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This paper investigates the performance of a non-symmetric airfoil in a perturbed flow for a low Reynolds number by creating small vortical structures. A newly designed two-dimensional numerical tool is used to examine the interaction between the NACA 23015 airfoil and the vortex shedding from a square cylinder. Different airfoil position ratios are numerically simulated concerning the square cylinder G/D (D: square cylinder diameter), the channel centerline T/d (d=D/2), and the vortices scale size D/c (c: airfoil chord length). Results show that the maximum values of the lift and drag aerodynamic coefficients are influenced by the airfoil’s lateral and longitudinal positions. The Proper Orthogonal Decomposition (POD) method is used to identify the most energetic flow structures. For all simulated scenarios, it was found that the first two modes reflect the dominating coherent structures in the flow field. The results also show that a leading-edge vortex is formed over the airfoil. The observed phenomena of symmetric and antisymmetric shedding vortex mechanisms essentially depend on the lateral distance of the airfoil T/d and the vortex scale size D/c. However, the spectral analysis demonstrates that the shedding frequency mainly depends on the gap distance G/D.

The West-Palearctic region is a diversity hotspot for the ant genus Aphaenogaster. Species in this region are characterized by high morphological variation, which has led to their subdivisioninto different infrageneric groups. The very first classification in three subgenera, dated 1915, was gradually replaced by eight species-groups. To probe the evolutionary consistency of these species-groups, we sequenced 46 species from all eight species-groups and biogeographic sectors of the region, using one mitochondrial (COI) and six nuclear markers (EPICs), and interpreted the results by integrating qualitative morphology. Our results demonstrate the non-monophyly of all formerly recognized subgenera and species-groups, except for the crocea group. We use the phylogeny and morphological characters to propose a new classification of six monophyletic species-groups (crocea, gibbosa, graeca, pallida, sardoa, subterranea). The pallida, subterranea and sardoa (formerly testaceopilosa) groups attain monophyletic status by reassigning a few taxa. The gibbosa group is to be considered exclusively Western-Mediterranean until further assessments of similar Eastern species. The new graeca group is established by including former members of the splendida and subterranea groups, while the polyphyletic cecconii, obsidiana, and splendida groups are dismissed. Notably, the first is not part of the tropical Deromyrma clade as previously thought, while at least two independent clades which require further investigation are composed of species from both the cecconii and splendida groups, suggesting repeated morphological convergences based on similar ecological adaptations. Finally, A. cardenai is confirmed to be a significantly divergent lineage. In addition, three Aphaenogaster species are moved to different genera: Messor asmaae (Sharaf, 2018) comb. nov., Messor isekram (Bernard, 1977) comb. nov., and Pheidole sarae (Sharaf, 2018) comb. nov. Further studies should address the evolutionary relationships between the clades recovered in this study.

Abstract The use of human derived induced pluripotent stem cells (hiPSCs) differentiated to dopaminergic (DA) neurons offers a valuable experimental model to decorticate the cellular and molecular mechanisms of Parkinson’s disease (PD) pathogenesis. However, the existing approaches present with several limitations, notably the lengthy time course of the protocols and the high variability in the yield of DA neurons. Here we report on the development of an improved approach that combines neurogenin-2 programming with the use of commercially available midbrain differentiation kits for a rapid, efficient, and reproducible directed differentiation of hiPSCs to mature and functional induced DA (iDA) neurons, with minimum contamination by other brain cell types. Gene expression analysis, associated with functional characterization examining neurotransmitter release and electrical recordings, support the functional identity of the iDA neurons to A9 midbrain neurons. iDA neurons showed selective vulnerability when exposed to 6-hydroxydopamine, thus providing a viable in vitro approach for modeling PD and for the screening of small molecules with neuroprotective proprieties.

Here, we characterized the first French NDM-9-producing Acinetobacter baumannii isolate. A. baumannii 13A297, which belonged to the STPas25 (international clone IC7), was highly resistant to β-lactams including cefiderocol (MIC >32 mg/L). Whole genome sequencing (WGS) using both Illumina and Oxford Nanopore technologies revealed a 166-kb non-conjugative plasmid harboring a blaNDM-9 gene embedded in a Tn125 composite transposon. Complementation of E. coli DH5α and A. baumannii CIP70.10 strains with the pABEC plasmid carrying the blaNDM-1 or blaNDM-9 gene, respectively, resulted in a significant increase in cefiderocol MIC values (16 to >256-fold), particularly in the NDM-9 transformants. Interestingly, steady-state kinetic parameters, measured using purified NDM-1 and NDM-9 (Glu152Lys) enzymes, revealed that the affinity for cefiderocol was 3-fold higher for NDM-9 (Km = 53 μM) than for NDM-1 (Km = 161 μM), leading to a 2-fold increase in catalytic efficiency for NDM-9 (0.13 and 0.069 μM−1.s−1, for NDM-9 and NDM-1, respectively). Finally, we showed by molecular docking experiments that the residue 152 of NDM-like enzymes plays a key role in cefiderocol binding and resistance, by allowing a strong ionic interaction between the Lys152 residue of NDM-9 with both the Asp223 residue of NDM-9 and the carboxylate group of the R1 substituent of cefiderocol.

Dopamine agonists are the first-line treatment of prolactinomas. The risk of developing de novo psychiatric symptoms during dopamine agonist therapy is low. Herein, we report the case of a 42-year-old woman with a giant prolactinoma who developed a psychiatric disorder after 1 day of cabergoline therapy initiation. She presented with amenorrhea, galactorrhea, headaches, and disturbed vision. Biological investigations revealed hyperprolactinemia (2975 ng/ml) with gonadotropin deficiency. Pituitary MRI showed a giant pituitary adenoma. The patient was treated with cabergoline at the dose of 1 mg twice weekly. One day after the treatment initiation, she developed acute delirium with temporospatial disorientation and compulsive medication use. These symptoms disappeared 1 week after the reduction of the dose of cabergoline. Patients with hyperprolactinemia receiving an initial high dose of cabergoline may develop changes in mood and behavior regardless of prior psychiatric history.

Abstract Introduction Several ultrasound scoring systems have been developed to stratify the risk of malignancy of thyroid nodules, including ACR (American College of Radiology) and EU (European) TI‐RADS. This study aimed to assess the diagnostic performance of these two classifications using histology as a reference standard. Methods It was a single‐centre, retrospective study including 156 patients who underwent thyroidectomy. Ultrasound data of 198 nodules (99 malignant nodules and 99 benign nodules) were analysed. Both classifications were applied for all nodules. Results Ultrasound criteria associated with malignancy were solid composition (OR=7.81; p

Renal vein thrombosis is not a common manifestation in the context of acute pyelonephritis. We report the case of a 29-year-old female diabetic patient that was admitted to our department for an episode of complicated acute pyelonephritis. Initial imaging showed a left lower polar abscess of 27 mm and urine cultures grew community acquired K. Pneumoniae. Two days after the patient was discharged, she was readmitted with worsening symptoms. Repeat imaging showed stability in the size of the abscess and revealed a left lower segmental vein thrombosis. The patient responded favorably to antibiotics and heparin-warfarin therapy.

Pelvic leiomyoma in male patients is a very rare occurrence and its association with prostate cancer is a unique clinical situation. This study reports a new case of a 9 cm pelvic Leiomyoma associated with intermediate-risk localized prostate cancer in a 68-year-old patient. The leiomyoma was discovered fortuitously after an MRI was performed in the context of prostate cancer work-up. Surgical excision of the pelvic mass along with a radical prostatectomy were performed and the diagnosis of leiomyoma was confirmed by histopathology.

The intrinsic cation exchange capacity (CEC) of clays is a crucial characteristic that offers a tool to assess their overall chemical properties. For the confinement of industrial and radioactive waste, clays are deployed as geological barriers, hence it is important to consider how they will react under external stresses. With respect to the electronegativity rate and cation ionic potential, the impact of a series of sequential cation exchange processes with heavy metals exchangeable cations was the main emphasis of this work. Using X-ray diffraction (XRD) profile modeling to assess interlayer space (IS) deformation and highlight geochemical alteration, the structural reactivity of Na-rich montmorillonite was investigated. To determine the ideal structural characteristics defining IS configuration, the study contrasted estimated reflections produced from theoretical models with those produced experimentally from 00l reflections. Per each exchanged cation, the results showed a partial CEC saturation and a heterogeneous mixed layer structure (MLS), with heterogeneous hydration behavior continuing to exist regardless the type of exchangeable cation. The established chemical constraint had no effect on the cation hydration sphere for Co (II), Ni (II), Mg (II), Cu (II), and Zn (II) exchangeable cations. However, significant interlamellar water molecule development was observed for the Cd (II), Pb (II), and Ba (II) cations, indicating a major alteration in the discretization of the hydration states and particular hydration heterogeneities. The Cd (II), Pb (II), and Ba cations were most affected by these alterations, which resulted in a constrained and inhibited CEC performance. The theoretical decomposition of the observed XRD profiles was used to show the existence of multiple layer type populations and their stacking mode, with most of the studied samples showing a tendency toward segregated stacking configuration. Moreover, as a function of the applied stress, the CEC of the stress samples gradually dropped.

Objective. The study was aimed to assess the effect of hydrocortisone (HC) replacement therapy on bone mineral density (BMD) and bone turnover markers in patients with primary adrenal insufficiency (PAI).

BackgroundAdrenomedullin (ADM) regulates vascular tone and endothelial permeability during sepsis. Levels of circulating biologically active ADM (bio-ADM) show an inverse relationship with blood pressure and a direct relationship with vasopressor requirement. In the present prospective observational multinational Adrenomedullin and Outcome in Sepsis and Septic Shock 1 (, AdrenOSS-1) study, we assessed relationships between circulating bio-ADM during the initial intensive care unit (ICU) stay and short-term outcome in order to eventually design a biomarker-guided randomized controlled trial.MethodsAdrenOSS-1 was a prospective observational multinational study. The primary outcome was 28-day mortality. Secondary outcomes included organ failure as defined by Sequential Organ Failure Assessment (SOFA) score, organ support with focus on vasopressor/inotropic use, and need for renal replacement therapy. AdrenOSS-1 included 583 patients admitted to the ICU with sepsis or septic shock.ResultsCirculating bio-ADM levels were measured upon admission and at day 2. Median bio-ADM concentration upon admission was 80.5 pg/ml [IQR 41.5-148.1 pg/ml]. Initial SOFA score was 7 [IQR 5-10], and 28-day mortality was 22%. We found marked associations between bio-ADM upon admission and 28-day mortality (unadjusted standardized HR 2.3 [CI 1.9-2.9]; adjusted HR 1.6 [CI 1.1-2.5]) and between bio-ADM levels and SOFA score (p < 0.0001). Need of vasopressor/inotrope, renal replacement therapy, and positive fluid balance were more prevalent in patients with a bio-ADM > 70 pg/ml upon admission than in those with bio-ADM ≤ 70 pg/ml. In patients with bio-ADM > 70 pg/ml upon admission, decrease in bio-ADM below 70 pg/ml at day 2 was associated with recovery of organ function at day 7 and better 28-day outcome (9.5% mortality). By contrast, persistently elevated bio-ADM at day 2 was associated with prolonged organ dysfunction and high 28-day mortality (38.1% mortality, HR 4.9, 95% CI 2.5-9.8).ConclusionsAdrenOSS-1 shows that early levels and rapid changes in bio-ADM estimate short-term outcome in sepsis and septic shock. These data are the backbone of the design of the biomarker-guided AdrenOSS-2 trial.Trial registrationClinicalTrials.gov, NCT02393781 . Registered on March 19, 2015.

BackgroundIntensive care unit (ICU) survivors have reduced long-term survival compared to the general population. Identifying parameters at ICU discharge that are associated with poor long-term outcomes may prove useful in targeting an at-risk population. The main objective of the study was to identify clinical and biological determinants of death in the year following ICU discharge.MethodsFROG-ICU was a prospective, observational, multicenter cohort study of ICU survivors followed 1 year after discharge, including 21 medical, surgical or mixed ICUs in France and Belgium. All consecutive patients admitted to intensive care with a requirement for invasive mechanical ventilation and/or vasoactive drug support for more than 24 h following ICU admission and discharged from ICU were included. The main outcome measure was all-cause mortality at 1 year after ICU discharge. Clinical and biological parameters on ICU discharge were measured, including the circulating cardiovascular biomarkers N-terminal pro-B type natriuretic peptide, high-sensitive troponin I, bioactive-adrenomedullin and soluble-ST2. Socioeconomic status was assessed using a validated deprivation index (FDep).ResultsOf 1570 patients discharged alive from the ICU, 333 (21%) died over the following year. Multivariable analysis identified age, comorbidity, red blood cell transfusion, ICU length of stay and abnormalities in common clinical factors at the time of ICU discharge (low systolic blood pressure, temperature, total protein, platelet and white cell count) as independent factors associated with 1-year mortality. Elevated biomarkers of cardiac and vascular failure independently associated with 1-year death when they are added to multivariable model, with an almost 3-fold increase in the risk of death when combined (adjusted odds ratio 2.84 (95% confidence interval 1.73-4.65), p

Abstract A 48‐year‐old woman with a history of primary hypothyroidism, presented with compressive symptoms secondary to a rapid enlargement of a preexisting goiter. She had no clinical signs of hypocalcemia. Biological tests revealed hypoparathyroidism. Cervicothoracic computed tomography scan showed a heterogeneous compressive goiter. The patient was treated with levothyroxine, calcium, and alfacalcidol. A total thyroidectomy was not performed because of the hard adhesion to neighboring structures. Histopathological examination of the thyroid biopsy was consistent with the diagnosis of Riedel's thyroiditis (RT). The patient was treated with glucocorticoids. The outcome was marked by the resolution of compressive symptoms and the decrease of the thyroid gland volume. Serum calcium and parathyroid hormone levels reached normal ranges after the discontinuation of vitaminocalcic supplementation. Hypoparathyroidism may be clinically asymptomatic in a patient with RT as in our case. Early administration of glucocorticoids may be effective in reducing the fibrosclerotic process and lead to the recovery of parathyroid dysfunction.