The use of drug calendars for the diagnosis of cutaneous drug eruptions in the age of electronic medical records

A morbilliform drug eruption is the most common condition leading to a dermatology consultation for a patient in the hospital. Timing is an important diagnostic tool since the onset of a skin rash usually takes place within days-to-weeks of the start of the implicated drug. A comprehensive, thorough, and reliable drug history by the clinician is essential. Therefore, to assist in the task of determining the causative medication of a new skin rash in a hospitalized patient, the creation of a drug calendar is recommended. The development of an electronic version of the drug calendar offers several benefits over the manual version. As the use of electronic medical records continues to become the standard in medicine, the electronic drug calendar will serve as an invaluable tool for the diagnosis of drug hypersensitivity

Herpetic zoster folliculitis in the immunocompromised host

Introduction Exclusive involvement of herpes zoster (HZ) in the follicular epithelium occurs rarely and lacks the typical cutaneous and histopathologic findings associated with herpesvirus. We describe a patient who underwent adjuvant chemotherapy for pancreatic cancer and subsequently had a nonvesicular rash for several weeks, ultimately proving to be herpetic zoster folliculitis. Case report A 78-year-old man with adenocarcinoma of the tail of the pancreas treated with surgical resection and 1 round of adjuvant chemotherapy with gemcitabine, docetaxel, and capecitabine presented with a 3-week history of a right leg rash. He first noticed the rash 5 days after the initiation of his chemotherapy. It initially appeared on his middorsal foot, and over the next couple weeks progressed proximally along the anteromedial leg to the distal knee and medial thigh. It was not painful and was minimally pruritic. Two and a half weeks after the onset of his rash, a fever to 38.5°C developed along with back pain. At this time, he had a nondiagnostic skin biopsy by an outside dermatologist and was given diphenhydramine and topical hydrocortisone with no improvement in his rash. He also had an abdominal computed tomography (CT) performed at an outside hospital, which found a left upper quadrant fluid collection. He was subsequently admitted to Columbia Presbyterian Medical Center for evaluation. On our examination, he had purpuric patches and edematous, purpuric papules along the right dorsal foot, extending proximally up the right anteromedial leg (Fig 1). He also had a few faint pink papules along the right hip and superior buttock (Fig 2). There were no vesicles. A comprehensive metabolic panel and liver function test results were normal. Noted were a leukocytosis level of 14,400/μL with 76% neutrophils and 1% bands, an elevated lipase level of 194 U/L (3-43 U/L), and an amylase level of 95 U/L (20-96 U/L). A CT scan of the abdomen confirmed an 8.0- × 7.0-cm fluid collection of the left upper quadrant of the abdomen. A skin biopsy of the right anteromedial leg found only alteration of the basal layer epidermis with a perivascular mononuclear cell infiltrate and extravasated erythrocytes. However, deeper sections had necrotic keratinocytes and multinucleated epithelial-type giant cells with ground-glass nuclei restricted to the follicular epithelium, confirming a diagnosis of follicular herpetic infection (Fig 3, A and B). A diagnosis of HZ in the L4 and L5 dermatomes was made, and the eruption promptly resolved with a 7-day course of valganciclovir (1-g tablet 3 times a day)

Resolution of urticarial vasculitis after treatment of neurocysticercosis

Urticarial vasculitis is most often idiopathic, but may occur in association with autoimmune disease, malignancy, drugs, or infection. Parasitic infection is a rare cause of urticarial vasculitis. We report a case of urticarial vasculitis that resolved after the diagnosis and treatment of neurocysticercosis

Supersymmetric Froggatt-Nielsen Models with Baryon- and Lepton-Number Violation

We systematically investigate the embedding of U(1)_X Froggatt-Nielsen models in (four-dimensional) local supersymmetry. We restrict ourselves to models with a single flavon field. We do not impose a discrete symmetry by hand, e.g. R-parity, baryon-parity or lepton-parity. Thus we determine the order of magnitude of the baryon- and/or lepton violating coupling constants through the Froggatt-Nielsen mechanism. We then scrutinize whether the predicted coupling constants are in accord with weak or GUT scale constraints. Many models turn out to be incompatible.Comment: Final version, references added, minor corrections; LaTeX, 46 page

BioTIME: A database of biodiversity time series for the Anthropocene.

MotivationThe BioTIME database contains raw data on species identities and abundances in ecological assemblages through time. These data enable users to calculate temporal trends in biodiversity within and amongst assemblages using a broad range of metrics. BioTIME is being developed as a community-led open-source database of biodiversity time series. Our goal is to accelerate and facilitate quantitative analysis of temporal patterns of biodiversity in the Anthropocene.Main types of variables includedThe database contains 8,777,413 species abundance records, from assemblages consistently sampled for a minimum of 2 years, which need not necessarily be consecutive. In addition, the database contains metadata relating to sampling methodology and contextual information about each record.Spatial location and grainBioTIME is a global database of 547,161 unique sampling locations spanning the marine, freshwater and terrestrial realms. Grain size varies across datasets from 0.0000000158 km2 (158 cm2) to 100 km2 (1,000,000,000,000 cm2).Time period and grainBioTIME records span from 1874 to 2016. The minimal temporal grain across all datasets in BioTIME is a year.Major taxa and level of measurementBioTIME includes data from 44,440 species across the plant and animal kingdoms, ranging from plants, plankton and terrestrial invertebrates to small and large vertebrates.Software format.csv and .SQL

The \u3cem\u3eChlamydomonas\u3c/em\u3e Genome Reveals the Evolution of Key Animal and Plant Functions

Chlamydomonas reinhardtii is a unicellular green alga whose lineage diverged from land plants over 1 billion years ago. It is a model system for studying chloroplast-based photosynthesis, as well as the structure, assembly, and function of eukaryotic flagella (cilia), which were inherited from the common ancestor of plants and animals, but lost in land plants. We sequenced the ∼120-megabase nuclear genome of Chlamydomonas and performed comparative phylogenomic analyses, identifying genes encoding uncharacterized proteins that are likely associated with the function and biogenesis of chloroplasts or eukaryotic flagella. Analyses of the Chlamydomonas genome advance our understanding of the ancestral eukaryotic cell, reveal previously unknown genes associated with photosynthetic and flagellar functions, and establish links between ciliopathy and the composition and function of flagella

Unifying generative and discriminative learning principles

<p>Abstract</p> <p>Background</p> <p>The recognition of functional binding sites in genomic DNA remains one of the fundamental challenges of genome research. During the last decades, a plethora of different and well-adapted models has been developed, but only little attention has been payed to the development of different and similarly well-adapted learning principles. Only recently it was noticed that discriminative learning principles can be superior over generative ones in diverse bioinformatics applications, too.</p> <p>Results</p> <p>Here, we propose a generalization of generative and discriminative learning principles containing the maximum likelihood, maximum a posteriori, maximum conditional likelihood, maximum supervised posterior, generative-discriminative trade-off, and penalized generative-discriminative trade-off learning principles as special cases, and we illustrate its efficacy for the recognition of vertebrate transcription factor binding sites.</p> <p>Conclusions</p> <p>We find that the proposed learning principle helps to improve the recognition of transcription factor binding sites, enabling better computational approaches for extracting as much information as possible from valuable wet-lab data. We make all implementations available in the open-source library Jstacs so that this learning principle can be easily applied to other classification problems in the field of genome and epigenome analysis.</p

Midwall Fibrosis Is an Independent Predictor of Mortality in Patients With Aortic Stenosis

ObjectivesThe goal of this study was to assess the prognostic significance of midwall and infarct patterns of late gadolinium enhancement (LGE) in aortic stenosis.BackgroundMyocardial fibrosis occurs in aortic stenosis as part of the hypertrophic response. It can be detected by LGE, which is associated with an adverse prognosis in a range of other cardiac conditions.MethodsBetween January 2003 and October 2008, consecutive patients with moderate or severe aortic stenosis undergoing cardiovascular magnetic resonance with administration of gadolinium contrast were enrolled into a registry. Patients were categorized into absent, midwall, or infarct patterns of LGE by blinded independent observers. Patient follow-up was completed using patient questionnaires, source record data, and the National Strategic Tracing Service.ResultsA total of 143 patients (age 68 ± 14 years; 97 male) were followed up for 2.0 ± 1.4 years. Seventy-two underwent aortic valve replacement, and 27 died (24 cardiac, 3 sudden cardiac deaths). Compared with those with no LGE (n = 49), univariate analysis revealed that patients with midwall fibrosis (n = 54) had an 8-fold increase in all-cause mortality despite similar aortic stenosis severity and coronary artery disease burden. Patients with an infarct pattern (n = 40) had a 6-fold increase. Midwall fibrosis (hazard ratio: 5.35; 95% confidence interval: 1.16 to 24.56; p = 0.03) and ejection fraction (hazard ratio: 0.96; 95% confidence interval: 0.94 to 0.99; p = 0.01) were independent predictors of all-cause mortality by multivariate analysis.ConclusionsMidwall fibrosis was an independent predictor of mortality in patients with moderate and severe aortic stenosis. It has incremental prognostic value to ejection fraction and may provide a useful method of risk stratification. (The Prognostic Significance of Fibrosis Detection in Cardiomyopathy; NCT00930735

The HOXB4 Homeoprotein Promotes the Ex Vivo Enrichment of Functional Human Embryonic Stem Cell-Derived NK Cells

Human embryonic stem cells (hESCs) can be induced to differentiate into blood cells using either co-culture with stromal cells or following human embryoid bodies (hEBs) formation. It is now well established that the HOXB4 homeoprotein promotes the expansion of human adult hematopoietic stem cells (HSCs) but also myeloid and lymphoid progenitors. However, the role of HOXB4 in the development of hematopoietic cells from hESCs and particularly in the generation of hESC-derived NK-progenitor cells remains elusive. Based on the ability of HOXB4 to passively enter hematopoietic cells in a system that comprises a co-culture with the MS-5/SP-HOXB4 stromal cells, we provide evidence that HOXB4 delivery promotes the enrichment of hEB-derived precursors that could differentiate into fully mature and functional NK. These hEB-derived NK cells enriched by HOXB4 were characterized according to their CMH class I receptor expression, their cytotoxic arsenal, their expression of IFNγ and CD107a after stimulation and their lytic activity. Furthermore our study provides new insights into the gene expression profile of hEB-derived cells exposed to HOXB4 and shows the emergence of CD34+CD45RA+ precursors from hEBs indicating the lymphoid specification of hESC-derived hematopoietic precursors. Altogether, our results outline the effects of HOXB4 in combination with stromal cells in the development of NK cells from hESCs and suggest the potential use of HOXB4 protein for NK-cell enrichment from pluripotent stem cells