We present a case report of an immunocompetent African young man who presented with persistent chest pain and fever, and was diagnosed with EPTB following chest CT scan, pleural biopsy histopathology examination and Ziehl-Neelsen (ZN) staining, and pleural fluid gene Expert studies.

Necrotizing pneumonia (NP) is a severe form of lung disease with a high mortality rate. Although NP generally occurs as a complication in community-acquired pneumonia, our case illustrates that NP can occur as a secondary infection even if the clinical course of COVID-19 pneumonia is favorable, particularly in intubated patients.

The use of pulsed dc-sputtering sources for reactive magnetron sputtering with oxygen offers a possibility to suppress the negative effects of target poisoning (such as arcing). This results in a wide process range for the selection of a desired operating point. The control of target poisoning plays a major role in maintaining constant coating properties and affects the stoichiometry of the reactive coating, as well as the coating rate and the economic impact of the coating process. In a hysteresis, the target poisoning during the reactive sputtering of titanium under oxygen addition proceeds nonlinearly. Without the use of a suitable target poisoning control technique, the sputtering process can abruptly change to an unstable state. As a result, variations of stoichiometry can occur during the deposition process. A proven method for maintaining a stable reactive sputtering process is the control of oxygen flow with the input variable target voltage. By determining the typical oxygen hysteresis at constant target power and constant argon flow, an operating point for the control loop is derived. The desired target voltage then serves as the input variable for the control loop of the target poisoning. The controlling technique for target poisoning is a basic requirement for the production of the photolytic active anatase phase of titanium dioxide (TiO2) using reactive magnetron sputtering. The photocatalytic equipment of surfaces with a titanium dioxide coating in the anatase phase can be realized with the reactive pulsed dc magnetron sputter ion plating process (DC-MSIP). The pulsed DC-MSIP process facilitates coating a variety of surfaces at temperatures below 200 °C in an environmentally friendly manner.

In this paper, we show that any displacement of a plate is the sum of a Kirchhoff-Love displacement and two terms, one for shearing and one for warping. Then, the plate is loaded in order to obtain that the bending and shearing contribute the same order of magnitude to the fiber rotations.

Our sensory system is able to build a unified perception of the world, which although rich, is limited and inaccurate. Sometimes, features from different objects are erroneously combined. At the neural level, the role of the parietal cortex in feature integration is well-known (Humphreys, 2016; Shafritz et al., 2002). However, the brain dynamics underlying correct and incorrect feature integration are less clear. To explore the temporal dynamics of feature integration, we studied the modulation of different frequency bands in trials in which feature integration was correct or incorrect. Participants responded to the color of a shape target, surrounded by distractors. A calibration procedure ensured that accuracy was around 70% in each participant. To explore the role of expectancy in feature integration, we introduced an unexpected feature to the target in the last blocks of trials. Results demonstrated the contribution of several frequency bands to feature integration both pre- and post-stimulus. During the pre-stimulus period, alpha power was higher for illusions compared to hits. After stimulus onset, alpha, beta, and gamma-band power was reduced for hits compared to illusions. Moreover, gamma power was overall larger during the experiment for participants who were aware of the unexpected target presented during the last blocks of trials (as compared to unaware participants). These results demonstrate that feature integration is a complex process that can go wrong at different stages of information processing and is influenced by top-down expectancies.

Hypnotizability is a psychophysiological trait measured by scales and associated with several differences including interoceptive accuracy and the morpho-functional characteristics of interoception-related brain regions. The aim of the study was to assess whether the amplitude of the heartbeat evoked cortical potential (HEP), a correlate of interoceptive accuracy, differs in participants with low (lows) and high (highs) hypnotizability scores (assessed by the Stanford Hypnotic Susceptibility Scale, form A) before and after the induction of hypnosis. ECG and EEG were monitored in 16 highs and 15 lows during an experimental session including open eyes baseline (B), closed eyes relaxation (R), hypnotic induction (IND), neutral hypnosis (NH), post session baseline (Post). No significant difference was observed between groups and conditions in autonomic variables. The HEP amplitude was lower in highs than in lows at the right parietal site, likely due to hypnotizability-related differences in the functional connection between the right insula and parietal cortex. It increased in highs and decreased in lows across the session, possibly due to the highs’ preeminently internally directed attention and to the lows’ possible disengagement from the task. Since interoception is involved in several cognitive-emotional functions, its hypnotizability-related differences may contribute to the variability of experience and behavior in daily life.

Room-temperature phosphorescence (RTP) of purely organic materials is easily quenched with unexpected purposes because the excited triplet state is extremely susceptible to external stimuli. How to stabilize the RTP property of purely organic luminogens is still challenging and considered as the bottleneck in the further advancement of the bottom-up approach. Here, we describe a gated strategy that can effectively harness RTP by employing complexation/dissociation with proton. Due to the order-disorder transition orientation of intermolecular packing, the RTP of triazine derivative Br-TRZ will easily vanish upon mechanical force. Impressively, by enhancing its intramolecular charge transfer effect, the protonated Br-TRZ stubbornly possesses an obvious RTP under external grinding, whatever in the ordered or disordered intermolecular arrangement state. Consequently, the “Lock” gate of RTP was achieved in the protonated Br-TRZ molecule. Combined with theoretical calculation analysis, the enhanced charge transfer effect can narrow the singlet−triplet energy gap significantly, and stabilize the RTP property of triazine derivative sequentially. Furthermore, the locked RTP can be tuned via proton and counterions repeatedly and show excellent reversibility. This gated RTP concept provide an effective strategy for stabilizing the RTP emission of purely organic systems.

Analysis of human emotions from multimodal data for making critical decisions is an emerging area of research. The evolution of deep learning algorithms has improved the potential for extracting value from multimodal data. However, these algorithms do not often explain how certain outputs from the data are produced. This study focuses on the risks of using black-box deep learning models for critical tasks, such as emotion recognition, and describes how human understandable interpretations of these models are extremely important. This study utilizes one of the largest multimodal datasets available - CMU-MOSEI. Many researchers have used the pre-extracted features provided by the CMU Multimodal SDK with black-box deep learning models making it difficult to interpret the contribution of individual features. This study describes the implications of individual features from various modalities (audio, video, text) in Context-Aware Multimodal Emotion Recognition. It describes the process of curating reduced feature models by using the GradientSHAP XAI method. These reduced models with highly contributing features achieve comparable and even better results compared to their corresponding all feature models as well as the baseline model GraphMFN proving that carefully selecting significant features can help improve the model robustness and performance and in turn make it trustworthy.

Adipose-derived stem cells (ADSCs) have important applications in basic research, especially in fat transplantation. Some studies have found that three-dimensional (3D) spheroids formed by mesenchymal stem cells have enhanced therapeutic potential. However, the fundamental basics of this effect are still being discussed. In this study, ADSCs were harvested from subcutaneous adipose tissues and 3D spheroids were formed by the automatic aggregation of ADSCs in a non-adhesive 6-well plate. Oxygen glucose deprivation (OGD) was used to simulate the transplantation microenvironment. We found that 3D culture of ADSCs triggered cell autophagy. After inhibiting autophagy by Chloroquine, the rates of apoptosis were increased. When the 3D ADSC-spheroids were re-planked, the number of senescent ADSCs decreased, and the proliferation ability was promoted. In addition, there were more cytokines secreted by 3D ADSC-spheroids including VEGF, IGF-1 and TGF-β. After adding the conditioned medium with human umbilical vein endothelial cells (HUVECs), 3D ADSC-spheroids were more likely to promote migration, and tube formation, stimulating the formation of new blood vessels. Fat grafting experiments in nude mice also showed that 3D ADSC-spheroids enhanced survival and neovascularization of fat grafts. These results suggested that 3D spheroids culturing of ADSCs can increase the therapeutic potential in fat transplantation.

RATIONALE: Selective derivatization of peptide N-terminus with 4-formyl-benzenesulfonic acid (FBSA) enables chemically activated fragmentation in ESI+/- (positive and negative ion mode) under charge reduction conditions. Overlapped positive and negative tandem mass spectra pinpoint b-ions making the assignment of b-ion series fragments easy and accurate. METHODS: We developed a FBSA-peptide microwave assisted derivatization procedure. Derivatized and non-derivatized bovine serum albumin tryptic peptides and insulin non-tryptic peptide were compared after MS/MS analysis in positive and negative ion mode. High-quality dataset of sulfonated b-ions obtained in negative tandem mass spectra of singly charged FBSA-peptides were matched to detected b-ions in positive MS/MS spectra. Moreover, negative spectra signals were converted and matched against y-ions in positive tandem mass spectra to identify complete peptide sequences. RESULTS: The FBSA derivatization procedure produced a significantly improved MS/MS dataset (populated by high-intensity signals of b- and y-ions) in comparison to commonly used N-terminal sulfonation reagents. Undesired side reactions do not occur and the procedure reduces the derivatization time. It was found that b-ions comprise 15% and 13% of all fragment ions generated in positive and negative ion mode, respectively. High visibility of b-ion series in negative ion mode can be attributed to the N-terminal sulfonation which had no effect on the production of b-ion series in positive ion mode. CONCLUSIONS: The FBSA derivatization and de novo sequencing approach outlined here provides a reliable method for accurate peptide sequence assignment. Increased production of the b-ions in positive and negative ion mode greatly improves peak assignment and thus enables accurate sequence reconstruction. Implementation of the named methodology would improve the quality of de novo sequencing data and reduce the number of misinterpreted spectra.

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Background and Purpose Vancomycin is one of the most common antibiotics administered in the hospital setting, yet acute kidney injury is a major limiting factor. Common combinations of antibiotics with vancomycin have been reported to worsen and improve vancomycin-induced kidney injury. We aimed to study the impact of flucloxacillin and imipenem-cilastatin on kidney injury when combined with vancomycin in our translational rat model. Experimental Approach Male Sprague-Dawley rats received allometrically scaled (1) vancomycin (2) flucloxacillin, (3) vancomycin+flucloxacillin, (4) vancomycin+imipenem-cilastatin, or (5) saline for 4 days. Vancomycin was administered intravenously and flucloxacillin or imipenem-cilastatin were administered intraperitoneally. Kidney injury was evaluated via drug accumulation and urinary biomarkers including urinary output, kidney injury molecule-1 (KIM-1), clusterin, and osteopontin. Relationships between vancomycin accumulation in the kidney and urinary kidney injury biomarkers were explored. Key Results Urinary output increased every study day for vancomycin+flucloxacillin; whereas in the vancomycin group it was elevated after the first dose only. In the vancomycin+flucloxacillin group, urinary KIM-1/24h increased on all days compared to vancomycin. In the vancomycin+imipenem-cilastatin group, urinary KIM-1/24h was decreased on days 1 and 2 compared to vancomycin. Similar trends were observed for clusterin. More vancomycin accumulated in the kidney with vancomycin+flucloxacillin compared to vancomycin and vancomycin+imipenem-cilastatin. The accumulation of vancomycin in the kidney tissue correlated with increasing urinary KIM-1 (4-parameter Hill Slope, R2=0.7985). Conclusion and Implications Vancomycin+flucloxacillin caused more kidney injury compared to vancomycin alone and vancomycin+imipenem-cilastatin in a translational rat model as determined by multiple kidney injury biomarkers. The combination of vancomycin+imipenem-cilastatin was nephroprotective.

Title : Comment on: [Lost at Sea in Search of a Diagnosis: A Case of Unexplained Bleeding]Subtitle : Scurvy from chemotherapy-induced adverse effects in an adolescent oncology patientAuthors : Michelle Toker, BS and Benedict Wu, DO, PhDAffiliation : Division of Dermatology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USACorresponding author :Michelle TokerAlbert Einstein College of Medicine, Montefiore Medical CenterEmail: [email protected]: 516-946-4726Funding and support : NoneConflicts of Interest : NoneManuscript word count : 452Reference count : 6Figure count : 1Table count : 0Key words : chemotherapy, oncology, pediatrics, nutritional deficiency, vitamin C deficiency, scurvyDear Editor,The brief report published by Amos et al in 2016 shed light on the occurrence of scurvy in pediatric and adolescent patients with dietary restrictions.1 Indeed, patients with neurodevelopmental conditions are most commonly associated with the risk of developing scurvy; other at-risk patients include those with gastrointestinal disorders, alcoholism, and psychiatric conditions.2, 3 We aim to expand upon the situations when scurvy should be considered by presenting a case of an adolescent male diagnosed with scurvy secondary to the adverse effects of his chemotherapy.A 19-year-old male with a 10-month history of high-risk pre-B-cell acute lymphoblastic leukemia was consulted by the dermatology service for a new diffuse rash present for four days. He was recently enrolled in a phase 3 randomized trial of inotuzumab ozogamicin and was receiving methotrexate and vincristine. The chemotherapy regimen induced severe dizziness, nausea, and vomiting refractory to anti-emetic medications. His aversion to chemotherapy was so strong that it caused him to feel nauseated between treatment sessions. He also endorsed painful oral and pharyngeal sores that made it difficult to tolerate a regular diet. In addition to oropharyngeal pain, he experienced marked arthralgia and fatigue, which he also attributed to the chemotherapy. Additionally, the patient reported that vincristine reduced his taste sensation, which led to a poor appetite. These adverse symptoms culminated in a loss of 6.7 kg (9.1%) in less than one month.Physical examination revealed peri-follicular purpura on the back (Fig 1A), face, and bilateral upper and lower extremities. Upon closer inspection, we noted prominent corkscrew (spiral and curly appearance) hairs (Fig 1B). The lower mucosal lip had superficial erosions with scalloped-borders and fine petechiae (Fig 1C). Laboratory evaluation revealed pancytopenia with a platelet count of 42 k/UL and low serum levels of vitamin C (<0.1 mg/dL), potassium (3.4 mEq/L), magnesium (1.1 mg/dL), and albumin (2.8 g/dL). Serum vitamin A (35 mcg/dL) levels were within normal limits. The patient was diagnosed with scurvy due to poor food intake from his chemotherapy-induced nausea, emesis, and mucositis. It was thought that acidic foods, such as citrus, exacerbated the mucosal erosions, which caused him to avoid vitamin C-rich foods.Scurvy, caused by a prolonged L-ascorbic acid (vitamin C) deficiency, may manifest as pathognomonic corkscrew hairs with petechiae, gingival pain and bleeding, vascular fragility, arthralgias, fatigue, and numerous gastrointestinal symptoms.4,5, 6 Although vitamin C deficiency was an indirect result of his chemotherapy, scurvy, by itself, may have aggravated his symptoms, thereby creating a vicious cycle of poor oral intake. Our case highlights the complex relationship between chemotherapy-induced mucocutaneous adverse effects, a limited diet, and vitamin C deficiency. We recommend clinicians to consider scurvy in oncology patients, with or without thrombocytopenia, presenting with peri-follicular purpura and corkscrew hairs.Ethics Statement: Informed patient consent was obtained for publication of the case details and photographs.

Monkeypox infections in the US and across the world have been rising in the past few months. Most of these infections have been found to be transmitted among men who have sex with men (MSM). Our case report discusses the rare presentation of a patient with monkeypox along with multiple comorbidities, including AIDS, late latent syphilis, acute hepatitis C, and asymptomatic and scrotal and penile cellulitis secondary to MRSA. Further, our case report raises discussion on the need for further research to identify the effect of monkeypox vaccine on symptomatic patients who are immunocompromised.

Deprescribing is an essential component of safe prescribing, especially for people with higher levels of polypharmacy. Identifying individuals prepared to consider medicine changes may facilitate deprescribing-orientated reviews. We aimed to explore the relationship between revised patient attitudes towards deprescribing (rPATD) scores and medication changes in older people prescribed ≥15 medicines. A secondary analysis of rPATD scores and prescription data from a cluster randomised controlled trial of a GP-delivered, deprescribing-orientated medication review was conducted. The association between number of medicines stopped, started and changed and baseline rPATD scores was assessed using Poisson regression adjusting for patient age, gender, study group allocation, baseline number of medicines and effects of clustering. Participants (n=404) had a mean age of 76.4 years and were prescribed a mean of 17.1 medicines at baseline. Willingness to stop a medicine was associated with higher rates of both deprescribing (IRR: 1.40; 95%CI: 1.06-1.84) and initiating medicines (IRR: 1.43; 95%CI: 1.09-1.88). Satisfaction with current medicines was associated with a lower rate of deprescribing (IRR: 0.69; 95%CI: 0.57-0.85). The rPATD questionnaire could be used as part of a deprescribing intervention to identify participants who may be prepared to engage in deprescribing, enabling more efficient use of clinician time during complex consultations.

Background Healthcare workers (HCWs) have suffered considerable morbidity and mortality during the COVID-19 pandemic. Few studies have evaluated Coronavac vaccine effectiveness (VE), particularly in eastern Europe, where the vaccine has been widely used. Methods We conducted a prospective cohort study among HCWs in seven hospitals in Baku, Azerbaijan between May 17 to December 1, 2021, to evaluate primary series (two-dose) CoronaVac VE against symptomatic SARS-CoV-2 infection. Participants completed weekly symptom questionnaires, provided nasal swabs for SARS-CoV-2 RT-PCR testing when symptomatic, and provided serology samples at enrolment that were tested for anti-spike and anti-nucleocapsid antibodies. We estimated VE as (1 – hazard ratio)*100 using a Cox proportional hazards model with vaccination status as a time-varying covariate. Results We enrolled 1582 HCWs. At enrolment, 1040 (66%) had received two doses of CoronaVac; 421 (27%) were unvaccinated. During the study period, 72 PCR-positive SARS-CoV-2 infections occurred; 36/39 (92%) sequenced samples were classified as delta variant. The adjusted primary series VE against COVID-19 illness was 29% (95% CI:-51%;67%). For the delta-predominant period, adjusted primary series VE was 19% (95% CI:-81%;64%). For the entire analysis period, adjusted primary series VE was 39% (95% CI:-40%;73%) for HCW vaccinated within 14–149 days, and 19% (95%CI:-81;63) for those vaccinated ≥150 days. Conclusions During a delta-predominant period in Azerbaijan, point estimates suggest that primary series CoronaVac protected nearly 1 in 3 HCWs against COVID-19, but this finding was not statistically significant. Our findings underscore the need to consider booster doses in individuals who have received primary series CoronaVac.

Possible structural variation of a bio-based dimethacrylate derived from oleic acid and ethylene glycol is discussed as well as sources to obtain the starting material for manufacturing of this monomer. Furthermore, aspects influencing the transfer of a newly developed product or further scientific result to application are included into the discussion as well focusing to manufacturing processes and development of a new product for the market.

DNA glycosylases protect genetic fidelity during DNA replication by removing potentially mutagenic chemically damaged DNA bases. Bacterial Lhr proteins are well-characterized DNA repair helicases that are fused to additional 600-700 amino acids of unknown function, but with structural homology to SecB chaperones and AlkZ DNA glycosylases. Here we identify that E. coli Lhr is a uracil-DNA glycosylase that depends on an active site aspartic acid residue. We show that the Lhr DNA helicase activity is functionally independent of the uracil-DNA glycosylase activity, but that the helicase domains are required for fully active uracil DNA glycosylase activity. Consistent with uracil DNA glycosylase activity, deletion of lhr from the E. coli chromosome sensitized cells to oxidative stress that triggers cytosine deamination to uracil. The ability of Lhr to translocate single-stranded DNA and remove uracil bases suggests a surveillance role to seek and remove potentially mutagenic base changes during replication stress.