The Expansion of Lyme Disease: A Case of Infection in the Absence of Known Exposure

Lyme disease is a systemic infection caused by the spirochete Borrelia burgdorferi often carried the Ixodes tick. It is associated with dermatologic manifestations, most notably the “bullseye rash” of erythema migrans. The disease can progress in stages to involve other organs such as joints, heart, and the nervous system. Lyme disease is continuing to spread, with West Virginia cases increasing dramatically in the last 2 decades. As a result, physicians are likely to encounter this disease more often, making recognition and early treatment a top priority in order to prevent potentially dangerous sequelae. We present a case of a 60-year-old man who presented with multiple erythematous annular plaques and was subsequently diagnosed with Lyme disease. He had no known exposure to ticks, was treated for Lyme Disease, and subsequently developed a Jarisch- Herxheimer reaction (JHR)

Eruptive Lentigines Confined to Resolving Psoriatic Plaques Following Treatment with Guselkumab

Eruptive lentigines in the area of resolving psoriatic plaques has been well documented in the literature following successful treatment with multiple therapies. This is historically associated with light treatment but has been expanded to include other therapies such as anti-tumor necrosis factor therapies and, more recently, some biologics5. Guselkumab (Tremfya) is an IgG1λ monoclonal antibody used in the treatment of plaque psoriasis with only one case of eruptive lentigines confined to resolving psoriatic plaques (ELRP) noted as a side effect. We present the second such case of ELRP associated with successful treatment of plaque psoriasis with Guselkumab, as it is important to document potential side effects of medications regardless of their severity

Smartphone Mobile Application to Enhance Diagnosis of Skin Cancer: A Guide for the Rural Practitioner

Primary care physicians occupy a vital position to impact many devastating conditions, especially those dependent upon early diagnosis, such as skin cancer. Skin cancer is the most common cancer in the United States and despite improvements in skin cancer therapy, patients with a delay in diagnosis and advanced disease continue to have a grave prognosis. Due to a variety of barriers, advanced stages of skin cancer are more prominent in rural populations. In order to improve early diagnosis four things are paramount: increased patient participation in prevention methods, establishment of screening guidelines, increased diagnostic accuracy of malignant lesions, and easier access to dermatologists. Recent expansion in smartphone mobile application technology offers simple ways for rural practitioners to address these problems. More than 100,000 health related applications are currently available, with over 200 covering dermatology. This review will evaluate the newest and most useful of those applications offered to enhance the prevention and early diagnosis of skin cancer, particularly in the rural population

The first complete mitogenome of Indian star tortoise (Geochelone elegans)

The complete mitochondrial genome of Indian star tortoise (Geochelone elegans) was characterized having 16,446 bp nucleotides encoding 37 genes in circular orientation comprising 13 protein-coding genes, 22 tRNA genes and two rRNA genes. The lengths of 12S and 16S ribosomal RNA were 973 bp and 1600 bp. A non-coding control region (D-Loop) of 966 bp was identified between tRNAPro and tRNAPhe having seven interrupted tandem repeats. A single A + 1 frameshift insertion in the ND3 gene (ND3-174) was also discovered. The complete mitogenome of G. elegans would contribute in deeper understanding of the evolutionary dynamics and conservation effort of vulnerable testudine families

Magnetic properties and magnetocaloric effect in layered NdMn 1.9V0.1Si2

The structural and magnetic properties of the compounds NdMn2-xVxSi2 have been studied by x-ray and high resolution neutron powder diffraction, specific heat, dc magnetization, and differential scanning calorimetry measurements over the temperature range 3-450 K. The Curie temperature and Néel temperature of layered NdMn1.9V0.1Si2 are been indicate at TC ~ 24 K and TN ~ 376 K respectively. The giant magnetocaloric effect (GMCE) around TC is found in layered NdMn1.9V0.1Si2 associated with first order magnetic transition from antiferromagnetic [AFil-type] to ferromagnetic [F(Nd)+Fmc]. This behaviorhas been confirmed as contribution of the magnetostructural coupling by using neutron powder diffraction. The magnetic entropy change −ΔSM ~ 25.4J kg-1 K-1 and adiabatic temperature change ΔTad~ 6.7 K have been determined using magnetization and specific heat measurement under 0-8 T field applied. This compound belongs with the small thermal ~ 0.8 K and magnetic ~ 0.1 T hysteresis characteristic providing high potential material for magnetic refrigerator

Complete Mitochondrial Genome Sequence of a Seabird, Wedge-Tailed Shearwater (Ardenna pacifica)

Here, we report the complete mitochondrial genome sequence of a seabird, wedge-tailed shearwater (Ardenna pacifica). The circular genome has a size of 16,434 bp and contains 13 protein-coding genes, 22 tRNA genes, and 2 rRNA genes. The study provides a reference mitochondrial genome of wedge-tailed shearwater for further molecular studies

Evidence for spatially-responsive neurons in the rostral thalamus

Damage involving the anterior thalamic and adjacent rostral thalamic nuclei may result in a severe anterograde amnesia, similar to the amnesia resulting from damage to the hippocampal formation. Little is known, however, about the information represented in these nuclei. To redress this deficit, we recorded units in three rostral thalamic nuclei in freely-moving rats (the parataenial nucleus, the anteromedial nucleus and nucleus reuniens). We found units in these nuclei possessing previously unsuspected spatial properties. The various cell types show clear similarities to place cells, head direction cells, and perimeter/border cells described in hippocampal and parahippocampal regions. Based on their connectivity, it had been predicted that the anterior thalamic nuclei process information with high spatial and temporal resolution while the midline nuclei have more diffuse roles in attention and arousal. Our current findings strongly support the first prediction but directly challenge or substantially moderate the second prediction. The rostral thalamic spatial cells described here may reflect direct hippocampal/parahippocampal inputs, a striking finding of itself, given the relative lack of place cells in other sites receiving direct hippocampal formation inputs. Alternatively, they may provide elemental thalamic spatial inputs to assist hippocampal spatial computations. Finally, they could represent a parallel spatial system in the brain

Cutaneous Manifestations of Nutritional Deficiencies in the Context of Food Deserts of United States.

Food deserts exist due to a multitude of factors ranging from socioeconomic status, racial disparities, geography, cost, and healthful food access. Given the vast biological function of vitamins and minerals, the clinical presentation for nutritional deficiencies ranges from benign to life-threatening. Often, the first indicators of underlying nutritional deficiencies are cutaneous manifestations. The first patient case is a 36-year-old female at 25 weeks gestation with a pruritic and painful rash that began in the genital region and spread centrifugally to her legs. The second patient case is a 42-year-old male with a pruritic rash that began at his abdomen and progressed to his thighs. The third patient case is a 48-year-old female with scattered lower extremity ecchymoses in different healing stages and scattered perifollicular erythema with corkscrew hairs. All three patients were found to have nutritional deficiencies and lived in identified food deserts. Deficiencies of zinc, vitamin A, thiamine, pyridoxine, and vitamin C and their subsequent cutaneous manifestations have scarce documentation within food deserts. These cases provide further insight into nutritional deficiencies and offer an opportunity for providers to identify patients at risk. To promote wellness, patients suffering from food insecurity must be identified efficiently and connected with essential resources

Neo-Anal Sphincter Fabrication in the Rat

Undergraduate Research Opportunity Program (UROP)http://deepblue.lib.umich.edu/bitstream/2027.42/116119/1/Neo_Anal_SphincterFabrication_Rats.pd