Brucellosis – Granulomatous Spine Infection

Brucellosis mainly affects the musculoskeletal system, with the spine as the most common location. Diagnosis is based on clinical symptoms, but in some cases, they may be lacking. Laboratory diagnosis is mainly made on the combination of high erythrocyte sedimentation rate (ESR) together with high levels of C-reactive protein (CRP) and leukocytosis. Blood culture is a very cost-effective investigation; plain radiographs may be useful, but magnetic resonance images (MRI) with gadolinium enhancement is the choice for diagnosing osteoarticular and spinal complications of human brucellosis. MRI diffusion-weighted imaging fast sequence is the most sensitive for differentiating acute and chronic forms of spondylodiscitis. The basis for treatment is usually the medical management. The indications for surgical treatment (endoscopy or open) are when: no microorganism has been isolated, spinal cord or dural compression is seen in MRI, or there\u27s spinal instability or severe deformity. Open surgery is the standard: the anterior approach allows for anterior disc and bone debridement. If there is an epidural abscess or posterior elements are involved it\u27s indicated as a posterior approach. To prevent relapses and reduce the rate of sequelae, it\u27s necessary to have an appropriate duration of antimicrobial therapy and a timely indication to perform surgery

Multi-Atom Quasiparticle Scattering Interference for Superconductor Energy-Gap Symmetry Determination

Complete theoretical understanding of the most complex superconductors requires a detailed knowledge of the symmetry of the superconducting energy-gap $\Delta_\mathbf{k}^\alpha$, for all momenta $\mathbf{k}$ on the Fermi surface of every band $\alpha$. While there are a variety of techniques for determining $|\Delta_\mathbf{k}^\alpha|$, no general method existed to measure the signed values of $\Delta_\mathbf{k}^\alpha$. Recently, however, a new technique based on phase-resolved visualization of superconducting quasiparticle interference (QPI) patterns centered on a single non-magnetic impurity atom, was introduced. In principle, energy-resolved and phase-resolved Fourier analysis of these images identifies wavevectors connecting all k-space regions where $\Delta_\mathbf{k}^\alpha$ has the same or opposite sign. But use of a single isolated impurity atom, from whose precise location the spatial phase of the scattering interference pattern must be measured is technically difficult. Here we introduce a generalization of this approach for use with multiple impurity atoms, and demonstrate its validity by comparing the $\Delta_\mathbf{k}^\alpha$ it generates to the $\Delta_\mathbf{k}^\alpha$ determined from single-atom scattering in FeSe where $s_{\pm}$ energy-gap symmetry is established. Finally, to exemplify utility, we use the multi-atom technique on LiFeAs and find scattering interference between the hole-like and electron-like pockets as predicted for $\Delta_\mathbf{k}^\alpha$ of opposite sign

Phase-sensitive determination of nodal d-wave order parameter in single-band and multiband superconductors

Determining the exact pairing symmetry of the superconducting order parameter in candidate unconventional superconductors remains an important challenge. Recently, a new method, based on phase sensitive quasiparticle interference measurements, was developed to identify gap sign changes in isotropic multiband systems. Here we extend this approach to the single-band and multiband nodal d-wave superconducting cases relevant, respectively, for the cuprates and likely for the infinite-layer nickelate superconductors. Combining analytical and numerical calculations, we show that the antisymmetrized correction to the tunneling density of states due to nonmagnetic impurities in the Born limit and at intermediate-scattering strength shows characteristic features for sign-changing and sign-preserving scattering wave vectors, as well as for the momentum-integrated quantity. Furthermore, using a realistic approach accounting for the Wannier orbitals, we model scanning tunneling microscopy data of Bi2Sr2CaCu2O8+delta, which should allow the comparison of our theory with experimental data

Practitioner needs to adapt to Sea-Level Rise: Distilling information from global workshops

Climate-induced sea-level rise threatens the world’s coastal populations, critical infrastructure, and ecosystems. The science of sea-level rise (SLR) has developed to inform understanding of global climate mitigation and adaptation challenges, but there is much less engagement with practitioners to discern their climate services needs and support the development of adaptation planning and action on the ground. In addition, adaptation planning and implementation processes for SLR are relatively new and practitioners developing leading practices are seeking interaction with their peers and the SLR science community. To address these gaps, we co-produced online global workshops with sixty-nine practitioners from twenty-six countries. These workshops aimed to increase understanding of the state of SLR adaptation planning practice worldwide, gather information on practitioners' existing knowledge and service needs to advance their adaptation efforts, and facilitate exchange between practitioners engaged with coastal adaptation and the SLR science community. The workshops uncovered commonalities across contexts and identified consistent needs from scientists and other technical experts amongst the practitioner community. These needs include generating more localized SLR impact data, understanding of compound risk, creating data timelines for decision making, and developing clarity about uncertainties and probabilities. We also observed important differences between urban and rural locations and between places with different economic resources. To meet their needs, practitioners identified three crucial next steps: 1) Develop more online engagement opportunities, 2) Establish a global practitioner community of practice, and 3) Scale and improve the provision of climate services

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Intracellular free calcium responses to protons and capsaicin in cultured trigeminal neurons

Acidic solutions and capsaicin are selective chemical stimuli for nociceptive neurons. The effect of these stimuli on intracellular calcium concentration was analysed in cultured trigeminal neurons of newborn rabbits. Rapid reductions in pH (from 7.4 to 5) evoked a transient rise in intracellular calcium concentration of 270% on average over the basal level (162.5 ± 3.5 nM;n = 174) in 86% of the neurons. Maximal responses were found at pH 5.5. Proton-induced transients were diminished or abolished by 20 mM CaCl2, by zero CaCl2 and by 1 μ M Ruthenium Red. In response to 1 μM capsaicin, 40% of the cells that were sensitive to protons also increased their intracellular calcium concentration to 218% of control. Capsaicin-induced intracellular calcium concentration rises were composed of an initial peak followed by a second, slower intracellular calcium concentration elevation. The capsaicin response was completely blocked by 1 μM Ruthenium Red, and disappeared in zero calcium, but was augmented in high extracellular calcium. Intracellular calcium concentration responses to capsaicin were still observed in neurons whose response to protons was desensitized by sustained exposure to low pH (pH 6.5). Cells surviving a 10–24 h capsaicin (10 μM) treatment, still displayed responses to pH reductions. These results suggest that intracellular calcium concentration rises induced by moderate reductions in pH0 and capsaicin occur through different mechanisms.Supported by grants PM90-0113 and SAF93-0267 of the Comision Nacional de Ciencia y Tecnologia, Direccion General de Investigacion Cientifica y Tecnica, and F.I.S. 93/134 of the Fondo de Investigaciones Sanitarias de la Seguridad Social, Spain.Peer reviewe