An improved understanding of the molecular actions underpinning bone marrow stromal cell (BMSC) differentiation could highlight new therapeutics for osteoporosis (OP). Current evidence indicates that microRNAs (miRNAs) exert critical roles in many biological systems, including osteoblast differentiation. In this study, we examined miR-468-3p effects on osteogenic differentiation (OD). Distinct miR-468-3p reductions were identified during OD. MiR-468-3p also suppressed BMSC OD in gain- and loss-of-function assays, while it negatively regulated Runx2 as shown by molecular, protein, and bioinformatics approaches. When Runx2 was inhibited by small-interfering RNA (siRNA), the inhibitory effects of miR-468-3p toward BMSC osteogenesis were considerably reversed. Also, silenced miR-468-3p in ovariectomized (OVX) and sham mice augmented bone mass (BM) and bone formation (BF) and improved trabecular (Tb) microarchitecture. Therefore, miR-468-3p is a novel Runx2 regulator with key physiological action in BF and OD.

Herbivorous insects tolerate chemical variation in their host plant diet by modulating several traits. Insect immune response is one trait that plays a crucial role in maintaining fitness but can be heavily influenced by variation in host plant quality. An important question is how the use of different host plants affects the ability of herbivorous insects to resist viral pathogens. Furthermore, the transcriptional changes associated with this interaction of diet and viral pathogens remain understudied. The Melissa blue butterfly (Lycaeides melissa) has colonized the exotic legume Medicago sativa as a larval host within the past 200 years. Here we study the interplay between the effects of host plant variation and viral infection on larval immune responses and global gene expression. We measured immune strength in response to infection by the Junonia coenia densovirus (JcDV) and performed transcriptional sequencing of L. melissa larvae exposed to different viral and host plant treatments. Our results demonstrate that viral infection caused total phenoloxidase (total PO) to increase and viral infection and host plant interactively affected total PO such that for infected larvae, total PO was significantly higher for larvae consuming the native host plant. Additionally, larvae differentially expressed hundredgenes in response to host plant treatment, but with minimal changes in gene expression in response to viral infection. These results demonstrate that in herbivorous insects, diet can alter both physiological and transcriptional responses relevant to viral infection, emphasizing the importance of considering immune and detoxification mechanisms into models of evolution of host range in insects.

Primary diffuse leptomeningeal melanomatosis Leading to raised intracranial pressure in pediatric patientShiva Sareh1,Zohre Habibi2,Mohammad Vasei3,Moeindin Safavi4,Alieh Safari Sharari5 Neda Pak6, \RL Golazin shahbodagh khan7 , Mahmoudreza Ashrafi8 ,Morteza Heidari9 *

Objective: To assess the effectiveness of auditory and visual distraction interventions on patient discomfort, pain and anxiety during office-based Otolaryngologic upper airway procedures. Data Sources: Literature searches were done through Cochrane Central Register of Controlled Trials, Lilacs, MEDLINE, Embase, PsycINFO, and Cumulative Index to Nursing and Allied Health Literature. Review Methods: The protocol was registered in PROSPERO on August 17 th 2022, under Registration number CRD42020204354. Results: We identified 138 records; two randomized controlled trials using virtual reality as a distraction technique in adults and one in children were included. All studies had some concerns regarding risk of bias. In adults, anxiety was lower in the virtual reality group than in the standard of care, (mean difference -16.72, 95% CI -27.19 to -6.24, p=0.002, I 2=0%). There was no difference in procedure related pain between groups, (mean difference -0.28, 95% CI -1.24 to 0.68, p=0.57, I 2=10%). There was no difference in satisfaction between groups (Standardized mean difference 0.18, 95% CI -0.22 to 0.58, p = 0.37, I 2=0%). Only one Pediatric study was included hence no meta-analysis was done. Anxiety and pain were lower and satisfaction was higher in the group using virtual reality. Conclusions: The use of virtual reality distraction in addition to standard analgesia during office-based Otolaryngology upper airway procedures reduced anxiety in adults. It did not decrease pain or increase the level of patient satisfaction. In the paediatric population, there is a reported benefit for procedural anxiety, pain and satisfaction.

Candida and other yeast infections represent a major component of invasive mycoses globally, including the Arabian Peninsula. In this review, we present epidemiological features and trends, clinical manifestations, species distribution, antifungal resistance, and outcomes available for yeast-related infections in different countries of the Arabian Peninsula. We also discuss gaps in knowledge and provide recommendations for improving various aspects for better management of infections by these fungal pathogens. Candida species prevail, with Candida albicans being the most isolated organism in all countries but not in all time periods. The next most frequently isolated organism varied from country-to-country within the region. Generally, invasive infections by non- albicans Candida species are increasing. Candida auris is causing serious health risks in all countries including those with appropriate diagnostic capacity and awareness. A major goal of this collaborative work is to set-up a regional system to share information on the clinical, epidemiological and molecular characteristics of C. auris-related infections and share experiences on best management and infection control strategies in the region. Information is also reviewed on other yeast infections in the region which are less frequently observed and seem to differ between different countries, likely because of differences in clinical practices and research interests among individual countries.

Mental spatial transformations such as rotation and folding have been well-characterised both behaviorally and electrophysiologically. However, the parity of mental rotation and mental folding mechanisms is an unresolved question. The neurophysiological signature of mental rotation is a late negative deflection over parietal regions that becomes more negative with greater rotation angles. The same negativity is present during mental folding, but typically does not change in amplitude with different folding difficulties. This dissociation suggests that the two processes may rely on separate mechanisms, or it could occur due to typical mental folding experiments utilising stimuli for which each fold involves a fixed 90° transformation angle . The aim of this study is to test the latter explanation. If varying the angle of folding required coincides with changes to the magnitude of the folding-related parietal negativity, mental folding can be viewed as a series of rotations for the component parts of an object. Participants will mentally fold a cube net to completion to decide whether two points on the net will meet. In a 2x2 design, the cube nets will require different numbers of folding (4 faces carried vs 6 faces carried), and the folds will require different degrees of rotation to complete (50° vs 90°). Electroencephalography data will be analysed to determine the presence of a transformation negativity over parietal leads between 400-800 ms. Greater negativity in this component for larger degrees of folding angle will be taken as evidence for a shared mechanism between mental folding and mental rotation.

not-yet-known not-yet-known not-yet-known unknown Background: Chronic musculoskeletal pain has been associated with changes at various levels regarding pain processing. One of the fields that has highlighted such differences between healthy individuals and people suffering from chronic musculoskeletal pain is neuroimaging of the brain. The mixed results arising from the different pathologies in addition to the use of different brain imaging modalities do not offer a conclusive overview, implicating the interpretation of the findings and their relevance as a causal or a consequent factor to chronification of pain. The aim of this systematic review is to provide a comprehensive summary of the available evidence assessing chronic painful conditions against healthy populations per functional neuroimaging modality. Methods: The protocol for this systematic review was informed and reported in line with the Preferred Reporting Items for Systematic Reviews. The databases that will be searched from inception to 8 January 2024 include PubMed, EMBASE (Ovid Interface), Scopus, Cochrane Library and Web of Science (Clarivate Analytics). Risk of bias will be assessed with the Newcastle-Ottawa tool, and the quality of the cumulative evidence assessed with the Grading of Recommendations, Assessment, Development and Evaluation guidelines. Discussion: The results of this review will provide an up-to-date report on what the main findings of brain neuroimaging per pathological population and imaging modality are, assessing at the same time the quality of the evidence and indicating future directions in the field of neuroimaging assessment of the musculoskeletal patient.

A document by Tirhani Maluleke. Click on the document to view its contents.

Spontaneous Uterine Rupture in the Second Trimester: A Case Report

Mosquitoes, as temperature-sensitive ectothermic vectors, exhibit temperature-dependent traits like reproduction and survival. This study investigates Culex pallens (Cx. pallens) mosquito responses to abrupt temperature increases and their implications for mosquito control programs. Cx. pallens first instar larvae (24hr post hatching) and newly enclosed adults (24hr post emergence) were separately exposed to heat shock regimes of 33℃, 37℃, and 42℃ for 3 days alongside a control temperature of 27℃. Results showed that mortality was triggered at 42℃ within a day. Newly enclosed males were less tolerant to all temperatures than larvae and females (p < 0.05. Heat exposure significantly decreased larvae’s development time, growth and adult emergency (p < 0.05). Reproductive fitness was significantly reduced (p < 0.05) in males emerging from larvae exposed to 37℃. Life table parameters showed significantly increased mortality rate, kill power and decreased life expectancy at the embryonic stage (p < 0.05). Sporadic heat deactivated the Transient receptor protein ankyrin 1 at 37℃ (p < 0.05) in larvae but not adults. Calmodium, Heat shock protein 90, and small heat shock protein expression was significantly decreased in larvae at 37℃ (p < 0.05) as compared to larvae raised at 33℃ and 27℃. In conclusion, we classified the heat waves into three categories: adaptable (33℃), critical (37℃), and fatal (42℃). Prolonged exposure of Cx. pallens larvae to heat affects the male reproductive output. These findings may serve as an important reference for forecasting vector and pest dynamics. They can be used to tailor mosquito prevention and control measures.

Here, we reported a rare case of linear porokeratosis (LP) treated topically with atorvastatin nanoemulgel for 12 weeks. The patient reported no obvious skin irritation and was delighted with the outcome. We evaluated the efficacy of topical atorvastatin as a monotherapy in this LP patient and reviewed the relevant studies on the application of topical statins/cholesterol in treating LP.

Background: Otorhinolaryngology traumas are common among patients with head and neck injuries. Most of this involves the facial region and to a lesser extent ear and throat. Etiology of Otorhinolaryngology trauma includes Motor traffic accidents, falls from height, assault and sports injury. Identification of this trauma by general practitioners is challenging because Otorhinolaryngology examination requires special instruments and skills. Study aim: To determine the prevalence, etiology and distribution of otorhinolaryngology trauma among patients with head and neck injury admitted at Kilimanjaro Christian Medical Center from November 2017 to May 2018. Methods: Hospital-based descriptive cross-sectional study conducted at Kilimanjaro Christian Medical Center. A total of 384 patients with head and neck injuries were included. Relevant information was collected while interviewing patients and during the physical examination was noted and data was handled with SPSS version 20 and transferred to STATA version 13 for analysis. Result. Out of 384 patients, 340 (88.5%) were male, majority 197(51.3) were aged between 21 to 40 years. Out of 384 patients 238(62%) were having Otorhinolaryngology trauma, the majority are male and are between 21 to 40 years old. Motor traffic accident was a common etiology (77.3%) in this study. The maxillofacial area was the common ORL trauma site encountered (70.3%) followed by ear trauma (17.0%) and throat 2%. Conclusion The prevalence of Otorhinolaryngology trauma among patients with head and neck injuries admitted at Kilimanjaro Christian Medical Centre is high, motor traffic accidents were the leading etiology and maxillofacial region was a common ORL trauma site encountered.

The emergence of jaws in early vertebrates introduced a novel feeding apparatus and potent oral defenses but also increased the risk of physical injury and pathogen exposure. Innate immunity and inflammation constitute the body’s first line of defense against invading microbes and tissue damage, aiming to eliminate threats and restore internal homeostasis. Interferon regulatory factor 5 (IRF5) plays a critical role in orchestrating innate immunity and inflammation by regulating the transcription of genes that encode type I interferons (IFNs) and pro-inflammatory cytokines. As the closest member of IRF5, IRF6 is involved in jaw development in humans and mice. However, the evolution of IRF5 and IRF6 has remained poorly understood. We have identified the IRF5 and IRF6 genes in cartilaginous fish, including sharks. As cartilaginous fish represent one of the oldest surviving jawed vertebrate lineages, the presence of these genes suggests that they have ancient origins potentially dating back hundreds of millions of years to early jawed vertebrates. Furthermore, our analysis shows that IRF5 has conserved nuclear export sequences and phosphorylation sites for activation throughout evolution from cartilaginous fish to humans, indicating that these regulatory elements evolved early and have been maintained across jawed vertebrates. Additionally, the shift in the subcellular localization of IRF5 from the nucleus to the cytosol, and of other interferon-related IRFs, aligns with functional enhancements of IRFs in innate immunity and the emergence of IFNs across jawed vertebrates. This analysis implies that the evolution of jaws may have driven the emergence of new IRF members, the expansion of their functions, and the development of a unique inflammation and innate immune system in vertebrates.

not-yet-known not-yet-known not-yet-known unknown Paper mulberry is a fiber resource for paper making. Washi, a traditional paper in Japan, has been produced from Broussonetia kajinoki, which is a hybrid between B. monoica and B. papyrifera. Elite strains have been vegetatively propagated and distributed within Japan. In this study, the complete chloroplast (cp) genomes of these three strains were reconstructed as pseudomolecules consisting of 160,861, 160,868, and 160,878 bp, respectively. They were compared with other strains in databases to detect insertion/deletion (INDEL) polymorphisms. There were 25 INDELs identified in these cp genomes. ISSR based MIG-seq polymorphisms were applied to determine whether varieties or regional groups can be discriminated. Although various types of cultivars exhibiting different appearances are hard to discriminate, PCA-analysis distinguished major two groups. Maternal lineages reflecting the diverse origins of Japanese paper mulberry were determined using hypervariable maternal markers. NGS-oriented nuclear markers systems revealed the heterogeneous nature of cultivars, reflecting the complex origins of Japanese B. kajinoki.

Insects, the most numerous and diverse group of animal species on Earth, have important interactions with humans through providing resources, transmitting diseases, and damaging agricultural cultivars. Cytochrome P450 monooxygenases (P450s) are one of the most important protein families in insects implicated in the endogenous metabolism and detoxification of xenobiotics, including allelochemicals, insecticides, and environmental pollutants. To better understand the evolution and function of insect P450s and support the development and application of insecticides for pest control, an integrated bioinformatics platform is highly desirable. Here, we present the Insect Cytochrome P450 database (ICPD, http://www.insectp450.net/), which contains 66,513 P450s collected from public databases and predicted from the genomes of 680 insect species using a standardized bioinformatics protocol. Phylogenetic relationships between P450 genes are constructed for each species. The structures of all P450 proteins in the database are predicted using AlphaFold v2 and/or ESMFold, then visualized using WeView. Web services, such as BLAST, homogeneous modeling, and molecular docking, are provided for determining the catalytic activities of P450 proteins. The ICPD will facilitate systematic investigations of the evolution and functions of the complete insect P450 complement, and represents a powerful tool for guiding insecticide design and application.

Coexistence of Macrophage Activation Syndrome, Systemic Lupus Erythematosus, and Hepatitis B: A Management Challenge

1 INTRODUCTIONAcute appendicitis continues to be the most frequent cause of acute abdomen requiring surgical intervention and the most common general surgical emergency seen in the majority of hospitals. It usually presents in the first 24 to 48 hours of onset. The diagnosis of acute appendicitis is usually based on a carefully taken history and physical examination. Radiologic studies can also be helpful in patients with atypical presentations(1, 2). The most used imaging studies are ultrasonography and computed tomography. While ultrasonography is more accessible, the latter is the modality of choice due to finer accuracy(3).Since only two-thirds of patients with acute appendicitis present with the classic symptoms, patients with less acute symptoms may be missed (4). One of the complications of a missed acute appendicitis is perforation of the appendix, which should be suspected in cases with temporary improvement in visceral pain, soon followed by symptoms of peritonitis (1). In this report, we present a 44-year-old Afghan male, a rare case of undiagnosed appendicitis, manifested first time with fasciitis and several abdominal abscesses with no physical examination, radiologic, or laboratory findings in favor of appendicitis. The diagnosis of Perforated appendicitis finally became clear after three months via laparotomy when the patient referred again to surgery clinic with intestinal obstruction. We believe this is the first report of fasciitis and obstruction as together being very delayed consequences of appendicitis, leading to a late diagnosis thereof. This case has been reported in line with the SCARE criteria (5).

Juvenile xanthogranuloma (JXG) is a clonal non-Langerhans cell histiocytic disorder characterized by a variety of cutaneous and non-cutaneous manifestations, predominantly in children. The mitogen-activated protein kinase pathway (MAPK) is a key driver in many histiocytic disorders, including JXG. We report a rare presentation of JXG in the mastoid bone of a which recurred after surgery and was refractory to two lines of chemotherapy before responding to the MEK inhibitor trametinib, even in the absence of an identifiable MAPK pathway mutation. MEK inhibitors may be a therapeutic option for this sometimes difficult to treat disease.