Predictive factors of adrenal insufficiency in patients admitted to acute medical wards: a case control study.

BACKGROUND: Adrenal insufficiency is a rare and potentially lethal disease if untreated. Several clinical signs and biological markers are associated with glucocorticoid failure but the importance of these factors for diagnosing adrenal insufficiency is not known. In this study, we aimed to assess the prevalence of and the factors associated with adrenal insufficiency among patients admitted to an acute internal medicine ward. METHODS: Retrospective, case-control study including all patients with high-dose (250 μg) ACTH-stimulation tests for suspected adrenal insufficiency performed between 2008 and 2010 in an acute internal medicine ward (n = 281). Cortisol values <550 nmol/l upon ACTH-stimulation test were considered diagnostic for adrenal insufficiency. Area under the ROC curve (AROC), sensitivity, specificity, negative and positive predictive values for adrenal insufficiency were assessed for thirteen symptoms, signs and biological variables. RESULTS: 32 patients (11.4%) presented adrenal insufficiency; the others served as controls. Among all clinical and biological parameters studied, history of glucocorticoid withdrawal was the only independent factor significantly associated with patients with adrenal insufficiency (Odds Ratio: 6.71, 95% CI: 3.08 -14.62). Using a logistic regression, a model with four significant and independent variable was obtained, regrouping history of glucocorticoid withdrawal (OR 7.38, 95% CI [3.18 ; 17.11], p-value <0.001), nausea (OR 3.37, 95% CI [1.03 ; 11.00], p-value 0.044), eosinophilia (OR 17.6, 95% CI [1.02; 302.3], p-value 0.048) and hyperkalemia (OR 2.41, 95% CI [0.87; 6.69], p-value 0.092). The AROC (95% CI) was 0.75 (0.70; 0.80) for this model, with 6.3 (0.8 - 20.8) for sensitivity and 99.2 (97.1 - 99.9) for specificity. CONCLUSIONS: 11.4% of patients with suspected adrenal insufficient admitted to acute medical ward actually do present with adrenal insufficiency, defined by an abnormal response to high-dose (250 μg) ACTH-stimulation test. A history of glucocorticoid withdrawal was the strongest factor predicting the potential adrenal failure. The combination of a history of glucocorticoid withdrawal, nausea, eosinophilia and hyperkaliemia might be of interest to suspect adrenal insufficiency

Impact of smoking on fertility and age of menopause: a population-based assessment.

Studies in patients seeking medically assisted reproduction have shown that smoking reduces fertility, but little information is available in the general population. We assessed the associations between smoking and the number of children, childbearing planning and age at menopause in a representative sample of the population of Lausanne, Switzerland. Data from 6711 participants (3530 women, age range 35-75 years) collected between 2003 and 2006 and again in 2009 and 2012. Smoking status, number of offsprings and age of menopause were assessed. Women who currently smoke had significantly less children than former or never smokers: the number of children per women (average±SD) was 1.38±1.05, 1.45±1.07 and 1.576±1.16, respectively (p<0.001). Women who currently smoke had their first child at an earlier age than the others: 26.7±5.2, 27.4±5.4 and 26.9±5.2 years old for current, former and never smokers, respectively, (p=0.01). Similar findings were found for men: number of children per men 1.475±1.16, 1.67±1.13 and 1.55±1.22 for current, former and never smokers, respectively (p<0.001); no difference was found regarding age at the first child. The difference persisted after multivariate adjustment (adjusted for age, body mass index, Caucasian origins, alcohol consumption, caffeinated drinks consumption, educational level, receiving social help and women taking contraceptives) for the age at first child among women. No association was found between Heaviness of Smoking Index and the number of children among current smokers in both genders. Women who smoke had their menopause more than 1 year prior than never-smoking women (48.9±0.2 years compared with 47.8±0.3 years, respectively, p=0.002). Smoking is associated with an earlier age of having the first child and of menopause among women

Effects of NaBH4 additions on hydrogen absorption by nanostuctured FeTi powders

Hydrogen is nowadays considered as one of the most promising fuels for the future transportation market, since it is highly energetic and its combustion products are non-toxic. There are however some inherent problems related to its handling and storage that makes its implementation difficult in the energy market [1]. One way of storing hydrogen is in form of intermetallic hydrides. Some intermetallics can store large amounts of hydrogen in their interstitial sites and, in some cases, reversible equilibrium absorption/desorption cycles might be realized near ambient temperature and normal pressure. FeTi is an intermetallic compound that is being widely studied for hydrogen storage purposes. This system has one of the highest volumetric storage capacities and can be produced at low cost [2,3]. However, the FeTi alloy prepared through conventional metallurgical process requires activation treatments at elevated temperature. It has been shown previously that the nanostructured FeTi can be activated at room temperature with the mechanical alloying of pure metallic constituents, Fe and Ti, with NaBH4 [4]. In this work nanostructured FeTi based powders were produced by mechanical alloying, and the effects of adding different amounts of NaBH4 on the hydrogen absorption capacity and on the agglomeration of the powders were studied. The effect of handling powders in a glovebox with oxygen free atmosphere or in atmospheric ambient condition was also examined. Several parameters of the as-milled powders were controlled. Among the characterization performed are phase identification and crystallite size determinations by X-ray diffraction, micro hardness measurements, scanning electron microscopy and absorption isotherms determinations

Pod shattering: A homologous series of variation underlying domestication and an avenue for crop improvement

All rights reserved. In wild habitats, fruit dehiscence is a critical strategy for seed dispersal; however, in cultivated crops it is one of the major sources of yield loss. Therefore, indehiscence of fruits, pods, etc., was likely to be one of the first traits strongly selected in crop domestication. Even with the historical selection against dehiscence in early domesticates, it is a trait still targeted in many breeding programs, particularly in minor or underutilized crops. Here, we review dehiscence in pulse (grain legume) crops, which are of growing importance as a source of protein in human and livestock diets, and which have received less attention than cereal crops and the model plant Arabidopsis thaliana. We specifically focus on the (i) history of indehiscence in domestication across legumes, (ii) structures and the mechanisms involved in shattering, (iii) the molecular pathways underlying this important trait, (iv) an overview of the extent of crop losses due to shattering, and the effects of environmental factors on shattering, and, (v) efforts to reduce shattering in crops. While our focus is mainly pulse crops, we also included comparisons to crucifers and cereals because there is extensive research on shattering in these taxa

Bio-based synthesis of oxidation resistant copper nanowires using an aqueous plant extract

Copper nanowires have recently emerged as promising nanomaterials for transparent conducting electrodes applications, however, their production commonly involves the use of harmful reagents. In this study, we describe for the first time a simple and cost-effective bio-based synthesis of copper nanowires using an aqueous plant extract (Eucalyptus globulus) as the reducing/stabilizing agent and oleic acid and oleylamine as surfactants. Well-dispersed crystalline copper nanowires (λmáx = 584–613 nm) were obtained with average diameters in the nanometric range (44 and 145 nm) and lengths in the micrometric range (from 5 to dozens of micrometres) using extract concentrations between 10 and 50 mg mL−1. Moreover, the aspect ratio of these nanowires can be adjusted (from around 14–20 to 160–400) by changing the experimental conditions, namely the use of oleic acid. Phenolic compounds were found to have a key role in this bioreduction process allowing to obtain practically only nanowires (without other morphologies). Nevertheless, the use of oleic acid/oleylamine is essential to manipulate their size and aspect ratio. Most importantly, these bio-based copper nanowires were found to be resistant under storage in ethanol and when submitted to air exposure, both for 2 weeks, certainly due to the adsorption of antioxidant biomolecules (phenolic) at their surface, thus avoiding the use of other polymeric protective layers. The conductivity of the CuNWs was found to be 0.009 S cm−1. As a result, this study opens a new standpoint in this field, “closing the door” to the use of hazardous reagents and synthetic polymeric protective layers, on the production of stable copper nanowires with potential application as conductive materials.publishe

Spin-orbit coupling and intrinsic spin mixing in quantum dots

Spin-orbit coupling effects are studied in quantum dots in InSb, a narrow-gap material. Competition between different Rashba and Dresselhaus terms is shown to produce wholesale changes in the spectrum. The large (and negative) $g$-factor and the Rashba field produce states where spin is no longer a good quantum number and intrinsic flips occur at moderate magnetic fields. For dots with two electrons, a singlet-triplet mixing occurs in the ground state, with observable signatures in intraband FIR absorption, and possible importance in quantum computation.Comment: REVTEX4 text with 3 figures (high resolution figs available by request). Submitted to PR