Hepatitis C virus-associated porphyria cutanea tarda: A case report

Porhyria cutanea tarda (PCT) is a rare, inherited or acquired disorder due to decreased activity or deficiency of uroporphyrinogen decarboxylase (UROD), one of the enzymes in the haem synthetic pathway. It is characterized by cutaneous manifestations such as erosions, blisters and bulae in the dorsum of the hand, forearm, elbows and knees; and painful indolent sores that heal with dyspigmented and scarring lesions. A 25 year old sales man presented with a 7 month history of recurrent blistering of the skin of the extremities- hands, elbows, knees and feet which occurred spontaneously or following trivial trauma. There was no family history of similar skin symptoms. Examination showed broken and fresh blisters of varying sizes with some healed lesions on the dorsum of the hands, over the elbow and knee joints, and toes. Serum ferritin was 360μ/L (40- 340 μ/L), urine uroporphyrinogen was positive (+++) and Hepatitis C antibodies screening was positive. Some improvement of the cutaneous lesion was noticed following commencement of therapeutic phlebotomy.Keywords: Porhyria, blisters, Hepatitis C virus, uroporphyrinoge

A new species of Mandevilla (Apocynaceae) from limestone outcrops in Central Brazil with a short note on the occurrence of geophytes in rauvolfioids and apocynoids

Mandevilla calcicola, endemic to limestone formations in Goias state, Brazil, is described. A key and photos for all Mandevilla species reported in Goias and Distrito Federal, Brazil, are included. This new species is assessed as Critically Endangered (CR). A short note on the occurrence of geophytes in rauvolfioids and apocynoids (focused on Mandevilla) and its taxonomic value is included

Indo-Brazilian Late Palaeozoic wildfires: an overview on macroscopic charcoal

Carvão vegetal macroscópico é amplamente aceito como um indicador direto da ocorrência de paleo-incêndios vegetacionais, sendo relativamente bem estudado e distribuído de forma homogênea em depósitos do Paleozoico Superior da Euramérica e Cataísia. Por outro lado, apenas alguns registros deste tipo de material foram publicados para o Paleozoico Superior do Gondwana e, somente recentemente foi demonstrado que carvão vegetal macroscópico (e, portanto, incêndios) também é comum no continente meridional. Os mais importantes registros do Gondwana se constituem em fragmentos carbonizados de lenhos gimnospérmicos e estão associados, principalmente, a depósitos de carvão mineral. Registros de macro-charcoal (carvão vegetal macroscópico) foram descritos para níveis do Paleozoico Superior da Bacia Damodar (Índia) e da Bacia do Paraná (Brasil), demonstrando que paleo-incêndios vegetacionais ocorriam em sequências e intervalos estratigráficos variados no Gondwana durante esse período. Com base nos registros publicados até o momento e em novos exemplares provenientes do nível de carvão Seam-IV, Formação Raniganj, Bacia Damodar (Lopingiano da Índia), uma revisão acerca dos registros indo-brasileiros de carvão vegetal macroscópico em níveis do Paleozoico Superior são apresentados. O material inédito foi analisado sob Microscópio Eletrônico de Varredura para a definição de características anatômicas, sendo estabelecida uma afinidade gimnospérmica para os fragmentos. Os dados apresentados reforçam a importância dos paleo-incêndios vegetacionais como elemento perturbador dos diferentes paleoambientes gondvânicos durante o Paleozoico Superior.Sedimentary charcoal is widely accepted as a direct indicator for the occurrence of paleo-wildfires and, in Upper Paleozoic sediments of Euramerica and Cathaysia, reports on such remains are relatively common and (regionally and stratigraphically) more or less homogeneously distributed. On the contrary, just a few reliable records have been published for the Late Paleozoic of Gondwana and only recently it has been demonstrated that macroscopic charcoals (and thus fires) were also common in the southern continent during this period. The most important Gondwanan records are predominantly charred gymnosperm woods mainly related to coal bearing strata. Late Paleozoic macro-charcoal occurs in both, the Damodar Basin (India) and the Paraná Basin (Brazil), demonstrating that paleo-wildfires were spread out in different sequences and distinct stratigraphic intervals during this period in Gondwana. Based on the so far published records as well as new samples from the Seam-VI coalfield, Raniganj Formation (Damodar Basin – Lopingian of India), an overview of the Late Paleozoic Indo‑Brazilian macro-charcoal remains is presented. The hitherto unpublished samples were anatomically analyzed under Scanning Electron Microscope and a gymnosperm affinity could be established. The data presented here reinforce the relevance of paleo-wildfire as a source of environmental disturbance over large areas of Gondwana during the Late Paleozoic

Post‐socialist language ideologies in action: Linking interview context and language ideology through stance

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/136334/1/josl12225_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/136334/2/josl12225.pd

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Measurement of the top quark forward-backward production asymmetry and the anomalous chromoelectric and chromomagnetic moments in pp collisions at √s = 13 TeV

Abstract The parton-level top quark (t) forward-backward asymmetry and the anomalous chromoelectric (d̂ t) and chromomagnetic (μ̂ t) moments have been measured using LHC pp collisions at a center-of-mass energy of 13 TeV, collected in the CMS detector in a data sample corresponding to an integrated luminosity of 35.9 fb−1. The linearized variable AFB(1) is used to approximate the asymmetry. Candidate t t ¯ events decaying to a muon or electron and jets in final states with low and high Lorentz boosts are selected and reconstructed using a fit of the kinematic distributions of the decay products to those expected for t t ¯ final states. The values found for the parameters are AFB(1)=0.048−0.087+0.095(stat)−0.029+0.020(syst),μ̂t=−0.024−0.009+0.013(stat)−0.011+0.016(syst), and a limit is placed on the magnitude of | d̂ t| < 0.03 at 95% confidence level. [Figure not available: see fulltext.

Measurement of t(t)over-bar normalised multi-differential cross sections in pp collisions at root s=13 TeV, and simultaneous determination of the strong coupling strength, top quark pole mass, and parton distribution functions

Peer reviewe

An embedding technique to determine ττ backgrounds in proton-proton collision data

An embedding technique is presented to estimate standard model tau tau backgrounds from data with minimal simulation input. In the data, the muons are removed from reconstructed mu mu events and replaced with simulated tau leptons with the same kinematic properties. In this way, a set of hybrid events is obtained that does not rely on simulation except for the decay of the tau leptons. The challenges in describing the underlying event or the production of associated jets in the simulation are avoided. The technique described in this paper was developed for CMS. Its validation and the inherent uncertainties are also discussed. The demonstration of the performance of the technique is based on a sample of proton-proton collisions collected by CMS in 2017 at root s = 13 TeV corresponding to an integrated luminosity of 41.5 fb(-1).Peer reviewe

Measurement of the Splitting Function in &ITpp &ITand Pb-Pb Collisions at root&ITsNN&IT=5.02 TeV

Data from heavy ion collisions suggest that the evolution of a parton shower is modified by interactions with the color charges in the dense partonic medium created in these collisions, but it is not known where in the shower evolution the modifications occur. The momentum ratio of the two leading partons, resolved as subjets, provides information about the parton shower evolution. This substructure observable, known as the splitting function, reflects the process of a parton splitting into two other partons and has been measured for jets with transverse momentum between 140 and 500 GeV, in pp and PbPb collisions at a center-of-mass energy of 5.02 TeV per nucleon pair. In central PbPb collisions, the splitting function indicates a more unbalanced momentum ratio, compared to peripheral PbPb and pp collisions.. The measurements are compared to various predictions from event generators and analytical calculations.Peer reviewe