The molybdenum isotopic composition in river water: Constraints from small catchments

We report molybdenum isotope compositions and concentrations in water samples from a variety of river catchment profiles in order to investigate the influence of anthropogenic contamination, catchment geology, within-river precipitation, and seasonal river flow variations on riverine molybdenum. Our results show that the observed variations in δ98/95Mo from 0‰ to 1.9‰ are primarily controlled by catchment lithology, particularly by weathering of sulfates and sulfides. Erosion in catchments dominated by wet-based glaciers leads to very high dissolved molybdenum concentrations. In contrast, anthropogenic inputs affect neither the concentration nor the isotopic composition of dissolved molybdenum in the rivers studied here. Seasonal variations are also quite muted. The finding that catchment geology exerts the primary control on the delivery of molybdenum to seawater indicates that the flux and isotope composition of molybdenum to seawater has likely varied in the geologic past.

High expression of octamer-binding transcription factor 4A, prominin-1 and aldehyde dehydrogenase strongly indicates involvement in the initiation of lung adenocarcinoma resulting in shorter disease-free intervals

The increasing relevance of the cancer stem cell (CSC) hypothesis and the impact of CSC-associated markers in the carcinogenesis of solid tumours may provide potential prognostic implications in lung cancer. We propose that a collective genetic analysis of established CSC-related markers will generate data to better define the role of putative CSCs in lung adenocarcinoma (LAC).

Determinants of timely management of acute bacterial meningitis in the ED

PURPOSE: The purpose was to study the emergency management of patients with suspected meningitis to identify potential areas for improvement. METHODS: All patients who underwent cerebrospinal fluid puncture at the emergency department of the University Hospital of Bern from January 31, 2004, to October 30, 2008, were included. A total of 396 patients were included in the study. For each patient, we analyzed the sequence and timing for the following management steps: first contact with medical staff, administration of the first antibiotic dose, lumbar puncture (LP), head imaging, and blood cultures. The results were analyzed in relation to clinical characteristics and the referral diagnosis on admission. RESULTS: Of the 396 patient analyzed, 15 (3.7%) had a discharge diagnosis of bacterial meningitis, 119 (30%) had nonbacterial meningitis, and 262 (66.3%) had no evidence of meningitis. Suspicion of meningitis led to earlier antibiotic therapy than suspicion of an acute cerebral event or nonacute cerebral event (P < .0001). In patients with bacterial meningitis, the average time to antibiotics was 136 minutes, with a range of 0 to 340 minutes. Most patients (60.1%) had brain imaging studies performed before LP. On the other hand, half of the patients with a referral diagnosis of meningitis (50%) received antibiotics before performance of an LP. CONCLUSIONS: Few patients with suspected meningitis received antimicrobial therapy within the first 30 minutes after arrival, but most patients with pneumococcal meningitis and typical symptoms were treated early; patients with bacterial meningitis who received treatment late had complex medical histories or atypical presentations.