Development and validation of a prognostic model for predicting 30-day mortality risk in medical patients in emergency department (ED)

© 2017 The Author(s). The primary aim of this prospective study is to develop and validate a new prognostic model for predicting the risk of mortality in Emergency Department (ED) patients. The study involved 1765 patients in the development cohort and 1728 in the validation cohort. The main outcome was mortality up to 30 days after admission. Potential risk factors included clinical characteristics, vital signs, and routine haematological and biochemistry tests. The Bayesian Model Averaging method within the Cox's regression model was used to identify independent risk factors for mortality. In the development cohort, the incidence of 30-day mortality was 9.8%, and the following factors were associated with a greater risk of mortality: male gender, increased respiratory rate and serum urea, decreased peripheral oxygen saturation and serum albumin, lower Glasgow Coma Score, and admission to intensive care unit. The area under the receiver operating characteristic curve for the model with the listed factors was 0.871 (95% CI, 0.844-0.898) in the development cohort and 0.783 (95% CI, 0.743-0.823) in the validation cohort. Calibration analysis found a close agreement between predicted and observed mortality risk. We conclude that the risk of mortality among ED patients could be accurately predicted by using common clinical signs and biochemical tests

A formal proof of the Kepler conjecture

This article describes a formal proof of the Kepler conjecture on dense sphere packings in a combination of the HOL Light and Isabelle proof assistants. This paper constitutes the official published account of the now completed Flyspeck project

The Biomphalaria glabrata DNA methylation machinery displays spatial tissue expression, is differentially active in distinct snail populations and is modulated by interactions with Schistosoma mansoni

BBSRC Grant (BB/K005448/1)Background The debilitating human disease schistosomiasis is caused by infection with schistosome parasites that maintain a complex lifecycle alternating between definitive (human) and intermediate (snail) hosts. While much is known about how the definitive host responds to schistosome infection, there is comparably less information available describing the snail?s response to infection. Methodology/Principle findings Here, using information recently revealed by sequencing of the Biomphalaria glabrata intermediate host genome, we provide evidence that the predicted core snail DNA methylation machinery components are associated with both intra-species reproduction processes and inter-species interactions. Firstly, methyl-CpG binding domain protein (Bgmbd2/3) and DNA methyltransferase 1 (Bgdnmt1) genes are transcriptionally enriched in gonadal compared to somatic tissues with 5-azacytidine (5-AzaC) treatment significantly inhibiting oviposition. Secondly, elevated levels of 5-methyl cytosine (5mC), DNA methyltransferase activity and 5mC binding in pigmented hybrid- compared to inbred (NMRI)- B. glabrata populations indicate a role for the snail?s DNA methylation machinery in maintaining hybrid vigour or heterosis. Thirdly, locus-specific detection of 5mC by bisulfite (BS)-PCR revealed 5mC within an exonic region of a housekeeping protein-coding gene (Bg14-3-3), supporting previous in silico predictions and whole genome BS-Seq analysis of this species? genome. Finally, we provide preliminary evidence for parasite-mediated host epigenetic reprogramming in the schistosome/snail system, as demonstrated by the increase in Bgdnmt1 and Bgmbd2/3 transcript abundance following Bge (B. glabrata embryonic cell line) exposure to parasite larval transformation products (LTP). Conclusions/Significance The presence of a functional DNA methylation machinery in B. glabrata as well as the modulation of these gene products in response to schistosome products, suggests a vital role for DNA methylation during snail development/oviposition and parasite interactions. Further deciphering the role of this epigenetic process during Biomphalaria/Schistosoma co-evolutionary biology may reveal key factors associated with disease transmission and, moreover, enable the discovery of novel lifecycle intervention strategiespublishersversionPeer reviewe

Construction et validation préliminaire d’un outil francophone mesurant les conceptions épistémiques en lien avec les sciences

Éduquer les futurs citoyens à la science requiert de former les enseignants à la didactique et à l’épistémologie des sciences, de manière à faire évoluer leurs conceptions sur la science, l’enseignement et l’apprentissage des sciences (conceptions épistémiques en lien avec les sciences). Ces conceptions sont objet du champ de recherche de l’épistémologie personnelle, d’origine nord-américaine, où les publications sont majoritairement en langue anglaise. En France, le besoin d’outils d’évaluation des conceptions épistémiques en lien avec les sciences est croissant, et pourtant il n’existe pas d’instrument psychométrique proprement validé en français. Ici nous rapportons la mise au point d’un tel outil, le Questionnaire mesurant les Conceptions Épistémique en lien avec les Sciences (QCES). Une analyse factorielle nous a permis d’identifier des sous-échelles de Likert, de consistance interne satisfaisante. Nous évaluons leur capacité à discriminer les conceptions épistémiques de différentes populations d’étudiants, et à mesurer leur évolution après une formation à l’épistémologie et/ou la didactique des sciences. Nos résultats, conformes à nos hypothèses de départ, montrent une efficacité psychométrique du QCES.Science education for a better citizenship requires training teachers to science epistemology and didactics of science education, in order to favor the evolution of their conceptions about science, science teaching and science learning (epistemic conceptions). These conceptions are studied in the mainly North American research field about personal epistemology. In France, tools are needed to evaluate the impact of teachers’ trainings in science epistemology and didactics of science education. However, there does not exist so far any French psychometric instrument that evaluate epistemic conceptions in science and that is properly validated. Here, we present the outcome of several years of endeavor to develop and set up the Questionnaire that measures Epistemic Conceptions in Science (QCES in French) that are adapted to the epistemological context that is encountered in French science syllabi. We explored the structure and properties the QCES. Results indicated robust internal consistencies of the subscales and their ability to discriminate between different student populations and measure changes in students’ epistemic conceptions

Naloxone increases maturation rate and ratio of inner cell mass to total cells in blastocysts in pigs.

The purposes of the present study were to examine the effect of naloxone, a mu-opioid receptor (MOR) antagonist, on porcine oocyte maturation and embryo development. MOR gene was expressed in germinal vesicle (GV) and metaphase II (M-II) porcine oocytes, one-, four-cell stage embryos and blastocysts. In blastocysts, MOR gene was mainly expressed in inner cell mass (ICM) cells. Supplementation of 10(-8) mol/L naloxone in in vitro maturation (IVM) medium increased the maturation rate (P < 0.05). However, 10(-4) mol/L naloxone reduced the maturation rate (P < 0.05) compared with the control. The presence of naloxone during IVM had no effects on fertilization status and subsequent embryonic development after in vitro culture (IVC). The addition of 10(-3) mol/L dibutyryl cyclic adenosine monophosphate (dbcAMP), and 10(-8 ) mol/L naloxone together into IVM medium increased nuclear maturation (P < 0.05) compared with the addition of either dbcAMP or naloxone alone. Supplementation with naloxone in IVC medium did not improve embryonic development. However, at the concentrations of 10(-6) mol/L and 10(-8) mol/L, naloxone increased the ratio of ICM to total cells in blastocysts (P < 0.05). In conclusion, at low concentration, naloxone increases maturation rate and the ratio of ICM to total cells in blastocysts. Naloxone and cAMP have a synergistic effect on oocyte maturation

Acute febrile myalgia in Vietnam due to trichinellosis following the consumption of raw pork.

Trichinellosis outbreaks occur occasionally in Vietnam following the consumption of undercooked pork. Diagnosing trichinella can be problematic because fever and myalgia are nonspecific, and diagnosis may be delayed. We describe 5 Vietnamese patients in whom trichinellosis was diagnosed after several weeks of illness