A Rare Case of HIV-Induced Inflammatory Demyelinating Polyneuropathy.

Background:Acute inflammatory demyelinating polyneuropathy (AIDP) is an uncommon form of neuropathy in HIV-infected patients that can cause pain, sensory disturbance, and motor weakness. Case presentation:A 23-year-old African American male with past medical history of Guillain-Barre Syndrome (GBS), Lyme disease, and sexually transmitted infections including syphilis and chlamydia presented with acute back pain radiating to bilateral lower extremities with worsening right foot weakness for four days. Cerebrospinal fluid (CSF) studies including meningoencephalitis panel were negative as well as blood tests for Lyme disease and HIV antibody testing. Patient was initially treated with penicillin for positive treponemal serology but without improvement in lower extremity weakness. Electromyogram showed evidence of early demyelinating motor polyneuropathy. Four days after presentation, repeat HIV antibody testing returned positive. Recurrent AIDP in this case was suspected to be secondary to acute HIV infection, and highly active antiretroviral therapy (HAART) was administered along with intravenous immunoglobulin (IVIG). Muscle strength improved with therapy and patient was expected to have continued improvement with intensive rehabilitation after discharge. Conclusion:Acute inflammatory demyelinating polyneuropathy (AIDP) tends to present early in course of HIV infection. Therefore, HIV testing should be obtained in individuals presenting with new neurological deficits. Our patient received HAART therapy, in addition to the traditional modalities to manage AIDP, which led to a substantial recovery of his sensorimotor function

Scaling Behavior of Human Locomotor Activity Amplitude: Association with Bipolar Disorder

Scale invariance is a feature of complex biological systems, and abnormality of multi-scale behaviour may serve as an indicator of pathology. The hypothalamic suprachiasmatic nucleus (SCN) is a major node in central neural networks responsible for regulating multi-scale behaviour in measures of human locomotor activity. SCN also is implicated in the pathophysiology of bipolar disorder (BD) or manic-depressive illness, a severe, episodic disorder of mood, cognition and behaviour. Here, we investigated scaling behaviour in actigraphically recorded human motility data for potential indicators of BD, particularly its manic phase. A proposed index of scaling behaviour (Vulnerability Index [VI]) derived from such data distinguished between: [i] healthy subjects at high versus low risk of mood disorders; [ii] currently clinically stable BD patients versus matched controls; and [iii] among clinical states in BD patients

Global disparities in surgeons’ workloads, academic engagement and rest periods: the on-calL shIft fOr geNEral SurgeonS (LIONESS) study

: The workload of general surgeons is multifaceted, encompassing not only surgical procedures but also a myriad of other responsibilities. From April to May 2023, we conducted a CHERRIES-compliant internet-based survey analyzing clinical practice, academic engagement, and post-on-call rest. The questionnaire featured six sections with 35 questions. Statistical analysis used Chi-square tests, ANOVA, and logistic regression (SPSS® v. 28). The survey received a total of 1.046 responses (65.4%). Over 78.0% of responders came from Europe, 65.1% came from a general surgery unit; 92.8% of European and 87.5% of North American respondents were involved in research, compared to 71.7% in Africa. Europe led in publishing research studies (6.6 ± 8.6 yearly). Teaching involvement was high in North America (100%) and Africa (91.7%). Surgeons reported an average of 6.7 ± 4.9 on-call shifts per month, with European and North American surgeons experiencing 6.5 ± 4.9 and 7.8 ± 4.1 on-calls monthly, respectively. African surgeons had the highest on-call frequency (8.7 ± 6.1). Post-on-call, only 35.1% of respondents received a day off. Europeans were most likely (40%) to have a day off, while African surgeons were least likely (6.7%). On the adjusted multivariable analysis HDI (Human Development Index) (aOR 1.993) hospital capacity > 400 beds (aOR 2.423), working in a specialty surgery unit (aOR 2.087), and making the on-call in-house (aOR 5.446), significantly predicted the likelihood of having a day off after an on-call shift. Our study revealed critical insights into the disparities in workload, access to research, and professional opportunities for surgeons across different continents, underscored by the HDI

Sub-ångström cryo-EM structure of a prion protofibril reveals a polar clasp

The atomic structure of the infectious, protease-resistant, β-sheet-rich and fibrillar mammalian prion remains unknown. Through the cryo-EM method MicroED, we reveal the sub-ångström-resolution structure of a protofibril formed by a wild-type segment from the β2–α2 loop of the bank vole prion protein. The structure of this protofibril reveals a stabilizing network of hydrogen bonds that link polar zippers within a sheet, producing motifs we have named ‘polar clasps’.Fil: Gallagher Jones, Marcus. University of California at Los Angeles; Estados UnidosFil: Glynn, Calina. University of California at Los Angeles; Estados UnidosFil: Boyer, David R.. University of California at Los Angeles; Estados UnidosFil: Martynowycz, Michael W.. Howard Hughes Medical Institute; Estados UnidosFil: Hernandez, Evelyn. University of California at Los Angeles; Estados UnidosFil: Miao, Jennifer. University of California at Los Angeles; Estados UnidosFil: Zee, Chih Te. University of California at Los Angeles; Estados UnidosFil: Novikova, Irina V.. Pacific Northwest National Laboratory; Estados UnidosFil: Goldschmidt, Lukasz. University of California at Los Angeles; Estados UnidosFil: Mc Farlane, Heather T.. University of California at Los Angeles; Estados UnidosFil: Helguera, Gustavo Fernando. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Biología y Medicina Experimental. Fundación de Instituto de Biología y Medicina Experimental. Instituto de Biología y Medicina Experimental; ArgentinaFil: Evans, James E.. Pacific Northwest National Laboratory; Estados UnidosFil: Sawaya, Michael R.. University of California at Los Angeles; Estados UnidosFil: Cascio, Duilio. University of California at Los Angeles; Estados UnidosFil: Eisenberg, David S.. University of California at Los Angeles; Estados UnidosFil: Gonen, Tamir. Howard Hughes Medical Institute; Estados UnidosFil: Rodriguez, Jose A.. University of California at Los Angeles; Estados Unido