Infantile Scurvy: Two Case Reports

Background. Ascorbic acid (vitamin C) is necessary for the formation of collagen, reducing free radicals, and aiding in iron absorption. SCURVY, a disease of dietary ascorbic acid deficiency, is uncommon today. It still exists in high risk groups including economically disadvantaged populations with poor nutrition. The incidence of SCURVY in the pediatric population is very low. Cases Report. Here we report two cases of SCURVY revealed by subperiosteal hematoma in children with cerebral palsy and developmental delay. Conclusion. SCURVY is extremely rare in children. Musculoskeletal manifestations are prominent in pediatric SCURVY. Multiple subperiosteal hematomas are an important indicator for diagnosis

Nail-Patella Syndrome Associated with Short Stature: A Case Series

Introduction. Nail-patella syndrome (NPS) is a rare genetic disorder that is characterized by a pleiotropic malformation affecting the nail, the skeleton, and occasionally the central nervous system and the kidneys. Case Presentation. We report two paediatric cases, which are of two sisters, who aged, respectively, two and five years. They are admitted to explore short stature. The initial clinical examination and radiologic findings confirmed the diagnosis of Nail-patella syndrome. Conclusion. Skeletal, ophthalmologic, and renal involvements were mostly associated with NPS. The association with short stature was exceptional

K0.8Ag0.2Nb4O9AsO4

The title compound, potassium silver tetra­niobium nona­oxide arsenate, K0.8Ag0.2Nb4O9AsO4, was prepared by a solid-state reaction at 1183 K. The structure consists of infinite (Nb2AsO14)n chains parallel to the b axis and cross-linked by corner sharing via pairs of edge-sharing octa­hedra. Each pair links together four infinite chains to form a three-dimensional framework. The K+ and Ag+ ions partially occupy several independent close positions in the inter­connected cavities delimited by the framework. K0.8Ag0.2Nb4O9AsO4 is likely to exhibit fast alkali-ion mobility and ion-exchange properties. The Wyckoff symbols of special positions are as follows: one Nb 8e, one Nb 8g, As 4c, two K 8f, one Ag 8f, one Ag 4c, one O 8g, one O 4c

K3VO2(V2As2O12)

A new potassium vanadium arsenate, tripotassium trivanadium bis­(arsenate) hexa­oxide, K3VO2(V2As2O12), was synthesized by a solid-state reaction at 743 K. The structure is built up from VO5 pyramids, VO4 tetra­hedra (.m. symmetry) and AsO4 tetra­hedra linked together by corner-sharing to form a three-dimensional framework. The two crystallographically independent K+ cations, one of which has .m. symmetry, are located in the inter­connected tunnels running along the a and b directions

Non-centrosymmetric Na3Nb4As3O19

A new non-centrosymmetric compound, tris­odium tetra­niobium triarsenic nona­deca­oxide, Na3Nb4As3O19, has been synthesized by a solid-state reaction at 1123 K. The structure consists of AsO4 tetra­hedra and NbO6 octa­hedra sharing corners to form a three-dimensional framework containing two types of tunnels running along the c axis, in which the sodium ions are located. Na+ cations occupying statistically several sites, respectively, are surrounded by seven, six and four O atoms at distances ranging from 2.08 (1) to 2.88 (4) Å. The title structure is compared with those containing the same groups, viz. M 2XO13 and M 2 X 2O17 (M = transition metal, and X = As or P)

La variété β-NaMoO2(AsO4)

The title compound, sodium dioxidomolybdenum(VI) arsenate(V), β-NaMoO2AsO4, was prepared by solid-state reaction at 953 K. In the crystal structure, the AsO4 tetra­hedra and MoO6 octa­hedra (both with m symmetry) share corner atoms to form a three-dimensional framework that delimits cavities parallel to [010] where disordered six-coordinated sodium cations (half-occupation) are located. Structural relationships between the different orthoarsenates of the AMoO2AsO4 series (A = Ag, Li, Na, K and Rb) are discussed

Outcomes of elective liver surgery worldwide: a global, prospective, multicenter, cross-sectional study

Background: The outcomes of liver surgery worldwide remain unknown. The true population-based outcomes are likely different to those vastly reported that reflect the activity of highly specialized academic centers. The aim of this study was to measure the true worldwide practice of liver surgery and associated outcomes by recruiting from centers across the globe. The geographic distribution of liver surgery activity and complexity was also evaluated to further understand variations in outcomes. Methods: LiverGroup.org was an international, prospective, multicenter, cross-sectional study following the Global Surgery Collaborative Snapshot Research approach with a 3-month prospective, consecutive patient enrollment within January–December 2019. Each patient was followed up for 90 days postoperatively. All patients undergoing liver surgery at their respective centers were eligible for study inclusion. Basic demographics, patient and operation characteristics were collected. Morbidity was recorded according to the Clavien–Dindo Classification of Surgical Complications. Country-based and hospital-based data were collected, including the Human Development Index (HDI). (NCT03768141). Results: A total of 2159 patients were included from six continents. Surgery was performed for cancer in 1785 (83%) patients. Of all patients, 912 (42%) experienced a postoperative complication of any severity, while the major complication rate was 16% (341/2159). The overall 90-day mortality rate after liver surgery was 3.8% (82/2,159). The overall failure to rescue rate was 11% (82/ 722) ranging from 5 to 35% among the higher and lower HDI groups, respectively. Conclusions: This is the first to our knowledge global surgery study specifically designed and conducted for specialized liver surgery. The authors identified failure to rescue as a significant potentially modifiable factor for mortality after liver surgery, mostly related to lower Human Development Index countries. Members of the LiverGroup.org network could now work together to develop quality improvement collaboratives

Search for dark matter produced in association with bottom or top quarks in √s = 13 TeV pp collisions with the ATLAS detector

A search for weakly interacting massive particle dark matter produced in association with bottom or top quarks is presented. Final states containing third-generation quarks and miss- ing transverse momentum are considered. The analysis uses 36.1 fb−1 of proton–proton collision data recorded by the ATLAS experiment at √s = 13 TeV in 2015 and 2016. No significant excess of events above the estimated backgrounds is observed. The results are in- terpreted in the framework of simplified models of spin-0 dark-matter mediators. For colour- neutral spin-0 mediators produced in association with top quarks and decaying into a pair of dark-matter particles, mediator masses below 50 GeV are excluded assuming a dark-matter candidate mass of 1 GeV and unitary couplings. For scalar and pseudoscalar mediators produced in association with bottom quarks, the search sets limits on the production cross- section of 300 times the predicted rate for mediators with masses between 10 and 50 GeV and assuming a dark-matter mass of 1 GeV and unitary coupling. Constraints on colour- charged scalar simplified models are also presented. Assuming a dark-matter particle mass of 35 GeV, mediator particles with mass below 1.1 TeV are excluded for couplings yielding a dark-matter relic density consistent with measurements

Prognostic model to predict postoperative acute kidney injury in patients undergoing major gastrointestinal surgery based on a national prospective observational cohort study.

Background: Acute illness, existing co-morbidities and surgical stress response can all contribute to postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. The aim of this study was prospectively to develop a pragmatic prognostic model to stratify patients according to risk of developing AKI after major gastrointestinal surgery. Methods: This prospective multicentre cohort study included consecutive adults undergoing elective or emergency gastrointestinal resection, liver resection or stoma reversal in 2-week blocks over a continuous 3-month period. The primary outcome was the rate of AKI within 7 days of surgery. Bootstrap stability was used to select clinically plausible risk factors into the model. Internal model validation was carried out by bootstrap validation. Results: A total of 4544 patients were included across 173 centres in the UK and Ireland. The overall rate of AKI was 14·2 per cent (646 of 4544) and the 30-day mortality rate was 1·8 per cent (84 of 4544). Stage 1 AKI was significantly associated with 30-day mortality (unadjusted odds ratio 7·61, 95 per cent c.i. 4·49 to 12·90; P < 0·001), with increasing odds of death with each AKI stage. Six variables were selected for inclusion in the prognostic model: age, sex, ASA grade, preoperative estimated glomerular filtration rate, planned open surgery and preoperative use of either an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker. Internal validation demonstrated good model discrimination (c-statistic 0·65). Discussion: Following major gastrointestinal surgery, AKI occurred in one in seven patients. This preoperative prognostic model identified patients at high risk of postoperative AKI. Validation in an independent data set is required to ensure generalizability