When the spleen meets the fetus.

Patient's first pregnancy was complicated by mild thrombocytopenia caused by a 13-cm splenic cyst, who delivered vaginally without complication. Risks and management of maternal splenic cysts in pregnancy and delivery are reviewed here.

Nestepakkauskartongin kosteuden hallinta

Koska kartonki on hygroskooppista, sen kosteus on riippuvainen ilman lämpötilasta ja suhteellisesta kosteudesta. Liian korkea kosteus kartongissa aiheuttaa jäykkyyden alenemista, kartongin sitkeyttä, sekä pullistuneita pakkauksia kuluttajilla. Kosteusongelmia syntyy varastoinnissa, sekä kylmän rullan käsittelyn aikana lämpimissä tuotantotiloissa. Rullaa tulisi säilyttää tiiviissä paketissa, jotta se olisi suojattu ympäristön vaihtelevilta olosuhteilta. Jos pakkaus ei ole tiivis ja ympäröivä ilma pääsee kontaktiin kartongin kanssa kylmävarastoinnin aikana, nousee kartongin kosteus jo parissa vuorokaudessa yli 7 %:iin ilman lämpötilan ollessa 15 °C ja suhteellisen kosteuden 95 %. Kirjallisuusosan tavoitteena oli kartoittaa tekijät, joilla on vaikutusta kuitujen ominaisuuteen imeä itseensä kosteutta ympäröivästä ilmasta. Kokeellisessa osassa selvitettiin, oliko kartongin kosteuden nousu johtunut tasapainokosteuden nousemisesta. Painopisteenä oli tutkia kosteuden muutokset varastoinnin ja konvertoinnin sekä pakkaustuotteen käytön aikana. Simuloinnin avulla määritettiin kosteuden penetroituminen rullaan. Tutkittiin pakkausmateriaalien vesihöyrytiiveydet ja käärinnän vaikutus rullapakkauksen sisäisiin olosuhteisiin. Nestepakkauskartongin tasapainokosteus ei ollut muuttunut. Käytännön varastointikokeiden avulla havaittiin, että pinon päällimmäinen rulla altistui eniten ympäröivän ilman olosuhteiden muutoksille. Havaittiin myös kosteuseroa tämän rullan reunojen välillä. Mitä lyhyempi on varastointiaika kartongin päällystyksen jälkeen, sitä paremmin ehkäistään kosteuden noususta aiheutuvat haitat kartongissa. Maksimivarastointiaika rullille on 1,5 kuukautta, jolloin kartongin kosteus oli 6,5 % ja pinon päällimmäisessä rullassa noin 6,7 %. Pitkään varastoidusta kartongista valmistetuissa maitotölkeissä oli korkein kosteus, suurin pullistuma ja alhaisin otejäykkyys 10 päivän jälkeen täytöstä. Varastointiajan ollessa pitkä, kartongista tulee sitkeää ja venyvää, ja se sitoo enemmän kosteutta kuin mitä se on sitonut ennen varastoon tuloa. Skaivaus pienentää kosteuspenetraatiota raakakartonkiin, jolloin jäykkyys säilyy ja pullistuma pienenee pakkauksessa.

Discrete distributions when modeling the disability severity score of motor victims

Many European states apply score systems to evaluate the disability severity of non-fatal motor victims under the law of third-party liability. The score is a non-negative integer with an upper bound at 100 that increases with severity. It may be automatically converted into financial terms and thus also reflects the compensation cost for disability. In this paper, discrete regression models are applied to analyze the factors that influence the disability severity score of victims. Standard and zero-altered regression models are compared from two perspectives: an interpretation of the data generating process and the level of statistical fit. The results have implications for traffic safety policy decisions aimed at reducing accident severity. An application using data from Spain is provided.

The effect of skewness and kurtosis on the Kenward-Roger approximation when group distributions differ

This study examined the independent effect of skewness and kurtosis on the robustness of the linear mixed model (LMM), with the Kenward-Roger (KR) procedure, when group distributions are different, sample sizes are small, and sphericity cannot be assumed. Methods: A Monte Carlo simulation study considering a split-plot design involving three groups and four repeated measures was performed. Results: The results showed that when group distributions are different, the effect of skewness on KR robustness is greater than that of kurtosis for the corresponding values. Furthermore, the pairings of skewness and kurtosis with group size were found to be relevant variables when applying this procedure. Conclusions: With sample sizes of 45 and 60, KR is a suitable option for analyzing data when the distributions are: (a) mesokurtic and not highly or extremely skewed, and (b) symmetric with different degrees of kurtosis. With total sample sizes of 30, it is adequate when group sizes are equal and the distributions are: (a) mesokurtic and slightly or moderately skewed, and sphericity is assumed; and (b) symmetric with a moderate or high/extreme violation of kurtosis. Alternative analyses should be considered when the distributions are highly or extremely skewed and samples sizes are small.

Maladie de Whipple: quand y penser [Whipple's disease, when to think about it?].

Whipple's disease is a chronic, systemic, bacterial infection caused by Tropheryma whipplei. Its cardinal symptoms include intermittent and recurrent arthralgia or arthritis together with chronic diarrhoea, abdominal pain and weight loss. It may mimick many chronic inflammatory diseases, and the diagnosis remains a challenge. Salivary and faecal quantitative PCR for T. whipplei should be ensued, if positive, by an upper endoscopy for duodenal biopsies. The treatment consists of a combination of oral doxycycline and hydroxychloroquine for 12 months followed by life-long doxycycline. Whipple's disease, although rare, is an entity that should be considered regularly, as its progression may be fatal if left untreated.

Absence of flash-lag when judging global shape from local positions

When a flash is presented aligned with a moving stimulus, the former is perceived to lag behind the latter (the flash-lag effect). We study whether this mislocalization occurs when a positional judgment is not required, but a veridical spatial relationship between moving and flashed stimuli is needed to perceive a global shape. To do this, we used Glass patterns that are formed by pairs of correlated dots. One dot of each pair was presented moving and, at a given moment, the other dot of each pair was flashed in order to build the Glass pattern. If a flash-lag effect occurs between each pair of dots, we expect the best perception of the global shape to occur when the flashed dots are presented before the moving dots arrive at the position that physically builds the Glass pattern. Contrary to this, we found that the best detection of Glass patterns occurred for the situation of physical alignment. This result is not consistent with a low-level contribution to the flash-lag effect.

When the non-contrast-enhanced phase is unnecessary in abdominal computed tomography scans? A retrospective analysis of 244 cases

Objective: To evaluate the necessity of the non contrast-enhanced phase in abdominal computed tomography scans. Materials and Methods: A retrospective, cross-sectional, observational study was developed, evaluating 244 consecutive abdominal computed tomography scans both with and without contrast injection. Initially, the contrast-enhanced images were analyzed (first analysis). Subsequently, the observers had access to the non-contrast-enhanced images for a second analysis. The primary and secondary diagnoses were established as a function of the clinical indications for each study (such as tumor staging, acute abdomen, investigation for abdominal collection and hepatocellular carcinoma, among others). Finally, the changes in the diagnoses resulting from the addition of the non-contrast-enhanced phase were evaluated. Results: Only one (0.4%; p > 0.999; non-statistically significant) out of the 244 reviewed cases had the diagnosis changed after the reading of non-contrast-enhanced images. As the secondary diagnoses are considered, 35 (14%) cases presented changes after the second analysis, as follows: nephrolithiasis (10%), steatosis (3%), adrenal nodule (0.7%) and cholelithiasis (0.3%). Conclusion: For the clinical indications of tumor staging, acute abdomen, investigation of abdominal collections and hepatocellular carcinoma, the non-contrast-enhanced phase can be excluded from abdominal computed tomography studies with no significant impact on the diagnosis.

A Preclinical Model for ERα-Positive Breast Cancer Points to the Epithelial Microenvironment as Determinant of Luminal Phenotype and Hormone Response.

Seventy-five percent of breast cancers are estrogen receptor α positive (ER(+)). Research on these tumors is hampered by lack of adequate in vivo models; cell line xenografts require non-physiological hormone supplements, and patient-derived xenografts (PDXs) are hard to establish. We show that the traditional grafting of ER(+) tumor cells into mammary fat pads induces TGFβ/SLUG signaling and basal differentiation when they require low SLUG levels to grow in vivo. Grafting into the milk ducts suppresses SLUG; ER(+) tumor cells develop, like their clinical counterparts, in the presence of physiological hormone levels. Intraductal ER(+) PDXs are retransplantable, predictive, and appear genomically stable. The model provides opportunities for translational research and the study of physiologically relevant hormone action in breast carcinogenesis.

Identification of metabolites and thermal transformation products of quinolones in raw cow milk by liquid chromatography coupled to high resolution mass spectrometry

The presence of residues of antibiotics, metabolites, and thermal transformation products (TPs), produced during thermal treatment to eliminate pathogenic microorganisms in milk, could represent a risk for people. Cow"s milk samples spiked with enrofloxacin (ENR), ciprofloxacin (CIP), difloxacin (DIF), and sarafloxacin (SAR) and milk samples from cows medicated with ENR were submitted to several thermal treatments. The milk samples were analyzed by liquid chromatography-mass spectrometry (LC-MS) to find and identify TPs and metabolites. In this work, 27 TPs of 4 quinolones and 24 metabolites of ENR were found. Some of these compounds had been reported previously, but others were characterized for the first time, including lactose-conjugated CIP, the formamidation reaction for CIP and SAR, and hydroxylation or ketone formation to produce three different isomers for all quinolones studied.

When decisions of others matter to me: an electrophysiological analysis.

Background: Actions of others may have immediate consequences for oneself. We probed the neural responses associated with the observation of another person"s action using event-related potentials in a modified gambling task. In this task a"performer" bet either a higher or lower number and could win or lose this amount. Three different groups of"observers" were also studied. The first (neutral) group simply observed the performer"s action, which had no consequences for the observers. In the second (parallel) group, wins/losses of the performer were paralleled by similar wins and losses by the observer. In the third (reverse) group, wins of the performer led to a loss of the observer and vice versa. Results: ERPs of the performers showed a mediofrontal feedback related negativity (FRN) to losses. The neutral and parallel observer groups did similarly show an FRN response to the performer"s losses with a topography indistinguishable from that seen in the performers. In the reverse group, however, the FRN occurred for wins of the performer which translated to losses for the observer. Conclusions: Taking into account previous experiments, we suggest that the FRN response in observers is driven by two evaluative processes (a) related to the benefit/loss for oneself and (b) related to the benefit/loss of another person

Identification of metabolites and thermal transformation products of quinolones in raw cow milk by liquid chromatography coupled to high resolution mass spectrometry.

The presence of residues of antibiotics, metabolites, and thermal transformation products (TPs), produced during thermal treatment to eliminate pathogenic microorganisms in milk, could represent a risk for people. Cow"s milk samples spiked with enrofloxacin (ENR), ciprofloxacin (CIP), difloxacin (DIF), and sarafloxacin (SAR) and milk samples from cows medicated with ENR were submitted to several thermal treatments. The milk samples were analyzed by liquid chromatography-mass spectrometry (LC-MS) to find and identify TPs and metabolites. In this work, 27 TPs of 4 quinolones and 24 metabolites of ENR were found. Some of these compounds had been reported previously, but others were characterized for the first time, including lactose-conjugated CIP, the formamidation reaction for CIP and SAR, and hydroxylation or ketone formation to produce three different isomers for all quinolones studied.