ThePlasmodiumClass XIV Myosin, MyoB, Has a Distinct Subcellular Location in Invasive and Motile Stages of the Malaria Parasite and an Unusual Light Chain

Myosin B (MyoB) is one of the two short class XIV myosins encoded in the Plasmodium genome. Class XIV myosins are characterized by a catalytic “head,” a modified “neck,” and the absence of a “tail” region. Myosin A (MyoA), the other class XIV myosin in Plasmodium, has been established as a component of the glideosome complex important in motility and cell invasion, but MyoB is not well characterized. We analyzed the properties of MyoB using three parasite species as follows: Plasmodium falciparum, Plasmodium berghei, and Plasmodium knowlesi. MyoB is expressed in all invasive stages (merozoites, ookinetes, and sporozoites) of the life cycle, and the protein is found in a discrete apical location in these polarized cells. In P. falciparum, MyoB is synthesized very late in schizogony/merogony, and its location in merozoites is distinct from, and anterior to, that of a range of known proteins present in the rhoptries, rhoptry neck or micronemes. Unlike MyoA, MyoB is not associated with glideosome complex proteins, including the MyoA light chain, myosin A tail domain-interacting protein (MTIP). A unique MyoB light chain (MLC-B) was identified that contains a calmodulin-like domain at the C terminus and an extended N-terminal region. MLC-B localizes to the same extreme apical pole in the cell as MyoB, and the two proteins form a complex. We propose that MLC-B is a MyoB-specific light chain, and for the short class XIV myosins that lack a tail region, the atypical myosin light chains may fulfill that role

Rehabilitation versus surgical reconstruction for non-acute anterior cruciate ligament injury (ACL SNNAP): a pragmatic randomised controlled trial

BackgroundAnterior cruciate ligament (ACL) rupture is a common debilitating injury that can cause instability of the knee. We aimed to investigate the best management strategy between reconstructive surgery and non-surgical treatment for patients with a non-acute ACL injury and persistent symptoms of instability.MethodsWe did a pragmatic, multicentre, superiority, randomised controlled trial in 29 secondary care National Health Service orthopaedic units in the UK. Patients with symptomatic knee problems (instability) consistent with an ACL injury were eligible. We excluded patients with meniscal pathology with characteristics that indicate immediate surgery. Patients were randomly assigned (1:1) by computer to either surgery (reconstruction) or rehabilitation (physiotherapy but with subsequent reconstruction permitted if instability persisted after treatment), stratified by site and baseline Knee Injury and Osteoarthritis Outcome Score—4 domain version (KOOS4). This management design represented normal practice. The primary outcome was KOOS4 at 18 months after randomisation. The principal analyses were intention-to-treat based, with KOOS4 results analysed using linear regression. This trial is registered with ISRCTN, ISRCTN10110685, and ClinicalTrials.gov, NCT02980367.FindingsBetween Feb 1, 2017, and April 12, 2020, we recruited 316 patients. 156 (49%) participants were randomly assigned to the surgical reconstruction group and 160 (51%) to the rehabilitation group. Mean KOOS4 at 18 months was 73·0 (SD 18·3) in the surgical group and 64·6 (21·6) in the rehabilitation group. The adjusted mean difference was 7·9 (95% CI 2·5–13·2; p=0·0053) in favour of surgical management. 65 (41%) of 160 patients allocated to rehabilitation underwent subsequent surgery according to protocol within 18 months. 43 (28%) of 156 patients allocated to surgery did not receive their allocated treatment. We found no differences between groups in the proportion of intervention-related complications.InterpretationSurgical reconstruction as a management strategy for patients with non-acute ACL injury with persistent symptoms of instability was clinically superior and more cost-effective in comparison with rehabilitation management

Factors Associated with Revision Surgery after Internal Fixation of Hip Fractures

Background: Femoral neck fractures are associated with high rates of revision surgery after management with internal fixation. Using data from the Fixation using Alternative Implants for the Treatment of Hip fractures (FAITH) trial evaluating methods of internal fixation in patients with femoral neck fractures, we investigated associations between baseline and surgical factors and the need for revision surgery to promote healing, relieve pain, treat infection or improve function over 24 months postsurgery. Additionally, we investigated factors associated with (1) hardware removal and (2) implant exchange from cancellous screws (CS) or sliding hip screw (SHS) to total hip arthroplasty, hemiarthroplasty, or another internal fixation device. Methods: We identified 15 potential factors a priori that may be associated with revision surgery, 7 with hardware removal, and 14 with implant exchange. We used multivariable Cox proportional hazards analyses in our investigation. Results: Factors associated with increased risk of revision surgery included: female sex, [hazard ratio (HR) 1.79, 95% confidence interval (CI) 1.25-2.50; P = 0.001], higher body mass index (fo

Acid-base status in patients diseased with COVID-19

Pretrage ABS-a i povezanih mjerenja pripadaju prvoj skupini dijagnostičkih postupaka kod hitnih stanja, a na temelju nalaza se donose neodgodive kliničke odluke za procjenu i praćenje stanja svih kritično oboljelih pacijenata, tako i oboljelih od COVID-19. Nalaz arterijske krvi, uzorkovan uz krevet bolesnika, pruža uvid u točnu procjenu izmjene plinova i oksigenacijskog statusa, što je od izrazite važnosti kod liječenja COVID pozitivnih bolesnika s težim oblicima bolesti. Ta pretraga predstavlja brz, dostupan i jeftin dijagnostički postupak koji omogućuje žurno donošenje terapijskih odluka i intervencija. U organizmu sudjeluju tri glavna sustava za kontrolu koncentracije vodikovih iona u tjelesnim tekućinama - puferski sustav, bubrežni mehanizmi i respiracijski mehanizmi. Ispitivanje acidobazne ravnoteže izravno ukazuje na vrstu nastalog poremećaja u organizmu kao što su metabolička i respiratorna alkaloza, odnosno metabolička i respiratorna acidoza. Istraživanja pokazuju da se kod pacijenata oboljelih od COVID-19 bilježe sve vrste metaboličkih poremećaja, s metaboličkom i respiratornom alkalozom među najzastupljenijim slučajevima, što je potvrđeno i istraživanjem u sklopu rada provedenog u OB Pula na COVID 1 odjelu. Uloga medicinske sestre usmjerena je prema uočavanju znakova i simptoma metaboličkih poremećaja, pravilnoj pripremi pacijenta za uzorkovanje krvi, pravilnoj tehnici uzorkovanja krvi, ispravnom rukovanju uzorkom i POCT aparatom za analizu krvi, kao i pravovremenom uočavanju mogućih komplikacija i nuspojava vađenja arterijske krvi. Važnu zadaću predstavlja i usvajanje bazičnih znanja o interpretaciji nalaza koje može doprinijeti brzini donošenja odluka o postupku liječenjaABG, arterial blood gases test and related measurements belong to the first group of diagnostic tools especially in treating criticly ill patients, based on the results, immediate clinical decisions are made to assess and monitor the condition of all critically ill among which are also COVID-19 patients. POCT provides an insight into the accurate assessment of gas exchange and oxygenation status of patients, which is extremely important in the treatment of COVID positive patients with more severe forms of the disease. Testing is a fast, accessible and inexpensive. The body has a wide array of mechanisms to maintain homeostasis controlling the concentration of hydrogen ions in body fluids. The main 3 are: buffer system, renal mechanisms and respiratory mechanisms. Analizing the acid-base balance directly indicates what type of disorder may be happening in the body, such as metabolic and respiratory alkalosis, as well as metabolic and respiratory acidosis. Studies show that in patients with COVID-19 disease, all types of metabolic disorders have been reported, with metabolic and respiratory alkalosis being among the most common cases, which was also confirmed by a study conducted in the hospital in Pula at the COVID 1 department. Nurse's role is aimed towards recognizing signs and symptoms of metabolic disorders, preparing the patient before drawing blood, an adequate technique of blood sampling, correct transport of the blood sample and using of a POCT device for blood analysis, asessment of possible complications and side effects of arterial blood sampling. It's also important to acquire basic knowledge on the interpretation of the findings, which can positively affect the speed of decidion making when it comes to medical procedures

Amber inclusions from New Zealand

Terrestrial ecosystems of the long-isolated former Gondwanan landmass of New Zealand are hotspots of modern global biodiversity, based on the level of endemism and distinctiveness of the biota. However, little is known of the evolutionary history of the rarely preserved but diverse, distinctive, fragile, mainly soft-bodied organisms such as arthropods and fungi that comprise 95% of biodiversity in forest ecosystems. Our discovery of fossils preserved in Oligocene/Miocene amber of araucarian origin reveals a diverse invertebrate and fungal biota and complex ecological networks. These fossils comprise 10 orders and approximately 20 families of terrestrial arthropods and include representatives of Pseudoscorpiones, Acari, Araneae, Collembola, Hemiptera, Psocoptera, Hymenoptera, Coleoptera, Lepidoptera and Diptera, together with nematodes, mold fungi and araucarian wood. Ecologically the fossils encompass predators such as spiders with web remains, soil and bark mites, detritivores, parasites, fungivores and decomposers, fungi that grew on solidified resin flows, as well as predatory fungi. This study reports the first major amber deposit with an abundance of biological inclusions from the Southern Hemisphere and the only Cenozoic one of verified araucarian origin. These fossils expand the global record and evolutionary history of many arthropod and fungal groups, providing insights into mid-Cenozoic araucarian forest ecosystems and resolving controversial issues around the antecedents of the modem New Zealand terrestrial biota. (C) 2017 International Association for Gondwana Research. Published by Elsevier B.V. All rights reserved.Peer reviewe

Ice Giant Systems: The scientific potential of orbital missions to Uranus and Neptune

This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain

Ice Giant Systems: The Scientific Potential of Missions to the Uranus and Neptune Systems (ESA Voyage 2050 White Paper)

Uranus and Neptune, and their diverse satellite and ring systems, represent the least explored environments of our Solar System, and yet may provide the archetype for the most common outcome of planetary formation throughout our galaxy. Ice Giants are the last remaining class of planet in our system to have a dedicated orbital mission. This white paper describes how such a mission could explore their origins, ice-rich interiors, dynamic atmospheres, unique magnetospheres, and myriad icy satellites, to address questions at the very heart of modern planetary science. These two worlds are superb examples of how planets with shared origins can exhibit remarkably different evolutionary paths: Neptune as the archetype for Ice Giants, Uranus as the oddball. Exploring Uranus' natural satellites and Neptune's captured moon Triton could reveal how Ocean Worlds form and remain active, redefining the extent of the habitable zone in our Solar System. For these reasons and more, we propose that an Ice Giant System mission should become a strategic cornerstone spacecraft for ESA in the Voyage 2050 programme