Search

Background Pituitary apoplexy (PA) is a rare, but life-threatening, condition characterized by pituitary infarction and hemorrhage, most often in the setting of a preexisting adenoma. The risk factors and mechanisms associated with PA are poorly understood. Although neurovascular manifestations of coronavirus disease 2019 (COVID-19) infection have been documented, its association with PA has not yet been determined. Methods From a prospectively collected database of patients treated at a tertiary care center for pituitary adenoma, we conducted a retrospective medical record review of PA cases during the COVID-19 pandemic from March 2020 to December 2020. We also conducted a literature review to identify other reported cases. Results We identified 3 consecutive cases of PA and concomitant COVID-19 infection. The most common symptoms at presentation were headache and vision changes. The included patients were successfully treated with surgical decompression and medical management of the associated endocrinopathy, ultimately experiencing improvement in their visual symptoms at the latest follow-up examination. COVID-19 infection in the perioperative period was corroborated by polymerase chain reaction test results in all the patients. Conclusions With the addition of our series to the literature, 10 cases of PA in the setting of COVID-19 infection have been confirmed. The present series was limited in its ability to draw conclusions about the relationship between these 2 entities. However, COVID-19 infection might represent a risk factor for the development of PA. Further studies are required.

Lumbosacral interbody fusion is a mainstay of surgical treatment for degenerative spinal pathologies causing chronic pain and functional impairment. However, the optimal technique for this procedure remains controversial. Well-established open approaches, including anterior lumbar interbody fusion (ALIF), posterior lumbar interbody fusion (PLIF), and transforaminal lumbar interbody fusion (TLIF), have historically been the standard of practice. A recent paradigm shift in spinal surgery has led to the investigation of minimally invasive approaches to mitigate tissue damage without compromising outcomes. This extensive review aims to examine current clinical and biomechanical evidence on the paracoccygeal transsacral approach to an axial lumbosacral interbody fusion. Since this technique was first described in 2004, accumulating evidence suggests it results in high fusion rates, consistent improvements in pain and function, reduced perioperative morbidity, and low rates of complication. Although early clinical outcomes have been promising, there is a paucity of comparative data investigating outcomes of the paracoccygeal transsacral approach to traditional alternatives and other minimally invasive techniques. Here, we summarize current evidence and discuss pertinent topics for the spinal surgeon considering this novel approach, including indications, advantages, relevant anatomy, contraindications, and technical considerations.

Background: Cholesteatomas are growths of squamous epithelium that can form inside the middle ear and mastoid cavity and damage nearby structures causing hearing loss when located at the petrous apex. The primary goal of petrous apex cholesteatoma resection is gross total removal with tympanoplasty and canal-wall up or canal-wall down tympanomastoidectomy. At present, there is no definitive surgical approach supported by greater than level 4 evidence in the literature to date. Methods: A systematic review was conducted utilizing PubMed, Embase, and Scopus databases. Articles were screened and selected to be reviewed in full text. The articles that met inclusion criteria were reviewed for relevant data. Data analysis, means, and standard deviations were calculated using Microsoft Excel. Results: After screening, five articles were included in the systematic review. There were a total of eight pediatric patients with nine total cholesteatomas removed. Conductive hearing loss was the most common (77%) presenting symptom. Perforations were noted in seven ears (86%). Recurrence was noted in 50% of patients with an average recurrence rate of 3.5 years (SD = 1.73). Average length of follow-up was 32.6 months (SD = 21.7). Canal-wall up was the most utilized technique (60%) and there were zero noted surgical complications. Five of the seven (71%) patients that experienced hearing loss from perforation noted improved hearing. Conclusion: Due to its rarity, diagnostic evaluation and treatment can vary. Further, multi-institutional investigation is necessary to develop population-level management protocols for pediatric patients affected by petrous apex cholesteatomas.

The first organofunctionalized mixed-valent polyoxo-30-molybdate wheel, [Mo

Purpose: The purpose of this article is to analyze the main infractions committed by independent auditors in the sphere of the Brazilian Securities and Exchange Commission from 2010 to 2020. Methodology: The study is characterized as descriptive and documentary with a quali-quantitative approach. Information from administrative sanctioning processes judged by CVM in the period 2010 to 2020 was used to identify characteristics such as the profile of the accused and the penalties applied, which were submitted to correlation analysis to verify if there is any direct relationship of these variables with the infractions committed. Results: The study points out that among the most recurrent infractions are "Absence of planning and audit procedures that lead to divergences in the independent auditor's report" and "Irregularities in the External Quality Review Program", which represent 39.47% and 34, 21% of the analyzed sample, respectively. In the correlation analysis, it was identified that the occurrence of infraction “b” is linked with the “repeat infractions” charges and the “temporary suspension” penalty. In addition, it was evident that the increase of “repeat infractions” charges are mainly linked to the increase of defendants classified as “non Big Four”. Contributions of the Study: The results of the study show users of financial statements the motivation for filling lawsuits against independent auditors with the CVM and the infractions they committed with the aim of contributing to the improvement of compliance with auditing standards and procedures by revealing the most recurrent infractions under different methodologies and periods. It also presents the degree of correlation between the infraction committed, the profile of the accused (segregating into Big Four and not Big Four) and the penalty applied. Objetivo: El propósito de este artículo es analizar las principales infracciones cometidas por auditores independientes en el ámbito de la Comisión Nacional de Valores de Brasil de 2010 a 2020. Metodología: El estudio se caracteriza por ser descriptivo y documental con un enfoque cuali-cuantitativo. Para identificar características como el perfil del imputado y las sanciones aplicadas, se utilizó información de los procesos administrativos sancionadores juzgados por la CVM en el período 2010 a 2020, las cuales fueron sometidas a análisis de correlación para verificar si existe alguna relación directa de estas variables con la infracciones cometidas. Resultados: El estudio señala que entre las infracciones más recurrentes se encuentran "Ausencia de procedimientos de planificación y auditoría que den lugar a divergencias en el informe del auditor independiente" y "Irregularidades en el Programa de Revisión Externa de Calidad", que representan el 39,47% y el 34,21% de la muestra analizada, respectivamente. En el análisis de correlación, se identificó que la ocurrencia del delito “b” se vincula con los imputados “reincidentes” y con la pena de “suspensión temporal”. Además, se evidenció que el aumento de los “reincidentes” está principalmente vinculado al aumento de los clasificados como “no Big Four”. Contribuciones del Estudio: Los resultados del estudio muestran a los usuarios de los estados financieros la motivación para entablar una demanda contra los auditores independientes ante la CVM y qué infracciones cometieron con el objetivo de contribuir a la mejora del cumplimiento de las normas y procedimientos de auditoría, revelando las infracciones más recurrente bajo tres metodologías y periodos diferentes. También presenta el grado de correlación entre la infracción cometida, el perfil del imputado (segregando los Big Four y no Big Four) y la sanción aplicada. Objetivo: O objetivo deste artigo é analisar as principais infrações cometidas por auditores independentes na esfera da Comissão de Valores Mobiliários no período de 2010 a 2020. Metodologia: O estudo caracteriza-se como descritivo e documental com abordagem quali-quantitativa. Utilizou-se das informações de processos administrativos sancionadores julgados pela CVM no período de 2010 a 2020 para identificar características como o perfil dos acusados e as penalidades aplicadas, as quais foram submetidas a análise de correlação para verificar se há alguma relação direta dessas variáveis com as infrações cometidas. Resultados: O estudo aponta que entre as infrações mais recorrentes estão “Ausência de planejamento e procedimentos de auditoria que acarretam em divergências no relatório do auditor independente” e “Irregularidades no Programa de Revisão Externa de Qualidade”, as quais representam 39,47% e 34,21% da amostra analisada, respectivamente. Na análise de correlação, identificou-se que a ocorrência da infração “b” está vinculada com os acusados “reincidentes” e com a penalidade “suspensão temporária”. Além disso, evidenciou-se que o aumento de acusados “reincidentes” está ligado principalmente ao aumento de acusados classificados como “não Big Four”. Contribuições do Estudo: Os resultados do estudo evidenciam aos usuários das demonstrações financeiras a motivação da abertura de processos contra auditores independentes junto à CVM e quais as infrações por eles cometidas com o intuito de contribuir para a melhoria do cumprimento das normas e procedimentos de auditoria pela revelação das infrações mais recorrentes sob três metodologias e períodos diferentes. Apresenta ainda o grau de correlação existente entre a infração cometida, o perfil dos acusados (segregando Big Four e não Big Four) e a penalidade aplicada.&nbsp

Six arsenic(III)-capped 12-tungsto-2-arsenates(III) of the type [M2(AsIIIW6O25)2(AsIIIOH)x]n- (M = CrIII, 1; FeIII, 2; ScIII, 3; InIII, 4; TiIV, 5; MnII, 6) have been synthesized in aqueous medium by direct reaction of the elements using a one-pot strategy and structurally characterized by FT-IR spectroscopy, single-crystal XRD, and elemental analysis. Polyanions 1-6 are comprised of two octahedrally coordinated guest metal ions M sandwiched between two {AsW6} units, resulting in a structure with C2h point-group symmetry. Polyanions 1-5 contain tri- and tetravalent metal ion guests M (M = CrIII, FeIII, ScIII, InIII, and TiIV, respectively), and they have one {AsIIIOH} group grafted on each {AsW6} unit, whereas the divalent MnII-containing derivative 6 has two such {AsIIIOH} groups grafted on each {AsW6} unit. Magnetic studies on polyanions 3-5 over the temperature range 1.8-295 K and magnetic fields of 0-7 T confirmed that they are diamagnetic. On the other hand, polyanions 1, 2, and 6 are strongly magnetic and follow the Curie-Weiss law above 30 K. The susceptibility plots of 1 and 6 exhibit broad peaks suggesting short-range antiferromagnetic ordering, while the very weak antiferromagnetic ordering of 2 is overshadowed by traces of a paramagnetic impurity. The magnetization data of 1, 2, and 6 at 1.8 K over 0-7 T were analyzed by using the Heisenberg exchange procedure. Small (negative) values of the obtained J values help in understanding the absence of long-range antiferromagnetic ordering.

ARK thanks Ciência sem Fronteiras/Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) for a fully funded PhD fellowship at the University of St Andrews (1091/13-1) and the School of Biology of the University of St Andrews. ARK acknowledges a Postdoctoral fellowship at the International Institute for Applied Systems Analysis (IIASA) funded by CAPES (88881.308367/2018-01) and AEM thanks the Leverhulme Trust (RPG-2019-402) for support. How do invasive species change native biodiversity? One reason why this long-standing question remains challenging to answer could be because the main focus of the invasion literature has been on shifts in species richness (a measure of alpha-diversity). As the underlying components of community structure-intraspecific aggregation, interspecific density and the species abundance distribution (SAD)-are potentially impacted in different ways during invasion, trends in species richness provide only limited insight into the mechanisms leading to biodiversity change. In addition, these impacts can be manifested in distinct ways at different spatial scales. Here we take advantage of the new Measurement of Biodiversity (MoB) framework to reanalyse data collected in an invasion front in the Brazilian Cerrado biodiversity hotspot. We show that, by using the MoB multi-scale approach, we are able to link reductions in species richness in invaded sites to restructuring in the SAD. This restructuring takes the form of lower evenness in sites invaded by pines relative to sites without pines. Shifts in aggregation also occur. There is a clear signature of spatial scale in biodiversity change linked to the presence of an invasive species. These results demonstrate how the MoB approach can play an important role in helping invasion ecologists, field biologists and conservation managers move towards a more mechanistic approach to detecting and interpreting changes in ecological systems following invasion. Publisher PDF

We report on the synthesis and structural characterization of four arylarsonate- and phosphonate-capped polyoxomolybdates that exhibit different organic substituents in the para position of the phenyl group. The reaction of arylarsonates (RAsO3, wherein R = 4-BrC6H4 or 4-N3C6H4) with molybdate in aqueous pH 3.5 media resulted in the cyclic hexamolybdates [(BrC6H4As)2Mo6O24]4- (Mo6As2La) and [(N3C6H4As)2Mo6O24]4- (Mo6As2Lb), whereas the reaction of arylphosphonates (R'PO3, wherein R' = 4-O2CC6H4 or 4-O2CC6H4CH2) with molybdate in aqueous pH 3 media resulted in the cyclic pentamolybdates [(O2CC6H4P)2Mo5O21]6- (Mo5P2Lc) and [(HO2CC6H4CH2P)2Mo5O21]4- (Mo5P2Ld), respectively. Polyanions Mo6As2La and Mo6As2Lb comprise a ring of six MoO6 octahedra that is capped on either side by an organoarsonate group, whereas Mo5P2Lc and Mo5P2Ld consist of a ring of five MoO6 octahedra that is capped on either side by an organophosphonate group, with the organic arms protruding away from the metal-oxo core of the polyanions. All four polyanions Mo6As2La, Mo6As2Lb, Mo5P2Lc, and Mo5P2Ld have been characterized in the solid state by single-crystal X-ray diffraction, IR spectroscopy, and thermogravimetric and elemental analysis and in solution by multinuclear NMR (31P, 13C, and 1H). The synthetic procedure of (4-bromophenyl)arsonic acid, BrC6H4AsO3H2, is reported here for the first time.