The Airborne Hyperspectral Scanner (AHS) and the Hyperion satellite hyperspectral sensors were evaluated for their ability to predict topsoil organic carbon (C) in burned mountain areas of ...northwestern Spain slightly covered by heather vegetation. Predictive models that estimated total organic C (TOC) and oxidizable organic C (OC) content were calibrated using two datasets: a ground observation dataset with 39 topsoil samples collected in the field (for models built using AHS data), and a dataset with 200 TOC/OC observations predicted by AHS (for models built using Hyperion data). For both datasets, the prediction was performed by stepwise multiple linear regression (SMLR) using reflectances and spectral indices (SI) obtained from the images, and by the widely-used partial least squares regression (PLSR) method. SMLR provided a performance comparable to or even better than PLSR, while using a lower number of channels. SMLR models for the AHS were based on a maximum of eight indices, and showed a coefficient of determination in the leave-one-out cross-validation R2 = 0.60–0.62, while models for the Hyperion sensor showed R2 = 0.49–0.61, using a maximum of 20 indices. Although slightly worse models were obtained for the Hyperion sensor, which was attributed to its lower signal-to-noise ratio (SNR), the prediction of TOC/OC was consistent across both sensors. The relevant wavelengths for TOC/OC predictions were the red region of the spectrum (600–700 nm), and the short wave infrared region between ~2000–2250 nm. The use of SMLR and spectral indices based on reference channels at ~1000 nm was suitable to quantify topsoil C, and provided an alternative to the more complex PLSR method.
The objective of this study is to assess the impact of various actions in the management of pain in a pediatric hospital emergency department. This is an observational study, preaction (phase 1) and ...postaction (phase 2), with two cohorts of patients diagnosed with abdominal pain, chest pain, and severe headache. Between the two phases, various actions were carried out (distribution of pain assessment scales and a new guide for the management of pain, and the holding of clinical training sessions). Three hundred patients were included in the study, with an average age of 9 years and average evolution time of pain of 20 h. Pain assessment in phases 1 and 2 was 30 and 99.3%, respectively. Analgesics were administered to 23% (phase 1) and 38.6% (phase 2) of the patients with pain. No side-effects from the analgesics given were recorded. In conclusion, the various actions carried out yielded an improvement in pain management, especially in its assessment.
OBJECTIVE To report, to our knowledge, the first case of detection of human metapneumovirus in the cerebrospinal fluid of a patient during acute encephalitis. DESIGN Case report. SETTING University ...hospital. PATIENT A 10-year-old girl with acute encephalitis. RESULTS Human metapneumovirus was detected in cerebrospinal fluid and nasal-wash specimens during the initial phase of mild encephalitis. Abrupt clinical deterioration was associated with the presence of multiple areas of demyelination and cortical abnormalities. Demyelinated areas improved after immunomodulatory therapy, but cortical lesions spread in both hemispheres. Surprisingly, clinical worsening occurred when the virus became undetectable in cerebrospinal fluid. CONCLUSIONS The detection of human metapneumovirus in cerebrospinal fluid strongly suggests its causative role in acute encephalitis. The evolution of the clinical and radiological features provided insight into the pathogenesis of human metapneumovirus encephalitis.
Abstract 4649
Chronic lymphocytic leukemia (CLL) is characterized by the accumulation of monoclonal CD5+ B lymphocytes. In addition, immune disturbances are commonly present. Although CLL is still ...considered incurable, long term remissions can be observed after allogeneic stem cell transplantation (SCT). Whether immune function is restored in patients responding to treatment is largely unknown. We report on the immune status in 19 patients with CLL in long-lasting complete remission (CR) after SCT (13 allogeneic, 6 autologous). Median age was 51 (range, 33- 64) and median follow-up since transplantation was 6 years (range, 2-17). Three patients had chronic graft-versus host disease at sample collection, two of whom were receiving immunosuppression. Lymphocyte subsets were studied using multiparameter flow cytometry and compared to healthy controls. We quantified immunoglobulin subtypes, complement proteins, and β2-microglobulin (B2M) by standard techniques and IL-10 and VEGF by using flow-based cytometric bead array technology. CD8+ T cell response to CMV was assessed using a pentameric HLA-A2 binding CMV pp65-derived peptide. Three patients (all following allogeneic SCT) had detectable residual CLL cells (> 10-4) in peripheral blood at the time of the analysis. In the remaining 16 patients with no detectable minimal residual disease (MRD) normal CD19+CD5- and CD19+CD5+ B cell populations were lower than in healthy individuals (10.5% vs. 14.5%; p=0.02 and 1.6% vs. 3.9 %; p=0.002 respectively). A significant increase in the proportion of CD8+ T cells (median 28.1% vs. 18.7%, p=0.03), particularly those with a chronically activated phenotype CD3+CD8+DR+ (10.2% of CD3+ cells vs. 4.9% in controls), was observed (p=0.013). The nine CMV+/HLA-A2 patients all showed specific cytotoxic CD8+ T cells which exhibit predominantly a CD45RA+CD27- phenotype, being better preserved in autologous SCT than in allogeneic SCT patients. Also, higher numbers of CD8+CD45RA+CD27- T cells were observed in patients with a longer follow-up. CD4+ T cell count was < 400/mm3 in 4 patients. An abnormal CD4:CD8 ratio was seen in 7 out of 19 patients. Interestingly, a significant increase of double positive CD4 and CD8 T cells was detected in most patients comprising 2.6% vs.1.6% of lymphocytes in normal subjects (p=0.02). There were no quantitative abnormalities in CD3-CD56+ cells. Not surprisingly, hypogammaglobulinemia was present in all but four patients immediately prior to transplant. Whereas IgM levels normalized in all patients, 4 and 6 patients respectively still had low IgG and IgA levels more than two years after transplantation. Of note, low serum immunoglobulin levels were seen in 6 out of 14 MRD negative-CR patients and all three MRD positive-CR patients, including one who had normal immunoglobulin levels at the time of transplant. Complement proteins C3 and C4 were within the normal range in all cases. The direct Coombs test (DCT) was also negative in all patients although one patient had indirect signs of hemolysis. Regarding serum markers, B2M was increased (>2.5mg/dl) in 5 out of 19 patients. No significant differences were found in IL-10 and VEGF levels between patients and normal controls (median levels, 2.14 vs. 1.06 pg/ml and 156.88 vs. 104.14 pg/ml), but there were 2 patients with markedly elevated IL-10. In summary, these data demonstrate that immune defects persist over time in CLL patients with a long lasting CR (including MRD-negative CRs) after SCT.
No relevant conflicts of interest to declare.
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