A Case of Multiple Acquired Depressed Smooth Muscle HamartomaShort title: Multiple Acquired Depressed Smooth Muscle HamartomaKaoru Chiba, MD1, Itaru Dekio, MD1, Isami Uno, MD1, Yoshimasa Nobeyama, MD1, Akihiko Asahina, MD11. Department of Dermatology, The Jikei University School of Medicine, Tokyo, JapanCorresponding Author: Yoshimasa NobeyamaDepartment of Dermatology, The Jikei University School of Medicine3-25-8, Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, JapanTel: +81-3-3433-1111 Ext. 3341; Fax: +81-3-5401-0125E-mail [email protected] authors received no financial support for this study.The authors have no conflicts of interest to declare.988 words, 2 figuresKey words : hamartoma, smooth muscle, multiple, acquired, depressed

Arrest of Labor Secondary to Large Uterine Fibroid

The aim of this study was to explore the mechanism of the age-related P3 ‘anterior’ shift using high-precision temporal principal components analysis (tPCA). Continuous EEG was recorded from younger and older adults while completing a two-stimulus visual oddball task. We narrowed our tPCA input to the P3 range to enhance precision and reveal potentially overlapping temporal components. eLORETA was used to model group and condition-related differences in component sources to further understanding of the functional relevance and neurobiology of the P3 anterior shift. The target P3a and P3b and the nontarget P3/l-P3 (late P3) evidenced the expected anterior shift. There was a general reduction in P3 component amplitudes in older compared to younger adults across both stimulus types, consistent with the P3 ‘ageing effect’. For all P3 components, eLORETA modelled changes in activation of multiple and diffuse sources with age, suggesting that neural processing is extending beyond frontal regions and that crosstalk between different neural networks is likely. Findings are aligned with the dedifferentiation hypothesis, as reduced P3 target amplitudes reflect attenuated responding to a preferred stimulus, and the anterior shift to nontargets is a form of neural broadening, or decreased selectivity of processing and increased responding to a non-preferred stimulus.

This study aims to investigate the influences of maternal dietary patterns on the triacylglycerol (TAG) composition, particular medium- and long-chain triacylglycerol (MLCT) in human breast milk. A total of 180 Chinese human breast milk samples were collected and divided into three dietary patterns groups accounting to semi-quantitative food intake frequency questionnaire and a 24-hour dietary recall. Using high performance liquid chromatography combined with quadrupole time-of-flight mass spectrometry, 108 TAGs were identified and quantified. In breast milk samples, MLCTs accounted for 25.76 % (median of 24.63%; 95% CI: 24.60, 26.92) of the total TAGs. In human breast milk, the main type of MLCT is TAGs esterified with one medium-chain fatty acid and two long-chain fatty acids (MLL type) which accounted for ~81% of total MLCTs. Among the molecular species of MLCT, O-P-La, O-L-La, and O-L-M are the three most abundant configurations in MLCT (2.28%, 2.17%, and 2.01% of total TAGs, respectively). MLCT in breast milk was positively correlated with the energy supply ratio of carbohydrates (P = 0.205), which was significantly higher than that of the other two groups (P = −0.150 and −0.232).

Objective To investigate the value of quantitative computed tomography (QCT) body composition parameters in assessing the prognosis of patients with resectable rectal cancer (RC). Methods A total of 94 patients with colorectal adenocarcinoma from 2016 to 2021 were retrospectively collected. All patients underwent QCT scan before operation. Skeletal muscle cross-sectional area, total fat area, subcutaneous fat area and visceral fat area were measured, and skeletal muscle index (SMI), total fat tissue index (TATI), subcutaneous fat index (SATI) and visceral fat index (VATI) were calculated. TATI, SATI, and VATI truncation values were obtained to predict postoperative outcomes in RC patients, and sarcopenia (SA) was evaluated by SMI. Results The cut off values of TATI, SATI, and VATI were 106.39 cm 2/m 2, 47.33 cm 2/m 2, and 42.61 cm 2/m 2. The overall incidence of SA was 30.0% (28/94). Tumor N-stage, SA, and VATI were independent risk factors for postoperative outcomes in RC patients ( P < 0.05). The AUC of the nomogram model was 0.844 (95% CI: 0.755 - 0.911). Conclusion Tumor N-stage, SA, and VATI correlated with prognosis in RC patients undergoing surgery. The nomogram model established in this study has some value for evaluating the prognosis of patients with resectable RC.

Background Neuroblastoma (NB) is a childhood cancer of the sympathetic nervous system, and its prognosis is poor. NB undergoes transcription changes to use aerobic glycolysis as its primary metabolic pathway. Aerobic glycolysis provides an immediate source of ATP in metastasis proliferation, and therefore may be exploited in dietary therapies, such as the ketone diet. Procedure In this study, the expression of glycolytic and ketolytic genes in the context of MYCN oncogene amplification, tumor staging, and Kaplan-Meier survivability was investigated using the R2: Genomics analysis and visualisation platform (http://r2.amc.nl). The R2 database is a platform for gene expression and prognostic data for primary tumour samples. Six NB genomics datasets were accessed and further analysed in GraphPad Prism to investigate the relationships between glycolytic and ketolytic gene expression and prognosis. Results Glycolytic gene expression is increased in MYCN amplified, metastatic tumours, and is associated with worse event free survival. Ketolytic gene expression is lower in metastatic tumours and is associated with better event free survivability. The glycolytic gene expression profile of NB suggests that elevated levels correlate with tumorigenicity and low probability of survival. Ketolytic gene expression patterns suggest a decreased reliance for ketolytic energy, which may be exploited to slow tumorigenic growth. Conclusions This study validates the glycolytic gene expression profiles in metastatic and MYCN-amplified NB tumours and suggest the potential use of these genes in prognosis prediction. Furthermore, the study highlights the reliability and utility of the R2 database as an oncogenomic tool for NB research.

Colour polymorphism can be maintained by colour morph-specific benefits across environmental conditions. Currently, the amount and duration of snow cover during winter decreases especially in northern latitudes, which can alter the potential for camouflage of animals with light and dark morphs. Tawny owls, Strix aluco, are colour polymorphic avian predators with dark (brown) and light (grey) colour morphs, where the grey morph is presumed to enjoy camouflage benefits under snowy conditions. We studied the two tawny owls’ morphs’ camouflage potential using passerines’ probability to detect and mob in the wild during spring, autumn, and winter with and without snow. We find that grey tawny owls are both less likely to be detected and have a lower probability of being mobbed compared to brown tawny owls only during snowy winters. The two colour morphs therefore experience differential benefits across snow conditions, which may help to maintain colour morphs in the population, although further warming of winter climate will reduce the potential for camouflage for grey tawny owls in northern latitudes.

Diffuse large B cell lymphoma presenting with hypersomnia

1. Introduction The success of in vitro fertilization (IVF) relies on a series of crucial laboratory procedures, including the culture and development of embryos in a controlled environment. However, despite strict quality control, there is a risk of bacterial contamination during the embryo culture process [1]. Such contamination poses a threat to the IVF outcomes. Bacterial contamination in the IVF laboratory can arise from various sources, including air, water, equipment, and personnel [2]. It can also occur at different stages of the IVF process, such as during oocyte retrieval, sperm preparation, handling of culture dishes, or manipulation of embryos. Bacteria introduced into the culture media can proliferate rapidly, producing harmful byproducts and triggering inflammatory responses that may negatively impact embryo development. Additionally, certain bacteria may directly adhere to the embryo’s zona pellucida, compromising its integrity and reducing the chances of successful implantation.Commonly, the washing technique is employed to rescue embryos that have been contaminated. It involves the gentle removal of external contaminants from the embryo’s surface. The washing process begins by transferring the contaminated embryo to a clean petri dish containing a culture media supplemented with antibiotics or antifungal agents. Gentle swirling motions are then used to perform the washing. After that, the embryo is transferred to a fresh, uncontaminated dish with a clean culture medium. However, a study has demonstrated that washing alone is not effective in eliminating bacteria, as some still remained in the zona pellucida [3]. In a recent case report by Li R et al., a new method was proposed to rescue contaminated embryos, involving the removal of the contaminated zona pellucida using Tyrode acid [4]. It has been observed that the porous structure of the zona pellucida makes it difficult to completely eliminate microorganisms [5]. Additionally, the zona pellicida itself can prevent embryo development in later stages [6]. Therefore, removing zona pellucida is a promissing method to solve the contamination problems.In our report, we describes an alternative method using laser to remove the contaminated zona pellucida from an embryo. We present the clinical details, procedural methodology, and subsequent outcomes of this unique case, thereby shedding light on the promising prospects for assisted reproductive technologies.

We present some existence and localization results for periodic solutions of impulsive first-order coupled non-linear systems of two equations, without requiring periodicity for the nonlinearities. The arguments are based on Schauder's Fixed Point Theorem together with the upper and lower solution method, where the upper and lower solutions are not necessarily well-ordered. In addition, results on equi-regulated functions are required for the impulsive analysis. An application to a Wilson-Cowan system of two strongly coupled neurons illustrates one of the main results.

Introduction  The presence of anterior diastemas may compromise the esthetics of a patient’s smile, causing mental and social trauma in many patients. In such patients’ careful consideration must be given to the etiology behind the presence of the diastemas before a treatment plan can be formulated. Individual treatment planning is essential in such cases and may require more than just fixed orthodontic intervention. Periodontal, surgical, and prosthodontic treatments are sometimes required to ensure a successful outcome (1,2).

In this work, a novel technique to train machine learning models is introduced, which is based on digital simulations of certain types of quantum systems. This represents a drastic departure from the standard approach which, to these days, is based on the use of actual physical quantum systems. Thus, to provide a clear context, a proper introduction to the field of quantum machine learning is first provided. Then, we proceed with a detailed description of our proposed method. To conclude, some preliminary, yet compelling, results are presented and discussed. Although at a seminal stage, the author firmly believes that this approach could represent a valid and robust alternative to the way machine learning models are trained today.

Introduction An arteriovenous fistula (AVF) in patients with end-stage kidney disease (ESKD) can influence flow states. We sought to evaluate if assessment of aortic stenosis (AS) by transthoracic echocardiographic (TTE) differs in the presence of AVF compared to other dialysis accesses in patients on dialysis. Methods We identified consecutive ESKD patients on dialysis and concomitant AS from a single center between January 2000 and March 2021. We analyzed TTE parameters of AS severity (velocities, gradients, aortic valve area [AVA]) and hemodynamics (cardiac output [CO], valvuloarterial impedance [Zva]) and compared AS parameters in patients with AVF versus other dialysis access. Results The cohort included 94 patients with co-prevalent ESKD and AS; mean age 66 years, 71% male; 43% Black, 24% severe AS. Dialysis access: 53% AVF, 47% others. In the overall cohort, no significant differences were noted between AVF vs. non-AVF in AVA/CO/Zva, but with notable subgroup differences. In mild AS, CO was significantly higher in AVF vs. non-AVF (6.3 vs. 5.2 L/min; p=0.04). In severe AS, Zva was higher in the AVF vs. non-AVF (4.6 vs. 3.6 mmHg/ml/m 2). With increasing AS severity in the AVF group, CO decreased, coupled with increase in Zva, likely counterbalancing the net hemodynamic impact of the AVF. Conclusion Among ESKD patients with AS, TTE parameters of flow states and AS severity differed in those with AVF versus other dialysis accesses and varied with progression in severity of AS. Future longitudinal assessment of hemodynamic parameters in a larger cohort of co-prevalent ESRD and AS would be valuable.

Dengue fever and Scrub typhus co-infection deteriorating Severe Acute Cholangitis: A rare case report

Dopaminergic (DA) neurons play pivotal roles in diverse brain functions, spanning movement, reward processing, and sensory perception. DA neurons are most abundant in the midbrain (Substantia Nigra pars compacta, SNC, and Ventral Tegmental Area, VTA) and the olfactory bulb (OB) in the forebrain. Interestingly, a subtype of OB DA neurons is capable of regenerating throughout life, while a second class is exclusively born during embryonic development. Emerging evidence in SNC and VTA also indicates substantial heterogeneity in terms of morphology, connectivity, and function. To further investigate this heterogeneity and directly compare form and function of midbrain and forebrain DA neurons, we performed immunohistochemistry and whole-cell patch-clamp recordings in ex vivo brain slices from juvenile DAT-tdTomato mice. After confirming the penetrance and specificity of the dopamine transporter (DAT) Cre line, we compared soma shape, passive membrane properties, voltage sags and action potential firing across midbrain and forebrain DA subtypes. We found that each DA subgroup within midbrain and forebrain was highly heterogeneous, and that DA neurons across the two brain areas are also substantially different. These findings complement previous work in rats as well as gene expression and in vivo datasets, further questioning the existence of a single “dopaminergic” neuronal phenotype.

Both maternal substance use and unpredictability of her sensory signals may affect child development, but no studies have examined them together. We explored the unpredictability, frequency, and duration of maternal sensory signals in 59 mother-child dyads, 34 with and 25 without maternal substance use. We also examined the association between unpredictability of maternal signals and children's cognitive development. Maternal sensory signals were evaluated with videorecorded dyadic free-play interactions at child age of 24 months. Children's cognitive development was evaluated with Bayley-III at 24 months and with WPPSI-III at 48 months. We found no differences in sensory signals between substance-using and non-using mothers. Higher unpredictability of maternal sensory signals was associated with poorer child cognitive and language development at 24 months and with poorer nonverbal reasoning at 48 months. Unpredictability of maternal sensory signals may be a vital parenting aspect shaping children's development, but more research is needed in high-risk groups.

Aims: Previous research showed that short-term second language training modulates children’s brain responses. However, little is known about how well young children’s brains process second language-related information acquired from short-term usage of language-immersive apps. Methodology: To examine this, we compared the auditory event-related potential (ERP) to non-native language words learnt via language-immersive applications (apps), as compared to those learnt via digital flash cards, in 3-5-year-old children. We also compared their auditory ERPs to known and unknown words. Data analysis: Thirty-two participants have completed the (audio) word-picture pair experiment while their electroencephalography (EEG) was recorded. We compared the auditory ERPs in the 200-300ms window and the 400-600ms window between the apps group and the flash-card group, and the response to the known and unknown words. Results: We found that the early positive potential (of the whole group) to the known words was significantly larger than that to the unknown words. Further, the early negative potential of the language immersed group was significantly larger than that of the flash card group. Conclusions: Short-term training from language-immersive apps has a positive impact on the developing brain.

An algorithm is proposed to implement digital peeling to determine dominant time constants of an exponential transient process. The method is simpler to implement and reduces computational time to a large extent in comparison to other techniques widely used. Apart from a synthetic test function, the algorithm has been implemented on reported experimental transient decay curves of Cs 2HfCl 6 (CHC) single crystal scintillation to verify its efficacy. Finally, drain current detrapping transients of unpassivated AlGaN/GaN high electron mobility transistors (HEMTs) are analysed to determine the trap energy levels and concentrations. The validation of this digital peeling technique is also carried out by comparing with conventional method of time constant extraction from HEMT current transients. The extracted exponentials from the transient data efficiently fits well with the experimental data and can be extensively used for transient analysis. The digital peeling technique has wide applicability and can be used to analyze all exponential processes which occur in all domains of science.