Actinomycosis may be presented in unusual organs: A report of two cases

Actinomycosis is a chronic granulomatous suppurative disease characterized by direct extension to the contagious tissue with the formation of multiple drainage sinus tracts through which tiny colonies of organisms called sulfur granules are discharged. Here, we report 2 cases of actinomycosis from Iran. One of them had actinomycosis on the hand and the other on the foot. Samples of tissue biopsy showed sulfur granules associated with colonies of actinomyces, thus confirming the diagnosis in both cases. The response to curettage and penicillin therapy was satisfactory in our patients. The chronic and indolent course of actinomycosis resembles tuberculosis, fungal infection and malignancy. So, increasing awareness among the clinicians and clinical microbiologists will help in the early diagnosis of the disease and in the initiation of early and proper treatment

A cost benefit analysis of retrofitting public policies on Atlanta residential housing

The residential building sector has a major share in carbon emission and energy consumption. In the US, around 60% of the housing stock belongs to the owner-occupied sector. Since more than half of the existing building stock was built before the modern energy efficiency standards are taken place, there is a potential to reduce the energy consumption and greenhouse gas emissions in this sector, only by retrofitting the existing buildings. However, this goal cannot be achieved without a larger scale Cost Benefit Analysis (CBA) to develop and demonstrate market ready retrofit solutions/policies from both the government and the homeowner’s standings. To this extend, the aim of the presented paper is to conduct a city-level CBA on the city of Atlanta which ranked 5th in producing GHG emissions among 100 US metropolitan areas while residential buildings sector is ranked 4th among other contributing sectors. To this end, a hypothetical public policy of retrofitting single-family residential buildings built before 1970s is proposed with the objective of reducing the regional energy consumption rate while calculating the upper bound of the tax to be proposed on the properties rejecting to renovate. The preliminary results of this CBA revealed that although retrofitting all the prior 1970s buildings won’t be beneficial comparing to the status quo, the numbers are highly sensitive to the proposed discount rate as well as the percentage of the homeowners practically decide to retrofit. The sensitivity analysis showed that if only 30-40% of participants decided not to renovate and pay the tax, the CBA could be a positive Net Present Value (NPV) with a relatively low tax rate (less than $0.5/sqft) implementation. Therefore, it is recommended to more accurately study the reaction of the homeowners to the policy before implementing the tax/subsidy rates while precisely observe the fluctuations of the market discount rate

FTIR microspectroscopy reveals chemical changes in mice fetus following Phenobarbital administration

Phenobarbital is a phenobarbiturate used as a sedative, anticonvulsant or hypnotic with the doses prescribed and can cause teratogenic effects. The goal of this study was to examine an alternative method for the recognition of the mechanism or the bimolecular potential changes in mice fetus caused by Phenobarbital using FTIR micro spectroscopy. The mice were injected with Phenobarbital (120 mg/Kg) on gestation day 9. Fetuses were dissected on day 15 of gestation and morphological and histological studies on the fetus were carried out. Sections (10 μm) of normal and Phenobarbital treated fetus brains and livers were used for FTIR measurement in the wave number region of 400- 4000 cm. The results were shown by 2 derivatization of spectra and also subtracting from control spectra. In liver, the intensity at 1054 cm, 1155 cm, 1353 cm, 1453cm,1645 cm, 1622 cm, 2944 cm, 2913 cm and 2845 cm were shifted and increased. In the brain, the intensity at 879 cm, 911 cm, 955 cm, 1223 cm, 1256 cm, 1304 cm, 1360 cm, 1453 cm, 1529 cm, 1636 cm, 2845 cm, 2915 cm and 2950 cm were increased and shifted. The most important changes of the fetus brain tissue are on the β structure of proteins due to the amide I bands at 1636 cm, while extensive effects on the DNA structure were obvious for the Phenobarbital treated liver tissues. As a conclusion, FTIR spectroscopy might well be assumed as a potentially powerful teratogenic measurement instrument with a unique ability to identify the modified bimolecular structures. © 2015 by School of Pharmacy Shaheed Beheshti University of Medical Sciences and Health Services

Long-term changes of prostacyclin secretion in radiation-induced myelopathy

Background: We have previously reported the short-term changes in prostacyclin profile after irradiation of rat cervical cord. Aim: Present research investigated the long-term changes of prostacyclin content. Materials/Methods: Wistar rats in groups of five were irradiated with doses of 2, 4, 6, 15, 25, 30Gy and a single group of 25 with 35Gy X-rays. After 26 and 39 weeks, prostacyclin content was quantified by 6-keto-prostaglandin-F1α (prostacyclin stabilized metabolite) . Specimens were stained routinely for histological studies. Results: The 50 latent period and effective dose were 14.86±1.16 weeks and 25.66±0.54Gy (p<0.0001), respectively. Average ratios of 6-keto-PG-F1α for doses of 2-30Gy were between 78.33-12.93 and 79.48-99.96 for 26 and 39 weeks, respectively. Prostacyclin level after 35Gy shows approximately a 7:1 ratio in comparison to the control group (p<0.002). Histopathological changes in glial and vascular tissues were diagnosed and scored. Prostacyclin bimodal profile was observed. Conclusions: Radiation can cause complex fluctuations of prostacyclin in association with marked histopathological changes

Water quality index for the Skudai River and its tributaries for identifying the problematic areas for better watershed management

It is very important to develop a rehabilitation plan for the watersheds that have been degraded because of increased development activities and high urbanization. Identifying the most vulnerable parts of a watershed is challenging and can be done if water quality in the river was determined in different sections from the upstream to the downstream of a watershed. In this study, we delineated the Skudai River watershed into 25 sub-watersheds using ArcGIS technique. Later, we identified tributaries in each sub-watershed. The subwatersheds were grouped into three main categories, i.e. natural, semi-urban, and urban subwatersheds depending on land use patterns. Water quality samples were collected at different tributaries from all three categories of sub-watersheds. The paper presents water quality analysis results. The Skudai River (natural part) was classified into natural sub-watershed as this sub-watershed was dominated with natural forest. The Senai and Kempas rivers were classified into sub-urban watersheds while Melana and Danga rivers were classified into urban watersheds. The water quality index (WQI) for the Skudai River (Natural) was 95.2 and falls in Class I category, i.e. clean. The Senai River had WQI of 84.5 and Class II category, i.e. slightly polluted. However, Kempas River which was also in the sub-urban watershed had calculated WQI of 54.5, in Class III and polluted. Melana River was also polluted river with WQI of 68.8 (Class III). The Danga River was also polluted river with WQI value as 55.2. Water quality in the direction of flow in the Skudai River was deteriorating because of some local pollutants entry on the way

Effects of Zoledronate and Mechanical Loading during Simulated Weightlessness on Bone Structure and Mechanical Properties

Space flight modulates bone remodeling to favor bone resorption. Current countermeasures include an anti-resorptive drug class, bisphosphonates (BP), and high-force loading regimens. Does the combination of anti-resorptives and high-force exercise during weightlessness have negative effects on the mechanical and structural properties of bone? In this study, we implemented an integrated model to mimic mechanical strain of exercise via cyclical loading (CL) in mice treated with the BP Zoledronate (ZOL) combined with hindlimb unloading (HU). Our working hypothesis is that CL combined with ZOL in the HU model induces additive structural and mechanical changes. Thirty-two C57BL6 mice (male,16 weeks old, n8group) were exposed to 3 weeks of either HU or normal ambulation (NA). Cohorts of mice received one subcutaneous injection of ZOL (45gkg), or saline vehicle, prior to experiment. The right tibia was axially loaded in vivo, 60xday to 9N in compression, repeated 3xweek during HU. During the application of compression, secant stiffness (SEC), a linear estimate of slope of the force displacement curve from rest (0.5N) to max load (9.0N), was calculated for each cycle once per week. Ex vivo CT was conducted on all subjects. For ex vivo mechanical properties, non-CL left femurs underwent 3-point bending. In the proximal tibial metaphysis, HU decreased, CL increased, and ZOL increased the cancellous bone volume to total volume ratio by -26, +21, and +33, respectively. Similar trends held for trabecular thickness and number. Ex vivo left femur mechanical properties revealed HU decreased stiffness (-37),and ZOL mitigated the HU stiffness losses (+78). Data on the ex vivo Ultimate Force followed similar trends. After 3 weeks, HU decreased in vivo SEC (-16). The combination of CL+HU appeared additive in bone structure and mechanical properties. However, when HU + CL + ZOL were combined, ZOL had no additional effect (p0.05) on in vivo SEC. Structural data followed this trend with ZOL not modulating trabecular thickness in CL + NAHU mice. In summary, our integrated model simulates the combination of weightlessness, exercise-induced mechanical strain, and anti-resorptive treatment that astronauts experience during space missions. Based on these results, we conclude that, at the structural and stiffness level, zoledronate treatment during simulated spaceflight does not impede the skeletal response to axial compression. In contrast to our hypothesis, our data show that zoledronate confers no additional mechanical or structural benefit beyond those gained from cyclical loading

The role of aspirin in prevention of preeclampsia in twin pregnancies: Does the dose matter?

OBJECTIVE: The aspirin use in twin pregnancies for prevention of preeclampsia is a controversial topic and the evidence on the required dose of aspirin is scarce. We aimed to assess the efficacy of 75mg/day versus 150mg/day aspirin for prevention of preeclampsia in twin pregnancies. STUDY DESIGN: This is a retrospective cohort study of twin pregnancies managed at St. George's University Hospital between 2012 and 2019. The National Institute for Health and Care Excellence (NICE) guideline published in 2010 has recommended low-dose aspirin to women at high risk of preeclampsia.1 Monochorionic and dichorionic twin pregnancies were included in the cohort. Pregnancies between 2010 and 2012 were excluded to ensure thorough implementation of national guideline. High-order multi-fetal gestations and pregnancies complicated by fetal anomalies were also excluded. Twin pregnancies with any of these risk factors (hypertension in a previous pregnancy, chronic hypertension, renal disease, autoimmune disorder, diabetes, nulliparity, maternal age >40 years, pregnancy interval >10years, body mass index >35kg/m2 or family history of preeclampsia) as per NICE guideline were started on aspirin1. The aspirin dose was changed from 75mg/day to 150mg/day after 2017, following reports of effective prevention of preeclampsia using aspirin 150mg/day.2-4 The main outcome was preeclampsia diagnosed according to International Society for the Study of Hypertension in Pregnancy guideline.5 Hypertensive disorders of pregnancy (HDP) included preeclampsia or gestational hypertension. RESULTS: There were 630 pregnancies in the cohort; 404 received aspirin (108 received 150mg/day and 296 received 75mg/day), while 226 did not. There were 28 (4.4%) cases of preeclampsia and 47 (7.5%) cases of HDP in the cohort. No significant differences in maternal age (P=0.510), nulliparity (P = 0.945), chorionicity (P=0.700) were observed between 75mg/day and 150mg/day aspirin groups. The incidence of preeclampsia was similar between aspirin 150mg/day and no aspirin groups (1.8% vs. 3.1%, P=0.510). However, there was a trend towards a significant decrease in preeclampsia in those receiving aspirin 150mg/day compared to 75mg/day (1.8% vs 6.4%, P=0.067). There were no statistically significant differences between aspirin 150mg/day and no aspirin groups regarding the incidence of HDP (1.8% vs 5.3%, P =0.140), but the incidence of HDP was significantly lower in aspirin 150mg/day group compared to 75mg/day (1.8% vs 11.1%, P =0.003) (Figure 1). The incidence of HDP was significantly higher in aspirin 75mg/day group compared to no aspirin (11.1%% vs 5.3%, P=0.018). We investigated the association of aspirin dose with HDP in a multivariable logistic regression model after adjusting for maternal age in years, chorionicity, and smoking during pregnancy. The reference group was the low-risk twin pregnancies who did not receive aspirin. The direction of the association changed from a significant increase in HDP (odds ratio: 2.01, 95% confidence interval: 1.03-4.18, P=0.048) to a non-significant decrease (odds ratio: 0.31, 95% confidence interval: 0.05-1.16, P =0.127) when the aspirin dose was increased from 75mg/day to 150mg/day. CONCLUSION: The incidence of hypertensive disorders in twin pregnancies with additional risk factors for preeclampsia was significantly lower in those receiving aspirin 150mg/day compared to 75mg/day

CSNL: A cost-sensitive non-linear decision tree algorithm

This article presents a new decision tree learning algorithm called CSNL that induces Cost-Sensitive Non-Linear decision trees. The algorithm is based on the hypothesis that nonlinear decision nodes provide a better basis than axis-parallel decision nodes and utilizes discriminant analysis to construct nonlinear decision trees that take account of costs of misclassification. The performance of the algorithm is evaluated by applying it to seventeen datasets and the results are compared with those obtained by two well known cost-sensitive algorithms, ICET and MetaCost, which generate multiple trees to obtain some of the best results to date. The results show that CSNL performs at least as well, if not better than these algorithms, in more than twelve of the datasets and is considerably faster. The use of bagging with CSNL further enhances its performance showing the significant benefits of using nonlinear decision nodes. The performance of the algorithm is evaluated by applying it to seventeen data sets and the results are compared with those obtained by two well known cost-sensitive algorithms, ICET and MetaCost, which generate multiple trees to obtain some of the best results to date. The results show that CSNL performs at least as well, if not better than these algorithms, in more than twelve of the data sets and is considerably faster. The use of bagging with CSNL further enhances its performance showing the significant benefits of using non-linear decision nodes

Ionizing Radiation Affects Gene Expression in Mouse Skin and Bone

Future long-duration space exploration beyond low earth orbit will increase human exposure to space radiation and microgravity conditions as well as associated risks to skeletal health. In animal studies, radiation exposure (greater than 1 Gy) is associated with pathological changes in bone structure, enhanced bone resorption, reduced bone formation and decreased bone mineral density, which can lead to skeletal fragility. Definitive measurements and detection of bone loss typically require large and specialized equipment which can make their application to long duration space missions logistically challenging. Towards the goal of developing non-invasive and less complicated monitoring methods to predict astronauts' health during spaceflight, we examined whether radiation induced gene expression changes in skin may be predictive of the responses of skeletal tissue to radiation exposure. We examined oxidative stress and growth arrest pathways in mouse skin and long bones by measuring gene expression levels via quantitative polymerase chain reaction (qPCR) after exposure to total body irradiation (IR). To investigate the effects of irradiation on gene expression, we used skin and femora (cortical shaft) from the following treatment groups: control (normally loaded, sham-irradiated), and IR (0.5 Gy 56Fe 600 MeV/n and 0.5 Gy 1H 150 MeV/n), euthanized at one and 11 days post-irradiation (IR). To determine the extent of bone loss, tibiae were harvested and cancellous microarchitecture in the proximal tibia quantified ex vivo using microcomputed tomography (microCT). Statistical analysis was performed using Student's t-test. At one day post-IR, expression of FGF18 in skin was significantly greater (3.8X) than sham-irradiated controls, but did not differ at 11 days post IR. Expression levels of other genes associated with antioxidant response (Nfe2l2, FoxO3 and Sod1) and the cell cycle (Trp53, Cdkn1a, Gadd45g) did not significantly differ between the control and IR groups at either time point. Radiation exposure resulted in a 27.0% increase in FGF18-positive hair follicles at one day post-IR and returned to basal levels at 11 days post-IR. A similar trend was observed from FGF18 gene expression analysis of skin. In bone (femora), there was an increase in the expression of the pro-osteoclastogenic cytokine, MCP-1, one day after IR compared to non-irradiated controls. FGF18 expression in skin and MCP- 1 expression in bone were found to be positively correlated (P less than 0.002, r=0.8779). Further, microcomputed tomography analysis of tibia from these animals showed reduced cancellous bone volume (-9.9%) at 11 days post- IR. These results suggest that measurements of early radiation induced changes in FGF18 gene expression in skin may have value for predicting subsequent loss of cancellous bone mass. Further research may lead to the development of a relatively simple diagnostic tool for bone loss, with the advantage that hair follicles and skin are relatively easy to acquire from human subjects