Secondary recurrent multiple EGIST of the mesentary: A case report and review of the literature

AbstractINTRODUCTIONGastrointestinal stromal tumors (GISTs) are rare intra-abdominal tumors arising from mesenchymal stromal cells. EGISTs are mesenchymal tumors that originate outside the GI tract and tend to have similar characteristics to GISTs. To the best of our knowledge, few cases of long standing recurrent EGIST have been reported.PRESENTATION OF CASEWe present the case of a rare recurrent EGIST in the mesentery of a 39 year old female patient. The tumor was symptomatic at the time of complaint and measured 8.4cm×7.7cm×7.6cm. Histological analysis revealed a spindled pattern with fusiform cells arranged in long fascicles and little atypia. Immunochemistry showed positivity for CD117 and was negative for CD34, S-100, Desmin, and MSA. B-catenin was weakly positive. A Ki-67 staining shows approximately 5% positivity revealing a low proliferative rate. The patient was doing well postoperatively and was discharged on 400mg imanitib regimen.DISCUSSIONWhile GISTs are the most common tumors of the GI tract, recurrent EGISTs of the mesentery are extremely rare. Factors that indicate poor prognosis include tumor size greater than 5cm, mitotic rate greater than 1–5/10 HPF, presence of tumor necrosis or metastasis and most recently the c-kit mutation. Our patient had a very long time between recurrence of disease.CONCLUSIONThe current literature on EGISTs is limited. Our patient presents a very interesting case due to the time elapsed between disease recurrence and lack of metastasis or excessive growth

Metodología de la enseñanza de la redacción comercial en el duodécimo grado de comercio del Instituto Urracá-Santiago de Veraguas.

Este estudio es una investigación descriptiva, aplicada que expone los datos recogidos para conocer las metodologías utilizadas por los docentes en su didáctica, así como las dificultades de los estudiantes durante el uso de la expresión escrita. Su estructuración en cinco aspectos ofrece la comprensión total del tema y presenta, al final, el hecho de que los docentes, en su mayoría, siguen utilizando metodologías tradicionales con las que el estudiante presenta deficiencias en el aprendizaje de la redacción comercial. Se evidencia la falta de motivación, también, del discente y la contradicción de los resultados de ambos, pues mientras el facilitador dice utilizar métodos adecuados, al revisar las pruebas de sus discípulos, se hace patente la carencia de conocimientos en la estructuración de documentos y otros temas relacionados, como la ortografía y la puntuación. Al obtener estos hallazgos se comprueba la necesidad de cambios en la práctica educativa del Bachiller en Comercio, ante los desafíos de la empresa moderna; se propone el desarrollo de un seminario estratégico de metodologías para la enseñanza de la redacción comercial, con el fin de ofrecer diversos métodos y técnicas, que ayuden a mejorar la práctica pedagógica

Characterisation of the oral glucose and sugar tolerance tests and the enteroinsular axis response in healthy adult donkeys

Background Insulin dysregulation (ID) is diagnosed in horses and ponies using oral glucose (OGTT) and oral sugar (OSTT) tolerance tests. The enteroinsular axis plays a major role in postprandial glucose disposal and insulin response in horses, ponies and foals. The insulin and incretin response to oral carbohydrate challenges has not been characterised in donkeys. Objectives (a) To characterise OGTT and OSTT, and (b) to assess the plasma incretin response to OGTT and OSTT in healthy donkeys. Study design In vivo experiments. Methods Six healthy adult female Andalusian donkeys were challenged with OGTT (1 g/kg glucose, 20% solution by nasogastric tube) and OSTT (0.45 mL/kg corn syrup orally by syringe) with a 1-week washout. Blood samples were collected for glucose (spectrophotometry), insulin (radioimmunoassay), glucose-dependent insulinotropic polypeptide (GIP, ELISA) and active glucagon-like peptide-1 (aGLP-1, ELISA) determination over 6 hours. Curves were analysed and proxies calculated. Results Glucose and insulin concentrations peaked at 180 minutes in OGTT, but at 300 and 150 minutes in OSTT, respectively. Plasma GIP concentrations increased in the OGTT and OSTT (peaked at 180 and 360 minutes, respectively), but aGLP-1 increased only in OGTT (240 minutes). Main limitations Single breed, narrow age and sample, diet, season and not having donkeys with evidence of ID to provide clinical validation. Conclusions Donkeys have a functional enteroinsular axis that is activated by enteral carbohydrates. Donkeys have evident endocrine differences with horses, supporting the validation of the OSTT and OGTT to assess insulin sensitivity in this species to avoid extrapolation from horses

When did cosmic acceleration start? How fast was the transition?

Cosmic acceleration is investigated through a kink-like expression for the deceleration parameter (q). The new parametrization depends on the initial (q_i) and final (q_f) values of q, on the redshift of the transition from deceleration to acceleration (z_{t}) and the width of such transition (\tau). We show that although supernovae (SN) observations (Gold182 and SNLS data samples) indicate, at high confidence, that a transition occurred in the past (z_{t}>0) they do not, by themselves, impose strong constraints on the maximum value of z_{t}. However, when we combine SN with the measurements of the ratio between the comoving distance to the last scattering surface and the SDSS+2dfGRS BAO distance scale (S_{k}/D_{v}) we obtain, at 95.4% confidence level, z_{t}=0.84+{0.17}-{0.13} and \tau =0.51-{0.17}+{0.23} for (S_{k}/D_{v}+Gold182), and z_{t}=0.88-{0.10}+{0.12} and \tau =0.35-{0.10}+{0.12} for (S_{k}/D_{v} + SNLS), assuming q_i=0.5 and q_f=-1. We also analyze the general case, q_f\in(-\infty,0) finding the constraints that the combined tests (S_{k}/D_{v} + SNLS) impose on the present value of the deceleration parameter (q_0).Comment: 7 pages, 3 figures. Replaced to match the published versio

The Longest Delay: A 14.5 yr Campaign to Determine the Third Time Delay in the Lensing Cluster SDSS J1004+4112

We present new light curves for the four bright images of the five image cluster-lensed quasar gravitational lens system SDSS J1004+4112. The light curves span 14.5 yr and allow the measurement of the time delay between the trailing bright quasar image D and the leading image C. When we fit all four light curves simultaneously and combine the models using the Bayesian information criterion, we find a time delay of Δt DC = 2458.47 ± 1.02 days (6.73 yr), the longest ever measured for a gravitational lens. For the other two independent time delays we obtain Δt BC = 782.20 ± 0.43 days (2.14 yr) and Δt AC = 825.23 ± 0.46 days (2.26 yr), in agreement with previous results. The information criterion is needed to weight the results for light curve models with different polynomial orders for the intrinsic variability and the effects of differential microlensing. The results using the Akaike information criterion are slightly different, but, in practice, the absolute delay errors are all dominated by the ∼4% cosmic variance in the delays rather than the statistical or systematic measurement uncertainties. Despite the lens being a cluster, the quasar images show slow differential variability due to microlensing at the level of a few tenths of a magnitude

Erratum: "The Longest Delay: A 14.5 yr Campaign to Determine the Third Time Delay in the Lensing Cluster SDSS J1004+4112" (2022, ApJ, 937, 34)

[no abstract available

Estimation of sensitivity and flock-sensitivity of pooled faecal culture for Mycobacterium avium subsp. paratuberculosis in sheep

Pooled faecal culture (PFC) is a widely used test in ovine Johne’s disease (OJD) control programmes in Australia but information about its characteristics is limited. We conducted this study to estimate sensitivity and flock-sensitivity of PFC in sheep with different OJD histopathological lesions in simulated flocks with a range of infection prevalence levels. Initially, a known quantity of faeces from sheep with pauci- or multi-bacillary lesions was pooled with uncontaminated faeces from confirmed non-infected sheep and cultured using PFC technique. PFC sensitivity, calculated as a proportion of the pools of a particular size that tested positive, was determined to be 90% in sheep with the multibacillary form of the disease but varied with pool size in sheep with the paucibacillary form of OJD. Subsequently, probabilistic models were developed to estimate overall pool-sensitivity achieved in a flock (Sek) and flock-sensitivity of PFC (FSe) in various simulated scenarios. In flocks with a given ratio of multi- to pauci-bacillary sheep and with low to moderate infection prevalence level, Sek decreased with increase in pool size, but increased with pool size in flocks with ≥ 10 % prevalence. FSe, in contrast, increased with pool size in all the tested scenarios. Both Sek and FSe increased with infection prevalence, ratio of multi- to pauci-bacillary sheep and the number of pools sourced from flocks. Sensitivity analyses indicated that the estimates and trends were robust to moderate changes in input parameters. The results suggest that the current testing of seven pools of size 50 is adequate for most scenarios, however, for very low prevalence flocks, a gain in FSe can be made by increasing the number of pools tested and a higher Sek can be achieved by reducing pool sizes. Keywords: pooling, paratuberculosis, ovine Johne’s disease, Australia, Mycobacterium, epidemiology.Meat and livestock australi

Evaluation of the combined glucose-insulin and intravenous glucose tolerance tests for insulin dysregulation diagnosis in donkeys

Background. Insulin dysregulation (ID) and donkey metabolic syndrome (DMS) are common in this species. Contrary to horses, diagnostic guidelines compiling insulin cut-offs values and dynamic testing interpretations have not been reported for this species. Objectives. To evaluate resting serum insulin concentrations, the combined glucose-insulin test (CGIT) and the glucose intravenous tolerance test (IVGTT) for the diagnosis of DMS with ID suspicion. Study design. Diagnostic test comparison.Methods. Six of 80 mix-breed adult donkeys fulfilled the inclusion criteria for DMS based on history or clinical evidence of recurrent laminitis, body condition >6 and neck score >2 or baseline insulin and leptin concentrations >20 µIU/mL and >12 ng/mL respectively. CGIT and IVGTT were performed in all donkeys within a week and interpreted following guidelines reported for equine metabolic syndrome (EMS). Insulin and glucose curves were analysed, proxies calculated and correlations and multivariate analysis assessed. Results. Following EMS guidelines, CGIT classified 2 (using glucose-positive phase duration) or 3 (using insulin concentration) and IVGTT classified 5 donkeys as ID. ID donkeys showed a lower glucose/insulin ratio, QUICKI and RISQI, and a higher insulin/glucose ratio, MIRG and HOMA-B%. Main limitations. Comparison of these tests with additional dynamic testing including a larger number of ID donkeys is necessary. Conclusions. This is the first study evaluating dynamic tests to assess ID/DMS in DMS-suspected donkeys. IVGTT detected more ID donkeys than CGIT. EMS recommendations could also be used for DMS diagnosis, although a baseline insulin cut-off value is needed