Case reports of hypercalcemia and chronic renal disease due to cosmetic injections of polymethylmethacrylate (PMMA)

Injeções de preenchimento de caráter estético são procedimentos comuns em cirurgia plástica em todo o mundo. O polimetilmetacrilato (PMMA) é um material de preenchimento aprovado apenas para procedimentos minimamente invasivos no tecido facial, e está entre as substâncias injetáveis mais frequentemente usadas para fins estéticos. A injeção de um grande volume de PMMA pode levar ao desenvolvimento de hipercalcemia grave e lesão renal crônica em uma frequência provavelmente subestimada. Nesses casos, a hipercalcemia se desenvolve devido a uma reação granulomatosa de corpo estranho, secundária à produção extrarenal de calcitriol. No presente artigo, descrevemos os casos de dois pacientes que receberam injeções de grandes volumes de PMMA e desenvolveram hipercalcemia grave e doença renal crônica avançada. Esses relatos destacam a importância de seguir as regulamentações sobre o uso do PMMA e informar adequadamente os pacientes sobre a possibilidade de complicações antes de realizar tais procedimentos.Cosmetic injections of fillers are common plastic surgery procedures worldwide. Polymethylmethacrylate (PMMA) is a filler approved only for minimally invasive procedures in facial tissue and is among the most frequently used injectable substances for cosmetic purposes. Injection of a large volume of PMMA may lead to the development of severe hypercalcemia and chronic kidney damage in a probably underestimated frequency. In such cases, hypercalcemia develops due to a granulomatous foreign body reaction with extrarenal production of calcitriol. In the present report, we describe the cases of two patients who received injections of large volumes of PMMA and developed severe hypercalcemia and advanced chronic kidney disease. These reports highlight the importance of adhering to regulations regarding the use of PMMA and properly informing patients of the possibility of complications before undertaking such procedures

From the Big Bang Theory to the Theory of a Stationary Universe

We consider chaotic inflation in the theories with the effective potentials phi^n and e^{\alpha\phi}. In such theories inflationary domains containing sufficiently large and homogeneous scalar field \phi permanently produce new inflationary domains of a similar type. We show that under certain conditions this process of the self-reproduction of the Universe can be described by a stationary distribution of probability, which means that the fraction of the physical volume of the Universe in a state with given properties (with given values of fields, with a given density of matter, etc.) does not depend on time, both at the stage of inflation and after it. This represents a strong deviation of inflationary cosmology from the standard Big Bang paradigm. We compare our approach with other approaches to quantum cosmology, and illustrate some of the general conclusions mentioned above with the results of a computer simulation of stochastic processes in the inflationary Universe.Comment: No changes to the file, but original figures are included. They substantially help to understand this paper, as well as eternal inflation in general, and what is now called the "multiverse" and the "string theory landscape." High quality figures can be found at http://www.stanford.edu/~alinde/LLMbigfigs

Probabilistic model checking multi-agent behaviors in dispersion games using counter abstraction

Accurate analysis of the stochastic dynamics of multi-agent system is important but challenging. Probabilistic model checking, a formal technique for analysing a system which exhibits stochastic behaviors, can be a natural solution to analyse multi-agent systems. In this paper, we investigate this problem in the context of dispersion games focusing on two strategies: basic simple strategy (BSS) and extended simple strategies (ESS). We model the system using discrete-time Markov chain (DTMC) and reduce the state space of the models by applying counter abstraction technique. Two important properties of the system are considered: convergence and convergence rate. We show that these kinds of properties can be automatically analysed and verified using probabilistic model checking techniques. Better understanding of the dynamics of the strategies can be obtained compared with empirical evaluations in previous work. Through the analysis, we are able to demonstrate that probabilistic model checking technique is applicable, and indeed useful for automatic analysis and verification of multi-agent dynamics.No Full Tex

Left axis deviation in brugada syndrome: Vectorcardiographic evaluation during ajmaline provocation testing reveals additional depolarization abnormalities

Patients with Brugada syndrome (BrS) can show a leftward deviation of the frontal QRS-axis upon provocation with sodium channel blockers. The cause of this axis change is unclear. In this study, we aimed to determine (1) the prevalence of this left axis deviation and (2) to evaluate its cause, using the insights that could be derived from vectorcardiograms. Hence, from a large cohort of patients who underwent ajmaline provocation testing (n = 1430), we selected patients in whom a type-1 BrS-ECG was evoked (n = 345). Depolarization and repolarization parameters were analyzed for reconstructed vectorcardiograms and were compared between patients with and without a >30◦ leftward axis shift. We found (1) that the prevalence of a left axis deviation during provocation testing was 18% and (2) that this left axis deviation was not explained by terminal conduction slowing in the right ventricular outflow tract (4th QRS-loop quartile: +17 ± 14 ms versus +13 ± 15 ms, nonsignificant) but was associated with a more proximal conduction slowing (1st QRS-loop quartile: +12[8;18] ms versus +8[4;12] ms, p < 0.001 and 3rd QRS-loop quartile: +12 ± 10 ms versus +5 ± 7 ms, p < 0.001). There was no important heterogeneity of the action potential morphology (no difference in the ventricular gradient), but a left axis deviation did result in a dis

Anticholinesterasic activity of Manilkara subsericea (Mart.) Dubard triterpenes

Manilkara subsericea (Mart.) Dubard (Sapotaceae) is popularly known in Brazil as "guracica". The species from the genus Manilkara have been studied and several substances were found, including triterpenes. In the present study, we describe the anticholinesterasic activity of an extract of M. subsericea containg beta-amyrin acetate (76.3 %) and alpha-amyrin acetate (23.7 %) using a TLC bioassay.Colegio de Farmacéuticos de la Provincia de Buenos Aire

Demonstration of the temporal matter-wave Talbot effect for trapped matter waves

We demonstrate the temporal Talbot effect for trapped matter waves using ultracold atoms in an optical lattice. We investigate the phase evolution of an array of essentially non-interacting matter waves and observe matter-wave collapse and revival in the form of a Talbot interference pattern. By using long expansion times, we image momentum space with sub-recoil resolution, allowing us to observe fractional Talbot fringes up to 10th order.Comment: 17 pages, 7 figure

Azimuthal anisotropy at RHIC: the first and fourth harmonics

We report the first observations of the first harmonic (directed flow, v_1), and the fourth harmonic (v_4), in the azimuthal distribution of particles with respect to the reaction plane in Au+Au collisions at the Relativistic Heavy Ion Collider (RHIC). Both measurements were done taking advantage of the large elliptic flow (v_2) generated at RHIC. From the correlation of v_2 with v_1 it is determined that v_2 is positive, or {\it in-plane}. The integrated v_4 is about a factor of 10 smaller than v_2. For the sixth (v_6) and eighth (v_8) harmonics upper limits on the magnitudes are reported.Comment: 6 pages with 3 figures, as accepted for Phys. Rev. Letters The data tables are at http://www.star.bnl.gov/central/publications/pubDetail.php?id=3

Non-bee insects are important contributors to global crop pollination

Wild andmanaged bees arewell documented as effective pollinators of global crops of economic importance. However, the contributions by pollinators other than bees have been little explored despite their potential to contribute to crop production and stability in the face of environmental change. Non-bee pollinators include flies, beetles, moths, butterflies, wasps, ants, birds, and bats, among others. Here we focus on non-bee insects and synthesize 39 field studies from five continents that directly measured the crop pollination services provided by non-bees, honey bees, and other bees to compare the relative contributions of these taxa. Non-bees performed 25-50% of the total number of flower visits. Although non-bees were less effective pollinators than bees per flower visit, they made more visits; thus these two factors compensated for each other, resulting in pollination services rendered by non-bees that were similar to those provided by bees. In the subset of studies that measured fruit set, fruit set increased with non-bee insect visits independently of bee visitation rates, indicating that non-bee insects provide a unique benefit that is not provided by bees. We also show that non-bee insects are not as reliant as bees on the presence of remnant natural or seminatural habitat in the surrounding landscape. These results strongly suggest that non-bee insect pollinators play a significant role in global crop production and respond differently than bees to landscape structure, probably making their crop pollination services more robust to changes in land use. Non-bee insects provide a valuable service and provide potential insurance against bee population declines.Peer Reviewe