Fingertip soft tissue defect caused by periungual warts: a case report

An Aesthetic, Functional, and Low-Invasive Lower Red Lip Reconstruction Using a Mucosal Perforator Flap: A Case Report

Working memory (WM) is one of the fundamental cognitive functions associated with the dorsolateral prefrontal cortex (DLPFC). However, we still know little about the neurochemical mechanisms of WM in the DLPFC. Here, we investigated WM-related dynamic neurometabolite and hemodynamic responses in the DLPFC. We measured Glx (glutamate+glutamine) and GABA alterations as well as blood-oxygen-level-dependent (BOLD) signal changes during a WM task combining functional magnetic resonance spectroscopy and functional magnetic resonance imaging (fMRI). In the DLPFC, we found that a 2-back task increased Glx concentrations and larger BOLD signal changes, and that these task-modulated Glx increases were positively correlated with task-induced regional activity. Importantly, task induced Glx changes in the DLPFC were associated with individual WM performance. Higher Glx increases were associated with increased DLPFC activation and lower WM task performance in the individuals. There were no changes in DLPFC GABA levels during WM processing. Our findings suggest that glutamatergic modulation in the DLPFC may play a critical role in WM processing and its performance.

Leucine and Isoleucine are two amino acids that differ only by the positioning of one methyl group. This small difference has however important consequences in α-helices, as the β-branching of Ile results in helix destabilization. We set out to investigate whether there are general trends for the occurrences of Leu and Ile residues in structures and sequences of class A GPCRs (G protein-coupled receptors). GPCRs are integral membrane proteins in which α-helices span the plasma membrane seven times and which play a crucial role in signal transmission into the cell. We found that Leu side chains are generally present in less densely packed regions and are more protein-surface exposed than Ile side chains. We explored whether this difference might be attributed to different functions of the two amino acids and tested if Leu adjusts the hydrophobicity of the transmembrane domain based on the Wimley-White whole-residue hydrophobicity scales. In class A GPCRs, Leu decreases the variation in hydropathy between receptors and Leu content correlates positively with hydropathy calculated without Leu. Both measures indicate that hydropathy is tuned by Leu. To test this idea further, we generated protein sequences with random amino acid compositions using a simple numerical model, in which hydropathy was tuned by adjusting the number of Leu residues. The model was able to replicate the observations made with class A GPCR sequences. We speculate that Leu tunes the hydropathy of the transmembrane domain of class A GPCRs to facilitate correct insertion into membranes and/or for stability within them.

Ecosystems function in a series of feedback loops that can change or maintain vegetation structure. Vegetation structure influences the ecological niche space available for animals to partition, shaping many aspects of behavior and reproduction. In turn, animals perform ecological functions that shape vegetation structure. However, most studies concerning 3D vegetation structure consider only one of these relationships. Here, we review these separate lines of research and integrate them into a single concept that describes a feedback mechanism. We also show how remote sensing and animal tracking technologies are now available at the global scale to describe feedback loops and their consequences for ecosystem functioning. An improved understanding of how animals interact with vegetation structure in feedback loops is needed to conserve ecosystems that face major disruptions in response to climate and land use change.

In low- and middle-income countries, malignancies remain underreported due to lack of quality data. This study outlines the histopathological pattern of pediatric solid malignancies in children aged 0-15yrs at the largest referral hospital in Ethiopia. 432 solid malignancies were evaluated. The most common malignancies were Lymphoma (21.8%), Retinoblastoma (19.4%), and Wilms tumor (13.9%). Burkitt lymphoma accounted for 2.1%, despite being the most reported pediatric malignancy in sub-Saharan Africa in published literature. Definitive diagnosis could not be made in 7% of cases, related to the lack of confirmatory testing. The study highlights the need for improvements in diagnostic capabilities in LMIC.

Development of disposable, rapid and convenient biosensor with high sensitivity and reliability is the most desired method of viral disease prevention. To achieve this goal, in this work, a practical impedimetric biosensor has been implemented into a disposable electrode on a screen-printed carbon electrode (SPCE) for the detection of two mosquito-borne viruses. The biosensor fabrication has step-wisely carried out on the disposable electrode surface at room temperature: starting from conductive film formation, physical binding of the gold nanoparticles (AuNPs)-polyaniline (PAni) into the conductive film, and biofunctionalization. To get the maximum efficiency of the antibody, biotinylated antibody has been conjugated on the surface of AuNP-PAni /PAni-SPCE via the streptavidin-biotin conjugation method which is a critical factor for the high sensitivity. Using the antibody-antigen interaction, this disposable electrode has designed to detect mosquito-borne infectious viruses, Chikungunya virus (CHIKV) and Zika Virus (ZIKV) separately in a wide linear range of 100 fg/mL to 1 ng/mL with a low detection limit of 1.33 fg/mL and 12.31 fg/mL, respectively.

Background: Serotonin syndrome is a potentially life-threatening syndrome with manifestations spanning from mild adverse effects to life-threatening toxicity. The syndrome is caused by overstimulation of serotonin receptors by serotonergic drugs. Since the use of serotonergic drugs is increasing, primarily due to the widespread use of selective serotonin reuptake inhibitors, cases of serotonin syndrome have likely seen a parallel increase. The true incidence of serotonin syndrome remains unknown due to its diffuse clinical presentation. Objectives: This review aims to provide a clinically focused overview of serotonin syndrome, covering its pathophysiology, epidemiology, clinical manifestations, diagnostic criteria, differential diagnosis, and treatment as well as classifying serotonergic drugs and their mechanism of action. The pharmacological context is emphasized, as it is crucial for detection and management of serotonin syndrome. Methods: Focused review based on a literature search using the PubMed database. Findings and conclusion: Serotonin syndrome can occur through therapeutic use or overdose of a single serotonergic drug, or as a drug interaction between two or more serotonergic drugs. Central clinical features consist of neuromuscular excitation, autonomic dysfunction and altered mental status, occurring in a patient undergoing new or altered serotonergic therapy. Early clinically recognition and treatment are crucial to prevent significant morbidity.

Soil salinization is a serious problem leading to ecological degradation. Melia azedarach is highly salt-tolerant, and its application to saline-alkali land is a promising strategy for restoring degraded lands. In this study, we analyzed the soil properties and metabolome of M. azedarach roots grown in low- (< 3 g/kg; L), medium- (5~8 g/kg; M), and high- (> 10 g/kg; H) salinity soils to explore the amelioration effect and adaptation mechanism of M. azedarach to soils with differential salinity. Cultivation of M. azedarach was associated with a decrease in the concentration of Na + and increases in organic matter content and alkaline phosphatase and urease activities in the rhizosphere soil. The metabolome analysis revealed that a total of 382 (ESI+) and 277 (ESI-) differential metabolites (DEMs) were detected. The number of DEMs in roots rose with increased soil salinity, such as sugars and flavonoids in H vs. L, and amino acids in M vs. L. The most up-regulated DEMs were 13-S-hydroxyoctadecadienoic acid, 2’-Deoxyuridine and 20-hydroxyleukotriene B4. Combined analysis of soil properties and M. azedarach DEMs indicated that alkaline phosphatase activity was positively correlated with traumatic acid concentration. Taken together, these results indicate that M. azedarach has the potential to reduce soil salinity and enhance soil enzyme activity, and it can adapt to salt stress by regulating metabolites like sugars, amino acids, and flavonoids . This study provided a basis for understanding the mechanism underlying the adaptation of M. azedarach to saline-alkali soil and its amelioration.

Studying the interactions between humans, landscapes and biodiversity is necessary for the sustainable management of socio-ecosystems and requires long-term reconstructions of past landscapes, improving the integration of slow ecological processes. The main source of information on past vegetation is fossil pollen, but pollen data are biased by inter-taxonomic differential production and dispersal. The Landscape Reconstruction Algorithm (LRA) approach is today the most widely used to correct pollen data for these biases and also allows to identify the spatial extent of the local vegetation reconstruction zone via the Relevant Source Area of Pollen (RSAP). While LRA estimates have already been integrated into certain past land-cover mapping approaches, none have been designed to allow the diachronic reconstruction of the land-cover mosaic of a landscape over the long term combining the following points: the direct integration of LRA estimates as a source of variability in the composition and distribution of pollen taxa, without resorting to multiple scenarios, and the integration of spatiotemporal autocorrelation in the taxa distribution between two periods. In this study, we propose an innovative approach for Backward Landscape reconstruction (BACKLAND), combining these previous points and estimating past landscapes within a set of RSAPs. Based on three stages using parsimonious assumptions and easy-to-implement probabilistic and statistical tools, the implementation of this approach requires LRA estimates of sites with overlapping RSAPs, botanical data, a Digital Elevation Model and two recent land-cover maps. Developed and tested on a small study area within the mountain landscape of the Bassiès valley (French Pyrenees), BACKLAND achieved the reconstruction of a past land-cover map representing eight land-cover types at a spatial resolution of 20m with a good level of accuracy. We showed in this study the originality of this approach and discussed its potential for palaeoenvironmental studies, historical ecology and the management of socio- ecosystems.

Pemphigus Vulgaris Presenting with Epigastric PainAuthors: Marawan Elmassry MD1, Jerapas Thongpiya MD1, Pitchaporn Yingchoncharoen MD1, Jali Garza MS1, Matthew Soape MD2, Kanak Das MD11Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA2Department of Gastroenterology, Covenant Medical Center, Lubbock, TX, USA

Rhinoscleroma is a granulomatous infectious disease that typically affects the nasopharynx and upper respiratory tract. Non-endemic (e.g., North American) and laryngeal cases are rare. This case highlights the importance of pathognomonic Mikulicz cells for diagnosis.

Background: Neonatal foals are born essentially agammaglobulinemic and therefore must ingest colostrum or receive immunoglobulins to maintain health. Failure of passive transfer treatment involves administration of equine colostrum, plasma or commercial powdered colostrum (CPC). Anecdotal reports suggest a risk of anaphylaxis associated with plasma transfusion in neonates that received CPC prior to gut closure. Bovine serum albumin (BSA) in CPC may serve as a target for BSA-specific immunoglobulin E (IgE) in donor equine plasma. Objectives: To determine presence of BSA-specific IgE in samples collected post-routine vaccination in healthy horses, horses experiencing adverse vaccine reactions and commercial equine plasma. Study Design: Prospective Observational Methods: Serum was collected from 65 healthy horses at day 0, 14, 28, 90, 180, 270 and 365 post-vaccination, 26 horses after vaccine reaction at day 1, 180 or 270 post-vaccination, 4 horses not vaccinated and 10 horses from a commercial plasma donor herd. BSA-specific IgE was determined using enzyme-linked immunosorbent assay (ELISA). Results: BSA-specific IgE was not detected in non-vaccinated horses and was identified in all vaccinated horses. Younger horses demonstrated higher fold changes in post-vaccination BSA-specific IgE expression compared to older horses. No significant difference in BSA-specific IgE levels between commercial plasma donors and healthy horses was identified. No significant difference in post-vaccination anti-BSA IgE levels between reactor and healthy horses at day 180 and 270 post-vaccination were identified. Main Limitations: Small number of reactor horses at day 180 and 270 post-vaccination with most samples being collected 24 hours. There were no healthy horse samples for 24 hours post-vaccination; therefore, it was not possible to compare the two groups at this timepoint. Conclusions: Horses may express BSA specific IgE following vaccination. There may be risk of hypersensitivity type reaction when veterinarians administer commercial plasma to neonatal foals that have consumed CPC prior to gut closure.

Chronic hepatitis B virus (HBV) infection causes hepatitis, liver cirrhosis and hepatocellular carcinoma. Covalently closed circular DNA (cccDNA) is the transcription template for HBV RNAs and not affected by current treatment options. Effective therapeutics with ability to remove cccDNA need to be developed. Previously, we established an HBV persistence mouse model via hydrodynamic injection of a clinical isolate (BPS) and identified IL-21 as a potent inducer of viral clearance. Here, we aimed to explore the anti-HBV effects of IL-21 messenger RNA (mRNA) delivered by lipid nanoparticle (LNP-IL-21) system. First, LNP-IL-21 was prepared and analyzed for its safety, expression, biodistribution and stability in vitro and in vivo. Next, LNP-IL-21 was injected into two HBV persistence mouse models based on BPS and recombinant cccDNA (rcccDNA) respectively. LNP-IL-21 administration successfully cleared HBV serum markers, and more importantly, BPS replicons and rcccDNA in livers, which was associated with activation of viral specific immune responses. Notably, transfer of peripheral blood mononuclear cells from BPS persistence mice stimulated ex vivo with LNP-IL-21 and viral antigen could induce HBV clearance in recipient mice. These findings suggested that both LNP-IL-21-based gene and cellular therapies provided novel therapeutic strategies against chronic HBV infection.

Context: Computational materials science (CMS) focuses on in silico experiments to compute the properties of known and novel materials, where many software packages are used in the community. The NOMAD Laboratory1 offers to store the input and output files in its FAIR data repository. Since the file formats of these software packages are non-standardized, parsers are used to provide the results in a normalized format. Objective: The main goal of this article is to report experience and findings of using grammar-based fuzzing on these parsers. Method: We have constructed an input grammar for four common software packages in the CMS domain and performed an experimental evaluation on the capabilities of grammar-based fuzzing to detect failures in the NOMAD parsers. Results: With our approach, we were able to identify three unique critical bugs concerning the service availability, as well as several additional syntactic, semantic, logical, and downstream bugs in the investigated NOMAD parsers. We reported all issues to the developer team prior to publication. Conclusion: Based on the experience gained, we can recommend grammar-based fuzzing also for other research software packages to improve the trust level in the correctness of the produced results.

Monochorionicity in the absence of TTTS is not associated with an increased risk of adverse neurodevelopment at 5 years of age.Richard N Brown, MBBS, FRCOG, FACOGDirector of Obstetrics and Maternal Fetal Medicine, McGill University, McGill University Health Centre, Montreal, CanadaCorrespondence AddressRichard Brown, Division of Maternal Fetal Medicine, McGill University Health Centre, 1001 Decarie Blvd, Montreal, Canada H4A [email protected]: noneDespite stabilising twin pregnancy rates over the last two decades, as much as one birth in 30 is a twin birth. With twin preterm birth rates being as high as 60% (Martin et al, National Vital Statistics Reports;2019:68), prematurity represents the major factor influencing overall perinatal outcomes in twins. Monochorionicity (MC), with its attendant unique complications (including twin-to-twin transfusion syndrome (TTTS) and selective fetal growth restriction (sFGR)), represents another major risk factor for adverse perinatal outcome in twinning. MC complications contribute to the increased perinatal death rate evident in MC twins compared to dichorionic (DC) twins, as well as the greater premature birth rates [often iatrogenic] amongst MC twins. The potential for neurological harm associated with TTTS is now well understood, whilst in comparison that associated with growth discordance / sFGR or monochorionicity itself, remains less well established.Existing data have suggested increased rates of long-term neurodevelopmental deficits in MC twins overall and especially in those with growth discordance. Perinatal care of twins has improved significantly since data from cases followed in the 90’s reported an 8-fold greater risk of cerebral palsy (CP) in MC twins over DC twins, with this being 19-fold higher in MC twins with discordant growth (Adegbite et al AJOG 2004,190:156-63). A 37% rate of neurological damage has been reported even in the normally grown twin of an sFGR pair, when the co-twin has abnormal Dopplers; however, this was based on neuro-imaging findings within the first month and a half of life (Gratacos et al Ultrasound Obstet Gynecol 2004;24: 15-63). More recent data has shown a difference in mild neurological morbidities only, but follow-up, at a median of 24 months, ranged broadly from 12 months to 7 years (Rustico et al Ultrasound Obstet Gynecol 2017,49, 387-93). Despite the limitations of the available outcome data, such information underpins counselling in MC gestations complicated by sFGR. The question “will my twins be OK in the end?” remains one that is not easy to answer with confidence.The EPIPAGE2 cohort has the advantage of representing a more recent large national cohort of preterm births, recruited over a single year and with long term follow-up data. The sub-analysis presented here (Horau et al BJOG 2023, TBC), addresses the association of chorionicity and neurodevelopmental outcomes of prematurely delivered twins (22-34 weeks) at early school age (5 ½ years). The comprehensive testing likely paints a more realistic picture of the neurodevelopmental and neurobehavioural status of MC twins than these prior studies.Within the described population, 24% of twins were MC. The 20% of these complicated by TTTS were excluded from the outcome analysis given the known impact of TTTS. Growth discordance of 20% or more was found in 26.2% of the MC twins compared with 11.8% of the DC twins. In the context of a population with over a quarter of MC twins displaying significant growth discordance, the results are encouraging. Although fewer (68%) of MC twins were alive at discharge compared to DC twins (78%), the severe CP rates at 5 years were equivalent at around 1%. Amongst survivors there were no differences in the neuro-developmental or neuro-behavioural assessments between the MC and DC twins; with adverse outcomes seemingly therefore being linked principally to prematurity rather than chorionicity or growth discordance itself.

Introduction:Brucellosis is a zoonotic infectious disease with a wide range of manifestations including malaise, anorexia, fever, and profound muscular weakness, as described by Marston in 18601. It is caused by the Gram-negative coccobacillus, Brucella, and remains endemic in some developing countries, such as Iran. There are 6 types of brucella that 4 of which include Brucella melitensis, Brucella abortus, Brucella canis, and Brucella suis were recognized as pathogens involving humans. Brucella melitensis was described as the most common and virulent pathogen worldwide. The first case of ocular brucellosis in a human being was described by Lemaire in 1924 2, presented with bilateral optic neuritis and external ophthalmoplegia in a patient with brucella meningitis.Ocular manifestations of acute and chronic infection include anterior and posterior uveitis, panuveitis, keratitis, conjunctivitis, papillitis, cataract, maculopathies, glaucoma, and ocular muscle paresis. Modern treatments of ocular brucellosis, intraocular as well as systemic antibiotics, have improved the prognosis of the disease3. Herein, we present a patient with endogenous endophthalmitis caused by Brucella Melitensis (B.Melitensis), which is very rare and unusual.

As a result of a warming global climate, understanding how organisms adjust their behaviour to environmental thermal conditions has become an increasingly important question in animal biology. Temperature-driven adjustments in parental care are potentially important due to their repercussions on offspring size, quality and survival. In 2015 and 2016 we monitored 70 zebra finch (Taeniopygia castanotis) breeding attempts in the wild. We recorded the frequency of parental visits to the nest together with mean maximum ambient temperature experienced between day 7 and 14 of the nestling period. We found that for each increase of 1 °C in the daytime temperature there was a 1% reduction in the hourly rate of parental visits. Our data suggest that nestlings may receive less food under thermally challenging conditions, which is consistent with recent studies that demonstrate offspring are smaller when reared during periods of high temperature. Understanding the behavioural drivers that may contribute to the production of smaller offspring in the heat could prove useful to forecast long-term consequences for fitness triggered by climate change.