Beneficial effect of ustekinumab in familial pityriasis rubra pilaris with a new missense mutation in CARD14

Pityriasis rubra pilaris (PRP) represents a group of rare chronic inflammatory skin disorders in which ~1 in 20 affected individuals show autosomal dominant inheritance. In such cases, there may be gain-of-function mutations in CARD14, encoding caspase recruitment domain-containing protein 14 (CARD14) that activates the non-canonical nuclear factor-kappa B (NF-κB) pathway, thereby promoting cutaneous inflammation. Here, we report a mother and son with PRP due to a new missense mutation in CARD14 and describe the beneficial clinical effects of ustekinumab, a monoclonal antibody against interleukins-12 and -23, in both subjects. A 49 year-old female and her 20 year-old son had lifelong, generalised, patchy erythematous scale with a few islands of sparing, as well as minor nail ridging and mild palmoplantar keratoderma, features consistent with generalised PRP. Topical steroids, phototherapy and oral retinoids proved ineffective therapies. Following informed consent, Sanger sequencing of CARD14 in both individuals revealed a new heterozygous single nucleotide transversion in exon 16, c.356T>G, resulting in the missense mutation, p.Met119Arg. Ustekinumab, at a dose of 45mg every 12 weeks, brought about a significant physical and emotional improvement in both the mother and son within a few days of the initial dose, which was sustained on maintenance dosing. This report highlights the therapeutic potential of biologics that downregulate NF-kB signalling in familial PRP with mutations in CARD14. This article is protected by copyright. All rights reserved

Protecting Preteens on Facebook: An Exploratory Examination of Parental Mediation Strategies for Children’s Facebook Use in Singapore

Children are particularly vulnerable to the risks of going online, yet the profile of the child Internet user is becoming younger, particularly on social media. Parental mediation describes efforts by parents to translate the complexities of the physical/social environment as well as mass media into terms that children at various levels of cognitive development can understand. This exploratory study examined parental mediation strategies as predictors of parents’ intention to control underage use of Facebook in Singapore, a country with high internet penetration but little data protection regulation. The study found that parents with mediation styles that were highest on Regulated mediation (Restrictive and Selective mediation) as well as parents whose eldest child was female showed the highest level of intentions to control underage Facebook usage. Additionally, the younger the age group of the eldest child in the family, the more likely parents were to express intentions to control Facebook usage

Efficacy and effectiveness of dihydroartemisinin-piperaquine versus artesunate-mefloquine in falciparum malaria: an open-label randomised comparison.

BACKGROUND: Artemisinin-based combinations are judged the best treatments for multidrug-resistant Plasmodium falciparum malaria. Artesunate-mefloquine is widely recommended in southeast Asia, but its high cost and tolerability profile remain obstacles to widespread deployment. To assess whether dihydroartemisinin-piperaquine is a suitable alternative to artesunate-mefloquine, we compared the safety, tolerability, efficacy, and effectiveness of the two regimens for the treatment of uncomplicated falciparum in western Myanmar (Burma). METHODS: We did an open randomised comparison of 3-day regimens of artesunate-mefloquine (12/25 mg/kg) versus dihydroartemisinin-piperaquine (6.3/50 mg/kg) for the treatment of children aged 1 year or older and in adults with uncomplicated falciparum malaria in Rakhine State, western Myanmar. Within each group, patients were randomly assigned supervised or non-supervised treatment. The primary endpoint was the PCR-confirmed parasitological failure rate by day 42. Failure rates at day 42 were estimated by Kaplan-Meier survival analysis. This study is registered as an International Standard Randomised Controlled Trial, number ISRCTN27914471. FINDINGS: Of 652 patients enrolled, 327 were assigned dihydroartemisinin-piperaquine (156 supervised and 171 not supervised), and 325 artesunate-mefloquine (162 and 163, respectively). 16 patients were lost to follow-up, and one patient died 22 days after receiving dihydroartemisinin-piperaquine. Recrudescent parasitaemias were confirmed in only two patients; the day 42 failure rate was 0.6% (95% CI 0.2-2.5) for dihydroartemisinin-piperaquine and 0 (0-1.2) for artesunate-mefloquine. Whole-blood piperaquine concentrations at day 7 were similar for patients with observed and non-observed dihydroartemisinin-piperaquine treatment. Gametocytaemia developed more frequently in patients who had received dihydroartemisinin-piperaquine than in those on artesunate-mefloquine: day 7, 18 (10%) of 188 versus five (2%) of 218; relative risk 4.2 (1.6-11.0) p=0.011. INTERPRETATION: Dihydroartemisinin-piperaquine is a highly efficacious and inexpensive treatment of multidrug-resistant falciparum malaria and is well tolerated by all age groups. The effectiveness of the unsupervised treatment, as in the usual context of use, equalled its supervised efficacy, indicating good adherence without supervision. Dihydroartemisinin-piperaquine is a good alternative to artesunate-mefloquine

Seagrass conservation and monitoring in Myanmar: the biodiversity, distribution and coverage of seagrasses in the Tanintharyi and Rakhine

Surveys on seagrass taxonomy, distribution and extent were carried out in 14 locations within Myeik Archipelago and along the Rakhine Coast

Modal analysis of holey fiber mode-selective couplers

Mode Division Multiplexing is currently investigated as a possible way to increase fiber system capacity. With this approach, different modes of the same fiber carry distinct information. One of the problems to be solved in these systems concerns coupling/decoupling of the various modes to/from the same fiber. In this presentation, the mode features of a mode mux/demux based on holey fibers are investigated, with particular emphasis on optimal device design. Some preliminary experimental results will also be presented

Comparison of equations to predict the metabolisable energy content as applied to the vertical strata and plant parts of forage sorghum (Sorghum bicolor)

Context: Nutritive values, particularly energy content of tropical forages, need to be accurately assessed so that rations can be more precisely formulated. Aims: The research aimed to collate and compare equations used to predict metabolisable energy content in forage sorghum (Sorghum bicolor (L.) Moench) to ascertain the effect of vertical strata on metabolisable energy content to assist in producing silage of defined quality. Methods: Twenty-four predictive metabolisable energy equations derived from international feeding standards were compared using forage sorghum samples grown under fertiliser and growth stage treatments. Samples were separated into leaf, stem and seed heads (where present) over four vertical strata. Key results: Equations based on digestibility with crude protein were robust in the prediction of metabolisable energy and had application to routine laboratory use. Conclusions: The current study suggests that predictions based on digestibility and crude protein content are best placed for metabolisable energy application. Such equations should be originally based on measured metabolisable energy content to establish a regression so as to be used for predictive purposes, and satisfy the biological requirement of in vivo and the laboratory measurement relationship with acceptable statistical error. Chemical composition relationships predicted different metabolisable energy contents. Implications: Improved accuracy of the prediction of metabolisable energy content in tropical forages will provide better application of production models and more accurate decisions in ration formulation

Comparison of equations to predict the metabolisable energy content as applied to the vertical strata and plant parts of forage sorghum (Sorghum bicolor)

Context: Nutritive values, particularly energy content of tropical forages, need to be accurately assessed so that rations can be more precisely formulated. Aims: The research aimed to collate and compare equations used to predict metabolisable energy content in forage sorghum (Sorghum bicolor (L.) Moench) to ascertain the effect of vertical strata on metabolisable energy content to assist in producing silage of defined quality. Methods: Twenty-four predictive metabolisable energy equations derived from international feeding standards were compared using forage sorghum samples grown under fertiliser and growth stage treatments. Samples were separated into leaf, stem and seed heads (where present) over four vertical strata. Key results: Equations based on digestibility with crude protein were robust in the prediction of metabolisable energy and had application to routine laboratory use. Conclusions: The current study suggests that predictions based on digestibility and crude protein content are best placed for metabolisable energy application. Such equations should be originally based on measured metabolisable energy content to establish a regression so as to be used for predictive purposes, and satisfy the biological requirement of in vivo and the laboratory measurement relationship with acceptable statistical error. Chemical composition relationships predicted different metabolisable energy contents. Implications: Improved accuracy of the prediction of metabolisable energy content in tropical forages will provide better application of production models and more accurate decisions in ration formulation

Utility of Parental Mediation Model on Youth’s Problematic Online Gaming

The Parental Mediation Model PMM) was initially designed to regulate children’s attitudes towards the traditional media. In the present era, because of prevalent online media there is a need for similar regulative measures. Spending long hours on social media and playing online games increase the risks of exposure to the negative outcomes of online gaming. This paper initially applied the PMM developed by European Kids Online to (i) test the reliability and validity of this model and (ii) identify the effectiveness of this model in controlling problematic online gaming (POG). The data were collected from 592 participants comprising 296 parents and 296 students of four foreign universities, aged 16 to 22 years in Kuala Lumpur (Malaysia). The study found that the modified model of the five-factor PMM (Technical mediation, Monitoring mediation, Restrictive mediation, Active Mediation of Internet Safety, and Active mediation of Internet Use) functions as a predictor for mitigating POG. The findings suggest the existence of a positive relation between ‘monitoring’ and ‘restrictive’ mediation strategies and exposure to POG while Active Mediation of Internet Safety and Active mediation of Internet use were insignificant predictors. Results showed a higher utility of ‘technical’ strategies by the parents led to less POG. The findings of this study do not support the literature suggesting active mediation is more effective for reducing youth’s risky behaviour. Instead, parents need to apply more technical mediations with their children and adolescents’ Internet use to minimize the negative effects of online gaming