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This case highlights an atypical presentation of a patient with unknown history of mental disease who has been diagnosed with a bipolar disorder associated with severe COVID‐19 symptoms. Neuroimaging was only positive for subtle white matter changes; he was treated with antipsychotics and mood‐stabilizing agents until he reached partial remission. The authors urge clinicians to consider the impact of the COVID‐19 pandemic on patients with mental illness and the urgent need for vigilant monitoring of presenting signs and symptoms., Laboratory investigations

In this work, a thermal behaviour comparison of a new bamboo-based and banana-based Green Bio-Composites (GBC) is conducted using thermogravimetric analysis (TGA) and cone-calorimeter experiments. An Intumescent Fire-Retardant (IFR) coating (a mixture of Exolit IFR36 and boric acid) has been applied on the investigated GBC materials in order to explore the flammability resistance of such GBCs. Vacuum Bag Resin Transfer Moulding (VBRTM) technique has been used to manufacture the samples. TGA test have been conducted under oxidative atmosphere with three different heating rates while cone calorimeter tests have been performed with a horizontally exposure on the top surface of the sample. The outcomes of TGA revealed that Bamboo-based (BM-GBC) and Banana-based (Bn-GBC) materials exhibited similar thermal degradation patterns. However, BM-GBC outperformed Bn-based in the cone calorimetry analysis, this is proven by the fire reaction parameters as well as the higher char residue. In addition, IFR coating improved the flame retardancy of both GBCs, reduced the Peak Heat Release Rate (PHRR) by approximately 40–50% and smoke production (SEA) by 26%. SEM and EDS analysis of char residue were performed to deeply investigate the effectiveness of the IFR as a protecting layer.

Purpose To implement a free‐breathing sequence for simultaneous quantification of T1, T2, and T2∗ for comprehensive tissue characterization of the myocardium in a single scan using a multi‐gradient‐echo readout with saturation and T2 preparation pulses. Methods In the proposed Saturation And T2‐prepared Relaxometry with Navigator‐gating (SATURN) technique, a series of multi‐gradient‐echo (GRE) images with different magnetization preparations was acquired during free breathing. A total of 35 images were acquired in 26.5 ± 14.9 seconds using multiple saturation times and T2 preparation durations and with imaging at 5 echo times. Bloch simulations and phantom experiments were used to validate a 5‐parameter fit model for accurate relaxometry. Free‐breathing simultaneous T1, T2, and T2∗ measurements were performed in 10 healthy volunteers and 2 patients using SATURN at 3T and quantitatively compared to conventional single‐parameter methods such as SASHA for T1, T2‐prepared bSSFP, and multi‐GRE for T2∗. Results Simulations confirmed accurate fitting with the 5‐parameter model. Phantom measurements showed good agreement with the reference methods in the relevant range for in vivo measurements. Compared to single‐parameter methods comparable accuracy was achieved. SATURN produced in vivo parameter maps that were visually comparable to single‐parameter methods. No significant difference between T1, T2, and T2∗ times acquired with SATURN and single‐parameter methods was shown in quantitative measurements (SATURN T1=1573±86ms, T2=33.2±3.6ms, T2∗=25.3±6.1ms; conventional methods: T1=1544±107ms, T2=33.2±3.6ms, T2∗=23.8±5.5ms; P>.2) Conclusion SATURN enables simultaneous quantification of T1, T2, and T2∗ in the myocardium for comprehensive tissue characterization with co‐registered maps, in a single scan with good agreement to single‐parameter methods.

Purpose: To implement a free-breathing sequence for simultaneous quantification of (Formula presented.), (Formula presented.), and (Formula presented.) for comprehensive tissue characterization of the myocardium in a single scan using a multi-gradient-echo readout with saturation and (Formula presented.) preparation pulses. Methods: In the proposed Saturation And (Formula presented.) -prepared Relaxometry with Navigator-gating (SATURN) technique, a series of multi-gradient-echo (GRE) images with different magnetization preparations was acquired during free breathing. A total of 35 images were acquired in 26.5 ± 14.9 seconds using multiple saturation times and (Formula presented.) preparation durations and with imaging at 5 echo times. Bloch simulations and phantom experiments were used to validate a 5-parameter fit model for accurate relaxometry. Free-breathing simultaneous (Formula presented.), (Formula presented.), and (Formula presented.) measurements were performed in 10 healthy volunteers and 2 patients using SATURN at 3T and quantitatively compared to conventional single-parameter methods such as SASHA for (Formula presented.), (Formula presented.) -prepared bSSFP, and multi-GRE for (Formula presented.). Results: Simulations confirmed accurate fitting with the 5-parameter model. Phantom measurements showed good agreement with the reference methods in the relevant range for in vivo measurements. Compared to single-parameter methods comparable accuracy was achieved. SATURN produced in vivo parameter maps that were visually comparable to single-parameter methods. No significant difference between (Formula presented.), (Formula presented.), and (Formula presented.) times acquired with SATURN and single-parameter methods was shown in quantitative measurements (SATURN (Formula presented.), (Formula presented.), (Formula presented.); conventional methods: (Formula presented.), (Formula presented.), (Formula presented.); (Formula presented.)). Conclusion: SATURN enables simultaneous quantification of (Formula presented.), (Formula presented.), and (Formula presented.) in the myocardium for comprehensive tissue characterization with co-registered maps, in a single scan with good agreement to single-parameter methods.

The procedures of the current novel automated technique for the determination of hardness, Carbonate, bicarbonate and alkalinity in drinking water have been modified from both classical batch titration and the method of the flow analysis Skalar San++ method (classical scalar current). The forms of standards in the current methods have been modified. The calcium chloride used previously in the current method for the determination of both calcium and total hardness was replaced by a mixed standard that contains calcium and magnesium carbonate in an aqueous solution. Likewise, calcium carbonate and sodium bicarbonate standards currently used in determination of alkalinity and bicarbonate respectively were replaced by using only one standard of calcium, sodium carbonate salt, and the required bicarbonate concentrations were derived from the same calcium carbonate formula mathematically in the stoichiometry equation. The new approach method was validated and applied successfully for analysis of drinking water and proficiency tests samples (PTS).The technique is used for an automatic online analysis of total, calcium hardness, total alkalinity and bicarbonate in drinking water covering a range of 10 - 100 ppm for total hardness and calcium hardness and a range of 5-100 ppm for alkalinity and bicarbonate mg/L as CaCO3. The method gave a distinct merit over the manual titration method and the current skalar method, with enhanced detection limit, high precision (RSD) which was found to be less than 1%) and accuracy of ( ± 1-2%), as well as a high spectral peak resolution and sample throughput.. Moreover, additional merits of the proposed method over the classical skalar one, other than being economic in use, as there is some chemical cut off, is the feasibility of the automatic determination of carbonate ions concentrations in the same run, which could not be achieved automatically by the classical skalarc method, as it always needs mathematical subtraction of bicarbonate concentration from alkalinity concentrations from multi runs. The latter approach is tedious, involved lots of reagents and procedures, time consuming, and could impact the overall method precision and accuracy. The methoddemonstrated selectivity as online automated approach for selective determination of total hardness and calcium hardness in one run and determination of total alkalinity and bicarbonate from the same standard in the second run, when keeping all of the four chemistry reagents aspirated automatically. Sole analysis for every parameter as in the current method was achieved demonstrating simultaneous analysis without discernment, the recovery was found to be comparable with the novel proposed method, but the latter gave a marked enhancement in precision and peak resolution.. Analysis for drinking water samples gave quantitative results with Z score of less than ± 1.2. Accuracy of the automated analysis was investigated by multiple techniques including recovery by standard addition method, run of CRM and t test statistical analysis. The merit of the accuracy for this proposed method has been demonstrated successfully through applications to real samples., Moroccan Journal of Chemistry, Vol. 8, No 1 (2020)

Due to its major influence on individual’s performance, engagement is increasingly becoming popular among practitioners. While its influence on performance has been well established, research on the influence of variables related to organizations on engagement is still in its nascent stage. Therefore, this study examines the mediating role of employee engagement in the corporate social responsibility (CSR) – organizational commitment relationship. Multiple regression results using responses from 150 academics working in Indian management institutes predominantly owned by business groups partially support the relationships hypothesized. The findings may encourage Indian management institutes owned by business groups to consider CSR in teaching and research as serious investment areas in order to have a more engaged and committed workforce.

Real-time NMR spectroscopy has proven to be a rapid and an effective monitoring tool to study the hypervalent iodine(III) mediated cyclopropanation. With the ever increasing number of new synthetic methods for carbon−carbon bond formation, the NMR $\textit{in situ}$ monitoring of reactions is becoming a highly desirable enabling method. In this study, we have demonstrated the versatility of benchtop NMR using inline and online real-time monitoring methods to access mutually complementary information for process understanding, and we developed new approaches for real-time monitoring addressing challenges associated with better integration into continuous processes.

Objective: To ascertain the incidence, and describe the various forms of neural tube defects (NTDs) due to genetic, chromosomal, and syndromic causes. Methods: We carried out a retrospective analysis of data retrieved from the medical records of newborn infants admitted to the Neonatal Intensive Care Unit with NTDs and their mothers spanning 14 years (1996-2009) at the Security Forces Hospital, Riyadh, Saudi Arabia. The cases were ascertained by a perinatologist, neonatologist, geneticist, radiologist, and neurologist. The literature was reviewed via a MEDLINE search. Only liveborn babies were included. Permission from the Educational Committee at the Security Forces Hospital was obtained prior to the collection of data. Results: Out of 103 infants with NTDs admitted during this period, 20 (19.4%) were found to have an underlying genetic syndromic, chromosomal and/or other anomalies. There were 5 cases of Meckel-Gruber syndrome, 2 Joubert syndrome, one Waardenburg syndrome, one Walker-Warburg syndrome, 2 chromosomal disorders, 2 caudal regression, one amniotic band disruption sequence, one associated with omphalocele, one with diaphragmatic hernia, and 4 with multiple congenital anomalies. Conclusions: There is a high rate of underlying genetic syndromic and/or chromosomal causes of NTDs in the Saudi Arabian population due to the high consanguinity rate. Identification of such association can lead to more accurate provisions of genetic counseling to the family including preimplantation genetic diagnosis or early termination of pregnancies associated with lethal conditions.

Background Medical students are the source of a country’s surgeons. There are concerns regarding a possible decline in the proportion of students choosing surgery as a career in some developing countries. Objective To identify the level of interest in surgical careers and the factors influence a student’s interest in pursuing a surgical career in Sudan. Methods A cross-sectional descriptive study was conducted in September 2013 at the Faculty of Medicine, University of Medical Sciences and Technology, Khartoum, Sudan. A self administered questionnaire was distributed to 887 male and female students, (from first to fifth academic years) recruited in the fifth academic years) recruited in the study. Results Response rate was 73% with 647 questionnaires were collected, out of 887 medical students. Of the returned questionnaires, 604 were valid. Most of the students have decided upon a specialty 541 (89.6%) while 63 (10.4%) did not. Two hundred (36.9%) out of the 541 respondents stated that surgery is their choice for specialty.General Surgery was the popular surgical specialty (48%), followed by Cardiothoracic Surgery (16.5%), Neurosurgery (11%) and Orthopedics (10.5%). Compared with students interested in a career in other medical specialties, those interested in surgery were younger (Pre-clerkship students). Conclusion Surgery is the most popular choice of postgraduate training by medical students. Fewer than half of the medical students who choose surgery were willing to consider general surgery as a future career choice. Financial reasons and advice from of others were considered by many students as important factors to select surgery.

To determine the outcome of infants born to diabetic mothers at Security Forces Hospital, Riyadh, Saudi Arabia, and compare the complications seen in these infants with infants of non-diabetic mothers.This is a concurrent prospective cohort study of a population of newborn infants delivered at Security Forces Hospital, Riyadh, Saudi Arabia for diabetic mothers between January 2011 and November 2011.A total of 601 infants were enrolled in the study consisting of 319 infants of non-diabetic mothers, and 282 infants of diabetic mothers. Infants of diabetic mothers showed significantly higher rates of associated complications and prolonged hospital stay reflected in their admission to the neonatal intensive care when compared with infants of non-diabetic mothers. There was no difference in rate of complications between infants of gestational diabetics and pre-gestational diabetics.Our study showed that diabetic pregnancies are associated with an increased incidence of neonatal complications. These seem to be related to the degree of maternal glycemic control. The higher rates of complications among our infants of diabetic mothers, particularly major congenital malformations call for those involved in the care of diabetic mothers to consolidate their efforts to facilitate early booking in specialist clinics.

Objectives: The analytical performances of the Sebia capillary electrophoresis (CE), Roche turbidimetric inhibition immunoassay (TINIA), Tosoh G8 cation-exchange high-performance liquid chromatography (HPLC) and Premier boronate affinity chromatography methods were evaluated. Capillary electrophoresis (CE) was accepted as a comparative method. Design and Methods: This study comprised randomly chosen 224 whole blood samples from the diabetic and non-diabetic patients. HbA1c level was quantified using four methods as follows: Roche TINIA, Premier Hb9210 boronate affinity chromatography, Tosoh G8 cation-exchange HPLC and Sebia CE. The analytical performances of the methods were evaluated with imprecion, bias estimation and comparison studies. Results: The results of all precision studies CV% were under 2.0%. The accepted goals for imprecision are 2.8% (IFCC) and

To assess the frequency and accuracy of prenatal diagnosis of a single umbilical artery (SUA) and to compare the fetal and neonatal outcome of isolated SUA to that of a normal three-vessel umbilical cord in a population from the Middle East and Gulf region.Data were collected from 37,500 singleton pregnancies that were scheduled for antenatal care and delivered at Security Forces Hospital in Riyadh, Saudi Arabia, between May 2004 and December 2012. Comparisons between the groups were performed using a chi-square test or a Fisher exact test for the categorical variables, and Student's t test or Wilcoxon's rank-sum test were used for continuous variables. The Kappa statistic was used to study the agreement between the antenatal and final neonatal diagnosis of SUA. A univariable analysis was used to calculate the unadjusted and adjusted ORs and the 95% CIs expressing the relationship of the normal three-vessel umbilical cord, the isolated SUA, and each outcome.A total of 35,249 cases completed the study, including 35,026 cases with normal neonatal three-vessel umbilical cords (Group B). SUA was present in 223 (0.63%) neonates (0.45% isolated SUA (Group A) and 0.18% non-isolated SUA). The sensitivity, specificity, positive predictive value and negative predictive value of using prenatal ultrasound for the diagnosis of SUA were 90.58%, 99.9%, 98.5% and 99.94%, respectively. Neonatal anomaly was present in 2.6% of the fetuses with isolated SUA. A pregnancy with isolated SUA was more likely to be complicated with polyhydramnios (OR 3.32; CI 1.22-9.04), preterm delivery34 weeks (OR 4.662; CI 2.346-9.195), birth weight10th percentile (OR 2.1; CI 1.44-2.93), cesarean delivery for fetal distress (OR 2.72; CI 1.53-4.81), perinatal death (OR 3.31; CI 1.34-8.12), admission to NICU (OR 2.71; CI 1.87-3.91), and placental abnormalities (OR 3.25; CI 2.14-4.93; p value 0.0001) compared to a pregnancy with a fetal and neonatal three-vessel cord.Isolated SUA is associated with anomalies at birth and with an increased risk of adverse pregnancy outcomes even in the absence of other anomalies. A pregnancy with this complication should receive close fetal monitoring for growth and fetal wellbeing.

Obtaining accurate understanding of three dimensional structures and their relationships is important in learning human anatomy. To leverage the learning advantages of using both physical and virtual models, we built a hybrid platform consisting of virtual and mannequin pelvis, motion tracking interface, anatomy and pathology knowledge base. The virtual mentorship concept is to allow learners to conveniently manipulate and explore the virtual pelvic structures through the mannequin model and VR interface, and practice on anatomy identification tasks and pathology quizzes more intuitively and interactively than in a traditional self-study classroom, and to reduce the demands of access to dissection lab or wet lab.

Babies admitted to a neonatal intensive care unit in whom acute renal failure developed were studied prospectively to determine the etiology, course, and outcome of the disorder, as well as the reliability of renal indices in distinguishing intrinsic from prerenal renal failure. The incidence of neonatal acute renal failure was 3.6% (22/603). The most frequent causes were hypotension (86%), respiratory distress syndrome (41%), sepsis (32%), and asphyxia (27%). Half of the patients were born at less than 32 weeks' gestation and had a birth weight of less than 1500 gm. There was intrinsic renal failure in 15 neonates and prerenal failure in seven. Renal indices (urine-to-plasma ratio of osmolality, fractional excretion of sodium, and renal failure index) were not reliable in differentiating between intrinsix or prerenal failure. Mortality from renal failure was high at 77%. Survivors of neonatal acute renal failure who had no underlying congenital anomalies of the urinary tract did not appear to exhibit residual renal impairment during follow-up evaluation. It is important to identify those clinical indices that can be used in determining the diagnosis and prognosis of acute renal failure in neonates, particularly in very premature, low-birth-weight babies.

A total of 155 transcutaneous bilirubin (TcB) measurements were performed on 155 healthy full-term Saudi newborns with neonatal jaundice using the Minolta/Airshield Jaundice Meter applied to the forehead. The TcB measurements correlated well with the serum bilirubin determinations (r = 0.817). The regression equation for our population was y = 13.24 + 0.69x. At a cut-off TcB index of 21 the machine could identify infants with serum bilirubin levels of 12.5 mg/dl or more with a sensitivity of 74% and a specificity of 90%. The positive and negative predictive values were 78% and 88%, respectively. We think at that action line the machine is a useful screening tool that can identify children with significant jaundice who will need serum bilirubin determination.

Experiments indicate that gypsum can be precipitated by the mixing of seawater brines of different stages of evaporation, in addition to the previously recognized mechanisms of direct evaporative crystallization and crystallization due to temperature changes. A proposed geologic model shows how gypsum precipitation by brine mixing might occur in an evaporite basin. Conclusions based on the experiments and their relations to the geologic model are as follows. 1. Precipitation of gypsum can occur in a marine evaporite basin by mixing brines of different composition and specific gravity. 2. Precipitation occurs without further water loss by evaporation. 3. Precipitation can occur from a brine that was undersaturated before mixing. 4. The only form of calcium sulfate to precipitate in these experiments was gypsum. 5. Brine mixing could cause different salts to be deposited simultaneously in different parts of a basin depending on the stage of the evaporite cycle.

The effect of eicosapentaenoic acid (EPA) and vitamin E on hepatic hydroxyproline content, as an index of collagen was examined in rabbits receiving cholesterol rich diets for a period of 45 days. Rabbits were divided as control (A) and cholesterol fed groups (B, C, D). Group C received 80 mg. of EPA and group D received 100 IU of vitamin E daily in addition to the cholesterol rich diet (2% w/w) which was solely given to group B. The maintenance of rabbits on high cholesterol diets resulted in significantly increased liver cholesterol concentrations. This effect was most pronounced in rabbits receiving cholesterol alone. Hepatic triglyceride levels remained unchanged in all cholesterol-fed rabbits, but total phospholipid levels in liver significantly decreased in EPA and vitamin E supplemented rabbits. An interesting finding was the increase in hepatic hydroxyproline content in rabbits following the administration of EPA and vitamin E to cholesterol rich diet.

The evaporites of the Paradox Member of the Hermosa Formation of Pennsylvanian age in southeast Utah and southwest Colorado are direct precipitates from marine brines and have been changed only slightly by subsequent events. Geophysical logs of deep wells indicate that the Paradox Member is composed of 29 evaporite cycles. Lithologies that make up the cycles, in order of increasing salinity, are: black calcareous shale, dolomite, anhydrite, and halite (with or without potash). Studies of cores from two wells in the central part of the basin show that some of the cycles in the upper part of the Paradox Member are remarkably symmetrical above and below the black shale, indicating regular changes in salinity. Lithic texture, crystal morphology, and bromine distribution are s ggestive of primary sedimentation with only minor early diagenesis related to burial dehydration. End_of_Article - Last_Page 1698

Experiments using artificial and seawater brines indicate that halite and sylvite can be precipitated by mixing brines of differing stages of evaporation, in addition to the previously recognized mechanisms of direct evaporative crystallization and crystallization by temperature changes. A modification of present geologic models is proposed to show how brine mixing might work in an evaporite basin. Conclusions based on the experiments and their relations to the geologic model are as follows. (1) Salt can precipitate in a marine evaporite basin by mixing brines of different composition and specific gravity. (2) Precipitation may occur without further water loss by evaporation. (3) Precipitation can take place from brines that were undersaturated before mixing. (4) Brine mi ing would cause the most salt to be deposited in the deepest parts of a basin, although nearly all parts of the basin could receive such deposits. (5) Sylvite could be precipitated as a primary mineral. (6) Hopper crystals (cubic and tabular) can form as a result of brine mixing in water of any depth.

During Late Pennsylvanian time a major landmass, the Ancestral Front Range, extended north and south through central Colorado. Terrigenous sediments in the adjacent basins were, for the most part, derived from this highland. These sedimentary rocks are predominantly redbeds which have been interpreted to be of primary detrital origin, and the conclusion has been drawn that the red pigment (hematite) originated in lateritic soils which covered the highland. Accordingly, because modern laterites are formed only in areas of tropical climates, it has been concluded by various authors that the climate in the area of the Ancestral Front Range during Pennsylvanian time was warm and humid. The close association of redbeds with evaporites in the Eagle basin on the west side of the Front Range suggests an arid climate. Hence, two conflicting lines of evidence exist concerning the Pennsylvanian climate. This study was undertaken to determine what information concerning this problem might be obtained from a study of the clay mineralogy of the rocks which were derived from the Ancestral Front Range. Inasmuch as most of the clay-size material in the rocks probably was derived from the soils of the source area, and because climate has a dominant effect on the types of clay minerals formed in soils, it seems likely that the nature of the clays would offer important clues regarding the source-area climate. Clay-mineral analyses were made of samples from the Molas regolith, the Belden Formation, and the Minturn Formation on the west flank of the Ancestral Front Range; and from the pre-Fountain regolith, the Glen Eyrie Formation, and the Fountain Formation on the east flank of the Ancestral Front Range. Two major types of clay-mineral assemblages occur in these rocks. The Molas regolith, and the Belden and Glen Eyrie Formations contain illite, montmorillonite, mixed-layer illite-montmorillonite, and significant amounts of detrital koalinite. On the basis of this assemblage it is concluded that the climate in which these clay minerals formed was temperate with moderate rainfall. The pre-Fountain regolith (east flank of the Ancestral Front Range), and the Minturn and Fountain Formations, co tain illite, mixed-layer illite-montmorillonite, chlorite, mixed-layer chlorite-vermiculite, and subordinate amounts of authigenic kaolinite. On the basis of this clay-mineral assemblage it is concluded that the climate in which these clay minerals formed was semiarid to arid.

Stratigraphic studies of the Triassic and associated formations were made in southeastern Utah and adjoining parts of Colorado and Arizona. Five principal lines of investigation were followed: regional stratigraphy, sedimentary petrology, pebble studies, sedimentary-structure studies, and lithofacies studies. The formations studied are the Cutler formation, Coconino sandstone, and Kaibab limestone of Permian age; the Moenkopi formation, Chinle formation, and Wingate sandstone of Triassic age; the Kayenta formation of Jurassic (?) age; and the Navajo sandstone of Jurassic and Jurassic (?) age. The Cutler formation grades from a conglomeratic facies in southwestern Colorado to a unit containing alternating reddish siltstone and yellowish-gray sandstone members in southeastern Utah. The reddish siltstone members comprise the Halgaito, Organ Rock, and Hoskinnini tongues. These alternate with the yellowish-gray sandstone members the Cedar Mesa, White Rim, and De Chelly sandstone members. The conglomeratic facies of the Cutler is classified as an arkose that was deposited by streams flowing westward from a rising granitic area in southwestern Colorado. The reddish siltstone members were deposited by quiet water in basins of accumulation on a slowly sinking continental margin, and they, also, were derived from a source area in southwestern Colorado. The Organ Rock tongue is part graywacke and part arkose, whereas the Hoskinnini tongue is arkose. The yellowish-gray sandstone members were deposited by winds blowing toward the southeast, and the materials probably were derived from a source area to the northwest. The Cedar Mesa sandstone member is feldspathic orthoquartzite, and the De Chelly sandstone member is tuffaceous feldspathic orthoquartzite. The Coconino sandstone and Kaibab limestone crop out in the western part of southeastern Utah. The Coconino is laterally equivalent to part of the Cutler formation and is an eolian deposit formed by southeastward-blowing winds. The Kaibab is a marine deposit. The Moenkopi formation of Triassic age consists of reddish horizontally and ripple-laminated siltstone that is classified as arkose and some cross-stratified sandstone of moderately well sorted sand that is classified as feldspathic orthoquartzite. The Sinbad limestone member crops out in central and southcentral Utah and to the south overlaps the underlying part of the Moenkopi.

Hip fracture is one of the severest consequences of osteoporosis affecting elderly women, but abnormalities of bone turnover responsible for bone loss have not been clearly defined. This study evaluated the relationship of bone turnover parameters to hip fracture in postmenopausal elderly women. We also investigated the effects of endogenous hormones and vitamin D deficiency on osteoporotic hip fracture. The subjects were 21 osteoporotic patients with hip fracture (study group) and 20 healthy postmenopausal women (control group). We measured osteocalcin levels, total and bone alkaline phosphatase (T-ALP and B-ALP), calcitonin, intact parathyroid hormone (iPTH), serum 25 hydroxyvitamin D (25OHD), urinary free deoxypyridinoline (D-pyr) and cross-linked N-telopeptides of type 1 collagen (NTx) levels. Serum T-ALP and B-ALP levels in the study group were lower than those of the control group. The mean serum 25OHD levels in the study group were not significantly different from the control group, but in five cases the mean serum iPTH level was increased. The mean urinary NTx levels were significantly increased in the study group compared with the control group (p0.05). There was no significant increase in urinary free D-pyr between the two groups. There was significant correlation between serum T-ALP levels and B-ALP levels and between serum iPTH levels and B-ALP levels. The mean serum SHBG level in the study group was higher than in the control group (p0.05). These data suggest that postmenopausal hip fracture patients have biochemical evidence of decreased bone formation and increased bone resorption compared with postmenopausal healthy subjects. We suggest these abnormalities play a role in the decrease of bone mass and the consequent increase in bone fragility that characterises osteoporotic hip fracture.

Background Asparagine synthetase deficiency (OMIM# 615574) is a very rare newly described neurometabolic disorder characterized by congenital microcephaly and severe global developmental delay, associated with intractable seizures or hyperekplexia. Brain MRI typically shows cerebral atrophy with simplified gyral pattern and delayed myelination. Only 12 cases have been described to date. The disease is caused by homozygous or compound heterozygous mutations in the ASNS gene on chromosome 7q21. Case presentation Family 1 is a multiplex consanguineous family with five affected members, while Family 2 is simplex. One affected from each family was available for detailed phenotyping. Both patients (Patients 1 and 2) presented at birth with microcephaly and severe hyperekplexia, and were found to have gross brain malformation characterized by simplified gyral pattern, and hypoplastic cerebellum and pons. EEG showed no epileptiform discharge in Patient 2 but multifocal discharges in patient 1. Patient 2 is currently four years old with severe neurodevelopmental delay, quadriplegia and cortical blindness. Whole exome sequencing (WES) revealed a novel homozygous mutation in ASNS (NM_001178076.1) in each patient (c.970C > T:p.(Arg324*) and c.944A > G:p.(Tyr315Cys)). Conclusion Our results expand the mutational spectrum of the recently described asparagine synthetase deficiency and show a remarkable clinical homogeneity among affected individuals, which should facilitate its recognition and molecular confirmation for pertinent and timely genetic counseling. Electronic supplementary material The online version of this article (doi:10.1186/s12883-016-0633-0) contains supplementary material, which is available to authorized users.

Background: Virus-specific T-cells (VSTs) proliferate exponentially after adoptive transfer into hematopoietic stem cell transplant (HSCT) recipients, eliminate virus infections, then persist and provide long-term protection from viral disease. If VSTs behaved similarly when modified with tumor-specific chimeric antigen receptors (CARs), they should have potent anti-tumor activity. This theory was evaluated by Cruz et al. in a previous clinical trial with CD19.CAR-modified VSTs, but there was little apparent expansion of these cells in patients. In that study, VSTs were gene-modified on day 19 of culture and we hypothesized that by this time, sufficient T-cell differentiation may have occurred to limit the subsequent proliferative capacity of the transduced T-cells. To facilitate the clinical testing of this hypothesis in a project supported by the NHLBI-PACT mechanism, we developed and optimized a good manufacturing practices (GMP) compliant method for the early transduction of VSTs directed to Epstein-Barr virus (EBV), Adenovirus (AdV) and cytomegalovirus (CMV) using a CAR directed to the tumor-associated antigen disialoganglioside (GD2).Results: Ad-CMVpp65-transduced EBV-LCLs effectively stimulated VSTs directed to all three viruses (triVSTs). Transduction efficiency on day three was increased in the presence of cytokines and high-speed centrifugation of retroviral supernatant onto retronectin-coated plates, so that under optimal conditions up to 88% of tetramer-positive VSTs expressed the GD2.CAR. The average transduction efficiency of early-and late transduced VSTs was 55 ± 4% and 22 ± 5% respectively, and early-transduced VSTs maintained higher frequencies of T cells with central memory or intermediate memory phenotypes. Early-transduced VSTs also had higher proliferative capacity and produced higher levels of TH1 cytokines IL-2, TNF-α, IFN-γ, MIP-1α, MIP-1β and other cytokines in vitro.Conclusions: We developed a rapid and GMP compliant method for the early transduction of multivirus-specific T-cells that allowed stable expression of high levels of a tumor directed CAR. Since a proportion of early-transduced CAR-VSTs had a central memory phenotype, they should expand and persist in vivo, simultaneously protecting against infection and targeting residual malignancy. This manufacturing strategy is currently under clinical investigation in patients receiving allogeneic HSCT for relapsed neuroblastoma and B-cell malignancies (NCT01460901 using a GD2.CAR and NCT00840853 using a CD19.CAR).

Hyaluronic acid (HA) constitutes one of the major components of the extracellular matrix domain in almost all mammals. The aim of this study was to evaluate the regenerative capacity of HA matrix in rat calvarial bone defects and compare with those of different combinations of resorbable collagen membrane (M) and bovine-derived xenograft (G). Twenty-four 3-month-old male Sprague-Dawley rats weighing 200-250 g were included. Control group was created by leaving one defect empty from 2 critical size defects with 5 mm diameter formed in the calvarial bones of 8 rats. In the same rats, the other defect was treated with HA matrix alone. One of the 2 defects formed in other 8 rats was treated with HA+G and the other with HA+M. One of the 2 defects formed in the remaining 8 rats was treated with G+M and the other with HA+G+M. The animals were sacrificed at 4 weeks. Histologic, histomorphometric, and immunohistochemical analyses were performed. Both HA matrix alone and its combinations with G and M supported new bone formation (NBF). However, NBF was significantly greater in G+M and HA+G+M groups compared to control and HA alone (P