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With the advent of special education in Brazil boosted by the Salamanca Declaration (1994), some theoretical positions presented themselves, such as the full inclusion of persons with disabilities in ordinary schools and the inclusion from the look from the perspective of the development of higher psychological functions (VYGOTSKY, 1997). In addition, there are other theoretical positions and intermediate educational practices aimed at organic conditions of students with disabilities and to the possibilities of integration of those more committed in relation to disability in specialized education centers. From these considerations is that aims to understand the contributions of the authors of 12 articles of the Brazilian Journal of Special Education (RBEE) on special education in higher education, as well as the prospects for the students of special education target audience (PAEE) that enters the higher education. The qualitative approach, from the perspective of Cultural-historical. Psychology, has guided the analysis of these RBEE productions, in the period from 2010 to 2014. As a result it was found that the students who reach the PAEE higher education face difficulties through veiled prejudice, physical accessibility, inadequate curriculum, among others. It can be concluded that the inclusion of students PAEE lacks attention, since Kindergarten, with educational work guided in developing their higher psychological functions, so you can overcome the barriers located at all levels of schooling, so as to contribute to not only reach to higher education, but also (and especially) that come out with knowledge. [ABSTRACT FROM AUTHOR]

The evaluation of thermal maturity of Lower Paleozoic sedimentary rocks is somewhat complex, mainly because of the absence of humic vitrinite maceral material. Various sedimentary basins of this age contain a syndepositional vitrinite-like maceral that resembles vitrinite but has a lower reflectance. Samples of shales from outcrops and boreholes from the Ponta Grossa Formation (Middle Devonian or older) in the Paraná Basin were studied for maturation assessment. Hydrous pyrolysis assays were conducted for 27 combinations of time and temperature to compare the reflectances of the vitrinite-like maceral and humic vitrinite in response to increasing temperature and time. This data confirmed that the maturation pathway of the vitrinite-like maceral is lower than that of humic vitrinite. The Spore Coloration Index for the outcrop samples was also evaluated for natural series studies. The combination of the natural and artificial series led to the development of two-stage linear regression equations that estimate the equivalent vitrinite reflectance values from measured vitrinite-like maceral reflectances. To validate the proposed equations, reported measurements of vitrinite-like maceral reflectances from sedimentary basins in China, North America and Europe were selected from the literature for comparison. The validations showed that the values obtained from the proposed equations correlated well with other maturity parameters. [ABSTRACT FROM AUTHOR]

Vitrinite reflectance generally is considered the most robust thermal maturity parameter available for application to hydrocarbon exploration and petroleum system evaluation. However, until 2011 there was no standardized methodology available to provide guidelines for vitrinite reflectance measurements in shale. Efforts to correct this deficiency resulted in publication of ASTM D7708: Standard test method for microscopical determination of the reflectance of vitrinite dispersed in sedimentary rocks . In 2012–2013, an interlaboratory exercise was conducted to establish precision limits for the D7708 measurement technique. Six samples, representing a wide variety of shale, were tested in duplicate by 28 analysts in 22 laboratories from 14 countries. Samples ranged from immature to overmature (0.31–1.53% R o ), from organic-lean to organic-rich (1–22 wt.% total organic carbon), and contained Type I (lacustrine), Type II (marine), and Type III (terrestrial) kerogens. Repeatability limits (maximum difference between valid repetitive results from same operator, same conditions) ranged from 0.03 to 0.11% absolute reflectance, whereas reproducibility limits (maximum difference between valid results obtained on same test material by different operators, different laboratories) ranged from 0.12 to 0.54% absolute reflectance. Repeatability and reproducibility limits degraded consistently with increasing maturity and decreasing organic content. However, samples with terrestrial kerogens (Type III) fell off this trend, showing improved levels of reproducibility due to higher vitrinite content and improved ease of identification. Operators did not consistently meet the reporting requirements of the test method, indicating that a common reporting template is required to improve data quality. The most difficult problem encountered was the petrographic distinction of solid bitumens and low-reflecting inert macerals from vitrinite when vitrinite occurred with reflectance ranges overlapping the other components. Discussion among participants suggested this problem could not be easily corrected via kerogen concentration or solvent extraction and is related to operator training and background. No statistical difference in mean reflectance was identified between participants reporting bitumen reflectance vs. vitrinite reflectance vs. a mixture of bitumen and vitrinite reflectance values, suggesting empirical conversion schemes should be treated with caution. Analysis of reproducibility limits obtained during this exercise in comparison to reproducibility limits from historical interlaboratory exercises suggests use of a common methodology (D7708) improves interlaboratory precision. Future work will investigate opportunities to improve reproducibility in high maturity, organic-lean shale varieties. [ABSTRACT FROM AUTHOR]

This paper presents results of an interlaboratory exercise on organic matter optical maturity parameters using a natural maturation series comprised by three Devonian shale samples (Huron Member, Ohio Shale) from the Appalachian Basin, USA. This work was conducted by the Thermal Indices Working Group of the International Committee for Coal and Organic Petrology (ICCP) Commission II (Geological Applications of Organic Petrology). This study aimed to compare: 1. maturation predicted by different types of petrographic parameters (vitrinite reflectance and spectral fluorescence of telalginite), 2. reproducibility of the results for these maturation parameters obtained by different laboratories, and 3. improvements in the spectral fluorescence measurement obtained using modern detection systems in comparison with the results from historical round robin exercises. Mean random vitrinite reflectance measurements presented the highest level of reproducibility (group standard deviation 0.05) for low maturity and reproducibility diminished with increasing maturation (group standard deviation 0.12). Corrected fluorescence spectra, provided by 14 participants, showed a fair to good correspondence. Standard deviation of the mean values for spectral parameters was lowest for the low maturity sample but was also fairly low for higher maturity samples. A significant improvement in the reproducibility of corrected spectral fluorescence curves was obtained in the current exercise compared to a previous investigation of Toarcian organic matter spectra in a maturation series from the Paris Basin. This improvement is demonstrated by lower values of standard deviation and is interpreted to reflect better performance of newer photo-optical measuring systems. Fluorescence parameters measured here are in good agreement with vitrinite reflectance values for the least mature shale but indicate higher maturity than shown by vitrinite reflectance for the two more mature shales. This red shift in λmax beyond 0.65% vitrinite reflectance was also observed in studies of Devonian shale in other basins, suggesting that the accepted correlation for these two petrographic thermal maturity parameters needs to be re-evaluated. A good linear correlation between λmax and Tmax for this maturation series was observed and λmax 600nm corresponds to Tmax of 440°C. Nevertheless if a larger set of Devonian samples is included, the correlation is polynomial with a jump in λmax ranging from 540 to 570nm. Up to 440°C of Tmax, the λmax, mostly, reaches up to 500nm; beyond a Tmax of 440°C, λmax is in the range of 580-600nm. This relationship places the "red shift" when the onset of the oil window is reached at Tmax of 440°C. Moreover, the correlation between HI and λmax (r²=0.70) shows a striking inflection and decrease in HI above a λmax of 600nm, coincident with the approximate onset of hydrocarbon generation in these rocks. [ABSTRACT FROM AUTHOR]

Neospora caninum is considered in many countries as one of the key abortion agents in cattle. This study aims to investigate the parasite behavior in dairy cattle in the municipality of Avaré, SP, Brazil, where abortions frequently occur. An ELISA was performed to compare two samplings on a total of 615 animals; tests were performed in the same herds with a gap of 3 years. An increase in the percentage of reactive animals was observed, ranging from 21.6% at the first sampling to 38.9% at the second sampling. Of the 176 animals tested at both samplings, 61.93% retained a non-reactive status, 15.9% retained a reactive status, 19.88% switched from non-reactive to reactive and 2.27% switched from reactive to non-reactive. Of the 100 animals with reproductive disturbances, 50% presented anti- Neospora antibodies, thereby indicating the presence of the protozoa. When comparing cows and their respective female offspring, a predominance of horizontal infection was observed. Moreover, considering the significant percentage of animals that switched from non-reactive to reactive and the abundant presence of dogs among the herds, the N. caninum transmission may be attributed to presence of carnivores. [ABSTRACT FROM AUTHOR]

Abstract: From a fundamental point of view, the family of compounds known as phosphorus oxoacids is among the most intriguing proton conducting systems. Two of its members, phosphoric (H3PO4) and phosphonic (H3PO3) acid, show the highest known intrinsic proton conductivities. However, little is known about the last member, phosphinic acid (H3PO2), that completes this series and could provide a fundamental insight into the relationship between proton transport and the other properties of the hydrogen bond network. Here we present the results of a proton conductivity and diffusion study of molten nominally dry phosphinic acid (H3PO2) by 1H PFG-NMR (Pulsed Magnetic Field Gradient Nuclear Magnetic Resonance) and AC impedance spectroscopy. While the general features of proton transport in H3PO2 share some similarities to those of H3PO4 and H3PO3, there are also important differences between these systems. The intrinsic conductivity is found to arise primarily, from the vehicular diffusion of protonic charge carriers that form as a result of the relatively high degree of self-dissociation (~3.5–4.75%). Nevertheless, the experimentally measured diffusion coefficients of the exchangeable protons are ~10% higher than the molecular diffusion coefficients, and assuming that the correlations in the structural diffusion of protonic charge carriers are slightly higher (Haven ratio in the range of ~2–3.5), this results in ~21–38% of the total conductivity coming from structural diffusion. [Copyright &y& Elsevier]

Polyurethane composites reinforced with curaua fiber at 5, 10 and 20% mass/mass proportions were prepared by using the conventional melt-mixing method. The influence of curaua fibers on the thermal behavior and polymer cohesiveness in polyurethane matrix was evaluated by dynamic mechanical thermal analysis (DMTA) and by differential scanning calorimetry (DSC). This specific interaction between the fibers and the hard segment domain was influenced by the behavior of the storage modulus E′ and the loss modulus E″ curves. The polyurethane PU80 is much stiffer and resistant than the other composites at low temperatures up to 70°C. All samples were thermoplastic and presented a rubbery plateau over a wide temperature range above the glass transition temperature and a thermoplastic flow around 170°C. [ABSTRACT FROM AUTHOR]

Abstract: A novel aluminum precursor, aluminum lactate (Al(lact)3), was used in the sol–gel synthesis of alumina-based systems. The peculiar chelation properties of aluminum lactate in aqueous solution make this precursor quite attractive for the sol–gel synthesis of alumina-containing materials. Based on the reaction of aluminum lactate with different precursors such as phosphorus, boron, fluorine and others, (Na2O–)Al2O3–P2O5, (Na2O–)Al2O3–B2O3, (Na2O–)Al2O3–B2O3–P2O5, (Na–)Al–P–O–F, amorphous gels and glasses were prepared. The local structures of glasses prepared by both sol–gel and melt-cooling methods were compared by using solid state NMR. [Copyright &y& Elsevier]

The cyclopeptide alkaloid, named condaline-A, was isolated from the root bark of Condalia buxifolia Reissek (Rhamnaceae), along with the known compounds adouetine-Y′, scutianine-B, and scutianine-C. Their structures were determined by spectroscopic analyses, with their antibacterial activities being evaluated by use of a direct bioautography method. [Copyright &y& Elsevier]

Early treatment of kidney disease can slow disease progression and reduce the increased risk of mortality associated with end-stage kidney disease. However, uncertainty exists whether early referral (ER) to nephrological care per se or an optimal dialysis start impacts patient outcome after dialysis initiation. We determined the effect of ER and suboptimal dialysis start on the 3-year mortality and hospitalizations after dialysis initiation. Between January 2015 and July 2018, 349 patients with ≥1 month of follow-up started dialysis at nine Romanian dialysis clinics. After excluding patients with COVID-19 during follow-up, 254 patients (97 ER and 157 late referral) were included in this retrospective study. The observational period was truncated at 3 years, death, or loss to follow-up. Clinical and laboratory data were retrieved from the quality database of the nephrological care providers. Patients were followed for a median (25–75%) of 36 (16–36) months. At dialysis start, ER patients had higher hemoglobin, phosphate, and albumin levels and started dialysis less often via a central dialysis catheter (p < 0.001 for each). Logistic regression analysis demonstrated an independent lower risk for frequent hospitalizations for ER patients (odds ratio 0.22 (95% confidence interval 0.1–0.485), p < 0.001), and Cox regression analysis revealed an improved survival (hazard ratio 0.540 (95% confidence interval 0.325–0.899), p = 0.02), both independent of optimal dialysis start. In conclusion, early referral to nephrological care was associated with improved survival and lower hospitalization rates during the three years after dialysis initiation, independent of optimal dialysis start. These results strongly support the reimbursement of nephrological care before dialysis initiation. [ABSTRACT FROM AUTHOR]

An interlaboratory study (ILS) was conducted to test reproducibility of vitrinite and solid bitumen reflectance measurements in six mudrock samples from United States unconventional source-rock reservoir petroleum systems. Samples selected from the Marcellus, Haynesville, Eagle Ford, Barnett, Bakken and Woodford are representative of resource plays currently under exploitation in North America. All samples are from marine depositional environments, are thermally mature (T max >445 °C) and have moderate to high organic matter content (2.9–11.6 wt% TOC). Their organic matter is dominated by solid bitumen, which contains intraparticle nano-porosity. Visual evaluation of organic nano-porosity (pore sizes < 100 nm) via SEM suggests that intraparticle organic nano-pores are most abundant in dry gas maturity samples and less abundant at lower wet gas/condensate and peak oil maturities. Samples were distributed to ILS participants in forty laboratories in the Americas, Europe, Africa and Australia; thirty-seven independent sets of results were received. Mean vitrinite reflectance (VR o) values from all ILS participants range from 0.90 to 1.83% whereas mean solid bitumen reflectance (BR o) values range from 0.85 to 2.04% (no outlying values excluded), confirming the thermally mature nature of all six samples. Using multiple statistical approaches to eliminate outlying values, we evaluated reproducibility limit R, the maximum difference between valid mean reflectance results obtained on the same sample by different operators in different laboratories using different instruments. Removal of outlying values where the individual signed multiple of standard deviation was >1.0 produced lowest R values, generally ≤0.5% (absolute reflectance), similar to a prior ILS for similar samples. Other traditional approaches to outlier removal (outside mean ± 1.5*interquartile range and outside F10 to F90 percentile range) also produced similar R values. Standard deviation values < 0.15*(VR o or BR o) reduce R and should be a requirement of dispersed organic matter reflectance analysis. After outlier removal, R values were 0.1%–0.2% for peak oil thermal maturity, about 0.3% for wet gas/condensate maturity and 0.4%–0.5% for dry gas maturity. That is, these R values represent the uncertainty (in absolute reflectance) that users of vitrinite and solid bitumen reflectance data should assign to any one individual reported mean reflectance value from a similar thermal maturity mudrock sample. R values of this magnitude indicate a need for further standardization of reflectance measurement of dispersed organic matter. Furthermore, these R values quantify realistic interlaboratory measurement dispersion for a difficult but critically important analytical technique necessary for thermal maturity determination in the source-rock reservoirs of unconventional petroleum systems. • Reproducibility of organic reflectance measurements from shale plays was tested. • Vitrinite reflectance was 0.90–1.83% and solid bitumen reflectance was 0.85–2.04%. • Reproducibility limit R was evaluated. • R values were 0.1–0.2% for peak oil, 0.3% for wet gas and 0.4–0.5% for dry gas. • R values represent uncertainty assigned to an individual mean reflectance value. [ABSTRACT FROM AUTHOR]

Early treatment of kidney disease can slow disease progression and reduce the increased risk of mortality associated with end-stage kidney disease. However, uncertainty exists whether early referral (ER) to nephrological care per se or an optimal dialysis start impacts patient outcome after dialysis initiation. We determined the effect of ER and suboptimal dialysis start on the 3-year mortality and hospitalizations after dialysis initiation. Between January 2015 and July 2018, 349 patients with ≥1month of follow-up started dialysis at nine Romanian dialysis clinics. After excluding patients with COVID-19 during follow-up, 254 patients (97 ER and 157 late referral) were included in this retrospective study. The observational period was truncated at 3years, death, or loss to follow-up. Clinical and laboratory data were retrieved from the quality database of the nephrological care providers. Patients were followed for a median (25–75%) of 36 (16–36) months. At dialysis start, ER patients had higher hemoglobin, phosphate, and albumin levels and started dialysis less often via a central dialysis catheter (p<0.001 for each). Logistic regression analysis demonstrated an independent lower risk for frequent hospitalizations for ER patients (odds ratio 0.22 (95% confidence interval 0.1–0.485), p<0.001), and Cox regression analysis revealed an improved survival (hazard ratio 0.540 (95% confidence interval 0.325–0.899), p=0.02), both independent of optimal dialysis start. In conclusion, early referral to nephrological care was associated with improved survival and lower hospitalization rates during the three years after dialysis initiation, independent of optimal dialysis start. These results strongly support the reimbursement of nephrological care before dialysis initiation. [ABSTRACT FROM AUTHOR]

Peritoneal dialysis-related infections are important morbidity/mortality causes, being staphylococci the most prevalent agents. Since Staphylococcus aureus nasopharynx carriage is a known risk factor for PD infections and the oral cavity is a starting point for systemic diseases development, we aimed at comparing the oral staphylococci colonization between PD patients and controls and studying the association with PD-related infections. Saliva samples were plated in Mannitol salt, and isolates were identified by DnaJ gene sequencing. Staphylococci PD-related infections were recorded throughout the 4-year period following sample collection. Staphylococcus colonization was present in >90% of the samples from both groups (a total of nine species identified). PD patients presented less diversity and less prevalence of multispecies Staphylococcus colonization. Although all patients presenting Staphylococcus epidermidis PD-related infections were also colonized in the oral cavity by the same agent, only 1 out of 7 patients with ESI caused by S. aureus presented S. aureus oral colonization. Staphylococci are highly prevalent in the oral cavity of both groups, although PD patients presented less species diversity. The association between oral Staphylococcus carriage and PD-related infections was present for S. epidermidis but was almost inexistent for S. aureus, so, further studies are still necessary to evaluate the infectious potential of oral Staphylococcus carriage in PD. [ABSTRACT FROM AUTHOR]

Pott's edematous tumor is a subperiosteal abscess of the frontal bone with osteomyelitis, constituting an extracranial complication of acute frontal sinusitis. It is more common in adolescents, due to the increased vascularization in the diploic circulation of the frontal sinus in this age group, which allows for a faster spread of infection. Objectives: To report a case of puffy pott tumor followed up in the otorhinolaryngology service, relating it to risk factors such as age, sex and comorbidities. Case report: JCSS patient, male, 14 years old, previously healthy, coming from Imperatriz-Ma, with no history of alcoholism or smoking, comes to the emergency department of Otorhinolaryngology with headache for 1 week and sudden-onset retroorbital edema, associated with mild diplopia. Deny other symptoms. No neurological deficits and altered level of consciousness. On physical examination: face with the presence of retroorbital edema on the left and swelling in the frontal region, painful on superficial palpation. Rhinoscopy: mucopurulent secretion in the left middle meatus, without the presence of a mass lesion in the left nasal cavity. Surgical treatment was performed. The procedure consisted of a Lynch incision in the right eyebrow to drain the secretion in the frontal sinus. Endoscopically, correction of anterosuperior and high posterior septum deviation, bullectomy, ethmoidectomy, antrostomy and left frontotomy were performed, with drainage of an abundant amount of purulent secretion. Conclusion: Pott's edematous tumor is a rare entity, caused by a subperiosteal abscess and often associated with a complication of frontal sinusitis. [ABSTRACT FROM AUTHOR]

Summary: Lenalidomide maintenance in myeloma is well established. Nevertheless, pomalidomide could provide an alternative. Myeloma patients in first relapse, initially treated in the Intergroupe Francophone du Myélome (IFM) 2009 trial, and subsequently in the IFM 2013‐01 phase 2 trial, received four cycles of salvage therapy with pomalidomide plus cyclophosphamide plus dexamethasone (PCD) with transplantation plus 2 PCD consolidation or without transplantation but with 5 PCD and for all patients pomalidomide plus dexamethasone maintenance therapy. This consisted of 28‐day cycles of pomalidomide 4 mg daily on days 1–21 and dexamethasone 20 mg weekly until progression. The primary endpoint was an improved response to treatment. A total of 75/100 patients reached therapy. The median follow‐up time was 73 months. The median duration of treatment was 23.7 months. One third of patients improved their response from the initiation of treatment: 11%, 19% and 4% to a very good partial response, complete response or stringent complete response respectively. The median progression‐free survival time was 33.2 months and the median overall survival time was not reached. Among the 75 patients, the reasons for pomalidomide discontinuation were progressive disease (54%), adverse events (AEs) (30%), investigator discretion (11%) and consent withdrawal (5%). Grade (G) 3/4 haematological AEs included neutropenia (51%) and lymphopenia (35%); G3/4 drug‐related non‐haematological AEs (>5%) comprised 13% infections. Long‐term administration of pomalidomide and dexamethasone is feasible and one third of the patients improved their response. [ABSTRACT FROM AUTHOR]

Background: Acupuncture treatment has become increasingly popular in the Western due to its therapeutic effects and low cost. However, some studies suggest that both real and sham acupuncture have effects. Objectives: Our study aimed to evaluate the effect of real and placebo acupuncture in cutaneous and deep sensitivity threshold. Methods: Three different types of placebo acupunctures were compared with real acupuncture, four groups at the St25 point (abdominal) and four at the Bl52 point (lumbar region), totaling eight groups. 185 subjects were recruited and randomized, ratings of cutaneous sensitivity threshold (von Frey filaments) and pressure pain threshold (algometer) occurred before and after the application. Results: The cutaneous sensitivity threshold showed no significant difference in the intragroup analysis and also compared between groups. The pressure pain threshold showed a significant decrease in values in the Real group Bl52 (p = 0.044) and insertion and removal Bl52 (p = 0.037) for intra-group analysis and comparison between groups, there was a significant reduction in Real groups St25 and insertion and withdrawal in Bl52 point compared to Park Sham Bl52 and Real Bl52, respectively (p < 0.05). Conclusion: Cutaneous sensitivity threshold did not change after applying acupuncture or placebo, but these techniques influence the pressure pain threshold. [ABSTRACT FROM AUTHOR]

Background: In peritoneal dialysis (PD) patients, information on the immunogenicity and tolerability of SARS‐CoV‐2 vaccination is still scarce. We compared the immunogenicity and tolerability of SARS‐CoV‐2 vaccination of PD patients with that of medical personnel. Methods: In a prospective observational cohort study, PD patients and immunocompetent medical personnel were evaluated for SARS‐CoV‐2 spike‐IgG‐ and Nucleocapsid‐IgG‐antibody‐levels before, 2 weeks after the first, and 6 weeks after the second SARS‐CoV‐2 vaccination and vaccine tolerability after the first and second vaccination. Results: In COVID‐19‐naïve PD patients (N = 19), lower SARS‐CoV‐2‐spike‐IgG‐levels were found compared with COVID‐19‐naïve medical personnel (N = 24) 6 weeks after second vaccination (median 1438 AU/ml [25th–75th percentile 775–5261] versus 4577 [1529–9871]; p = 0.045). This finding resulted in a lower rate of strong vaccine response (spike‐IgG ≥ 1000 AU/ml) of COVID‐19‐naïve PD patients compared with medical personnel (58% versus 92%; p = 0.013), but not for seroconversion rate (spike‐IgG ≥ 50 AU/ml: 100% vs. 100%; p > 0.99). After first vaccination, COVID‐naïve PD patients presented with significantly fewer side effects than medical personnel (number of any side effect: 1 [1–2] vs. 4 [1–7]; p = 0.015). A similar pattern with slightly decreased frequencies of side effects was observed for tolerability of second SARS‐CoV‐2 vaccination in PD patients and medical personnel (number of any side effects: 1 [1–1] vs. 2 [1–5]; p = 0.006). Conclusions: SARS‐CoV‐2 vaccination in COVID‐19‐naïve PD patients appeared to induce a very high rate of seroconversion but a substantially lower rate of patients with a strong response compared with medical personnel. Vaccination appeared to be safe in the PD patients studied. [ABSTRACT FROM AUTHOR]

Sarcoplasmic reticulum (SR) calcium pump function requires a high local ATP/ADP ratio, which can be maintained by direct nucleotide channelling from mitochondria, and by SR-bound creatine kinase (CK)-catalysed phosphate-transfer from phosphocreatine. We hypothesized that SR calcium uptake supported by mitochondrial direct nucleotide channelling, but not bound CK, depends on the juxtaposition of these organelles. To test this, we studied a well-described model of cytoarchitectural disorganization, the muscle LIM protein (MLP)-null mouse heart. Subcellular organization was characterized using electron microscopy, and mitochondrial, SR and myofibrillar function were assessed in saponin-permeabilized fibres by measuring respiration rates and caffeine-induced tension transients. MLP-null hearts had fewer, less-tightly packed intermyofibrillar mitochondria, and more subsarcolemmal mitochondria. The apparent mitochondrial Km for ADP was significantly lower in the MLP-null heart than in control (175 ± 15 and 270 ± 33 μm, respectively), indicating greater ADP accessibility, although maximal respiration rate, mitochondrial content and total CK activity were unaltered. Active tension in the myofibres of MLP-null mice was 54% lower than in controls (39 ± 3 and 18 ± 1 mN mm−2, respectively), consistent with cytoarchitectural disorganization. SR calcium loading in the myofibres of MLP-null mice was similar to that in control myofibres when energy support was provided via Bound CK, but ∼36% lower than controls when energy support was provided by mitochondrial ( P < 0.05). Mitochondrial support for SR calcium uptake was also specifically decreased in the desmin-null heart, which is another model of cytoarchitectural perturbation. Thus, despite normal oxidative capacity, direct nucleotide channelling to the SR was impaired in MLP deficiency, concomitant with looser mitochondrial packing and increased nucleotide accessibility to this organelle. Changes in cytoarchitecture may therefore impair subcellular energy transfer and contribute to energetic and contractile dysfunction. [ABSTRACT FROM AUTHOR]

Summary: Langerhans cell histiocytosis (LCH) is a rare protean disease that usually affects children. Few data are available for management of adult‐onset cases. A complete picture of the efficacy and safety of 2CdA (2‐chlorodeoxyadenosine, cladribine) is lacking. We report a retrospective multicentre study of 23 adult LCH (a‐LCH) patients who received single‐agent 2CdA and a systematic literature review. All had previously received systemic therapy (vinblastine, n = 19). Response to 2CdA was evaluable in 22 cases. Overall response rate (ORR) was 91%. Complete response (CR) occurred in 11 cases (50%). Nine patients (39%) developed grade 3–4 neutropenia and/or severe infection. A literature review yielded 48 additional cases. A pooled analysis confirmed our findings (ORR: 88%, CR: 49%). CRs were rare with cumulative dose <50 mg/m2. Disease progression rates were 20% and 30% at two and five years, respectively. Partial response (PR) to 2CdA was predictive of disease progression. Among eight re‐treated patients, five went into CR, two in PR, and one died. Single‐agent 2CdA is effective in reactivated a‐LCH, including at intermediate doses. Toxicity, significant but acceptable, warrants infectious prophylaxis. Complete responders may enter prolonged remission. Further studies are needed to determine 2CdA sequencing with other agents (vinblastine, cytarabine). [ABSTRACT FROM AUTHOR]

Delivering of > 80% planned relative dose intensity (RDI) of fludarabine-cyclophosphamide-rituximab (FCR) is key to benefit from longer progression free survival (PFS) and survivals in CLL. In this randomized trial, we sought to investigate whether a telephone intervention strategy (called AMA) delivered by an oncology nurse could reduce the risk of RDI < 80% by alleviating adverse events and supporting patients' adherence. Sixty FCR patients were randomized 1:1 for AMA (stratified on Binet stage C). As per guidelines, patients received pegfilgrastim as primary prophylaxis of febrile neutropenia. At the end of therapy, RDI < 80% was reported in 31% of patients, shortening PFS (median 26 months versus not reached, P = 0.021) and OS at 3 years (100 vs 70%, P = 0.0089). Oncology nurse interventions tended to significantly reduce this event (RDI < 80%: 41.4% in non-AMA versus 20.7% in AMA patients (p = 0.09)). By adjusting our logistic regression model on published parameters exposing to RDI < 80%, we found that AMA protected significantly against the risk of reduced RDI (OR = 0.22, IC95% 0.05-0.84, p = 0.04), independently of grade 3/4 neutropenia (< 15% per cycle) and febrile neutropenia (< 5% per cycle) events. As a conclusion, we confirmed that > 20% reduction of FCR dose-intensity was detrimental for PFS/OS, but that oncology nurse interventions reduced the risk of dose concessions. [ABSTRACT FROM AUTHOR]

Chronic nonspecific low back pain is common and one of the most disabling conditions in the world. There is moderate evidence that chronic low back pain patients present altered functional connectivity in areas related to pain processing. Quantitative sensory testing is a way of clinical measure of these alterations. Although there is not enough evidence, there are some reports that electroacupuncture is supposedly more effective in relieving pain than acupuncture because the addition of electric current could optimize the effects of traditional technique. Thus, the objective of this randomized clinical trial was to verify if electroacupuncture treatment reduces pain and changes quantitative sensory testing responses in patients with chronic nonspecific low back pain. Patients were evaluated before and after 10 sessions regarding pain (11-point numerical rating pain scale) and quantitative sensory testing (pressure pain threshold, temporal summation, and conditioned pain modulation). There were 1 treatment group (electroacupuncture (EA)) and three different control groups (CTR 1, CTR 2, and CTR 3). A total of 69 patients participated in the study. No significant differences were found in pain intensity or quantitative sensory testing responses when comparing electroacupuncture group to the three control groups. There was a significant reduction in both resting and movement pain intensity in groups EA, CTR 1, and CTR3. Although ten sessions of electroacupuncture have diminished pain intensity in both resting and movement, it could not change significantly quantitative sensory testing and diminish central sensitization in patients with chronic nonspecific low back pain. The implications of this study involve the fact that, maybe, in chronic nonspecific low back pain, electroacupuncture should be associated with other treatments that target central sensitization. [ABSTRACT FROM AUTHOR]

Summary: The treatment of low‐tumour burden follicular lymphoma (LTBFL) remains a challenge. Rituximab‐based strategies may be improved by adding chemotherapy. This Lymphoma Study Association multicentre phase II study assessed rituximab and bendamustine in 63 patients with untreated LTBFL who were aged over 60 years old and had a follicular lymphoma International Prognostic Index (FLIPI) score ≥2. Induction comprised 4 weekly cycles of rituximab 375 mg/m2 intravenously combined with 2 cycles of bendamustine 90 mg/m2 days 1–2 with a 28‐day interval, followed by twelve cycles of 375 mg/m2 rituximab maintenance therapy every 8 weeks. The primary endpoint was complete response (CR)/unconfirmed CR (CRu), at 12 weeks. Median age was 67·4 years and median FLIPI was 3. Ultimately, 18 patients (29%) had high tumour burden according to Groupe d'Etude des Lymphomes Folliculaires criteria. The 12‐week CR/CRu rate was 54·0% and the overall response rate was 93·7%. Surprisingly, 3 patients died during maintenance (2 sepsis, 1 neoplasm). Progression‐free survival was 85·4% at 24 months. In LTBFL patients with FLIPI ≥2, two cycles of rituximab and bendamustine result in a CR rate of 54·0%. However, the treatment‐related deaths observed do not allow this regimen to be recommended for LTBFL patients aged over 60 years. EudraCT: 2010‐020757‐14; ClinicalTrials.gov: NCT01313611. [ABSTRACT FROM AUTHOR]

The combination of pomalidomide and low-dose dexamethasone (Pom-Dex) has proved effective and safe in patients with end-stage relapsed/refractory multiple myeloma (RRMM), otherwise characterized by a very poor outcome. MM remains an incurable disease with unavoidable relapses, and the outcome after pomalidomide is still dismal. However, some patients demonstrate prolonged survival even beyond pomalidomide therapy.We sought to analyze the treatment of RRMM patients following Pom-Dex therapy and the response and survival after this next treatment line.We studied 134 patients treated with Pom-Dex until progression across two IFM studies. Seventy percent of these patients received further therapy after Pom-Dex. Among the treated patients, one third responded and one third maintained stable disease. The median OS for treated patients was 12 months (6.5;17), with 22 and 12.5% of patients surviving beyond 2 and 3 years, respectively. The factors associated with a better outcome were exposure to a triplet-based regimen containing a novel agent, response to therapy, absence of adverse cytogenetic, and a longer time from diagnosis to post pomalidomide therapy.This study suggests that patients relapsing after Pom-Dex therapy can still benefit from a further line of treatment. A subset of these treated patients even displayed a prolonged OS, while the prognosis remained very poor without treatment. An active approach could therefore be recommended even in this adverse situation, however guided by the patients' prognosis factors. [ABSTRACT FROM AUTHOR]

Nerium oleander is distributed worldwide, mainly in tropical and subtropical regions. These shrubs are frequently used as ornamental plants. However, they contain more than 30 cardiac glycosides that can cause serious toxic effects in dogs. The objective of this study was to report the clinical and electrocardiographic alterations in dogs experimentally poisoned with N. oleander. Ten adult, healthy, mixed-breed dogs weighing 10-25kg and aged 3-6 years were selected for the study. We orally administered 0.25g kg-1 of fresh ground leaves of N. oleander to the dogs. No dog died after the ingestion, but all exhibited signs of poisoning such as vomiting, sialorrhea, nausea, apathy, conjunctiva congestion, dehydration, abdominal pain, tremors, diarrhea, loss of appetite, and tenesmus. Electrocardiogram revealed occurrence of several types of arrhythmias: sinus bradycardia, second-degree atrioventricular block, paroxysmal ventricular tachycardia, and ventricular premature complexes. Systolic blood pressure, as well as heart rate, decreased in the first 24 hours. The present study concluded that a single dose of 0.25g kg-1 of N. oleander green leaves is sufficient to cause a moderate intoxication in dogs, with nonspecific clinical changes mainly related to the digestive system and heart rate, thus demonstrating the importance of this type of intoxication in the list of differential diagnoses of small animals routine. [ABSTRACT FROM AUTHOR]

Guidelines for monitoring multiple myeloma patients expressing light chains only (light chain multiple myeloma; LCMM) rely on measurements of the monoclonal protein in urine. Alternatively serum free light chain (sFLC) measurements have better sensitivity over urine methods, however, demonstration that improved sensitivity provides any clinical benefit is lacking. Here we compared the performance of serum and urine measurements in 113 (72κ, 41λ) newly diagnosed LCMM patients enrolled onto the IFM-2009 trial. All diagnostic samples (100%) had an abnormal κ/λ sFLC ratio, and involved (monoclonal) FLC (iFLC) expressed at levels deemed measurable for monitoring (=100mg/L). By contrast, only 64% patients had measurable levels of the monoclonal protein (=200mg/24h) in urine protein electrophoresis (UPEP). After 1 and 3 treatment cycles, iFLC remained elevated in 71% and 46% patients, respectively, whilst UPEP reported a positive result in 37% and 18%; all the patients with a positive UPEP at cycle 3 also had elevated iFLC levels. Importantly, elevated iFLC or an abnormal κ/λ sFLC ratio after 3 treatment cycles associated with poorer PFS (p=0.006 and p<0.0001, respectively), whereas positive UPEP or urine immunofixation (uIFE) did not. In addition, patients with an abnormal κ/λ sFLC ratio had poorer overall survival (p=0.022). Finally, early normalisation of κ/λ sFLC ratio but not negative uIFE predicted achieving negative minimal residual disease, as determined by flow cytometry, after consolidation therapy (100% positive predictive value). We conclude that improved sensitivity and prognostic value of serum over urine measurements provide a strong basis for recommending the former for monitoring LCMM patients. [ABSTRACT FROM AUTHOR]

The article cites a research study that examines the prevalence of potential drug-drug interactions (PDDIs) in type 2 diabetes patients in Brazil. It classifies PDDIs relation to level of severity, scientific evidence, time of onset, and potential clinical impact in these patients. This cross-sectional study was conducted in a tertiary care outpatient center and included up of 140 patients.

Background/Aims: Exogenous surfactant has been proposed as adjunctive therapy for acute respiratory distress syndrome (ARDS), but it is inactivated by different factors present in the alveolar space. We hypothesized that co-administration of LASSBio596, a molecule with significant anti-inflammatory properties, and exogenous surfactant could reduce lung inflammation, thus enabling the surfactant to reduce edema and improve lung function, in experimental ARDS. Methods: ARDS was induced by cecal ligation and puncture surgery in BALB/c mice. A sham-operated group was used as control (CTRL). After surgery (6 hours), CTRL and ARDS animals were assigned to receive: (1) sterile saline solution; (2) LASSBio596; (3) exogenous surfactant or (4) LASSBio596 plus exogenous surfactant (n = 22/group). Results: Regardless of exogenous surfactant administration, LASSBio596 improved survival rate and reduced collagen fiber content, total number of cells and neutrophils in PLF and blood, cell apoptosis, protein content in BALF, and urea and creatinine levels. LASSBio596 plus surfactant yielded all of the aforementioned beneficial effects, as well as increased BALF lipid content and reduced surface tension. Conclusion: LASSBio596 exhibited major anti-inflammatory and anti-fibrogenic effects in experimental sepsis-induced ARDS. Its association with surfactant may provide further advantages, potentially by reducing surface tension. © 2016 The Author(s) Published by S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Background: Bortezomib with dexamethasone is a standard treatment option for relapsed or refractory multiple myeloma. Carfilzomib with dexamethasone has shown promising activity in patients in this disease setting. The aim of this study was to compare the combination of carfilzomib and dexamethasone with bortezomib and dexamethasone in patients with relapsed or refractory multiple myeloma.Methods: In this randomised, phase 3, open-label, multicentre study, patients with relapsed or refractory multiple myeloma who had one to three previous treatments were randomly assigned (1:1) using a blocked randomisation scheme (block size of four) to receive carfilzomib with dexamethasone (carfilzomib group) or bortezomib with dexamethasone (bortezomib group). Randomisation was stratified by previous proteasome inhibitor therapy, previous lines of treatment, International Staging System stage, and planned route of bortezomib administration if randomly assigned to bortezomib with dexamethasone. Patients received treatment until progression with carfilzomib (20 mg/m(2) on days 1 and 2 of cycle 1; 56 mg/m(2) thereafter; 30 min intravenous infusion) and dexamethasone (20 mg oral or intravenous infusion) or bortezomib (1·3 mg/m(2); intravenous bolus or subcutaneous injection) and dexamethasone (20 mg oral or intravenous infusion). The primary endpoint was progression-free survival in the intention-to-treat population. All participants who received at least one dose of study drug were included in the safety analyses. The study is ongoing but not enrolling participants; results for the interim analysis of the primary endpoint are presented. The trial is registered at ClinicalTrials.gov, number NCT01568866.Findings: Between June 20, 2012, and June 30, 2014, 929 patients were randomly assigned (464 to the carfilzomib group; 465 to the bortezomib group). Median follow-up was 11·9 months (IQR 9·3-16·1) in the carfilzomib group and 11·1 months (8·2-14·3) in the bortezomib group. Median progression-free survival was 18·7 months (95% CI 15·6-not estimable) in the carfilzomib group versus 9·4 months (8·4-10·4) in the bortezomib group at a preplanned interim analysis (hazard ratio [HR] 0·53 [95% CI 0·44-0·65]; p<0·0001). On-study death due to adverse events occurred in 18 (4%) of 464 patients in the carfilzomib group and in 16 (3%) of 465 patients in the bortezomib group. Serious adverse events were reported in 224 (48%) of 463 patients in the carfilzomib group and in 162 (36%) of 456 patients in the bortezomib group. The most frequent grade 3 or higher adverse events were anaemia (67 [14%] of 463 patients in the carfilzomib group vs 45 [10%] of 456 patients in the bortezomib group), hypertension (41 [9%] vs 12 [3%]), thrombocytopenia (39 [8%] vs 43 [9%]), and pneumonia (32 [7%] vs 36 [8%]).Interpretation: For patients with relapsed or refractory multiple myeloma, carfilzomib with dexamethasone could be considered in cases in which bortezomib with dexamethasone is a potential treatment option.Funding: Onyx Pharmaceuticals, Inc., an Amgen subsidiary. [ABSTRACT FROM AUTHOR]

The present study focuses on the Chia Gara Formation that is part of the oil-prone sedimentary formations of Northern Iraq, being under extensive scientific concern in recent years. The Chia Gara Formation is considered one of the major source rocks of the prolific Kirkuk oil field of Northern Iraq, consisting of alternating layers of bituminous limestones and calcareous shales that were deposited during Late Jurassic – Early Cretaceous. The studied sequence from the Miran-2 well (depth 2185–2315 m) comprises mostly argillaceous limestones with calcite and quartz being the main minerals with variable amounts of clay minerals, K-feldspars, pyrite, gypsum, and anhydrite. TOC wt% ranges between 0.73 and 7.24 wt%, pointing to a significant variation regarding organic matter content. The average random vitrinite reflectance (VR o) is 1.00% and the average value of solid bitumen random reflectance (BR o) is 0.73%. Solid bitumens and bituminite (the latter corresponding to kerogen type II) are the predominant organic particles, particularly in the bottom to middle part of the Formation, whereas alginite occurs subordinately. Additionally, the common occurrence of vitrinite fragments indicates a significant terrestrial input (kerogen type III). Organic petrography proved to be the most important tool to provide with clear-cut results regarding the organic matter characteristics. Chia Gara Formation was deposited in a shallow marine palaeoenvironment probably shelf-slope, under reducing conditions. In particular in Miran-2 the studied strata are within the oil window, and the obtained results provide a better understanding of the organic matter type and maturation of this highly prolific and productive Formation. • Chia Gara Formation in NE Iraq is one of the most interesting "natural laboratory" for maturation studies. • Bituminite and solid bitumens dominate the organic matter of Chia Gara Formation. • Chia Gara Formation represents a shallow marine palaeoenvironment, with intense terrigenous siliciclastic influx. [ABSTRACT FROM AUTHOR]

CSF leaks are more prevalent in the ethmoid sinus (35%) and sphenoid sinus (32%). CSF leaks in the ethmoid sinus can be spontaneous or caused by trauma, whether head trauma or iatrogenic. Spontaneous fistulas are usually difficult to diagnose, mainly because of their complex location. Objectives: To report a case of spontaneous cerebrospinal fluid fistula followed up at the OTHOS otorhinolaryngology service, relating it to risk factors such as age, sex and comorbidities. Case report: L.J.R.S, female, 40 years old, obese, referred from the HOSPITAL MUNICIPAL DE IMPERATRIZ (HMI) by the neurosurgery team to the OTORHINOLARYNGOLOGY service. Patient reported abundant unilateral hyaline coryza for 10 years, without improvement with treatment for allergic rhinitis. He denies trauma or other complaints. Direct rhinoscopy shows drainage of hyaline secretion in the left nasal cavity. Video rhinoscopy was performed with cerebrospinal fluid drainage, failing to locate a specific point of secretion exit. A contrast-enhanced tomography of the sinuses was requested, and a small continuity solution was identified in the anterior ethmoid. In view of this, she underwent endonasal surgery using 5% sodium fluorescein via lumbar puncture. Conclusion: Endoscopic detection and repair of CSF leaks with a three-layer graft and fibrin glue have a high success rate and low complication rate. The use of 5% sodium fluorescein solution for intrathecal administration at the appropriate dose is a safe procedure for the detection of cerebrospinal fluid fistulas during endoscopic surgery and does not cause adverse effects. [ABSTRACT FROM AUTHOR]

The Intergroupe Francophone du Myelome conducted a randomized trial to compare bortezomib-dexamethasone (VD) as induction before high-dose therapy (HDT) and autologous stem cell transplantation (ASCT) to a combination consisting of reduced doses of bortezomib and thalidomide plus dexamethasone (vtD) in patients with multiple myeloma. Overall, a total of 199 patients were centrally randomly assigned to receive VD or vtD. After 4 cycles, the complete response (CR) rate was the same in both groups (13% in the vtD arm, 12% in the VD arm, P = .74). However, the CR plus very good partial response (VGPR) rate was significantly higher in the vtD arm (49% vs 36%, P = .05). After ASCT, the CR plus VGPR rate was significantly higher in the vtD arm (74% vs 58%, P = .02). The reduced doses of bortezomib and thalidomide translated into a reduced incidence of peripheral neuropathy (PN): grade ≥ 2 PN were reported in 34% in the VD arm versus 14% in the vtD arm (P = .001). vtD, including reduced doses of bortezomib and thalidomide, yields higher VGPR rates compared with VD and can be considered a new effective triplet combination before HDT/ASCT. This study was registered with www.clinicaltrials.gov as #NCT00910897 and EudraCT as #2007-005204-40. [ABSTRACT FROM AUTHOR]

Abstract: The Pera-Lakkos coal located on top of bauxite deposits in the Ghiona mining district (Central Greece), is the only known Mesozoic (Late Cretaceous) coal in the country. It was derived from herbaceous plants and algae growing in mildly brackish mires that formed behind a barrier system during a regression of the sea, on a karstified limestone partly filled in with bauxitic detritus. Petrological, mineralogical and geochemical data point to the predominance of reducing conditions and intense organic matter degradation in the palaeomires. O/C vs. H/C and OI vs. HI plots, based on elemental analysis and Rock-Eval data, characterize kerogen types I/II. This reflects the relatively high liptinite content of the coal. Besides kerogen composition, O/C vs. H/C plot for the Pera-Lakkos coals is in accordance with a catagenesis stage of maturation in contrast with vitrinite reflectance and T max from Rock-Eval pyrolysis, which indicate the onset of oil window maturation stage. Suppression of vitrinite reflectance should be considered and the high liptinite content corroborates this hypothesis. Despite some favourable aspects for petroleum generation presented by the Pera-Lakkos coal, its maximum thickness (up to 50cm) points to a restricted potential for petroleum generation. Coal oxidation took place either during the late stage of peat formation, due to wave action accompanying the subsequent marine transgression, or epigenetically after the emergence of the whole sequence due to percolation of drainage waters. Both options are also supported by the REE shale-normalized profiles, which demonstrate an upwards depletion in the coal layer. Oxidation also affected pyrite included in the coal; this led to the formation of acidic (sulfate-rich) solutions, which percolated downwards resulting in bleaching of the upper part of the underlying bauxite. [Copyright &y& Elsevier]

Abstract: Numerous studies have shown that several red blood cell polymorphisms protect against severe malaria. Such a relation is much less clear for mild malaria attacks and for the asymptomatic carriage of Plasmodium falciparum. The impact of red blood cell polymorphisms on the level of parasite density was assessed in a group of 464 Senegalese children from the Sereer ethnic group, studied for 18 months. These genetic factors were also related to the malarial morbidity, investigated during 2 successive transmission seasons among 169 of these children. The frequencies of the host genetic factors in the whole group were 0.52 for blood group O, 0.13 for hemoglobin S, 0.16 for the G6PD A-deficient variant and 0.24 for α+-thalassemia (–α3.7 deletion). Hemoglobin S was associated with protection against mild malaria attacks. None of the genetic factors was implicated in a better control of parasite densities. These associations may be particular to this ethnic group due to the specificities of malaria endemicity in this area. The pressure exerted in the area by other non-malarial infectious diseases as well as the genetic heterogeneity of circulating parasites may also contribute to these observations. [Copyright &y& Elsevier]