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Objective: Report the clinical case of Gastric Adenomyoma as etiology of pyloric syndrome. Clinical case: We present a 52 years old man who attended the emergency room due pyloric syndrome and who underwent a distal gastrectomy. The pathological report revealed a gastric adenomyoma with ulcerative lesion. Discussion: This pathology is an unusual finding, and the literature describe it with extremely low rate of malignant transformation. Conclusion: Gastric adenomyoma is a infrequent pathology and should be taken into account when endoscopic studies are not enough to determine the etiology of a pyloric syndrome.

Severe regional haze events, which are characterized by exceedingly high levels of fine particulate matter (PM), occur frequently in many developing countries (such as China and India), with profound implications for human health, weather, and climate. The occurrence of the haze extremes involves a complex interplay between primary emissions, secondary formation, and conducive meteorological conditions, and the relative contributions of the various processes remain unclear. Here we investigated severe regional haze episodes in 2013 over the Northern China Plain (NCP), by evaluating the PM production and the interactions between elevated PM and the planetary boundary layer (PBL). Analysis of the ground-based measurements and satellite observations of PM properties shows nearly synchronized temporal PM variations among the three megacities (Beijing, Baoding, and Shijiazhuang) in this region and a coincidence of the aerosol optical depth (AOD) hotspots with the three megacities during the polluted period. During the clean-to-hazy transition, the measured oxygenated organic aerosol concentration ([OOA]) well correlates with the odd-oxygen concentration ([Ox]=[O3]+[NO2]), and the mean [OOA] / [Ox] ratio in Beijing is much larger than those in other megacities (such as Mexico City and Houston), indicating highly efficient photochemical activity. Simulations using the Weather Research and Forecasting (WRF) model coupled with an explicit aerosol radiative module reveal that strong aerosol–PBL interaction during the polluted period results in a suppressed and stabilized PBL and elevated humidity, triggering a positive feedback to amplify the haze severity at the ground level. Model sensitivity study illustrates the importance of black carbon (BC) in the haze–PBL interaction and the aerosol regional climatic effect, contributing to more than 30 % of the PBL collapse and about half of the positive radiative forcing on the top of the atmosphere. Overall, severe regional haze exhibits strong negative radiative forcing (cooling) of −63 to −88 W m−2 at the surface and strong positive radiative forcing (warming) of 57 to 82 W m−2 in the atmosphere, with a slightly negative net radiative forcing of about −6 W m−2 on the top of the atmosphere. Our work establishes a synthetic view for the dominant regional features during severe haze events, unraveling rapid in situ PM production and inefficient transport, both of which are amplified by atmospheric stagnation. On the other hand, regional transport sufficiently disperses gaseous aerosol precursors (e.g., sulfur dioxide, nitrogen oxides, volatile organic compounds, and ammonia) during the clean period, which subsequently result in rapid in situ PM production via photochemistry during the transition period and via multiphase chemistry during the polluted period. Our findings highlight the co-benefits for reduction in BC emissions, which not only improve local and regional air quality by minimizing air stagnation but also mitigate the global warming by alleviating the positive direct radiative forcing.

Ectopic pancreas is an unusual finding, with an incidence below 0.5% of all reports worldwide. We report a 26 years old woman who went to emergency room with abdominal pain and underwent laparoscopic cholecystectomy. The pathology report described pancreatic ectopic tissue in the wall of the gallbladder. This finding must be thoroughly evaluated because this tissue can suffer diseases like pancreatitis, cystic tumours and malign degeneration, and should be considerated in the context of gallbladder polips with digestive sintomatology.

The distribution and dynamics of atmospheric pollutants are spatiotemporally heterogeneous due to variability in emissions, transport, chemistry, and deposition. To understand these processes at high spatiotemporal resolution and their implications for air quality and personal exposure, we present custom, low-cost air quality monitors that measure concentrations of contaminants relevant to human health and climate, including gases (e.g., O3, NO, NO2, CO, CO2, CH4, and SO2) and size-resolved (0.3–10 µm) particulate matter. The devices transmit sensor data and location via cellular communications and are capable of providing concentration data down to second-level temporal resolution. We produce two models: one designed for stationary (or mobile platform) operation and a wearable, portable model for directly measuring personal exposure in the breathing zone. To address persistent problems with sensor drift and environmental sensitivities (e.g., relative humidity and temperature), we present the first online calibration system designed specifically for low-cost air quality sensors to calibrate zero and span concentrations at hourly to weekly intervals. Monitors are tested and validated in a number of environments across multiple outdoor and indoor sites in New Haven, CT; Baltimore, MD; and New York City. The evaluated pollutants (O3, NO2, NO, CO, CO2, and PM2.5) performed well against reference instrumentation (e.g., r=0.66–0.98) in urban field evaluations with fast e-folding response times (≤ 1 min), making them suitable for both large-scale network deployments and smaller-scale targeted experiments at a wide range of temporal resolutions. We also provide a discussion of best practices on monitor design, construction, systematic testing, and deployment.

Background: Azacitidine (AZA) is approved for the treatment of high-risk chronic myelomonocytic leukemia (CMML) of myelodysplastic (MD) subtype. Data of response rates using the specific response criteria for this disease are scarce. The aim of this study was to evaluate the response to AZA in patients diagnosed with CMML from the Spanish Registry of Myelodysplastic Syndromes (MDS) applying the overlap myelodysplastic/myeloproliferative neoplasms (MDS/MPN) response criteria. Methods: We retrospectively studied 91 patients with CMML treated with at least one cycle of AZA from the Spanish Registry of MDS. As it was a real-world study, the response rate was evaluated between cycle 4 and 6, applying the MDS/MPN response criteria Findings: The overall response rate at cycle 4-6 was 58%. Almost half of the patients achieved transfusion independence and one quarter showed clinical benefit, regardless of the CMML French-American-British (FAB) and World Health Organization (WHO) subtypes and CMML Specific Prognosis Scoring (CPSS) risk groups. Toxicity was higher in the MD-CMML subtype. Interpretation: In our series, most CMML patients achieved an overall response rate with AZA according to the overlap-MDS/MPN response criteria regardless of the CMML FAB and WHO subtypes and CPSS risk groups. Thus, AZA may also be a treatment option for patients with the myeloproliferative CMML subtype and those with a lower-risk CPSS, but symptomatic.

Significance High concentrations of ultrafine particles (UFPs), approaching 1 million/cm3, are frequently produced from new particle formation under urban environments, but the fundamental mechanisms regulating nucleation and growth for UFPs are poorly understood. From simultaneous ambient and environmental chamber measurements, we demonstrate remarkable formation of UFPs from urban traffic emissions. By replicating ambient conditions using an environmental chamber method, we elucidate the roles of existing particles, photochemistry, and synergy of multipollutant photooxidation in nucleation and growth of UFPs. Our results reveal that synergetic oxidation of vehicular exhaust leads to efficient formation of UFPs under urban conditions. Recognition of this large urban source for UFPs is essential to accurately assessing their impacts and to effectively developing mitigation policies., High levels of ultrafine particles (UFPs; diameter of less than 50 nm) are frequently produced from new particle formation under urban conditions, with profound implications on human health, weather, and climate. However, the fundamental mechanisms of new particle formation remain elusive, and few experimental studies have realistically replicated the relevant atmospheric conditions. Previous experimental studies simulated oxidation of one compound or a mixture of a few compounds, and extrapolation of the laboratory results to chemically complex air was uncertain. Here, we show striking formation of UFPs in urban air from combining ambient and chamber measurements. By capturing the ambient conditions (i.e., temperature, relative humidity, sunlight, and the types and abundances of chemical species), we elucidate the roles of existing particles, photochemistry, and synergy of multipollutants in new particle formation. Aerosol nucleation in urban air is limited by existing particles but negligibly by nitrogen oxides. Photooxidation of vehicular exhaust yields abundant precursors, and organics, rather than sulfuric acid or base species, dominate formation of UFPs under urban conditions. Recognition of this source of UFPs is essential to assessing their impacts and developing mitigation policies. Our results imply that reduction of primary particles or removal of existing particles without simultaneously limiting organics from automobile emissions is ineffective and can even exacerbate this problem.

Severe wintertime haze events with exceedingly high levels of aerosols have occurred frequently in China in recent years, impacting human health, weather, and the climate. A better knowledge of the formation mechanism and aerosol properties during haze events is helpful for the development of effective mitigation policies. In this study, we present field measurements of aerosol properties at an urban site in Beijing during January and February 2015. A suite of aerosol instruments were deployed to measure a comprehensive set of aerosol chemical and physical properties. The evolution of haze events in winter, dependent on meteorological conditions, consistently involves new particle formation during the clean period and subsequently continuous growth from the nucleation mode particles to submicron particles over the course of multiple days. Particulate organic matter is primarily responsible for producing the nucleation mode particles, while secondary organic and inorganic components jointly contribute to the high aerosol mass observed during haze events. The average effective density and hygroscopic parameter (κ) of ambient particles are approximately 1.37 g cm−3 and 0.25 during the clean period and increase to 1.42 g cm−3 and 0.4 during the polluted period, indicating the formation of secondary inorganic species from the continuous growth of nucleation mode particles. Our results corroborate that the periodic cycles of severe haze formation in Beijing during winter are attributed to the efficient nucleation and secondary aerosol growth under high gaseous precursor concentrations and the stagnant air conditions, highlighting that reductions in emissions of aerosol precursor gases are critical for remedying secondary aerosol formation and thereby mitigating haze pollution.

Many studies, focused in TiO2 nanotubes obtained by anodization, uses frequently a NH4F salt concentration from 0.3 – 0.5 wt% and the information about how voltage and time affects to nanotubes morphology, are valid for these concentration, moreover, this range induces a long time of anodized. TiO2 nanotubes were prepared by anodization process of a set of titanium foils in order to study the influence of time and voltage on the morphology of them. The anodization process consists of an organic media of ethylene glycol and 1.2 wt% of NH4F salts, voltage from 5 to 30 V for a time period from 1 to 6 hours, constant potential of 30 V for a time lapse from 10 to 360 minutes and 5 to 480 seconds. All anodized samples are rinsed and annealed to 400 °C by 3 hours to obtain an anatase crystalline structure. The morphological characterization was carried out by Field Emission Scanning Electron Microscopy (FESEM) to verify the presence of the nanostructures: nanopores, nanotubes and nanograss, these nanostructures were identified to appear for a time period from 5 to 480 seconds, 10 to 60 minutes and 1 to 6 hours, respectively. The surface morphology, inner diameter and length of the nanotubes varied with the electrochemical anodization parameters. Raman spectroscopy was used for optical characterization in order to identify the changes in signal intensity and Eg mode Shift and it was observed that intensity suffers an increment and Eg mode suffers a blue shift as a thickness function.

This work deals with daylighting for quality indoor atmospheres, considering building skins. In recent years, almost all retrofit facades of restaurants are highly glazed façades, boosting glare, sun ray absorption and overheating inside. Most of the time, they are not integrated with daylight control, therefore, lighting and out view requirements are not so balanced. Taking into account this daylighting complexity, an alternative façade system is proposed to simulate by Radiance. Previously, perception simulations are compared with measured data, in order to discretize the simulations. In addition, for one point three different view are assessed as: work plane, relation plane and the out plane. Subsequently, two virtual façade models, windows combined by complex fenestration system (CFS) as prismatic film (PF) and highly glazed façade, are tested according to daylighting. For that, three indexes have been used: daylight glare probability (DGP), daylight glare index (DGI) and daylight autonomy (DA). The results show that the proposed complex façade has a good light contribution with less absorption, while maintaining the outside view. In addition, the DGI is needed to test the out plane, because DGP is more suitable for lower luminance, therefore, each visual plane should be assessed regarding different visual comfort conditions, or parameters and methods. Accordingly, the mean DGI result of window combined by CFS is approximately lower in 5% than highly glazed façade. However, the DA of highly glazed is higher in 5%, but the DA of window combined by CFS is enough, above 80%. Definitely, the complex scene at restaurant with the proposed integrated façade system improves light performance and indoor atmosphere.

In the province of Santiago de Cuba, Cuba, the COVID-19 epidemic has a limited progression that shows an early small-number peak of infections. Most published mathematical models fit data with high numbers of confirmed cases. In contrast, small numbers of cases make it difficult to predict the course of the epidemic. We present two known models adapted to capture the noisy dynamics of COVID-19 in the Santiago de Cuba province. Parameters of both models were estimated using the approximate-Bayesian-computation framework with dedicated error laws. One parameter of each model was updated on key dates of travel restrictions. Both models approximately predicted the infection peak and the end of the COVID-19 epidemic in Santiago de Cuba. The first model predicted 57 reported cases and 16 unreported cases. Additionally, it estimated six initially exposed persons. The second model forecasted 51 confirmed cases at the end of the epidemic. In conclusion, an opportune epidemiological investigation, along with the low number of initially exposed individuals, might partly explain the favorable evolution of the COVID-19 epidemic in Santiago de Cuba. With the available data, the simplest model predicted the epidemic evolution with greater precision, and the more complex model helped to explain the epidemic phenomenology.

Hollow bricks in fired clay for masonry are important in design and construction of buildings. Their thermal and mechanical properties must be considered because of the impact they have on energy consumption. The objective of this research is to evaluate thermal and mechanical properties of a new hollow brick, called Eco Design, made of fired clay and rice husk additive, in order to identify the benefits of its use in the construction of masonry walls in regions with a tropical climate. The methodology develops simulation of thermal properties of brick, manufacturing at the laboratory level and characterization of mechanical properties of finished product. Thermal validation simulates the behavior of heat transfer and fluxes of Eco Design in mixtures of 100% fired clay, 95% -5%, 85% -15% and 70% -30% fired clay with rice husk, respectively. Eco Design samples are manufactured by extrusion and fired at 1000 °C. The characterization of mechanical properties of samples manufactured consists of determining dimensions, water absorptive capacity, linear shrinkage, mass losses and mechanical resistance to compression according to Colombian normative. The results indicate that Eco Design brick has a thermal benefit of 6.9 °C in 95% -5% mixture, as the percentage of rice husk increases, benefit increases 0.75 °C additional. Furthermore, the implementation of rice husk additive improves 7.15% mechanical resistance to compression and increases 18.3% water absorption capacity. Finally, the assessment of thermal and mechanical properties of Eco Design is a reference to promote innovation in ceramic industry in Norte de Santander and Colombia.

Significance Particulate matter exposure causes infant respiratory morbidity and mortality, but the role of ultrafine particles (UFPs) with an aerodynamic diameter of less than 0.1 μm in asthma and respiratory tract infections is unclear. Limited mechanistic information is available concerning UFP influence on the etiology of childhood asthma or susceptibility to respiratory infections. Here we exposed two strains of mice (sensitive to oxidative stress or allergen exposure) to UFPs throughout gestation at concentrations relevant to human exposures. Our results reveal a window of pulmonary immunosuppression in offspring following in utero UFP exposure. A dampened host immune response during early development underlies increased childhood susceptibility to respiratory infections, highlighting the necessity to develop strategies to protect the fetus during this vulnerable period., Early life exposure to fine particulate matter (PM) in air is associated with infant respiratory disease and childhood asthma, but limited epidemiological data exist concerning the impacts of ultrafine particles (UFPs) on the etiology of childhood respiratory disease. Specifically, the role of UFPs in amplifying Th2- and/or Th17-driven inflammation (asthma promotion) or suppressing effector T cells (increased susceptibility to respiratory infection) remains unclear. Using a mouse model of in utero UFP exposure, we determined early immunological responses to house dust mite (HDM) allergen in offspring challenged from 0 to 4 wk of age. Two mice strains were exposed throughout gestation: C57BL/6 (sensitive to oxidative stress) and BALB/C (sensitive to allergen exposure). Offspring exposed to UFPs in utero exhibited reduced inflammatory response to HDM. Compared with filtered air (FA)-exposed/HDM-challenged mice, UFP-exposed offspring had lower white blood cell counts in bronchoalveolar lavage fluid and less pronounced peribronchiolar inflammation in both strains, albeit more apparent in C57BL/6 mice. In the C57BL/6 strain, offspring exposed in utero to FA and challenged with HDM exhibited a robust response in inflammatory cytokines IL-13 and Il-17. In contrast, this response was lost in offspring exposed in utero to UFPs. Circulating IL-10 was significantly up-regulated in C57BL/6 offspring exposed to UFPs, suggesting increased regulatory T cell expression and suppressed Th2/Th17 response. Our results reveal that in utero UFP exposure at a level close to the WHO recommended PM guideline suppresses an early immune response to HDM allergen, likely predisposing neonates to respiratory infection and altering long-term pulmonary health.

Biochemical and molecular genetic studies were performed on two novel Gram-stain-positive, catalase-negative, coccus-shaped organisms isolated from liquid joint samples of two pigs. The micro-organisms were not identified as members of a recognized species based on results of cellular, morphological and biochemical tests. 16S rRNA gene sequence comparison studies allowed their identification as members of the genus Jeotgalibaca , but the organisms were different to Jeotgalibaca dankookensis , the single species of the genus. The two micro-organisms shared 96.3 and 96.9 % 16S rRNA gene sequence similarity values with their nearest phylogenetic relative, J. dankookensis . The novel bacterial isolates were distinguished from J. dankookensis using biochemical tests. Based on both phenotypic and phylogenetic findings, it is proposed that the unknown bacteria be classified as representatives of two novel species of the genus Jeotgalibaca , Jeotgalibaca porci sp. nov. and Jeotgalibaca arthritidis sp. nov. The type strain of Jeotgalibaca porci sp. nov. is 1804-02T (=CECT 9156T=CCUG 69148T) and that of Jeotgalibaca arthritidis sp. nov. is 1805-02T (=CECT 9157T=CCUG 69147T).

Exposure to fine particulate matter (PM) during pregnancy is associated with high risks of birth defects/fatality and adverse long-term postnatal health. However, limited mechanistic data are available to assess the detailed impacts of prenatal PM exposure. Here we evaluate fine PM exposure during pregnancy on prenatal/postnatal organogenesis in offspring and in predisposing metabolic syndrome for adult life. Between days 0 and 18 of gestation, two groups of adult female rats (n = 10 for each) were placed in a dual-exposure chamber device, one with clean ambient air (∼3 µg·m(−3)) and the other with ambient air in the presence of 100 to 200 µg·m(−3) of ultrafine aerosols of ammonium sulfate. At birth (postnatal day 0, PND0), four males and four females were selected randomly from each litter to be nursed by dams, whereas tissues were collected from the remaining pups. At PND21, tissues were collected from two males and two females, whereas the remaining pups were fed either a high- or low-fat diet until PND105, when tissues were obtained for biochemical and physiological analyses. Maternal exposure to fine PM increased stillbirths; reduced gestation length and birth weight; increased concentrations of glucose and free fatty acids in plasma; enhanced lipid accumulation in the liver; and decreased endothelium-dependent relaxation of aorta. This lead to altered organogenesis and predisposed progeny to long-term metabolic defects in an age-, organ-, and sex-specific manner. Our results highlight the necessity to develop therapeutic strategies to remedy adverse health effects of maternal PM exposure on conceptus/postnatal growth and development.

Background The introduction of MALDI-TOF MS in the clinical microbiology laboratory has modified the approaches for the identification of fungi. Thanks to this tool, it is possible to identify cryptic species, which possess critical susceptibility patterns. Clinical strains were identified using the MicroScan and MALDI-TOF MS systems. Discrepant results from both methods were investigated using ITS rDNA barcoding. Finally, these isolates were also tested for in vitro susceptibility. Results The percentage of agreement between both methods to 498 yeast isolates was of 93.6% (32 discrepant isolates). The concordance of ITS sequencing with MALDI-TOF MS was higher (99%) than that of MicroScan (94%). Several of these discordant yeasts displayed high MICs for antifungal agents. Conclusions Our study highlights the need of the MS and molecular approaches such as MALDI-TOF MS and ITS rDNA barcoding for the correct identification of emerging or cryptic yeast species; besides, some of these could be multidrug resistant. This work was the first experience in the implementation of the MALDI-TOF MS technology in Colombia. We found the first uncommon yeasts including Candida auris and we could identify Trichosporon faecalis. Our work highlights a clear necessity of an accurate yeast identification as a much more pertinent technique than the susceptibility profiles, because the most unusual yeasts exhibit resistance profiles to the few available antifungals.

La irrupción del Covid-19 ha generado un escenario de confusión e incertidumbre en los sistemas educativos, pues las prácticas de formación debieron cambiar abruptamente hacia una lógica no presencial, sin precedentes. Con este propósito, las universidades chilenas han puesto en marcha diversas acciones para la gestión pedagógica en el marco de continuidad formativa pretendida. Por ello, surge la pregunta en torno a cuáles son los dominios y aspectos específicos de dicha gestión que los académicos reconocen como desafíos. Como respuesta, se desarrolló una investigación descriptiva que aplicó un cuestionario a directivos y docentes en distintas instituciones de educación superior en el país. Los principales resultados indican que el dominio metodológico y el dominio evaluativo presentan mayores desafíos a los participantes, mientras que el foco curricular es el menos relevado. Las proyecciones apuntan a la necesidad de generar una visión institucional compartida de continuidad formativa, que movilice acciones articuladas de gestión pedagógica por parte de los actores educativos. Entre otros aspectos, se releva la necesidad de conducir procesos de rediseño de las propuestas formativas planificadas prepandemia, identificando los nudos críticos que deben ser resueltos para resguardar la calidad y la equidad de la educación no presencial, en el contexto emergente que hoy se está experimentando.

In Mexico, Euphorbia strigosa has been identified as a species with ornamental potential, as a result of its color and small size (35 cm, is considered a dwarf version of Euphorbia pulcherrima). The difficulty in the conservation of E. strigosa is found in the great variability of its seeds depending on environmental and genotypic conditions where the species grows. Therefore, the objective of the present study was to describe the seeds of E. strigosa wild plants of the State of Nayarit, México (2013-2014). Group variables of 1000 and 100 seeds were measured, as well as the number of seeds in 1 g and in 10 mL. In addition, a sample of 130 seeds from each year were individually assessed for physical variables. The seeds were classified according to three degrees of luminosity of the brown color (Clear medium and dark) and four weight ranges (3.0-8.0; 8.1-13.0; 13.1-18.0 y > 18.1 mg). Based on the classification of factors: Year of collection, lightness of coffee color and weight, 22 subgroups were formed. In each subgroup the percentage of germination was evaluated. There were significant differences in all characteristics evaluated, which indicates the morphogenetic diversity of the seeds collected.

Sulfate aerosols exert profound impacts on human and ecosystem health, weather, and climate, but their formation mechanism remains uncertain. Atmospheric models consistently underpredict sulfate levels under diverse environmental conditions. From atmospheric measurements in two Chinese megacities and complementary laboratory experiments, we show that the aqueous oxidation of SO_2 by NO_2 is key to efficient sulfate formation but is only feasible under two atmospheric conditions: on fine aerosols with high relative humidity and NH_3 neutralization or under cloud conditions. Under polluted environments, this SO_2 oxidation process leads to large sulfate production rates and promotes formation of nitrate and organic matter on aqueous particles, exacerbating severe haze development. Effective haze mitigation is achievable by intervening in the sulfate formation process with enforced NH_3 and NO_2 control measures. In addition to explaining the polluted episodes currently occurring in China and during the 1952 London Fog, this sulfate production mechanism is widespread, and our results suggest a way to tackle this growing problem in China and much of the developing world.

Los lipomas gástricos son una patología muy rara que representan el 5% de los lipomas gastrointestinales y menos del 1% de los tumores benignos del estómago. Los lipomas gástricos gigantes (≥ 4 cm) son extremadamente raros, habiéndose encontrado solo 32 casos reportados en la bibliografía. Reportamos el primer caso de un lipoma gástrico gigante en el Perú, operado por gastrectomía corporal por laparotomía en una paciente mujer de 79 años que acudió con un cuadro clínico de dos meses de evolución caracterizado por dolor abdominal en epigastrio más sensación de llenura precoz, deposiciones oscuras y pérdida de peso. Al examen físico se halló una masa palpable de aproximadamente 8 cm en hipocondrio izquierdo. La endoscopía digestiva alta reveló una lesión elevada en el tercio proximal del cuerpo gástrico de aproximadamente 30 mm. Se realizó un estudio tomográfico que evidenció una masa sospechosa de lipoma gástrico por lo que se procedió a realizar una gastrectomía corporal por laparotomía. El informe anatomopatológico confirmó el diagnóstico de lipoma gástrico gigante. En el posoperatorio no hubo complicaciones y fue dada de alta al séptimo día.

Objective: To assess the frequency of care in an emergency department in the 6 months prior to the diagnosis of tuberculosis and to determine the reasons for the care, the degree of suspicion in the emergency department and the factors associated with this suspicion. Method: A retrospective study was conducted on patients with pulmonary tuberculosis treated in the general emergency department between 2011 and 2017. Results: Of the 54 included patients, 38 (70%) had been treated in the emergency department in the 6 months prior to the diagnosis: 6 (16%) patients had been treated for processes unrelated to the tuberculosis, and 32 (84%) were treated for processes that were potentially related to the tuberculosis. Pulmonary tuberculosis was suspected in the emergency department for 12 (38%) of these patients and not suspected in the remaining 20 patients (62%). The group in which pulmonary tuberculosis was suspected had a higher rate of general and respiratory symptoms and cavitation in the radiography. Conclusions: A high percentage of patients with pulmonary tuberculosis were admitted to the emergency department in the 6 months prior to the diagnosis, and this diagnostic possibility was often not suspected. (C) 2019 Elsevier Espana, S.L.U. and Sociedad Espanola de Medicina Interna (SEMI). All rights reserved.

The detection and analysis of circulating tumor cells (CTCs) may enable a broad range of cancer-related applications, including the identification of acquired drug resistance during treatments. However, the non-scalable fabrication, prolonged sample processing times, and the lack of automation, associated with most of the technologies developed to isolate these rare cells, have impeded their transition into the clinical practice. This work describes a novel membrane-based microfiltration device comprised of a fully automated sample processing unit and a machine-vision-enabled imaging system that allows the efficient isolation and rapid analysis of CTCs from blood. The device performance was characterized using four prostate cancer cell lines, including PC-3, VCaP, DU-145, and LNCaP, obtaining high assay reproducibility and capture efficiencies greater than 93% after processing 7.5 mL blood samples from healthy donors, spiked with 100 cancer cells. Cancer cells remained viable after filtration due to the minimal shear stress exerted over cells during the procedure, while the identification of cancer cells by immunostaining was not affected by the number of non-specific events captured on the membrane. We were also able to identify the androgen receptor (AR) point mutation T878A from 7.5 mL blood samples spiked with 50 LNCaP cells using RT-PCR and Sanger sequencing. Finally, CTCs were detected in 8 of 8 samples from patients diagnosed with metastatic prostate cancer (mean $\pm$ SEM = 21 $\pm$ 2.957 CTCs/mL, median = 21 CTC/mL), thereby validating the potential clinical utility of the device., Comment: 13 pages, 6 figures, under review

Brown Carbon (BrC) aerosols scatter and absorb solar radiation, directly affecting the Earth's radiative budget. However, considerable uncertainty exists concerning the chemical mechanism leading to BrC formation and their optical properties. In this work, BrC particles were prepared from mixtures of small α-dicarbonyls (glyoxal and methylglyoxal) and amines (methylamine, dimethylamine, and trimethylamine). The absorption and scattering of BrC particles were measured using a photoacoustic extinctometer (405 and 532 nm), and the chemical composition of the α-dicarbonyl-amine mixtures was analyzed using orbitrap-mass spectrometry and thermal desorption-ion drift-chemical ionization mass spectrometry. The single scattering albedo for methylglyoxal-amine mixtures is smaller than that of glyoxal-amine mixtures and increases with the methyl substitution of amines. The mass absorption cross-section for methylglyoxal-amine mixtures is two times higher at 405 nm wavelength than that at 532 nm wavelength. The derived refractive indexes at the 405 nm wavelength are 1.40-1.64 for the real part and 0.002-0.195 for the imaginary part. Composition analysis in the α-dicarbonyl-amine mixtures reveals N-heterocycles as the dominant products, which are formed via multiple steps involving nucleophilic attack, steric hindrance, and dipole-dipole interaction between α-dicarbonyls and amines. BrC aerosols, if formed from the particle-phase reaction of methylglyoxal with methylamine, likely contribute to atmospheric warming.

Deletions of chromosome 1p36 are associated with a high incidence of congenital heart defects (CHDs). The arginine-glutamic acid dipeptide repeats gene (RERE) is located in a critical region for CHD on chromosome 1p36 and encodes a cardiac-expressed nuclear receptor co-regulator. Mutations affecting RERE cause atrial and ventricular septal defects (VSDs) in humans, and RERE-deficient mice also develop VSDs. During cardiac development, mesenchymal cells destined to form part of the atrioventricular (AV) septum are generated when endocardial cells in the AV canal undergo epithelial-to-mesenchymal transition (EMT) and migrate into the space between the endocardium and the myocardium. These newly generated mesenchymal cells then proliferate to fill the developing AV endocardial cushions. Here, we demonstrate that RERE-deficient mouse embryos have reduced numbers of mesenchymal cells in their AV endocardial cushions owing to decreased levels of EMT and mesenchymal cell proliferation. In the endocardium, RERE colocalizes with GATA4, a transcription factor required for normal levels of EMT and mesenchymal cell proliferation. Using a combination of in vivo and in vitro studies, we show that Rere and Gata4 interact genetically in the development of CHDs, RERE positively regulates transcription from the Gata4 promoter and GATA4 levels are reduced in the AV canals of RERE-deficient embryos. Tissue-specific ablation of Rere in the endocardium leads to hypocellularity of the AV endocardial cushions, defective EMT and VSDs, but does not result in decreased GATA4 expression. We conclude that RERE functions in the AV canal to positively regulate the expression of GATA4, and that deficiency of RERE leads to the development of VSDs through its effects on EMT and mesenchymal cell proliferation. However, the cell-autonomous role of RERE in promoting EMT in the endocardium must be mediated by its effects on the expression of proteins other than GATA4. This article has an associated First Person interview with the first author of the paper., Summary: In the developing atrioventricular canal, RERE promotes endothelial-to-mesenchymal transition and mesenchymal cell proliferation by positively regulating Gata4. Tissue-specific ablation of Rere in the endocardium causes ventricular septal defects.

The aim of the study was to determine if amniotic fluid cells of rats can be used to provide evidence of genotoxicity. In order to do that micronuclei formation was induced in rats during pregnancy after treatment with cyclophosphamide (CP), at different CP doses. On gestational day 19, we collected the amniotic fluid and determined the frequency of micronucleated cells (MNCs) from the offspring. Samples were centrifuged and placed on clean slides. The smears were observed with an epifluorescence microscope. The number of MNCs in 2000 cells per pregnant rat was counted. The fetus weight and size were recorded and provided evidence of DNA damage caused by CP administration to their mothers. A significantly greater number of MNCs was observed only for the medium CP dose (

Black carbon (BC) exerts profound impacts on air quality and climate because of its high absorption cross-section over a broad range of electromagnetic spectra, but the current results on absorption enhancement of BC particles during atmospheric aging remain conflicting. Here, we quantified the aging and variation in the optical properties of BC particles under ambient conditions in Beijing, China, and Houston, United States, using a novel environmental chamber approach. BC aging exhibits two distinct stages, i.e., initial transformation from a fractal to spherical morphology with little absorption variation and subsequent growth of fully compact particles with a large absorption enhancement. The timescales to achieve complete morphology modification and an absorption amplification factor of 2.4 for BC particles are estimated to be 2.3 h and 4.6 h, respectively, in Beijing, compared with 9 h and 18 h, respectively, in Houston. Our findings indicate that BC under polluted urban environments could play an essential role in pollution development and contribute importantly to large positive radiative forcing. The variation in direct radiative forcing is dependent on the rate and timescale of BC aging, with a clear distinction between urban cities in developed and developing countries, i.e., a higher climatic impact in more polluted environments. We suggest that mediation in BC emissions achieves a cobenefit in simultaneously controlling air pollution and protecting climate, especially for developing countries.

The suitability of EGNSS (including EGNOS and Galileo early services) for safety railway applications has been analysed by several European projects such as Grail, Grail-2, Satloc, 3InSat, and it is currently being analysed by ERSAT EAV. ERSAT EAV in particular is addressing the following three challenges beyond the state-of-the-art: a) reuse of ETCS odometry by adding the virtual balise concept to eliminate the fixed balise along the line; b) adoption of the public EGNOS Augmentation network “upgraded” with Local augmentation networks to fulfil the railways’ requirements; c) verification and validation of alternative GNSS solutions to guarantee localization functions in areas where the GNSS signal is not available and/or subject to interference. This paper focuses on the third of these challenges, addressing the design and the implementation of a complementary positioning system (CPS) for GNSS-denied areas. This system is based mainly on the Public Land Mobile Network (PLMN) information but also incorporates additional source information (such as predefined GNSS blocked zone information and GNSS positioning information for calibration purposes, when available) in order to enhance positioning performance. This paper deals with the different steps taken to create the CPS: 1. Analysis of the alternatives for complementary positioning systems when GNSS is not available 2. Simulation and development of algorithms for the CPS in the lab 3. Creation of a prototype for the CPS based on COTS components More specifically, after analysing the state-of-the-art technologies, the algorithms for the selected solution will be implemented in the laboratory. In order to analyse the theoretical performance of the algorithms, the environment and observables for the algorithms will also be modelled in the simulation platform. The performance of the CPS will be analysed in terms of accuracy, reliability, continuity and integrity in a way similar to the GNSS systems. Finally, the algorithms will be implemented in a prototype based on COTS components so that the CPS will not be a theoretical solution but also a real solution that could be useful for the on-board positioning function in trains when GNSS solutions are not available.