A document by Jonathan Zalevsky. Click on the document to view its contents.

IgG4 Related Disease: case report and 6-year follow up of an elusive diagnosis mimicking malignancySara Melo Oliveira1, Inês Trigo1, Ana Sofia Oliveira1, Isabel Gomes1, Rita Neto Lopes11Family Health Unit of Barrinha, Esmoriz, ACeS Baixo-Vouga, Aveiro, PortugalCorrespondence: Sara Melo Oliveira, Family Health Unit of Barrinha, ACeS Baixo-Vouga, Aveiro, Portugal. Email:sara.portu@gmail.comKey Clinical Message: IgG4-related disease is a rare and emerging pathology, characterized by the appearance of pseudotumors. Due to the ability to mimic other pathologies, it is essential to consider it as a differential diagnosis in multisystemic processes. The diagnosis is challenging, requiring a multidisciplinary approach, to minimize the associated morbidity and mortality.Abstract: IgG4-related disease (IgG4-RD) is a rare, emerging, systemic and chronic pathology,characterized by the appearance of pseudotumors resulting from tissue infiltration by IgG4-positive plasmablasts that promote eosinophilic inflammation of the tissue with subsequent fibrosis. We present the case of a male, 45-year-old patient, who consulted his Family Health Unit with complaints of postprandial discomfort in the left hypochondrium with a feeling of fullness, weight loss, chronic fatigue and hyperhidrosis that had lasted for a month. During physical examination, he was pale, and had pain at palpation of the left hypochondrium. Laboratory data showed increased inflammation markers, abdominal ultrasound and CT demonstrated numerous enlarged lymph nodes in the upper quadrants, raising concern for a malignant lymphoproliferative process. Laparoscopic excisional biopsy revealed features of IgG4-related lymphadenopathy and excluded malignant lymphoproliferative disease. The increase in serum IgG4 supported the final diagnosis of IgG4-RD.Keywords: IgG4-related disease; Pseudotumor; Immune-mediated; Systemic; Chronic.FUNDING INFORMATION: This work did not receive any type of financial support from any entity in the public or private domain.CONFLICT OF INTEREST STATEMENT: The authors have no conflicts of interest to declare.DATA AVAILABILITY STATEMENT: The data that support the findings of this study are available from the corresponding author upon reasonable request.ETHICS STATEMENT: All procedures performed in this case were in accordance with the Helsinki Declaration (as revised in 2013). Written informed consent was obtained from the patient for the publication of this case report and accompanying images. A copy of the written consent is available for review by the editorial office of this journal.CONSENT: Written informed consent was obtained from the patient to publish this report in accordance with the journal’s patient consent policy.PATIENT PERSPECTIVE: The patient was anxious and worried about his health condition, mainly due to the possibility of a neoplastic disease. However, he felt calmer as soon as he was informed about the diagnosis and experienced symptomatic improvement after starting treatment. During the follow-up, he remained cooperative and assiduous in regular consultations.ORCID: Sara Melo Oliveira:https://orcid.org/0000-0003-0649-2694

This study explores a combined strategy of Raman and reflectance spectroscopy for quantifying liver fat content and fat droplet size, crucial in assessing donor livers. By using Monte Carlo simulations and experimental setups with oil-in-water phantoms, our findings indicate that Raman scattering can solely differentiate between varying fat contents, while reflectance intensity is influenced by both fat content and oil droplet size, with a more pronounced sensitivity to fat droplet size. This study demonstrates the efficacy of combined Raman and reflectance spectroscopy in assessing liver steatosis and fat droplet size, potentially aiding in assessing donor livers for transplantation.

Targeted proteomics, which includes parallel reaction monitoring (PRM), is typically utilized for more precise detection and quantitation of key proteins and/or pathways derived from complex discovery proteomics datasets. Initial discovery-based analysis using data independent acquisition (DIA) can obtain deep proteome coverage with low data missingness while targeted PRM assays can provide additional benefits in further eliminating missing data and optimizing measurement precision. However, PRM method development from bioinformatic predictions can be tedious and time-consuming because of the DIA output complexity. We address this limitation with a Python script that rapidly generates a PRM method for the TIMS-TOF platform using DIA data and a user-defined target list. To evaluate the script, DIA data generated from HeLa cell lysate (200 ng, 45-minute gradient method) as well as canonical pathway information from Ingenuity Pathway Analysis was utilized to generated a pathway-driven PRM method. Subsequent PRM analysis of targets within the example pathway, regulation of apoptosis, resulted in improved chromatographic data and enhanced quantitation precision (100% peptides below 10% CV with a median CV of 2.9%, n=3 technical replicates). The script is freely available at https://github.com/StevensOmicsLab/PRM-script and provides a framework that can be adapted to multiple DDA/DIA data outputs and instrument-specific PRM method types.

Human activities drive ecological transformation, impacting island ecosystems from species diversity to ecological traits, mainly through habitat degradation and invasive species. Using two unique long-term datasets we aim to evaluate whether species traits (body size, trophic level, dispersal capacity and habitat occupancy) can predict temporal variations in the abundance of endemic, native non-endemic and exotic arthropods in the Azores Islands. We found that body size is crucial to predict arthropods abundance trends. Small-bodied herbivorous arthropods showed a decrease in abundance, while large-bodied indigenous arthropods increased in abundance, mainly in well-preserved areas. Also, large-bodied exotic arthropods increased in abundance across the entire archipelago. Moreover, endemic canopy dwellers increased in abundance, while endemic ground-dwellers decreased in abundance. Simultaneously, exotic arthropods showed the opposite result, increasing abundance in the ground while decreasing abundance in the canopy. Finally, habitat influenced both endemic and exotic spider abundance trends. Endemic spiders that occupy solely natural habitats experienced a decline in abundance, while exotic spiders in the same habitats increased in abundance. Our study underscores the significance of arthropod species traits in predicting abundance changes in island ecosystems over time, as well as the importance of monitoring species communities. Conservation efforts must extend beyond endangered species to protect non-threatened ones, given the increased extinction risk faced by even common species on islands. Monitoring and restoration programs are essential for preserving island ecosystems and safeguarding endemic arthropod populations.

The genus Encephalartos is entirely endemic to Africa. Like most cycad species, the genus is at risk of extinction. One of the threats jeopardizing the future of the genus is reproduction failure. Our objective is to investigate what predisposes Encephalartos species to reproduction failure. We collected functional traits of 430 individuals of Encephalartos villosus, including pre-dispersal seed predation and habitat types and elevation in Origi Gorge Nature Reserve in South Africa. Then, we analysed our data by fitting a structural equation model (SEM). Surprisingly, elevation does not predict pre-dispersal seed predations, adding to the inconsistent effects of elevation on seed predation. However, there was evidence of more predated seeds on plants with more leaves, fitting the patterns of resource concentration hypothesis which predicts more insect herbivores, particularly specialist herbivores, where food resources (e.g., leaves, flowers, fruits, and seeds) are abundant. We also found that more predated seeds are in open habitats, perhaps mirroring the specialist feeding behaviour of the weevil Antliarhinus zamiae feeding on the seeds of Encephalartos spp. Furthermore, taller plants tend to bear more predated seeds, potentially because taller plants are easy located by the weevil. Finally, large canopy correlates negatively with predated seeds, mirroring our finding of increased seed predation in open habitats. Our SEM explains 67% of the variations in pre-dispersal seed predations, suggesting that this metamodel provides insights into the predisposition of cycad seed to predations. Since open habitats correlate with more seed predation, we suggest that anthropogenic activities that contribute to open forest must be avoided if we are to limit seed predations.

In bacteria, faithful DNA segregation of chromosomes and plasmids is mainly mediated by ParABS systems. These systems, consisting of a ParA ATPase, a DNA binding ParB CTPase, and centromere sites parS, orchestrate the separation of newly replicated DNA copies and their intracellular positioning. Accurate segregation relies on the assembly of a high-molecular-weight complex, comprising a few hundreds of ParB dimers nucleated from parS sites. This complex assembles in a multi-step process and exhibits dynamic liquid-droplet properties. Despite various proposed models, the complete mechanism for partition complex assembly remains elusive. This study investigates the impact of DNA supercoiling on ParB DNA binding profiles in vivo, using the ParABS system of the plasmid F. We found that variations in DNA supercoiling does not significantly affect any steps in the assembly of the partition complex. Furthermore, physical modeling, leveraging ChIP-seq data from linear plasmids F, suggests that ParB sliding is restricted to approximately 2-Kbp from parS, highlighting the necessity for additional mechanisms beyond ParB sliding over DNA for concentrating ParB into condensates nucleated at parS. Lastly, explicit simulations of a polymer coated with bound ParB suggest a dominant role for ParB-ParB interactions in DNA compaction within ParB condensates.

In bacteria, the chromosome is folded into a structure called the nucleoid. This compaction must facilitate and maintain key biological processes such as gene expression and DNA transactions (replication, recombination, repair, segregation). Chromosome and chromatin 3D-organization in bacteria has been a puzzle for decades. Chromosome conformation capture coupled to deep sequencing (HiC) in combination with other ‘omics’ approaches has allowed dissection of the structural layers that shape bacterial chromosome organization, from DNA topology to global chromosome architecture. Here we review the latest findings in the field and discuss the main features of bacterial genome folding.

In this note, we consider the initial boundary value problem for a parabolic equation with logarithmic nonlinearity, which has been studied by Chen et al. (J. Math. Anal. Appl. 2015, 422, 84-98) and Han (J. Math. Anal. Appl. 2019, 474, 513-517). On the one hand, we not only prove the existence of doubly exponential decay solutions, but also find its threshold, and obtain the solutions with ∥ u 0 ∥ 2 2 → 0 + is always zero. On the other hand, we also prove the existence of doubly exponential growth solutions. The reseach results in this note extend previous results from both decay and growth.

Caring for children with asthma continues to be an essential responsibility of the pediatric pulmonologist. In this Pediatric Pulmonology Year in Review, we summarize the significant publications focused on pediatric asthma that have been published over the last year. We will discuss new findings that assist in the diagnosis and evaluation of pediatric asthma, highlight risk factors and social determinants that impact successful care, and discuss new interventions and treatment modalities for acute exacerbations and maintenance control. We hope this review can provide new insights and guidance for implementation into clinical practice within the field of pediatric asthma.

Globally, biodiversity is at risk of extinction, and megadiverse countries become key targets for conservation. South Africa, the only country hosting three biodiversity hotspots, harbours tremendous diversity of at-risk species deserving to be protected. However, the lengthy risk assessment process and the lack of required data to complete assessments is a serious limitation to conservation since several species may slide into extinction while awaiting risk assessment. Here, we employed deep neural network model integrating species climatic and geographic features to predict the conservation status of 116 unassessed plant species. Our analysis involved in total 1072 plant species and 112 066 occurrence points. The best-performing model exhibits high accuracy, reaching up to 83.6% at the binary classification and 56.8% at the detailed classification. Our best-performing model predicts that 32% and 8% of Data Deficient and Not-Evaluated species are likely threatened, respectively, amounting to a proportion of 24.1% of unassessed species facing a risk of extinction. Interestingly, all unassessed species predicted to be threatened are in protected areas, revealing the effectiveness of the South Africa’s network of protected areas in conservation, although these likely threatened species are more abundant outside protected areas. Considering the limitation in assessing only species with available data, there remains a possibility of a higher proportion of unassessed species being imperiled.

TITLENeuroendocrine tumor mimicking a recalcitrant vocal fold granuloma: appearances can be deceiving

Left Atrial Strain

A case of renal hypouricemia due to T217M mutation in SLC22A12incidentally associated with IgA nephropathyYoshimasa Sakurabu, MD,1. Haruhito A. Uchida, MD, PhD,1. 2.Toshihisa Tahara, MD,1. Tomohiko Asakawa, MD,1 Haruka Yamasaki, MD,1.3.Katsuyoshi Katayama MD,1. Shugo Okamoto, MD,1.Yasuhiro Onishi, MD, PhD,1. Natsumi Matsuoka-Uchiyama, MD,1.Keiko Tanaka, MD, PhD,1. Hidemi Takeuchi, MD, PhD,1.Kenji Tsuji, MD, PhD,1. Ryoko Umebayashi, MD, PhD,1.Yuki Ohashi, PhD,4,5 Kimiyoshi Ichida, MD, PhD,4. Jun Wada, MD, PhD1.Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, JapanDepartment of Chronic Kidney Disease and Cardiovascular Disease, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, JapanDepartment of Internal Medicine, Kagawa Rosai Hospital, Kagawa, JapanDepartment of Pathophysiology, Tokyo University of Pharmacy and Life Sciences, Tokyo, JapanDepartment of Pharmaceutical Sciences, International University of Health and Welfare, Tochigi, JapanCorrespondence to:Haruhito A. UchidaDepartment of Chronic Kidney Disease and Cardiovascular Disease,Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan2‑5‑1 Shikata‑cho, Kita-ku, Okayama 700‑8558, Japan.Phone: +81-86-235-7235, FAX: +81-86-222-5214hauchida@okayama-u.ac.jp

Background: Legacy-oriented interventions have the potential to offer pediatric oncology patients and families comfort at end-of-life and during bereavement. Certified Child Life Specialists often provide these services, and presently little is known about whether disparities exist in the provision of legacy-oriented interventions. Methods: In this retrospective decedent cohort study, we examined demographic and clinical characteristics from a sample of 678 pediatric oncology patients who died between 2015-2019. Bivariate analysis assessed differences between patients who received any versus no legacy-oriented intervention. Uni- and multivariable logistic regression models assessed associations of baseline characteristics and likelihood of receiving legacy-oriented intervention. Further multivariable analysis explored joint effects of significant variables identified in the univariable analysis. Results: 52% of patients received a legacy-oriented intervention. Older adolescents (≥13 years) had lower odds (OR: 1.73, p=0.007) of receiving legacy-oriented interventions than younger ones. Patients with Home/hospice deaths showed decreased likelihood (OR: 19.98, p<0.001) compared to patients who passed away at SJCRH locations. Hispanic patients (OR: 1.53, p=0.038) and those in palliative care (OR: 10.51, p<0.001) were more likely to receive interventions. No significant race association was noted. Conclusion: All children and adolescents with cancer deserve quality care at end-of-life, including access to legacy-oriented interventions, yet nearly half of patients in this cohort did not receive these services. By identifying demographic and clinical characteristics associated with decreased odds of receiving legacy-oriented interventions, healthcare professionals can modify end-of-life care processes to improve access. Introducing legacy-oriented interventions early and increasing exposure in community spaces may enhance access to legacy-oriented interventions for pediatric oncology patients.

Abnormal traffic between the left atrium and the inferior vena cava in the database is currently rare. Herein, we present a unique case of abnormal traffic between the left atrium and the inferior vena cava, which was diagnosed using transesophageal echocardiography and confirmed by computed tomography angiography (CTA). This case substantiates

A document by Sabthagi Sivathasan. Click on the document to view its contents.

The oceanographic conditions of the Southern California Bight (SCB) dictate the distribution and abundance of prey resources and therefore the presence of mobile predators, such as Cuvier’s beaked whales (Ziphius cavirostris). Cuvier’s beaked whales are deep-diving odontocetes that spend a majority of their time foraging at depth. Due to their cryptic behavior, little is known about how they respond to seasonal and interannual changes in their environment. This study utilizes passive acoustic data recorded from two sites within the SCB to explore the oceanographic conditions that Cuvier’s beaked whales appear to favor. Utilizing optimum multiparameter analysis, modeled temperature and salinity data are used to identify and quantify these source waters: Pacific Subarctic Upper Water (PSUW), Pacific Equatorial Water (PEW), and Eastern North Pacific Central Water (ENPCW). The interannual and seasonal variability in Cuvier’s beaked whale presence was related to the variability in El Niño Southern Oscillation events and the fraction and vertical distribution of the three source waters. Cuvier’s beaked whale acoustic presence was highest during the winter and spring and decreased during the late summer and early fall. These seasonal increases occurred at times of increased fractions of PEW in the California Undercurrent and decreased fractions of ENPCW in surface waters. Interannual increases in Cuvier’s beaked whale presence occurred during El Niño events. These results establish a baseline understanding of the oceanographic characteristics that correlate with Cuvier’s beaked whale presence in the SCB. Furthering our knowledge of this elusive species is key to understanding how anthropogenic activities impact Cuvier’s beaked whales.