Rheumatoid arthritis (RA) is a chronic inflammatory disease, characterized by symmetric and destructive polyarthritis with a broad spectrum clinical manifestation of various organs. Rheumatoid neutrophilic dermatitis (RND) is an unusual distinctive manifestation of RA and typically develops in severe RA. 51-year-old female presented with a skin rash involving her extremities.

Nucleotides metabolism is a fundamental process in all organisms. Two families of nucleoside phosphorylases (NP) that catalyze the phosphorolytic cleavage of the glycosidic bond in nucleosides have been found, including the trimeric or hexameric NP-I and dimeric NP-II family enzymes. Recently studies revealed another class of NP protein in E. coli named Pyrimidine/purine nucleoside phosphorylase (ppnP), which can catalyze the phosphorolysis of diverse nucleosides and yield D-ribose 1-phosphate and the respective free bases. Here, we solve the crystal structures of ppnP from E. coli and the other three species. Our studies revealed that the structure of ppnP belongs to the Rlmc-like cupin fold and showed as a rigid dimeric conformation. Detail analysis revealed a potential nucleoside binding pocket full of hydrophobic residues. And the residues involved in the dimer and pocket formation are all well conserved in bacteria. Since the cupin fold is a large superfamily in the biosynthesis of natural products, our studies provide the structural basis for understanding and the directed evolution of NP proteins.

Cordyceps is a large group of entomogenous, medicinally important fungi. In this study, we sequenced, assembled, and annotated the entire mitochondrial genome of O. xuefengensis, in addition to comparing it against three other complete cordyceps mitogenomes that were previously published. Comparative analysis indicated that the four complete mitogenomes are all composed of circular DNA molecules, although their sizes significantly differ due to high variability in intron and intergenic region sizes in the O. sinensis and O. xuefengensis mitogenomes. All mitogenomes contain 14 conserved genes and two ribosomal RNA genes, but varying numbers of tRNA introns. The Ka/Ks ratios for all 14 PCGs and rps3 were all less than 1, indicating that these genes have been subject to purifying selection. Phylogenetic analysis was conducted using concatenated amino acid and nucleotide sequences of the 14 PCGs and rps3 using two different methods (Maximum Likelihood and Bayesian analysis), revealing highly supported relationships between O. xuefengensis and other Ophiocordyceps species, in addition to a close relationship with O. sinensis. Further, the analyses indicated that cox1 and rps3 play important roles in population differentiation. These mitogenomes will allow further study of the population genetics, taxonomy, and evolutionary biology of medicinally important cordyceps species.

We consider a nonautonomous eco-epidemiological model with general functions for predation on infected and uninfected preys as well as general functions associated to the vital dynamics of the susceptible prey and predator populations. We obtain persistence and extinction results for the infected prey based on assumptions on auxiliary systems constructed from the disease-free system. We moreover consider an iterative process that can improve the extinction results. We apply our results to general eco-epidemiological models that include several examples existent in the literature.

The concept of depth of an almost strictly sign regular matrix is introduced and used to simplify some algorithmic characterizations of these matrices.

The purpose of this article is to introduce an application to draw the asymptotes of Bode diagram module and phase from each constituent elementary factors of any transfer function for minimum and non-minimal phase systems without transport delay. The Bode diagram is the most used tool in the frequency response method. Python was used to program the application to perform the operations as well as the Qt5 Design for the simple graphical interface for the application and all this in the Linux operating system. The application purpose is to assist students in learning the concept and drawing of Bode diagram. For students the non-minimum phase system Bode diagram is more difficult to draw than a minimum phase system due to the presence of zeros and/or poles on right half of s-plane. The phase asymptotes of a quadratic factor was closest to the real phase curve around the corresponding undamped natural frequency and this can be observed in the example showed in this article. This example must be used as a help and not a simply to solve a problem.

Alveolar bone grafting is a complex procedure utilized in alveolar cleft repair, however, the ideal site of bone graft material remains highly debated. In this paper, we describe the management of a 14 year old female with bilateral alveolar clefts using alternative intra-oral donor sites for bone graft harvest.

Cemento-Osseous dysplasia(COD) is a condition where normal bone is replaced by fibrous connective tissue and cementum-like deposits. Implant rehabilitation of a posterior mandibular edentulism in presence of a COD can be a challenging situation due to the lack of vascularization and the high risk of infection of such lesions.

A cutaneous sinus tract of dental origin may easily be misdiagnosed and incorrectly treated. This paper reported a case of a 20-years-old male patient referred for a productive cutaneous sinus tract misdiagnosed by medical doctors for more than 4 years. The clinical and radiographic examinations confirmed the odontogenic origin

Riparian vegetation provides many noteworthy functions in river and floodplain systems including its influence on hydrodynamic processes. Traditional methods for predicting hydrodynamic characteristics in the presence of vegetation involve the application of static roughness ( ns) values, which neglect changes in roughness due to local flow characteristics. The objectives of this study were to: (1) implement numerical routines for simulating dynamic hydraulic roughness ( nd) in a two-dimensional (2D) hydrodynamic model; (2) evaluate the performance of two dynamic roughness approaches; and (3) compare vegetation parameters and hydrodynamic model results based on field-based and remote sensing acquisition methods. A coupled vegetation-hydraulic solver was developed for a 2D hydraulics model using two dynamic approaches, which required vegetation parameters to calculate spatially distributed, dynamic roughness coefficients. Vegetation parameters were determined by field survey and using airborne LiDAR data. Water surface elevations modeled using conventional and the proposed dynamic approaches produced similar profiles. The method demonstrates the suitability in modeling the system where there is no calibration data. Substantial spatial variations in both n and hydraulic parameters were observed when comparing the static and dynamic approaches. Thus, the method proposed here is beneficial for describing the hydraulic conditions for the area having huge variation of vegetation. The proposed methods have the potential to improve our ability to simulate the spatial and temporal heterogeneity of vegetated floodplain surfaces with an approach that is more physically-based and reproducible than conventional “look up” approaches. However, additional research is needed to quantify model performance with respect to spatially distributed flow properties and parameterization of vegetation characteristics.

Cardiac angiofibroma is a very rare diagnosis when a patient develops an intracardiac mass. It is a primary benign cardiac tumor with a scarcity of information in the literature.  This case report illustrates a 26-year-old man with a complaint of chronic chest tightness who was firstly diagnosed with right ventricle tumor by echocardiography then underwent cardiac MRI which confirmed the presence of a highly-vascular tumor with radiologically benign behavior. Then his tumor was excised, his postoperative course was uncomplicated and he was well within almost 2 months after discharge. Ultimately the histopathologic findings demonstrated vascular and stromal tissue in favor of angiofibroma and excluded the other diagnoses with IHC and trichrome staining.  Angiofibroma is a benign, highly vascular tumor, mostly discovered in the nasopharynx. When it is found in the heart, CMR and pathology are pivotal to rule in its diagnosis. It is isointense in T1 weighted and hyperintense in T2 weighted sequences with intense enhancement following contrast injection. Its pathology contains an admixture of vasculatures with CD31 positive immunoreactivity for endothelial cells and fibrotic tissue with bluish coloration in trichrome staining. Eventually, its treatment includes merely surgical excision given its benign nature.

Alternative splicing is a molecular mechanism that enables a single gene to encode multiple transcripts and proteins by post-transcriptional modification of pre-RNA molecules. Changes in the splicing scheme of genes can lead to modifications of the transcriptome and the proteome. This mechanism can enable organisms to respond to environmental fluctuations. In this study, we investigated patterns of alternative splicing in the liver of the coral reef fish Acanthochromis polyacanthus in response to the 2016 marine heatwave on the Great Barrier Reef. The differentially spliced (DS; n=40) genes during the onset of the heatwave (i.e. 29.49°C or +1°C from average) were related to essential cellular functions such as the MAPK signaling system, Ca(2+) binding and homeostasis. With the persistence of the heatwave for a period of one month (February to March), 21 DS genes were detected, suggesting that acute warming during the onset of the heatwave is more influential on alternative splicing than the continued exposure to elevated temperatures. After the heatwave, the water temperature cooled to ~24.96°C, and fish showed differential splicing of genes related to cyto-protection and post-damage recovery (n=26). Two-thirds of the DS genes detected across the heatwave were also differentially expressed, revealing that the two molecular mechanisms act together in A. polyacanthus to cope with the acute thermal change. This study exemplifies how splicing patterns of a coral reef fish can be modified by marine heatwaves. Alternative splicing could therefore be a potential mechanism to adjust cellular physiological states under thermal stress and aid coral reef fishes in their response to more frequent acute thermal fluctuations in upcoming decades.

Augmentation genioplasty is a common surgical procedure with extremely low infection rates. We present the case of a healthy middle-aged woman who experienced years of chronic infection after chin implantation due to a fractured mandibular canine root, which is exceedingly rare. Awareness of this potential complication will reduce patient morbidity.

Hereditary hemorrhagic telangiectasia (HHT) is a rare disorder affecting skin and body’s internal organs with tendency for bleeding. We reports a case of Sudanese 42-year-old with family history of HHT presented with recurrent epistaxis and telangiectasias

AIM: To explore the level of agreement on drug-drug interaction (DDI) information listed in three major online drug information resources (DIRs) in terms of: (1) interacting drug pairs; (2) severity rating; (3) evidence rating and (4) clinical management recommendations. METHODS: We extracted DDI information from the British National Formulary (BNF), Thesaurus, and Micromedex. Following drug name normalisation, we estimated the overlap of the DIRs. We annotated clinical management recommendations either manually, where possible, or through application of a machine learning algorithm. RESULTS: The DIRs contained 51,481 (BNF), 38,037 (Thesaurus), and 65,446 (Micromedex) drug pairs involved in DDIs. The number of common DDIs across the three DIRs was 6,970 (13.54% of BNF, 18.32% of Thesaurus, and 10.65% of Micromedex). Micromedex and Thesaurus overall showed higher levels of similarity in their severity ratings, while the BNF agreed more with Micromedex on the critical severity ratings and with Thesaurus on the least significant ones. Evidence rating agreement between BNF and Micromedex was generally poor. Variation in clinical management recommendations was also identified, with some categories (i.e. Monitor and Adjust dose) showing higher levels of agreement compared to others (i.e. Use with caution, Wash-out, Modify administration). CONCLUSIONS: There is considerable variation in the DDIs included in the examined DIRs, together with variability in categorisation of severity and clinical advice given. DDIs labelled as critical are more likely to appear in multiple DIRs. Such variability in information could have deleterious consequences for patient safety, and there is a need for harmonisation and standardisation.

Although Mobitz type II atrioventricular block is an arrhythmia based on a permanent organic disorder of the His-Purkinje system, reversible factors should be considered. Here, we report the association between a rare reversible Mobitz type II atrioventricular block and antipsychotic medication in a 75-year-old patient with schizophrenia.

A 27-year-old female presenting palpitation without ECG documentation underwent electrophysiology study. EP study revealed atrioventricular accessory pathway with poor and unidirectional pathway conduction, and a fasciculoventricular pathway. During isoproterenol infusion, delta wave promptly became prominent, after which an antidromic AV reentrant tachycardia was induced. When the pathway was mapped, widely split double pathway potentials were observed at 12 o'clock site of tricuspid annulus during mild preexcitation, demonstrating an example of intra-pathway conduction delay, which can be reversed by isoproterenol. Ablation at the site caused accelerated pathway rhythm and eliminated the pathway, rendering the tachycardia non-inducible.

We proved the existence and uniqueness of comporessible subsonic impinging jet flow in the work \cite{WX}. As a continuation, in this paper, we investigate the shape of free boundary to the impinging jet flow established in \cite{WX}. More specifically, if the nozzle wall is concave to the fluid, then the free boundary of flow will be convex to the fluid. On another hand, the higher regularity of free boundary at separation point is obtained, provided that the nozzle satisfies corresponding hypotheses.