vaccine. The odds ratios (OR) of influenza-like illness were calculated for non-adjuvant vs. adjuvant vaccine recipients, also stratifying for chronic cardiovascular, respiratory, and renal diseases. The risk was higher for the non-adjuvant vaccine recipients and highest for those with respiratory disease (OR 2·27, 95% CI 1·09–4·82) and cardiovascular disease (OR 1·88; 95% CI 1·31–2·72). In this study the MF59-adjuvant vaccine provided superior clinical protection among the elderly, especially those with chronic diseases.

The dehydration of cyclododecanol with copper(II) sulfate (anhydrous, monohydrate, and pentahydrate) unsupported and supported on silica (prepared in situ and as a preformed catalyst) was studied to develop an improved method for dehydrating secondary alcohols. The dehydration progress, synergism of the catalyst(s), and purity of the products were monitored by gas chromatography. Reactions were studied in refluxing octane, a series of aromatic hydrocarbons, and tetrachloroethylene. A comparison is made of dehydration methods contrasting the use of a reflux condenser with no provision for removing water, a conventional Dean−Stark apparatus, and a modified Dean−Stark apparatus incorporating a molecular sieve (AW-500). Aluminum potassium sulfate, supported on silica, was also shown to be an effective dehydration catalyst. The supported catalysts did not cause formation of side products and were found to retain activity in multiple runs. Characterization of the catalysts was performed using Brunauer−Emmett−Teller surface area measurements, Fourier transform infrared spectroscopy, thermogravimetric analysis/differential thermal analysis, and Hammett indicators.

Beta-endorphin/beta-lipotropin immunoreactivity (BE/BLPH-IR) content was evaluated in the CSF of patients suffering by deafferentation pain syndromes. BE/BLPH-IR CSF concentrations of these patients were compared with those obtained in a group of patients affected by low back pain and in a control group without pain problems. No statistically significant variation in BE/BLPH-IR levels were found between controls and subjects with different types of chronic pain.

Summary The effect of trigeminal electrical stimulation on cerebral blood flow has been studied in conditions of normal or reduced cerebral blood flow (CBF).

Summary The authors describe percutaneous radiofrequency (rf) thermocoagulation of the sphenopalatine ganglion used to treat seven patients with sphenopalatine ganglion neuralgia.

Summary The authors discuss about five cases of diabetes insipidus observed in patients affected by traumatic cervical spine fractures and/ or dislocations, without either evident lesions of the cerebral structures at CT scan examination, or important craniocerebral trauma.

The diffuse reflectance IR technique has permitted the study of corrosion products to be carried out in a very simple manner. The products formed in the presence of aggressive anions such as chlorides and sulfates were studied. The advantage of this technique was the fact that the products could be studied while intact on the specimen and thus not requiring sample preparation and avoiding interferences that can occur during sample preparations. The technique is also relatively easier and less costly compared to other techniques such as ESCA.

The chemical study on bone and cartilage to be reported here supplements the work described in an earlier paper1 on the mineral composition of the human fetus. In other investigations2 made on similar material only a few of the mineral constituents have been considered. Apparently the percentage of some minerals remains fairly constant during short periods of fetal growth, but it has not been shown that this constancy persists for the entire fetal period or that the concentrations of other mineral elements show the same tendency. This investigation presents the values for the most important mineral constituents of specimens of bone and cartilage taken from twenty-one fetuses weighing from 197 to 4,150 Gm.The material for this study was obtained at autopsy from eight to sixteen hours after death. Postmortem changes during the interval between death and autopsy were controlled as far as possible by refrigeration. The specimens

Quantitative determinations of minerals excreted by the skin of infants have received little consideration in the literature. Only one paper by Rominger and Meyer,1 which bears directly on this subject, has come to our attention. A number of papers2 deal with the mineral content of the sweat in the normal adult, in the sick adult and in the adult in whom sweating was induced artificially.Rominger and Meyer1 determined the combined amount of sodium and potassium as chlorides excreted through the skin of an infant fed on cow's milk. They concluded that the amount of sodium and potassium lost through the skin did not materially affect the differences in retention of these elements obtained in the breast-fed infants and in those fed cow's milk. In our extended study of this problem, it was our object to determine separately the amount of sodium, potassium, chlorine, calcium and phosphorus

Calcification occurring in the skin, subcutaneous tissues and in the deeper structures, where calcium deposits are not normally found, is referred to in medical literature as calcinosis. In 1907, Reines1 published the findings of a case of calcinosis under the title, "Petrificatio cutis circumscripta." Versé,2 in 1912, described a case of calcinosis, calling the condition "calcinosis universalis," since the calcification involved not only the skin but also the deeper structures. Recently Steinitz3 published a comprehensive review of the literature dealing with this type of abnormal calcification. He groups the 105 cases that he has gathered from the literature, including a case of his own, according to the classification suggested by Reines1 and Versé.2 Of these 105 cases he finds that 71 may be listed as calcinosis circumscripta and 34 as calcinosis universalis.The reasons for this classification may be summarized as follows: 1. The abnormal

The amount of blood lost during surgical operations of various types has been measured and reported by a number of observers. The facts disclosed by these observations have not been generally recognized, nor has their practical importance been sufficiently emphasized. In order to bring attention to this technical problem, the literature on it has been reviewed and further studies have been made as are here reported. Shock appearing during and after operation is still the apprehension of the surgeon and a menace to the patient. During the past three years an enormous amount of investigation on the subject of shock has added materially to our knowledge of it. One fact, however, remains clear: There is no single reliable test or clinical sign of impending shock, especially in anesthetic and postanesthetic states. By the time shock is recognized as such it is well established. Our ability to treat shock has improved,

The mineral growth of the human fetus may be determined from the chemical composition at various stages of fetal development. Data on the chemical composition from which such growth can be shown earlier than the sixth lunar month are, to our knowledge, practically lacking in the literature. This may be due to the difficulty of obtaining sufficient material for the macrochemical methods used by the earlier investigators. In the present study, we were able, using microchemical methods, to study the chemical composition of the human fetus as early as the third lunar month.In a series of sixteen fetuses, analyses were made for sodium, potassium, calcium, magnesium, phosphorus, chlorine and nitrogen. The analyses of the two youngest fetuses are not complete, since there was not sufficient material for all the microchemical methods. Data which give the per cent of body fat, constant dry weight and per cent of water are

It has long been taken for granted that the weight of the bony and cartilaginous skeleton at birth comprises from 15 to 20 per cent1 of the body weight. About a year ago it was found, on careful dissection, that the weight of the skeleton of an early and of a full term fetus approximated more nearly 10 per cent of the body weight. Recently this observation has been confirmed by the results of examination of three human fetuses weighing 530, 2,060 and 3,140 Gm. From these results have been determined the weight relation of cartilage to bone and of skeleton to body weight and the chemical composition of the skeletal components of the fetus.The freeing of bone and cartilage from the other body tissues becomes more difficult as the fetus approaches term. In the very small fetus the bones and, to some extent, the cartilage were cleaned

IT HAS been well substantiated that the proportion of aged in the population of the United States is increasing. In 1900, the average life expectancy was 48 years. By 1950, it had increased to 68.27 years. During the period 1930-1940, there was a 7% increase in the total population of this country, but during the same period the number of persons between the ages of 65 and 74 had increased 35% and the number over 75 years by 38%.1 As a natural consequence, there has been an increase in the number of patients undergoing surgery in the latter decades of life. At the University of Michigan Hospital there has been a 112% increase in the number of major abdominal operations in patients more than 50 years of age in 1950, as compared with the number in 1940. Furthermore, a steady increase in the relative number of patients over 60

MANY studies on the behavior of body fluids have led to an increasing interest in the subject of cellular electrolytes and the transfer of cations across the cell barrier. Losses of the main cellular cation, potassium, in "excess" of nitrogen have been reported in fasting,1 dehydration,2 diabetic coma3 and diarrhea.4 Furthermore, partial replacement of deficits of cell potassium by extracellular sodium have been effected in animals5 on low potassium-high sodium diets, in animals treated with desoxycorticosterone6 and in patients with alkalosis7 and infants with diarrhea.8 The administration of potassium as well as sodium has beenfound to have therapeutic value in some of these conditions.In this paper data of potassium and nitrogen losses have been analyzed from a large number of infusion studies in control subjects and patients undergoing mild and traumatizing operations (herniorrhaphies and combined abdominoperineal resections for carcinoma of the

The reduced sulfur balances of growing infants reported in an earlier paper1 impelled us to make a third long term study of the metabolism of a normal infant, fed breast milk for the first 8 test periods and cow's milk for the remaining 6.Efforts were made to reduce all possible chances of error in the determinations of sulfur. The open-dish method of oxidation of Benedict2 and Denis,3 used for the determination of sulfur in urine, stool and dried milk, was modified according to the suggestion of Waelsch and Klepetar:4 The oxidizing medium was made alkaline to approximately pH 7.2 by the addition of a saturated solution of sodium carbonate. Sulfur was determined subsequently as barium sulfate. Average values of 10.4 mg of sulfur per hundred cubic centimeters for breast milk and 0.204 per cent sulfur for powdered whole cow's milk were obtained; these correspond

The knowledge of mineral metabolism in osteogenesis imperfecta has been obtained mainly from the investigations of Schwarz and Bass,1 Bookman,2 and Klercker3 and recently from a more detailed study by Sindler.4 A summary and comparison of their data with a study of the metabolism in a similar case are presented in this paper. Only by thus summarizing the data and by adding more complete analyses will an approach to the study of this baffling disease yield its store of information. No attempt has been made to review the clinical and pathologic literature on the subject since this has been done recently by Dietrich.5We were fortunate in being able to study soon after birth a female infant who showed all the clinical signs of osteogenesis imperfecta. The clinical diagnosis was further verified by the roentgenogram, as shown in the figure. REPORT OF A CASE The

A short preliminary report1 of this study was made in 1932. In a table presented at that time were shown the amounts of sodium potassium, magnesium, chlorine, nitrogen, calcium and phosphorus in the ash content of rat pups. These figures revealed that the calcium and phosphorus contents of the fetal ash were increased when the mother rat was given vitamin D. In view of the present tendency on the part of obstetricians to give pregnant mothers large doses of vitamin D for various causes, this observation becomes significant, and it seemed advisable to make a further study on a larger series of rat pups, comparing the effect of viosterol and cod liver oil on the calcium and phosphorus transmission from the mother to the fetus.The rats used for our experimental work were raised from our stock colony. Only first litter pups were used in this study. The female