C1–C2 Instability Associated with Periodontoid Inflammatory Tissue Leading to Subarachnoid Hemorrhage: A Case Report and Review of the Literature

Abstract The authors present a case of atlantoaxial instability associated with C1–C2 inflammatory tissue leading to subarachnoid hemorrhage. A 65-year-old male patient arrived in June 2011 to the emergency unit for cervical pain and fever. Imaging studies documented periodontoid pseudotumor at C1–C2 level. Infective disease was suspected; the patient was therefore hospitalized and treated with antibiotics. Subsequent computed tomographic (CT) scans revealed C1–C2 instability. In August, the patient showed acute neurological deterioration and coma. Urgent brain CT revealed a hemorrhagic lesion which caused compression on the medulla oblongata, subarachnoid hemorrhage, and ventricular dilatation. An external ventricular drainage was positioned. Angio-CT and angiography did not show any vascular abnormalities. Cervical magnetic resonance imaging documented a solid tissue lesion between the atlas arch and axis. The lesion was associated with an epidural and subdural hematoma, exerting compression on brainstem. The patient underwent posterior decompression and C1–C2 fusion according to Harms technique in October, with significant clinical improvement. The authors present a case of atlantoaxial instability associated with a periodontoid pseudotumor at C1–C2 level determining dural sac compression. The patient showed an acute neurological deterioration caused by bleeding of the solid component of the cervical lesion. Hemorrhage of the solid component of periodontoid masses linked to atlantoaxial instability has not yet been reported in literature. To the best of our knowledge, this is the first case of C1–C2 instability with periodontoid pseudotumor leading to subarachnoid hemorrhage

Histogram Reweighting Method for Dynamic Properties

The histogram reweighting technique, widely used to analyze Monte Carlo data, is shown to be applicable to dynamic properties obtained from Molecular Dynamics simulations. The theory presented here is based on the fact that the correlation functions in systems in thermodynamic equilibrium are averages over initial conditions of functions of the trajectory of the system in phase-space, the latter depending on the volume, the total number of particles and the classical Hamiltonian. Thus, the well-known histogram reweighting method can almost straightforwardly be applied to reconstruct the probability distribution of initial states at different thermodynamic conditions, without extra computational effort. Correlation functions and transport coefficients are obtained with this method from few simulation data sets.Comment: 4 pages, 3 figure

Emerging resistance among bacterial pathogens in the intensive care unit – a European and North American Surveillance study (2000–2002)

Background Globally ICUs are encountering emergence and spread of antibiotic-resistant pathogens and for some pathogens there are few therapeutic options available. Methods Antibiotic in vitro susceptibility data of predominant ICU pathogens during 2000–2 were analyzed using data from The Surveillance Network (TSN) Databases in Europe (France, Germany and Italy), Canada, and the United States (US). Results Oxacillin resistance rates among Staphylococcus aureus isolates ranged from 19.7% to 59.4%. Penicillin resistance rates among Streptococcus pneumoniae varied from 2.0% in Germany to as high as 20.2% in the US; however, ceftriaxone resistance rates were comparably lower, ranging from 0% in Germany to 3.4% in Italy. Vancomycin resistance rates among Enterococcus faecalis were ≤ 4.5%; however, among Enterococcus faecium vancomycin resistance rates were more frequent ranging from 0.8% in France to 76.3% in the United States. Putative rates of extended-spectrum β-lactamase (ESBL) production among Enterobacteriaceae were low, \u3c6% among Escherichia coli in the five countries studied. Ceftriaxone resistance rates were generally lower than or similar to piperacillin-tazobactam for most of the Enterobacteriaceae species examined. Fluoroquinolone resistance rates were generally higher for E. coli (6.5% – 13.9%), Proteus mirabilis (0–34.7%), and Morganella morganii (1.6–20.7%) than other Enterobacteriaceae spp (1.5–21.3%). P. aeruginosa demonstrated marked variation in β-lactam resistance rates among countries. Imipenem was the most active compound tested against Acinetobacter spp., based on resistance rates. Conclusion There was a wide distribution in resistance patterns among the five countries. Compared with other countries, Italy showed the highest resistance rates to all the organisms with the exception of Enterococcus spp., which were highest in the US. This data highlights the differences in resistance encountered in intensive care units in Europe and North America and the need to determine current local resistance patterns by which to guide empiric antimicrobial therapy for intensive care infections

Bayesboost: Identifying and Handling Bias Using Synthetic Data Generators

Paper presented at the Third International Workshop on Learning with Imbalanced Domains: Theory and Applications (LIDTA 2021), online, 17 September 2021.Advanced synthetic data generators can model sensitive personal datasets by creating simulated samples of data with realistic correlation structures and distributions, but with a greatly reduced risk of identifying individuals. This has huge potential in medicine where sensitive patient data can be simulated and shared, enabling the development and robust validation of new AI technologies for diagnosis and disease management. However, even when massive ground truth datasets are available (such as UK-NHS databases which contain patient records in the order of millions) there is a high risk that biases still exist which are carried over to the data generators. For example, certain cohorts of patients may be under-represented due to cultural sensitivities amongst some communities, or due to institutionalised procedures in data collection. The under-representation of groups is one of the forms in which bias can manifest itself in machine learning, and it is the one we investigate in this work.These factors may also lead to structurally missing data or incorrect correlations and distributions which will be mirrored in the synthetic data generated from biased ground truth datasets. In this paper, we explore methods to improve synthetic data generators by using probabilistic methods to firstly identify the difficult to predict data samples in ground truth data, and then to boost these types of data when generating synthetic samples. The paper explores attempts to create synthetic data that contain more realistic distributions and that lead to predictive models with better performance.NHSX

The sovereign debt crisis: the impact on the intermediation model of Italian banks

The aim of the contribute is to analyze the impact of the financial crisis, in particular since the start of the sovereign debt phase, on Italian banks and their intermediation model. Italian banks\u2019 specific business model explains why they suffered less than those of other countries during the first phase of the crisis, requiring one of the lowest levels of public facilities in the EC as compared to GDP. Most of these same characteristics have changed from positive to negative factors since the sovereign debt crisis, which hit Italy hard, affecting first banks\u2019 liquidity and secondly the cost and volumes of funding and loans. Italian banks are now facing the effects of the double-dip recession, which has significantly weakened businesses and households, their key customer segments, and their borrowing and saving capability, with an increasing rate of non-performing loans. This situation is impairing the sustainability of the \u201ctraditional\u201d intermediation model and means that banks must introduce strategies for significantly modifying the banking business model they adopt

The transmission of unconventional monetary policy to bank credit supply : evidence from the TLTRO

We assess the transmission of the Targeted Longer-Term Refinancing Operations (TLTRO) to the bank credit supply for the Euro area (2014:05-2018:01) and for Portugal (2011:01-2018:01), using a panel data setup. For the Euro area, we find a positive relationship between the TLTRO and the amount of credit granted to the real economy. For the vulnerable countries, the effects of the TLTRO on the stock of credit increased from 2016 to 2017. Among the group of small banks, the effects are stronger in less vulnerable countries. We also find that competition has no statistically significant impact on the transmission of the TLTRO to the bank credit supply for the Euro area. For Portugal, using a difference-in-differences model, we find no statistically significant impact of the TLTRO on credit granted by banks. Finally, bidding banks set lower interest rates than non-bidding banks and the difference seems to be larger in 2017. In Portugal, the effects of the TLTRO on loan interest rates also increased from 2016 to 2017 and are stronger for small banks.info:eu-repo/semantics/publishedVersio

Report of mycobacteria isolated from domestic and wildlife species during 2004-2008

La identificación de la tuberculosis bovina y su diferenciación de las micobacteriosis es fundamental durante el diagnóstico. Es por eso que los laboratorios especializados en micobacterias son de suma importancia en los servicios de salud pública y salud animal. El objetivo de la presente investigación es diferenciar Mycobacterium bovis de micobacterias no tuberculosas en cepas cultivadas a partir de especies domésticas y silvestres de siete provincias de Argentina durante 2004-2008. La diferenciación se basó sobre las pruebas bioquímicas, las características fenotípicas y el “spolygotyping” de M. bovis. Con la identificación bioquímica y fenotípica se detectaron 20 cepas de M. bovis, 18 de las cuales fueron confirmadas mediante “spolygotyping”, y 34 cepas de micobacterias no tuberculosas. Trece especies fueron caracterizadas y todas ellas fueron agrupadas considerando el riesgo biológico y el potencial patógeno notificado en seres humanos y/o animales. En este trabajo se han logrado avances en el diagnóstico de tuberculosis y micobacteriosis en medicina veterinaria. En este área el diagnóstico habitualmente se basa sobre la observación micro y macroscópica de los tubérculos y los resultados de la intradermorreacción. Estos avances son importantes porque la tuberculosis zoonótica aún es un problema de salud pública en América Latina.Detection and identification of bovine tuberculosis and its differentiation from micobacteriosis is fundamental during diagnoses. That is why mycobacteria laboratories improvement becomes essential in public health and veterinary medicine services. The objective of the present research is to differentiate Mycobacterium bovis and nontuberculous mycobacterias in isolates cultured from domestic and wildlife species from seven Argentinean provinces during 2004-2008. Differentiation was based on biochemical tests, phenotypic characteristics and M. bovis spolygotyping. Biochemical and phenotypic identification resulted in 20 M. bovis strains, 18 of them were confirmed by spolygotyping, and 34 nontuberculous mycobacteria strains. Thirteen species were characterized and all of them were grouped considering biological risk and pathogenic potential reported in humans and/or animals. Here we have reached advances in tuberculosis and micobacteriosis diagnoses in veterinary medicine. In this area diagnoses are often based on micro and macroscopic observation of the tubercles and skin test results. These advances are not minor as zoonotic tuberculosis is still a public health problem in Latin America.Facultad de Ciencias Veterinaria

Rathke's cleft cyst associated with pituitary granulomatosis with polyangiitis : an unusual combination of hypothalamus-pituitary region pathologies

The authors present an unusual case of a patient suffering from visual deficit due to pituitary granulomatosis with polyangiitis (GPA) associated with Rathke's cleft cyst (RCC). The patient was referred to our Neurosurgery Department presenting right eye amaurosis, third cranial nerve palsy, and left temporal hemianopsia. Magnetic resonance imaging documented a sellar or suprasellar lesion with solid and cystic components. The dura mater of the skull base was also strongly enhanced. The patient underwent surgery. Histologic examination revealed RCC associated with pituitary GPA. To our knowledge, this is the first reported case of concomitant pituitary GPA and RCC. Pituitary involvement in GPA is rare, usually diagnosed in hormonal dysfunctions. The patient in case first presented optic chiasm compression, probably due to inflammation of both the pituitary gland and the previously asymptomatic RCC. We focus on the symptoms that led us to diagnose GPA pituitary involvement and on the peculiar and unusual Magnetic resonance imaging of the case presented

Identification and characterization of a nodH ortholog from the alfalfa-nodulating Or191-like rhizobia

Nodulation of Medicago sativa (alfalfa) is known to be restricted to Sinorhizobium meliloti and a few other rhizobia that include the poorly characterized isolates related to Rhizobium sp. strain Or191. Distinctive features of the symbiosis between alfalfa and S. meliloti are the marked specificity from the plant to the bacteria and the strict requirement for the presence of sulfated lipochitooligosaccharides (Nod factors [NFs]) at its reducing end. Here, we present evidence of the presence of a functional nodH-encoded NF sulfotransferase in the Or191-like rhizobia. The nodH gene, present in single copy, maps to a high molecular weight megaplasmid. As in S. meliloti, a nodF homolog was identified immediately upstream of nodH that was transcribed in the opposite direction (local synteny). This novel nodH ortholog was cloned and shown to restore both NF sulfation and the Nif +Fix+ phenotypes when introduced into an S. meliloti nodH mutant. Unexpectedly, however, nodH disruption in the Or191-like bacteria did not abolish their ability to nodulate alfalfa, resulting instead in a severely delayed nodulation. In agreement with evidence from other authors, the nodH sequence analysis strongly supports the idea that the Or191-like rhizobia most likely represent a genetic mosaic resulting from the horizontal transfer of symbiotic genes from a sinorhizobial megaplasmid to a not yet clearly identified ancestor.Instituto de Biotecnologia y Biologia Molecula