Prevalence and aetiology of thyrotoxicosis in patients with hyperemesis gravidarum presenting to a tertiary hospital in Cape Town, South Africa

Background: The association between hyperemesis gravidarum (HG) and abnormal thyroid function is well known.Aims: The prevalence, aetiology and course of thyrotoxicosis in women with hyperemesis gravidarum (HG) were studied.Methods: Women admitted for HG, who underwent thyroid function evaluation between 1 August 2016 and 30 April 2019, were studied. Laboratory data included baseline human chorionic gonadotropin (hCG) and baseline (t1), discharge (t2) and follow-up (t3) thyroid function tests (thyroid stimulating hormone [TSH] and free  thyroxin [fT4]). Available TSH receptor antibody status was assessed.Results: Eighty-two patients were included. The incidence of thyrotoxicosis was 49% based on local laboratory TSH range and 48% if trimester-specific ranges used. In the majority of normal pregnancies, thyrotoxicosis was hCG-mediated (72.5%), 15% were confirmed to have Graves’ disease and 12% had a molar pregnancy. Very high fT4 levels (> 40 pmol/l) at baseline [t1] were documented in 24% of women with hCG-mediated thyrotoxicosis. Clinical features were absent in a third of women with Graves’ disease and the diagnosis was reliant on positive antibody status. Free T4 values declined from (t1) to later in gestation (t3) (p < 0.001).Conclusion: The incidence of thyrotoxicosis in women with HG is high. Free-T4 values decrease with clinical stabilisation of HG, suggesting a contribution of dehydration to the large variation in baseline fT4 measurements. Testing for TSH-receptor antibodies should be considered in women with TSH < 0.01 pmol/l and persistent fT4 elevation on follow-up. Final review of thyroid function should be performed after 15 weeks’ gestation

Stretching of polymers in a random three-dimensional flow

Behavior of a dilute polymer solution in a random three-dimensional flow with an average shear is studied experimentally. Polymer contribution to the shear stress is found to be more than two orders of magnitude higher than in a laminar shear flow. The results indicate that the polymer molecules get strongly stretched by the random motion of the fluid.Comment: 4 pages, 3 figure

TC83 Sequelae

Long-term neurological complications, termed sequelae, can result from viral encephalitis, which are not well understood. In human survivors, alphavirus encephalitis can cause severe neurobehavioral changes, in the most extreme cases, a schizophrenic-like syndrome. In the present study, we aimed to adapt an animal model of alphavirus infection survival to study the development of these long-term neurological complications. Upon low-dose infection of wild-type C57B/6 mice, asymptomatic and symptomatic groups were established and compared to mock-infected mice to measure general health and baseline neurological function, including the acoustic startle response and prepulse inhibition paradigm. Prepulse inhibition is a robust operational measure of sensorimotor gating, a fundamental form of information processing. Deficits in prepulse inhibition manifest as the inability to filter out extraneous sensory stimuli. Sensory gating is disrupted in schizophrenia and other mental disorders, as well as neurodegenerative diseases. Symptomatic mice developed deficits in prepulse inhibition that lasted through 6 months post infection; these deficits were absent in asymptomatic or mock-infected groups. Accompanying prepulse inhibition deficits, symptomatic animals exhibited thalamus damage as visualized with H&E staining, as well as increased GFAP expression in the posterior complex of the thalamus and dentate gyrus of the hippocampus. These histological changes and increased GFAP expression were absent in the asymptomatic and mock-infected animals, indicating that glial scarring could have contributed to the prepulse inhibition phenotype observed in the symptomatic animals. This model provides a tool to test mechanisms of and treatments for the neurological sequelae of viral encephalitis and begins to delineate potential explanations for the development of such sequelae post infection

Recent Advances in Complex Fluids Modeling

In this chapter, we present a brief description of existing viscoelastic models, starting with the classical differential and integral models, and then focusing our attention on new models that take advantage of the enhanced properties of the Mittag-Leffler function (a generalization of the exponential function). The generalized models considered in this work are the fractional Kaye-Bernstein, Kearsley, Zapas (K-BKZ) integral model and the differential generalized exponential Phan-Thien and Tanner (PTT) model recently proposed by our research group. The integral model makes use of the relaxation function obtained from a step-strain applied to the fractional Maxwell model, and the differential model generalizes the familiar exponential Phan-Thien and Tanner constitutive equation by substituting the exponential function of the trace of the stress tensor by the Mittag-Leffler function. Since the differential model is based on local operators, it reduces the computational time needed to predict the flow behavior, and, it also allows a simpler description of complex fluids. Therefore, we explore the rheometric properties of this model and its ability (or limitations) in describing complex flows

ABC 2 -SPH risk score for in-hospital mortality in COVID-19 patients: development, external validation and comparison with other available scores

Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Hospitalitzacions; MortalitatCoronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Hospitalizaciones; MortalidadCoronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Hospitalizations; MortalityObjectives The majority of available scores to assess mortality risk of coronavirus disease 2019 (COVID-19) patients in the emergency department have high risk of bias. Therefore, this cohort aimed to develop and validate a score at hospital admission for predicting in-hospital mortality in COVID-19 patients and to compare this score with other existing ones. Methods Consecutive patients (≥ 18 years) with confirmed COVID-19 admitted to the participating hospitals were included. Logistic regression analysis was performed to develop a prediction model for in-hospital mortality, based on the 3978 patients admitted between March–July, 2020. The model was validated in the 1054 patients admitted during August–September, as well as in an external cohort of 474 Spanish patients. Results Median (25–75th percentile) age of the model-derivation cohort was 60 (48–72) years, and in-hospital mortality was 20.3%. The validation cohorts had similar age distribution and in-hospital mortality. Seven significant variables were included in the risk score: age, blood urea nitrogen, number of comorbidities, C-reactive protein, SpO 2 /FiO 2 ratio, platelet count, and heart rate. The model had high discriminatory value (AUROC 0.844, 95% CI 0.829–0.859), which was confirmed in the Brazilian (0.859 [95% CI 0.833–0.885]) and Spanish (0.894 [95% CI 0.870–0.919]) validation cohorts, and displayed better discrimination ability than other existing scores. It is implemented in a freely available online risk calculator (https://abc2sph.com/). Conclusions An easy-to-use rapid scoring system based on characteristics of COVID-19 patients commonly available at hospital presentation was designed and validated for early stratification of in-hospital mortality risk of patients with COVID-19.This study was supported in part by Minas Gerais State Agency for Research and Development ( Fundação de Amparo à Pesquisa do Estado de Minas Gerais – FAPEMIG ) [grant number APQ-00208-20], National Institute of Science and Technology for Health Technology Assessment ( Instituto de Avaliação de Tecnologias em Saúde – IATS )/ National Council for Scientific and Technological Development ( Conselho Nacional de Desenvolvimento Científico e Tecnológico – CNPq ) [grant number 465518/2014-1], and CAPES Foundation ( Coordenação de Aperfeiçoamento de Pessoal de Nível Superior ) [grant number 88887.507149/2020-00]. AS was supported by a postdoctoral grant “Juan Rodés” (JE18/00022) from Instituto de Salud Carlos III through the Ministry of Economy and Competitiveness, Spain

The Bitter Truth About Sugar and Willpower: The Limited Evidential Value of the Glucose Model of Ego Depletion

This work was supported by European Research Council Grant 283849 (to N. Gold) under the European Union’s Seventh Framework Programme (FP/2007–2013)

Linking changes in species composition and biomass in a globally distributed grassland experiment

Global change drivers, such as anthropogenic nutrient inputs, are increasing globally. Nutrient deposition simultaneously alters plant biodiversity, species composition and ecosystem processes like aboveground biomass production. These changes are underpinned by species extinction, colonisation and shifting relative abundance. Here, we use the Price equation to quantify and link the contributions of species that are lost, gained or that persist to change in aboveground biomass in 59 experimental grassland sites. Under ambient (control) conditions, compositional and biomass turnover was high, and losses (i.e. local extinctions) were balanced by gains (i.e. colonisation). Under fertilisation, the decline in species richness resulted from increased species loss and decreases in species gained. Biomass increase under fertilisation resulted mostly from species that persist and to a lesser extent from species gained. Drivers of ecological change can interact relatively independently with diversity, composition and ecosystem processes and functions such as aboveground biomass due to the individual contributions of species lost, gained or persisting.EEA Santa CruzFil: Ladouceur, Emma. German Centre for Integrative Biodiversity Research (iDiv); AlemaniaFil: Ladouceur, Emma. Helmholtz Centre for Environmental Research – UFZ. Department of Physiological Diversity; AlemaniaFil: Ladouceur, Emma. University of Leipzig. Department of Biology; AlemaniaFil: Ladouceur, Emma. Martin Luther University Halle-Wittenberg. Institute of Computer Science; AlemaniaFil: Blowes, Shane A. German Centre for Integrative Biodiversity Research (iDiv); AlemaniaFil: Blowes, Shane A. Martin Luther University Halle-Wittenberg. Institute of Computer Science; AlemaniaFil: Chase, Jonathan M. German Centre for Integrative Biodiversity Research (iDiv); AlemaniaFil: Chase, Jonathan M. Martin Luther University Halle-Wittenberg. Institute of Computer Science; AlemaniaFil: Clark, Adam T. German Centre for Integrative Biodiversity Research (iDiv); AlemaniaFil: Clark, Adam T. Helmholtz Centre for Environmental Research – UFZ. Department of Physiological Diversity; AlemaniaFil: Clark, Adam T. Karl-Franzens University of Graz. Institute of Biology; Austria.Fil: Garbowski, Magda. German Centre for Integrative Biodiversity Research (iDiv); AlemaniaFil: Garbowski, Magda. Helmholtz Centre for Environmental Research – UFZ. Department of Physiological Diversity; AlemaniaFil: Alberti, Juan. Universidad Nacional de Mar del Plata. Instituto de Investigaciones Marinas y Costeras. Laboratorio de Ecología. Mar del Plata; Argentina.Fil: Alberti, Juan. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina.Fil: Arnillas, Carlos Alberto. University of Toronto. Department of Physical and Environmental Sciences; Canadá.Fil: Bakker, Jonathan D. University of Washington. School of Environmental and Forest Sciences; Estados UnidosFil: Barrio, Isabel C. Agricultural University of Iceland. Faculty of Environmental and Forest Sciences; IslandiaFil: Bharath, Siddharth. Atria University; India.Fil: Peri, Pablo Luis. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Santa Cruz; Argentina.Fil: Peri, Pablo Luis. Universidad Nacional de la Patagonia Austral; Argentina.Fil: Peri, Pablo Luis. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina.Fil: Harpole, Stanley. German Centre for Integrative Biodiversity Research (iDiv); AlemaniaFil: Harpole, Stanley. Helmholtz Centre for Environmental Research – UFZ. Department of Physiological Diversity; AlemaniaMartin Luther University Halle-Wittenberg. Institute of Computer Science; Alemani

TOPBP1 missense variant Arg309Cys and breast cancer in a German hospital-based case-control study

The DNA double strand break repair gene TOPBP1 has been suggested as a breast cancer susceptibility gene and a missense variant Arg309Cys was observed at elevated frequency in familial breast cancer cases compared to healthy controls from Finland. We found the Arg309Cys allele at a 13% carrier frequency in a hospital-based series of 1064 German breast cancer patients and at a 14% carrier frequency in 1014 population controls (OR 0.89, 95%CI 0.69-1.15; p = 0.4). Arg309Cys carriers were not enriched among patients with a family history of breast cancer (OR = 0.87, 95%CI 0.53-1.43, p = 0.6) and were slightly underrepresented in patients with bilateral disease (OR = 0.49, 95%CI = 0.24-0.99; p = 0.047). In the latter group, the mean age at diagnosis was 62 years in carriers and 54 years in non-carriers (p = 0.004). We conclude that there is no evidence for the TOPBP1*Arg309Cys variant to confer an increased risk for breast cancer in the German population

Cancer survival in the elderly: Effects of socio-economic factors and health care system features (ELDCARE project)

The purpose of the ELDCARE project is to study differences in cancer survival for elderly patients by country, taking into account the socio-economic conditions and the characteristics of health care systems at the ecological level. Fifty-three European cancer registries, from 19 countries, participating in the EUROCARE 3 programme, collected information to compute relative survival on patients aged 65-84 years, diagnosed over the period 1990-1994. National statistics offices provided the macro-economic and labour force indicators (gross domestic product, total health expenditure, and proportion of people employed in the agriculture sector) as well as the features of national health care systems. Survival for several of the cancer sites had high positive Pearson's correlations (r) with the affluence indicators (usually r > 0.7), but survival for the poor prognosis cancers (lung, ovary, stomach) and for cervix uteri was not so well correlated. Among the medical resources considered, the number of computed tomography scanners was the variable most related to survival in the elderly; the number of total health practitioners in the country did not show any relationship. Survival was related to the marital status of elderly women more strongly than for men and younger people. The highest correlations of survival with the percentage of married elderly women in the population were for cancers of the rectum (r = 0.79) and breast (r = 0.66), while survival correlated negatively with the proportion of widows for most cancers. Being married or widowed is for elderly people, in particular elderly women, an important factor influencing psychological status, life habits and social relationships. Social conditions could play a major role in determining health outcomes, particularly in the elderly, by affecting access to health care and delay in diagnosis