Absorption and fluorescence properties of chromophoric dissolved organic matter of the eastern Bering Sea in the summer with special reference to the influence of a cold pool

The absorption and fluorescence properties of chromophoric dissolved organic matter (CDOM) are reported for the inner shelf, slope waters and outer shelf regions of the eastern Bering Sea during the summer of 2008, when a warm, thermally stratified surface mixed layer lay over a cold pool (< 2 °C) that occupied the entire middle shelf. CDOM absorption at 355 nm (<i>a</i>_g355) and its spectral slope (<i>S</i>) in conjunction with excitation–emission matrix (EEM) fluorescence and parallel factor analysis (PARAFAC) revealed large variability in the characteristics of CDOM in different regions of the Bering Sea. PARAFAC analysis aided in the identification of three humic-like (components one, two and five) and two protein-like (a tyrosine-like component three, and a tryptophan-like component four) components. In the extensive shelf region, average absorption coefficients at 355 nm (<i>a</i>_g355, m⁻¹) and DOC concentrations (μM) were highest in the inner shelf (0.342 ± 0.11 m⁻¹, 92.67 ± 14.60 μM) and lower in the middle (0.226 ± 0.05 m⁻¹, 78.38 ± 10.64 μM) and outer (0.185 ± 0.05 m⁻¹, 79.24 ± 18.01 μM) shelves, respectively. DOC concentrations, however were not significantly different, suggesting CDOM sources and sinks to be uncoupled from DOC. Mean spectral slopes <i>S</i> were elevated in the middle shelf (24.38 ± 2.25 μm⁻¹) especially in the surface waters (26.87 ± 2.39 μm⁻¹) indicating high rates of photodegradation in the highly stratified surface mixed layer, which intensified northwards in the northern middle shelf likely contributing to greater light penetration and to phytoplankton blooms at deeper depths. The fluorescent humic-like components one, two, and five were most elevated in the inner shelf most likely from riverine inputs. Along the productive "green belt" in the outer shelf/slope region, absorption and fluorescence properties indicated the presence of fresh and degraded autochthonous DOM. Near the Unimak Pass region of the Aleutian Islands, low DOC and <i>a</i>_g355 (mean 66.99 ± 7.94 μM; 0.182 ± 0.05 m⁻¹) and a high <i>S</i> (mean 25.95 ± 1.58 μm⁻¹) suggested substantial photobleaching of the Alaska Coastal Water, but high intensities of humic-like and protein-like fluorescence suggested sources of fluorescent DOM from coastal runoff and glacier meltwaters during the summer. The spectral slope <i>S</i> vs. <i>a</i>_g355 relationship revealed terrestrial and oceanic end members along with intermediate water masses that were modeled using nonlinear regression equations that could allow water mass differentiation based on CDOM optical properties. Spectral slope <i>S</i> was negatively correlated (<i>r</i>² = 0.79) with apparent oxygen utilization (AOU) for waters extending from the middle shelf into the deep Bering Sea indicating increasing microbial alteration of CDOM with depth. Although our data show that the CDOM photochemical environment of the Bering Sea is complex, our current information on its optical properties will aid in better understanding of the biogeochemical role of CDOM in carbon budgets in relation to the annual sea ice and phytoplankton dynamics, and to improved algorithms of ocean color remote sensing for this region

Spinal disease in myeloma: cohort analysis at a specialist spinal surgery centre indicates benefit of early surgical augmentation or bracing

BACKGROUND: Multiple myeloma osteolytic disease affecting the spine results in vertebral compression fractures. These are painful, result in kyphosis, and impact respiratory function and quality of life. We explore the impact of time to presentation on the efficacy of spinal treatment modalities. METHODS: We retrospectively reviewed 183 patients with spinal myeloma presenting to our service over a 2 year period. RESULTS: Median time from multiple myeloma diagnosis to presentation at our centre was 195 days. Eighty-four patients (45.9 %) were treated with balloon kyphoplasty and the remainder with a thoracolumbar-sacral orthosis as per our published protocol. Patients presenting earlier than 195 days from diagnosis had significant improvements in patient reported outcome measures: EuroQol 5-Dimensions (p < 0.001), Oswestry Disability Index (p < 0.001), and Visual Analogue Pain Score (p < 0.001) at follow-up, regardless of treatment. Patients presenting after 195 days, however, only experienced benefit following balloon kyphoplasty, with no significant benefit from non-operative management. CONCLUSION: Vertebral augmentation and thoracolumbar bracing improve patient reported outcome scores in patients with spinal myeloma. However, delay in treatment negatively impacts clinical outcome, particularly if managed non-operatively. It is important to screen and treat patients with MM and back pain early to prevent deformity and improve quality of life

Reducing dose for digital cranial radiography : The increased source to the image-receptor distance approach

This investigation proposes that an increased source to the image-receptor distance (SID) technique can be used to optimize occipital frontal and lateral cranial radiographs acquired with direct digital radiography. Although cranial radiography is not performed on a routine basis, it should nonetheless be optimized to keep the dose to the patient as low as reasonably achievable, particularly because it can form part of the facial bone and sinus series. Dose measurements were acquired at various SIDs, and image quality was assessed using visual grading analysis. Statistically significant reductions in the effective dose between 19.2% and 23.9% were obtained when the SID was increased from the standard 100 to 150 cm (P ≤.05), and visual grading analysis scores indicate that image quality remained diagnostically acceptable for both projections. This investigation concludes that increasing the SID effectively optimizes occipital frontal and lateral skull radiographs. Radiology departments must be advised of the benefits of this technique with the goal of introducing an updated reference SID of 150 cm into clinical practice.Peer reviewe

Sensory Structures on the Antenniform Legs of Whip Spider, Phrynichus phipsoni (Arachnida, Amblypygi), from the Indian State of Goa: Scanning Electron Microscopic Elucidation

Amblypygi have a tropical and sub-tropical distribution and their first of the four pairs of legs, is modified as feelers. Their activity period and dark habitats render visual cues ineffective and they rely on non-visual sensory perception. There is agreement among researchers that the whip spiders invest in olfactory and tactile senses imparted by sensory structures concentrated on the tarsal segment of the first pair of long, well-articulated non-ambulatory legs that are constantly moved in all directions to sample the environment for detecting location of prey, as also for navigating. This is the first attempt to elucidate the sensory structures present on the antenniform legs of the whip spider, Phrynichus phipsoni (Pocock, 1894), collected from the state of Goa, India; using scanning electron micro[1]scope, and paves way for further research on sensory biology of this cryptic arachnid order. The examined specimen generally conforms to the diversity and morphology of sensory assemblage on the antenniform legs reported in other amblypygi species. Sensory structures elucidated include terminal trident tarsal claws, tarsal organ, bristles, porous sensilla, club sensilla, rod sensilla, slit sensilla, trichobothria, plate organ, pit organ and foliate leaf like hairs

Frequent central nervous system, pachymeningeal and plexus MRI changes in POEMS syndrome

OBJECTIVE: Polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, skin changes (POEMS) syndrome is a rare multisystem disease associated with a plasma-cell dyscrasia. Although pachymeningeal involvement has occasionally been described, MRI of the central nervous system (CNS) has not yet been extensively investigated. METHODS: We retrospectively evaluated CNS MRI in Europe’s largest single-center cohort of POEMS syndrome. Of 77 patients who have been formally diagnosed with POEMS, 41 had MRI brain and 29 had MRI spine. A control group of 33 patients with chronic inflammatory demyelinating polyneuropathy (CIDP) was used as this is the major differential diagnosis. Of these CIDP patients, 12 underwent both MRI brain and spine, 7 had solely MRI brain and 14 had MRI spine. RESULTS: In 41 POEMS patients with MRI brain, we identified frequent smooth, diffuse meningeal thickening of the cerebral convexities and falx (n = 29, 71%), of which 4 had meningeal collections. 17 (41%) had vascular abnormalities including white-matter disease, of which 4 had established infarcts. Of 29 patients with MRI spine, 17 (59%) had thickening of the brachial and lumbosacral plexus. Conversely in 19 CIDP patients with MRI brain, none had meningeal thickening (p < 0.0001); however, 8 (42%) had vascular abnormalities (p = 0.85). Of 26 patients with MRI spine, 9 (35%) had brachial or lumbosacral plexus thickening (p = 0.06). CONCLUSIONS: In contrast to CIDP, POEMS patients frequently have pachymeningeal thickening. Vascular abnormalities and plexus thickening were also common but not statistically different to CIDP

A Nutrient Formulation Affects Developmental Myelination in Term Infants: A Randomized Clinical Trial

Background and Objectives: Observational studies suggest differences between breast-fed and formula-fed infants in developmental myelination, a key brain process for learning. The study aims to investigate the efficacy of a blend of docosahexaenoic acid (DHA), arachidonic acid (ARA), iron, vitamin B12, folic acid, and sphingomyelin (SM) from a uniquely processed whey protein concentrate enriched in alpha-lactalbumin and phospholipids compared with a control formulation on myelination, cognitive, and behavioral development in the first 6 months of life. Methods: These are 6-month results from an ongoing two-center, randomized controlled trial with a 12-month intervention period (completed for all participants). In this study, full term, neurotypical infants of both sexes (N = 81) were randomized into investigational (N = 42) or control groups (N = 39). In addition, non-randomized breast-fed children (N = 108) serve as a natural reference group. Main outcomes are myelination (MRI), cognitive (Bayley Scales of Infant and Toddler Development, 3rd edition [Bayley-III]), social-emotional development (Ages and Stages Questionnaires: Social-Emotional, 2nd edition [ASQ:SE-2]), sleep (Brief Infant Sleep Questionnaire [BISQ]), and safety (growth and adverse events [AEs]). Results: The full analyses set comprises N = 66 infants. Significant differences in myelin structure, volume, and rate of myelination were observed in favor of the investigational myelin blend at 3 and 6 months of life. Effects were demonstrated for whole brain myelin and for cerebellar, parietal, occipital, and temporal regions, known to be functionally involved in sensory, motor, and language skills. No statistically significant differences were found for early behavior and cognition scores. Conclusions: This is the first study demonstrating the efficacy of a myelin nutrient blend in well-nourished, term infants on developmental myelination, which may be foundational for later cognitive and learning outcomes.publishedVersio

A prognostic index predicting survival in transformed Waldenström macroglobulinemia

Histological transformation into diffuse large B-cell lymphoma is a rare complication in patients with Waldenström macroglobulinemia (WM) usually associated with a poor prognosis. The objective of this study was to develop and validate a prognostic index for survival in transformed WM patients. Through this multicenter, international collaborative effort, we developed a scoring system based on data from 133 patients with transformed WM who were evaluated between 1995 and 2016 (training cohort). Univariate and multivariate analyses were used to propose a prognostic index with 2-year survival after transformation as an end-point. For external validation, a data set of 67 patients was used to evaluate the performance of the model (validation cohort). By multivariate analysis, three adverse covariates were identified as independent predictors of 2-year survival after transformation: elevated serum LDH (2 points), platelet count < 100 x 109/L (1 point) and any previous treatment for WM (1 point). Three risk groups were defined: low-risk (0-1 point, 24% of patients), intermediate-risk (2-3 points, 59%, hazard ratio (HR) = 3.4) and high-risk (4 points, 17%, HR = 7.5). Two-year survival rates were 81%, 47%, and 21%, respectively (P < 0.0001). This model appeared to be a better discriminant than the International Prognostic Index (IPI) and the revised IPI (R-IPI). We validated this model in an independent cohort. This easy-to-compute scoring index is a robust tool that may allow identification of groups of transformed WM patients with different outcomes and could be used for improving the development of risk-adapted treatment strategies