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An Aesthetic, Functional, and Low-Invasive Lower Red Lip Reconstruction Using a Mucos...
Sho Yamakawa
Shota Suda

Sho Yamakawa

and 2 more

March 18, 2023
An Aesthetic, Functional, and Low-Invasive Lower Red Lip Reconstruction Using a Mucosal Perforator Flap: A Case Report
Emerging advances of composite membranes for seawater pre-treatment: A review
Nadia Zari
Dipika Jaspal

Nadia Zari

and 6 more

March 18, 2023
Currently, as the population continues to grow, the preservation of the world’s water resources is becoming a serious challenge. The seawater desalination process is considered a sustainable option for the future. The two most common technologies used in desalination are reverse osmosis (RO) and membrane distillation (MD). However, membrane fouling caused by the accumulation of contaminants membrane surface is an emerging and growing problem. then a pre-treatment stage is required to reach an optimal efficiency during desalination process, since this stage is crucial for a successful desalination process. In this regard, developing new material-based composite membranes has the potential to upgrade the anti-fouling features of RO membranes and thereby enhance the desalination efficiency due to the characteristics of these composite membranes especially, their high permeability, hydrophilicity, selectivity mechanical strength, thermal stability, and anti-bacterial property. The objective of this review is to present the main techniques for seawater pre-treatment. the results of several membrane types and methods of modification were also discussed. Finally, the performance of composite membranes for seawater pre-treatment is defined and future perspectives are highlighted.
A preliminary study of dynamic neurochemical changes in the dorsolateral prefrontal c...
Hyerin Oh
Adam Berrington

Hyerin Oh

and 5 more

March 18, 2023
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.
Forest cover and environmental type shape functional diversity of insectivorous birds...
Enzo  Coletti Manzoli
Lucas Pacciullio Da Silva Gaspar

Enzo Coletti Manzoli

and 5 more

March 18, 2023
Arthropod-eating birds are a heterogeneous group, with different levels of environmental sensitivity and diverse responses to habitat degradation. In this paper, we tested the effects of landscape on the functional diversity of insectivorous birds within the Brazilian Atlantic Forest. We predict that (I) species composition and functional diversity are shaped by turnover and nestedness across different habitats, and (II) the gradient of forest cover has a positive effect on bird species composition and functional diversity. We used data from 22 landscapes of the Atlantic Forest in the Cantareira-Mantiqueira region (Brazil), within buffers of 1 km radius, surrogating three types of environments (i.e., forests, pastures, and swamps). The components of β-functional diversity were calculated using the beta pair and beta multi-function for each type of environment, and the effects of the forest cover gradient and environment type were tested using linear models and GLMM, respectively. Our results showed that the forest cover gradient and the type of environment had a negative effect on the indices of functional diversity, contrary to our expectations. Pasturelands and marshes were susceptible to turnover and nestedness, respectively. The beta diversity of forests was influenced by both species nestedness and turnover. The regional native forest fragments are generally small-sized, and in early successional stages, which could explain the patterns we found. The presence of secondary forests may have affected the expected pattern of functional diversity, therefore, caution is needed when interpreting this, since the way in which compensatory dynamics may not involve real functional compensation.
A Harmonic Model of MMC Based on Nearest-Level Modulation With the Equidistant Contro...
Xiaowen Chen
Zaibin Jiao

Xiaowen Chen

and 1 more

March 20, 2023
With the rapid development of flexible DC transmission systems, the application of modular multilevel converter MMC is becoming increasingly widespread. Meanwhile, the nearest-level modulation is most applied. This paper establishes a simple and efficient harmonic model of MMC based on nearest-level modulation with the equidistant controlled firing scheme. First, based on the analysis of the working principle of MMC and the modulation principle, the Fourier decomposition of the stair wave is obtained. Then, according to the equivalent circuit diagram of MMC, the stair wave is exactly the differential-mode voltage. Moreover, the amplitude and phase of each differential-mode voltage harmonic content are obtained. So far, MMC can be regarded as a harmonic voltage source. Finally, simulations were performed on PSCAD to verify the accuracy of the MMC harmonic model proposed in this paper. Furthermore, the MMC harmonic model under the equidistant controlled firing scheme and real-time trigger control were also compared. The final results show that the model proposed in the paper can accurately reflect the harmonic characteristics of MMC in the existing power system after considering the equally-spaced trigger control.
Forgive or complain: Interpersonal distance modulates reactive attitudes and neural r...
Sijin Li
Si Cheng

Sijin Li

and 4 more

March 17, 2023
While the effect of interpersonal distance on forgiveness has been investigated over the past few years, it remains unclear whether this facilitating effect holds even when measured implicitly. Meanwhile, though cognitive control and the corresponding prefrontal cortex play a prominent role in forgiveness processing, the neural mechanism underlying forgiveness toward varied wrongdoers is largerly unexplored. Here, forty-two participants initially underwent noise offense either from their friend or stranger, followed by a word identification test to examine their reactive attitude, during which they were presented with word-name combinations and required to categorize forgive- or complain-label words while ignoring the names of their friends or strangers below. A shorter reaction time reflects more congruence with one’s implicit attitude. Electroencephalogram was recorded during the word identification test. Behaviorally, while individuals reacted faster to forgive-friend relative to complain-friend pairings, no such reaction bias was found for the stranger-wrongdoer, which suggests that individuals were more inclined to forgive someone close. Regarding the EEG/ERP results, forgive-friend elicited lower alpha oscillation and more negative frontal alpha asymmetry (FAA) value than complain-friend combinations, suggesting increased and dominant activity in the right prefrontal network during forgiveness toward friends. Whereas complain- relative to forgive-stranger combinations elicited larger P3 amplitudes, suggesting a neural encoding bias to information associated with complaints about stranger-wrongdoer. These findings provide objective evidence for the benefits of closeness on forgiveness, which broaden previous findings depending on explicit measures into situations where forgiveness was measured implicitly and thus minimized confounding factors such as social desirability.
Neural and cognitive underpinnings of ball/strike judgments of baseball umpires: An f...
Yin-Hua Chen
Shih-Kuei  Huang

Yin-Hua Chen

and 1 more

March 17, 2023
We used functional magnetic resonance imaging to study the pitch-calling behavior of baseball umpires with varying experience, with a particular interest in understanding the pitcher handedness effect. Expert and intermediate umpires were recruited and asked to make ball/strike calls on videotaped pitches of left- and right-handed pitchers and rate their certainty for the call while undergoing scanning. Behavioral results replicated previous findings that expert umpires were more certain but not more accurate or quicker than intermediate umpires, suggesting that umpires learn to project confidence to maintain control of the game as sports officials. Both expert and intermediate umpires were less accurate when judging the left-handed pitcher than the right-handed pitcher (particularly with longer reaction times and less uncertainty for ball pitches), possibly due to their lower familiarity with rarely encountered left-handed pitchers. The umpires greatly engaged the action observation network, cerebellum, and caudate when making correct calls, and these activations were comparatively weaker when calling left-handed pitches, implying their less effective perceptual processing of the visual information details of the left-handed pitcher. The lower activity in the right premotor cortex for ball pitches from the left-handed pitcher further implies the umpires’ poorer predictive processing of the pitching action and baseball trajectory of the left-handed pitcher than the right-handed one, particularly for ball pitches. Our findings shed light on the influence of pitcher handedness on the pitch-calling behavior of baseball umpires and extend the current understanding of the perceptual and decision-making behavior of baseball umpires (sports officials).
Leucine tunes hydropathy of class A GPCRs
Christian Baumann
Oliver Zerbe

Christian Baumann

and 1 more

March 17, 2023
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.
ChatGPT: The Evolution of Natural Language Processing
Ho Ngoc Hai

Ho Ngoc Hai

March 20, 2023
This document focuses on ChatGPT, a natural language processing (NLP) model built by the transformer neural network. The document provides a comprehensive overview of the architecture, training, and fine-tuning of ChatGPT, as well as its applications in various fields, including customer service and support, healthcare, education, research, and development. The document analyzes the evaluation results of ChatGPT on different datasets, compares it with other NLP models, and proposes solutions to address security-related challenges. Finally, the document discusses the potential and challenges of ChatGPT in the future and its importance for humans and society, as well as the regulations and policies that need to be developed to ensure the proper and legal use of ChatGPT.
Description of a new cellulosic natural fiber extracted from Helianthus tuberosus L....
Ramazan Dalmis

Ramazan Dalmis

March 17, 2023
Natural fiber-reinforced composites are generally known as eco-friendly, long-lasting, and recyclable materials. Considering, this study characterizes cellulosic Helianthus tuberosus L. fiber for polymer-based green composites for the first time. It has been found that Helianthus tuberosus L. fiber has many advantages as a reinforcement material in polymer-based composites. For example, the high roughness provided by the fiber surface in cellular morphology increases the locking into the composite body. One of the most critical advantages is its high thermal stability temperature of 247.3 oC. Also, other advantages of the Helianthus tuberosus L. fiber can be listed as high cellulose content, high crystallinity, and high tensile strength. The hollow fiber structure can allow it to be used in materials used for insulation. Eventually, the high cellulose content of 62.65% supports its usage in various industries, including paper and paperboard manufacturing.
Feedback loops between 3D vegetation structure and ecological functions of animals
Nicholas Russo
Andrew Davies

Nicholas Russo

and 4 more

November 15, 2022
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.
A Retrospective Review on the Histopathological Pattern of Childhood Malignant Solid...
Benjamin Watkins
Rahell Hailu Ayele

Benjamin Watkins

and 7 more

November 02, 2022
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 electrode for the detection of mosquito-borne viruses
Fahmida Nasrin
Indra Mwmdi Khoris

Fahmida Nasrin

and 4 more

March 17, 2023
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.
Serotonin Syndrome - A Focused Review
Nicolaj Mikkelsen
Per Damkier

Nicolaj Mikkelsen

and 2 more

March 17, 2023
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.
Amelioration of saline-alkali land by cultivating Melia azedarach and characterizatio...
Xiaohua Long
Na Li

Xiaohua Long

and 9 more

March 17, 2023
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.
Biochar improves the yield and quality of Erigeron breviscapus in heavily cadmium-pol...
Guangqiang Long
Jingling Zhang

Guangqiang Long

and 7 more

March 17, 2023
Simultaneous utilization and remediation of soils contaminated with cadmium (Cd) is a propitious and economically beneficial task. Here, we undertook a pot experiment with biochar application at four rates (0, 5, 10, and 15%, denoted as BC0, BC5, BC10, and BC15, respectively) with the addition of 0.1% Cd, along with a control without Cd and biochar addition (CK). Erigeron breviscapus, a raw medicinal material used to extract scutellarin, was grown in all treatments to investigate a new method of utilizing and remediating heavily Cd-contaminated soil. The results showed that the high Cd-contaminated soil decreased the yield and scutellarin content of E. breviscapus by 33.6% and 70.8%, respectively. Compared to BC0, the yield and scutellarin content in BC15 increased by 24.7% and 312.0%, respectively. Biochar application (BC5, BC10, BC15) changed the soil Cd speciation and reduced the soil available Cd content by 17.4–121.8% and plant Cd content by 26.4–42.6% compared with BC0. However, chlorophyll content, catalase (CAT) activity, and acquisition of N, Fe 2+ and Cu 2+ of E. breviscapus increased in BC5, BC10, and BC15 compared to BC0. Additionally, the mitigation effect of Cd toxicity enhanced with increasing biochar application, and 15% biochar application resulted in the highest yield and scutellarin content of E. breviscapus. This study highlights the importance of biochar for improving the Cd adaptability of E. breviscapus and provides a reference for the simultaneous utilization and remediation of heavily Cd-contaminated soil.
BACKLAND: spatially explicit and high resolution pollen-based BACKward LANDscape reco...
Clara Plancher
Florence  Mazier

Clara Plancher

and 3 more

March 17, 2023
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.
“Huge Retropharyngeal Lipoma causing Dysphagia and Dyspnea in a child - A Case Report...
Rajlakshmi Yadav
Neha Singh

Rajlakshmi Yadav

and 3 more

March 17, 2023
Abstract- Lipoma is most common mesenchymal benign tumor in the body. Lipoma at retropharyngeal location is rare and clinical presentation in a pediatric age group is even rarer. We are presenting a case of huge retropharyngeal lipoma with mediastinal extension in an 11 year old boy who presented with progressive dysphagia and dyspnea. Diagnosis of lipoma was made on computed tomography, and it was surgically managed with complete resolution of symptoms on post operative follow up.Key words- Retropharyngeal lipoma, computed tomography, dysphagia, dyspnea, case report.Introduction- Lipoma is the most common mesenchymal benign tumor in the body and only 15% of them are located in head and neck region(1). Head and neck lipomas are usually located in posterior triangle region and incidence in retropharyngeal region is rare(2). Other masses in this region, especially in paediatric age group are mostly infectious in nature- pyogenic or tuberculous(3). Retropharyngeal lipomas are slow growing benign tumour, which becomes symptomatic after achieving a large size(4). Clinical presentation is usually abnormal sensation in the throat, noisy breathing, hoarseness, dyspnea, dysphagia, obstructive sleep apnoea, excessive day time sleepiness (5). In this report we present a rare case of huge retropharyngeal lipoma with mediastinal extension in an 11 year old boy who presented with progressive dysphagia and dyspnea for last 5 years. Diagnosis was made on computed tomography and disease was managed with complete surgical excision.Case Presentation- An 11 year old boy with history of progressive dysphagia and dyspnea for 5 years with significant weight loss. Dysphagia was more for solids. Patient used to push the food bolus in mouth with his fingers to ease the deglutition. On general examination, patient was cachexic. Respiratory rate was increased with nasal flaring and retraction of chest wall muscles with breathing. On inspection a bulge was noted in posterior pharyngeal wall with normal overlying mucosa which was seen in approximation with uvula. On chest x ray AP view a homogenous right upper mediastinal radiopacity was present with well defined lateral margin. Both lung fields were unremarkable. On lateral view of chest X ray a cervical soft tissue density with well-defined anterior border was noted anterior to vertebrae(Figure 1). Cross sectional imaging was performed for characterization of cervicothoracic mass. Contrast enhanced CT cervical and thoracic region showed a homogenous fat attenuating retropharyngeal mass measuring 15 x 5 x 3 cm with mediastinal extension with caudo- cranial extent from C1 to D5 vertebral level(Figure 2A). The mass was seen effacing oro-hypopharynx, compressing inlet of larynx and trachea. On axial section of neck, mass was extending to lateral aspect of pharynx and larynx on both sides and displacing bilateral carotid vessels laterally (Figure 2B). The mass was displacing trachea and oesophagus anteriorly and upper mediastinal vessels laterally (Figure 2C). Diagnosis of lipoma was made. There was no evidence of enhancing soft tissue component within mass or invasion of adjacent organs, suggestive of its benign nature.Under general anaesthesia complete surgical excision of mass was done through lateral cervical approach. A vertical incision done on left side of neck, skin was retracted and lipoma was exposed. The mass was separated from surrounding tissue like carotid vessels, internal jugular veins, thyroid, trachea and oesophagus. Mass was resected intact and wound was closed with sutures. Macroscopically it was yellowish with shiny surface and encapsulated appearance (Figure 3). Microscopically tumour composed of mature adipocytes, typical of lipoma with no evidence of malignant changes. Patient’s dyspnea was alleviated on same day. Post operative course was unremarkable and patient was discharged on fourth post operative day. On 2 months follow up, patients’ symptoms were completely alleviated. CT scan was performed to confirm complete removal of mass, which revealed no residual lesion at follow up scan. On 6 months follow up, patient had no complain of dysphagia/dyspnea to suggest recurrence and patient started to regain weight.Discussion- The retropharyngeal space is an anatomical region that spans from the base of the skull to the mediastinum. Its location is anterior to the prevertebral muscles and posterior to the pharynx and oesophagus. It is bounded anteriorly by the buccopharyngeal fascia, laterally by the carotid sheath, and posteriorly by the prevertebral fascia(6). Cerebral palsy, acquired/traumatic brain injury, neuromuscular disorders, craniofacial malformations and airway malformations are various causes of dysphagia in paediatric age group(7). Retropharyngeal tumours are rare cause of dysphagia. Common causes of retropharyngeal mass in paediatric group are infective (abscess, oedema, lymphadenopathy). Other causes are lymphoma and to a lesser extent hematoma(3).Haddad et al reported a case of retropharyngeal lipoma in 2005 and they collected total 52 cases of retropharyngeal lipoma after review of worldwide literature till date(3). After an extensive search of worldwide literature, we could find additional 26 case reports including our case. Total 78 cases of retropharyngeal lipoma are reported till date including our case and out of these only 9 cases were reported previously in paediatric age group. Our case is likely to be 10th case report of retropharyngeal lipoma in paediatric age group. A huge retropharyngeal lipoma in paediatric age group was previously reported in a single case report by Kurilin, with tumour size 14 cm(8). Our case is second case report of huge retropharyngeal lipoma in paediatric age group with tumour size 15 cm. This benign tumour at retropharyngeal location can be potentially life threatening due to severe compression on aerodigestive tract(3). Diagnosis is usually made on imaging, either computed tomography or magnetic resonance imaging. Role of imaging is also in evaluation of extent of tumour and in differentiation from liposarcoma.Transoral approach is preferred surgical approach for retropharyngeal lipoma due to its less post operative morbidity and lack of scar(1), however lateral cervical approach should be considered in large tumours extending in mediastinum.Conclusion - Lipoma at retropharyngeal location is rare, and It should be suspected if clinical presentation is slowly progressive dysphagia and dyspnea with a bulge in posterior pharyngeal wall on oral examination. Diagnosis is based on imaging and complete surgical excision is treatment of choice.
Successful use of anti-PD-1 antibody to treat multiple metastatic carcinomas in a pat...
Mai Itoyama
Akihiro Ohara

Mai Itoyama

and 11 more

March 17, 2023
Successful use of anti-PD-1 antibody to treat multiple metastatic carcinomas in a patient with xeroderma pigmentosum: case report and literature reviewMai Itoyama1, Akihiro Ohara1, Kazuki Yokoyama1, Shun Yamamoto1, Ken Kato1, Taisuke Mori2, Hiroshi Igaki3, Eiji Nakano4,5, Naoya Yamazaki4, Kuniko Sunami6, Chikako Nishigori5,7, Yoshitaka Honma11. Department of Head and Neck, Esophageal Medical Oncology, National Cancer Center Hospital2. Department of Diagnostic Pathology, National Cancer Center Hospital3. Department of Radiation Oncology, National Cancer Center Hospital4. Department of Dermatologic Oncology, National Cancer Center Hospital5. Department of Dermatology, Kobe University Graduate School of Medicine6. Department of Laboratory Medicine, National Cancer Center Hospital7. Hyogo Blood Center, Japanese Red CrossContact (Mai Itoyama):Adress: 5-1-1 Tsukiji, Chuo-ku, Tokyo, JapanEmail: mitoyama@ncc.go.jp
Pemphigus Vulgaris Presenting with Epigastric Pain
Marawan Elmassry
Jerapas Thongpiya

Marawan Elmassry

and 5 more

March 17, 2023
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
Clostridium sordellii: A cause of toxic shock syndrome after a breach in the GI tract
Sydney Pence
Rajshri Joshi

Sydney Pence

and 2 more

March 17, 2023
Clostridium sordellii: A cause of toxic shock syndrome after a breach in the GI tractSydney Pence,1 Rajshri Joshi,2Kasturi Shrestha31. Ohio University Heritage College of Osteopathic Medicine, 4180 Warrensville Center Rd, Warrensville Heights, OH 44122. Email: sp883713@ohio.edu2. Internal Medicine, Cleveland Clinic Akron General, 1 Akron General Ave, Akron, OH 44307. Email: JOSHIR4@ccf.org3. Infectious Disease, Cleveland Clinic Akron General, 1 Akron General Ave, Akron, OH 44307. Email: SHRESTK2@ccf.org
Long-standing laryngeal rhinoscleroma with rare Mikulicz cells
Raheem  Peerani
Manish Shah

Raheem Peerani

and 7 more

March 17, 2023
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.
Investigation of Bovine Serum Albumin specific IgE expression in horses
Elizabeth Perry
Katherine  Delph

Elizabeth Perry

and 5 more

March 17, 2023
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.
Effects of Cholinergic Receptor Activation and Magnetic Fields on Motor Behavior in I...
Manoela Pitta
Kelly Zhang

Manoela Pitta

and 5 more

March 17, 2023
Aim of the study: Given the known synergistic relationship between magnetic field (MF) and cholinergic receptor activation in the cholinergic system, the present study aims to investigate whether the combined use of a static MF and an agonist for nicotinic acetylcholine receptors (nAChR) can preserve motor behavior in ischemic gerbils. Materials & methods: We randomly allocated 72 Mongolian gerbils into nine groups (n=8), distributed according to surgical procedure and treatment. The animals were trained and evaluated on the Rotarod (RR) to assess motor performance. Results: Our main finding was the preservation of motor behavior in the Sham Ischemia + Nicotine + Sham Magnetic Stimulation (Sh+N+SMS) and Ischemia + Nicotine + South Pole (I+N+SP) groups, as evidenced by the results of the RR test. Conclusions: Our findings are consistent with previous literature and provide insight into the mechanism of potentiation, as results showed that adding a nAChR agonist to the MF preserved motor performance in the RR test of ischemic animals.
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