Two Immigrants with Tuberculosis of the Ear, Nose, and Throat Region with Skull Base and Cranial Nerve Involvement

We report two immigrants with tuberculosis of the skull base and a review of the literature. A Somalian man presented with bilateral otitis media, hearing loss, and facial and abducens palsy. Imaging showed involvement of both mastoid and petrous bones, extending via the skull base to the nasopharynx, suggesting tuberculosis which was confirmed by characteristic histology and positive auramine staining, while Ziehl-Neelsen staining and PCR were negative. A Sudanese man presented with torticollis and deviation of the uvula due to paresis of N. IX and XI. Imaging showed a retropharyngeal abscess and lysis of the clivus. Histology, acid-fast staining, and PCR were negative. Both patients had a positive Quantiferon TB Gold in-tube result and improved rapidly after empiric treatment for tuberculosis. Cultures eventually yielded M. tuberculosis. These unusual cases exemplify the many faces of tuberculosis and the importance to include tuberculosis in the differential diagnosis of unexplained problems

Objective classification of residents based on their psychomotor laparoscopic skills

Background - From the clinical point of view, it is important to recognize residents’ level of expertise with regard to basic psychomotor skills. For that reason, surgeons and surgical organizations (e.g., Acreditation Council for Graduate Medical Education, ACGME) are calling for assessment tools that credential residents as technically competent. Currently, no method is universally accepted or recommended for classifying residents as ‘‘experienced,’’ ‘‘intermediates,’’ or ‘‘novices’’ according to their technical abilities. This study introduces a classification method for recognizing residents’ level of experience in laparoscopic surgery based on psychomotor laparoscopic skills alone. Methods - For this study, 10 experienced residents (>100 laparoscopic procedures performed), 10 intermediates (10– 100 procedures performed), and 11 novices (no experience) performed four tasks in a box trainer. The movements of the laparoscopic instruments were recorded with the TrEndo tracking system and analyzed using six motion analysis parameters (MAPs). The MAPs of all participants were submitted to principal component analysis (PCA), a data reduction technique. The scores of the first principal components were used to perform linear discriminant analysis (LDA), a classification method. Performance of the LDA was examined using a leave-one-out crossvalidation. Results - Of 31 participants, 23 were classified correctly with the proposed method, with 7 categorized as experienced, 7 as intermediates, and 9 as novices. Conclusions - The proposed method provides a means to classify residents objectively as experienced, intermediate, or novice surgeons according to their basic laparoscopic skills. Due to the simplicity and generalizability of the introduced classification method, it is easy to implement in existing trainers.Biomechanical EngineeringMechanical, Maritime and Materials Engineerin

Interstellar Carbon in Translucent Sightlines

We report interstellar C II column densities or upper limits determined from weak absorption of the 2325.4029 A intersystem transition observed in six translucent sightlines with STIS. The sightlines sample a wide range of interstellar characteristics including total-to-selective extinction, R_{V} = 2.6 - 5.1; average hydrogen density along the sightline, = 3 - 14 cm^{-3}; and fraction of H in molecular form, 0 - 40%. Four of the sightlines, those toward HD 37021, HD 37061, HD 147888 and HD 207198, have interstellar gas-phase abundances that are consistent with the diffuse sightline ratio of 161 +/- 17 carbon atoms in the gas per million hydrogen nuclei. We note that while it has a gas-phase carbon abundance that is consistent with the other sightlines, a large fraction of the C II toward HD 37061 is in an excited state. The sightline toward HD 152590 has a measured interstellar gas-phase carbon abundance that is well above the diffuse sightline average; the column density of C in this sightline may be overestimated due to noise structure in the data. Toward HD 27778 we find a 3 sigma abundance upper limit of <108 C atoms in the gas per million H, a substantially enhanced depletion of C as compared to the diffuse sightline value. The interstellar characteristics toward HD 27778 are otherwise not extreme among the sample except for an unusually large abundance of CO molecules in the gas.Comment: Accepted for publication in the Astrophysical Journa

The human papillomavirus type 16 E7 oncoprotein targets Myc-interacting zinc-finger protein-1

AbstractWe demonstrate that HPV-16 E7 forms a complex with Miz-1. UV-induced expression of the CDK-inhibitor p21Cip1 and subsequent cell cycle arrest depends upon endogenous Miz-1 in HPV-negative C33A cervical cancer cells containing mutated p53. Transient expression of E7 in C33A inhibits UV-induced expression of p21Cip1 and overcomes Miz-1-induced G1-phase arrest. The C-terminal E7Δ79LEDLL83-mutant with reduced Miz-1-binding capacity was impaired in its capability to repress p21Cip1 expression; whereas the pRB-binding-deficient E7C24G-mutant inhibited p21Cip1 expression similar to wild-type E7. Using ChIP, we demonstrate that endogenous E7 is bound to the endogenous p21Cip1 core-promoter in CaSki cells and RNAi-mediated knock down of Miz-1 abrogates E7-binding to the p21Cip1 promoter. Co-expression of E7 with Miz-1 inhibited Miz-1-induced p21Cip1 expression from the minimal-promoter via Miz-1 DNA-binding sites. Co-expression of E7Δ79LEDLL83 did not inhibit Miz-1-induced p21Cip1 expression. E7C24G retained E7-wild-type capability to inhibit Miz-1-dependent transactivation. These findings suggest that HPV-16 E7 can repress Miz-1-induced p21Cip1 gene expression

Towards an Asymptotic-Safety Scenario for Chiral Yukawa Systems

We search for asymptotic safety in a Yukawa system with a chiral $U(N_L)_L\otimes U(1)_R$ symmetry, serving as a toy model for the standard-model Higgs sector. Using the functional RG as a nonperturbative tool, the leading-order derivative expansion exhibits admissible non-Ga\ssian fixed-points for $1 \leq N_L \leq 57$ which arise from a conformal threshold behavior induced by self-balanced boson-fermion fluctuations. If present in the full theory, the fixed-point would solve the triviality problem. Moreover, as one fixed point has only one relevant direction even with a reduced hierarchy problem, the Higgs mass as well as the top mass are a prediction of the theory in terms of the Higgs vacuum expectation value. In our toy model, the fixed point is destabilized at higher order due to massless Goldstone and fermion fluctuations, which are particular to our model and have no analogue in the standard model.Comment: 16 pages, 8 figure

Characterization of the nasopharyngeal and middle ear microbiota in gastroesophageal reflux-prone versus gastroesophageal reflux non-prone children

Otitis media (OM) is one of the most common pediatric infections worldwide, but the complex microbiology associated with OM is poorly understood. Previous studies have shown an association between OM and gastroesophageal reflux (GER) in children. Therefore, in order to bridge the gap in our current understanding of the interaction between GER and OM, we investigated the nasopharyngeal and middle ear microbiota of children suffering from GER-associated OM and OM only, using culture-independent 16S rRNA gene sequencing. Middle ear fluid, nasopharyngeal swabs, and clinical data were collected as part of a prospective pilot study conducted at the Department of Otorhinolaryngology of the Erasmus MC-Sophia Children’s Hospital, Rotterdam, the Netherlands. A total of 30 children up to 12 years of age who suffered from recurrent acute otitis media (AOM) (5), chronic otitis media with effusion (OME) (23), or both (2), and who were listed for tympanostomy tube placement, were included in the study. Nine children were included in the GER-associated OM cohort and 21 in the OM-only cohort. We found no obvious effect of GER on the nasopharyngeal and middle ear microbiota between the two groups of children. However, our results highlight the need to assess the true role of Alloiococcus spp. and Turicella spp. in children presenting with a high prevalence of recurrent AOM and chronic OME

The furan microsolvation blind challenge for quantum chemical methods: First steps

© 2018 Author(s). Herein we present the results of a blind challenge to quantum chemical methods in the calculation of dimerization preferences in the low temperature gas phase. The target of study was the first step of the microsolvation of furan, 2-methylfuran and 2,5-dimethylfuran with methanol. The dimers were investigated through IR spectroscopy of a supersonic jet expansion. From the measured bands, it was possible to identify a persistent hydrogen bonding OH-O motif in the predominant species. From the presence of another band, which can be attributed to an OH-π interaction, we were able to assert that the energy gap between the two types of dimers should be less than or close to 1 kJ/mol across the series. These values served as a first evaluation ruler for the 12 entries featured in the challenge. A tentative stricter evaluation of the challenge results is also carried out, combining theoretical and experimental results in order to define a smaller error bar. The process was carried out in a double-blind fashion, with both theory and experimental groups unaware of the results on the other side, with the exception of the 2,5-dimethylfuran system which was featured in an earlier publication

Reduction of peritoneal carcinomatosis by intraperitoneal administration of phospholipids in rats

<p>Abstract</p> <p>Background</p> <p>Intraperitoneal tumor cell attachment after resection of gastrointestinal cancer may lead to a developing of peritoneal carcinosis. Intraabdominal application of phospholipids shows a significant decrease of adhesion formation even in case of rising tumor cell concentration.</p> <p>Methods</p> <p>In experiment A 2*10⁶colonic tumor cells (DHD/K12/Trb) were injected intraperitonely in female BD-IX-rats. A total of 30 rats were divided into three groups with treatments of phospholipids at 6% or 9% and the control group. In experiment B a total of 100 rats were divided into ten groups with treatments of phospholipids at 9% and the control group. A rising concentration of tumor cells (10,000, 50,000, 100,000, 250,000 and 500,000) were injected intraperitonely in female BD-IX-rats of the different groups. After 30 days, the extent of peritoneal carcinosis was determined by measuring the tumor volume, the area of attachment and the Peritoneal Cancer Index (PCI).</p> <p>Results</p> <p>In experiment A, we found a significant reduction (control group: tumor volume: 12.0 ± 4.9 ml; area of tumor adhesion: 2434.4 ± 766 mm²; PCI 28.5 ± 10.0) of peritoneal dissemination according to all evaluation methods after treatment with phospholipids 6% (tumor volume: 5.2 ± 2.2 ml; area of tumor adhesion: 1106.8 ± 689 mm²; PCI 19.0 ± 5.0) and phospholipids 9% (tumor volume: 4.0 ± 3.5 ml; area of tumor adhesion: 362.7 ± 339 mm²; PCI 13.8 ± 5.1). In experiment B we found a significant reduction of tumor volume in all different groups of rising tumor cell concentration compared to the control. As detected by the area of attachment we found a significant reduction in the subgroups 1*10⁴, 25*10⁴and 50*10⁴. The reduction in the other subgroups shows no significance. The PCI could be reduced significantly in all subgroups apart from 5*10⁴.</p> <p>Conclusion</p> <p>In this animal study intraperitoneal application of phospholipids resulted in reduction of the extent of peritoneal carcinomatosis after intraperitoneal administration of free tumor cells. This effect was exceptionally noticed when the amount of intraperitoneal tumor cells was limited. Consequently, intraperitoneal administration of phospholipids might be effective in reducing peritoneal carcinomatosis after surgery of gastrointestinal tumors in humans.</p

Natural and anthropogenic forcing of Holocene lake ecosystem development at Lake Uddelermeer (The Netherlands)

The majority of water bodies in the world is affected by human impact on their catchment, and pollution of freshwater ecosystems is now considered a global problem. Palaeoecological research allows to reconstruct the natural ecosystem variability of such polluted systems, and many reconstructions that date back a few centuries or beyond inform on the natural background of polluted lakes. Only a limited number of studies have so far looked at long term (e.g. Holocene) changes in lake ecosystem status, even though human impact is known to date back for several millennia in some parts of the world. We apply a combination of classic palaeoecological proxies and novel geochemical proxies in our study of the Holocene sediments of Lake Uddelermeer (The Netherlands). Lake Uddelermeer is a shallow freshwater lake that is currently characterized by turbid conditions. These are currently thought to have resulted from increased agricultural activity in the 20th century AD, but human impact in the surroundings of this site date back to 6000 BP (late Mesolithic/ early Neolithic). We show that the lake ecosystem was characterized by a mix of aquatic macrophytes and abundant phytoplankton throughout the Early and Middle Holocene (11.5-6 cal kyr BP). A transition to a lake ecosystem with clear-water conditions and relatively high abundances of ‘isoetids’ coincides with the first signs of human impact on the landscape around Lake Uddelermeer (6000 cal yr BP). An abrupt and dramatic ecosystem shift can be seen at ~1030 cal yr BP when increases in the abundance of algal microfossils and concentrations of sedimentary pigments indicate a transition to a turbid phytoplankton-dominated state. A strong increase in concentrations of faecal biomarkers can be seen only after 1950 AD, indicating that an increased input of manure-derived material into the lake is not the initial cause for eutrophication of the system. Canonical Correspondence Analysis (CCA) suggests that reconstructed lake ecosytem changes are best explained by environmental drivers that show long-term gradual changes (sediment age, water depth). These combined results document the long-term anthropogenic impact on the ecosystem of Lake Uddelermeer and provide evidence for pre-Industrial Era signs of eutrophication