To clinical case report1

Manuscript category: Letters to the EditorTitle: New-onset bullous pemphigoid after SARS-CoV-2 infectionKeywords: COVID-19, Bullous pemphigoid, SARS-CoV-2Word count: 451 wordsFigure count: 2Table count: 0Sijie Zhou1, Xue Wang1, Lizhi Ma1, Jiaming Fan1, Xinyun Tang1, Peimei Zhou1*1 Department of Dermatovenereology, Chengdu Second People’s Hospital, Qingyun Street, Chengdu, 610041, China.Correspondence to: Peimei Zhou, M.D., Ph.D.Department of Dermatovenereology, Chengdu Second People’s Hospital, Qingyun Street, Chengdu, 610041, China.Tel: +86 18908176315; E-mail: 46551704@qq.comFunding sources: NoneConflict of interest disclosures: All authors declare no conflicts of interest.Data availability statement: Data sharing does not apply to this article as no new data were created or analysed in this study.Ethics statement: The patient consented to publish this information. A 78-year-old male patient with a history of diabetes, hypertension, and renal insufficiency was diagnosed with bullous pemphigoid (BP) after contracting coronavirus disease 2019 (COVID-19). The patient had a positive nasopharyngeal swab for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in late December 2022 and was hospitalised for two to three weeks. After discharge, the patient developed erythema and blisters on both hands with itching that gradually involved the whole body. The patient presented to our dermatology department on 3 March 2023.At presentation to the dermatology department, the patient had tense blisters covering the entire body, some of which were breaking down, leaving a small patchy vesicular surface with a yellowish exudate (Fig. 1). Routine blood, procalcitonin, and C-reactive protein tests suggested infection, and a chest computed tomography exam indicated viral pneumonia, consistent with SARS-CoV-2 infection. In addition, the patient’s BP180 antibody levels were >150 U/mL (range: positive >20 U/mL), and rickle cell desmosome antibodies were negative. Furthermore, direct immunofluorescence showed linear basal deposition of immunoglobin G and C3 (uncertain). Finally, histological analyses of an incisional cutaneous biopsy obtained from the patient’s left lower extremity showed the formation of subepidermal blisters containing a few eosinophils, lymphocytes and fibrin, and some epidermal basal cells next to the blisters were edematous, liquefied and deformed.(Fig. 2). These findings were consistent with a BP diagnosis. The patient’s condition did not resolve after conventional treatment with glycyrrhizin, a Chinese herbal extract compound, and other anti-inflammatory treatments; therefore, dupilumab (600 mg initially, then 300 mg every two weeks after) was subcutaneously administered. The symptoms were relieved after two weeks.An increasing number of studies are reporting cutaneous manifestations after COVID-19. For instance, nonspecific skin symptoms, including urticarial lesions, chilblain-like lesions, vesicular eruptions, maculopapular rashes, and livedo, have been reported1,2. We identified no other reports of COVID-19-induced BP but did find a description of BP after SARS-CoV-2 vaccination3. The vaccine mimics antigens to induce specific immune responses in the body, similar to those produced by humans infected with novel coronaviruses, which can cause autoimmune symptoms4. Therefore, our case was likely associated with a novel coronavirus infection.BP is an autoimmune, subepidermal blistering disease occurring in elderly individuals. The exact pathogenesis of BP is unknown, but several factors, such as drugs, thermal or electrical burns, surgical procedures, trauma, ultraviolet irradiation, radiotherapy, chemical preparations, transplants, and infections, may induce or exacerbate BP5. Yet, viral infection-induced BP has rarely been considered. This may be because viruses, as pathogens, can induce cross-reactive autoantibodies sharing epitopes with host cells. Additionally, the virus can directly infect keratinocytes, induce the expression of hidden epitopes, modify existing epitopes, or insert envelope fragments into cells to produce new antigens, which could be responsible for BP development6,7.

A novel double Z-scheme ternary heterostructure photocatalyst of MIL-101(Cr)/Fe3O4-SiO2/nanorod-graphitic carbon nitride (MIL-Cr/F@S/nr-GCN) was fabricated via the hydrothermal method. Physicochemical properties of photocatalysts were measured by XRD, FTIR, FESEM, EDX, TEM, BET, PL, and UV-vis DRS analysis. The adsorption and photodegradation of oilfield-produced water (O-PW) pollutants were investigated by synthesized photocatalysts. The ternary heterostructure composite containing 20 wt% of nr-GCN showed remarkable photocatalytic performance than nr-GCN and MIL-Cr/F@S binary composite. The maximum chemical oxygen demond (COD) removal efficiency of synthetic oilfield-produced water obtained 97.4% under visible-light illumination at optimum conditions (pH 4, illumination time 90 min, photocatalyst dosage 0.6 g/L, and pollutant initial concentration 754 mg/L). Also, total petroleum hydrocarbons (TPHs) were removed 98% at these conditions. The kinetic and isotherm adsorption study revealed that the O-PW adsorption process obeyed the pseudo-second-order kinetic and Freundlich isotherm models. The degradations rate of O-PW by ternary composite is 2.8 times, and 2 times higher than the nr-GCN, and MIL-Cr/F@S, respectively. The high specific surface area (653 m2/g), appropriate bandgap energy (1.6 eV), and the good charge carrier separation based on the double Z-scheme caused the enhancement of photocatalytic activity. The ternary photocatalysts exhibited high reusability after 5 cycles without leaching Cr ions into the treated water. The results confirmed that the new ternary heterostructure is a green and robust photocatalyst in treatment of oilfield-produced water.

This study proposes a direct current power supply circuit (DPS) that can match the impedance of the freestanding-sliding mode triboelectric nanogenerator (FS-TENG) with multi-harmonic characteristics and continuously supply power to the load with reduced energy loss. The proposed DPS consists of a double charge circuit (DCC) and a DC conversion circuit based on a comb filtering circuit (CFC). The proposed DPS successfully matched the high internal impedance of the FS-TENG, collected multi-harmonic electrical energy, and provided stable DC voltage for practical applications in real-time. The proposed FS-TENG and DPS supplied a continuous DC voltage of 2.2 V to loads with 0.039 % ripple, while reducing the impedance of the TENG from 221 MΩ to 11 MΩ. The present results demonstrate that the proposed DPS has higher output power than conventional buck and buck-boost converters for the FS-TENG with high impedance and multi-harmonic characteristics. This work presents a significant advancement towards continuous DC power supply utilizing the FS-TENG. In addition, the practical application of the FS-TENG and DPS was successfully demonstrated to drive a self-powered temperature sensor in real-time by generating a constant DC output voltage across a thermistor.

Intraspecific genetic variation in foundation species such as aspen (Populus tremuloides Michx.) shapes their impact on forest structure and function. Identifying genes underlying ecologically important traits is key to understanding that impact. Previous studies using single-locus genome-wide association (GWA) analyses to identify candidate genes have identified fewer genes than anticipated for highly heritable quantitative traits. Mounting evidence suggests that polygenic control of quantitative traits is largely responsible for this “missing heritability” phenomenon. Our research characterized the genetic architecture of 35 ecologically important traits using a common garden of aspen through genomic and transcriptomic analyses. A multilocus association model revealed that most traits displayed a polygenic architecture, with most variation explained by loci with small effects (likely below the detection levels of single-locus GWA methods). Consistent with a polygenic architecture, our single-locus GWA analyses found only 38 significant SNPs in 22 genes across 15 traits. Next, we used differential expression analysis on a subset of aspen genets with divergent concentrations of salicinoid phenolic glycosides (key defense traits). This complementary method to traditional GWA discovered 1,243 differentially expressed genes for a polygenic trait. Soft clustering analysis revealed three gene clusters (241 candidate genes) involved in secondary metabolite biosynthesis and regulation. Our results support the omnigenic model that complex traits are largely controlled by many small effect loci, most of which may not have obvious connections to the traits of interest. Our work reveals that ecologically important traits governing higher-order community- and ecosystem-level attributes of a foundation forest tree species have complex underlying genetic structures and will require methods beyond traditional GWA analyses to unravel.

MXenes are mentioned in many applications due to their unique properties. However, the traditional etching method has a long synthesis time, dangerous process and high cost. Molten salt etching is not only short in time, but also safe and simple, laying a good foundation for industrialization. Here, we compare the traditional F–containing etching method with the molten salt etching method. TEM elemental mapping images and XPS show that the Ti3C2Tx surface end of traditional etching is terminated by –F, while the Ti3C2Tx surface end of molten salt etching is terminated by –Cl. Finally, the sodium–ion batteries is fabricated and the performance difference of the three etching methods is compared, the results show that the capacity of 102.1 mAh g–1 can still be reached when the molten salt etching MXene material returns to 0.1 A g–1 after the current density of 5 A g–1. After 500 cycles at 1 A g–1, there is no significant loss of capacity and the coulomb efficiency is close to 100%. This work describes that molten salt etching MXene has comparable sodium storage capacity to conventional F–containing etched MXene, making it a potential candidate for large–scale sodium–ion batteries production.

This review article presents recent advancements in deep learning methodologies and applications for autonomous navigation. It analyzes state-of-the-art deep learning frameworks used in tasks like signal processing, attitude estimation, obstacle detection, scene perception, and path planning. The implementation and testing methodologies of these approaches are critically evaluated, highlighting their strengths, limitations, and areas for further development. The review emphasizes the interdisciplinary nature of autonomous navigation and addresses challenges posed by dynamic and complex environments, uncertainty, and obstacles. With a particular focus on mobile robots, self-driving cars, unmanned aerial vehicles, and space vehicles to underscore the importance of navigation in these domains. By synthesizing findings from multiple studies, the review aims to be a valuable resource for researchers and practitioners, contributing to the advancement of novel approaches. Key aspects covered include the classification of deep learning applications, recent advancements in methods, general applications in the field, innovations, challenges, and limitations associated with learning-based navigation systems. This review also explores current research trends and future directions in the field. This extensive overview, initiated in 2020, provides a valuable resource for researchers of all levels, from seasoned experts to newcomers. Its main purpose is to streamline the process of identifying, evaluating, and interpreting relevant research, ultimately contributing to the progress and development of autonomous navigation technologies.

A clinical study on bismuth potassium citrate was conductedQualified subjects were randomly numbered in ascending order of screening number before taking the drug in the first cycle. The assignment of each subject (TR or RT) in the trial was determined by the randomization table. The fasting group plans to enroll 24 cases. The test was administered once per cycle, and the subjects were randomly divided into two groups with equal numbers in each group, and the washout period was 7 days. This project establishes and verifies an analytical method for the determination of bismuth concentration in human plasma by inductively coupled plasma mass spectrometry (ICP-MS). Results: The pharmacokinetic parameters (Cmax, AUC0-t and AUC0-∞) of the test preparation and reference preparation were analyzed by linear mixed effects model after natural logarithm transformation. The results showed that the test preparation was better than the reference preparation. The 90% confidence intervals of Cmax, AUC0-t and AUC0- ∞ after natural log transformation were 5.44%-12.82%, 10.86%-22.44% and 13.79%-27.42%, respectively. There, the lower limit of the 90% confidence interval of the geometric mean ratio (test preparation/reference preparation) is not greater than 100%.

Seed dispersal is one of the most important ecosystem services globally. It shapes plant populations, enhances forest succession, and has multiple, indirect benefits for humans, yet it is one of the most threatened processes in plant regeneration, worldwide. The restricted movement of local frugivores, through habitat fragmentation, is one of the main threats to seed dispersal. These restrictions alter the behaviour associated with movements before, during and after interacting with fruits and seeds. Consequently, there have been recent calls for animal movement and behaviour to be better integrated with seed dispersal studies to enable researchers to fully understand the processes that determine seed rain. To assess the current use of animal tracking in frugivory studies and to provide a baseline for future studies, we provide a comprehensive review and synthesis on the existing primary literature of global tracking studies that monitor movement of frugivorous animals. Specifically, we identify studies that estimate dispersal distances and how they vary with morphological and environmental traits. We show that over the last two decades there has been a large increase in frugivore tracking studies that determine seed dispersal distances. However, gaps across taxa and geographic distribution still exist. Furthermore, we found that certain morphological and environmental traits can be used to predict seed dispersal distances. We demonstrate that an increase in body mass significantly increases the estimated seed dispersal mean and maximum distances, as does species flight ability. Our results also suggest that protected areas have a positive effect on mean seed dispersal distances when compared to unprotected areas. We anticipate that this review act as a reference for future frugivore tracking studies to build upon, specifically to understand the drivers of movement, and to interpret how seed dispersal and other ecosystem services will be impacted by human disturbance and land use changes.

Efforts to define the marine connectivity among populations have been focused overwhelmingly on corals, sponges and fish populations, but are lacking in other well represented marine taxa. The sea urchin Echinometra lucunter lucunter was selected due to its wide distribution throughout the Caribbean Sea and its biological and ecological characteristics. The aim of this research was to postulate genetic connections between populations of Echinometra lucunter lucunter throughout the Caribbean Sea to detect whether the marine discontinuities identified for other taxa affect their connectivity, a critical issue for future conservation and management. Specific microsatellites were used to detect the genetic structure of E. lucunter lucunter through the region. The results showed clear evidence of genetic structure and gene flow through the Caribbean region, with three genetic populations from the south-west to the north-east: first the Colombian Caribbean Sea, a second population related to Venezuela and Belize, and a third group defined for Puerto Rico in the North-East. The evidence of structure and gene flow between the populations of E. lucunter lucunter is related to marine discontinuities such as the influence of physical factors (continental margin, Caribbean currents, calcareous rock as the main substrate, riverine discharges) and their variation through the area, as well the biological characteristics of the specie (e.g., assortative mating through gamete recognition, stochastic reproduction, patchy gamete distribution). These results will facilitate their conservation efforts in the area and offer important key data for the application of conservation and management strategies of Marine Protected Areas

1. Wetlands belong to the globally most threatened habitats, and organisms depending on them are of conservation concern. Wetland destruction and quality loss may affect negatively also boreal breeding ducks in which habitat selection often needs balancing between important determinants of habitat suitability. In Finland duck population trajectories are habitat-specific, while the reasons behind are not known. 2. In this research, the balance of nest predation risk and invertebrate food abundance in boreal breeding ducks was studied in Finland at 45 lakes and ponds in 2017 and 2018. Nest predation experiments were conducted with artificial nests followed by wildlife cameras during seven days. Invertebrates were sampled from the study water bodies using emergence and activity traps. Duck pairs and broods were also surveyed from these and 18 additional water bodies. 3. The wildlife camera results indicate that predation risk was higher in the water bodies surrounded by agricultural land than forestland. Ponds (seasonal, beaver and man-made) had lower nest predation risk and they were also more invertebrate-rich habitats than permanent lakes. In addition, artificial nests further away from water bodies had higher survival than shoreline nests. Habitat use of duck pairs (prior to nesting) was not associated with invertebrate food, but duck broods preferred habitats rich in food. 4. High nest predation pressure in shorelines of especially agricultural landscapes may contribute the declining population trends of ducks in Finland. Controlling predators would be an important conservation action to improve duck breeding success. This research underlines the benefits of the availability of different water body types for the breeding ducks. There is an urgent need to pay attention to protecting seasonal ponds, while the lack of flooded waters may be mitigated by favouring beavers or man-made ponds.

The respective simplifications of prime-point DFT and ultra-long-point IDFT in PRACH are proposed. The former is an equivalent substitution of DFT function by using the property of ZC sequence, and the latter is an approximation based on cubic spline interpolation, which not only reduces the IDFT points, but also is easy to construct.

The influence of a magnetic field on the peristaltic transport of Jeffrey fluid in an unevenly curved conduit has been explored in this paper. A radial magnetic field is applied to a fluid in the direction of flow. The governing equations for flow, heat, and mass transmission are formulated using approximations based on a large wavelength and a tiny Reynolds number. An exact solution is obtained. The formulae for velocity profile, temperature, concentration, and stream function are computed. While plotting graphs and stream functions, the physical properties of pertinent parameters have been discussed.

Since ancient times, honey has been utilised as an alternative treatment for some clinical diseases. This study investigates the antibacterial potential of honey extracts obtained from Obanliku Hills in Cross River State, Nigeria, against Staphylococcus aureus, Pseudomonas aeruginosa, and Escherichia coli. Honey was extracted using successive solvent extraction; Methanol, Ethyl acetate and n-Hexane were used as extraction solvents. The bacteriostatic potential of all three extracts was determined using well diffusion assay. Methanol and n-hexane extracts showed no bacteriostatic impact, while the ethyl acetate extract exhibited concentration-dependent bacteriostatic and bactericidal effects. A significant (p<0.05) higher inhibition was observed at 40 mg/ml of the honey extract compared to 10 mg/ml against all three test organisms. In conclusion, honey extract had a greater bactericidal effect against Staphylococcus aureus compared to E. coli and P. aeruginosa.

SARS-CoV-2 and Crimean-Congo hemorrhagic fever virus coinfection: A case report and review of the diagnostic challengesZeinab Mohseni Afshar1, Mohammad Barary2, Arefeh Babazadeh3, Soheil Ebrahimpour3, *Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, IranStudent Research Committee, Virtual School of Medical Education and Management, Shahid Beheshti University of Medical Sciences, Tehran, IranInfectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, IranCorrespondence: Soheil Ebrahimpour, Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran. Email: drsoheil1503@yahoo.com

Pseudotumor cerebri due to brucellosis: A rare case reportEhsan Alimohammad1, Arefeh Babazadeh2, Soheil Ebrahimpour2, Ali Alizadeh Khatir3 Mohammad Barary4, Zeinab Mohseni Afshar5, *Department of Neurosurgery, Kermanshah University of Medical Science, Kermanshah, IranInfectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, I.R. IranMobility Impairment Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, IranStudent Research Committee, Virtual School of Medical Education and Management, Shahid Beheshti University of Medical Sciences, Tehran, IranClinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, IranCorrespondence: Zeinab Mohseni Afshar, Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran. Email: baboldr2019@gmail.com

This paper aims to develop a robust decomposed system control (RDSC) strategy under input constraints for an electro-mechanical linear actuator (EMLA) with model uncertainty and external disturbances. At first, a state-space model of a complex multi-stage gearbox EMLA system, driven by a permanent magnet synchronous motor (PMSM), is developed, and the non-ideal characteristics of the ball screw are presented through the model. This results in a six-order nonlinear strict-feedback form (NSFF) system that is decomposed into three subsystems. As the paper’s main result, a novel RDSC strategy with uniform exponential stability for controlling subsystem states is presented. This developed controller avoids the “explosion of complexity” problem associated with backstepping by treating the time derivative of the virtual control input as an uncertain system term. The proposed method, while assuming load disturbances and input constraints with arbitrary bounds, offers a straightforward control approach for a broader range of applications. The controller’s performance is evaluated through the simulation of two distinct duty cycles, each representing different levels of demand on the actuator facing load disturbances near the rated motor performance.

The present research study helps in evaluation of F 1 hybrids for enhancement of the okra production through the selection of superior heterotic hybrids by L x T design during monsoon-2022. A total of 48 crosses are developed by crossing in 8 x 6 fashion of lines and testers along with standard checks Punjab-8 and Punjab-7 were sown in 3 replications in experimental design of Randomized Block Design at Agricultural research farm in Lovely Professional University, Phagwara, Punjab for heterosis of fruit yield and its component traits in bhendi. An observation of fifteen quantitative characters were recorded. The ANOVA for mean sum of squares is substantial across all the characters suggests that there is an ample amount of genetic variation present among parents and hybrids. The fruit yields of GFS GOLD-V4 x IC058768, VRO-4 x IC048281 and Palm Komal x IC048281 were much higher than those resulting from standard checks, and they are recommended for additional evaluation and can be utilized for heterosis commercially.The maximum positive and substantial heterosis was observed for Height of Plant (113.22) in Palm Komal x IC048281 and next to it is Nodes per Plant (77.79) and Fruits per Plant (77.13) in Palm Komal x IC046018. The cross Palm Komal x IC048281 displaying significant desirable heterobeltiosis and economic heterosis not only for yield and also characters like Height of Plant, Fruits per Plant, Nodes per Plant, Average Fruit weight, Branches per Plant, Fruit girth and Fruit length among top three cross combinations for component traits which is highly recommended for commercial okra crop improvement.

In the study of fatigue fracture in metals, fatigue indicator parameters (FIPs) are nonlocal quantities that are used to model and predict the driving force needed to incubate fatigue cracks. These FIP values can be used to design materials with microstructural features less prone to fatigue failure. However, the nonlocal nature of fatigue indicator parameters introduces another unknown variable that must be determined for accurate predictions: the volume over which nonlocal averages are performed. Many studies use nonlocal volumes that enclose a predetermined number of finite elements in a polygranular crystal plasticity simulation. To encapsulate the entire microstructure, these nonlocal volumes must be conformal to the microstructure (i.e., they do not overlap or have gaps between them). Some studies base the length scale of these nonlocal volumes on constant values or on the size of relevant microstructural features. It has been shown that if the length scale is too small, the nonlocal FIP predictions are mesh dependent. But, if the length scale is too large, the experimentally observed statistical spread in fatigue life is not captured. This work introduces a nonconformal nonlocal volume (i.e., a volume that surrounds each element and overlaps nonlocal volumes). Averaging FIP over this nonlocal volume both captures the spread in fatigue data and is mesh independent. It also allows for weighted nonlocal averages that would have excluded some of the microstructure using the conformal approach. While this approach is more accurate than the previous approaches, it does require a large amount of computational resources to determine each nonlocal volume, so a parallelized algorithm that is scalable across multiple computing nodes is employed. The example polycrystalline material for this work is Ti-6Al-4V, a common titanium alloy with a hexagonal closed-packed crystal structure.

A 70-year-old man revealed a rare type of atrioventricular nodal reentrant tachycardia (AVNRT) involving distinct retrograde pathways, Superior Slow Pathway (SSP) and Inferolateral Left Atrial Slow Pathway (ILA-SP). Radiofrequency ablation was successfully performed on the non-coronary cusp and in the left atrium, respectively, to eliminate the tachycardias. Due to the anomalous electrical conduction patterns, careful diagnosis and ablation strategies were necessary to avoid the risk of atrioventricular block. These findings underscore the diversity and complexity of AVNRT and highlight the importance of tailored therapeutic approaches.

Abstract Background: Persons with diabetes may have an elevated risk of Parkinson’s disease. Statin use could also modify the progression of Parkinson’s disease. Objective: The aim was to study whether there is an association between statin exposure and risk of Parkinson’s disease in persons with diabetes Methods: A nationwide nested case-control study of 2,017 Parkinson’s disease cases and their 7,934 matched controls with diabetes was performed using data from the Finnish Parkinson’s disease study (FINPARK). Persons with Parkinson’s disease were diagnosed between 1999–2015 and statin use (1995–2015) was determined from Prescription Register. In the main analysis exposure at least three years before outcome was considered. Cumulative exposure was categorized into tertiles, and associations were analyzed with conditional logistic regression. Results: Prevalence of statin use was similar in Parkinson’s disease cases and controls, with 54.2% of cases and 54.4% controls exposed before the lag time (adjusted odds ratio (aOR) = 1.02; 95% CI: 0.91–1.15). Those in the highest cumulative statin exposure tertile had higher risk of Parkinson’s disease than statin nonusers (aOR = 1.21; 95% CI: 1.04–1.42), or those in the lowest cumulative statin exposure tertile (aOR = 1.29; 95% CI: 1.07–1.57). Conclusions: Our nationwide study that controlled for diabetes duration and reverse causality does not provide support for the hypothesis that statin use decreases the risk of Parkinson’s disease.

IntroductionHemophagocytic lymphohistiocytosis (HLH) is a potentially lethal immune system dysregulation in children and adults. Failure to properly inhibit the immune response leads to constant and excessive activity of the cytotoxic T-cells, natural killer (NK) cells, and macrophages. Inflammatory reactions caused by the intense activity of the cellular immune system and cytokine storm in tissues lead to multiple organ failure in this disease. HLH is categorized as primary, which defines as the presence of a predisposing genetic mutation in the immune system, and reactive to an infectious, inflammatory, or malignant trigger. The diagnosis is challenging as it has no clinical or laboratory pathognomonic features. Fever, organomegaly, liver dysfunction, cytopenias, coagulopathy, hemophagocytosis, and neurologic dysfunction are common manifestations of HLH.Ocular involvement is relatively rare in HLH. Unilateral panuveitis, Purtscher retinopathy, trabecular meshwork involvement, and choroidal infiltration with secondary extension to the retina and optic nerve head (ONH) have been reported previously.This report aims to introduce a child with HLH and bilateral ONH infiltration.

Objective: Metamizole is quite an old drug with analgesic, antipyretic and spasmolytic properties. Recent findings have shown that it may induce several cytochrome P450 enzymes, especially CYP3A4 and CYP2B6. The clinical relevance of these properties is uncertain. We aimed to unravel potential pharmacokinetic interactions between metamizole and the CYP3A4 substrate quetiapine. Methods: Plasma concentrations of quetiapine from a large therapeutic drug monitoring database were analyzed. Two groups of 33 patients, either receiving quetiapine as a monotherapy (without CYP modulating co-medications) or with concomitantly applied metamizole were compared addressing a potential impact of metamizole on the metabolism of quetiapine being reflected in differences of plasma concentrations of quetiapine and dose-adjusted plasma concentrations (C/D). Results: Patients co-medicated with metamizole showed significantly lower plasma concentrations of quetiapine (median 45.2 ng/mL, Q1=15.5; Q3=90.5 vs. 92.0 ng/mL, Q1=52.3; Q3=203.8, p=0.003). Accordingly, plasma concentrations of quetiapine in the control group were more than twice of those in the metamizole group (+103% higher). The dose-adjusted plasma concentrations were 69 % lower in the co-medication group (p=0.001). Conclusions: The combination of metamizole and quetiapine leads to significantly lower drug concentrations of quetiapine, most likely via an induction of cytochrome P450 CYP3A4 by metamizole. Clinicians have to consider the risk of adverse drug reactions, especially treatment failure under quetiapine when adding metamizole.

The human brain is postulated to function as a prediction machine, constantly comparing incoming sensory input to predictions based on past experiences. When an event contradicts these predictions, it results in a prediction error (PE), which has been shown to enhance subsequent memory. However, the neural mechanisms underlying the influence of PE on subsequent memory remain unclear. This study investigated the electrophysiological correlates during encoding and retrieval of events eliciting PE. We employed a statistical learning task in which participants were presented with pairs of objects in sequence. Subsequently, while recording electroencephalography (EEG), we introduced PE by replacing the second object of each pair with new objects and we then tested the participants’ memory. Behaviorally, PE did not enhance memory. During retrieval, we observed higher amplitudes of the posterior recollection component for violation items that were remembered compared to those that were forgotten. In contrast, no evidence for the presence of the frontal negative familiarity component was found. These results suggest that recollection, but not familiarity, plays a crucial role in the interplay between PE and memory. Contrary to our hypothesis, we did not observe a relationship between PE and the P3 component during encoding. In conclusion, our study contributes to the growing body of knowledge concerning the intricate relationship between PE and episodic memory. It sheds light on the underlying neural mechanisms involved and emphasizes the importance of recollection in this context.