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Estuaries include some of the most productive yet anthropogenically impacted marine ecosystems on the planet, and provide critical habitat to many ecologically and economically important marine species. In order to elucidate ecological function in estuaries, we must understand what factors drive community dynamics. Delaware Bay is the third largest estuary in the United States and hosts over 200 species of migrant and resident fishes and invertebrates. The Delaware Division of Fish and Wildlife has conducted two long-term trawl surveys at monthly intervals in Delaware Bay since 1966. The two surveys collect data on environmental conditions, species composition, and number of fishes and macroinvertebrates across different size classes and life histories. Using a suite of multivariate approaches including hierarchical cluster analysis, canonical correlation analysis, and permutational multivariate analysis of variance, we characterized the fish and macroinvertebrate community in Delaware Bay and found that community composition and environmental conditions varied across spatial and seasonal scales. We identified four distinct biogeographic regions, based on environmental conditions and community composition, which were consistent across surveys. We found that the community was driven primarily by gradients in temperature and salinity and that abundant, frequently occurring species in the Bay have well-defined environmental associations. Our work represents the first attempt to use an existing historical survey to better understand how environmental parameters influence diversity and distribution of macrofauna within Delaware Bay, providing insight into how abiotic variables, influenced by climate, may impact the Delaware Bay ecosystem and similar estuarine ecosystems worldwide. [ABSTRACT FROM AUTHOR]

The California Current Trophic Database (CCTD) was developed at NOAA Southwest Fisheries Science Center in collaboration with numerous diet data contributors. We compiled the CCTD from twenty-four data sets, representing both systematic collections and directed trophic studies. Diet composition data, including stomach and scat samples, were obtained from 105,694 individual predators among 143 taxa collected throughout the California Current Large Marine Ecosystem (CCLME) from 1967–2019. Predator taxa consist of squids (n = 5), elasmobranchs (n = 13), bony fishes (n = 118), and marine mammals (n = 7). Extensive time series are available for some predators (e.g., California Sea Lion, Pacific Hake, Chinook Salmon). The CCTD represents the largest compilation of raw trophic data within the CCLME, allowing for more refined analyses and modeling studies within this region. Our intention is to further augment and periodically update the dataset as additional historical or contemporary data become available to increase its utility and impact. [ABSTRACT FROM AUTHOR]

Understanding the nature and origin of the precursor material to terrestrial planets is key to deciphering the mechanisms and timescales of planet formation1. Nucleosynthetic variability among rocky Solar System bodies can trace the composition of planetary building blocks2–5. Here we report the nucleosynthetic composition of silicon (μ30Si), the most abundant refractory planet-building element, in primitive and differentiated meteorites to identify terrestrial planet precursors. Inner Solar System differentiated bodies, including Mars, record μ30Si deficits of −11.0 ± 3.2 parts per million to −5.8 ± 3.0 parts per million whereas non-carbonaceous and carbonaceous chondrites show μ30Si excesses from 7.4 ± 4.3 parts per million to 32.8 ± 2.0 parts per million relative to Earth. This establishes that chondritic bodies are not planetary building blocks. Rather, material akin to early-formed differentiated asteroids must represent a major planetary constituent. The μ30Si values of asteroidal bodies correlate with their accretion ages, reflecting progressive admixing of a μ30Si-rich outer Solar System material to an initially μ30Si-poor inner disk. Mars’ formation before chondrite parent bodies is necessary to avoid incorporation of μ30Si-rich material. In contrast, Earth’s μ30Si composition necessitates admixing of 26 ± 9 per cent of μ30Si-rich outer Solar System material to its precursors. The μ30Si compositions of Mars and proto-Earth are consistent with their rapid formation by collisional growth and pebble accretion less than three million years after Solar System formation. Finally, Earth’s nucleosynthetic composition for s-process sensitive (molybdenum and zirconium) and siderophile (nickel) tracers are consistent with pebble accretion when volatility-driven processes during accretion and the Moon-forming impact are carefully evaluated.The nucleosynthetic composition of silicon in meteorites indicates that material akin to early-formed differentiated asteroids must represent a major constituent of terrestrial planets such as Earth and Mars. [ABSTRACT FROM AUTHOR]

Volatiles are vital ingredients for a habitable planet. Angrite meteorites sample the most volatile-depleted planetesimal in the Solar System, particularly for the alkali elements. They are prime targets for investigating the formation of volatile-poor rocky planets, yet their exceptionally low volatile content presents a major analytical challenge. Here, we leverage improved sensitivity and precision of K isotopic analysis to constrain the mechanism of extreme K depletion (>99.8%) in angrites. In contrast with the isotopically heavy Moon and Vesta, we find that angrites are strikingly depleted in the heavier K isotopes, which is best explained by partial recondensation of vaporized K following extensive evaporation on the angrite parent body (APB) during magma-ocean stage. Therefore, the APB may provide a rare example of isotope fractionation controlled by condensation, rather than evaporation, at a planetary scale. Furthermore, nebula-wide K isotopic variations primarily reflect volatility-driven fractionations instead of presolar nucleosynthetic heterogeneity proposed previously. This study reports strikingly light K isotopic compositions for the extremely K-depleted angrite meteorites, thereby providing the first observation of isotope fractionation likely controlled by partial recondensation at a planetary scale. [ABSTRACT FROM AUTHOR]

We describe the AMBITION project, a mission to return the first-ever cryogenically-stored sample of a cometary nucleus, that has been proposed for the ESA Science Programme Voyage 2050. Comets are the leftover building blocks of giant planet cores and other planetary bodies, and fingerprints of Solar System's formation processes. We summarise some of the most important questions still open in cometary science and Solar System formation after the successful Rosetta mission. We show that many of these scientific questions require sample analysis using techniques that are only possible in laboratories on Earth. We summarize measurements, instrumentation and mission scenarios that can address these questions. We emphasize the need for returning a sample collected at depth or, still more challenging, at cryogenic temperatures while preserving the stratigraphy of the comet nucleus surface layers. We provide requirements for the next generation of landers, for cryogenic sample acquisition and storage during the return to Earth. Rendezvous missions to the main belt comets and Centaurs, expanding our knowledge by exploring new classes of comets, are also discussed. The AMBITION project is discussed in the international context of comet and asteroid space exploration. [ABSTRACT FROM AUTHOR]

Use of high-flow oxygen via nasal cannula (HFO2-NC) is increasingly common in intensive care unit (ICU) settings. Despite the critical interface between respiration and swallowing, and the high acuity of patients in ICUs, the impact of HFO2-NC on feeding and swallowing is unknown. The present prospective, single-center, cohort study investigated the impact of HFO2-NC use on oral alimentation in neonatal and adult ICU patients. Oral alimentation status was evaluated in 100 consecutive ICU inpatients (50 neonatal and 50 adult) requiring HFO2-NC. Participant characteristics, respiratory support, successful initiation of oral feeding in neonates, and successful resumption of oral feeding in adults were recorded. Seventeen of 50 (34 %) neonates requiring HFO2-NC were deemed developmentally and medically appropriate by the neonatologist and nursing to begin oral alimentation. All 17 (100 %) were successful with initiation of oral feedings. Thirty-three of 50 (66 %) continued nil per os due to prematurity or medical conditions precluding oral alimentation at time of data collection. Thirty-nine of 50 (78 %) adults requiring HFO2-NC were deemed medically appropriate by the intensivist and nursing to resume oral alimentation (n = 34) or with a functional swallow without aspiration on FEES (n = 5). All 39 (100 %) resumed oral alimentation successfully. Eleven of 50 (22 %) continued nil per os due to severe respiratory issues precluding both swallow testing and oral alimentation at time of data collection. All developmentally and medically appropriate neonatal and adult patients requiring HFO2-NC were successful with either the introduction or resumption of oral alimentation. Patients requiring HFO2-NC who are identified as having feeding or swallowing issues should be referred for swallowing evaluations using the same criteria as patients who do not require HFO2-NC, as it is not the use of HFO2-NC but rather patient-specific determinants of feeding and swallowing readiness and their underlying medical conditions that impact readiness for oral alimentation status. [ABSTRACT FROM AUTHOR]

The formation of a primordial crust is a critical step in the evolution of terrestrial planets but the timing of this process is poorly understood. The mineral zircon is a powerful tool for constraining crust formation because it can be accurately dated with the uranium-to-lead (U-Pb) isotopic decay system and is resistant to subsequent alteration. Moreover, given the high concentration of hafnium in zircon, the lutetium-to-hafnium (176Lu-176Hf) isotopic decay system can be used to determine the nature and formation timescale of its source reservoir [1]- [3]. Ancient igneous zircons with crystallization ages of around 4,430 million years (Myr) have been reported in Martian meteorites that are believed to represent regolith breccias from the southern highlands of Mars [4], [5]. These zircons are present in evolved lithologies interpreted to reflect re-melted primary Martian crust [4], thereby potentially providing insight into early crustal evolution on Mars. Here, we report concomitant high-precision U-Pb ages and Hf-isotope compositions of ancient zircons from the NWA 7034 Martian regolith breccia. Seven zircons with mostly concordant U-Pb ages define 207Pb/206Pb dates ranging from 4,476.3 ± 0.9 Myr ago to 4,429.7 ± 1.0 Myr ago, including the oldest directly dated material from Mars. All zircons record unradiogenic initial Hf-isotope compositions inherited from an enriched, andesitic-like crust extracted from a primitive mantle no later than 4,547 Myr ago. Thus, a primordial crust existed on Mars by this time and survived for around 100 Myr before it was reworked, possibly by impacts [4], [5], to produce magmas from which the zircons crystallized. Given that formation of a stable primordial crust is the end product of planetary differentiation, our data require that the accretion, core formation and magma ocean crystallization on Mars were completed less than 20 Myr after the formation of the Solar System. These timescales support models that suggest extremely rapid magma ocean crystallization leading to a gravitationally unstable stratified mantle, which subsequently overturns, resulting in decompression melting of rising cumulates and production of a primordial basaltic to andesitic crust [6], [7]. Isotopic compositions of ancient zircons from the NWA 7034 Martian meteorite suggest that Mars must have formed its primordial crust extremely swiftly, less than 20 million years after the formation of the Solar System. [ABSTRACT FROM AUTHOR]

Light-triggered release of active ingredients from polymeric nanosized capsules can be employed in a wide range of applications, such as biomedicine, active packaging, and cosmetics. However, the preparation of core-shell polymeric nanocarriers typically involves the use of toxic organic solvents. To improve the sustainability and safety of nanocapsule applications, we demonstrate that natural essential oils can be used both as solvent and active material in light-responsive nanocapsules synthesized via miniemulsion polycondensation. The documented antimicrobial, anti-inflammatory, and antioxidant activity of essential oils enables the design of multipurpose light-responsive delivery platforms. The photo-responsive behavior of the capsules, achieved by means of photochromic azobenzene segments embedded in the capsule shell, is triggered by UV light irradiation (λmax = 360 nm). Light-induced release kinetics of the essential oils and a fluorescent probe molecule, coumarin-6, is evaluated via UV-vis spectroscopy and spectrofluorimetry, respectively, demonstrating the efficiency and reliability of the release mechanism. Biological tests prove that the capsules are non-cytotoxic and readily internalized by cells, indicating the suitability of these smart nanocarriers for biological applications. [ABSTRACT FROM AUTHOR]

Healthy and impaired cognitive aging may be associated to different prevalences of single-nucleotide polymorphisms (SNPs). In a multicenter case-control association study, we studied the SNPs rs11136000 (clusterin, CLU), rs541458 (phosphatidylinositol binding clatrin assembly protein, PICALM), and rs1554948 (transcription factor A, and tyrosine kinase, non-receptor, 1, TNK1) according to the three age groups 50-65 years (group 1), 66-80 years (group 2), and 80+ years (group 3) in 569 older subjects without cognitive impairment (NoCI) and 520 Alzheimer’s disease (AD) patients. In NoCI subjects, a regression analysis suggested a relationship between age and TNK1 genotypes, with the TNK1-A/A genotype frequency that increased with higher age, and resulting in a different distribution of the TNK1-A allele. In AD patients, a regression analysis suggested a relationship between age and PICALM genotypes and TNK1 genotypes, with the PICALM-T/C and TNK1-A/A genotype frequencies that decreased with increasing age. A resulting difference in the distribution of PICALM-C allele and TNK1-A allele was also observed. The TNK1-A allele was overrepresented in NoCI subjects than in AD patients in age groups 2 and 3. These results confirmed after adjustment for apolipoprotein E polymorphism, which suggested a different role of PICALM and TNK1 in healthy and impaired cognitive aging. More studies, however, are needed to confirm the observed associations. [ABSTRACT FROM AUTHOR]

Nucleosynthetic isotope variability among Solar System objects is often used to probe the genetic relationship between meteorite groups and the rocky planets (Mercury, Venus, Earth and Mars), which, in turn, may provide insights into the building blocks of the Earth-Moon system. Using this approach, it has been inferred that no primitive meteorite matches the terrestrial composition and the protoplanetary disk material from which Earth and the Moon accreted is therefore largely unconstrained. This conclusion, however, is based on the assumption that the observed nucleosynthetic variability of inner-Solar-System objects predominantly reflects spatial heterogeneity. Here we use the isotopic composition of the refractory element calcium to show that the nucleosynthetic variability in the inner Solar System primarily reflects a rapid change in the mass-independent calcium isotope composition of protoplanetary disk solids associated with early mass accretion to the proto-Sun. We measure the mass-independent 48Ca/44Ca ratios of samples originating from the parent bodies of ureilite and angrite meteorites, as well as from Vesta, Mars and Earth, and find that they are positively correlated with the masses of their parent asteroids and planets, which are a proxy of their accretion timescales. This correlation implies a secular evolution of the bulk calcium isotope composition of the protoplanetary disk in the terrestrial planet-forming region. Individual chondrules from ordinary chondrites formed within one million years of the collapse of the proto-Sun reveal the full range of inner-Solar-System mass-independent 48Ca/44Ca ratios, indicating a rapid change in the composition of the material of the protoplanetary disk. We infer that this secular evolution reflects admixing of pristine outer-Solar-System material into the thermally processed inner protoplanetary disk associated with the accretion of mass to the proto-Sun. The identical calcium isotope composition of Earth and the Moon reported here is a prediction of our model if the Moon-forming impact involved protoplanets or precursors that completed their accretion near the end of the protoplanetary disk's lifetime. [ABSTRACT FROM AUTHOR]

BRAF mutation, usually performed by DNA techniques, is one of the most common diagnostic markers in papillary thyroid carcinoma. Few papers have demonstrated that plump cells (eosinophilic cytoplasms and papillary thyroid carcinoma nuclei) and peculiar sickle-shaped nuclei represent morphological features of BRAF on papillary thyroid carcinomas. These features seem to be linked to glycolytic phenotype whereby monocarboxylate transporters 1-4 are hypothesized to have a dominant role as lactate transporters. We investigated the association between these morphological features and monocarboxylate transporters 1 and 4 in 48 cyto-histological samples diagnosed as 'positive for malignancy-favoring papillary thyroid carcinoma'. These cases were processed with liquid-based cytology and underwent BRAF mutational analysis (pyrosequencing) on liquid-based cytology and monocarboxylate transporters immunostaining on histology. The expression of monocarboxylate transporter 1, monocarboxylate transporter 4, glucose trasporter-1 and carbonic anhidrase were scored semi-quantitatively with expression from 0 to 3+ (strong positivity). The 33 mutated and 15 wild type cases showed 100 % cyto-histological concordance. The cytological evaluation revealed plump cells and sickle nuclear shape in 100 % mutated cases. Monocarboxylate transporter 1 yielded 76 % positivity in the mutated cases especially in both the plump cells and sickle-shaped nuclei, whereas the wild types showed 13.3 % positive monocarboxylate transporter 1 ( p = 0.00013). Monocarboxylate transporter 4 resulted in 100 % positivity in mutated and 40 % in wild types ( p < 0.005). Furthermore, 20 % of the wild types showed weak monocarboxylate transporter 1 nuclear expression associated to a less aggressive behavior. The analysis of glucose trasporter-1 and carbonic anhidrase did not highlight any statistical significance ( p > 0.05). This is the first report analyzing the association between monocarboxylate transporter expression and the morphological features of BRAF mutated papillary thyroid carcinomas suggesting the possible involvement of lactate in the morphological features. [ABSTRACT FROM AUTHOR]

Determining the prey composition and foraging habitats of U.S. Pacific Coast groundfishes are specified management directives that have not received much scientific attention. To address this knowledge gap, we conducted a meta-analysis of the feeding ecology of 18 commercially important species and their life stages during a recent review of Pacific Coast groundfish essential fish habitat. A Major Prey Index was developed to evaluate relative importance among 47 prey taxa. Based on this metric, unidentified teleosts, euphausiids, and brachyuran crabs were the most important prey groups. When 14 generalized prey categories were used, fishes represented the dominant taxon (mean % weight or volume = 32.3) followed by shrimps (11.5), crabs (10.0), and euphausiids (9.5). PERMANOVA results indicated that species-specific differences were the primary source of dietary variability among tested variables (life stage, functional group, taxonomic group). Pacific Coast groundfishes mainly were characterized as mesopredators with estimated trophic levels ranging from 3.4 to 4.2. Foraging habitats differed significantly among functional (benthic, demersal, pelagic) and taxonomic (elasmobranch, roundfish, rockfish, flatfish) groups. Using hierarchical agglomerative cluster analysis, we identified a significantly distinct trophic guild that consumes mainly polychaetes and hard-shelled molluscs (juvenile, juvenile-adult Dover Sole; juvenile-adult English Sole) and another that specializes on euphausiids (juvenile Pacific Hake; juvenile-adult Darkblotched Rockfish). Our findings filled substantial data gaps in the trophic ecology and habitat-based management of commercially important species and can be used to inform future reviews of Pacific Coast groundfish essential fish habitat. [ABSTRACT FROM AUTHOR]

Determining trophic relationships within and among species can provide insight into the structure and function of an ecosystem, and can inform the development of multi-species monitoring and management plans. The goal of this study was to address the need for dietary and trophic information of two common and abundant skates in Prince William Sound (PWS), the Bering skate, Bathyraja interrupta, and longnose skate, Raja rhina. Based on identification and analysis of stomach content data, both species were found to be generalist predators with diets dominated by crustaceans and supplemented with teleosts. The primary source of dietary variability for each species was total length, with spatial variables (i.e., latitude, longitude, and depth) also explaining a large portion of total dietary variability in the Bering skate. However, only a small proportion of the total intraspecific dietary variation was accounted for among the analyzed variables, suggesting substantial individual-based differences in the feeding habits of each species. Trophic level estimates indicated that the Bering skate and longnose skates <100 cm total length (TL) were secondary consumers, whereas longnose skates ≥100 cm TL were more piscivorous, tertiary consumers. Significant interspecific dietary differences were also evident, suggesting trophic separation, likely as a function of skate size. Given their abundance and generalistic feeding behavior, PWS skates can provide a means of monitoring demersal community health; information about their foraging ecology will be valuable in gaining a better understanding of trophodynamics within the PWS food web. [ABSTRACT FROM AUTHOR]

Purpose: This publication reviews the accepted knowledges and the findings still discussed on several features of autoimmune hypophysitis, including the most recently described forms, such as IgG4 and cancer immunotherapy- related hypophysitis. Methods: The most characteristic findings and the pending controversies were derived from a literature review and previous personal experiences. A single paragraph focused on some atypical examples of the disease presenting under confounding pretences. Results: Headache, visual field alterations and impaired pituitary secretion are the most frequent clinical findings of the disease. Pituitary biopsy, still considered the gold diagnostic standard, does not always receive consent from the patients. The role of magnetic resonance imaging is limited, as this disease may generate images similar to those of other diseases. The role of antipituitary and antihypothalamus antibodies is still discussed owing to methodological difficulties and also because the findings on the true pituitary antigen(s) are still debated. However, the low sensitivity and specificity of immunofluorescence, one of the more widely employed methods to detect these antibodies, may be improved, considering a predetermined cut-off titre and a particular kind of immunostaining. Conclusion: Autoimmune hypophysitis is a multifaceted disease, which may certainly be diagnosed by pituitary biopsy. However, the possible different clinical, laboratory and imaging features must be considered by the physician to avoid a misdiagnosis when examining a possibly affected patient. Therapeutic choice has to be made taking into account the clinical conditions and the degree of hypothalamic-pituitary involvement, but also considering that spontaneous remissions can occur. [ABSTRACT FROM AUTHOR]

Protein malnutrition (PM) is an important public health problem that affects resistance to infection by impairing a number of physiological processes. PM induces structural changes in the lymphoid organs that affect the roles of the immune and inflammatory responses in a crucial way. The activation of different transcription factors, including signal transducer and activator of transcription (STAT) family members, leads to the production of different cytokines, which are mediators essential to mounting adequate immune and inflammatory responses. In this study, malnourished animals presented anemia, leukopenia, and a severe reduction in spleen cellularity, with reduced numbers of most cell populations, as well as increased percentages of CD3 and CD4 cells. The proliferation rates were reduced, and cells were increasingly observed in the G0/G1 cell cycle phase; further, IL-2 production was reduced, while IL-10 production was increased. In spleen cells from malnourished animals, STAT-3 protein expression was increased, with a concomitant reduction in STAT-1 expression. Knowing that STAT-1 and STAT-3 are key transcription factors in both immunity and inflammatory pathways, these results infer, at least in part, a mechanistic pathway that affects the manner or intensity of the immune response in malnourished individuals, increasing susceptibility to infection. [ABSTRACT FROM AUTHOR]

Purpose: Detection of antipituitary antibodies (APA) at high levels and with a particular immunofluorescence pattern in patients with autoimmune polyendocrine syndromes may indicate a possible future autoimmune pituitary involvement. This longitudinal study was aimed at characterizing in patients with a single organ-specific autoimmune disease the pituitary cells targeted by APA at start, verifying whether this characterization allows to foresee the kind of possible subsequent hypopituitarism. Methods: Thirty-six APA positive and 40 APA negative patients with isolated autoimmune diseases participated in the study. None of them had pituitary dysfunction at entry. Characterization by four-layer immunofluorescence of pituitary cells targeted by APA in APA positive patients at entry and study of pituitary function in all patients were performed every 6 months during a 5 year follow-up. Results: Antipituitary antibodies immunostained selectively one type of pituitary-secreting cells in 21 patients (58.3 %, group 1), and several types of pituitary cells in the remaining 15 (41.7 %, group 2). All patients in group 1 showed subsequently a pituitary insufficiency, corresponding to the type of cells targeted by APA in 18 of them (85.7 %). Only 8 out of 15 patients in group 2 (53.3 %) showed a hypopituitarism, isolated in 7 and combined in the other one. None of APA negative patients showed hypopituitarism. Conclusions: The characterization of pituitary cells targeted by APA in patients with isolated autoimmune diseases, when the pituitary function is still normal, may help to foresee the kind of subsequent hypopituitarism, especially when APA immunostained selectively only one type of pituitary cells. A careful follow-up of pituitary function in these patients is advisable to allow an early diagnosis of hypopituitarism, even in subclinical phase and a consequent timely replacement therapy. [ABSTRACT FROM AUTHOR]

Objective:To reduce exposure to hyperoxia and its associated morbidities in preterm neonates.Study design:A multidisciplinary group was established to evaluate oxygen exposure in our neonatal intensive care unit. Infants were assigned target saturation ranges and signal extraction technology implemented to temporally quantify achievement of these ranges. The outcomes bronchopulmonary dysplasia/death, retinopathy of prematurity (ROP)/death, severe ROP and ROP requiring surgery were compared in a pre- versus post-intervention evaluation using multivariate analyses.Result:A total of 304 very low birth weight pre-initiative infants were compared with 396 post-initiative infants. Multivariate analyses revealed decreased odds of severe ROP (adjusted odds ratio (OR): 0.41; 95% confidence interval (CI): 0.24-0.72) and ROP requiring surgery (adjusted OR 0.31; 95% CI: 0.17-0.59) post-initiative. No differences in death were observed.Conclusion:Significant reductions in severe ROP and ROP requiring surgery were observed after staff education and implementation of new technology to quantify success in achieving targeted saturations and reinforce principles and practices. [ABSTRACT FROM AUTHOR]

Previous case reports and retrospective studies suggest that pituitary dysfunction may occur after acute bacterial or viral meningitis. In this prospective study we assessed the pituitary functions, lipid profile and anthropometric measures in adults with acute bacterial or viral meningitis. Moreover, in order to investigate whether autoimmune mechanisms could play a role in the pathogenesis of acute meningitis-induced hypopituitarism we also investigated the anti-pituitary antibodies (APA) and anti-hypothalamus antibodies (AHA) prospectively. Sixteen patients (10 males, 6 females; mean ± SD age 40.9 ± 15.9) with acute infectious meningitis were included and the patients were evaluated in the acute phase, and at 6 and 12 months after the acute meningitis. In the acute phase 18.7% of the patients had GH deficiency, 12.5% had ACTH and FSH/LH deficiencies. At 12 months after acute meningitis 6 of 14 patients (42.8%) had GH deficiency, 1 of 14 patients (7.1%) had ACTH and FSH/LH deficiencies. Two of 14 patients (14.3%) had combined hormone deficiencies and four patients (28.6%) had isolated hormone deficiencies at 12 months. Four of 9 (44.4%) hormone deficiencies at 6 months were recovered at 12 months, and 3 of 8 (37.5%) hormone deficiencies at 12 months were new-onset hormone deficiencies. At 12 months there were significant negative correlations between IGF-I level vs. LDL-C, and IGF-I level vs. total cholesterol. The frequency of AHA and APA positivity was substantially high, ranging from 35 to 50% of the patients throughout the 12 months period. However there were no significant correlations between AHA or APA positivity and hypopituitarism. The risk of hypopituitarism, GH deficiency in particular, is substantially high in the acute phase, after 6 and 12 months of the acute infectious meningitis. Moreover we found that 6th month after meningitis is too early to make a decision for pituitary dysfunction and these patients should be screened for at least 12 months. In addition, the occurrence of AHA and APA positivity due to acute infectious meningitis was demonstrated for the first time. Further longer-term prospective investigations need to be carried out on a larger cohort of patients to understand the role of autoimmunity in the pathogenesis of late hypopituitarism after acute infectious meningitis. [ABSTRACT FROM AUTHOR]

Objective:The objective of this study is to compare complication rates between peripherally inserted central catheters (PICCs) and peripherally inserted non-central catheters (PINCCs) in the neonatal intensive care unit (NICU).Study Design:A retrospective, observational study was conducted. The PICCs were catheters whose tip terminated in the vena cavae, and PINCCs were defined as those whose tip fell short of this location. Complication rates were assessed using generalized estimating equations modeling.Result:A total of 91 PINCCs and 889 PICCs were placed in 750 neonates. In all, 44.0% of PINCCs had a major complication compared with 25.2% of PICCs (P=0.0001). The unadjusted (unadj.) complication rate among PINCCs was 51.7 per 1000 line days and 15.9 for PICCs (unadj. rate ratio: 3.25; 95% confidence interval (CI): 2.32, 4.55). After adjusting for multiple confounders, the risk remained significantly higher for PINCCs (adjusted odds ratio: 2.41; 95% CI: 1.33, 4.37).Conclusion:The rate of associated complications with the use of PINCCs in the NICU population is more than twice that of the PICCs. [ABSTRACT FROM AUTHOR]

The findings in hyperthyroid patients with Graves' orbitopathy (GO) of antibodies against antigens shared between the thyroid and orbit, such as the TSH-receptor (TRAb) and a novel protein G2s (G2sAb), suggested a possible common therapeutic strategy. However, the gold therapeutic standard for hyperthyrodism in these patients remains still unsettled and is mainly based on personal experience. Studies on the effect of total thyroidectomy (TT) alone or followed by radioiodine ablation (RAI) of thyroid remnants showed often conflicting results. This longitudinal study was aimed at evaluating the influence of TT alone or followed by post-surgical RAI with respect to methimazole treatment on the activity and severity of GO in patients with hyperthyroidism and GO. Sixty consecutive patients with Graves' disease and mild/moderate GO were studied and grouped as follows: group 1, including 25 patients (16F, 9M) undergoing TT alone; group 2, including 10 patients (8F, 2M) undergoing TT followed by RAI for histological evidence of differentiated thyroid cancer; group 3, including 25 patients (18F, 7M) euthyroid under methimazole therapy, studied as controls. Clinical study of ophthalmopathy and measurements of TRAb and G2sAb were performed in all patients at start of the study (time of TT for group 1 and RAI after TT for group 2 and of the first finding of euthyroidism under methimazole treatment for group 3) and after 6, 12, 24 months. Patients of both groups 1 and 2 showed an early significant decrease and a further progressive reduction of the activity and severity of GO with a disappearance of TRAb and a decrease of G2sAb levels during the follow-up, without statistically significant differences between the two groups. Patients in group 3 showed a much later and less marked improvement of GO with persistence of TRAb and G2sAb positivity, even if with reduction of TRAb levels at 12 and 24 months. Our results suggest that in Graves' patients with large goiter or relapse of hyperthyroidism and mild/moderate GO, TT alone could be an advisable choice to treat hyperthyroidism also improving GO with reduction of cost/benefit ratio. [ABSTRACT FROM AUTHOR]

The integration of semiconductor nanoparticles (NPs) into a polymeric matrix has the potential to enhance the performance of polymer-based solar cells taking advantage of the physical properties of NPs and polymers. We synthesize a new class of CdS-NPs-based active layer employing a low-cost and low temperature route compatible with large-scale device manufacturing. Our approach is based on the controlled in situ thermal decomposition of a cadmium thiolate precursor in poly(3-hexylthiophene) (P3HT). The casted P3HT:precursor solid foils were heated up from 200 to 300 °C to allow the precursor decomposition and the CdS-NP formation within the polymer matrix. The CdS-NP growth was controlled by varying the annealing temperature. The polymer:precursor weight ratio was also varied to investigate the effects of increasing the NP volume fraction on the solar cell performances. The optical properties were studied by using UV-Vis absorption and photoluminescence (PL) spectroscopy at room temperature. To investigate the photocurrent response of P3HT:CdS nanocomposites, ITO/P3HT:CdS/Al solar cell devices were realized. We measured the external quantum efficiency (EQE) as a function of the wavelength. The photovoltaic response of the devices containing CdS-NPs showed a variation compared with the devices with P3HT only. By changing the annealing temperature the EQE is enhanced in the 400-600 nm spectral region. By increasing the NPs volume fraction remarkable changes in the EQE spectra were observed. The data are discussed also in relation to morphological features of the interfaces studied by Focused Ion Beam technique. [ABSTRACT FROM AUTHOR]

Objective:The objective of this study was to compare demographic and clinical events in three groups of preterm neonates: those with necrotizing enterocolitis totalis (NEC-T), those with NEC non-totalis (NEC non-T) and in preterm patients without NEC.Study Design:This retrospective case-control study was conducted at Yale New Haven Children's Hospital using patient data from January 1991 to December 2007. Study patients were less than 36 weeks of gestational age (GA) at birth, without gastrointestinal (GI) malformations. Cases (NEC-T) were diagnosed at operation or at autopsy with observation of >80% necrosis of the GI tract. Two control groups were assigned: Group 1 or NEC non-T and Group II or Non-NEC. Two to four controls per case were matched to cases by GA at birth±2 weeks. Demographic and clinical data for the day of diagnosis and retrospectively up to 7 days preceding diagnosis were recorded for those with NEC-T and NEC. Group II controls were matched for date of birth and day of life, in addition to GA at birth.Result:A total of 14 075 patients were admitted to the Newborn Special Care Unit during the study interval. Overall 328 patients (2.3%) developed NECBell's Stage II; 39 patients met inclusion criteria for NEC-T case status; 148 NEC non-T and 110 non-NEC controls were assigned. In the comparison of NEC T and NEC non-T neonates, use of breast milk was associated with decreased risk of NEC-T, adjusted odds ratio (OR)=0.26, 95% confidence interval (CI) of OR=0.08-0.085, P=0.03. When NEC T and non-NEC patients were compared, having reached full-enteral feeds before the date of diagnosis of the matched case (adjusted OR=28.5, 95% CI of OR=2.7-299, P=0.005) and use of breast milk (adjusted OR=0.09, 95% CI of OR=0.02-0.56, P=0.01) were significantly different between the two groups.Conclusion:Breast milk usage was significantly associated with decreased occurrence of NEC-T in our comparison of NEC-T, NEC non-T and non-NEC patients. Although there were some differences, the majority of demographic and clinical variables assessed were not shown to be significantly different between cases and controls. This highlights the need for more biological data in assessing risk of developing NEC-T. [ABSTRACT FROM AUTHOR]

Objective:Owing to resident work-hour reductions and more permanent personnel in the newborn intensive care unit (NICU), we sought to determine if pediatric housestaff are missing learning opportunities in procedural training due to non-participation.Study Design:A prospective, observational study was conducted at an academic NICU using self-reported data from neonatal personnel after attempting 188 procedures on 109 neonates, and analyzed using Fisher's exact and χ2-tests.Result:Housestaff first attempted 32% of procedures (P<0.001) and were less likely to make attempts early in the academic year (P<0.001). There was no significant difference in attempts based on urgency of situation (P=0.742). Of procedures performed by non-housestaff personnel, 93% were completed while housestaff were present elsewhere in the unit.Conclusion:Pediatric housestaff performed the minority of procedures in the NICU, even in non-urgent situations, and were often uninvolved in other procedures, representing missed learning opportunities. [ABSTRACT FROM AUTHOR]

Alzheimer’s disease (AD) is characterized by a significant reduction in AcetylCholinesterase and an increase in ButyrylCholinesterase (BuChE) activity. The existence of polymorphic regions on the BuChE gene has been previously described; the most frequently found polymorphism is the so-called K variant, which leads to a 30% decreased enzymatic activity. Different studies reported a positive association between K variant and AD, strongest among late-onset AD and Apolipoprotein E (APOE) e4 carriers. We analyzed APOE and BuChE polymorphisms in 167 AD and 59 fronto-temporal dementia (FTD) patients compared with 129 healthy controls (HC). We reported a significantly lower frequency of the BuChE K variant in AD compared with HC and FTD and a significant increased frequency of the K variant in FTD. These results are in agreement with the known increase of the BuChE activity in AD and support the evidence of different molecular pathways involved in the pathogenesis of AD and FTD. [ABSTRACT FROM AUTHOR]

OBJECTIVES:The possible autoimmune involvement of the pituitary gland in patients with celiac disease (CD) has been suggested but demonstrated in only a few patients on gluten-free diet. We aimed to assess the prevalence and clinical meaning of anti-pituitary antibodies (APA) in children and adolescents with the newly diagnosed CD.METHODS:A total of 119 patients with CD (0.9–15.8 years old) attending the inpatient clinic of University Hospital were recruited for the cross-sectional study. Their height, weight, and body mass index (BMI) were recorded, and insulin-like growth factor-1 (IGF-1) and APA were assayed. APA was also determined in 98 sex- and age-matched controls.RESULTS:APA were detected in 50 patients (42.0%), 15 of them with high titer (30%) and 35 with low titer (70%), and in 2 control subjects at low titer (2%) (P<0.001). IGF-1 was higher in patients with negative than with low titer (P=0.02) or high titer APA (P=0.03). Height was more reduced in high-titer APA patients than in the negative ones (P<0.01). Height was positively correlated with IGF-1 (P<0.01) and negatively with chronological age (P=0.001). IGF-1 was positively correlated with BMI (P<0.001). For height prediction the regression analysis showed the rank order 1 for chronological age and 2 for IGF-1.CONCLUSIONS:In this paper we have shown a remarkable prevalence of positive APA in newly diagnosed CD patients. High APA titers are associated with height impairment, likely mediated by a reduction of IGF-1, thus suggesting that autoimmune pituitary process could induce a linear-growth impairment. [ABSTRACT FROM AUTHOR]

Objective:To explore how neonates with respiratory failure are selected for extracorporeal membrane oxygenation (ECMO) once severity of illness criteria are met, and to determine how conflicts between ECMO providers and parents over the initiation of ECMO are addressed.Study Design:A cross-sectional study was conducted using a data collection survey, which was sent to the directors of neonatal respiratory ECMO centers.Result:The lowest birth weight and gestational age at which respondents would consider placing a neonate on ECMO were frequently below recommended thresholds. There was wide variability in respondents’ willingness to place neonates on ECMO in the presence of conditions such as intraventricular hemorrhage and hypoxic ischemic encephalopathy. The number of respondents who would never seek to override parental refusal of ECMO was equal to the number who would always do so.Conclusion:Significant variability exists in the selection criteria for neonatal ECMO and in how conflicts with parents over the provision of ECMO are resolved. [ABSTRACT FROM AUTHOR]

The single nucleotide polymorphisms (SNPs) rs449647, rs769446 and rs405509 in the promoter region of the APOE gene have been variously suggested to be ɛ4-independent risk factors for Alzheimer's disease (AD). A previous Italian study found that the rs449647 was significantly associated with late-onset AD. The aim of this study was to verify whether these APOE promoter SNPs are genetic risk factors for AD and to investigate their interaction with the common APOE polymorphism. A total of 169 clinically diagnosed AD patients and 99 cognitively intact age-matched controls were included in the study. Significant associations with AD independent from sex, age and APOE/ɛ4 status were found for rs449647 A/A and rs405509 G/G genotypes (positive), and rs449647 A/T and rs405509 T/T genotypes (negative). Haplotype frequency estimation at the APOE locus showed significant associations for the ATG4, ATT4 and ACG3 (positive) and ATT2, ATT3 and TCG3 (negative) haplotypes. Therefore this study confirms the role of the rs449647 A/A genotype as risk factor for AD in Italy and suggests that promoter genotypes and APOE haplotypes might have a complex function in AD-associated genetic risk factors.European Journal of Human Genetics (2009) 17, 938–945; doi:10.1038/ejhg.2008.263; published online 28 January 2009 [ABSTRACT FROM AUTHOR]

Selective resuscitation refers to the practice of providing resuscitative efforts to one or some (but not all) infants born in the setting of multiple gestation. When one fetus is known to have a severe anomaly or severe growth restriction, parents are sometimes offered this option. In the setting of extreme prematurity, in the absence of an anomaly or severe growth restriction, parents are generally expected to make one unified decision for all the infants involved. The introduction of the Outcome Estimator, a tool that provides the ability to make individual outcome predictions for each fetus in a multiple gestation at borderline gestational age, based on contributing variables such as weight and gender, has led to the ethical dilemma of whether parents in this setting should also be offered the option of selective resuscitation. No convincing ethical argument for denying the parents the right to decide for each individual infant is apparent.Journal of Perinatology (2009) 29, 479–482; doi:10.1038/jp.2009.44 [ABSTRACT FROM AUTHOR]

Necrotizing enterocolitis (NEC) is primarily a disease process of the gastrointestinal (GI) tract of premature neonates that results in inflammation and bacterial invasion of the bowel wall. Despite advances in the care of premature infants, NEC remains one of the leading causes of morbidity and mortality in this population. It occurs in 1-5% of all neonatal intensive care admissions and 5-10% of all very low birthweight (<1500 g) infants. Although research has presented an interesting array of potential contributing factors, the precise aetiology of this multifactorial disease process remains elusive. Historically, it was believed that NEC arose predominantly from ischaemic injury to the immature GI tract, yet alternate plausible hypotheses indicate that many factors are likely to be involved. These may include issues related to the introduction and advancement of enteric feeding, alterations in the normal bacterial colonization of the GI tract, bacterial translocation and activation of the cytokine cascade, decreased epidermal growth factor, increased platelet activating factor, and mucosal damage from free radical production.Clinical manifestations of NEC may be vague, including increased episodes of apnoea, desaturations, bradycardia, lethargy and temperature instability. There may also be GI-specific symptoms such as feeding intolerance, emesis, bloody stools, abdominal distention and tenderness, and abdominal wall discolouration. Laboratory values may be indicative of infection, coagulation abnormalities and fluid retention. Radiographic signs may include ileus, dilated or fixed intestinal loops, air in the intestinal wall or free air in the abdomen. Medical treatment typically consists of bowel rest and decompression, antibacterial therapy, and management of other haematological or electrolyte imbalances. Increased respiratory and cardiovascular support is sometimes needed. In neonates who do not respond adequately to medical management, or if pneumoperitoneum is present, surgical intervention may occur with either use of a peritoneal drain or laparotomy.Advances in antenatal and neonatal care have resulted in increased survival of extremely preterm neonates. As this at-risk population continues to increase, an effective preventative strategy for NEC is needed. One preventative strategy is the use of antenatal corticosteroids to enhance maturation of the fetus if preterm delivery is likely. Recommendation of use of breast milk, early initiation of trophic feeds and judicoius advancement of enteric feeds are current postnatal strategies. Other preventative strategies that have been investigated include the use of oral antibacterials, antioxidants, supplementation of arginine and epidermal growth factor, none of which have changed clinical practice. Recent promising data indicate that prophylactic use of probiotics may play a role in preventing the onset of NEC. However, more large-scale, definitive studies are needed. [ABSTRACT FROM AUTHOR]

The big ( Raja binoculata), California ( R. inornata), longnose ( R. rhina), and sandpaper ( Bathyraja kincaidii), skates are commonly found on soft-bottom regions of the central California continental shelf and upper slope. The feeding ecology of this assemblage was compared to evaluate the degree of trophic separation among species, based on the results of previous species-specific diet studies. Specimens were collected from fishery independent trawl surveys conducted during September 2002–March 2003 at depths of 9–536 m. Using single and compound measures, diet composition of small (≤60 cm TL) and large (>60 cm TL) individuals were compared within continental shelf (≤200 m) and slope (>200 m) regions using traditional, multivariate, and novel techniques. Diet compositions within size classes were similar in both regions. Diet compositions between size classes generally differed, however, with fishes more important and crustaceans (especially shrimps and euphausiids) less important in the diets of large individuals. Crabs contributed substantially to skate diet compositions on the shelf, but were uncommon prey items at deeper depths, probably because of their relative scarcity in slope waters. Conversely, cephalopods were common prey items at slope depths, but were rarely ingested at shelf depths. The studied skate assemblage appears to consist primarily of generalist crustacean and fish predators that exhibit high dietary overlap at similar sizes. It is possible that resource competition among skates and groundfish species has been reduced because of considerable recent declines in the biomass of upper trophic level groundfishes. Skates may therefore play important roles in contemporary benthic food web dynamics off central California. [ABSTRACT FROM AUTHOR]

Skates by virtue of their abundance and widespread occurrence appear to play an influential role in the food webs of demersal marine communities. However, few quantitative dietary studies have been conducted on this elasmobranch group. Therefore, to better understand the ecological role of skates, standardized diet compositions and trophic level (TL) values were calculated from quantitative studies, and compared within and among skate and shark taxa. Prey items were grouped into 11 general categories to facilitate standardized diet composition and TL calculations. Trophic level values were calculated for 60 skate species with TL estimates ranging from 3.48 to 4.22 (mean TL = 3.80 ± 0.02 SE). Standardized diet composition results revealed that decapods and fishes were the main prey taxa of most skate species followed by amphipods and polychaetes. Correspondingly, cluster analysis of diet composition data revealed four major trophic guilds, each dominated by one of these prey groups. Fish and decapod guilds were dominant comprising 39 of 48 species analyzed. Analysis of skate families revealed that the Arhynchobatidae and Rajidae had similar TL values of 3.86 and 3.79 ( t-test, P = 0.27), respectively. The Anacanthobatidae were represented by a single species, Cruriraja parcomaculata, with a TL of 3.53. Statistical comparison of TL values calculated for five genera ( Bathyraja, Leucoraja, Raja, Rajella, Rhinoraja) revealed a significant difference between Bathyraja and Rajella ( t-test, P = 0.03). A positive correlation was observed between TL and total length ( L T) with larger skates (e.g. >100 cm L T) tending to have a higher calculated TL value (>3.9). Skates were found to occupy TLs similar to those of several co-occurring demersal shark families including the Scyliorhinidae, Squatinidae, and Triakidae. Results from this study support recent assertions that skates utilize similar resources to those of other upper trophic-level marine predators, e.g. seabirds, marine mammals, and sharks. These preliminary findings will hopefully encourage future research into the trophic relationships and ecological impact of these interesting and important demersal predators. [ABSTRACT FROM AUTHOR]

Introduction: Coeliac disease (CD) is usually associated with impaired growth in children. A gluten-free diet (GFD) induces a catch-up growth with the recovery of height in about 2 years. AIM AND DISCUSSION: The lack of the height improvement has been related to growth hormone (GH) secretion impairment. CD is an autoimmune disease often associated with other endocrine and non-endocrine autoimmune disease. The aim of this study was to evaluate antipituitary autoantibodies (APA) and antihypothalamus autoantibodies in CD children with poor clinical response to a GFD and growth hormone deficiency (GHD). We diagnosed CD on the basis of specific antibodies and endoscopic biopsies in 130 patients aged 1-15 years. Seven CD children, without catch-up growth after at least 12-months GFD, were tested for GH secretion and, in five out of seven patients, the diagnosis of GHD was made in the absence of metabolic and systemic diseases.Results: APA and antihypothalamus antibodies were detected by the indirect immunofluorescence method in the seven CD children without catch-up growth factor and in 25 CD children without growth impairment matched for sex and age, and in 58 healthy children as control groups. APA resulted positive at high titres in four out of five CD-GHD patients and were also positive at low titres (<1:8) in three of only CD children and in two out of 58 controls. Hypothalamic-pituitary magnetic resonance imaging (MRI) was normal in all patients except in one with cystic pineal. APA have been previously detected not only in adults with GHD, but also in idiopathic GHD children, suggesting the occurrence of an autoimmune hypophysitis in these patients.Conclusion: In our study, the presence of APA in CD children without catch-up growth after GFD seems to be able to identify an autoimmune form of hypophysitis involving the somatotrophs cells. [ABSTRACT FROM AUTHOR]

Long- and short-lived radioactive isotopes and their daughter products in meteorites are chronometers that can test models for Solar System formation. Differentiated meteorites come from parent bodies that were once molten and separated into metal cores and silicate mantles. Mineral ages for these meteorites, however, are typically younger than age constraints for planetesimal differentiation. Such young ages indicate that the energy required to melt their parent bodies could not have come from the most likely heat source—radioactive decay of short-lived nuclides (26Al and 60Fe) injected from a nearby supernova—because these would have largely decayed by the time of melting. Here we report an age of 4.5662 ± 0.0001 billion years (based on Pb–Pb dating) for basaltic angrites, which is only 1 Myr younger than the currently accepted minimum age of the Solar System and corresponds to a time when 26Al and 60Fe decay could have triggered planetesimal melting. Small 26Mg excesses in bulk angrite samples confirm that 26Al decay contributed to the melting of their parent body. These results indicate that the accretion of differentiated planetesimals pre-dated that of undifferentiated planetesimals, and reveals the minimum Solar System age to be 4.5695 ± 0.0002 billion years. [ABSTRACT FROM AUTHOR]

The interrelationship between prolactin (PRL) and the immune system have been elucitaded in the last decade, opening new important horizons in the field of the immunoendocrinology. PRL is secreted not only by anterior pituitary gland but also by many extrapituitary sites including the immune cells. The endocrine/paracrine PRL has been shown to stimulate the immune cells by binding to PRL receptors. Increased PRL levels, frequently described in autoimmune diseases, could depend on the enhancement of coordinated bi-directional communications between PRL and the immune system observed in these diseases. Hyperprolactinemia has been described in the active phase of some non organ-specific autoimmune diseases, as systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) and organ-specific autoimmune diseases, as celiac disease, type 1 diabetes mellitus, Addison's disease, autoimmune thyroid diseases. In these diseases PRL increases the syntesis of IFNγ and IL-2 by Th1 lymphocytes. Moreover, PRL activates Th2 lymphocytes with autoantibody production. Of particular interest is the association between hyperprolactinemia and levels of anti DNA antibodies, islet cell antibodies (ICA), thyreoglobulin antibodies (TgAb), thyroperoxidase antibodies (TPOAb), adrenocortical antibodies (ACA), transglutaminase antibodies (tTGAb) in SLE, in type 1 diabetes mellitus, in Hashimoto's thyroiditis, in Addison's disease and in celiac disease, respectively. High levels of PRL have been also frequently detected in patients with lymphocytic hypophysitis (LYH). Several mechanisms have been invoked to explain the hyperprolactinemia in LYH. The PRL increase could be secondary to the inflammatory process of the pituitary gland but, on the other hand, this increase could have a role in enhancing the activity of the immune process in LYH. Moreover, the detection of antipituitary antibodies targeting PRL-secreting cells in some patients with idiopathic hyperprolactinemia suggests the occurrence of a possible silent LYH in these patients. Finally, the role of anti-prolactinemic drugs to inactivate the immune process in LYH is still discussed. [ABSTRACT FROM AUTHOR]

We investigated if, in patients with vascular lesions, the variable that best discriminated demented from non-demented patients was the severity of the vascular pathology or the degree of hippocampal atrophy. A total of 39 patients multiple subcortical infarcts, who could be considered as possible vascular dementia with small vessel pathology, with underwent a neuropsychological study and brain magnetic resonance imaging (MRI) DSM IV criteria supported by neuropsychological data were used to distinguish demented from non-demented patients. The MRI study took into account the degree of hippocampal atrophy (hippocampal height and interuncal distance) and the severity of vascular pathology (number of brain infarcts). The distribution of lesions and a factor analysis showed that hippocampal atrophy is a better predictor of dementia than the number of brain infarcts. Multiple subcortical infarcts alone are probably not able to cause clinical dementia but the presence of vascular lesions increases the expression of concomitant Alzheimer’s disease. [ABSTRACT FROM AUTHOR]

Primitive or undifferentiated meteorites (chondrites) date back to the origin of the Solar System, and thus preserve a record of the physical and chemical processes that occurred during the earliest evolution of the accretion disk surrounding the young Sun. The oldest Solar System materials present within these meteorites are millimetre- to centimetre-sized calcium-aluminium-rich inclusions (CAIs) and ferromagnesian silicate spherules (chondrules), which probably originated by thermal processing of pre-existing nebula solids. Chondrules are currently believed to have formed~2-3 million years (Myr) after CAIs (refs 5-10)-a timescale inconsistent with the dynamical lifespan of small particles in the early Solar System. Here, we report the presence of excess26Mg resulting from in situ decay of the short-lived26Al nuclide in CAIs and chondrules from the Allende meteorite. Six CAIs define an isochron corresponding to an initial26Al/27Al ratio of (5.25±0.10)×10-5, and individual model ages with uncertainties as low as±30,000 years, suggesting that these objects possibly formed over a period as short as 50,000 years. In contrast, the chondrules record a range of initial26Al/27Al ratios from (5.66±0.80) to (1.36±0.52)×10-5, indicating that Allende chondrule formation began contemporaneously with the formation of CAIs, and continued for at least 1.4?Myr. Chondrule formation processes recorded by Allende and other chondrites may have persisted for at least 2-3?Myr in the young Solar System. [ABSTRACT FROM AUTHOR]

The composition and thermal state of the lithospheric mantle under the North Atlantic craton was investigated using a suite of peridotite xenoliths from the diamond-bearing Sarfartoq kimberlite dike swarm of southwestern Greenland. Elevated olivine and whole-rock Mg# (>0.9) attest to the refractory nature of the Sarfartoq mantle showing comparable degrees of depletion to other cratonic roots. Modal analyses indicate that the Sarfartoq mantle is not typified by the orthopyroxene enrichment observed in the Kaapvaal root, but shows more affinity with the Canadian Arctic (Somerset Island), Tanzania, and East Greenland (Wiedemann Fjord) peridotites. The Sarfartoq peridotites have equilibrated at temperatures and pressures ranging from 660 to 1,280 °C and from 2.2 to 6.3 GPa, and define a relatively low mantle heat flow of 13.2±1 mW/m2. In addition, the lithospheric mantle underneath the Sarfartoq area is compositionally layered as follows: (1) an internally stratified upper layer (70 to 180 km) consisting of coarse, un-deformed, refractory garnet-bearing and garnet-free peridotites and, (2) a lower layer (180 to 225 km) characterized by fertile, CPX-bearing, porphyroclastic garnet lherzolites. The stratification observed in the upper refractory harzburgite layer (70–180 km) is reflected by an increase in fertility (e.g., decrease in olivine abundance and forsterite content) with depth. The sharp nature of the boundary between the upper and lower layers may indicate multistage growth of the lithospheric mantle. [ABSTRACT FROM AUTHOR]

The aim of this study was to detect linear arterial calcification (Mönckeberg's sclerosis) localized in feet, ankles, legs, knees and hands in an attempt to correlate the extent of calcification with the presence and severity of autonomic neuropathy as well as with microangiopathy (proliferative retinopathy, proteinuria >200 mg/ die) and peripheral neuropathy. Typical linear calcification were observed in 37 out of 41 (90.2%) patients with autonomic neuropathy and in none of those without autonomic neuropathy (p<0.001). These 37 patients were divided into two subgroups by cluster analysis: Subgroup A, including 18 subjects with calcification length ranging from 8 to 26 cm and moderate autonomic neuropathy, and Subgroup B, including 19 subjects with calcification length between 58 and 126 cm and severe autonomic neuropathy (p<0.0001 by Spearman's test). No difference in the length of arterial calcification was detected between patients with proteinuria >200 mg/24h and/or proliferative retinopathy and patients without these complications. A possible relationship between arterial calcification and peripheral neuropathy is difficult to evaluate; in fact, the majority of subjects having autonomic neuropathy had peripheral neuropathy, too. Vice versa, around 10% of patients without peripheral neuropathy but with autonomic neuropathy did not have Mönckeberg's sclerosis. Autonomic neuropathy is the principal factor responsible for calcification of the arterial media, and in addition the severity of the neuropathy, rather than the patient's age or the known disease duration seems to determine the extent of calcification. [ABSTRACT FROM AUTHOR]

To evaluate the predictive factors of insulin requirement in newly diagnosed patients with unclassifiable diabetes, 54 consecutive patients, aged less than 35 years, were prospectively followed for 3 years or more. At entry, haemoglobin Hb, basal and stimulated C-peptide concentrations, HLA phenotype, islet cell antibodies (ICA) status, and serum levels of soluble CD8 antigen (sCD8) were evaluated. After a median time of 9 (range 2-32) months, 31 patients (group 1) required insulin therapy, whereas 23 patients (group 2) remained non-insulin-requiring after 36 months. Group 1 patients were younger ( P<0.05) and had higher Hb and sCD8 serum levels ( P<0.001, respectively), a higher frequency of ICA positivity and of HLA DR3 and/or DR4 phenotype ( P<0.005 and P<0.0001, respectively), and lower C-peptide concentrations ( P<0.005 and P<0.0001, basal and stimulated, respectively) than group 2. The sensitivity, specificity, positive and negative predictive value, and overall accuracy for the subsequent insulin requirement were: sCD8 serum levels (>737 U/ml), 100%, 65%, 79%, 100% and 85%, respectively; stimulated C-peptide (<0.60 nmol/l), 71%, 96%, 96%, 74% and 81%, respectively; and ICA positivity (>20 JDFU), 45%, 91%, 87%, 55% and 65%, respectively. Thus, higher sCD8 serum levels, low stimulated C-peptide concentrations and ICA positivity are the most powerful predictors of subsequent recourse to insulin therapy in young, newly detected patients with unclassifiable diabetes. [ABSTRACT FROM AUTHOR]

The REDUCE MRSA Trial (Randomized Evaluation of Decolonization vs Universal Clearance to Eliminate Methicillin-Resistant Staphylococcus aureus), a large multicenter, randomized controlled trial in adult intensive care units (ICUs), found universal decolonization to be more effective than surveillance and isolation procedures with or without targeted decolonization for reducing rates of MRSA-positive clinical cultures. The Agency for Healthcare Research and Quality and the Centers for Disease Control and Prevention subsequently published protocols for implementing universal decolonization in ICUs based on the trial's methods. Caution should be exercised before widely adopting these procedures in neonatal intensive care units (NICUs), particularly strategies that involve bathing with chlorhexidine and mupirocin application due to the potential for adverse events in their unique patient population, especially preterm infants. Large multicenter trials in the NICUs are needed to evaluate the efficacy, short- and long-term safety, and cost effectiveness of these strategies prior to their widespread implementation. [ABSTRACT FROM AUTHOR]