Pediatric Bipolar disorder, in Malta is it under-diagnosed?

The objective of this retrospective study was to determine the frequency of Bipolar Disorder in children and adolescents referred to the Child Guidance Clinic (CGC), St. Luke’s Hospital, Malta, over a year. Diagnostic criteria were analyzed and compared to current literature. Of 141 children, none were diagnosed with Bipolar Disorder. Further awareness of clinicians is advised, to identify Bipolar Disorder, thus limiting its long term morbidity and mortality.peer-reviewe

Metallaaromaticity - a protean world

The nature of magnetically induced current densities (MICD) of metallabenzenes and related compounds has been examined with relativistic DFT calculations to assess the magnetic aromaticity of the molecules. The origin of the total MICD has been analyzed in terms of individual molecular orbital (MO) contributions. Our study reveals that the s-framework of the molecules always makes a diamagnetic contribution to the MICD. On the other hand, p-MOs and Craig–Möbius type p-MOs, i.e., MOs in which the dxy/dxz orbitals of the metal centers change the phase of the wave function akin to a Möbius twist, may not make a diatropic contribution. We have identified metallabenzenes with multiple magnetic aromaticities. In the case of iridabenzenes, s-MICD has been found to decrease dramatically from Ir(III) to Ir(V) systems. Furthermore, a brief examination of some recently synthesized metallapolycycles has shown that the metal center in a given ring can strongly modulate the aromaticity of neighboring rings. Finally, the finding that relatively minor perturbations in the ligand environment of the metal can substantially influence the aromaticity of metallabenzenes and related molecules underscores the protean character of metallaaromaticity and the need for even wider-ranging investigations. Considering the conflicts between magnetic response and ground-state aromaticity criteria (energetic, structural, and electronic criteria), we propose that the term aromatic be used for labeling a molecule if and only if all criteria confirm aromaticity. In other words, neither magnetic nor ground-state criteria are necessary and sufficient conditions for labeling a molecule aromatic

Aortic stenting for neonatal coarctation of the aorta : when should this be considered?

Aortic coarctation (CoA) constitutes the fifth most common congenital heart defect (1 in 2500 live births). This lesion comprises 5-8% of congenital heart disease and has variable severity and mode of presentation. Critical coarctation in newborns usually presents with severe narrowing of the upper thoracic aorta below the isthmus and adjacent to the arterial duct, and is dependent on duct patency for survival. Rapid deterioration of the patient usually results from spontaneous closure of the patent arterial duct (PDA). This deterioration is in part due to reduced renal perfusion resulting in fluid and acid retention causing heart failure and metabolic acidosis. This may be alleviated by the administration of intravenous prostaglandin, with temporary improvement of distal aortic blood flow, and overall condition. The treatment of choice is surgical resection with the ‘extended end-to-end’ technique. We present a case of a severely ill newborn with complex coarctation, multiorgan failure, disseminated intravascular coagulation and oedema, who was treated with emergency stenting on the tenth day of life. This was followed by surgical stent removal and repair of the arch on the 29th day of life. We followed the strategy of minimally invasive interventional bridging of a borderline patient with regard to the experience of stenting of native coarctations in older patients, or complex recurrent stenosis of previously surgically treated childrenpeer-reviewe

Communication écrite sur Internet et par sms en arabizi : analyse de corpus relevant des glosses dialectales libanaise et marocaine

Cette communication, inscrite dans le projet de recherche PARADE (partenaires : SYSTRAN, Laboratoire ICAR et ARADIC Editions), porte sur des analyses de copus en arabizi, qui correspond à l’usage sur Internet, réseaux sociaux ou SMS de l’arabe noté en caractères latins selon des modes de transcriptions issus de l’uage. Après un bref rappel de l’expansion d’Internet dans le monde arbe, de la littérature sur l’arabizi et des transcriptions qu’on y rencontre, les auteur(e)s procèdent à l’analyse de quatre brefs échanges sur Twitter. Deux concernent des internautes marocain(e)s et deux autres, des internautes libanais(es). Protégées par des pseudonymes, ces personnes s’expriment librement, à la fois quant au contenu et quant aux formes linguistiques qu’elles choisissent. Les données sont complexes. On y trouve : (1) des textes en arabizi, transcrivant le dialecte de l’auteur(e) ; (2) des textes en caractères arabes dans l’un des dialectes, l’un des arabes moyens ou en arabe littéraire moderne ; (3) de l’anglais ou du français (voire de l’espagnol ou de l’italien), soit en tant que tels (alternance codique), soit sous forme d’emprunts ; (4) des émoticônes qui sont parfois répétées (itération) ; (5) un usage de caratères de grande dimension, à côté des caractères habituels, ce qui correspond à une fonction expressive ; (6) des images. Les échanges relèvent la plupart du temps d’une analyse interactionnelle, ce qui rend leur interpétation fortement dépendante du contexte. Cette première intervention montre que la question fondamentale – pour un linguiste – est, au-delà de « qu’est-ce l’abizi ? », celle de savoir « comment fonctionne l’arabizi ? 

Tolerability and outcome of once weekly liposomal amphotericin B for the prevention of invasive fungal infections in hematopoietic stem cell transplant patients with graft-versus-host disease

BACKGROUND: Invasive fungal infections remain problematic in immunosuppressed allogeneic stem cell transplant recipients and the use of corticosteroids for the treatment of graft-versus-host-disease can increase the risk three-fold. Although antifungal prophylaxis has been shown to decrease the incidence of infection, the optimal antifungal prophylactic regimen in this patient population has yet to be identified. Since early diagnosis of fungal infections might not be possible and the treatment of established fungal infections might be difficult and associated with high infection related mortality, prevention has become an important strategy in reducing overall morbidity and mortality. While triazoles are the preferred agents, some patients are unable to tolerate them and an alternative drug is warranted. OBJECTIVES: To assess the tolerability of once weekly liposomal amphotericin B as a prophylactic strategy in patients undergoing stem cell transplantation by evaluating any adverse events leading to its discontinuation. In terms of efficacy, to also compare the outcome and incidence of invasive fungal infections in patients who received amphotericin B, triazoles, and echinocandins.RESULTS: A total of 101 allogeneic transplant recipients receiving corticosteroids for the treatment of graft-versus-host-disease and antifungal prophylaxis were evaluated from August 2009 to September 2012. Liposomal amphotericin B 3 mg/kg intravenous once weekly was found to be well-tolerated. The incidence of invasive fungal infections was 19%, 17%, and 7% in the liposomal amphotericin B, echinocandin, and triazole groups, respectively. Two deaths occurred in the liposomal amphotericin B group and one death occurred in the echinocandin group. None of the deaths were fungal infection-related. CONCLUSION: Antifungal prophylaxis with liposomal amphotericin B was well-tolerated but the incidence of invasive fungal infections in patients receiving liposomal amphotericin B was higher than other antifungal agents in this study. The optimal dose and schedule of liposomal amphotericin B for antifungal prophylaxis in this patient population is still not known and considering its broad spectrum activity, prospective trials in comparison to triazoles are warranted

Targeted Molecular Iron Oxide Contrast Agents for Imaging Atherosclerotic Plaque

Overview: Cardiovascular disease remains a leading cause of death worldwide, with vulnerable plaque rupture the underlying cause of many heart attacks and strokes. Much research is focused on identifying an imaging biomarker to differentiate stable and vulnerable plaque. Magnetic Resonance Imaging (MRI) is a non-ionising and non-invasive imaging modality with excellent soft tissue contrast. However, MRI has relatively low sensitivity (micromolar) for contrast agent detection compared to nuclear imaging techniques. There is also an increasing emphasis on developing MRI probes that are not based on gadolinium chelates because of increasing concerns over associated systemic toxicity and deposits1. To address the sensitivity and safety concerns of gadolinium this project focused on the development of a high relaxivity probe based on superparamagnetic iron oxide nanoparticles for the imaging of atherosclerotic plaque with MRI. With development, this may facilitate differentiating stable and vulnerable plaque in vivo. Aim: To develop a range of MRI contrast agents based on superparamagnetic iron oxide nanoparticles (SPIONs), and test them in a murine model of advanced atherosclerosis. Methods: Nanoparticles of four core sizes were synthesised by thermal decomposition and coated with poly(maleicanhydride-alt-1-octadecene) (PMAO), poly(ethyleneimine) (PEI) or alendronate, then characterised for core size, hydrodynamic size, surface potential and relaxivity. On the basis of these results, one candidate was selected for further studies. In vivo studies using 10 nm PMAO-coated SPIONs were performed in ApoE-/- mice fed a western diet and instrumented with a perivascular cuff on the left carotid artery. Control ApoE-/- mice were fed a normal chow diet and were not instrumented. Mice were scanned on a 3T MR scanner (Philips Achieva) with the novel SPION contrast agent, and an elastin-targeted gadolinium agent that was shown previously to enable visualisation of plaque burden. Histological analysis was undertaken to confirm imaging findings through staining for macrophages, CX3CL1, elastin, tropoelastin, and iron. Results: The lead SPION agent consisted of a 10 nm iron oxide core with poly(maleicanhydride-alt-1-octadecene), (-36.21 mV, r2 18.806 mmol-1/s-1). The irregular faceting of the iron oxide core resulted in high relaxivity and the PMAO provided a foundation for further functionalisation on surface -COOH groups. The properties of the contrast agent, including the negative surface charge and hydrodynamic size, were designed to maximise circulation time and evade rapid clearance through the renal system or phagocytosis. In vitro testing showed that the SPION agent was non-toxic. In vivo results show that the novel contrast agent accumulates in similar vascular regions to a gadolinium-based contrast agent (Gd-ESMA) targeted to elastin, which accumulates in plaque. There was a significant difference in SPION signal between the instrumented and the contralateral non-instrumented vessels in diseased mice (p = 0.0411, student’s t-test), and between the instrumented diseased vessel and control vessels (p = 0.0043, 0.0022, student’s t-test). There was no significant difference between the uptake of either contrast agent between stable and vulnerable plaques (p = 0.3225, student’s t-test). Histological verification was used to identify plaques, and Berlin Blue staining confirmed the presence of nanoparticle deposits within vulnerable plaques and co-localisation with macrophages. Conclusion: This work presents a new MRI contrast agent for atherosclerosis which uses an under-explored surface ligand, demonstrating promising properties for in vivo behaviour, is still in circulation 24 hours post-injection with limited liver uptake, and shows good accumulation in a murine plaque model

Impact of soybean derived chemical additive on the morphology of asphaltenes extracted from virgin asphalt, polymer modified asphalt and recycled asphalt pavement extracted binder through small-angle X-ray scattering by solids and solids in solution

Recent work has shown that epoxidized plant oil materials work well as rejuvenators in recycled asphalt pavement (RAP). At the end of the 2017 construction season, a field trial mix with 30% RAP (total recycled binder content of 30.3%) was produced and placed in Northwest Iowa on US-18, east of Sheldon, Iowa. The rejuvenator (SR) was used at a rate of 0.125% by total mix weight. The mix design for the control section used a PG 58-34H. Due to Iowa DOT specification (recycled binder content greater than 20%) a grade bump was needed for the binder in the SR trial section (PG 52-40H). With 0.125% SR by total mix weight the grade bump was achieved. To better understand the chemistry behind this rheological improvement two chemical characterization methods will be explored (SAXS/USAXS, and IM-MS) on the asphaltene portion of SARA fractions of several binders (PG 52-34, RAP, PG 52-34 w/polymer (PG 58-34H), PG 52-34 w/SR, PG 52-34 w/RAP, RAP w/SR, PG 58-34H + SR, PG 58-34H + RAP, PG 52-34 w/SR + RAP, and PG 58-34H + SR + RAP)