Streptococcal toxic shock syndrome (STSS) has a high mortality rate, and most patients die within a few days of onset. We report an elderly patient with STSS, necrotizing fasciitis and septic shock caused by group G Streptococcus (GGS) who was successfully treated with multidisciplinary therapy.

Title: Real-world evidence on the risk of cancer with anti-IL-5 and anti-IL-4Ra biologicalsAuthors : Diogo Mota1; Tiago Azenha Rama1, 2, 3, 4; André Moreira1, 2, 3, 4

Senescence seems to be universal in living organisms and plays a major role in life‐history strategies. Phenotypic senescence, the decline of body condition and/or performance with age, is a largely understudied component of senescence in natural insect populations, although it would be important to understand how and why insects age under natural conditions. We aimed (i) to investigate how body mass and thorax width change with age in a natural population of the univoltine Clouded Apollo butterfly (Parnassius mnemosyne, Lepidoptera: Papilionidae) and (ii) to assess the relationship of this change with sex and wing length. We studied a population between 2014 and 2020 using mark‐recapture during the whole flight period each year. Repeated measurements of body mass and thorax width and single measurements of wing length were performed on marked individuals. We analyzed body mass and thorax width change with age (days since marking), wing length, and the date of the first capture. Both body mass and thorax width declined nonlinearly with age. Individuals appearing earlier in the flight period had significantly higher initial body mass and thorax width and their body mass declined faster than later ones. Initial body sizes of females were higher, but males' body sizes decreased slower. Initial thorax width showed higher annual variation than body mass. To our best knowledge, this is the first study that revealed phenotypic senescence in a natural butterfly population, using in vivo measurements. We found sexual differences in the rate of phenotypic senescence. Despite the annual variation of initial body sizes, the rate of senescence did not vary considerably across the years. Phenotypic senescence is a largely understudied component of senescence in natural insect populations. In a wild Clouded Apollo population investigated by us, both body mass and thorax width declined nonlinearly with age. Individuals appearing earlier in the flight period had significantly higher initial body mass and thorax width, and their body mass declined faster than later ones. Initial body sizes of females were higher, but males' body sizes decreased slower. Initial thorax width showed higher annual variation than body mass.

Biofilms are intricate communities of microorganisms encapsulated within a self-produced matrix of extra-polymeric substances (EPS), creating complex three-dimensional structures allowing for liquid and nutrient transport through them. These aggregations offer constituent microorganisms enhanced protection from environmental stimuli - like fluid flow - and are also associated with higher resistance to antimicrobial compounds, providing a persistent cause of concern in numerous sectors like the marine (biofouling, aquaculture), medical (infections, antimicrobial resistance), dentistry (plaque on teeth), food safety, as well as causing energy loss and corrosion. Recent studies have demonstrated that biofilms interact with microplastics, often influencing their pathway to higher trophic levels. Previous research has shown that initial bacterial attachment is affected by surface properties. Using a microfluidic flow cell, we have investigated the relationship between both wall shear stress (τw) and surface properties (surface wettability) upon biofilm formation of two species (Cobetia marina and Pseudomonas aeruginosa). We investigated biofilm development on low-density polyethylene (LDPE) membranes, Permanox® slides, and glass slides, using nucleic acid staining and end-point confocal laser scanning microscopy (CLSM). The results show that flow conditions affect biomass, maximum thickness, and surface area of biofilms, with higher τw (5.6 Pa) resulting in thinner biofilms than lower τw (0.2 Pa). In addition, we observed differences in biofilm development across the surfaces tested, with LDPE typically demonstrating more overall biofilm in comparison to Permanox® and glass. Moreover, we demonstrate the formation of biofilm streamers under laminar flow conditions within straight micro-channels.

Idiopathic spinal subdural hematoma (SSDH) is a rare phenomenon. Here, we present a 16-year-old-boy who presented with acute sudden onset weakness and brown squared syndrome; the cervical MRI findings showed acute subdural hematoma from C2-C6. Emergent surgical intervention was performed and significant improvement was seen in follow-ups.

Absence of an internal jugular vein at birth is infrequent.A dull headache troubled a 32-year-old man for more than 20 years, which persisted, a diagnosis of left internal jugular vein agenesis was made, which was most likely the cause of the headache.

Introduction: There are no guidelines regarding the use of bovine pericardial or porcine valves for aortic valve replacement, and prior studies have yielded conflicting results. The current study sought to compare short- and long-term outcomes in propensity-matched cohorts of patients undergoing isolated AVR with bovine versus porcine valves. Methods: This was a retrospective study utilizing an institutional database of all isolated bioprosthetic surgical aortic valve replacements performed at our center from 2010 to 2020. Patients were stratified according to type of bioprosthetic valve (bovine pericardial or porcine), and 1:1 propensity-score matching was applied. Kaplan-Meier survival estimation and multivariable Cox regression for mortality were performed. Cumulative incidence functions were generated for all-cause readmissions and aortic valve reinterventions. Results: A total of 1,502 patients were identified, 1,090 (72.6%) of whom received a bovine prosthesis and 412 (27.4%) of whom received a porcine prosthesis. Propensity-score matching resulted in 412 risk-adjusted pairs. There were no significant differences in clinical or echocardiographic postoperative outcomes in the matched cohorts. Kaplan-Meier survival estimates were comparable, and, on multivariable Cox regression, valve type was not significantly associated with long-term mortality (HR 1.02, 95% CI: 0.74, 1.40, p=0.924). Additionally, there were no significant differences in competing-risk cumulative incidence estimates for all-cause readmissions (p=0.68) or aortic valve reinterventions (p=0.25) in the matched cohorts. Conclusion: The use of either bovine or porcine bioprosthetic aortic valves yields comparable postoperative outcomes, long-term survival, freedom from reintervention, and freedom from readmission.

Title page:Title : Letter to the editor: Mitral valve repair with the edge‐to‐edge technique: A 20 years single‐center experienceArticle type : Letter to the editorCorrespondence : 1. Syed HussainContact : +923323230575 Email : [email protected] : Shaheed Mohtarma Benazir Bhutto Medical College Liyari KarachiAddress : R-75 Railway Housing Society, 13-D1, Gulshan-e-Iqbal, Karachi, 75300Co-authors : 2.Muhammad MaazContact : +923032194036 Email : [email protected] : Shaheed Mohtarma Benazir Bhutto Medical College Liyari KarachiAddress : Flat No. B-16, Hasham Apartment, Rafa-e-aam, Malir Halt, Karachi, 752103. Dr. Sumeet KumarContact : +92-3337351513Email :[email protected] : Dow University of Health Sciences, KarachiAddress : Mission Rd, New Labour Colony Nanakwara, Karachi, Karachi City, Sindh 74200Word count : 482Conflict of interest : NoneDeclaration : NoneAcknowledgment : None

Although the field of urban evolutionary ecology is in its infancy, much progress has been made in identifying adaptations that arise as a result of selective pressures within these unique environments. However, as studies within urban environments have rapidly increased, researchers have recognized there are challenges and opportunities in characterizing urban adaptation. Some of these challenges are novel as a consequence of increased direct and indirect human influence, which compounds long-recognized issues with research on adaptive evolution more generally. In this perspective, we discuss several common research challenges to urban adaptation related to: (1) methodological approaches, (2) trait-environment relationships and the natural history of organisms, (3) agents and targets of selection, and (4) habitat heterogeneity. Ignoring these challenges may lead to misconceptions and further impede our ability to draw conclusions regarding evolutionary and ecological processes in urban environments. Our goal is to first shed light on the conceptual challenges of conducting urban adaptation research to help avoid propagation of these misconceptions. We further summarize potential strategies to move forward productively to construct a more comprehensive picture of urban adaptation, and discuss how urban environments also offer unique opportunities and applications for adaptation research.

Any random genetic change is more likely to impair than improve fitness, a situation that owes to the fact that contemporary genotypes bear a history of having been shaped by natural selection for a very long time. Most mutations are thus deleterious and generate a genetic load that can be difficult to handle in small populations and increase the risk of extinction. We used functional annotation and evolutionary conservation scores to study deleterious variation in 200+ genomes from the highly inbred Scandinavian wolf population, founded by only three wolves and suffering from inbreeding depression, and neighboring populations in northern Europe. The masked load was high in Russia and Finland with deleterious alleles segregating at lower frequency than neutral variation. Genetic drift in the Scandinavian population led to the loss of ancestral alleles and fixation of deleterious variants. The per-individual realized load increased with the extent of inbreeding and reached several hundred homozygous deleterious genotypes in protein-coding genes, and a total of more than 50,000 homozygous deleterious genotypes in the genome. Arrival of immigrants gave a temporary genetic rescue effect with ancestral alleles re-entering the population and moving deleterious alleles into heterozygote genotypes. However, in the absence of permanent connectivity inbreeding has then again led to the exposure of deleterious mutations. These observations provide genome-wide insight into the character of genetic load and genetic rescue at the molecular level, and in relation to population history. They emphasize the importance of securing gene flow in the management of endangered populations.

Hepatic portal venous gas is diagnosed via computed tomography due to unusual imaging features. HPVG when linked with pneumatosis intestinalis has a high mortality rate and required urgent intervention

Functional role of ST6GALNAC1-mediated sialylation of mucins in preserving intestinal barrier integrity and ameliorating inflammation. Authors : Elisa Sánchez-Martínez1*, Manuel Garrido-Romero1,2,*, F. Javier Moreno21Department of Immunology, Instituto de Investigación Sanitaria Hospital Universitario de La Princesa, (IIS-Princesa), Universidad Autónoma de Madrid (UAM), Madrid, Spain.2Department of Bioactivity and Food Analysis, Instituto de Investigación en Ciencias de la Alimentación, CIAL (CSIC-UAM), Madrid, Spain.*Equal contributionCorrespondence to:F. Javier Moreno. Department of Bioactivity and Food Analysis, Instituto de Investigación en Ciencias de la Alimentación, CIAL (CSIC-UAM), Nicolás Cabrera 9, 28049 Madrid, Spain.E-mail:[email protected]:ST6GALNAC1, ST6; mucin-2, MUC2; dextran sulfate sodium, DSS; wild-type, WT; short-chain fatty acids, SCFA.Funding information : MGR is supported by an EFSA project (Grant agreement GP/EFSA/ENCO/2020/02 – 1) granted to FJM. Conclusions, findings and opinions expressed in this document reflect only the view of the authors and not the official position of EFSA.Keywords: epithelial barrier; MUC2; intestinal mucus; gut microbiota disruption; colitis.

The upgrading of oleyl alcohol synthesis via methyl oleate reduction using NaBH4 without H2 supply was investigated. It was possible to synthesize selectively the valuable unsaturated fatty alcohol with high yields. Non-catalytic and catalytic experiments were developed trying to improve the low final oleyl alcohol yield previously obtained. The effect of reaction temperature, methyl oleate/NaBH4 molar ratio and properties of different catalysts on final oleyl alcohol yield was analyzed. Thus, alumina-supported metal (M) catalysts (M = Fe, Ce, Mo) were synthesized by impregnation at incipient wetness. The M/Al2O3 catalysts were characterized in their chemical, textural, structural and acid-base properties using ICP, N2 physisorption, XRD and NH3 and CO2 TPD. During non-catalytic methyl oleate reduction final methyl oleate conversion and oleyl alcohol yield of 94% were obtained using a methyl oleate/NaBH4 molar ratio of 0.11 at 333 K. Catalytic activity of M/Al2O3 solids did not correlate with basic site number but increased as acid site number and ionic potential of M cations increase. This suggests that cations with high acid site number and polarizing power are the ones that promote the polarization of the ester C=O and anion [BH4]- bonds favoring de methyl oleate conversion. In addition, the reaction mechanism for fatty acid methyl ester reduction was investigated from a theoretical approach using Density Functional Theory method at B3LYP/6-31++G(d,p) computational level. Results obtained during theoretical calculations confirmed that the formation of reducing alcoxyborohydride species is energetically favored and allowed to understand the events at microscopic level involved in the reaction mechanism.

The core of bioprinting related research aims to reduce the gap between ex vivo cell cultures and in vivo cellular tissue models to further its application within the biomedical field. While additive manufacturing is touted as disruptive technology, bioprinter equipment costs exceed limited resource budgets of many research laboratories restricting the scope for further development for biomedical research and potential medical application. In line with this, a relatively low-cost bioprinter (SidneV1) was successfully designed and manufactured using a low-cost, commercially available FDM Delta 3D printer as a prototype base with a successfully custom designed and manufactured micro-extrusion printhead. Printing accuracies assessed were 65% (for width measurements) and 64% (for height measurements). This study aimed to demonstrate a way to achieve low-cost bioprinting and hopefully pave the way for future system modifications and refinements such that this technology becomes more accessible to under-funded research groups around the world. Although these findings are preliminary, further optimization of printing parameters, bioink formulations and sterilization techniques will allow for the engineering of viable, physiologically relevant tissue models using low-cost bioprinting technology.

Duke-Davidoff-Masson syndrome (DDMS) is a rare neurological condition with unknown global prevalence. It typically manifests with body asymmetry, drugs resistant epilepsy, mental retardation, cerebral atrophy, skull bone thickening and hyperpneumatization of the frontal sinuses. In this report, we present an unusual case of DDMS revealed by status epilepticus.

Facial puffiness as a consequence of superior vena cava syndrome (SVCS), can be a presentation from which the physician would have to conjecture a diagnosis of a mediastinal mass including lymphomas. Pediatric SVCS can rapidly progress and pose a greater challenge for airway protection as was in our case.

A man with persistent dyspnea was brought to our hospital in an emergency. Cardiac catheterization revealed right coronary artery occlusion. The patient went into shock on the second day of treatment due to rapid pericardial effusion. The pericardial fluid was cloudy and non-bloody, which was judged purulent pericarditis.

Various conditions may mimic osteosarcoma. The differential diagnosis of osteosarcoma is broad. A proper history, examination, diagnostic imaging studies, and pathological analysis are essential to establish the precise diagnosis. This case report serves to illustrate the significance of recognizing similarities and other rare features to prevent late or misdiagnosis.