: Convergence spasm is manifest by intermittent occurrence of ocular convergence, accommodative spasm, and miosis. It is usually due to hysteria but can have an organic basis. Treatment has included various ophthalmologic interventions. An amytal interview was used successfully to establish a nonorganic basis for the gaze palsy and, more importantly, concomitant narcosuggestion proved to be effective treatment.


Archaeological mirrors from the Olmec civilization were analyzed in the context of bibliography produced in the last two decades. Photographs of its images are showed as a proof of its good quality. Some suggestions are made on its probable utilization.


A significant iron burden may occur after only 10 blood transfusions in patients with hematologic disorders. Children with acute lymphoblastic leukemia (ALL) routinely receive blood transfusions during therapy, although few studies to date have quantified transfusion‐related iron burden in these patients. This study quantifies the transfused blood volume and resultant iron load in a large cohort of pediatric patients with ALL, and evaluates risk factors that may impact transfusion volume.


Abstract 1341

Rationale: Studies to date clearly demonstrate that patients with multiple myeloma (MM) who receive induction chemotherapy consolidated with high-dose therapy (HDT) and peripheral blood autologous stem cell transplant rescue (ASCT) have increased event-free survival (PFS) and overall survival (OS) compared to those receiving conventional chemotherapy. Maximal benefit is seen in patients who ≥ very good partial response (VGPR) following induction therapy and ASCT. However, nearly one third of patients with newly diagnosed MM fail to achieve a partial response (PR) after initial therapy and though novel therapies induce better up-front response rates, failure to achieve at least a PR is still evident in up to 20% of patients. Therefore we sought to delineate the clinical course of patients who underwent ASCT with <PR following induction therapy for MM to determine prognostic factors associated with better outcomes.

Methods: Eligible patients were identified from the British Society of Blood and Marrow Transplantation (BSBMT) Data Registry and additional patient-specific data were acquired directly from individual centres. Patients were eligible if, after induction therapy, they demonstrated minimal response (MR), stable disease (SD) or progressive disease (PD), as defined by International Myeloma Working Group criteria. All patients received ASCT and disease response was assessed at day 100 (D+100) post-transplant.

Results: 228 eligible patients transplanted in 2000-08 were identified with a median age at transplant of 57 yrs (range 33–72). Patients had received between 1 and 7 prior therapies, and at the time of transplant 70 patients (31%) had obtained MR, 80 (35%) had SD and 77 (34%) had PD. Median time from diagnosis to transplant was 10 months (95% confidence intervals (CI) 9, 10). Median beta-2 microglobulin at diagnosis was 3.5 (range 1.1, 76), serum albumin 36 (range 13, 49), serum creatinine at ASCT 88.5 (range 43, 864). Responses to ASCT (D+100): 49/207 (24%) patients in complete response (CR), 6/207 (3%) in VGPR, 54/207 (26%) in PR, 2/207 (1%) in MR, 10/207 (5%) in SD and 3/207 (1%) had PD with 21 not evaluable for response (due to early death n=13). Non-relapse mortality (NRM) at 100 days, 1 year and 5 years was 2%, 3% and 10% respectively. By univariate analysis (UVA), albumin at diagnosis (p=0.007) impacted on NRM with a trend associated with male sex (p=0.07) and by multivariate analysis (MVA), only albumin at diagnosis (p=0.006) was an independent factor. The relapse rates at 1 year and 5 years were 29% and 79% respectively, with status at transplant (p=0.0004) the only significant variable on UVA. Progression-free survival (PFS) at 5 years was 13% with a median PFS of 18 months (95% CI 15, 21). On UVA, albumin at diagnosis (p=0.025), disease status at transplant (p=0.00003), time from diagnosis to transplant (p=0.027 for 9mns; p<0.00022 for continuous analysis) significantly affect the PFS and on MVA, disease status at (p=0.022) and albumin at diagnosis (p=0.026) were independent prognostic factors. OS at 5 years was 41%, with a median of 51 months (95% CI 45,61) On UVA, disease status (p=0.00015) and time from diagnosis to transplant (p=0.0029, continuous) were significant with a trend noted for albumin at diagnosis (p=0.061) and on MVA only status at transplant (p=0.031) significantly affected OS.

Conclusion: HDT followed by ASCT in patients failing to achieve at least a PR after induction therapy provides an effective means of inducing a deeper remission, which despite demonstrating a shorter median PFS than those transplanted in >PR, demonstrate a good 5 yr OS in an otherwise difficult-to-manage group of patients. This is likely to be reflective of advances in salvage therapy utilized at relapse.

Disclosures: No relevant conflicts of interest to declare.


Lung transplantation (single-lung transplantation, double-lung transplantation or heart-lung transplantation) may be the only effective therapy in end-stage pulmonary disease. At specialized institutions it has been performed on a routine basis for some years now. Diagnostic imaging plays an important role in the assessment of potential recipients as well as for the postoperative evaluation after transplantation. The aim of this review is to describe the role of imaging procedures of the chest in these patients and to demonstrate characteristic plain radiographic and computed tomographic findings. Normal postoperative findings specific to lung transplant patients as well as typical complications are presented. These include reimplantation response, acute and chronic rejection, and the typical bacterial, viral, and fungal infections as well as the sequelae of transbronchial biopsy.


The reactions feature of Facebook provides an opportunity to explore emotional responses to political messages across the globe on a common platform. In this article, we describe this new measure and present a dataset of over two million posts from the Facebook pages of 690 political parties in 79 democracies. We study Love and Angry reactions to these posts, their potential use as measures of emotional response, and party-level variation in the frequency of these reactions. We find that parties receive systematically different proportions of Love and Angry reactions depending on their ideology, party family, and populist orientation. More extreme parties tend to elicit relatively greater emotional responses. Nationalist, populist, and right-leaning parties in particular elicit a higher proportion of Angry reactions and emotional polarization.


An alternative simulation procedure is proposed for lattice hydrodynamics, based on the lattice Boltzmann equation instead of on the microdynamical evolution. The averaging step, used by the latter method to derive macroscopic quantities, is suppressed, as well as the associated fluctuations. The collision operator is expressed in terms of its linearized part, and condensed into a few parameters, which can be selected, independently of a particular collision rule, to decrease viscosity as much as desired.


Bed load sediment flux in an ephemeral channel, the Nahal Yatir, is shown to be a comparatively simple function of stream power and to reach levels that are several orders of magnitude higher than maxima measured at similar levels of stream power in perennial counterparts. Channel average submerged unit flux rates are recorded as high as 4.3 kg s−1 m−1, while at the center of the channel, the highest rate recorded is 6.5 kg s−1m−1. Transport efficiency is at least an order of magnitude higher than in other channels for which there are comparable data and, on average, as much as 400 times that of Oak Creek. These differences are explained by the fact that the bed of the Yatir is not armored. It is surmised that the unvegetated nature of this desert watershed provides ample supplies of sediment of all sizes and that this, together with the rapid recession of the flash flood hydrograph and the extended periods of no flow, discourages the development of an armor layer. The flux rates are not sediment supply-limited, as they are in perennial channels. Nahal Yatir and Oak Creek represent two ends of a spectrum, between which come seasonal and less well armored perennial streams. Transport efficiency is shown to vary considerably for each stream and from one stream to another, suggesting that it may not be possible to incorporate it easily into bed load equations in order to improve levels of prediction.


For a gigahertz microprocessor with multiple clock domains and a large amount of embedded RAMs (Random Access Memory), generating at-speed testing patterns is becoming very difficult and very time-consuming. This paper presents some novel techniques to improve at-speed testing coverage with low cost. These methods are major concern about preventing X states propagation, which include avoiding capturing X states for registers, sequential bypass of macros, clock control scheme for inter-clock domains and accurate analysis of exception paths in intra-clock domains. Functional patterns are utilized to further improve the efficiency of the at-speed testing. A novel optimal flow is presented by carefully selecting these techniques. By using the flow, 90% transition fault coverage is achieved. In addition, both the number of patterns and the test time of the transition test are decreased by 15%. The total area overhead is about a few hundreds of AND cells and has little timing impact on the critical paths.


ABSTRACT Aims: To compare the outcome, in terms of lameness score or return to athletic function, of horses with acute vs. chronic digital lameness that underwent magnetic resonance imaging (MRI) of the distal limb and to compare the proportion of horses that received intra-articular therapy of the distal interphalangeal (DIP) joint and pattern of diagnostic analgesia in these groups. Methods: This is a retrospective study of horses (n = 95) with acute (≤12 weeks; n = 46) or chronic (>12 weeks; n = 49) digital lameness that underwent MRI of the distal limb from 2009–2016, at two equine referral centres in the USA. Criteria for inclusion in the study were that a majority of lameness localised distal to the fetlock, and that lameness assessments for ≥12 months following MRI could be obtained from the medical record or the owner could be interviewed regarding their horse's athletic function. Outcome was characterised by an improvement score where 2 = return to work at a previous or higher level or lameness improved by one grade or more, 1 = return to work at a lower level or lameness improved by less than one grade, and 0 = did not return to work or lameness grade worsened. Whether horses had received intra-articular therapy of the DIP joint and the pattern of diagnostic analgesia prior to MRI was also obtained from medical records or by interviewing the owner. Results: There was a difference (p = 0.004) in the proportion of horses assigned to improvement scores of 0, 1 and 2 between horses with acute or chronic lameness. There was no evidence of a difference in the likelihood of having received intra-articular therapy of the DIP joint prior to MRI between horses with chronic or acute lameness (p = 0.085). Similarly, there was no evidence of a difference in the pattern of diagnostic analgesia prior to MRI between the two groups (p = 0.94). Eighty-two percent of owners of horses with acute and 62% of those with horses with chronic lameness had a positive opinion of the utility of MRI as a diagnostic modality. Conclusion: In a population of horses with digital lameness undergoing MRI, a difference in the outcome, in terms of lameness score or return to athletic function was identified between horses with acute lameness compared to those with chronic lameness. Clinical relevance: Horses with digital lameness that undergo MRI when the lameness is acute may have an improved prognosis due to accurate diagnosis and earlier application of appropriate therapy.


This study aimed to investigate the antimicrobial resistance and virulence genes of Enterococcus faecalis isolated from subclinical bovine mastitis cases in China. Enterococcus faecalis isolates were identified by 16S rRNA amplification and sequencing. Antimicrobial susceptibility was determined by the disc diffusion method. Antimicrobial resistance and virulence genes were tested by PCR. Overall, E. faecalis was recovered from 81 of 1,787 (4.5%) mastitic milk samples. The isolates showed high resistance against tetracycline (87.7%) and erythromycin (79.0%). The most prevalent resistance genes found in the E. faecalis were tetK (96.3%), tetL (79.0%), and tetM (87.7%) for tetracycline and ermC (97.5%) for erythromycin. Moreover, gelE (70.4%), esp (85.2%), efaA (91.4%) were the most common virulence genes. This is the first report to characterize E. faecalis recovered from subclinical bovine mastitis cases in China.