articles+ search results

RATINGS of hospitals and MEDICATION errors

Aims To demonstrate an epidemiological method to assess predictors of prescribing errors. Methods A retrospective case-control study, comparing prescriptions with and without errors. Results Only prescriber and drug characteristics were associated with errors. Prescriber characteristics were medical specialty (e.g. orthopaedics: OR: 3.4, 95% CI 2.1, 5.4) and prescriber status (e.g. verbal orders transcribed by nursing staff: OR: 2.5, 95% CI 1.8, 3.6). Drug characteristics were dosage form (e.g. inhalation devices: OR: 4.1, 95% CI 2.6, 6.6), therapeutic area (e.g. gastrointestinal tract: OR: 1.7, 95% CI 1.2, 2.4) and continuation of preadmission treatment (Yes: OR: 1.7, 95% CI 1.3, 2.3). Conclusions Other hospitals could use our epidemiological framework to identify their own error predictors. Our findings suggest a focus on specific prescribers, dosage forms and therapeutic areas. We also found that prescriptions originating from general practitioners involved errors and therefore, these should be checked when patients are hospitalized. [ABSTRACT FROM AUTHOR]

APPLE blue mold and MYCOTOXINS

Aims: To study the influence of culture preservation methods and culture conditions on the production of the mycotoxins patulin and citrinin by Penicillium expansum . Methods and results: Ten strains of Penicillium expansum were preserved using subculture and maintenance at 4 °C, mineral oil, drying on silica gel and freeze-drying. Patulin and citrinin production was assessed on yeast extract sucrose agar (YES) and grape juice agar (GJ), using TLC before and after 0·5, 2–3, 6 and 12 months preservation. Citrinin was detected in all cultures for all preservation techniques on YES. The patulin profiles obtained differed with strain and culture media used. Conclusions: Citrinin production seems to be a stable character for the tested strains. There is a tendency for patulin detection with time apparently more consistent for silica gel storage and freeze-drying, especially when the strains are grown on GJ. Significance and Impact of the Study: Variability in the profiles of the mycotoxins tested seems to be more strain-specific than dependent on the preservation technique used. [ABSTRACT FROM AUTHOR]

AUDITORY evoked response, AUDITORY perception, HEARING, and COMPACT discs

The purpose of this series of experiments was to develop a simple, 500-Hz masking-level difference (MLD) protocol that could be implemented easily in the clinic to assess auditory perceptual abilities using an audio compact disc. Five, 300-ms tones with 250-ms intertone intervals were embedded in 3-s bursts of 200-800 Hz noise presented at 42.2-dB pressure-spectrum level with 4-5 s interstimulus intervals. The homophasic and antiphasic conditions were interleaved with the signal-to noise ratios decreasing in 2-dB steps. A single-interval, "yes/no" response task was used. Three experiments were performed on 24-28 listeners with normal hearing. The mean SoNo thresholds (58.1- to 59.5-dB SPL) and the mean SπNo thresholds (45.1- to 46.0-dB SPL) produced ∼13-dB MLDs. Experiment 3 included a SoNπ condition that had a mean threshold of 48.8-dB SPL and a 10.0-dB MLD. The mean test, retest of the SoNo and SπNo thresholds on 15 listeners was <0.5 dB. Over the three experiments, 95% of the listeners had SπNo MLDs that were ≥10 dB. [ABSTRACT FROM AUTHOR]

HERBICIDES, CORN, WEEDS, and CROP yields

Summary This work was initiated to integrate an image analysis system and a prediction equation to support decisions for post-emergence herbicide applications under field conditions. Data were collected from 1999 to 2001 in 32 commercial fields to obtain weed cover data at the three to four leaf stage of maize (Zea mays L.), and crop yield at maturity. Relative crop yield was predicted using a non-linear sigmoidal equation with relative weed cover as the predictor variable (P < 0.0001; R [sup 2] = 0.39). The decision procedure consists of using the equation within the limits of a yield loss threshold that represents the loss one is willing to tolerate. The tolerance threshold (TT) allows determination of a weed threshold (WT). The procedure considers the variability around the prediction equation by setting the WT at the intersection between the lower 95% confidence interval of the prediction line and the TT. It also considers the variability around the weed cover estimate. For a given field, the decision is made by comparing the average weed cover corrected for sampling error, to the WT. We tested the performance of the decision procedure and found it could lead to a saving of 25% of herbicide use. We also computed a probability table showing the chances of getting relative yield above or below the TT. We suggest using the probability table in combination with the decision procedure to manage risks. The proposed approach does not offer a set ‘yes’ or ‘no’ answer but rather provides a framework to support decisions by producers who ultimately must manage the risks. [ABSTRACT FROM AUTHOR]

RUBIACEAE, WEEDS, PLANT viruses, SEED industry, and ERIOPHYIDAE

Galium spurium L. (Rubiaceae), native to Europe, is an increasingly serious annual weed of cultivated crops in the prairie provinces of Canada. The gall mite Cecidophyes rouhollahi Craemer (Acari, Eriophyidae), originally found on the related plant species Galium aparine L. in southern France, was evaluated as a potential biological control agent for G. spurium. In greenhouse tests, C. rouhollahi caused severe stunting and complete prevention of seed production by G. spurium. Host specificity tests showed that C. rouhollahi developed only on three closely related annual Galium species in the Kolgyda section. No native North American Galium species were attacked, with the exception of G. aparine. A review of available information on G. aparine suggests that it is probably an introduced species in North America. It has been reported that a related gall mite attacking G. aparine might be associated with a plant virus. A series of tests on a greenhouse colony of G. spurium infested with C. rouhollahi showed no evidence of viral infection. On the basis of these results, C. rouhollahi has been approved for field release against G. spurium in Canada. [ABSTRACT FROM AUTHOR]

PROSTATE cancer, EPITHELIAL cells, ESTROGEN, and STEROLS

Estradiol rapidly activates Src as well as the Src-dependent pathway in human mammary cancer-derived MCF-7 cells, in human prostate cancer-derived LNCaP cells and in Cos cells transiently expressing hERs [EMBO J. 15 (1996) 1292; EMBO J. 17 (1998) 2008]. In addition, estradiol immediately stimulates, yes, an ubiquitous member of the Src kinase family, in human colon carcinoma-derived Caco-2 cells [Cancer Res. 56 (1996) 4516]. Progestins and androgens activate the same pathway in human mammary and prostate cancer-derived cells [EMBO J. 17 (1998) 2008; EMBO J. 19 (2000) 5406]. We observed that estradiol also stimulates the phosphatidylinositol-3-kinase (PI3K)/AKT pathway in MCF-7 cells [EMBO J. 20 (2001) 6050]. In these cells, activation of the Src- and the PI3 K-dependent pathways is simultaneous and mediated by direct interactions of the two kinases with ERα. The signalling pathway activation by sex-steroid hormones leads to DNA synthesis and cell growth in human mammary and prostate cancer-derived cells [EMBO J. 19 (2000) 5406; EMBO J. 20 (2001) 6050; EMBO J. 18 (1999) 2500]. Furthermore, androgen stimulation of NIH3T3 fibroblasts activates the same pathways triggered by this hormone in LNCaP cells and promotes the S-phase entry or cytoskeleton changes in these cells [J. Cell Biol. 161 (2003) 547]. All the described effects are rapid and require classic steroid receptors, but, surprisingly, not their transcriptional activity. Indeed, a transcriptionally inactive mutant of hER mediates the estrogen-stimulated DNA synthesis of NIH3T3 fibroblasts [EMBO J. 18 (1999) 2500]. Furthermore, AR in NIH3T3 cells does not enter nuclei and is unable to respond to the hormone with transcription stimulation, whereas it activates signaling pathways and triggers important biological responses.Signaling pathway activation by steroids has also been described by other groups under different experimental conditions and/or in different cell types. In these cells, steroid stimulation triggers various effects, such as neuroprotection, vasorelaxation or bone protection [J. Neurosci. Res. 60 (2000) 321; Nature 407 (2000) 538; J. Cell Biochem. 76 (1999) 206]. Analysis of the mechanisms responsible for the hormone-dependent and steroid receptor-mediated pathway activation in epithelial as well as stromal cells reveals immediate association of steroid receptors with extranuclear signaling effectors [EMBO J. 17 (1998) 2008; Cancer Res. 56 (1996) 4516; EMBO J. 19 (2000) 5406; EMBO J. 20 (2001) 6050; J. Cell Biol. 161 (2003) 547]. These results further highlight the central role of the hormone-regulated protein–protein interactions in the steroid action. They also offer the possibility of interfering with important activities of hormones, such as proliferation or survival, cytoskeleton changes as well as invasiveness and vasorelaxation, without affecting the steroid effects that depend on receptor transcriptional activity. [Copyright &y& Elsevier]

ARTIFICIAL neural networks, COMPUTER architecture, EMBEDDED computer systems, PRODUCTION scheduling, and ESTIMATION theory

Real-time embedded systems are spreading to more and more new fields and their scope and complexity have grown dramatically in the last few years. Nowadays, real-time embedded computers or controllers can be found everywhere, both in very simple devices used in everyday life and in professional environments. Real-time embedded systems have to take into account robustness, safety and timeliness. The most-used schedulability analysis is the worst-case response time proposed by Joseph and Pandya (Comput J 29:390-395,1986). This test provides a bivaluated response (yes/no) indicating whether the processes will meet their corresponding deadlines or not. Nevertheless, sometimes the real-time designer might want to know, more exactly, the probability of the processes meeting their deadlines, in order to assess the risk of a failed scheduling depending on critical requirements of the processes. This paper presents RealNet, a neural network architecture that will generate schedules from timing requirements of a real-time system. The RealNet simulator will provide the designer, after iterating and averaging over some trials, an estimation of the probability that the system will not meet the deadlines. Moreover, the knowledge of the critical processes in these schedules will allow the designer to decide whether changes in the implementation are required. [ABSTRACT FROM AUTHOR]

ATHLETES, FATIGUE (Physiology), PHYSICAL education, QUESTIONNAIRES, and SPORTS medicine

Abstract: Objective. – The group of consensus of the French Society of Sport Medicine prepared a questionnaire in order to detect early stage of overtraining. This questionnaire includes 54 items which the subjects have to answer by “yes” or by “not”. A score is then established by summing the “yes”. Taking into account the formulation of the questions, this score will increase with the training load. The aim of our study is to propose a score of overtraining, and also to highlight the importance of some items or groups of items. Methods. – Our population consisted of French sportsmen of both sexes, from different geographical origins, age, sporting practice and level. A multicentric analysis was carried out on the basis of 1984 collected questionnaires. We analysed the evolution of the percentage of subjects, the weight of various parameters (age, overtraining) and the evolution of the frequency of each item as a function of the score. Results. – A score of 20 was proposed as an overtraining state threshold, which has to be confirmed on the basis of correlations with biological indices, in particular with a state of clinically established overtraining. Sixteen items present a linear evolution traducing an increase of tiredness according to the overload. Six items have a logarithmic increase, traducing a kind of “background noise”. The others items (N =32) presenting a non-linear increase are sign of a decompensation phenomenon. Conclusion. – This analysis by item make possible an improve of the questionnaire, by selecting items groups which may give an orientation on the type of tiredness. It also confirms the usefulness of this questionnaire as a tool for the follow-up of the training state of sportsmen, a score equal to or higher than 20 constituting the overtraining threshold. [Copyright &y& Elsevier]

SILAGE, CORN, PENICILLIN, BACTERIA, and PHYSIOLOGICAL effect of patulin

Abstract: The objectives were to investigate the presence of patulin-producing Penicillium sp. in corn silage and high moisture corn as well as adverse effects of patulin on microbial fermentation in continuous culture fermenters. Eighty-three samples of corn silage or high moisture corn were cultured to determine the presence of molds. Penicillium sp. were isolated from 0.82 of samples. Of these Penicillium sp. isolates, 0.03 produced patulin on yeast extract sucrose and potato dextrose agar. The patulin-producing isolates belonged to the P. viridicatum group. The other molds identified were: Mucor sp. (0.45), Aspergillus sp. (0.41), and Fusarium sp. (0.25). Eight single-flow continuous culture fermenters were used to study effects of patulin on fermentation by ruminal microbes. Two 1-l fermenters were supplemented with 0, 10, 20 or 40mg of patulin every 12h for three consecutive days. Increasing patulin reduced neutral detergent and acid detergent fiber digestibility at a decreasing rate (linear, P<0.01; quadratic, P<0.05). True digestion of organic matter and total non-structural carbohydrates decreased linearly (P<0.05) as patulin concentration increased. Crude protein digestion and bacterial N flows decreased linearly (P<0.05). Conversely, there was a linear increase (P<0.05) in ammonia nitrogen with increased patulin. Total, ammonia and non-ammonia N flows were not affected by patulin. Efficiency of microbial protein synthesis was not affected by patulin but there was a linear decreased (P<0.05) in the efficiency of N utilization. Increasing patulin levels caused a linear decrease (P<0.001) of total volatile fatty acid concentration and a quadratic decrease of acetate and propionate molar proportions (P<0.05). Ten and 20mg/l of patulin produced a decrease in acetate proportion and an increase in propionate proportion. Lactate concentration (mmol/l) increase from 0.0 to 216.5mmol/l (linear, P<0.05) with increasing patulin concentration. Penicillium sp. molds are common contaminants of corn silage and high moisture corn and they produce patulin that can adversely affect fermentation by ruminal microbes. Alterations in microbial digestion of dry matter, and production of microbial end products, impact the production and/or health of ruminants. [Copyright &y& Elsevier]

CYTOKINES, GROWTH factors, CHEMICAL reactions, and PHEOCHROMOCYTOMA

Abstract: Src family kinases are involved in transducing growth factor signals for cellular differentiation and proliferation in a variety of cell types. The activity of all Src family kinases (SFKs) is controlled by phosphorylation at their C-terminal 527-tyrosine residue by C-terminal SRC kinase, CSK. There is a paucity of information regarding the role of CSK and/or specific Src family kinases in neuronal differentiation. Pretreatment of PC12 cells with the Src family kinase inhibitor, PP1, blocked NGF-induced activation of SFKs and obliterated neurite outgrowth. To confirm a role for CSK and specific isoforms of SFKs in neuronal differentiation, we overexpressed active and catalytically dead CSK in the rat pheochromocytoma cell line, PC12. CSK overexpression caused a profound inhibition of NGF-induced activation of FYN, YES, RAS, and ERK and inhibited neurite outgrowth, NGF-stimulated integrin-directed migration and blocked the NGF-induced conversion of GDP–RAC to its GTP-bound active state. CSK overexpression markedly augmented the activation state of AKT following NGF stimulation. In contrast, kinase-dead CSK augmented the activation of FYN, RAS, and ERK and increased neurite outgrowth. These data suggest a distinct requirement for CSK in the regulation of NGF/TrkA activation of RAS, RAC, ERK, and AKT via the differential control of SFKs in the orchestration of neuronal differentiation. [Copyright &y& Elsevier]

SUICIDE prevention, MENTAL health services, SUICIDE, MEDICAL care, PSYCHIATRISTS, MENTAL health personnel, MENTAL depression, INTERPROFESSIONAL relations, PSYCHIATRY, and PSYCHOLOGICAL aspects

This article examines the role of psychiatrists in preventing suicide in Australia. It is noted that psychiatrists can help both in populations and in their patients but they cannot do it alone. It is recommended that primary care physicians need more training and education so that they can detect, engage in treatment and treat in collaboration patients with depression and substance abuse. Here again, psychiatrists can play a role through shared care models. Second, insufficient coordination between psychiatric services and addiction services was found in more than one-third of cases.

ANTIBIOTICS, MOLECULES, PHARMACEUTICAL industry, SCIENCE, and CLINICAL trials

Abstract: The golden age of antibacterial antibiotics extend from year 1941 to the 1990s decade. At that time, something like an earth quake occurred: from the thirty molecules or so whose development was being achieved or was already marketed, only three were put on the French market, and faced the greatest difficulties to be prescribed by practicians, because: [-] the knights of good practice want a strict limitation of their use to precise indications; [-] the pharmaceutical companies find that the return on investment is almost impossible; [-] the prescribers are stunned by the inconsistency between the MAs, the advances in science and the health economic authorities advices which claim that these products are not very interesting; [-] the research for new antibiotics is stalling; [-] thus, for the first time in 60 years, an iconoclastic question arises: do we need new antibiotics? However, while the debate is raging, many of us think “yes we do”, as it is a duty to anticipate today the consequences of tomorrow''s bacterial resistances. This paper presents three types of propositions to optimise the development of future molecules: [-] sharpening of the data concerning preclinical security for a better predicting both the activity and the toxicity; [-] improvement in performances and organization of clinical trials, which implicates to reconsider some of the present methodological rules; [-] inclusion in the evaluation data of some relevant and new features measuring the anti-bacterial activity while taking into account the present and future bacterial resistances. The development of new concepts to develop new drugs which would be active against tomorrow''s bacteria compels us to manage in a new fashion today''s systems, which have reached their own limits. [Copyright &y& Elsevier]

RADIOGRAPHY, MEDICAL radiology, PROSTATECTOMY, and THERAPEUTICS

Background: This study analyzed the outcome of salvage radiotherapy for biochemical failure after radical prostatectomy (RP). By comparing the outcomes for patients who received RT alone and for those who received combined RT and hormonal therapy, we assessed the potential benefits of hormonal therapy. Patients and Methods: This cohort was comprised of 101 patients who received salvage RT between 1990 and 2001 for biochemical failure after RP. Fifty-nine of these patients also received hormone. Margin status (positive vs. negative), extracapsular extension (yes vs. no), seminal vesicle involvement (yes vs. no), pathologic stage, Gleason score, pre-RP PSA, post-RP PSA, pre-RT PSA, hormonal use, radiotherapy dose and technique, RP at M. D. Anderson Cancer Center, and time from RP to salvage RT were analyzed. Statistically significant variables were used to construct prognostic groups. Results: Independent prognostic factors for the RT-alone group were margin status and pre-RT PSA. RP at M. D. Anderson Cancer Center was marginally significant (p = 0.06) in multivariate analysis. Pre-RT PSA was the only significant prognostic factor for the combined-therapy group. We used a combination of margin status and pre-RT PSA to construct a prognostic model for response to the salvage treatment based on the RT group. We identified the favorable group as those patients with positive margin and pre-RT PSA ≤0.5 ng/mL vs. the unfavorable group as otherwise. This stratification separates patients into clinically meaningful groups. The 5-year PSA control probabilities for the favorable vs. the unfavorable group were 83.7% vs. 61.7% with radiotherapy alone (p = 0.03). Androgen ablation seemed to be most beneficial in the unfavorable group. Conclusion: After prostatectomy, favorable-group patients may fare well with salvage radiotherapy alone. These patients may be spared the toxicity of androgen ablation. The other patients may benefit most from a combined approach with hormonal treatment. We further suggest that salvage radiotherapy should be given early when the PSA is still low. [Copyright &y& Elsevier]

STILLBIRTH, PHYSICAL diagnosis, REPRODUCTION, and FETAL death

Abstract: The objective of this study was to identify the risk factors of stillbirth and foetal mummification in 565 farrowings of four commercial pig farms in Brazil. Stillborn piglets were observed in 31.3% of the litters and the stillborn risk was 5.6%. Mummified foetuses occurred in 42.1% of the litters and the mummification risk was 3.4%. The potential risk factors were included in multivariable logistic regression models as categories: herd (1–4); parity (1, 2–5 and >5); litter size (<10, 10–12 and >12 piglets); farrowing length (≤3 or >3h); presence of mummified foetuses (yes or no); farrowing induction (yes or no); use of oxytocin (yes or no); use of vaginal palpation (yes or no); body condition score (<3, 3 and ≥4), and placental production index (PPI) (≤5 or >5) which was measured as the ratio of total foetal weight to total placental weight. Duration of farrowing and use of farrowing induction, oxytocin or vaginal palpation were not included in the model that investigated the risk factors of foetal mummification. Two models were used to investigate the risk factors of stillbirth, one with and the other without the inclusion of farrowing length. When compared to sows of parity 2–5, sows of parity >5 had 1.7- and 1.6-times higher odds (P <0.05) for stillbirth in the models with and without the inclusion of farrowing length, respectively. In both models, sows with more than 12piglets/litter had 3.6-times higher odds of stillbirth occurrence compared to sows with less than 10 piglets (P <0.05). Sows with prolonged farrowing (>3h) had 2.0-times higher odds of stillbirth occurrence than sows with short farrowing (P <0.05). Sows with more than 12piglets/litter had 14.5-times higher odds of mummification compared to sows with less than 10 piglets (P <0.05). Sows of parities 1 and >5 had 3.5- and 2.0-times, respectively, higher odds of mummification in comparison to sows of parity 2–5 (P <0.05). Sows with low PPI had 1.7-times higher odds of mummification compared to those with high PPI (P <0.05). A large litter, a high-parity and a prolonged farrowing increased the risk of stillbirth. The probability of having a mummified foetus was increased in very young and older sows, when having a large litter and a litter with a less efficient placenta. [Copyright &y& Elsevier]

GENETIC polymorphisms, HUMAN population genetics, HUMAN evolution, GENETICS, POPULATION, ASIANS, and NATIVE Americans

Background : Alu insertions provide useful markers for the study of inter-population affinities and historical processes, but data on these systems are not numerous in Native Americans and related populations. Aim : The study aimed to answer the following questions: (a) do the population relationships found agree with ethnic, historical and geographical data? and (b) what can heterozygote levels and associated results inform us about the events that led to the colonization of the New World? Subjects and methods : Twelve Alu insertion polymorphisms were studied in 330 individuals belonging to South American Native, Siberian and Mongolian populations. These data were integrated with those from 526 persons, to ascertain the relationships between Asian, Northern Arctic and Amerindian populations. Results : A decreasing trend concerning heterozygosities and amount of gene flow was observed in the three sets, in the order indicated above. Most results indicated the validity of these subdivisions. However, no clear structure could be observed within South American Natives, indicating the importance of dispersive (genetic drift, founder effects) factors in their differentiation. Conclusions : The answers to the questions are: (a) yes; and (b) an initial moderate bottleneck, intensified by more recent historical events (isolation and inbreeding), can explain the current Amerindian pattern of diversity. [ABSTRACT FROM AUTHOR]

IMPOTENCE, DIABETES complications, DRUG dosage, MEN'S health, and DRUG efficacy

Aim. The aim of this article is to evaluate the efficacy and safety of 20-mg tadalafil taken on demand or three times per week and its effect on the sexual activity of patients with diabetes mellitus and erectile dysfunction (ED). Methods. The scheduled use vs. on-demand regimen evaluation (SURE) was a randomized, crossover, open-label study with 4,262 patients in 14 European countries. The efficacy measures for the 762 patients with diabetes and ED included changes from baseline in the erectile function (EF) domain of the International Index of Erectile Function (IIEF), and the proportion of “yes” responses to patient Sexual Encounter Profile (SEP) questions 2 (SEP2) and 3 (SEP3). The treatment satisfaction was measured with responses to SEP question 4 (SEP4) and SEP question 5 (SEP5), and sexual attempts data were collected. Patient preference for either regimen was determined by the treatment preference question (TPQ). Results. At end point on both regimens, the mean IIEF EF domain score was 22, and >40% of the patients had a normal EF domain score (≥26). The proportion of “yes” responses was ≥73% for SEP2 (penetration), ≥58% for SEP3 (successful intercourse), >46% for SEP4 (hardness of erection), and ≥45% for SEP5 (overall satisfaction). Efficacy was maintained up to 36 hours post-dosing. More than 70% of sexual attempts while on the three-times-per-week regimen and approximately 50% of the attempts on the on-demand treatment occurred >4 hours post-dosing. Tadalafil was well tolerated, with dyspepsia and headache as the most frequent adverse events reported. Treatment preference was 57.2% for on demand and 42.8% for three times per week. Conclusions. Tadalafil, when taken on demand or three times per week, is efficacious and safe in men with diabetes and ED. Buvat J, van Ahlen H, Schmitt H, Chan M, Kuepfer C, and Varanese L. Efficacy and safety of two dosing regimens of tadalafil and patterns of sexual activity in men with diabetes mellitus and erectile dysfunction: Scheduled use vs. on-demand regimen evaluation (SURE) study in 14 European countries. J Sex Med 2006;3:512–520. [ABSTRACT FROM AUTHOR]

BIPOLAR disorder, MENTAL depression, DEPRESSED persons, ANTIPSYCHOTIC agents, and MENTAL health

Abstract: Introduction: Although depressive moods are recognised as a very broad condition, there is still only one definition in international classifications for describing a major depressive episode (MDE). However, there is currently some controversy surround the treatment of depressive states. This includes SSRIs and suicide in adolescents, and more specifically in bipolar disorders where some depressions are made worse by antidepressants. New data has suggested that depressive states in BP patients can be improved by atypical antipsychotics. Aim: We aimed to assess 1) whether it is possible to distinguish different forms of bipolar depression using a dimensional approach, and 2) if, yes, whether there are different patterns of treatment response. Method: We characterised 60 bipolar patients with a Major Depressive Episode (DSM-IV) using a new tool (MATHYS: Multidimensional Assessment of Thymic States) assessing five fundamental dimensions (emotional reactivity, cognitive speed, psycho-motricity, motivation and senses perception) of mood states (full description elsewhere). Results: A cluster analysis using the items of the dimensional scale revealed two types of depressive states. One group (G1; N =38), which had a low score, is characterised by an inhibition in all dimensions, whereas the other group (G2; N =22) is characterised by an over-activation. Emotional reactivity is a useful dimension for discriminating these two types of depression (G1: hyporeactivity; G2: hyperreactivity) whereas sadness is not. A lower score on the MAThyS scale at day 1 was associated with a good response to antidepressant treatment, whereas higher scores were linked to a good response to a mood stabilizers alone or in combination with an antipsychotic. Conclusion: Bipolar depressive states are not homogeneous and this heterogeneity can explain various patterns of treatment response. A dimensional approach could be useful for discriminating the different forms of bipolar depression and to help manage treatment. [Copyright &y& Elsevier]

HYDROGEN-ion concentration, ASPERGILLUS niger, OCHRATOXINS, MYCOTOXINS, SUCROSE, RECOMBINANT DNA, FOOD contamination, INDUSTRIAL contamination, and ACIDITY function

The effect of pH (2–10) on growth and ochratoxin A (OTA) production by 12 Aspergillus niger aggregate strains was studied in two culture media: Czapek yeast autolysate agar (CYA) and yeast extract sucrose agar (YES), over 30 days. The strains were selected to include different sources, different reported abilities to produce OTA and different ITS-5.8S rDNA RFLP patterns. YES was a better culture medium than CYA for OTA production. In this medium, OTA was produced from pH 2 or 3 to 10 depending on the strain. The results show the ability of A. niger aggregate strains not only to grow, but also to produce OTA over a wide pH range. The results will lead to a better understanding of the role of A. niger aggregate strains in the OTA contamination of several food commodities. [ABSTRACT FROM AUTHOR]

THROMBOEMBOLISM, DISEASE risk factors, THERAPEUTICS, DRUG utilization, PHARMACODYNAMICS, MEDICAL screening, and MEDICAL records

Objectives: Although effective strategies for the prevention of venous thromboembolism (VTE) are widely available, a significant number of patients still develop VTE because appropriate thromboprophylaxis is not correctly prescribed. We conducted this study to estimate the risk profile for VTE and the employment of adequate thromboprophylaxis procedures in patients admitted to hospitals in the state of São Paulo, Brazil. Methods: Four hospitals were included in this study. Data on risk factors for VTE and prescription of pharmacological and non-pharmacological thromboprophylaxis were collected from 1454 randomly chosen patients (589 surgical and 865 clinical). Case report forms were filled according to medical and nursing records. Physicians were unaware of the survey. Three risk assessment models were used: American College of Chest Physicians (ACCP) Guidelines, Caprini score, and the International Union of Angiololy Consensus Statement (IUAS). The ACCP score classifies VTE risk in surgical patients and the others classify VTE risk in surgical and clinical patients. Contingency tables were built presenting the joined distribution of the risk score and the prescription of any pharmacological and non-pharmacological thromboprophylaxis (yes or no). Results: According to the Caprini score, 29% of the patients with the highest risk for VTE were not prescribed any thromboprophylaxis. Considering the patients under moderate, high or highest risk who should be receiving prophylaxis, 37% and 29% were not prescribed thromboprophylaxis according to ACCP (surgical patients) and IUAS risk scores, respectively. In contrast, 27% and 42% of the patients at low risk of VTE, according to Caprini and IUAS scores, respectively, had thromboprophylaxis prescribed. Conclusion: Despite the existence of several guidelines, this study demonstrates that adequate thromboprophylaxis is not correctly prescribed: high-risk patients are under-treated and low-risk patients are over-treated. This condition must be changed to insure that patients receive adequate treatment for the prevention of thromboembolism. [ABSTRACT FROM AUTHOR]

ETHICS, PSYCHIATRISTS, MENTAL health personnel, PSYCHIATRY, and PSYCHOTHERAPISTS

Abstract: In legal proceedings the expert witness testimony may be considered a medical act only if the expert conducts his clinical observations within the limits established by the medical code of ethics. This will then allow the psychiatrist to help the judge reach a more informed legal decision. The difficulty inherent in this process is for the expert to give an exact answer (“yes” or “no”) to the questions formulated in order for the judge to arrive at an accurate decision. To better understand the evidence presented, the judge may ask empirical questions that require the expert witness to give testimony going beyond the information directly gathered through clinical observations. It is the expert witness'' responsibility to determine what amount of interpretation of material drawn from a clinical observation is appropriate to help the judge make a legal decision. This requires defining legal standards such as credibility, truth, and suggestibility. One must also recognize that the clinical observation of a victim is often the person''s first contact with a psychiatrist. [Copyright &y& Elsevier]

FERTILIZATION (Biology), HUMAN embryos, HUMAN artificial insemination, OVUM, CYTOPLASM, GONADOTROPIN, and HUMAN embryology

The aim of this study was to identify predictors of fertilization rate (FR) and embryo quality (EQ) in 126 donor women who underwent 160 intracytoplasmic sperm injection (ICSI) cycles. Main outcome measures were oocyte dysmorphisms (OD) [perivitelline space (normal/large), perivitelline debris (no/yes), oocyte shape (spherical/non-spherical), zona pellucida (normal/abnormal), first polar body morphology (normal/fragmented or irregular), cytoplasmic granularity (normal/excessive), cytoplasmic vacuoles (no/yes) and colour of cytoplasm (normal/dark)l, semen source (ejaculated or testicular), donor age, number of days of stimulation, plasma oestradiol concentration (pg/ml) on the day of human chorionic gonadotrophin administration, FR and day 2 EQ. No significant predictors of fertilization were identified. However, the presence of a dark cytoplasm decreased by 83% the likelihood of obtaining good quality embryos (OR = O. 17; 95% CI: 0.044-0.74). Oocytes with a larger than normal perivitelline space were associated with 1.8 times higher chance of having good quality embryos (OR = 1.80; 95% CI: 1.15-2.80). Patients and ovarian stimulation characteristics evaluated here did not affect FR and EQ. ICSI technique may guarantee good FR in spite of OD; however, certain cytoplasmic anomalies at the oocyte level, such as a dark cytoplasm, could compromise subsequent embryo development. [ABSTRACT FROM AUTHOR]

ANESTHESIA, PLACEBOS, ETOMIDATE, and HEART beat

Abstract: Objective: Various drugs including hydroxyzine are preoperatively administered to facilitate the induction of general anaesthesia. We investigated the effect of hydroxyzine premedication on BIS-based etomidate induction of general anaesthesia. Patients and methods: Sixty-seven ASA I–II consecutive patients were randomly allocated to receive oral hydroxyzine 1.5 mg/kg or placebo, 90 min prior to inducing general anaesthesia using intravenous etomidate alone 0.3 mg/kg. BIS values were continuously recorded. The times for the BIS to decrease to 50 and to loss of eyelid reflex; the evolution of arterial pressure and heart rate; and myoclonia rate and grade were investigated and compared. Results: The results for the hydroxyzine and placebo groups were similar with respect to: a) time [median (range) (seconds)] to a BIS decrease to 50 [100 (21–266) versus 113 (30–510), P =0.1] and to loss of eyelid reflex [83 (21–210) versus 97 (30–300), P =0.1]; b) myoclonia frequency (yes/no) (9/26 versus 4/28, P =0.2) and grade (P =0.3); the evolution of mean arterial pressure and heart rate (P =0.3). Conclusion: Oral weight-related hydroxyzine premedication does not alter BIS-based etomidate induction of GA. [Copyright &y& Elsevier]

PATIENTS, MEDICAL education, NURSING, and INTERNAL medicine

Abstract: To investigate if routine education by nurses is associated with improved metabolic control in type 2 diabetic (DM2) outpatients, we randomly selected 143 patients (81 women), not using insulin, at the Endocrine or Internal Medicine clinics, to be interviewed and submitted to a clinical and laboratory evaluation. Age was 59.1±10.1 years; duration of DM2 7.5±6.3 years; BMI 29.7±5.2kg/m2. Patients were grouped according to HbA1c (<7.0% or ≥7.0%). Age, gender, DM2 duration, BMI, and lipid profile were not different. Patients with HbA1c ≥7.0% (n =49) were more likely to be taking oral agents, and to be treated by internists rather than endocrinologists (P =0.04). Nurse education was associated with a greater proportion of patients with HbA1c <7.0%, especially among those attending the Internal Medicine clinic. In logistic regression, education by nurses remained associated to HbA1c <7.0% (OR: 3.29, P =0.005), after controlling for use of oral agents (OR 0.067, P =0.01), attending the Endocrine clinic (OR 4.11, P =0.002), self-reported adherence to diet (“yes” or “no”), known DM duration, and instruction level (NS). Nurse education contributes significantly and independently for better metabolic control in DM2 outpatients in a teaching hospital. [Copyright &y& Elsevier]

LISTERIA, MILK quality, DAIRY farms, DAIRY cattle, and SILAGE

This cross-sectional study determined the prevalence of Listeria spp. in bulk-tank milk on dairy farms in the region of Galicia in northwest Spain. The aim was to identify management practices associated with the presence ofListeria spp. and possible effects on milk hygienic quality. A total of 98 farms was randomly selected on the basis of an expected prevalence of 6.5% for Listeria monocytogenes from 20,107 dairy farms in the region. Bulk-tank milk samples were obtained from 98 farms, fecal samples from lactating cows from 97 farms, and silage samples from 83 farms. Listeria monocytogenes was detected in 6.1, 9.3, and 6.0% of these samples, respectively. Statistical analyses confirmed the relationship between low silage quality (as indicated by high pH) and presence ofListeria spp. in silage (29.5 vs. 6.2% for pH above or below 4.5, respectively). Only milking system [tie-stall systems (28.6%) vs. parlor milking (10%)] and inadequately controlled milking order [yes (32.0%) vs. no (10.7%)] had statistically significant effects on management practices for increasing the risk of Listeria contamination of bulk-tank milk. [ABSTRACT FROM AUTHOR]

ENZYMES, WIENER processes, FLUCTUATIONS (Physics), MONETARY systems, and DOW Jones averages

In Biology, all motor enzymes operate on the same principle: they trap favourable brownian fluctuations in order to generate directed forces and to move. Whether it is possible or not to copy one such strategy to play the market was the starting point of our investigations. We found the answer is yes! In this paper we describe one such strategy and appraise its performance with historical data from the European Monetary System (EMS), the US Dow Jones, the german Dax and the french Cac40. [ABSTRACT FROM AUTHOR]

SPASMS, SEIZURES (Medicine), EPILEPSY, MUSCLE cramps, BRAIN diseases, and DEVELOPMENTAL disabilities

Do early seizures beget seizures later in life? Clinical data and experimental observations seem to answer that question differently, with a no and a yes, respectively, which may stem from an inadequate readout of what experimental data actually do tell us and a possible simplification of what clinical data indicate. Using specific experimental examples, it is possible to show that in the developing brain, seizures do produce long-lasting alterations of neuronal excitability, although ongoing seizures are not observed in adults. The findings suggest that the long-lasting changes in developmental programs and network activity that seizures induce do not necessarily lead to epilepsy, unless other events that remain to be identified occur. [ABSTRACT FROM AUTHOR]

DETERMINANTS (Mathematics), TRAVELING wave antennas, FREDHOLM equations, and MATHEMATICAL analysis

Abstract: Continuing a line of investigation initiated in [F. Gesztesy, Y. Latushkin, K.A. Makarov, Evans functions, Jost functions, and Fredholm determinants, Arch. Rat. Mech. Anal. 186 (2007) 361–421] exploring the connections between Jost and Evans functions and (modified) Fredholm determinants of Birman–Schwinger type integral operators, we here examine the stability index, or sign of the first nonvanishing derivative at frequency zero of the characteristic determinant, an object that has found considerable use in the study by Evans function techniques of stability of standing and traveling wave solutions of partial differential equations (PDE) in one dimension. This leads us to the derivation of general perturbation expansions for analytically-varying modified Fredholm determinants of abstract operators. Our main conclusion, similarly in the analysis of the determinant itself, is that the derivative of the characteristic Fredholm determinant may be efficiently computed from first principles for integral operators with semi-separable integral kernels, which include in particular the general one-dimensional case, and for sums thereof, which appears to offer applications in the multi-dimensional case. A second main result is to show that the multi-dimensional characteristic Fredholm determinant is the renormalized limit of a sequence of Evans functions defined in [G.J. Lord, D. Peterhof, B. Sandstede, A. Scheel, Numerical computation of solitary waves in infinite cylindrical domains, SIAM J. Numer. Anal. 37 (2000) 1420–1454] on successive Galerkin subspaces, giving a natural extension of the one-dimensional results of [F. Gesztesy, Y. Latushkin, K.A. Makarov, Evans functions, Jost functions, and Fredholm determinants, Arch. Rat. Mech. Anal. 186 (2007) 361–421] and answering a question of [J. Niesen, Evans function calculations for a two-dimensional system, presented talk, SIAM Conference on Applications of Dynamical Systems, Snowbird, UT, USA, May 2007] whether this sequence might possibly converge (in general, no, but with renormalization, yes). Convergence is useful in practice for numerical error control and acceleration. [Copyright &y& Elsevier]

SEWAGE disposal plants, HOSPITALS, SEWAGE purification, REFUSE disposal facilities, STEROIDS, HORMONES, ENVIRONMENTAL impact charges, WATER quality management, and WATER utilities

Influent and effluent samples originating from two wastewater treatment plants (WWTPs) (treating hospital wastewater and domestic wastewater, Belgium) have been analyzed in order to estimate their steroid hormone content. The natural estrogens estrone (E1), 17β-estradiol (E2), and the synthetic 17α-ethinylestradiol (EE2) together with other steroid hormones progesterone (P) and testosterone (T) metabolites were detected in these samples. The hormone concentrations in both the hospital and the domestic WWTP samples were not significantly different and ranged from <0.2 ng EE2/L to 114 ng EE2/L, from <0.2 ng E1/L to 58 ng E1/L and from <0.2 ng P/L to >100 ng P/L. E2 was detected once at a concentration of 17 ng/L. In the domestic WWTP which comprises a conventional activated sludge treatment in parallel with a membrane bioreactor, no differences in estrogen removal efficiency could be observed for both treatments. In comparison to chemical analysis data, the Yeast Estrogen Screen (YES) appears to underestimate the influent estrogen concentrations, probably due to influent toxicity for the YES. Effluent estrogen concentrations, on the other hand, were overestimated by the YES test, probably due to the presence of other estrogenic compounds in the effluent. [ABSTRACT FROM AUTHOR]

QUASSIA, HERBAL teas, ANTIMALARIALS, MALARIA treatment, PLANT extracts, DICHLOROMETHANE, and CELL-mediated cytotoxicity

Abstract: Aim of the study: Our objective was to assess whether it could be contemplated to recommend Quassia amara young leaf tea for treatment against malaria, and if yes, set up a standard protocol for preparing the herbal tea. Materials and methods: The leaf tea was extracted with methylene chloride and the organic extract was fractionated with HPLC. Pure compounds were characterized and their in vitro cytotoxicity and antiplasmodial activity was determined. Results and discussion: We discovered that antimalarial Quassia amara young leaf tea contains several quassinoids: simalikalactone D (SkD, 1), picrasin B (2), picrasin H (3), neoquassin (4), quassin (5), picrasin I (6) and picrasin J (7). These last two compounds are new. In addition, our experiments demonstrate that both biological activity and cytotoxicity of the remedy may be attributed solely to the presence of SkD. Conclusion: In conclusion, this preparation should not be recommended for treatment of malaria until a clinical study in humans is performed with SkD. [Copyright &y& Elsevier]

AGERATUM conyzoides, ESSENTIAL oils, AFLATOXINS, ASPERGILLUS flavus, CARCINOGENICITY, YEAST extract, TRANSMISSION electron microscopy, and ULTRASTRUCTURE of bacteria

Abstract: Aflatoxin B1 (AFB1) is a highly toxic and carcinogenic metabolite produced by Aspergillus species on food and agricultural commodities. Inhibitory effects of essential oil of Ageratum conyzoides, on the mycelial growth and aflatoxin B1 production by Aspergillus flavus were studied. Cultures were incubated in yeast extract-sucrose (YES) broth for days at 25°C at the following different concentrations of the essential oil (from 0.0 to 30μg/mL). The essential oil inhibited fungal growth to different extents depending on the concentration, and completely inhibited aflatoxin production at concentrations above 0.10µg/mL. The analysis of the oil by GC/MS showed that its main components are precocene II (46.35%), precocene I (42.78%), cumarine (5.01%) and Trans-caryophyllene (3.02%). Comparison by transmission electron microscopy of the fungal cells, control and those incubated with different concentrations of essential oil, showed ultra-structural changes which were concentration dependent of the essential oil of A. conyzoides. Such ultra-structural changes were more evident in the endomembrane system, affecting mainly the mitochondria. Degradation was also observed in both surrounding fibrils. The ability to inhibit aflatoxin production as a new biological activity of A.conyzoides L. indicates that it may be considered as a useful tool for a better understanding of the complex pathway of aflatoxin biosynthesis. [Copyright &y& Elsevier]

FACE perception, MEMORY, NEUROPSYCHOLOGICAL tests, PICTURES, AVERSIVE stimuli, and PROBABILITY theory

The authors investigated directed forgetting as a function of the stimulus type (picture, word) presented at study and test. In an item-method directed forgetting task, study items were presented 1 at a time, each followed with equal probability by an instruction to remember or forget. Participants exhibited greater yes-no recognition of remember than forget items for each of the 4 study-test conditions (picture-picture, picture-word, word-word, word-picture). However, this difference was significantly smaller when pictures were studied than when words were studied. This finding demonstrates that the magnitude of the directed forgetting effect can be reduced by high item memorability, such as when the picture superiority effect is operating. This suggests caution in using pictures at study when the goal of an experiment is to examine potential group differences in the magnitude of the directed forgetting effect. [ABSTRACT FROM AUTHOR]

CHICKEN as food, ANIMAL products, VITAMIN E content of food, SOUS-vide cooking, PRECOOKED meat, OXIDATION, LIPID metabolism, MARKETING, and SAFETY

There is an increasing demand in precooked chicken meat products for restaurants and catering services. Because cooked chicken meat develops lipid oxidation relatively fast, sous vide chicken meat was studied to assess its shelf-life. Six hundred Cobb x Ross broilers were fed for 6 wk with a basal cornsoybean meal diet including soybean, palm kernel, or animal-vegetable oil, each supplemented with 33 or 200 mg/kg of DL-a-tocopheryl acetate. Broilers were randomly assigned into 6 treatments and 4 repetitions with 25 birds each. Boneless breast or thigh muscle pieces were dissected into 5 x 5 x 5 cm cubes, vacuumpacked, cooked in water bath (until 74°C internal temperature), chilled, and stored at 4°C for 1, 5, 10, 25, and 40 d. For each storage day, each pouch contained 3 pieces of meat, either breast or thigh. Thiobarbituric acid reactive substances analysis, to quantify malonaldehyde (MDA) values, was conducted to estimate the lipid oxidation development. Nonheme iron values of cooked meat were analyzed. Fatty acid methyl esters analysis was performed in chicken muscle to determine its fatty acid composition. There was no interaction between dietary fat and vitamin E level in all of the variables studied except in nonheme iron. Dietary fat significantly influenced the fatty acid composition of the muscle (P < 0.01), but it did not affect the MDA values, regardless of differences in the muscle fatty acid composition between treatments. Supplementation of the high level of vitamin E significantly reduced l;he MDA values in both breast and thigh meat (P < 0.01). The maximum MDA values were observed at d 40 of storage in thigh and breast meat in animal-vegetable and soybean oil treatments with the low levels of vitamin E, 0.91 and 0.70 mg/kg, respectively. Nonheme iron values in thigh meat differed between treatments at 1 or 25 d of storage but not in breast meat. In conclusion, refrigerated sous vide chicken meat has a prolonged shelf-life, which is enhanced by dietary supranutritional supplementation of vitamin E. [ABSTRACT FROM AUTHOR]

HEADACHE, TURKS, DISEASE prevalence, PSYCHIATRY, ANXIETY, MENTAL depression, COMORBIDITY, and HEALTH

Purpose: The aim of this study was to evaluate the prevalence of headache in psychiatry clinics. Method: Three hundred and seventy two consecutive patients aged between 18 and 82 (Mean: 36.4±13.2) years were interviewed with a semi-structured interview form. All patients were asked whether they had headache or not. If they answered 'yes, the differential diagnosis of headache was made. Findings: Two-hundred and fifty- two patients (67.7%) did not complain any kind of headache. Migraine (13.7%, n=51) and tension type headaches (12.6%, n=47) were the most commonly seen headaches in psychiatry outpatient clinics. The frequency of migraine in subjects with anxiety disorder was higher than that in subjects with other psychiatric conditions including major depression. The frequency of tension type headache was higher in subjects with anxiety disorder in comparison to other psychiatric disorders, too. We found a statistically significant positive relationship between anxiety disorder or depression, and headache disorders (p<0.00). The tension type or chronic daily headache was seen at later ages but migraine in younger ages (p<0.00). The prevalence of migraine was similar in psychiatry clinics and in the general population of Turkey previously reported. The similar frequency of headache in psychiatry clinics is probably due to a comorbidity with psychiatric diseases. Discussion and Conclusion: We concluded that it was important to ask standard questions about headache in the course of the anamnesis in patients with major depression and anxiety disorder. [ABSTRACT FROM AUTHOR]

BIOLOGICAL assay, ENVIRONMENTAL monitoring, XENOESTROGENS, WATER pollution measurement, ANALYTICAL chemistry techniques, WATER quality monitoring, IN vitro toxicity testing, and EVALUATION

Bioassays are well established in the pharmaceutical industry and single compound analysis, but there is still uncertainty about their usefulness in environmental monitoring. We compared the responses of five bioassays designed to measure estrogenic activity (the yeast estrogen screen, ER-CALUX, MELN, T47D-KBluc, and E-SCREEN assays) and chemical analysis on extracts from four different water sources (groundwater, raw sewage, treated sewage, and river water). All five bioassays displayed similar trends and there was good agreement with analytical chemistry results. The data from the ER-CALUX and E-SCREEN bioassays were robust and predictable, and well-correlated with predictions from chemical analysis. The T47D-KBluc appeared likewise promising, but with a more limited sample size it was less compelling. The YES assay was less sensitive than the other assays by an order of magnitude, which resulted in a larger number of nondetects. The MELN assay was less predictable, although the possibility that this was due to laboratory-specific difficulties cannot be discounted. With standardized bioassay data analysis and consistency of operating protocols, bioanalytical tools are a promising advance in the development of a tiered approach to environmental water quality monitoring. [ABSTRACT FROM AUTHOR]

PROTEIN-tyrosine kinase inhibitors, GENE transfection, EPIDERMAL growth factor, ENDOTHELIAL growth factors, TUMORS, PHARMACOKINETICS, and PATIENTS

Background: JNJ-26483327 is an oral, potent, multi-targeted tyrosine kinase inhibitor, inhibiting kinases of epidermal growth factor receptor (EGFR)-1, -2 and -4, rearranged during transfection (RET) receptor, vascular endothelial growth factor receptor (VEGFR)-3 and Src family (Lyn, Fyn, Yes) at low nanomolar concentrations. This phase I, accelerated titration study assessed maximum tolerated dose, safety, pharmacokinetics and pharmacodynamic effects of JNJ-26483327.Methods: Nineteen patients with advanced cancers received JNJ-26483327 continuous twice daily (BID) in escalating dose cohorts ranging from 100 to 2100 mg. Pharmacodynamic effects were assessed in paired skin biopsies and blood.Results: JNJ-26483327 was well tolerated in doses up to 1500 mg BID, with target-inhibition-related toxicity such as diarrhoea and skin rash, and other common reported toxicities being nausea, vomiting, anorexia and fatigue. At 2100 mg, two episodes of dose-limiting toxicity were observed, consisting of grade 3 anorexia and a combination of grade 3 anorexia and fatigue, respectively. Pharmacokinetics were dose proportional up to 1500 mg in which plasma levels were obtained showing anti-tumour activity in xenograft mouse models. Pharmacodynamic analysis did not show a substantial effect on expression of Ki-67, p27(kip1), phosphorylated mitogen-activated protein kinase, phosphorylated Akt and EGFR, and serum levels of sVEGFR-2, VEGF-C and VEGF-D remained unchanged. Stable disease was noted in six patients (32%).Conclusion: JNJ-26483327 is well tolerated and shows a predictable pharmacokinetic profile; the recommended dose for further studies is 1500 mg BID. [ABSTRACT FROM AUTHOR]

NUTRITIONAL assessment, FOOD consumption, INGESTION, OLDER people physiology, and POLISH people

Purpose: The aim of the research was to conduct a mini-nutritional assessment in relation to the food intake model and food intake variety for Polish older persons.Material and Methods: The research included 420 people aged 65+. Using the food consumption frequency method (by a FIVeQ questionnaire), the weekly intake of 63 groups of products was assessed (yes, no). Food intake variety was assessed with the use of food intake variety index (FIVeI), which was calculated as the total number of products eaten per week in the amounts exceeding trace quantities. Four models of food intake were established: "ordinary" (S1), "rich varied" (S2), "ordinary with a tendency to vary" (S3) and "moderate connoisseur" (S4). The risk of malnutrition or the incidence of malnutrition was determined based on the questionnaire of the mini nutritional assessment (MNA).Results: The good nutritional status of Polish older persons was affected by better results obtained in three parts of the questionnaire: "global evaluation" (MNA-2), "assessment of dietetic habits" (MNA-3) and "subjective assessment of self-perceived quality of health and nutrition" (MNA-4). It confirms the significance of those parts of the questionnaire in detecting malnutrition or the risk of malnutrition in older persons and suggests a lower share of the MNA-1 part which concerns anthropometric indicators. It was found that S2 and S3 persons were characterized by a greater food intake variety index (the median of 36 and 34 products eaten per week, respectively) and more often by a good nutritional status (88% and 79%, respectively) in comparison to S4 and S1 persons, who had a lower food intake variety index (the median of 4 and 30 products eaten per week, respectively) and more often occurring malnutrition (17% and 1% respectively) or a risk of malnutrition (17% and 30%, respectively).Conclusion: To conclude, a larger variety of food intake favoured better nutritional status of older persons, while a lower food intake variety increased the risk of malnutrition. [ABSTRACT FROM AUTHOR]

PROTEIN kinases, POLYMERS, IMMUNOGLOBULIN A, IGA glomerulonephritis, and EPIDERMAL growth factor

Polymeric immunoglobulin A (pIgA) transcytosis, mediated by the polymeric immunoglobulin receptor (pIgR), is a central component of mucosal immunity and a model for regulation of polarized epithelial membrane traffic. Binding of pIgA to pIgR stimulates transcytosis in a process requiring Yes, a Src family tyrosine kinase (SFK). We show that Yes directly phosphorylates EGF receptor (EGFR) on liver endosomes. Injection of pIgA into rats induced EGFR phosphorylation. Similarly, in MDCK cells, pIgA treatment significantly increased phosphorylation of EGFR on various sites, subsequently activating extracellular signal-regulated protein kinase (ERK). Furthermore, we find that the Rab11 effector Rab11-FIP5 is a substrate of ERK. Knocking down Yes or Rab11-FIP5, or inhibition of the Yes-EGFR-ERK cascade, decreased pIgA-pIgR transcytosis. Finally, we demonstrate that Rab11-FIP5 phosphorylation by ERK controls Rab11a endosome distribution and pIgA-pIgR transcytosis. Our results reveal a novel Yes-EGFR-ERK-FIP5 signalling network for regulation of pIgA-pIgR transcytosis. [ABSTRACT FROM AUTHOR]

RADIOMETERS, ULTRAVIOLET spectrometry, CALIBRATION, and DEVIATION (Statistics)

The article presents a study on the influence of using one-step and two-steps method on the experimental ultraviolet index (UVI) measured by a YES UVB-1 radiometer located in Granada, Spain for 2006-2009. Also, the study analyzes the deviation from the UVI values taken from the application of the calibration factors. Based on results, absolute mean differences between measured and modeled UVI data of the methods indicate an excellent performance for obtaining UVI data.

OCHRATOXINS, MICROBIAL growth, ASPERGILLUS, CULTURE media (Biology), MICROBIAL cultures, SUCROSE, and YEAST

As there is no knowledge of the influence of abiotic factors on the two new ochratoxin A (OTA)-producing species Aspergillus sclerotioniger and Aspergillus lacticoffeatus, the aim of this study was to evaluate the effect of temperature and incubation time on growth and OTA production by these species on culture media. The study was carried out on yeast extract sucrose agar (YES) and Czapek yeast extract agar (CYA) incubated at ten different temperatures from 5 to 50°C (at 5°C intervals). Growth assessment and OTA production were determined after 5, 10, 15, 20 and 30 days of incubation at each temperature. Aspergillus sclerotioniger grew from 10 to 35°C; OTA was detected from 10 to 35°C and the highest concentration was achieved at 15°C in CYA. Aspergillus lacticoffeatus grew from 10 to 45°C; OTA was detected from 15 to 45°C, and the maximum concentration was produced after 5 days at 25°C in YES. The studied species can produce OTA over a wide range of temperatures and significant amounts can be produced in only 5 days. This is the first report on the influence of ecophysiological factors on these two ochratoxigenic species. The pattern of effects of temperature on growth and OTA production by A. sclerotioniger and A. lacticoffeatus was similar to those reported for the closely related species Aspergillus carbonarius and Aspergillus niger, respectively. The two new OTA-producing species have both been isolated from coffee beans, and the closely related ochratoxigenic species of section Nigri, A. carbonarius and A. niger are important sources of OTA in this substrate. [ABSTRACT FROM AUTHOR]

CANCER treatment, SMALL cell lung cancer, OLDER patients, CANCER chemotherapy, POPULATION health, and DRUG toxicity

Background: Twenty percent of all newly diagnosed patients with small-cell lung cancer (SCLC) are >75 years. Elderly patients may show more toxicity due to co-morbidity. We evaluated motives for adherence to treatment guidelines, completion of treatment and toxicity.Patients and methods: Population-based data from patients aged ≥75 years and diagnosed with SCLC in 1997–2004 in The Netherlands were used (368 limited disease and 577 extensive disease). Additional data on co-morbidity (Adult Co-morbidity Evaluation 27), World Health Organisation performance status (PS), treatment, motive for no chemotherapy, adaptations and underlying motive and grade 3 or 4 toxicity were gathered from the medical records.Results: Forty-eight percent did not receive chemotherapy. The most common motives were refusal by the patient or family, short life expectancy or a combination of high age, co-morbidity and poor PS. Although only relatively fit elderly were selected for chemotherapy, 60%–75% developed serious toxicity, and two-thirds of all patients could not complete the full chemotherapy.Conclusions: We hypothesise that a better selection by proper geriatric assessments is needed to achieve a more favourable balance between benefit and harm. [ABSTRACT FROM AUTHOR]

EMBRYOS, PROGESTERONE, BOS, HEIFERS, ULTRASONIC imaging, HEART beat, and REPRODUCTION

Abstract: The objectives of this study were to evaluate embryonic size and survival, plasma progesterone (P4) and pregnancy-specific protein bovine (PSPB) concentrations in early pregnancies (n = 99) following the transfer of one whole (n = 66) or one demi (n = 33) embryo to recipient virgin dairy heifers. The experiment was designed to evaluate the fixed effects of embryo size at transfer (whole or demi embryo) on Day 7 of the estrous cycle (Day 0 = estrus) and P4 supplementation between Days 7 to 19 through an intravaginal device (yes or no) on plasma P4 and PSPB concentrations and on embryo measurements. Plasma P4 concentrations were measured by RIA on Days 0, 7, 14, 19, 21, 25, 35, 42, 49, 56 and 63 of pregnancy and, PSPB concentrations were measured by ELISA on Days 7, 21, 25, 35, 42, 49, 56 and 63. The presence of an embryonic vesicle was detected on Day 25, embryonic/fetal movements and heartbeat were evaluated on Days 42 and 63 and embryo measurements [crown-rump length (CRL) and width at mid body] were obtained on Day 42 through ultrasonography. In non-supplemented pregnancies, Day 42 whole embryos had higher (P < 0.05) CRL and width than demi embryos, but the difference averaged only 1 to 2 mm. In P4 supplemented pregnancies, whole and demi embryos attained a similar size on Day 42 of pregnancy. Embryo size at transfer, early exogenous P4 supplementation and their interactions had no effects (P > 0.05) on plasma P4 concentrations. However, the post-hoc LSD evaluation showed that plasma P4 concentrations on Day 25 were higher (P < 0.001) in whole than in demi embryo derived pregnancies and, that exogenous P4 supplementation increased (P < 0.05) plasma P4 concentrations on Day 19 of pregnancy. The plasma PSPB detection rate on Days 7 to 63 of pregnancy was similar in pregnancies resulting from the transfer of whole and demi embryos. From a total of 93 recipients remaining pregnant until Day 63, plasma PSPB was constantly undetectable on Day 7, was detected in 4% of Day 21 samples, 41% of Day 25, 95% of Day 35, 96% of Day 42, 99% of Day 49 and in 100% of samples of Days 56 and 63. Concentrations of PSPB increased (P < 0.05) from Days 21 to 42 and from Days 56 to 63, with a plateau between Days 42 to 56. Demi embryo pregnancies had higher (P < 0.05) plasma PSPB concentrations on Days 35 and 42 than whole embryo pregnancies. Progesterone supplementation had a positive effect (P < 0.01) on PSPB concentrations from Days 35 to 63. Concentrations of PSPB were similar in non-supplemented whole and demi embryo pregnancies from Days 7 to Day 63. In contrast, in supplemented recipients, demi embryo pregnancies had higher (P < 0.05) PSPB concentrations on Days 25 to 42 than whole embryo pregnancies. No significant correlation was found between P4 and PSPB concentrations or between the concentrations of these hormones and embryonic measurements on Day 42. In conclusion, demi embryos experienced a compensatory growth until Day 42 of pregnancy, attaining a similar size to that of whole embryos and originating conceptuses producing similar plasma PSPB concentrations to those of whole embryo derived conceptuses. Embryonic growth and conceptus secretion of PSPB were positively stimulated by early pregnancy exogenous P4 treatment. [Copyright &y& Elsevier]

MEIOSIS, EUKARYOTIC cells, RECOMBINASES, DNA, PLANT chromosomes, GENETIC recombination, CHROMATIDS, and PLANTS

Summary The eukaryotic recombinases RAD51 and DMC1 are essential for DNA strand-exchange between homologous chromosomes during meiosis. RAD51 is also expressed during mitosis, and mediates homologous recombination (HR) between sister chromatids. It has been suggested that DMC1 might be involved in the switch from intersister chromatid recombination in somatic cells to interhomolog meiotic recombination. At meiosis, the Arabidopsis Atrad51 null mutant fails to synapse and has extensive chromosome fragmentation. The Atdmc1 null mutant is also asynaptic, but in this case chromosome fragmentation is absent. Thus in plants, AtDMC1 appears to be indispensable for interhomolog homologous recombination, whereas AtRAD51 seems to be more involved in intersister recombination. In this work, we have studied a new AtRAD51 knock-down mutant, Atrad51-2, which expresses only a small quantity of RAD51 protein. Atrad51-2 mutant plants are sterile and hypersensitive to DNA double-strand break induction, but their vegetative development is apparently normal. The meiotic phenotype of the mutant consists of partial synapsis, an elevated frequency of univalents, a low incidence of chromosome fragmentation and multivalent chromosome associations. Surprisingly, non-homologous chromosomes are involved in 51% of bivalents. The depletion of AtDMC1 in the Atrad51-2 background results in the loss of bivalents and in an increase of chromosome fragmentation. Our results suggest that a critical level of AtRAD51 is required to ensure the fidelity of HR during interchromosomal exchanges. Assuming the existence of asymmetrical DNA strand invasion during the initial steps of recombination, we have developed a working model in which the initial step of strand invasion is mediated by AtDMC1, with AtRAD51 required to check the fidelity of this process. [ABSTRACT FROM AUTHOR]

DENTAL arch, BRACKETS, CORRECTIVE orthodontics, PAIN perception, and ORAL surgery

The use of self-ligating brackets, in different brands, has significantly grown over the last decade. Are they really better than conventional brackets? The answer tends to be "yes", regarding the efficiency of initial alignment, the changes in arch-form, the global reduction of treatment time, less clinical appointments and less pain perception by the patient. The explanation to this is to be found in the development of light forces by these brackets, which make the tooth movements smoother due to lower friction. The cases shown have been treated with GAC's In-ovation R, C and L brackets. Some of the cases have had an accessory treatment with RPE (rapid palatal expander) or the use of mini-screws. Others are preparations to oral maxillary surgery. [ABSTRACT FROM AUTHOR]

NILE tilapia, MARICULTURE, FISH feeds, FISH growth, and WATER quality

The experiment was accomplished at the Laboratory of Mariculture of the Federal University of Maranhão. With the objective of evaluating the effect of the alimentary restriction in the productive acting of juvenile of tilapia of Nile (Oreochromis niloticus) cultivated in system of recirculation of water. It was used 300 juvenile of tilápia, distributed in 6 tanks of fiber-cement of 1000 L. The treatments were: (A) food supplied daily; (B) food supplied day yes and day no and (C) food supplied once every 2 days, being four repetitions for each treatment. They were appraised physiochemical parameters of the water and of productive acting. The results were submitted the variance analysis, and the averages were compared by the test Tukey, to 5% of probability. The quality of the water and the alimentary conversion were not influenced by the alimentary strategy. The productive acting presents differentiates significant (P <0,05) among the treatments, being the best for the fish fed daily without alimentary restriction, the worst for the fish fed once every 2 days. The alimentary restriction in fish reduces the growth performance. [ABSTRACT FROM AUTHOR]

HEMATOPOIETIC stem cell transplantation, HOMOGRAFTS, MYELODYSPLASTIC syndromes, ACUTE myeloid leukemia, BLOOD donors, AZACITIDINE, COMPARATIVE studies, and DISEASE risk factors

Standard first-line therapy for older patients with high-risk myelodysplastic syndrome (MDS) includes hypomethylating agents, such as azacitidine (AZA). However, the only approach with curative potential remains allogeneic hematopoietic cell transplantation (HCT). To date, no direct comparison of both strategies has been reported. The outcomes of 2 well-balanced cohorts of patients with high-risk MDS defined by age (60-70 years), performance status (Eastern Cooperative Oncology Group score ≤2), and donor availability (yes/no) were compared, including 103 patients undergoing HCT and 75 patients without this option who received AZA. The estimated 2-year overall survival after the start of treatment was 39% (95% confidence interval, 30%-50%) for the patients undergoing HCT and 23% (95% confidence interval, 14%-40%) for the patients receiving AZA therapy. In a multivariate Cox regression analysis of all patients (n = 178), Eastern Cooperative Oncology Group score (0 versus 1 versus 2; hazard ratio [HR], 2.9/3.9; P <  .001), cytogenetics (good versus intermediate versus poor; HR, 1.2/1.7; P = .026), and treatment (HCT versus AZA; HR, 0.3; P = .007) were associated with overall survival. This retrospective cohort analysis suggests a survival advantage for allogeneic HCT compared with AZA therapy in medically fit patients with high-risk MDS age 60-70 years. Prospective controlled studies are warranted. [ABSTRACT FROM AUTHOR]

CROP genetics, SOYBEAN, SWEETPOTATO whitefly, DISEASE resistance of plants, BIOLOGICAL control of plant parasites, ANTIBIOSIS, OVIPARITY, GREENHOUSE plants, and TRICHOMES

Since it was first reported in Brazil in the 1990s, the B biotype of silverleaf whitefly (Bemisia tabaci [Genn.], Hemiptera Aleyrodidae) has been recognized as an important pest in soybeans (Glycine max L.), reducing the productivity of this legume species in some areas of the country. As an alternative to chemical control, the use of resistant genotypes represents an important tool for integrated pest management (IPM). This study evaluated the performance of 10 soybean genotypes prior to whitefly infestation, by testing attractiveness and preference for oviposition in the greenhouse and antibiosis in the laboratory. In a multiple-choice test, 'IAC-17' was the least attractive to insects. In a no-choice test, 'IAC-17' was the least attractive for egg deposition, indicating the occurrence of non-preference for oviposition on this genotype. Trichome density was positively correlated with the oviposition site and may be associated with the resistance of 'IAC-17' to infestation. The genotypes 'IAC-PLI', 'IAC-19', 'Conquista', 'IAC-24' and 'IAC-17' extended the insect's life cycle, indicating occurrence of a small degree of antibiosis and/or non-preference for feeding. [ABSTRACT FROM AUTHOR]

PREOPERATIVE risk factors, CATARACT surgery, REGRESSION analysis, ANESTHESIOLOGISTS, SYSTOLIC blood pressure, and MATHEMATICAL models

Purpose: To determine risk factors for anesthesiologist intervention during routine cataract surgery performed with topical and intracameral anesthesia and establish a regression model to identify high-risk patients. Setting: Department of Ophthalmology, Clínica Universidad de Navarra, Pamplona, Spain. Design: Prospective case series. Methods: After cataract surgery at an ambulatory surgical center, anesthesia personnel completed a questionnaire to determine adverse medical events and risk factors related to anesthesiologist intervention. A Poisson regression model was used to calculate the interventional risks. Bootstrapping was performed for internal model validation. Results: Of the 1010 cases, 50 (4.95%) required anesthesiologist intervention. Univariate analysis identified an association between anesthesiologist intervention and hypertension (P<.001), psychiatric history (P=.002), initial systolic blood pressure (P<.001), surgical duration (P=.001), and diabetes (P=.018). Scores were obtained using the following proposed regression model equation: (−8.68 + 0.33 × sex [men, 0; women, 1] + −0.02 × age [years] + 0.68 × hypertensive history [no, 0; yes, 1] + 1.18 × psychiatric background [no, 0; yes, 1] + 0.04 × initial systolic blood pressure [mm Hg]). The area under the receiver-operating curve was 0.803 (95% confidence interval [CI], 0.721-0.886). The area under the curve found in the validation method was 0.813 (95% CI, 0.727-0.887). Conclusion: Hypertension was the main risk factor for anesthesiologist intervention. The regression model discriminated between patients at lower and higher risk for intraoperative intervention for monitored anesthesia care. The probability of anesthesiologist intervention was 11.7 times higher when the model obtained a high score. Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. [ABSTRACT FROM AUTHOR]

STEM cells, CELL proliferation, WNT proteins, REGENERATION (Biology), GENE expression, and COLON cancer

A remarkable feature of regenerative processes is their ability to halt proliferation once an organ's structure has been restored. The Wnt signalling pathway is the major driving force for homeostatic self-renewal and regeneration in the mammalian intestine. However, the mechanisms that counterbalance Wnt-driven proliferation are poorly understood. Here we demonstrate in mice and humans that yes-associated protein 1 (YAP; also known as YAP1)-a protein known for its powerful growth-inducing and oncogenic properties-has an unexpected growth-suppressive function, restricting Wnt signals during intestinal regeneration. Transgenic expression of YAP reduces Wnt target gene expression and results in the rapid loss of intestinal crypts. In addition, loss of YAP results in Wnt hypersensitivity during regeneration, leading to hyperplasia, expansion of intestinal stem cells and niche cells, and formation of ectopic crypts and microadenomas. We find that cytoplasmic YAP restricts elevated Wnt signalling independently of the AXIN-APC-GSK-3? complex partly by limiting the activity of dishevelled (DVL). DVL signals in the nucleus of intestinal stem cells, and its forced expression leads to enhanced Wnt signalling in crypts. YAP dampens Wnt signals by restricting DVL nuclear translocation during regenerative growth. Finally, we provide evidence that YAP is silenced in a subset of highly aggressive and undifferentiated human colorectal carcinomas, and that its expression can restrict the growth of colorectal carcinoma xenografts. Collectively, our work describes a novel mechanistic paradigm for how proliferative signals are counterbalanced in regenerating tissues. Additionally, our findings have important implications for the targeting of YAP in human malignancies. [ABSTRACT FROM AUTHOR]

FIRE, COOKING, HUMAN evolution, ARCHAEOLOGY, PRIMATOLOGY, and EVOLUTIONARY psychology

Issues of early fire use have become topical in human evolution, after a long period in which fire scarcely featured in general texts. Interest has been stimulated by new archaeological finds in Europe, the Middle East and Africa, and also by major inputs from other disciplines, including primatology and evolutionary psychology. Evidence for fire is, however, often disputed, especially with regard to the early cases in Africa. Interpretations often struggle to take into account the implications of a huge bias in archaeological preservation, which means that our surviving evidence does not accurately map the past. Additionally, there is often a ‘yes-no’ presence/absence approach to fire, which does not recognise that earliest hominin fire use may have occurred in interaction with natural fire, and may not even have included deliberate hearth use in its first stages. Here we examine the need to integrate different approaches to the issues of early fire-use, considering especially the earliest archaeological evidence and the ‘cooking hypothesis’, while also tackling the issues of apparent differences in early African and European fire records. [ABSTRACT FROM AUTHOR]

ULCER treatment, COMBINATORIAL optimization, SURGICAL emergencies, ORAL diseases, HOSPITAL care, and PHYSICIAN practice patterns

Résumé: La prise en charge chirurgicale de l’escarre en France demeure très coûteuse même si les mesures de prévention et l’amélioration du parcours de soins ont permis de limiter les dépenses dans ce domaine ces dernières années. Depuis 2004, le mode de financement des établissements de santé français par la tarification à l’acte (TAA) et la maîtrise médicalisée des dépenses de soins hospitaliers nous obligent forcément à nous intéresser à ces considérations purement économiques et parfois à nuancer nos besoins en durée d’hospitalisation ou en soins spécialisés pour optimiser le groupe homogène de séjour (GHS) d’un patient. Cela ne risque-t-il pas à l’avenir d’obliger le chirurgien à biaiser les réels besoins du patient au profit de l’établissement hospitalier ? Au travers d’une analyse médico-économique de nos pratiques, réalisée dans le service de chirurgie plastique du CHU de Toulouse, nous avons tenté d’identifier comment optimiser la prise en charge chirurgicale de l’escarre en termes de valorisation de séjour. L’objectif étant néanmoins de rester critique sur les dérives que cela pourrait instaurer à l’avenir pour notre activité clinique. [ABSTRACT FROM AUTHOR]

SOCIAL influence, STOCHASTIC models, ECONOMIC convergence, QUANTIFIERS (Linguistics), ARITHMETIC mean, and SOCIAL change

Abstract: We study a stochastic model of influence where agents have “yes” or “no” inclinations on some issue, and opinions may change due to mutual influence among the agents. Each agent independently aggregates the opinions of the other agents and possibly herself. We study influence processes modeled by ordered weighted averaging operators, which are anonymous: they only depend on how many agents share an opinion. For instance, this allows to study situations where the influence process is based on majorities, which are not covered by the classical approach of weighted averaging aggregation. We find a necessary and sufficient condition for convergence to consensus and characterize outcomes where the society ends up polarized. Our results can also be used to understand more general situations, where ordered weighted averages are only used to some extent. Furthermore, we apply our results to fuzzy linguistic quantifiers, i.e., expressions like “most” or “at least a few”. [Copyright &y& Elsevier]

MILK yield, BEEF cattle feeding & feeds, GRAZING, GRASSLANDS, BODY weight, CALVES, and ANIMAL weaning

Ninety-six Hereford cow-calf pairs grazing Campo grasslands were used in a 2 × 2 factorial design that evaluated stocking rate (high [H] vs low [L]) and creep feeding (CF; yes or no). Creep-fed calves grazing L had a greater average daily gain (1.07 ± 0.03 kg/d) than CF calves grazing H (0.96 ± 0.03 kg/d;P< 0.05), but L − CF (0.78 ± 0.03 kg/d) and H − CF calves (0.73 ± 0.03 kg/d) had similar average daily gains (P> 0.05). Similarly, L + CF calves were heavier at weaning (172 ± 3 kg) than H + CF calves (160 ± 3 kg), but weaning weights between L − CF (144 ± 3 kg) and H − CF (138 ± 3 kg;P> 0.05) did not differ. Creep-fed calves grazed less (39 ± 10%) than non-supplemented calves (58 ± 15%;P< 0.05). Creep feeding had no effect on milk production, body condition and live weight of the dams, so it had no impact on their reproductive performance. We conclude that CF promotes greater live weight gains and weaning weights of Hereford calves grazing Campo grasslands. [ABSTRACT FROM AUTHOR]

PARKINSON'S disease, MILD cognitive impairment, MOVEMENT disorders, DEMENTIA, LOGISTIC regression analysis, NEUROLOGY, and DIAGNOSIS

Abstract: The detection of cognitive decline in Parkinson's disease (PD), at the Mild Cognitive Impairment (MCI) stage, has prognostic and treatment implications. The Movement Disorders Society (MDS) has recently published criteria and guidelines for the diagnosis of possible and probable PD-MCI. In the present study we assessed the ability of the Scales for Outcomes in Parkinson's disease-Cognition (SCOPA-Cog) to discriminate possible PD-MCI cases from patients with PD-dementia (PDD) and from cognitively intact PD subjects. Hundred-and-thirteen consecutive PD patients underwent the MMSE, the Dementia Rating Scale and an interview on independence in daily living, and were classified as cognitively intact (n = 49), or as possible PD-MCI (n = 33) or PDD (n = 31), according to MDS criteria. Logistic regression analysis was carried out with PD-MCI diagnosis (yes/no) as an outcome variable, and age, education and the SCOPA-Cog total score as covariates. Classification of cases according to the regression model was used for constructing Receiver Operating Characteristic (ROC) curves. Area Under the Curve (AUC) was 0.92 [95% CI 0.86–0.98], for the differential diagnosis between PD-MCI and cognitively normal patients, and 0.97 [95% CI 0.80–1.00], for the differential diagnosis between PD-MCI and PDD. Sensitivity and specificity were 90% and 73% for the PD-MCI versus no cognitive impairment differentiation, at the cutpoint ≥24, and 93% and 97% for the PD-MCI versus PDD discrimination, at the cutpoint ≥17. The SCOPA-Cog is a quick and psychometrically sound PD-specific scale. Our findings support its use for the screening of possible PD-MCI. [Copyright &y& Elsevier]

Background: Daycare attendance is an established risk factor for upper respiratory tract infections (URTI) and acute otitis media (AOM). Whether this results in higher use of healthcare resources during childhood remains unknown. We aim to assess the effect of first year daycare attendance on the timing and use of healthcare resources for URTI and AOM episodes during early childhood.Methods: In the Wheezing-Illnesses-STudy-LEidsche-Rijn birth cohort, 2,217 children were prospectively followed up to age six years. Children were categorized according to first-year daycare attendance (yes versus no) and age at entry when applicable (age 0 to 2 months, 3 to 5 months and 6 to 12 months). Information on general practitioner (GP) diagnosed URTI and AOM, GP consultations, antibiotic prescriptions and specialist referral was collected from medical records. Daycare attendance was recorded by monthly questionnaires during the first year of life.Results: First-year daycare attendees and non-attendees had similar total six-year rates of GP-diagnosed URTI and AOM episodes (59/100 child-years, 95% confidence interval 57 to 61 versus 56/100 child-years, 53 to 59). Daycare attendees had more GP-diagnosed URTI and AOM episodes before the age of one year and fewer beyond the age of four years than non-attendees (Pinteraction <0.001). Daycare attendees had higher total six-year rates for GP consultation (adjusted rate ratio 1.15, 1.00 to 1.31) and higher risk for specialist referrals (hazard ratio: 1.43, 1.01 to 2.03). The number of antibiotic prescriptions in the first six years of life was only significantly increased among children who entered daycare between six to twelve months of age (rate ratio 1.32, 1.04 to 1.67). This subgroup of child-care attendees also had the highest overall URTI and AOM incidence rates, GP consultation rates and risk for specialist referral.Conclusions: Children who enter daycare in the first year of life, have URTI and AOM at an earlier age, leading to higher use of healthcare resources compared to non-attendees, especially when entering daycare between six to twelve months. These findings emphasize the need for improved prevention strategies in daycare facilities to lower infection rates at the early ages. [ABSTRACT FROM AUTHOR]

The waltz of Afrikaans "a" with "l" The present study is a follow-up of previous ones on the rounding of the long low /a/ vowel in Afrikaans, a relatively new sound variation. Against the background of existing descriptions I report a similar tendency of rounding of short /a/ vowel, specifically when followed by the lateral consonant /l/. I suggest an explanation of such rounding as being the result of a process of coarticulation, specifically under the influence of a distinct dark, retroflex quality of this lateral. A post hoc investigation with an ultrasound scanner and lip video camera confirmed this to be the case. The vowel productions of a single speaker, known to be a clear rounding of long /a/ was explored in an extensively designed case study. The phenomenon of /a/-rounding implies a qualitative change of the /a/ to [ɒ] as in [jɒ] (ja; "yes") and in [snɒks (snaaks; "funny"). Apart from superficial references to its existence in linguistic handbooks, such as De Villiers and Ponelis (1987:100), the first systematic study was done by Wissing (2006), followed-up by more recent other studies (Wissing 2010; 2013). Rounding is currently seemingly limited to the speech of young adult female speakers of Afrikaans, but it appears as if it has lately been spreading to the broader Afrikaans speaking community at a rather noticeable pace. It is provoking extremely negative reactions in especially the case of older, or more conservative Afrikaans speaking persons. On the other hand, younger users of Afrikaans do not even seem to notice the existence of this phenomenon, especially in their own language use. Such a vowel change is apparently part of a larger vowel shift which has recently been taking place, viz. the lowering of the front-mid vowel /ε/ to almost the position of the short low /a/, or the shifting of /u/ from a back to a more centralised position (cf. Wissing 2010). Broadly defined, language change is a topic that integrates the social as well as the cognitive aspects of what it means to be human. A central feature of a language in the process of change is variation. During a period of change, there is variation in the language between forms that represent the current/previous stage and forms that represent the innovative/new stage of the language. Consequently, the rounding of /a/ could be of linguistic significance when considered against this general linguistic backdrop. The present investigation aims in particular at both broadening, developing and understanding of /a/-rounding to [ɒ] in modern Afrikaans. In order to achieve this, firstly the existing knowledge concerning this phenomenon was summarised, whereafter a variety of carefully constructed stimuli were used in an in-depth case study of the pronunciation of a young female radio presenter at Radio Sonder Grense, the leading Afrikaans public broadcaster (hence referred to as C). The testing material was created with a view to obtaining a fuller understanding of /a/- rounding to [ɒ] in Afrikaans in two respects. Firstly, the stimulus series concerning the degree to which long /a/ vowels are subjected to such rounding was expanded considerably. Secondly, stimuli were included with the aim of examining the possible co-articulatory influence of the rounding of /a/ followed by the lateral consonant /l/ (characterised as a dark l in the case of English pronunciation) on especially the short /ɑ/-vowel, as in wals ("waltz"). Dark /l/ has received much attention in literature. Moreover, word frequency also has been shown (Lin, Beddor & Coetzee 2013) to influence the magnitude of the tongue tip gesture in laterals, especially with regard to /l/ vocalization. It might be applicable on the case of /l/-velarisation as well. Degree of darkness, differences in articulatory closure, dorsopalatal contact size, closure duration, relative timing of events and formant frequency (cf. Recasens & Espinosa 2005) are some of the important factors to take into account when studying this consonant and its co-articulatory effects on phonetic environment. Up until now none of these have been mentioned in Afrikaans phonetic literature. In the present article I superficially touch on some of them. Obviously these facets deserve fundamental attention. I utilised three different types of recording tasks, namely firstly the reading of carrier phrases containing a focus form with the structure /sVs/ (eg. among others, saas and sas); secondly, the naming of the letters of the alphabet (with an interest in a, h, k; all pronounced with a long [a]), and thirdly, the reading of a variety of isolated words and phrases, mostly containing words relevant to this study. In some cases C was prompted to orally complete a task, for example, a noun like val was to be read, but its diminutive (valletjie) and plural forms (valle) were to be completed without visual stimulus. Syllable structure was controlled systematically. In the case of val, /a/ appears in a closed syllable, but in valletjie and valle the syllables are open. These tasks had to be carried out twice. Recordings were done with high quality equipment, in use by RSG. Processing and acoustic analyses of the recordings were performed by means of standard procedures. As is conventional in studies of this nature, acoustic characteristics of the production of long /a/ and short /Q/ were investigated via vowel formant frequencies, F1 as well as F2. F1, the first formant, corresponds to vowel openness (vowel height). An open vowel, such as /a/, has high F1 frequencies, while close vowels, like /i/, have low F1 frequencies. The second formant, F2, corresponds to the front positions of a vowel. Back vowels, which are normally at the same time also rounded, have low F2 frequencies, in contrast to front vowels, which have high F2 frequencies. Generally the results clearly confirm the audible perception that C is a strong rounder of the long /a/. There is a very positive correlation between C's acoustic measurements and that previously found for another young female individual (Wissing 2006) as well as that of twenty others of about the same age (Wissing 2013). This finding strongly suggests a restriction on the number of participants as well as the range of required stimuli in instances of experiments of this kind, especially in the case of pilot studies. The role of syllable structure was found to be of limited importance. The short /a / was rounded to a significant degree when followed by /l/ in open as well as closed syllables, but to a small degree as in the case of open syllables. Of special importance is the finding that F1 also plays a significant role in the expression of degree of roundedness of the /a/ vowel, albeit not quite to the same extent as is the case with F2, generally considered to be the sole carrier of roundedness. The fact that the rounded [594;] is frequently misinterpreted (as the rounded vowel [ɔ] (in kom "come")), from a perceptual angle supports the current results of the analysis of the rounded [594;] in Afrikaans. Of course, [ɔ] is characterised inter alia by a higher F1 than that of the unrounded [a]. In many languages the existence of dark /l/ ([ɫ]) is well-known (cf. Hamann 2003; also Lin, Beddor & Coetzee 2014 and references cited by them). With regard to Afrikaans, a co-articulatory effect of this lateral was found to be clearly manifested in the present study on the rounding to [...] of the short /a/, but also of the long /a/. In a broader linguistic perspective the present findings should be of distinctive importance to those interested in language change in general, and more specifically in sound variation. [ABSTRACT FROM AUTHOR]

QUESTION (Logic), RESEARCH teams, ROCK-forming minerals, SILICATE minerals, and CONFIGURATION space

Highlights: [•] CATA and forced-choice Yes/No questions were compared across 7 consumer studies. [•] CATA and forced-choice questions produced similar sensory spaces. [•] Frequencies of term use were higher for forced-choice Yes/No than for CATA questions. [•] Stability of sample and term configurations was similar for CATA and forced-choice questions. [•] Evidence of superiority of forced-choice questions relative to CATA was not obtained. [ABSTRACT FROM AUTHOR]

TOPOLOGICAL insulators, ELECTRIC insulators & insulation, ANTIFERROMAGNETIC resonance, ANTIFERROMAGNETISM, and MAGNETIC properties of Heusler alloys

A topological insulator is a state of matter which does not break any symmetry and is characterized by topological invariants, the integer expectation values of nonlocal operators. Antiferromagnetism, on the other hand, is a broken symmetry state in which the translation symmetry is reduced and time reversal symmetry is broken. Can these two phenomena coexist in the same material? A proposal by Mong et al. [Phys. Rev. B 81, 245209 (2010)] asserts that the answer is yes. Moreover, it is theoretically possible that the onset of antiferromagnetism enables the nontrivial topology since it may create spin-orbit coupling effects which are absent in the nonmagnetic phase. The current work examines a real system, half-Heusler GdBiPt, as a candidate for topological antiferromagnetism. We find that the magnetic moments of the gadolinium atoms form ferromagnetic sheets which are stacked antiferromagnetically along the body diagonal. This magnetic structure may induce spin-orbit coupling on band electrons as they hop perpendicular to the ferromagnetic sheets. [ABSTRACT FROM AUTHOR]

REPRODUCIBLE research, ULTRASONIC imaging, UTERUS abnormalities, COHORT analysis, LONGITUDINAL method, and COHEN'S kappa coefficient (Statistics)

Objective Purpose of this study is to determine the interobserver and intraobserver variability of 3D GIS in the assessment of intrauterine abnormalities. Study design Forty five 3D volumes were randomly selected from a larger prospective cohort study that studied the diagnostic accuracy of 3D GIS in addition to 2D GIS. To study interobserver agreement volumes were reviewed by two independent examiners. One examiner reviewed these samples twice with an interval of 1 month in a random order. Interobserver and intraobserver agreement were tested with Cohen's kappa coefficient and shown in Bland and Altman plots. Quality of the 3D volumes was evaluated. Results Cohen's kappa for interobserver variability for type of abnormalities (none, polyp, fibroid, other) was 0.64 and for presence of a fibroid (fibroid yes/no) 0.77. Agreement on type of fibroid was 0.59. Intraobserver agreement was almost perfect for type of abnormality (Cohen's kappa of 1.0) and good for fibroid diameter. Quality of the 3D volumes was poor in 11 out of 45 cases. Reproducibility increased when poor quality images were excluded. Conclusion Substantial interobserver and intraobserver agreement for 3D GIS in the diagnoses of intrauterine abnormalities was found. 3D GIS interobserver and intraobserver agreement are good for fibroid diameter and moderate for volume and protrusion. [ABSTRACT FROM AUTHOR]

Introduction: the Danish questionnaire entitled The Copenhagen Neck Functional Disability Scale(CNFDS) is a tool for self-assessment of cervical complaints,originally developed in English, of which there is, so far, no translation into Brazilian Portuguese. The process involvedin this researchproved to be relevant for the exploration of the questionnaire and the realization of adjustments necessary for it to be functiona l and applicable in Portuguese Language and Brazilian Culture settings. Thus, once this has been carried out, many health professionals will benefit from this version in their clinical practice. Objective: To perform the translation and cultural adaptation to Brazilian Portuguese of the Escala funcional de incapacidade do pescoço de Copenhagen (The Copenhagen Neck Functional Disability Scale -- CNFDS). Methods: The questionnaire was translated into Brazilian Portuguese by two bilingual, Brazilian physiotherapists who were aware of the objective of this research. The back-translation was performed by a third person, a Brazilian, bilingual English teacher, who had not participated in the previous step. After comparing the resulting translations, a single translated version was produced named the Escala Funcional de Incapacidade do Pescoço de Copenhagen (EFIPC) and in each question the option "not applicable" was added to the answer key. During the translation and cultural adaptation process there were no changes and/or eliminations of any questions. Result: The composition of the Escala Funcional de Incapacidade do Pescoço de Copenhagen reflects the original English version, with a total of 15 questions, with the questions numbered 1 to 5 presenting a positive direction response (a "yes" answer indicates good cervical condition), and questions numbered 6 to 15 presenting a negative direction response (a "yes" answer indicates poor cervical condition). Conclusion: The process involved in this research allowed the achievement of thedesired goal, and thus it was possible totranslate and culturally adapt to Brazilian Portuguese the content of the CNFDS questionnaire, giving riseto the Escala funcional de incapacidade do pescoço de Copenhagen. [ABSTRACT FROM AUTHOR]

COLOSTOMY, MEDICAL personnel, COLON surgery, SEXUAL intercourse, and CONTROL groups

Aim This study was carried out to determine how the partners of patients with a permanent colostomy perceive everyday life, particularly its sexual aspects. Method Data were collected prospectively from October 2011 to May 2012 using a three-part questionnaire to obtain demographic, social and sexual information. Both multiple-choice and yes/no questions were used. Results One hundred and eight questionnaires were given to 36 partners of patients with a permanent colostomy (the ostomy group) and to 72 partners of normal individuals matched for age, sex and social class. The sexual performance of the spouse was significantly better in the control group (P = 0.004), sexual performance of the partner was also better in the control group (P = 0.023) and reduced frequency of sexual activity was higher in the ostomy group (P = 0.042). There was, however, no significant difference in sexual interest between the two groups (P = 0.507). Conclusion The study demonstrated that about half of the partners of patients with a permanent colostomy experienced dissatisfaction with their spouse's performance, with a reduction in sexual interest and frequency of intercourse compared with the control group. Healthcare professionals should pay more attention to the partner of patients having a permanent colostomy. [ABSTRACT FROM AUTHOR]

HYPERCHOLESTEREMIA treatment, PROPROTEIN convertases, THERAPEUTIC use of monoclonal antibodies, LOW density lipoproteins, and DRUG efficacy

Background Heterozygous familial hypercholesterolaemia is characterised by low cellular uptake of LDL cholesterol, increased plasma LDL cholesterol concentrations, and premature cardiovascular disease. Despite intensive statin therapy, with or without ezetimibe, many patients are unable to achieve recommended target levels of LDL cholesterol. We investigated the effect of PCSK9 inhibition with evolocumab (AMG 145) on LDL cholesterol in patients with this disorder. Methods This multicentre, randomised, double-blind, placebo-controlled trial was undertaken at 39 sites (most of which were specialised lipid clinics, mainly attached to academic institutions) in Australia, Asia, Europe, New Zealand, North America, and South Africa between Feb 7 and Dec 19, 2013. 331 eligible patients (18–80 years of age), who met clinical criteria for heterozygous familial hypercholesterolaemia and were on stable lipid-lowering therapy for at least 4 weeks, with a fasting LDL cholesterol concentration of 2·6 mmol/L or higher, were randomly allocated in a 2:2:1:1 ratio to receive subcutaneous evolocumab 140 mg every 2 weeks, evolocumab 420 mg monthly, or subcutaneous placebo every 2 weeks or monthly for 12 weeks. Randomisation was computer generated by the study sponsor, implemented by a computerised voice interactive system, and stratified by LDL cholesterol concentration at screening (higher or lower than 4·1 mmol/L) and by baseline ezetimibe use (yes/no). Patients, study personnel, investigators, and Amgen study staff were masked to treatment assignments within dosing frequency groups. The coprimary endpoints were percentage change from baseline in LDL cholesterol at week 12 and at the mean of weeks 10 and 12, analysed by intention-to-treat. This trial is registered with ClinicalTrials.gov, number NCT01763918. Findings Of 415 screened patients, 331 were eligible and were randomly assigned to the four treatment groups: evolocumab 140 mg every 2 weeks (n=111), evolocumab 420 mg monthly (n=110), placebo every 2 weeks (n=55), or placebo monthly (n=55). 329 patients received at least one dose of study drug. Compared with placebo, evolocumab at both dosing schedules led to a significant reduction in mean LDL cholesterol at week 12 (every-2-weeks dose: 59·2% reduction [95% CI 53·4–65·1], monthly dose: 61·3% reduction [53·6–69·0]; both p<0·0001) and at the mean of weeks 10 and 12 (60·2% reduction [95% CI 54·5–65·8] and 65·6% reduction [59·8–71·3]; both p<0·0001). Evolocumab was well tolerated, with rates of adverse events similar to placebo. The most common adverse events occurring more frequently in the evolocumab-treated patients than in the placebo groups were nasopharyngitis (in 19 patients [9%] vs five [5%] in the placebo group) and muscle-related adverse events (ten patients [5%] vs 1 [1%]). Interpretation In patients with heterozygous familial hypercholesterolaemia, evolocumab administered either 140 mg every 2 weeks or 420 mg monthly was well tolerated and yielded similar and rapid 60% reductions in LDL cholesterol compared with placebo. INSET: Panel: Research in context. [ABSTRACT FROM AUTHOR]

NILPOTENT groups, LOGICAL prediction, LIE algebras, POLYNOMIALS, and MATHEMATICAL bounds

If ℤ+d -graded nilpotent finite-dimensional Lie algebra over a field of characteristic zero, a well-known result of Deninger and Singhof states that H*(n) ≥ L(p) where p is the polynomial associated to the grading and L(p) is the sum of the absolute values of the coefficients of p. From this result they derived the Toral Rank Conjecture (TRC) for 2-step nilpotent Lie algebras. An algebraic version of the TRC states that H*(n) ≥ 2(ℨ) for any finite-dimensional nilpotent Lie algebra n with center ℨ. The TRC is more than 25 years old and remains open even for -graded 3-step nilpotent Lie algebras. Investigating to what extent the bound given by Deninger and Singhof could help to prove the TRC in this case, we considered the following two questions regarding a nilpotent Lie algebra n with center ℨ: (A) If n admits a -grading , such that its associated polynomial p′ satisfies L(p) > 2adminℨ, does admit a ℤ+d-grading such that its associated polynomial p′ satisfies L(p′) > 2adminℨ? (B) If n is r-step nilpotent admitting a grading n = n′1⊕n′2⊕⋯⊕ n′k such that its associated polynomial p satisfies L(p) > 2adminℨ, does n admit a grading such that its associated polynomial p′ satisfies L(p′) > 2ℨadminℨ? In this paper we show that the answer to (A) is yes, but the answer to (B) is no. [ABSTRACT FROM AUTHOR]

NONIONIC surfactants, ETHOXYLATES, BIODEGRADATION of surface active agents, BIOMINERALIZATION, SULFATES, ULTRAVIOLET radiation, TOXICITY testing, and BIOLOGICAL assay

The degradation and mineralization of the nonionic surfactant octylphenol ethoxylate (OPEO), commercially known as Triton™ X-45, by the peroxymonosulfate (PMS)/UV-C process were investigated. Three different toxicity tests (Daphnia magna, Vibrio fischeri and Pseudokirchneriella subcapitata) as well as the Yeast Estrogen Screen (YES) bioassay were undertaken to evaluate the potential toxic and estrogenic effects of OPEO and its oxidation products. OPEO removal was very fast and complete after 7 min via PMS/UV-C treatment under the investigated reaction conditions (OPEO = 20 mg L−1 (47 μM); TOC = 12 mg L−1; PMS = 2.5 mM; initial reaction pH = 6.5; applied UV-C dose = 21 Wh L−1). TOC removal also proceeded rapidly; a gradual decrease was observed resulting in an overall TOC removal of 84%. The toxic responses of PMS/UV-C treated OPEO solutions varied according to the test organism used in the bioassay. Daphnia magna was found to be most sensitive to aqueous OPEO, whereas Pseudokirchneriella subcapitata appeared to be the least sensitive one. Daphnia magna and Vibrio fischeri tests revealed that the inhibitory effect of OPEO decreased significantly during the course of treatment. On the other hand, PMS/UV-C oxidation products exhibited a high toxic effect towards Pseudokirchneriella subcapitata (around 60%). YES test results underlined the need for improving the PMS/UV-C treatment performance to remove the estrogenic activity of OPEO and its oxidation products. [ABSTRACT FROM AUTHOR]

SPONDYLOARTHROPATHIES, PHYSICIAN-patient relations, DISEASE duration, RECEIVER operating characteristic curves, HLA histocompatibility antigens, and PATIENTS

There is no definition of flare in spondyloarthritis (SpA). The aim of this study was to evaluate thresholds of disease activity variations using validated composite indexes. Methods SpA patients (ASAS criteria) prospectively followed with at least two visits, were evaluated. Patients and physician answered at each visit the question: “do you consider your SpA/patient in a state of flare?”. Variations of BASDAI and ASDAS between visits were assessed and associated to the change of perception of a flare (yes/no). ROC curves were built to assess thresholds of variation in BASDAI and ASDAS associated with the change flare between visits. Results The patients were issued from a prospective series of 250 SpA. Ninety-nine cases with at least 2 visits were analysed. They were: 67% men, mean age 45 ± 12 years; disease duration: 16 ± 10 years; 84% HLA-B27 positive; purely axial SpA: 81%; PASS at baseline: 56%; mean CRP: 8.6 ± 13.5 mg/l. Mean BASDAI and ASDAS-CRP at baseline were 4.3 ± 2.2 and 2.5 ± 1.1, respectively. The kappa coefficient of agreement between patient and physician for considering a flare was 0.68. The main results of the ROC curves are: a variation ≥ 2.1 units in BASDAI (sensitivity 59%, specificity 83%), 0.8 units in ASDAS-ESR (sen 56%, spe 91%) or 1.3 units in ASDAS-CRP (sen 47%, spe 100%) is associated to a flare. Conclusion We propose thresholds of variations of BASDAI, ASDAS-ESR, and ASDAS-CRP associated to (and that may define) a flare, as considered by the patient and the physician. [ABSTRACT FROM AUTHOR]

PATIENT satisfaction, MEDICAL quality control, BREAST cancer, MEDICAL communication, and AGE factors in disease

Objectives: The Medical University of South Carolina implemented a patient-centered multidisciplinary breast clinic program (MDBC) in August 2012. In this study, patient satisfaction with the MDBC care delivery model and communication with healthcare providers was examined to inform the refinement of the MDBC program. Methods: During the first 10 months of the MDBC, patients were asked to complete a 14-question postconsultation telephone survey. A statistical analysis was performed to explore potential associations between age, race, and stage with overall patient satisfaction scores. Results: Overall, patients (N = 52, 56% white, 42% African American, 2% Hispanic; mean age 61 years) rated the quality of care highly (mean 4.7, range [1 = poor to 5 = excellent]) and felt comfortable with their plan of care (mean 1.63, range [1 = extremely comfortable to 5 = not at all comfortable]). No statistically significant differences in overall satisfaction were found by age, race, or stage; however, patient responses were commonly not optimal (ie, either "no" or "yes, but not as much as I would like") when asked if the care team addressed the impact of their diagnosis on personal relationships (40.4%) or emotional health (28.9%). Conclusions: Patients were highly satisfied with the care they received in the MDBC program. Findings suggest that this model is well suited to a diverse patient population and have highlighted quality improvement targets such as increased emphasis on providers' communication about psychosocial issues. [ABSTRACT FROM AUTHOR]

ARCHAEOLOGISTS, ARCHAEOLOGY, ANTIQUITIES, ARCHAEOLOGICAL research, ECONOMICS, and SOCIAL aspects

Archaeologists, particularly those engaged in contract archaeology, generate enormous volumes of information from their study of the archaeological record, much of which is created using substantial public and private funding resulting in weighty tomes and truckloads of artifacts sitting on library and museum shelves. Then what? Why, the next project of course! Can we say that we effectively disseminate our findings to the public? Occasionally yes. Generally no. This is a shame, as the audience for our findings is vast. People are fascinated by the past. As archaeologists it is our responsibility to more effectively communicate our knowledge to the public, not only to enlighten, but also to provide value for dollars spent and build better appreciation of archaeology's value to all segments of society. [ABSTRACT FROM AUTHOR]

SLEEP spindles, ELECTROENCEPHALOGRAPHY, POLYSOMNOGRAPHY, POPULATION, and STATISTICAL correlation

Objectives To measure the inter-expert and intra-expert agreement in sleep spindle scoring, and to quantify how many experts are needed to build a reliable dataset of sleep spindle scorings. Methods The EEG dataset was comprised of 400 randomly selected 115 s segments of stage 2 sleep from 110 sleeping subjects in the general population (57 ± 8, range: 42–72 years). To assess expert agreement, a total of 24 Registered Polysomnographic Technologists (RPSGTs) scored spindles in a subset of the EEG dataset at a single electrode location (C3-M2). Intra-expert and inter-expert agreements were calculated as F 1 -scores, Cohen’s kappa ( κ ), and intra-class correlation coefficient (ICC). Results We found an average intra-expert F 1 -score agreement of 72 ± 7% ( κ : 0.66 ± 0.07). The average inter-expert agreement was 61 ± 6% ( κ : 0.52 ± 0.07). Amplitude and frequency of discrete spindles were calculated with higher reliability than the estimation of spindle duration. Reliability of sleep spindle scoring can be improved by using qualitative confidence scores, rather than a dichotomous yes/no scoring system. Conclusions We estimate that 2–3 experts are needed to build a spindle scoring dataset with ‘substantial’ reliability ( κ : 0.61–0.8), and 4 or more experts are needed to build a dataset with ‘almost perfect’ reliability ( κ : 0.81–1). Significance Spindle scoring is a critical part of sleep staging, and spindles are believed to play an important role in development, aging, and diseases of the nervous system. [ABSTRACT FROM AUTHOR]

MENTAL arithmetic, ERRORS, BISECTORS (Geometry), MATHEMATICAL analysis, METACOGNITION, COMPARATIVE studies, MATHEMATICS, RESEARCH methodology, MEDICAL cooperation, PROBLEM solving, RESEARCH, EVALUATION research, and EXECUTIVE function

The feeling of error (FOE) is the subjective experience that something went wrong during a reasoning or calculation task. The main goal of the present study was to assess the accuracy of the FOE in the context of mental mathematical calculation. We used the number bisection task (NBT) to evoke this metacognitive feeling and assessed it by asking participants if they felt they have committed an error after solving the task. In the NBT participants have to determine whether the number presented in the middle οf a triplet corresponds to the arithmetic mean of the two outer numbers (e.g., 07_16_25) with a Yes/No answer. Our results show that FOE reports were strongly correlated with arithmetic errors and numerical properties of the NBT, suggesting that the FOE accurately represents the error. This finding indicates that even very fast metacognitive feelings are reliable when it comes to evaluating one's own mental performance. Moreover, our results suggest that the occurrence of FOEs is determined by the fluency with which each triplet was solved and the post-decision evaluation processes that occurred after the NBT was solved. Additionally, we asked participants to report their confidence in the given answer for the cases where they did not report FOEs. Participants reported less confidence for the (objectively) incorrect answers than for the (objectively) correct ones, suggesting that in cases where they did not have a conscious FOE they still were able to implicitly detect their errors. Remarkably, confidence was also determined by the fluency of the NBT. [ABSTRACT FROM AUTHOR]

CHINESE language, SENTENCE particles (Grammar), CONJUNCTIONS (Grammar), INTERROGATIVE (Grammar), and DISCOURSE

In a recent paper, Biberauer et al. (2014b) claim that the Chinese sentence-final particles (SFPs) ne and ma only “double” the information encoded elsewhere in the sentence and are to be analyzed as “acategorial” conjunctions. This contrasts with the current analysis of, e.g. ma as an interrogative force head. The present article provides evidence in favour of the SFPs ma and ne as C-elements and challenges some of the preconceived ideas commonly encountered in the literature. Within the head-final split CP proposed for Chinese ‘Low C < Force < Attitude’, ma instantiates a Force head, whereas ne realizes the discourse-related AttitudeP, not a wh -question typing particle ( pace Lisa L.-S. Cheng's, 1991 ). Furthermore, evidence is provided to show that the surface sentence-final position of SFPs in Chinese must be taken at face value. [ABSTRACT FROM AUTHOR]

ENVIRONMENTAL monitoring, ENVIRONMENTAL quality, SEDIMENTS, MIXTURES, EXTRACTION (Chemistry), and ATMOSPHERIC chemistry

Aquatic environments are often contaminated with complex mixtures of chemicals that may pose a risk to ecosystems and human health. This contamination cannot be addressed with target analysis alone but tools are required to reduce this complexity and identify those chemicals that might cause adverse effects. Effect-directed analysis (EDA) is designed to meet this challenge and faces increasing interest in water and sediment quality monitoring. Thus, the present paper summarizes current experience with the EDA approach and the tools required, and provides practical advice on their application. The paper highlights the need for proper problem formulation and gives general advice for study design. As the EDA approach is directed by toxicity, basic principles for the selection of bioassays are given as well as a comprehensive compilation of appropriate assays, including their strengths and weaknesses. A specific focus is given to strategies for sampling, extraction and bioassay dosing since they strongly impact prioritization of toxicants in EDA. Reduction of sample complexity mainly relies on fractionation procedures, which are discussed in this paper, including quality assurance and quality control. Automated combinations of fractionation, biotesting and chemical analysis using so-called hyphenated tools can enhance the throughput and might reduce the risk of artifacts in laboratory work. The key to determining the chemical structures causing effects is analytical toxicant identification. The latest approaches, tools, software and databases for target-, suspect and non-target screening as well as unknown identification are discussed together with analytical and toxicological confirmation approaches. A better understanding of optimal use and combination of EDA tools will help to design efficient and successful toxicant identification studies in the context of quality monitoring in multiply stressed environments. [ABSTRACT FROM AUTHOR]

HEAT equation, UNIQUENESS (Mathematics), NONLINEAR equations, CAUCHY problem, and INFINITE integrals

We study the existence of infinitely many solutions for the Cauchy problem associated with the nonlinear heat equation u t = ( u m − 1 u x ) x in the fast diffusion range of exponents −1 < m ≤ 0 with initial data u 0 ≥ 0, u 0 ≢ 0. The issue of non-uniqueness arises because of the singular character of the diffusivity for u ≈ 0. The precise question we want to clarify is: can we have multiple solutions even for initial data which are far away from the singular level u = 0, for instance for u 0 ( x ) ≡ 1? The answer is, rather surprisingly, yes. Indeed, there are infinitely many solutions for every given initial function. These properties differ strongly from other usual types of heat equations, linear or nonlinear. We take as initial data an arbitrary function in L loc 1 ( R ) . We prove that when the initial data have infinite integral on a side, say at x = ∞, then we can choose either to have infinite mass for all small times at least on that side, and the choice is then unique, or finite mass, and then we need to prescribe a flux function with diverging integral at t = 0, being otherwise quite general. Moreover, a new parameter appears in the solution set. The behaviour on both ends, x = ∞ and x = −∞ is similar and independent. [ABSTRACT FROM AUTHOR]

ENDOVASCULAR surgery, STROKE treatment, STROKE patients, HEMORRHAGIC diseases, TREATMENT effectiveness, LOGISTIC regression analysis, META-analysis, THERAPEUTICS, FIBRINOLYTIC agents, TISSUE plasminogen activator, CEREBRAL hemorrhage, CEREBRAL ischemia, CLINICAL trials, COMPARATIVE studies, RESEARCH methodology, MEDICAL cooperation, RESEARCH, STROKE, THROMBOSIS, VEIN surgery, EVALUATION research, ODDS ratio, NIH Stroke Scale, DISEASE complications, CEREBRAL ischemia treatment, and THERAPEUTIC use

Background: In 2015, five randomised trials showed efficacy of endovascular thrombectomy over standard medical care in patients with acute ischaemic stroke caused by occlusion of arteries of the proximal anterior circulation. In this meta-analysis we, the trial investigators, aimed to pool individual patient data from these trials to address remaining questions about whether the therapy is efficacious across the diverse populations included.Methods: We formed the HERMES collaboration to pool patient-level data from five trials (MR CLEAN, ESCAPE, REVASCAT, SWIFT PRIME, and EXTEND IA) done between December, 2010, and December, 2014. In these trials, patients with acute ischaemic stroke caused by occlusion of the proximal anterior artery circulation were randomly assigned to receive either endovascular thrombectomy within 12 h of symptom onset or standard care (control), with a primary outcome of reduced disability on the modified Rankin Scale (mRS) at 90 days. By direct access to the study databases, we extracted individual patient data that we used to assess the primary outcome of reduced disability on mRS at 90 days in the pooled population and examine heterogeneity of this treatment effect across prespecified subgroups. To account for between-trial variance we used mixed-effects modelling with random effects for parameters of interest. We then used mixed-effects ordinal logistic regression models to calculate common odds ratios (cOR) for the primary outcome in the whole population (shift analysis) and in subgroups after adjustment for age, sex, baseline stroke severity (National Institutes of Health Stroke Scale score), site of occlusion (internal carotid artery vs M1 segment of middle cerebral artery vs M2 segment of middle cerebral artery), intravenous alteplase (yes vs no), baseline Alberta Stroke Program Early CT score, and time from stroke onset to randomisation.Findings: We analysed individual data for 1287 patients (634 assigned to endovascular thrombectomy, 653 assigned to control). Endovascular thrombectomy led to significantly reduced disability at 90 days compared with control (adjusted cOR 2.49, 95% CI 1.76-3.53; p<0.0001). The number needed to treat with endovascular thrombectomy to reduce disability by at least one level on mRS for one patient was 2.6. Subgroup analysis of the primary endpoint showed no heterogeneity of treatment effect across prespecified subgroups for reduced disability (pinteraction=0.43). Effect sizes favouring endovascular thrombectomy over control were present in several strata of special interest, including in patients aged 80 years or older (cOR 3.68, 95% CI 1.95-6.92), those randomised more than 300 min after symptom onset (1.76, 1.05-2.97), and those not eligible for intravenous alteplase (2.43, 1.30-4.55). Mortality at 90 days and risk of parenchymal haematoma and symptomatic intracranial haemorrhage did not differ between populations.Interpretation: Endovascular thrombectomy is of benefit to most patients with acute ischaemic stroke caused by occlusion of the proximal anterior circulation, irrespective of patient characteristics or geographical location. These findings will have global implications on structuring systems of care to provide timely treatment to patients with acute ischaemic stroke due to large vessel occlusion.Funding: Medtronic. [ABSTRACT FROM AUTHOR]

LANGEVIN equations, APPROXIMATION theory, POLYMERS, FOKKER-Planck equation, INVERSE functions, and DISTRIBUTION (Probability theory)

The Langevin function is defined by L ( x ) = coth ( x ) − 1 / x . Its inverse is useful for many applications and especially for polymer science. As the inverse exact expression has no analytic representation, many approximations have been established. The most famous approximation is the one traditionally used for the finitely extensible non-linear elastic (FENE) dumbbell model in which the inverse is approximated by L − 1 ( y ) = 3 y / ( 1 − y 2 ) . Recently Martin Kröger has published a paper entitled ‘Simple, admissible and accurate approximations of the inverse Langevin and Brillouin functions, relevant for strong polymer deformation and flows’ (Kröger, 2015) in which he proposed approximations with very reduced error in relation to the numeric inverse of the Langevin function. The question we aim to analyze in this short communication is: when one uses the traditional approximation rather than the more accurate one proposed by Kröger is that really significant regarding the value of the probability distribution function (PDF) in the frame work of a kinetic theory simulation? If yes when we move to the upper scale by evaluating the value of the stress, can we observe a significant difference? By making some simple 1D simulations in homogeneous extensional flow it is demonstrated in this short communication that the PDF prediction within kinetic theory framework as well as the macroscopic stress value are both affected by the quality of the approximation. [ABSTRACT FROM AUTHOR]

RADIOGRAPHY use in painting, COLOR prints, X-ray spectroscopy, CROSS-sectional method, and COPPER phthalocyanine

The radiography performed on the painting There Is No Yes without a No—The Hermit (1985) by António Dacosta revealed one of his lost works. The last and only record of the lost painting is a black and white photograph taken during the exhibition L ' Artiste du Mois at Centre Culturel Portugais de la Fondation Calouste Gulbenkian in Paris, 1985. The chromatic reconstruction of the artwork would be of extreme importance for its dissemination as it was conceived. For this purpose, portable x-ray fluorescence analyses were carried out directly on the paintings for preliminary elemental identification and to determine the most favorable sampling areas for μ-Raman and SEM–EDS evaluation. Cross sections were observed under optical microscope for better discernment of the chromatic layers used in each painting. In both artworks, titanium white (rutile), Mars red, Mars black, ultramarine blue, phthalocyanine blue and dioxazine violet were identified. Mars yellow and Mars black were found on superficial layers from the latest painting; phthalocyanine green, chrome-based green and cadmium red/orange was found on deeper layers, belonging to the hidden painting. [ABSTRACT FROM AUTHOR]

BRAIN physiology, ELECTROENCEPHALOGRAPHY, MEMORY, RECOGNITION (Psychology), STATISTICAL sampling, RANDOMIZED controlled trials, PROMPTS (Psychology), REPEATED measures design, and ONE-way analysis of variance

Items that are produced (e.g., read aloud) during encoding typically are better remembered than items that are not produced (e.g., read silently). This "production effect" has been explained by distinctiveness: Produced items have more distinct features than nonproduced items, leading to enhanced retrieval. The goal of the current study was to use electroencephalography (EEG) to examine the neural basis of the production effect. During study, participants were presented with words that they were required to read silently, read aloud, or sing while EEG data were recorded. Subsequent memory performance was tested using a yes/no recognition test. Analysis focused on the event-related brain potentials (ERPs) evoked by the encoding instruction cue for each instruction condition. Our data revealed enhanced memory performance for produced items and a greater P300 ERP amplitude for instructions to sing or read aloud compared with instructions to read silently. Our results demonstrate that the amplitude of the P300 is modulated by at least 1 aspect of production, vocalization (singing/reading aloud relative to reading silently), and are consistent with the distinctiveness account of the production effect. The ERP methodology is a viable tool for investigating the production effect. [ABSTRACT FROM AUTHOR]

Colorrectal adenocarcinoma it's a common entity, but the vulvar metastasis from it, it's very rare, they can be metachronous. The vulvar metastasis it's only 5 to 8 % of all of the site tumors. W e present a case of a 35 years old woman, who was diagnosed with a poorly differentiated, infiltrating and ulcerated colorrectal adenocarcinoma by colonoscopy biopsy, latter a surgical resection it's taken so Dukes C2 stratification it's made. After 14 months a skin injury appears in vulvar and perirectal area, the next step skin biopsy is realized, the histopathological findings are a metastasic disease from invasive adenocarcinoma, an immunohistochemical cytokeratin (Cl<) 20 reactive shows positivity therefore the origin its colorrectal adenocarcinoma. The most frequent metastasis from colon adenocarcinoma is the liver, the female genital tract is rare, but within this system the ovary is the most common. Metastasis to skin is exceptional, but when it happens periumbilical area is the most frequent site, that means our case presentation has low incidence so the importance of it and the bad prognosis of it. [ABSTRACT FROM AUTHOR]

DEPRESSION in old age, MILD cognitive impairment, EPISODIC memory, ALZHEIMER'S disease risk factors, DEMENTIA risk factors, DEMENTIA -- Research, ANTIDEPRESSANTS, MENTAL depression, CLINICAL trials, COMPARATIVE studies, EMOTIONS, NEUROPSYCHOLOGICAL tests, RESEARCH methodology, MEDICAL cooperation, MEMORY, RECOGNITION (Psychology), RESEARCH, EVALUATION research, BLIND experiment, and PSYCHOLOGICAL aspects

Background: Amnestic mild cognitive impairment (aMCI) and late-life depression (LLD) are associated with increased risk of Alzheimer's disease (AD). This is also true for aMCI with concomitant depressive symptoms (aMCI/D+), but few studies have investigated this syndrome. Objectives: We aimed to clarify the association between cognitive and depressive symptoms in individuals at risk for AD by examining episodic memory for emotional stimuli in aMCI, aMCI/D+, and LLD. Methods: Participants were 34 patients with aMCI, 20 patients with aMCI/D+, 19 patients with LLD, and 28 healthy elderly adults. In an implicit encoding task, participants rated the emotional valence of 12 positive, 12 negative, and 12 neutral words. Immediately and 20 minutes later, participants recalled as many words as possible. They were also asked to identify previously presented words during a yes/no recognition trial. Results: At immediate recall, aMCI participants displayed better recall of emotional words, particularly positive words. aMCI/D+ and control participants displayed better recall of positive and negative words compared to neutral words. LLD participants recalled more negative than neutral words. At delayed recall, emotional words were generally better-remembered than neutral words by all groups. At recognition, all subjects responded more liberally to emotional than to neutral words. Conclusion: We find that the type of emotional information remembered by aMCI patients at immediate recall depends on the presence or absence of depressive symptoms. These findings contribute to identifying sources of heterogeneity in individuals at risk for AD, and suggest that the cognitive profile of aMCI/D+ is different from that of aMCI and LLD. Future studies should systematically consider the presence of depressive symptoms in elderly at-risk individuals. [ABSTRACT FROM AUTHOR]

CELIAC disease, DIARRHEA, DIGESTIVE system diseases, INFANT diseases, and LIQUID chromatography

Objectives and study In the development of Celiac Disease (CD) both genetic and environmental factors play a crucial role. The Human Leukocyte Antigen ( HLA )-DQ2 and HLA -DQ8 loci are strongly related to the disease and are necessary but not sufficient for the development of CD. Therefore, increasing interest lies in examining the mechanisms of CD onset from the early beginning. Differences in serum and urine metabolic profiles between healthy individuals and CD patients have been reported previously. We aimed to investigate if the metabolic pathways were already altered in young, 4 month old infants, preceding the CD diagnosis. Methods Serum samples were available for 230 four month old infants of the PreventCD project, a multicenter, randomized, double-blind, dietary intervention study. All children were positive for HLA -DQ2 and/or HLA -DQ8 and had at least one first-degree relative diagnosed with CD. Amino acids were quantified after derivatization with liquid chromatography – tandem mass spectrometry (MS/MS) and polar lipid concentrations (acylcarnitines, lysophosphatidylcholines, phosphatidylcholines, and sphingomyelins) were determined with direct infusion MS/MS. We investigated the association of the metabolic profile with (1) the development of CD up to the age of 8 years (yes/no), (2) with HLA-risk groups, (3) with the age at CD diagnosis, using linear mixed models and cox proportional hazards models. Gender, intervention group, and age at blood withdrawal were included as potential confounder. Results By the end of 2014, thirty-three out of the 230 children (14%) were diagnosed with CD according to the ESPGHAN criteria. Median age at diagnosis was 3.4 years (IQR, 2.4–5.2). Testing each metabolite for a difference in the mean between healthy and CD children, we (1) could not identify a discriminant analyte or a pattern pointing towards an altered metabolism (Bonferroni corrected P > 0.05 for all). Metabolite concentrations (2) did not differ across the HLA-risk groups. When investigating the age at diagnosis using (3) survival models, we found no evidence for an association between the metabolic profile and the risk of a later CD diagnosis. Conclusion The metabolic profile at 4 months of age was not predictive for the development of CD up to the age of 8 years. Our results suggest that metabolic pathways reflected in serum are affected only later in life and that the HLA-genotype does not influence the serum metabolic profile in young infants before introduction of solid food. [ABSTRACT FROM AUTHOR]

PERCEPTUAL learning, VISION, RETINAL degeneration, LEARNING, VISUAL acuity, and WESTERN countries

Background: Macular Degeneration (MD), a visual disease that produces central vision loss, is one of the main causes of visual disability in western countries. Patients with MD are forced to use a peripheral retinal locus (PRL) as a substitute of the fovea. However, the poor sensitivity of this region renders basic everyday tasks very hard for MD patients. Objective:We investigated whether perceptual learning (PL) with lateral masking in the PRL ofMDpatients, improved their residual visual functions. Method: Observers were trained with two distinct contrast detection tasks: (i) a Yes/No task with no feedback (MD: N= 3; controls: N= 3), and (ii) a temporal two-alternative forced choice task with feedback on incorrect trials (i.e., temporal-2AFC; MD: N= 4; controls: N= 3). Observers had to detect a Gabor patch (target) flanked above and below by two high contrast patches (i.e., lateral masking). Stimulus presentation was monocular with durations varying between 133 and 250 ms. Participants underwent 24-27 training sessions in total. Results: Both PL procedures produced significant improvements in the trained task and learning transferred to visual acuity. Besides, the amount of transfer was greater for the temporal-2AFC task that induced a significant improvement of the contrast sensitivity for untrained spatial frequencies. Most importantly, follow-up tests on MD patients trained with the temporal-2AFC task showed that PL effects were retained between four and six months, suggesting long-term neural plasticity changes in the visual cortex. Conclusion: The results show for the first time that PL with a lateral masking configuration has strong, non-invasive and long lasting rehabilitative potential to improve residual vision in the PRL of patients with central vision loss. [ABSTRACT FROM AUTHOR]

ACUTE otitis media, ANTIBIOTICS, DISEASE relapse, DRUG efficacy, DRUG prescribing, and THERAPEUTICS

Objective: Antibiotic treatment of acute otitis media (AOM) has been suggested to increase the risk of future AOM episodes by causing unfavorable shifts in microbial flora. Because current evidence on this topic is inconclusive and long-term follow-up data are scarce, we wanted to estimate the effect of antibiotic treatment for a first AOM episode occurring during infancy on AOM recurrences and AOM-related health care utilization later in life. Methods: We obtained demographic information and risk factors from data of the Wheezing Illnesses Study Leidsche Rijn, a prospective birth cohort study in which all healthy newborns born in Leidsche Rijn (between 2001 and 2012), The Netherlands, were enrolled. These data were linked to children’s primary care electronic health records up to the age of four. Children with at least one family physician-diagnosed AOM episode before the age of two were included in analyses. The exposure of interest was the prescription of oral antibiotics (yes vs no) for a child’s first AOM episode before the age of two years. Results: 848 children were included in analyses and 512 (60%) children were prescribed antibiotics for their first AOM episode. Antibiotic treatment was not associated with an increased risk of total AOM recurrences (adjusted rate ratio: 0.94, 95% CI: 0.78–1.13), recurrent AOM (≥3 episodes in 6 months or ≥4 in one year; adjusted risk ratio: 0.79, 95% CI: 0.57–1.11), or with increased AOM-related health care utilization during children’s first four years of life. Conclusions: Oral antibiotic treatment of a first AOM episode occurring during infancy does not affect the number of AOM recurrences and AOM-related health care utilization later in life. This information can be used when weighing the pros and cons of various AOM treatment options. [ABSTRACT FROM AUTHOR]

The article discusses the issue of education youth and adults (EJA). The objective is to analyze, from the perspective of students, as Mossoro campus IFRN comes materializing the proposed curriculum of integrated technical course in Building the EJA modality, offered under the National Programme Vocational Education Integration with Basic Education in the Modality Youth and Adult education (PROEJA). Methodologically, the study is included in the exploratory-descriptive category, based on dialectics. The sources of information are the Pedagogical Project of the Course and the data (questionnaires and interviews) collected from students last semester of the first class of the course. Considering the pedagogical practices developed by teachers, it appears that there is no concrete evidence of an integrated curriculum in the course and, yes, that only a few didactic actions, very specific and not systematic or planned collectively contribute to this end. [ABSTRACT FROM AUTHOR]

OSTEOSARCOMA, CANCER chemotherapy, PREOPERATIVE care, IFOSFAMIDE, ETOPOSIDE, COMBINATION drug therapy, and THERAPEUTICS

Background: We designed the EURAMOS-1 trial to investigate whether intensified postoperative chemotherapy for patients whose tumour showed a poor response to preoperative chemotherapy (≥10% viable tumour) improved event-free survival in patients with high-grade osteosarcoma.Methods: EURAMOS-1 was an open-label, international, phase 3 randomised, controlled trial. Consenting patients with newly diagnosed, resectable, high-grade osteosarcoma aged 40 years or younger were eligible for randomisation. Patients were randomly assigned (1:1) to receive either postoperative cisplatin, doxorubicin, and methotrexate (MAP) or MAP plus ifosfamide and etoposide (MAPIE) using concealed permuted blocks with three stratification factors: trial group; location of tumour (proximal femur or proximal humerus vs other limb vs axial skeleton); and presence of metastases (no vs yes or possible). The MAP regimen consisted of cisplatin 120 mg/m2, doxorubicin 37·5 mg/m2 per day on days 1 and 2 (on weeks 1 and 6) followed 3 weeks later by high-dose methotrexate 12 g/m2 over 4 h. The MAPIE regimen consisted of MAP as a base regimen, with the addition of high-dose ifosfamide (14 g/m2) at 2·8 g/m2 per day with equidose mesna uroprotection, followed by etoposide 100 mg/m2 per day over 1 h on days 1-5. The primary outcome measure was event-free survival measured in the intention-to-treat population. This trial is registered with ClinicalTrials.gov, number NCT00134030.Findings: Between April 14, 2005, and June 30, 2011, 2260 patients were registered from 325 sites in 17 countries. 618 patients with poor response were randomly assigned; 310 to receive MAP and 308 to receive MAPIE. Median follow-up was 62·1 months (IQR 46·6-76·6); 62·3 months (IQR 46·9-77·1) for the MAP group and 61·1 months (IQR 46·5-75·3) for the MAPIE group. 307 event-free survival events were reported (153 in the MAP group vs 154 in the MAPIE group). 193 deaths were reported (101 in the MAP group vs 92 in the MAPIE group). Event-free survival did not differ between treatment groups (hazard ratio [HR] 0·98 [95% CI 0·78-1·23]); hazards were non-proportional (p=0·0003). The most common grade 3-4 adverse events were neutropenia (268 [89%] patients in MAP vs 268 [90%] in MAPIE), thrombocytopenia (231 [78% in MAP vs 248 [83%] in MAPIE), and febrile neutropenia without documented infection (149 [50%] in MAP vs 217 [73%] in MAPIE). MAPIE was associated with more frequent grade 4 non-haematological toxicity than MAP (35 [12%] of 301 in the MAP group vs 71 [24%] of 298 in the MAPIE group). Two patients died during postoperative therapy, one from infection (although their absolute neutrophil count was normal), which was definitely related to their MAP treatment (specifically doxorubicin and cisplatin), and one from left ventricular systolic dysfunction, which was probably related to MAPIE treatment (specifically doxorubicin). One suspected unexpected serious adverse reaction was reported in the MAP group: bone marrow infarction due to methotrexate.Interpretation: EURAMOS-1 results do not support the addition of ifosfamide and etoposide to postoperative chemotherapy in patients with poorly responding osteosarcoma because its administration was associated with increased toxicity without improving event-free survival. The results define standard of care for this population. New strategies are required to improve outcomes in this setting.Funding: UK Medical Research Council, National Cancer Institute, European Science Foundation, St Anna Kinderkrebsforschung, Fonds National de la Recherche Scientifique, Fonds voor Wetenschappelijk Onderzoek-Vlaanderen, Parents Organization, Danish Medical Research Council, Academy of Finland, Deutsche Forschungsgemeinschaft, Deutsche Krebshilfe, Federal Ministry of Education and Research, Semmelweis Foundation, ZonMw (Council for Medical Research), Research Council of Norway, Scandinavian Sarcoma Group, Swiss Paediatric Oncology Group, Cancer Research UK, National Institute for Health Research, University College London Hospitals, and Biomedical Research Centre. [ABSTRACT FROM AUTHOR]

RHINITIS, WHEEZE, MILK allergy, EXERCISE-induced asthma, METERED-dose inhalers, FOOD allergy, and PROGNOSIS

Table of contents: WORKSHOP 4: Challenging clinical scenarios (CS01–CS06) CS01 Bullous lesions in two children: solitary mastocytoma S. Tolga Yavuz, Ozan Koc, Ali Gungor, Faysal Gok CS02 Multi‐System Allergy (MSA) of cystic fibrosis: our institutional experience Jessica Hawley, Christopher O'Brien, Matthew Thomas, Malcolm Brodlie, Louise Michaelis CS03 Cold urticaria in pediatric age: an invisible cause for severe reactions Inês Mota, Ângela Gaspar, Susana Piedade, Graça Sampaio, José Geraldo Dias, Miguel Paiva, Mário Morais‐Almeida CS04 Angioedema with C1 inhibitor deficiency in a girl: a challenge diagnosis Cristina Madureira, Tânia Lopes, Susana Lopes, Filipa Almeida, Alexandra Sequeira, Fernanda Carvalho, José Oliveira CS05 A child with unusual multiple organ allergy disease: what is the primer? Fabienne Gay‐Crosier CS06 A case of uncontrolled asthma in a 6‐year‐old patient Ioana‐Valentina Nenciu, Andreia Florina Nita, Alexandru Ulmeanu, Dumitru Oraseanu, Carmen Zapucioiu ORAL ABSTRACT SESSION 1: Food allergy (OP01–OP06) OP01 Food protein‐induced enterocolitis syndrome: oral food challenge outcomes for tolerance evaluation in a Pediatric Hospital Adrianna Machinena, Olga Domínguez Sánchez, Montserrat Alvaro Lozano, Rosa Jimenez Feijoo, Jaime Lozano Blasco, Mònica Piquer Gibert, Mª Teresa Giner Muñoz, Marcia Dias da Costa, Ana Maria Plaza Martín OP02 Characteristics of infants with food protein‐induced enterocolitis syndrome and allergic proctocolitis Ebru Arik Yilmaz, Özlem Cavkaytar, Betul Buyuktiryaki, Ozge Soyer, Cansin Sackesen OP03 The clinical and immunological outcomes after consumption of baked egg by 1–5 year old egg allergic children: results of a randomised controlled trial MerrynNetting, Adaweyah El‐Merhibi, Michael Gold, PatrickQuinn, IrmeliPenttila, Maria Makrides OP04 Oral immunotherapy for treatment of egg allergy using low allergenic, hydrolysed egg Stavroula Giavi, Antonella Muraro, Roger Lauener, Annick Mercenier, Eugen Bersuch, Isabella M. Montagner, Maria Passioti, Nicolò Celegato, Selina Summermatter, Sophie Nutten, Tristan Bourdeau, Yvonne M. Vissers, Nikolaos G. Papadopoulos OP05 Chemical modification of a peanut extract results in an increased safety profile while maintaining efficacy Hanneke van der Kleij, Hans Warmenhoven, Ronald van Ree, Raymond Pieters, Dirk Jan Opstelten, Hans van Schijndel, Joost Smit OP06 Administration of the yellow fever vaccine in egg allergic children Roisin Fitzsimons, Victoria Timms, George Du Toit ORAL ABSTRACT SESSION 2: Asthma (OP07–OP12) OP07 Previous exacerbation is the most important risk factor for future exacerbations in school‐age children with asthma S. Tolga Yavuz, Guven Kaya, Mustafa Gulec, Mehmet Saldir, Osman Sener, Faysal Gok OP08 Comparative study of degree of severity and laboratory changes between asthmatic children using different acupuncture modalities Nagwa Hassan, Hala Shaaban, Hazem El‐Hariri, Ahmed Kamel Inas E. Mahfouz OP09 The concentration of exhaled carbon monoxide in asthmatic children with different controlled stadium Papp Gabor, Biro Gabor, Kovacs Csaba OP10 Effect of vitamin D3 supplementation during pregnancy on risk of persistent wheeze in the offspring: a randomised clinical trial Bo Chawes, Klaus Bønnelykke, Jakob Stokholm, Lene Heickendorff, Susanne Brix, Morten Rasmussen, Hans Bisgaard OP11 Lung function development in childhood Henrik Wegener Hallas, Bo Chawes, Lambang Arianto, Hans Bisgaard OP12 Is the effect of maternal and paternal asthma different in female and male children before puberty? Maike Pincus, Thomas Keil, Andreas Reich, Ulrich Wahn, Susanne Lau, Linus Grabenhenrich ORAL ABSTRACT SESSION 3: Epidemiology—genetics (OP13–OP18) OP13 Lifestyle is associated with incidence and category of allergen sensitisation: the ALADDIN birth cohort Sara Fagerstedt, Helena Marell Hesla, Emelie Johansson, Helen Rosenlund, Axel Mie, Annika Scheynius, Johan Alm OP15 Maternal filaggrin mutations increase the risk of atopic dermatitis in children: an effect independent of mutation inheritance Jorge Esparza‐Gordillo, Anja Matanovic, Ingo Marenholz, Anja Bauerfeind, Klaus Rohde, Katja Nemat, Min‐Ae Lee‐Kirsch, Magnus Nordenskjöld, Marten C. G. Winge, Thomas Keil, Renate Krüger, Susanne Lau, Kirsten Beyer, Birgit Kalb, Bodo Niggemann, Norbert Hübner, Heather J. Cordell, Maria Bradley, Young‐Ae Lee OP16 Allergic multimorbidity of asthma, rhinitis and eczema in the first 2 decades of the German MAS birth cohort Thomas Keil, Hannah Gough, Linus Grabenhenrich, Dirk Schramm, Andreas Reich, John Beschorner, Antje Schuster, Carl‐Peter Bauer, Johannes Forster, Fred Zepp, Young‐Ae Lee, Renate Bergmann, Karl Bergmann, Ulrich Wahn, Susanne Lau OP17 Childhood anaphylaxis: a growing concern Filipe Benito Garcia, Inês Mota, Susana Piedade, Ângela Gaspar, Natacha Santos, Helena Pité, Mário Morais‐Almeida OP18 Indoor exposure to molds and dampness in infancy and its association to persistent atopic dermatitis in school age. Results from the Greek ISAAC II study Athina Papadopoulou, Despina Mermiri, Elpida Xatziagorou, Ioannis Tsanakas, Stavroula Lampidi, Kostas Priftis ORAL ABSTRACT SESSION 4: Pediatric rhinitis—immunotherapy (OP19–OP24) OP19 Associations between residential greenness and childhood allergic rhinitis and aeroallergen sensitisation in seven birth cohorts Elaine Fuertes, Iana Markevych, Gayan Bowatte, Olena Gruzieva, Ulrike Gehring, Allan Becker, Dietrich Berdel, Michael Brauer, Chris Carlsten, Barbara Hoffmann, Anita Kozyrskyj, Caroline Lodge, Göran Pershagen, Alet Wijga, Heinrich Joachim OP20 Full symptom control in pediatric patients with allergic rhinitis and asthma: results of a 2‐year sublingual allergen immunotherapy study Zorica Zivkovic, Ivana Djuric‐Filipovic, Jasmina Jocić‐Stevanovic, Snežana Zivanovic OP21 Nasal epithelium of different ages of atopic subjects present increased levels of oxidative stress and increased cell cytotoxicity upon rhinovirus infection Styliani Taka, Dimitra Kokkinou, Aliki Papakonstantinou, Panagiota Stefanopoulou, Anastasia Georgountzou, Paraskevi Maggina, Sofia Stamataki, Vassiliki Papaevanggelou, Evangelos Andreakos, Nikolaos G. Papadopoulos OP22 Cluster subcutaneous immunotherapy schedule: tolerability profile in children Monica Piquer Gibert, Montserrat Alvaro Lozano, Jaime Lozano Blasco, Olga Domínguez Sánchez, Rosa Jiménez Feijoo, Marcia Dias da Costa, Mª Teresa Giner Muñoz, Adriana Machinena Spera, Ana Maria Plaza Martín OP23 Rhinitis as a risk factor for asthma severity in 11‐year old children: population‐based cohort study Matea Deliu, Danielle Belgrave, Angela Simpson, Adnan Custovic OP24 The Global Lung Function Initiative equations in airway obstruction evaluation of asthmatic children João Gaspar Marques, Pedro Carreiro‐Martins, Joana Belo, Sara Serranho, Isabel Peralta, Nuno Neuparth, Paula Leiria‐Pinto POSTER DISCUSSION SESSION 1: Food allergy (PD01–PD05) PD01 Allergen‐specific humoral and cellular responses in children who fail egg oral immunotherapy due to allergic reactions Marta Vazquez‐Ortiz, Mariona Pascal, Ana Maria Plaza, Manel Juan PD02 FoxP3 epigenetic features in children with cow milk allergy Lorella Paparo, Rita Nocerino, Rosita Aitoro, Ilaria Langella, Antonio Amoroso, Alessia Amoroso, Carmen Di Scala, Roberto Berni Canani PD04 Combined milk and egg allergy in early childhood: let them eat cake? Santanu Maity, Giuseppina Rotiroti, Minal Gandhi PD05 Introduction of complementary foods in relation to allergy and gut microbiota in farm and non‐farm children Karin Jonsson, Annika Ljung, Bill Hesselmar, Ingegerd Adlerbert, Hilde Brekke, Susanne Johansen, Agnes Wold, Ann‐Sofie Sandberg POSTER DISCUSSION SESSION 2: Asthma and wheeze (PD06–PD16) PD06 The association between asthma and exhaled nitric oxide is influenced by genetics and sensitisation Björn Nordlund, Cecilia Lundholm, Villhelmina Ullemar, Marianne van Hage, Anne Örtqvist, Catarina Almqvist PD09 Prevalence patterns of infant wheeze across Europe Anna Selby, Kate Grimshaw, Thomas Keil, Linus Grabenhenrich, Michael Clausen, Ruta Dubakiene, Alessandro Fiocchi, Marek Kowalski, Nikos Papadopoulos, Marta Reche, Sigurveig Sigurdardottir, Aline Sprikkleman, Paraskevi Xepapadaki, Clare Mills, Kirsten Beyer, Graham Roberts PD10 Epidemiologic changes in recurrent wheezing infants Herberto Jose Chong Neto, Gustavo Falbo Wandalsen, Ana Carolina Dela Bianca, Carolina Aranda, Nelson Augusto Rosário, Dirceu Solé, Javier Mallol, Luis García Marcos PD13 A single nucleotide polymorphism in the GLCCI1 gene is associated with response to asthma treatment in children IvanaBanic, Matija Rijavec, Davor Plavec, Peter Korosec, Mirjana Turkalj PD14 Pollen induced asthma: Could small molecules in pollen exacerbate the protein‐mediated allergic response? Alen Bozicevic, Maria De Mieri, Matthias Hamburger PD15 A qualitative study to understand how we can empower teenagers to better self‐manage their asthma Simone Holley, Ruth Morris, Frances Mitchell, Rebecca Knibb, Susan Latter, Christina Liossi, Graham Roberts PD16 Polymorphism of endothelial nitric oxide synthase (eNOS) gene among Egyptian children with bronchial asthma Mostafa M. M. Hassan POSTER DISCUSSION SESSION 3: Mechanisms—Epidemiology (PD17–PD21) PD17 Pregnancy outcomes in relation to development of allergy in a Swedish birth cohort Malin Barman, Anna Sandin, Agnes Wold, Ann‐Sofie Sandberg PD18 Evolution of the IgE response to house dust mite molecules in childhood Daniela Posa, Serena Perna, Carl‐Peter Bauer, Ute Hoffmann, Johannes Forster, Fred Zepp, Antje Schuster, Ulrich Wahn, Thomas Keil, Susanne Lau, Kuan‐Wei Chen, Yvonne Resch, Susanne Vrtala, Rudolf Valenta, Paolo Maria Matricardi PD19 Antibody recognition of nsLTP‐molecules as antigens but not as allergens in the German‐MAS birth cohort Olympia Tsilochristou, Alexander Rohrbach, Antonio Cappella, Stephanie Hofmaier, Laura Hatzler, Carl‐Peter Bauer, Ute Hoffmann, Johannes Forster, Fred Zepp, Antje Schuster, RaffaeleD'Amelio, Ulrich Wahn, Thomas Keil, Susanne Lau, Paolo Maria Matricardi PD20 Early life colonization with Lactobacilli and Staphylococcus aureus oppositely associates with the maturation and activation of FOXP3+ CD4 T‐cells Sophia Björkander, Maria A. Johansson, Gintare Lasaviciute, Eva Sverremark‐Ekström PD21 Genome‐wide meta‐analysis identifies 7 susceptibility loci involved in the atopic march Ingo Marenholz, Jorge Esparza‐Gordillo, Franz Rüschendorf, Anja Bauerfeind, David P. Strachan, Ben D. Spycher, Hansjörg Baurecht, Patricia Margaritte‐Jeannin, Annika Sääf, Marjan Kerkhof, Markus Ege, Svetlana Baltic, Melanie C Matheson, Jin Li, Sven Michel, Wei Q. Ang, Wendy McArdle, Andreas Arnold, Georg Homuth, Florence Demenais, Emmanuelle Bouzigon, Cilla Söderhäll, Göran Pershagen, Johan C. de Jongste, Dirkje S Postma, Charlotte Braun‐Fahrländer, Elisabeth Horak, Ludmila M. Ogorodova, Valery P. Puzyrev, Elena Yu Bragina, Thomas J Hudson, Charles Morin, David L Duffy, Guy B Marks, Colin F Robertson, Grant W Montgomery, Bill Musk, Philip J Thompson, Nicholas G. Martin, Alan James, Patrick Sleiman, Elina Toskala, Elke Rodriguez, Regina Fölster‐Holst, Andre Franke, Wolfgang Lieb, Christian Gieger, Andrea Heinzmann, Ernst Rietschel, Thomas Keil, Sven Cichon, Markus M Nöthen, Craig E Pennell, Peter D Sly, Carsten O Schmidt, Anja Matanovic, Valentin Schneider, Matthias Heinig, Norbert Hübner, Patrick G. Holt, Susanne Lau, Michael Kabesch, Stefan Weidinger, Hakon Hakonarson, Manuel AR Ferreira, Catherine Laprise, Maxim B. Freidin, Jon Genuneit, Gerard H Koppelman, Erik Melén, Marie‐Hélène Dizier, A. John Henderson, Young Ae Lee POSTER DISCUSSION SESSION 4: Food allergy—Anaphylaxis (PD22–PD26) PD22 Atopy patch test in food protein induced enterocolitis caused by solid food Purificacion González‐Delgado, Esther Caparrós, Fernando Clemente, Begoña Cueva, Victoria M. Moreno, Jose Luis Carretero, Javier Fernández PD23 Watermelon allergy: a novel presentation Kate Swan, George Du Toit PD24 A pilot study evaluating the usefulness of a guideline template for managing milk allergy in primary care Mudiyur Gopi, Tim Smith, Edara Ramesh, Arun Sadasivam PD26 Efficacy and safety of cow's milk oral immunotherapy protocol Inês Mota, Filipe Benito Garcia, Susana Piedade, Angela Gaspar, Graça Sampaio, Cristina Arêde, Luís Miguel Borrego, Graça Pires, Cristina Santa‐Marta, Mário Morais‐Almeida POSTER DISCUSSION SESSION 5: Prevention and treatment—Allergy (PD27–PD36) PD27 Allergy‐protection by the lactic acid bacterium Lactococcus lactis G121: mode‐of‐action as revealed in a murine model of experimental allergy Stephanie Brand, Karina Stein, Holger Heine, Marion Kauth PD29 The relationship between quality of life and morning salivary cortisol after acute bronchiolitis in infancy Leif Bjarte Rolfsjord, Egil Bakkeheim, Johan Alm, Håvard Ove Skjerven, Kai‐Håkon Carlsen, Jon Olav Hunderi, Teresa Løvold Berents, Petter Mowinckel, Karin C. Lødrup Carlsen PD30 Randomised trial of the efficacy of MP29‐02* compared with fluticasone propionate nasal spray in children aged ≥6 years to <12 years with allergic rhinitis Ulrich Wahn, Ullrich Munzel, William Berger PD31 10 mg of oral bilastine in 2 to 11 years old children has similar exposure to the adult therapeutic dose (20 mg) Ulrich Wahn, Román Valiente, Valvanera Vozmediano, John C. Lukas, Mónica Rodríguez PD33 Daily symptoms, nocturnal symptoms, activity limitations and reliever therapies during the three steps of IOEASMA programme: a comparison Sebastiano Guarnaccia, Luigi Vitale, Ada Pluda, Emanuele D'Agata, Denise Colombo, Stefano Felici, Valeria Gretter, Susanna Facchetti, Gaia Pecorelli, Cristina Quecchia PD34 Sensitisation to an inert aeroallergen in weaning rats and longstanding disease, in a sensitisation‐tolerant and easily tolerisable rodent strain George Guibas, Evangelia Spandou, Spyridon Megremis, Peter West, Nikolaos Papadopoulos PD35 Bacterial and fungi exposure in school and allergic sensitisation in children João Cavaleiro Rufo, Joana Madureira, Inês Paciência, Lívia Aguiar, Patrícia Padrão, Mariana Pinto, Luís Delgado, Pedro Moreira, João Paulo Teixeira, Eduardo Oliveira Fernandes, André Moreira PD36 Comparative study of allergy rhinitis between two populations: children vs. adults Adriana Izquierdo Dominguez, Antonio Valero, Joaquim Mullol, Alfonso Del Cuvillo, Javier Montoro, Ignacio Jauregui, Joan Bartra, Ignacio Davila, Marta Ferrer, Joaquin Sastre POSTER VIEWING SESSION 1: Inflammation—Genetics—Immunology—Dermatology (PP01–PP09) PP01 Immune profile in late pregnancy: immunological markers in atopic asthmaticwomen as risk factors for atopy in the progeny Catarina Martins, Jorge Lima, Maria José Leandro, Glória Nunes, Jorge Cunha Branco, Hélder Trindade, Luis Miguel Borrego PP02 The impact of neonatal sepsis on development of allergic diseases Secil Conkar, Mehtap Kilic, Canan Aygun, Recep Sancak PP03 Clinical overview of selective IgE deficiency in childhood Athina Papadopoulou, Eleni Tagalaki, Lambros Banos, Anna Vlachou, Fotini Giannoula, Despina Mermiri PP04 Inverse relationship between serum 25(ΟΗ) vitamin D3 and total IgE in children and adolescence Athina Papadopoulou, Stavroula Lampidi, Marina Pavlakou, Maria Kryoni, Kostas Makris PP05 PP06 PP07 Asthma control questionnaire and specific IgE in children Snezhina Lazova, Guergana Petrova, Dimitrinka Miteva, Penka Perenovska PP08 Features of chronic urticaria of adolescents Aliya Klyucharova, Olesya Skorohodkina PP09 Cutaneous mastocytosis in children: a clinical analysis of 8 cases in Greece Dimitra Koumaki, Alkisti Manousaki, Maria Agrapidi, Lida Iatridou, Omima Eruk, Konstantinos Myridakis, Emmanouil Manousakis, Vasiliki Koumaki POSTER VIEWING SESSION 2: Food allergy—Anaphylaxis (PP10–PP47) PP10 Prognostic factors in egg allergy Maria Dimou, Maria Ingemansson, Gunilla Hedlin PP11 Evaluation of the efficacy of an amino acid‐based formula in infants who are intolerant to extensively hydrolysed protein formula Nitida Pastor, Delphine de Boissieu, Jon Vanderhoof, Nancy Moore, Kaitlin Maditz PP12 Anaphylaxis and epinephrine auto‐injector use: a survey of pediatric trainees Adeli Mehdi, Shaza Elhassan, Carolin Beck, Ahmed Al‐Hammadi PP13 Anaphylaxis in children: acute management in the Emergency Department Ioana Maris, Ronan O'Sullivan, Jonathan Hourihane, PP14 Understanding Cumbrian schools preparedness in managing children at risk of anaphylaxis in order to provide training and support which will create healthy and safe environments for children with allergies George Raptis, Louise Michaelis PP15 A new valid and reliable parent and child questionnaire to measure the impact of food protein enterocolitis syndrome on children: the FPIES Quality of Life Questionnaire (FPIESQL), Parent and Child Short Form Audrey DunnGalvin, Matthew Greenhawt, Carina Venter, Jonathan Hourihane PP16 An in‐depth case study investigation of the experiences of teenagers and young adults in growing up and living with food allergy with emphasis on coping, management and risk, support, and social and self‐identity Evelyn O'Regan, Duncan Cronin, Jonathan Hourihane, Anna O'Reilly, Audrey DunnGalvin PP17 Cow's milk protein allergy in Constantine. A retrospective study of 62 cases between 1996 and 2013 Foued Abdelaziz, Dounia Khelifi‐Touhami, Nihad Selim, Tahar Khelifi‐Touhami PP18 PP19 Cow's milk and egg oral immunotherapy in children older than 5 years Pablo Merida, Ana Mª Plaza, Juan Heber Castellanos, Adrianna Machinena, Montserrat Alvaro Lozano, Jaime Lozano, Olga Dominguez, Monica Piquer, Rosa Jimenez, Mª Teresa Giner PP20 Professionals' awareness of management of Cow's Milk Protein Allergy (CMPA) in North Wales Hospitals Konstantinos Kakleas, Manohar Joishy, Wendmu Maskele, Huw R. Jenkins PP21 PP22 Anaphylaxis: the great unknown for teachers. Presentation of a protocol for schools Mercedes Escarrer, Agustín Madroñero, Maria Teresa Guerra, Juan Carlos Julia, Juan Carlos Cerda, Javier Contreras, Eulalia Tauler, Maria Jesus Vidorreta, Ana Rojo, Silvia Del Valle PP23 Challenges facing children with food allergies and their parents in out of school activity sectors Niamh Flynn PP24 A review of food challenges at a Regional Irish Centre Gary Foley, Carol Harmon, John Fitzsimons PP25 The use of epinephrine in infants with anaphylaxis Krasimira Baynova, Ávila Maria Del Robledo, Labella Marina PP26 PP27 PP28 Mother's psychological state predicts the expression of symptoms in food allergic children Aaron Cortes, Alicia Sciaraffia, Angela Castillo PP29 The correlation between sIgE towards tree nuts and birch pollen in a Danish Pediatric Allergy Clinic Nanna Juel‐Berg, Kirsten Skamstrup Hansen, Lars Kærgaard Poulsen PP30 Food allergy in children: evaluation of parents' use of online social media Andreia Florina Nita, Ioana Valentina Nenciu, Adina Lazar, Dumitru Oraseanu PP31 The impact of food allergy on quality of life: FAQLQ questionnaire Rita Aguiar, Anabela Lopes, Maria J. Paes, Amélia S. Santos, M. A. Pereira‐Barbosa PP32 An unexpected cause of anaphylaxis: potato Hatice Eke Gungor, Salih Uytun, Umit Murat Sahiner, Yasemin Altuner Torun PP33 Is it clinical phenotype of allergic diseases determined by sensitisation to food? Mirjana Zivanovic, Marina Atanasković‐Marković PP34 PP35 Prescribing adrenaline auto‐injectors in children in 2014: the data from regional pediatricians Tina Vesel, Mihaela Nahtigal, Andreja Obermayer‐Temlin, Eva Šoster Križnik, Mirjana Maslar, Ruben Bizjak, Marjeta Tomšič‐Matic, Sonja Posega‐Devetak, Maja Skerbinjek‐Kavalar, Mateja Predalič, Tadej Avčin PP36 Who should have an adrenaline autoinjector? Adherence to the European and French guidelines among 121 allergists from the Allergy Vigilance Network Guillaume Pouessel, Etienne Beaudouin, Anne M. Moneret‐Vautrin, Antoine Deschildre, Allergy Vigilance Network PP37 Anaphylaxis by Anacardium Occidentale Marta Viñas, Bartolomé Borja, Nora Hernández, Mª José Castillo, Adriana Izquierdo, Marcel Ibero PP38 Anaphylaxis with honey in a child S. Tolga Yavuz, Ali Gungor, Betul Buyuktiryaki, Ozan Koc, Can Naci Kocabas, Faysal Gok PP39 Evaluation of courses adopted to children on prevention, recognition and management of anaphylaxis Tina Vesel, Mihaela Nahtigal PP40 Symptomatic dust mites and shrimp allergy: three pediatric case reports Filipa Almeida, Susana Lopes, Cristina Madureira, Tânia Lopes, Fernanda Carvalho PP41 Poor identification rates of nuts by high risk individuals: a call for improved education and support for families Camille Heming, Emily Garrett, Adam Blackstock, Santanu Maity, Rahul Chodhari PP42 DAFALL: database of food allergies in the Czech Republic Simona Belohlavkova, Eliska Kopelentova, Petr Visek, Ivana Setinova, Ivana Svarcova PP43 Serological cross‐reactivity between grass and wheat is not only caused by profilins and CCDs Sigrid Sjölander, Nora Nilsson, Malin Berthold, Helena Ekoff, Gunilla Hedlin, Magnus Borres, Caroline Nilsson PP44 Oil body associated proteins in children with nuts allergy. Allergens to consider in IgE‐mediated nuts allergy Loreto González Domínguez, Cristina Muñoz Archidona, Ana Moreira Jorge, Sergio Quevedo Teruel, Teresa Bracamonte Bermejo, Miriam Castillo Fernández, Fernando Pineda de la Losa, Luis Ángel Echeverría Zudaire PP45 PP46 Protective effect of helicobacter pylori infection against food allergy in children Olga Vrani, Antigone Mavroudi, Maria Fotoulaki, Maria Emporiadou, Kleomenis Spiroglou, Ioannis Xinias PP47 Anaphylaxis pathway: A road tryp‐tase to success? Helyeh A. Sadreddini, Mia Warnes, Donna Traves POSTER VIEWING SESSION 3: Miscellaneous (PP48–PP58) PP48 Surveillance study on safety of SLIT in pediatric population Ivana Djuric‐Filipovic, Zorica Zivkovic, Snežana Zivanovic, Gordana Kostić, Đorđe Filipovic PP49 Efficacy and safety of mixed mite subcutaneous immunotherapy among allergic rhinitis patients in the Northeastern Thailand Sawapon Sittisomwong, Siripong Sittisomwong PP50 Effect of inhaled beclomethasone or placebo on brain stem activity in a patient chronically treated with steroids: preliminary report Zygmunt Podolec, Marcin Hartel, Daria Panek, Magdalena Podolec‐Rubiś, Tomasz Banasik PP51 Sensitisation to aeroallergens in patients with allergic rhinitis, asthma and atopic dermatitis in Shiraz, Southwestern Iran Elham Abbasi, Mozhgan Moghtaderi PP52 Referring a child for allergy test: how appropriate are we? Phani Sanneerappa, Alina Deliu, Moosa Kutty, Nagabathula Ramesh PP53 EBV lymphoproliferative disease and cardiac lymphoma in a STK4 deficient patient Roya Sherkat, Mohammad Reza Sabri, Bahar Dehghan, Hamid Bigdelian, Nahid Raeesi, Mino Afshar, Hamid Rahimi, Christoph Klein PP54 A case study: the effect of massive honeybees attack on various body parameters atopic girl including allergy Mohemid Al‐Jebouri PP55 The role of TLR9, NLRP3 and proIL‐1β in activation of antiviral innate immunity Oxana A. Svitich, Daria O. Zubacheva, Dmitrii A. Potemkin, Ludmila V. Gankovskaya, Vitalii V. Zverev PP56 Overnight pulse oximetry, as a screening tool to diagnose obstructive sleep apnoea. How effective is it? Phani Sanneerappa, Elaine OB Doyle, Paul Gallagher, Nagabathula Ramesh PP57 The presentation and management of acute urticaria and allergic reactions in children in a multi‐ethnic, inner city Emergency Department (ED) Sherine Dewlett, Kin Man, Minal Gandhi, James Pocock, Anna Gerrardhughes PP58 Food allergens responsible for delayed‐type sensitisation in atopy patch test in children diagnosed with autism spectrum disorder Jolanta Wasilewska, Maciej Kaczmarski, Dariusz Lebensztejn POSTER VIEWING SESSION 4: Asthma—Rhinitis (PP59–PP87) PP59 Systematic review of incense as a trigger factor for asthma Chandramani Thuraisingham, Davendralingam Sinniah PP60 Increased risks of mood and anxiety disorders in children with asthma Yue Chen, Xiaomei Mei PP61 PP62 Asthma Control Test (ACT) and Pediatric Asthma Quality of Life Questionnaire (PAQLQ) association in children Sebnem Ozdogan, Pinar Karadeniz, Durdugul Ayyildiz‐Emecen, Ummuhan Oncul PP63 Seasonal and gender variations in vitamin D levels in children with asthma and its association with pulmonary function tests Sebnem Ozdogan, Gizem Sari, Sabanur Cavdar PP64 Defining treatment response in childhood asthma: rationale and design of the Pharmacogenomics in the Childhood Asthma (PiCA) consortium Niloufar Farzan, Susanne J. Vijverberg, Colin J. Palmer, Kelan G. Tantisira, Anke‐Hilseon Maitland‐van der Zee behalf of the PiCA consortium PP65 Prevalence of asthma and allergic disease in patients with inflammatory disease compared to celiac disease Fatma Yavuzyilmaz, Sebnem Ozdogan, Nafiye Urganci, Merve Usta PP66 A severe case with cystic fibrosis (CF) asthma Mehmet Hoxha, Maksim Basho PP67 Severe asthma exacerbation complicated with pneumothorax in a child with uncontrolled asthma due to poor treatment compliance Ioana Valentina Nenciu, Andreia Florina Nita, Adina Lazar, Alexandru Ulmeanu, Carmen Zapucioiu, Dumitru Oraseanu PP68 Evaluation of the Pediatric Quality of Life inventory (PedsQL) asthma module among low income asthmatic children and adolescents in Sao Paolo, Brazil Gustavo F. Wandalsen, Fernanda Monteiro, Dirceu Solé PP69 Early initiation of specific immunotherapy in asthma patients leads to higher benefits Blerta Lame, Eris Mesonjesi, Arjeta Sherri PP70 Treatment resistant asthma and rhinosinusitis with recurrent pulmonary infections. Is it primary ciliary dyskinesia? Alkerta Ibranji, Laert Gjati, Gjustina Loloci, Ardii Bardhi PP71 The comparison of sensitisation to animal allergens in children‐ and adult‐ onset patients with asthma Behnam Moghtaderi, Shirin Farjadian, Dorna Eghtedari PP72 Characterisation of children less than five years with wheezing episodes in Cali, Colombia Manuela Olaya, Laura Del Mar Vasquez, Luis Fernando Ramirez, Carlos Daniel Serrano PP73 Evaluation of the patients with recurrent croup Belgin Usta Guc, Suna Asilsoy, Fulya Ozer PP74 Obesity in adolescence compromising the asthma control Guergana Petrova, Sylvia Shopova, Vera Papochieva, Snezhina Lazova, Dimitrinka Miteva, Penka Perenovska PP75 Sleep behavior in children with persistent allergic rhinitis Gustavo F. Wandalsen, Jessica Loekmanwidjaja, Márcia Mallozi, Dirceu Solé PP76 Randomised trial of the safety of MP29‐02* compared with fluticasone propionate nasal spray in children aged ≥4 years to <12 years with allergic rhinitis William Berger, Ulrich Wahn, Paul Ratner, Daniel Soteres PP77 Safety and tolerability evaluation of bilastine 10 mg in children from 2 to 11 years of age with allergic rhinoconjunctivitis or urticaria Zoltán Novák, Anahí Yáñez, Kiss Ildikó, Piotr Kuna, Miguel Tortajada, Román Valiente, the Bilastine Pediatric Safety Study Group PP78 Sensitisation to Alternaria alternata: Is it a risk factor for severe rhinitis? Susana Lopes, Filipa Almeida, Tânia Lopes, Cristina Madureira, José Oliveira, Fernanda Carvalho PP79 Validation of the Patient Benefit Index (PBI) for the assessment of patient‐related outcomes in allergic rhinitis in children Julia Feuerhahn, Christine Blome, Meike Hadler, Efstrathios Karagiannis, Anna Langenbruch, Matthias Augustin PP80 Efficacy of sublingual tablet of house dust mite allergen extracts in adolescents with house dust mite‐associated allergic rhinitis Michel Roux, Shinji Kakudo, Efstrathios Karagiannis, Robert K. Zeldin PP81 Lung function improvement in a child treated with omalizumab for bronchial asthma Anna Sokolova, Tiago Milheiro Silva PP82 How to treat a child suffering from asthma, allergic rhinitis, allergy to peanuts and diabetes at the same time? Snezana S. Zivanovic, Vesna Cvetkovic, Ivana Nikolic, Sonja J. Zivanovic PP83 Nitric oxide in exhaled air in the relationship of the degree of sensitisation to aeroallergens Snezana S. Zivanovic, Ljiljana Saranac, Ivana Nikolic, Sonja J. Zivanovic, Zorica Zivkovic PP84 Clinical basis of diagnostic errors in pediatric asthma Zoia Nesterenko PP85 PP86 Childhood asthma control in Serbia and organised Asthma Educational Intervention (AEI) Snezana Radic, Branislava Milenkovic, Spomenka Smiljanic, Milka Micic‐Stanijevic, Olivera Calovic PP87 Experience from a group of adolescents with severe allergic asthma treated with Omalizumab Anne Marie Bro Hofbauer, Lone Agertoft THEMATIC POSTER SESSION 1: Prevention and Treatment—Epidemiology (TP01–TP18) TP01 A cost effective primary school asthma education program: pilot study from inner London schools Lucy Everson, Jessica Kearney, Jonny Coppel, Simon Braithwaite, Rahul Chodhari TP02 The prevalence of allergic diseases among 14–15 years old adolescents in two Danish birth cohorts 14 years apart Elisabeth S. Christiansen, Henrik Fomsgaard Kjaer, Esben Eller, Charlotte G. Mørtz, Susanne Halken TP03 Does pattern of sensitisation to phleum pratense change with age? Is it different in children with allergic rhinitis or asthma? Cristina Román India, Ana Moreira Jorge, Loreto González Domínguez, Cristina Muñoz Archidona, Sergio Quevedo Teruel, Teresa Bracamonte Bermejo, Juana Jiménez Jiménez, Luis Echeverría Zudaire TP04 Practicalities of prevention of peanut allergy: modelling a national response to LEAP Cathal O'Connor, Jonathan Hourihane TP05 Comparison of the influence of sunflower seed oil and skin care lotion on the skin barrier function of newborns: a randomised controlled trial Varvara Kanti, Lena Lünnemann, Günther Malise, Laine Ludriksone, Andrea Stroux, Wolfgang Henrich, Michael Abu‐Dakn, Ulrike Blume‐Peytavi, Natalie Garcia Bartels TP06 The effect of daily skin care on skin barrier properties in infants with dry skin and risk for atopic dermatitis Varvara Kanti, Lena Lünnemann, Laine Ludriksone, Marianne Schario, Andrea Stroux, Ulrike Blume‐Peytavi, Natalie Garcia Bartels TP07 Change in sum total aeroallergen skin prick test wheal diameters at 6 months predicts which children will respond to subcutaneous immunotherapy by three years Thorsten Stanley, Nicolien Brandenbarg TP08 Are mobile apps regarding adrenaline auto‐injectors accessed by adolescents for support and education in the community? Alia Boardman, Gary McGreevy, Emily Rodger, Katherine Knight, Victoria Timms, Trisha Taylor, Gemma Scanlan, Roisin Fitzsimons TP09 TP10 Prevention of early atopic dermatitis among low‐atopy‐risk infants by immunoactive prebiotics is not sustained after the first year of life Grüber Christoph, Ulrich Wahn, Margriet van Stuivenberg, Fabio Mosca, Guido Moro, Gaetano Chirico, Christian P. Braegger, Joseph Riedler, Yalcin Yavuz, Günther Boehm TP11 TP12 TP13 Treatment with Omalizumab in a 16‐year‐old Caucasian girl with refractory solar urticaria Stefania Arasi, Giuseppe Crisafulli, Lucia Caminiti, Federica Porcaro, Giovanni Battista Pajno TP14 Ultra‐pure soft water ameliorates skin conditions of adult and child patients with atopic dermatitis Akane Tanaka, Yaei Togawa, Kumiko Oida, Naotomo Kambe, Peter Arkwright, Yosuke Amagai, Naoki Shimojo, Yasunori Sato, Hiroyuki Mochizuki, Hyosun Jang, Saori Ishizaka, Hiroshi Matsuda TP15 Potential adjuvant effect of immunomodulator to improve specific immunotherapy in asthmatic child Wisnu Barlianto, Ery Olivianto, H. M. S. Chandra Kusuma TP16 How can Component Resolved Diagnosis (CRD) influence in Specific Immunotherapy (SIT) prescription, in a Spanish children population Ana Moreira Jorge, Cristina Román India, Loreto González Domínguez, Cristina Muñoz Archidona, Juana Jiménez Jiménez, Teresa Bracamonte Bermejo, Sergio Quevedo Teruel, Luis Echeverría Zudaire TP17 Mitochondrial dysfunction in food allergy: effects of L. rhamnosus GG in a mice model of peanut allergy Rosita Aitoro, Mariapia Mollica, Roberto Berni Canani, Giovanna Trinchese, Elena Alfano, Antonio Amoroso, Lorella Paparo, Francesco Amato, Claudio Pirozzi, Antonio Calignano, Rosaria Meli TP18 Prediction of atopic diseases in childhood: elevated blood eosinophils in infancy in a high risk birth cohort Siri Rossberg, Kerstin Gerhold, Kurt Zimmermann, Mohammad Zaino, Thomas Geske, Eckard Hamelmann, Susanne Lau THEMATIC POSTER SESSION 2: Food allergy—Anaphylaxis (TP19–TP38) TP19 TP20 TP21 Double‐blind provocation tests in non‐IgE mediated cow's milk allergy and the occurrence of placebo reactions Sarah Bogovic, Jochem van den Berg, Chantal Janssen TP22 Gradual introduction of baked egg (BE) in egg allergic patients under 2 years old Angela Claver TP23 Randomised controlled trial of SOTI with raw hen's egg in children with persistent egg allergy I: safety and efficacy of daily vs. weekly protocols of induction Mª Flor Martin‐Muñoz, C. Martorell, M. T. Belver, E. Alonso Lebrero, L. Zapatero, V. Fuentes, M. Piqué, A. Plaza, C. Muñoz, A. Martorell, Cristina Blasco, B. Villa, C. Gómez, S. Nevot, J. M. García, L. Echeverria TP24 Randomised controlled trial of SOTI with raw hen's egg in children with persistent egg allergy II: a randomised controlled trial to study a safer, more effective and easy to perform maintenance (daily vs. every two days) pattern of egg SOTI Mª Flor Martin‐Muñoz, C. Martorell, M. T. Belver, E. Alonso Lebrero, L. Zapatero, V. Fuentes, M. Piqué, A. Plaza, C. Muñoz, A. Martorell, Cristina Blasco, B. Villa, C. Gómez, S. Nevot, J. M. García, L. Echeverria TP25 Determining the safety of baked egg home reintroduction for children with mild egg allergy Brenda DeWitt, Judith Holloway, Donald Hodge TP26 Demographics, investigations and patterns of sensitisation in children with oral allergy syndrome in a London Teaching Hospital Sian Ludman, Merhdad Jafari‐Mamaghani, Rosemary Ebling, Adam T. Fox, Gideon Lack, George Du Toit TP27 Airborne peanut challenge in children: allergic reactions are rare Sofia Lovén Björkman, Caroline Nilsson, Natalia Ballardini TP28 The nutty question on Pediatric Wards: to be or "nut" to be? Supriyo Basu, Jenny Hallet, Jyothi Srinivas TP29 TP30 TP31 Allergy education in nursery schools Hazel Stringer, Nicola Jay TP32 Food allergy in the first year of life Tânia Lopes, Cristina Madureira, Filipa Almeida, Susana Lopes, Paula Fonseca, Clara Vieira, Fernanda Carvalho TP33 Prevalence and geographic distribution of oral allergy syndrome in Italian children: a multicenter study Carla Mastrorilli, Carlo Caffarelli, Riccardo Asero, Salvatore Tripodi, Arianna Dondi, Gianpaolo Ricci, Carlotta Povesi Dascola, Elisabetta Calamelli, Francesca Cipriani, Andrea Di Rienzo Businco, Annamaria Bianchi, Paolo Candelotti, Tullio Frediani, Carmen Verga, Paolo Maria Matricardi TP34 Are common standardised allergen extracts used in skin test enough in the diagnosis of nuts allergy? Cristina Muñoz Archidona, Loreto González Domínguez, Ana Moreira Jorge, Sergio Quevedo Teruel, Teresa Bracamonte Bermejo, Miriam Castillo Fernández, Fernando Pineda de la Losa, Luis Ángel Echeverría Zudaire TP35 Evaluation of IgE sensitisation in children with allergic proctocolitis and its relationship to atopic dermatitis Despina Mermiri, Paraskevi Korovessi, Skevi Tiliakou, Evaggelia Tavoulari, Kalliopi‐Maria Moraiti, Fotini Giannoula, Athina Papadopoulou TP36 Food allergy in children: are we managing them appropriately in the Emergency Department? Wan Jean Tee, Samir Deiratany, Raymond Seedhoo, Roisin McNamara, Ike Okafor TP37 Importance of oil body associated allergenic proteins in nuts suspected allergy children Loreto González Domínguez, Ana Moreira Jorge, Cristina Muñoz Archidona, Teresa Bracamonte Bermejo, Sergio Quevedo Teruel, Fernando Pineda de la Losa, Miriam Castillo Fernández, Luis Ángel Echeverría Zudaire TP38 Practical application of basophil activation test in children with food allergy Ekaterina Khaleva, Gennady Novic, Natalia Bychkova THEMATIC POSTER SESSION 3: Asthma (TP39–TP57) TP39 Effect of corticosteroid therapy upon serum magnesium level in chronic asthmatic children Amany Abd Al‐Aziz, Amany Fatouh, Ayat Motawie, Eman El Bostany, Amr Ibrahim TP40 ADAM33 in Bulgarian children with asthma Guergana Petrova, Dimitrinka Miteva, Snezhina Lazova, Penka Perenovska, Sylvia Andonova, Alexey Savov TP41 TP42 The impact of vitamin D serum levels in asthma and allergic rhinitis Maria Zoto, Marialena Kyriakakou, Paraskevi Xepapadaki, Nikolaos G. Papadopoulos TP43 Life‐threatening, first reported, paradoxical bronchospasm after nebulised Salbutamol in a 10 year old child Paraskevi Korovessi, Mariza Vassilopoulou, Athina Balaska, Lambros Banos, Stavroula Kostaridou, Despina Mermiri TP44 TP45 Asthma symptoms in children with treatment for allergic rhinoconjunctivitis Jorien Wartna, Arthur M. Bohnen, Gijs Elshout, David H. J. Pols, Patrick J. E. Bindels Erasmus MC, Rotterdam, The Netherlands TP46 Atopy increased the risk of developing exercise‐induced bronchoconstriction in young athletes Sven F. Seys; Ellen Dilissen, Sarah Van der Eycken, An‐Sofie Schelpe, Gudrun Marijsse, Thierry Troosters, Vincent Vanbelle, Sven Aertgeerts, Jan L. Ceuppens, Lieven J. Dupont, Koen Peers, Dominique M. Bullens TP47 The effect of higher BMI on risk for asthma and treatment outcome in overweight and obese children Ivana Banic, Sandra Bulat Lokas, Jelena Zivkovic, Boro Nogalo, Iva Mrkic Kobal, Davor Plavec, Mirjana Turkalj TP48 TP49 TP50 TP51 TP52 The impact of a multidisciplinary project intended to change the culture of nebulisers towards pressurised metered dose inhalers Georgeta Oliveira, Katharine Pike, Alda Melo, Tomás Amélia, José Carlos Cidrais Rodrigues, Cristina Serrano, José Manuel Lopes dos Santos, Carla Lopes TP53 TP54 TP55 TP56 Increased asthma control in patients with severe persistent allergic asthma after 12 month of nightly temperature controlled laminar airflow (TLA) Eckard Hamelmann, Uwe Schauer, Karl‐Christian Bergmann TP57 THEMATIC POSTER SESSION 4: Drug allergy—Dermatology (TP58–TP77) TP58 Should we proceed directly to provocation challenges to diagnose drug allergy? Our experience says yes Luis Moral, Teresa Toral, Nuria Marco, Beléns García Avilés, Mª Jesús Fuentes, Jesús Garde, Cristina Montahud, Javier Perona, Mª José Forniés TP59 Anaphylaxis to 13‐valent pneumococcal vaccine Esozia Arroabarren, Marta Anda, Maria Luisa Sanz, Maria Teresa Lizaso, Candida Arregui TP60 Intrapartum antibiotic exposure for treatment of group B streptococcus was not associated with the development of penicillin allergy in children Sara May, Martha Hartz, Avni Joshi, Miguel A. Park TP61 Evaluation of suspected drug hypersensitivity reactions in 169 children referred to the General Hospital Sonja Posega Devetak, Tina Vesel, Anja Koren Jeverica, Tadej Avčin TP62 Drug provocation testing: experience of a tertiary hospital Leonor Castro, Carolina Gouveia, Ana Carvalho Marques, Antonio Jorge Cabral TP63 Perioperative anaphylaxis: a growing concern in pediatric population Luis Amaral, Fabrícia Carolino, Eunice Castro, Madalena Passos, Josefina R. Cernadas TP64 Raising awareness of hypersensitivity to non‐steroidal anti‐inflammatory drugs in the pediatric age Fabrícia Carolino, Luís Amaral, Eunice Dias de Castro, Josefina R. Cernadas TP65 Perioperative anaphylaxis in young children: how to confirm the suspicion Josefina R. Cernadas, Fabrícia Carolino, Luís Amaral, Fernando Pineda, Armanda Gomes TP66 A case study of a child suspected to be penicillin allergic‐digging deeper Katherine Knight, Roisin Fitzsimons, Helen Brough TP67 Prevalence, characteristics and risk factors of hypersensitivity reactions to antibiotics in patients with cystic fibrosis Jobst Röhmel, Carsten Schwarz, Anne Mehl, Philippe Stock, Doris Staab TP68 Antibiotic drug hypersensitivity in cystic fibrosis: A pilot study using cellular allergy tests for diagnostics Jobst Röhmel, Carsten Schwarz, Christine Seib, Doris Staab, Philippe Stock TP69 Oral antibiotics challenges in children Anita Critchlow, Alyson Barber, Nicola Jay TP70 Hypersensitivity reaction to vancomycin: a new successful desensitization protocol Belen Delavalle, Teresa Garriga, Blanca Vilá, Cristina Blasco TP71 TP72 Clinical phenotypes according to FLG gene loss of function mutations in children with atopic dermatitis Francesca Cipriani, Annalisa Astolfi, Costanza Di Chiara, Elisabetta Calamelli, Iria Neri, Annalisa Patrizi, Gianpaolo Ricci TP73 TP74 Urticaria in children: clinical and epidemiological features Katerina Neskorodova, Asya Kudryavtseva TP75 TP76 Acute urticaria at the Pediatrics Emergency Department: is it allergy? Esozia Arroabarren, Jorge Alvarez, Marta Anda, Miriam Palacios, Marta Martinez‐Merino, Ibone Vaquero TP77 [ABSTRACT FROM AUTHOR]

HYPERTROPHIC pyloric stenosis, ERYTHROMYCIN, SYSTEMATIC reviews, META-analysis, CHILD patients, and DISEASE risk factors

Purpose: Macrolide antibiotics, erythromycin, in particular, have been linked to the development of infantile hypertrophic pyloric stenosis (IHPS). Our aim was to conduct a systematic review of the evidence of whether post-natal erythromycin exposure is associated with subsequent development of IHPS.Methods: A systematic review of postnatal erythromycin administration and IHPS was performed. Papers were included if data were available on development (yes/no) of IHPS in infants exposed/unexposed to erythromycin. Data were meta-analysed using Review Manager 5.3. A random effects model was decided on a priori due to heterogeneity of study design; data are odds ratio (OR) with 95 % CI.Results: Nine papers reported data suitable for analysis; two randomised controlled trials and seven retrospective studies. Overall, erythromycin exposure was significantly associated with development of IHPS [OR 2.45 (1.12-5.35), p = 0.02]. However, significant heterogeneity existed between the studies (I 2 = 84 %, p < 0.0001). Data on erythromycin exposure in the first 14 days of life was extracted from 4/9 studies and identified a strong association between erythromycin exposure and subsequent development IHPS [OR 12.89 (7.67-2167), p < 0.00001].Conclusion: This study demonstrates a significant association between post-natal erythromycin exposure and development of IHPS, which seems stronger when exposure occurs in the first 2 weeks of life. [ABSTRACT FROM AUTHOR]

SYMMETRY (Physics), INVARIANT measures, DE Bruijn graph, ENTROPY, and LATTICE constants

We investigate the following questions: Given a measure $$\mu _\Lambda $$ on configurations on a subset $$\Lambda $$ of a lattice $$\mathbb {L}$$ , where a configuration is an element of $$\Omega ^\Lambda $$ for some fixed set $$\Omega $$ , does there exist a measure $$\mu $$ on configurations on all of $$\mathbb {L}$$ , invariant under some specified symmetry group of $$\mathbb {L}$$ , such that $$\mu _\Lambda $$ is its marginal on configurations on $$\Lambda $$ ? When the answer is yes, what are the properties, e.g., the entropies, of such measures? Our primary focus is the case in which $$\mathbb {L}=\mathbb {Z}^d$$ and the symmetries are the translations. For the case in which $$\Lambda $$ is an interval in $$\mathbb {Z}$$ we give a simple necessary and sufficient condition, local translation invariance ( LTI), for extendibility. For LTI measures we construct extensions having maximal entropy, which we show are Gibbs measures; this construction extends to the case in which $$\mathbb {L}$$ is the Bethe lattice. On $$\mathbb {Z}$$ we also consider extensions supported on periodic configurations, which are analyzed using de Bruijn graphs and which include the extensions with minimal entropy. When $$\Lambda \subset \mathbb {Z}$$ is not an interval, or when $$\Lambda \subset \mathbb {Z}^d$$ with $$d>1$$ , the LTI condition is necessary but not sufficient for extendibility. For $$\mathbb {Z}^d$$ with $$d>1$$ , extendibility is in some sense undecidable. [ABSTRACT FROM AUTHOR]

DISEASE prevalence, LIVER diseases, HEPATITIS D virus, MIXED infections, and LIVER transplantation

Objective: The study aimed to evaluate the prevalence and predictor factors for compensated advanced chronic liver disease (c-ACLD) in patients with hepatitis Delta virus (HDV) infection. Methods: This cross-sectional study included consecutive HDV-infected patients defined by positive anti-HDV. Patients with hepatitis C coinfection, liver transplantation or presence of conditions that limit liver (LSM) or spleen stiffness measurement (SSM) were excluded. Blood tests, abdominal ultrasound, SSM and LSM by transient elastography (FibroScan®) were performed at the same day. Alcohol consumption was quantified using the AUDIT score and c-ACLD was defined by LSM ≥ 15 kPa performed by an experimented operator blinded for clinical and laboratory data. Results: 101 patients were eligible and few patients were excluded due to negative anti-HDV (n = 7), hepatitis C coinfection (n = 2), liver transplantation (n = 10) and limitation for LSM or SSM (n = 5). Therefore, 77 patients [61% male, age = 43 (IQR,36–52) years] were included. The prevalence of c-ACLD was 57% (n = 44/77). Patients with c-ACLD had a higher rate of detectable HBV viral load (p = 0.039), higher levels of transaminases, GGT, alkaline phosphatases, total bilirubin and INR (p<0.001 for all), as well as lower platelet count and albumin levels (p>0.001 for both) compared to those without c-ACLD. Patients with c-ACLD had higher SSM [65.2 (IQR,33.8–75.0) vs 21.8 (16.5–32.0) kPa; p<0.001] and higher splenic volume [475 (IQR,311–746) vs 154 (112–283) cm3; p<0.001] compared to those without. Detectable HBV viral load (>10 UI/ml), alkaline phosphatase (per IU/L) and GGT levels (per IU/L) were independently associated with c-ACLD in all multivariate models. Splenic volume [per cm3,OR = 1.01 (95%CI,1.01–1.02);p = 0.002], SSM [per kPa, OR = 1.04 (1.01–1.07);p = 0.012] and splenomegaly [yes vs no,OR = 28.45 (4.42–182.95);p<0.001] were independently associated with c-ACLD. Conclusions: The prevalence of c-ACLD was high in patients with chronic HDV infection in western Amazon basin. HBV viral load, liver enzymes and splenic features can be used to predict severe liver disease in HDV-infected patients. [ABSTRACT FROM AUTHOR]

B cell receptors, KINASE inhibitors, HODGKIN'S disease, CELL culture, and ANTINEOPLASTIC agents

Background: Pharmacological inhibition of B cell receptor (BCR) signaling has recently emerged as an effective approach in a wide range of B lymphoid neoplasms. However, despite promising clinical activity of the first Bruton's kinase (Btk) and spleen tyrosine kinase (Syk) inhibitors, a small fraction of patients tend to develop progressive disease after initial response to these agents. Methods: We evaluated the antitumor activity of IQS019, a new BCR kinase inhibitor with increased affinity for Btk, Syk, and Lck/Yes novel tyrosine kinase (Lyn), in a set of 34 B lymphoid cell lines and primary cultures, including samples with acquired resistance to the first-in-class Btk inhibitor ibrutinib. Safety and efficacy of the compound were then evaluated in two xenograft mouse models of B cell lymphoma. Results: IQS019 simultaneously engaged a rapid and dose-dependent de-phosphorylation of both constitutive and IgM-activated Syk, Lyn, and Btk, leading to impaired cell proliferation, reduced CXCL12-dependent cell migration, and induction of caspase-dependent apoptosis. Accordingly, B cell lymphoma-bearing mice receiving IQS019 presented a reduced tumor outgrowth characterized by a decreased mitotic index and a lower infiltration of malignant cells in the spleen, in tight correlation with downregulation of phospho-Syk, phospho-Lyn, and phospho-Btk. More interestingly, IQS019 showed improved efficacy in vitro and in vivo when compared to the first-in-class Btk inhibitor ibrutinib, and was active in cells with acquired resistance to this latest. Conclusions: These results define IQS019 as a potential drug candidate for a variety of B lymphoid neoplasms, including cases with acquired resistance to current BCR-targeting therapies. [ABSTRACT FROM AUTHOR]