Multisystem langerhans cell histiocytosis with advanced orbital involvement: Case report

Langerhans cell histiocytosis (LCH) is a rare disease occurring most frequently in infancy or early childhood. The aetiology is still not completely understood, although some form of immunologic dysfunction has been implicated. Clinically, the disease may either be localised or present with multisystem involvement. Here we discuss the case of a seven year old boy presenting with advanced proptosis. To the best of our knowledge, proptosis of this extent has not been reported previously in association with LCH

The Building of a Business Community: Focus on a University-Based Incubator

Abstract This study has investigated the building of business communities within university-based incubators (UBI) and provided a map of how a UBI Community is built. The interviews conducted with the incubator’s members and management gave a clear picture of the elements at stake in and outside the facility. As a result, the study identified external and internal pillars which pinnacle the building of a UBI Community. The external pillars create the settings within which the internal pillars exist. The internal pillars are called Socialisation Mechanisms, Bottom-Up Support System and People-Oriented Ecosystem. The study argues that a UBI Community is being built by its members in a bottom-up approach, with top-bottom managerial guidance. The study also found that the pillars are interconnected and presented them in order of appearance for the UBI members, who need the Socialisation Mechanisms to be able to partake in the Bottom-Up Support System. The People-Oriented Ecosystem is the backbone of a UBI Community and acts as a mind-set setter for both management and members. Finally, while this study first tried to map the building of a UBI entrepreneurial ecosystem, the amount of data and the level of clarity required narrowed the focus of this study down to the mapping of a UBI Community. As a result, this study suggests the possibility of a UBI Community being identified as a pillar of the UBI entrepreneurial ecosystem, along with notions of sustainability discussed in the Appendix section. This however is for further research to explore as the main discovering of this study remains the mapping of a UBI Community

Rapid systematic review of neonatal COVID-19 including a case of presumed vertical transmission

Objective: To carry out a systematic review of the available studies on COVID-19 (coronavirus disease 2019) in neonates seen globally since the onset of the COVID-19 global pandemic in 2020. The paper also describes a premature baby with reverse transcription (RT)-PCR-positive COVID-19 seen at the Blackpool Teaching Hospitals NHS Foundation Trust, UK. Design: We conducted a multifaceted search of the Cumulative Index to Nursing and Allied Health Literature, Embase, Medline and PubMed from 1 December 2019 to 12 May 2020 to harvest articles from medical journals and publications reporting cases of COVID-19 in neonates from anywhere in the world. Additional searches were also done so as not to miss any important publications. Write-up was in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, the protocol for the review was registered with International Prospective Register of Systematic Reviews (PROSPERO), and risk of bias was analysed with the Newcastle-Ottawa tool. Additionally, the preterm neonate with COVID-19 from our hospital is also reported. Results: The systematic review has revealed eight studies where neonates have been described to have confirmed COVID-19, with low risk of bias. Of the 10 reported cases elsewhere, only three are likely to be vertically transmitted, while seven occurred in the postperinatal period and are likely to have been postnatally acquired. All neonates had a mild course, recovered fully and were negative on retesting. Our case of COVID-19 in a 32-week premature baby from the UK was delivered by emergency caesarean section, with the mother wearing a face mask and the family having no contact with the neonate, suggesting vertical transmission. On day 33, the neonate was asymptomatic but was still RT-PCR-positive on nasopharyngeal airway swab. Conclusions: Neonatal infection is uncommon, with only two previously reported cases likely to be of vertical transmission. The case we report is still RT-PCR-positive on day 28 and is asymptomatic. Ongoing research is needed to ascertain the epidemiology of COVID-19 in neonates

The Effect of C-Reactive Protein Isoforms on Nitric Oxide Production by U937 Monocytes/Macrophages

Inflammation is regulated by many endogenous factors including estrogen, a steroid hormone that declines with increasing age, leading to excessive inflammation in the elderly. C-reactive protein (CRP) is an acute phase inflammatory protein that exists in two forms, native CRP (nCRP) and monomeric CRP (mCRP), which mediate distinct biological activities. It is unclear how each CRP isoform mediates nitric oxide (NO), a signalling molecule generated by NO synthase (NOS). This study investigated whether CRP isoforms have distinct effects on NO production by unstimulated and lipopolysaccharide (LPS)-activated monocytes/macrophages and whether estrogen mediates CRP-induced NO production in an in vitro model of ageing. NO and inducible NOS (iNOS) were measured (n=12) by the Griess assay and an enzyme-linked immunosorbent assay (ELISA) respectively following incubation (24 hours) of human-derived U937 monocytes/macrophages with CRP isoforms ([nCRP] = 500 and 1000µg/ml; [mCRP] = 100 and 250µg/ml) in the absence or presence of 17 beta-estradiol (1x10-7, 1x10-8 and 1x10-9M). The response to each CRP isoform and estrogen was dependent on the differentiation and activation status of cells. Monocytes with or without prior LPS-activation significantly increased (P0.05) on NO/iNOS production by unactivated or LPS-activated macrophages whereas nCRP significantly (P<0.05) reduced NO/iNOS production by macrophages, with or without prior LPS-activation. The nCRP isoform had opposing actions on monocytes, significantly (p<0.01) increasing and reducing NO/iNOS by unactivated and LPS-activated monocytes respectively. Estrogen significantly (P<0.01) reversed nCRP-mediated NO inhibition by unactivated macrophages but decreased CRP-induced NO by unactivated monocytes treated with nCRP or mCRP and LPS-activated monocytes treated with mCRP. NO was differentially mediated by CRP isoforms in a cell-type/state specific manner, with production corresponding to concomitant changes in iNOS levels. Collectively, the findings indicate nCRP and estrogen predominantly reduce NO production whereas mCRP increases NO production. This supports growing evidence that mCRP exacerbates inflammation whilst nCRP and estrogen dampen the overall inflammatory response. Therapeutic strategies that restore estrogen levels to those found in youth and promote the stability of nCRP or/and prevent the formation of mCRP may reduce NO production in age-related inflammatory conditions

The Building of a Business Community: Focus on a University-Based Incubator

Abstract This study has investigated the building of business communities within university-based incubators (UBI) and provided a map of how a UBI Community is built. The interviews conducted with the incubator’s members and management gave a clear picture of the elements at stake in and outside the facility. As a result, the study identified external and internal pillars which pinnacle the building of a UBI Community. The external pillars create the settings within which the internal pillars exist. The internal pillars are called Socialisation Mechanisms, Bottom-Up Support System and People-Oriented Ecosystem. The study argues that a UBI Community is being built by its members in a bottom-up approach, with top-bottom managerial guidance. The study also found that the pillars are interconnected and presented them in order of appearance for the UBI members, who need the Socialisation Mechanisms to be able to partake in the Bottom-Up Support System. The People-Oriented Ecosystem is the backbone of a UBI Community and acts as a mind-set setter for both management and members. Finally, while this study first tried to map the building of a UBI entrepreneurial ecosystem, the amount of data and the level of clarity required narrowed the focus of this study down to the mapping of a UBI Community. As a result, this study suggests the possibility of a UBI Community being identified as a pillar of the UBI entrepreneurial ecosystem, along with notions of sustainability discussed in the Appendix section. This however is for further research to explore as the main discovering of this study remains the mapping of a UBI Community

Berfikir Kreatif & Brainstorming

21 cm; 55 ha