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The Pliocene faunas of the northeastern Iberian Peninsula are poorly known due to the scarcity of deposits from this interval. In this context, the site of Sant Nofre-Campredó (Baix Ebre, Catalonia, Spain), comprising two contemporaneous outcrops belonging to geologically correlated sections (Sant Nofre and Campredó-Via Fèrria), makes a significant contribution to the study of Pliocene faunas in this region. The first vertebrate remains were recovered in the late 1970s in clay deposits close to the Sant Nofre Hill. Later, intensive sampling in the 1980s at the Campredó-Via Fèrria outcrop led to the recovery of more than a hundred fossil specimens, including small vertebrates and large mammals. Here, we revise these collections to expand and update the vertebrate list, better constrain the age of the continental deposits, and characterize the environment and climate around the mouth of the Ebro River during the formation of the site. Up to 24 vertebrate species have been identified at Sant Nofre-Campredó, including amphibians, reptiles, and mammals. The presence of the rodents Paraethomys baeticus Piñero & Verzi, 2020, Apocricetus barrierei (Mein & Michaux 1970), and Occitanomys brailloni Michaux, 1969 implies an early Ruscinian age (MN14 unit) for the two outcrops. Biostratigraphic correlations with other well-dated sites in the Iberian Peninsula refine the estimated age of Sant Nofre-Campredó to approximately 4.6 Ma. The ecological affinities of the identified fauna reveal a landscape dominated by woodland habitats in the surroundings of the site during the Early Pliocene, with presence of open humid meadows and water bodies under warm and moist climatic conditions.

It has been estimated that as many as 4 percent of strokes occurring in people under 45 are the result of some abnormality of the blood clotting process. Protein C is an important regulator of normal clotting, and much evidence has indicated that people who have inherited a deficiency of protein C may suffer venous thrombosis, the occlusion of veins, often in the legs, by blood clots. The data from a series of stroke patients now suggest that this same deficiency may result in strokes as well. To be more precise, the deficiency may result in nonhemorrhagic infarctions in which the circulation to some part of the brain is blocked, presumably by an arterial blood clot. A total of 1,333 patients with acute disease of brain blood vessels were admitted over a period just over four years. Fifty of these occurred in patients under the age of 45. Laboratory investigation revealed that three of these patients had signs of protein C deficiency. To confirm that the condition was inherited, the deficiency was identified in at least one other family member, and the absence of any other conditions which might lead to protein C deficiency was confirmed. Since protein C requires vitamin K for its normal function, it is also important to rule out vitamin K deficiency as a possible contributing factor. In all three cases, no abnormalities of blood coagulation could be found other than the protein C deficiency and no heart abnormalities which might have contributed to clot formation could be found. These cases strongly suggest that protein C deficiency may be a direct contributing factor to the occurrence of stroke in these young patients. Little can be said about the prognosis of strokes arising from this condition. One patient requires support to walk, cannot speak, and cannot use his right arm. The remaining two patients enjoyed almost complete recovery with no residual handicap. (Consumer Summary produced by Reliance Medical Information, Inc.)

CrSiTe3 has attracted recent interest as a candidate single-layer ferromagnetic semiconductor, but relatively little is known about the bulk properties of this material. Here, we report single-crystal X-ray diffraction, magnetic properties, thermal conductivity, vibrational, and optical spectroscopies and compare our findings with complementary electronic structure and lattice dynamics principles calculations. The high temperature paramagnetic phase is characterized by strong spin-lattice interactions that give rise to glassy behavior, negative thermal expansion, and an optical response that reveals that CrSiTe3 is an indirect gap semiconductor with indirect and direct band gaps at 0.4 and 1.2 eV, respectively. Measurements of the phonons across the 33 K ferromagnetic transition provide additional evidence for strong coupling between the magnetic and lattice degrees of freedom. The Si-Te stretching and Te displacement modes are sensitive to the magnetic ordering transition, a finding that we discuss in terms of the superexchange mechanism. Spin-lattice coupling constants are also extracted. [ABSTRACT FROM AUTHOR]

Background: Desmopressin (1-deamino-8-D-arginine vasopressin [DDAVP]) has demonstrated efficacy as a treatment option for patients with inherited bleeding disorders. Because of individuals' variable response to the medication, it is recommended to complete a challenge to document appropriate hemostatic response to the medication before recommending its use prior to surgical procedures or treatment of bleeding symptoms. The project aimed to reduce the errors in hemostatic response assessments for patients with bleeding disorders undergoing a DDAVP challenge (process outcome), particularly timing and number of blood samples drawn, from an error rate baseline of 36% to 0% by December 2021 and sustained for one year. Method: Plan-Do-Study-Act methodology was employed for this qualitative improvement initiative. Interventions designed and implemented included: an order set with medication doses and corresponding laboratory orders as clinically indicated for the bleeding disorder indication, clinical procedure guidelines for infusion nurses to follow, hemostasis nurse coordination of appointments with patients, and family education. Results: Baseline data on 22 patients who completed a DDAVP challenge demonstrated a 36% error rate not involving doses of medication administered. Errors encountered included improper timing of laboratory draw after DDAVP administration, incomplete laboratory evaluation, laboratory results displayed incorrectly due to testing orders released at once instead of in a sequential manner. These interventions resulted in a reduction of DDAVP challenge errors to 0% that were sustained for one year. Conclusion: Improvement in procedural medication administration and appropriate laboratory evaluation of patients undergoing a DDAVP challenge leads to a complete and reliable assessment of hemostatic response following medication administration., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Myeloid-derived suppressor cells (MDSC) are a heterogenous population of immunosuppressive myeloid cells now considered important immune regulatory cells in diverse clinical conditions, including cancer, chronic inflammatory disorders and transplantation. In rodents, MDSC administration can inhibit graft-versus-host disease lethality and enhance organ or pancreatic islet allograft survival. There is also evidence, however, that under systemic inflammatory conditions, adoptively-transferred MDSC can rapidly lose their suppressive function. To our knowledge, there are no reports of autologous MDSC administration to either human or clinically-relevant non-human primate (NHP) transplant recipients. Monocytic (m) MDSC have been shown to be more potent suppressors of T cell responses than other subsets of MDSC. Following their characterization in rhesus macaques, we have conducted a preliminary analysis of the feasibility and preliminary efficacy of purified mMDSC infusion into MHC-mismatched rhesus kidney allograft recipients. The graft recipients were treated with rapamycin and the high affinity variant of the T cell co-stimulation blocking agent cytotoxic T lymphocyte antigen 4 Ig (Belatacept) that targets the B7-CD28 pathway. Graft survival and histology were not affected by infusions of autologous, leukapheresis product-derived mMDSC on days 7 and 14 post-transplant (cumulative totals of 3.19 and 1.98 × 10 6 cells/kg in n = 2 recipients) compared with control monkeys that did not receive MDSC (n = 2). Sequential analyses of effector T cell populations revealed no differences between the groups. While these initial findings do not provide evidence of efficacy under the conditions adopted, further studies in NHP, designed to ascertain the appropriate mMDSC source and dose, timing and anti-inflammatory/immunosuppressive agent support are likely to prove instructive regarding the therapeutic potential of MDSC in organ transplantation., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Objective: To investigate the frequency of cancer developing in patients with peripheral sensory neuropathy of unexplained cause., Design: Prospective study., Setting: A neurologic unit in a general hospital., Methods: Following the diagnosis of neuropathy, we searched for occult malignancy. This search was repeated together with neurologic evaluations every 6 months thereafter. Patient recruitment began January 1, 1988, and ended December 31, 1995. The end point of the study was December 31, 1996., Results: In the study period, we observed 363 patients with peripheral sensory neuropathy. Of these, 53 patients without any identified cause of neuropathy were invited to participate in the study. Of the 53, 2 patients refused. Thus, we examined and followed up 51 patients, 42 men and 9 women, with a mean age of 64.5 years (range, 19-80 years). The range between the onset of neurologic symptoms and the diagnosis of neuropathy was 2 to 72 months (mean, 13.9 months). The follow-up period ranged from 14 to 94 months (mean, 51.4 months). In 18 patients (35.3%) (16 men and 2 women) whose mean age at diagnosis of neuropathy was 66.5 years. malignant growths were found 3 to 72 months (mean, 27.4 months) after the onset of the neuropathy. The cancer was in the liver in 4 patients (all had a primary hepatoma), the bladder in 3, the lymph nodes in 3 (all with non-Hodgkin lymphoma), the prostate gland in 2, the lungs in 2 (small cell lung cancer in both), the breast in 1, the pancreas in 1, the sublingual gland in 1, and the bone in 1 (a metastatic sarcoma)., Conclusions: More than one third of the patients with peripheral sensory neuropathy of unexplained cause developed cancer without any predominating type of malignancy.

We hypothesized that substitution of the hydroxyl group (OH) on the beta carbon of norepinephrine (NE) with an amino group would yield a compound, 1-(3,4-dihydroxyphenyl)-1,2-diaminoethane (DHPDAE), that would maintain the hemodynamic properties of NE during CPR, but would decrease the rate of post-defibrillation dysrhythmias. Six mixed breed swine weighing greater than 28 kg were studied. The animals were instrumented for cerebral (CBF) and myocardial blood flow (MBF) measurements. Ventricular fibrillation (VF) was induced. After 10 min of VF, CPR was begun. After 3 min of CPR, 2.5 mg/kg of DHPDAE was administered and CPR continued. Defibrillation was attempted 3.5 min after drug administration. CBF, MBF and defibrillation rates were compared to an historical control group receiving 0.16 mg/kg of NE. Outcome variables were compared using a Wilcoxon Rank Sum test and Fisher-exact test. NE significantly improved CBF and MBF compared to DHPDAE. All the animals in the NE group were successfully defibrillated into a perfusing rhythm. Sixty percent of the NE treated animals experienced post-defibrillation ventricular dysrhythmias. None of the animals in the DHPDAE were successfully defibrillated into a perfusing rhythm. Substitution of the hydroxyl group on the beta-carbon of NE with an amino group significantly decreases the hemodynamic properties of the parent molecule.

The case of a "young stroke" affecting a 22 years old man is reported. Essential clinical features were drowsiness, headache, motor aphasia, right hemiparesis and Claude-Bernard-Horner in the left eye. An extensive investigative protocol was carried out which revealed an occlusion of the intracranial left ICA with subsequent recanalization. The possible causes of the stroke (migraine, dissection or combination of both) are discussed and the importance of a complete evaluation of patients of this kind is stressed.

A Fortran IV computer program is described which identifies, computes, and statistically evaluates amino acid concentrations determined by an automatic amino acid analyzer in physiologic fluids. The program accepts retention time and intergrated peak areas from two calibration standards for identification and computational reference. Two internal standards are used to compensate for variations in injector performance and ninhydrin decay. Calibration standard responses are statistically treated to assist in detection of equipment malfunction. The statistical data base is automatically explanded through inclusion of data from normal patients. Amino acid concentrations are printed with appropriate mean and standard deviation values in a format acceptable as a final report.