Nasopharyngeal cancer mimicking otitic barotrauma in a resource-challenged center: a case report

<p>Abstract</p> <p>Introduction</p> <p>Nasopharyngeal cancer commonly manifests with cervical lymphadenopathy, recurrent epistaxis and progressive nasal obstruction. Neuro-ophthalmic and otologic manifestations can also occur. Isolated otologic presentations of nasopharyngeal cancer are rare and the diagnosis of nasopharyngeal cancer may not be foremost in the list of differentials.</p> <p>Case presentation</p> <p>We present the case of a 29-year-old Nigerian woman with bilateral conductive hearing loss and tinnitus after air travel. There were no other symptoms. The persistence of the symptoms after adequate treatment for otitic barotrauma necessitated re-evaluation, which led to a diagnosis of nasopharyngeal cancer.</p> <p>Conclusion</p> <p>Isolated otologic manifestations of nasopharyngeal cancer are rare in regions with low incidence of the disease. There is a need for it to be considered as a possible differential in patients presenting with bilateral serous otitis media.</p

A Herschel PACS and SPIRE study of the dust content of the Cassiopeia A supernova remnant

Using the 3.5-m Herschel Space Observatory, imaging photometry of Cas A has been obtained in six bands between 70 and 500 μm with the PACS and SPIRE instruments, with angular resolutions ranging from 6 to 37”. In the outer regions of the remnant the 70-μm PACS image resembles the 24-μm image Spitzer image, with the emission attributed to the same warm dust component, located in the reverse shock region. At longer wavelengths, the three SPIRE bands are increasingly dominated by emission from cold interstellar dust knots and filaments, particularly across the central, western and southern parts of the remnant. Nonthermal emission from the northern part of the remnant becomes prominent at 500 μm. We have estimated and subtracted the contributions from the nonthermal, warm dust and cold interstellar dust components. We confirm and resolve for the first time a cool (~35 K) dust component, emitting at 70-160 μm, that is located interior to the reverse shock region, with an estimated mass of 0.075

Enhanced hyporheic exchange flow around woody debris does not increase nitrate reduction in a sandy streambed

Anthropogenic nitrogen pollution is a critical problem in freshwaters. Although riverbeds are known to attenuate nitrate, it is not known if large woody debris (LWD) can increase this ecosystem service through enhanced hyporheic exchange and streambed residence time. Over a year, we monitored the surface water and pore water chemistry at 200 points along a ~50m reach of a lowland sandy stream with three natural LWD structures. We directly injected 15N-nitrate at 108 locations within the top 1.5m of the streambed to quantify in situ denitrification, anammox and dissimilatory nitrate reduction to ammonia, which, on average, contributed 85%, 10% and 5% of total nitrate reduction, respectively. Total nitrate reducing activity ranged from 0-16µM h-1 and was highest in the top 30cm of the stream bed. Depth, ambient nitrate and water residence time explained 44% of the observed variation in nitrate reduction; fastest rates were associated with slow flow and shallow depths. In autumn, when the river was in spate, nitrate reduction (in situ and laboratory measures) was enhanced around the LWD compared with non-woody areas, but this was not seen in the spring and summer. Overall, there was no significant effect of LWD on nitrate reduction rates in surrounding streambed sediments, but higher pore water nitrate concentrations and shorter residence times, close to LWD, indicated enhanced delivery of surface water into the streambed under high flow. When hyporheic exchange is too strong, overall nitrate reduction is inhibited due to short flow-paths and associated high oxygen concentrations

A cool dust factory in the Crab Nebula: a Herschel study of the filaments

Whether supernovae are major sources of dust in galaxies is a long-standing debate. We present infrared and submillimeter photometry and spectroscopy from the Herschel Space Observatory of the Crab Nebula between 51 and 670 μm as part of the Mass Loss from Evolved StarS program. We compare the emission detected with Herschel with multiwavelength data including millimeter, radio, mid-infrared, and archive optical images. We carefully remove the synchrotron component using the Herschel and Planck fluxes measured in the same epoch. The contribution from line emission is removed using Herschel spectroscopy combined with Infrared Space Observatory archive data. Several forbidden lines of carbon, oxygen, and nitrogen are detected where multiple velocity components are resolved, deduced to be from the nitrogen-depleted, carbon-rich ejecta. No spectral lines are detected in the SPIRE wavebands; in the PACS bands, the line contribution is 5% and 10% at 70 and 100 μm and negligible at 160 μm. After subtracting the synchrotron and line emission, the remaining far-infrared continuum can be fit with two dust components. Assuming standard interstellar silicates, the mass of the cooler component is 0.24+0.32 – 0.08 M ☉ for T = 28.1+5.5 – 3.2 K. Amorphous carbon grains require 0.11 ± 0.01 M ☉ of dust with T = 33.8+2.3 – 1.8 K. A single temperature modified blackbody with 0.14 M ☉ and 0.08 M ☉ for silicate and carbon dust, respectively, provides an adequate fit to the far-infrared region of the spectral energy distribution but is a poor fit at 24-500 μm. The Crab Nebula has condensed most of the relevant refractory elements into dust, suggesting the formation of dust in core-collapse supernova ejecta is efficient

Ptc6 is required for proper rapamycin-induced down-regulation of the genes coding for ribosomal and rRNA processing proteins in S. cerevisiae

Ptc6 is one of the seven components (Ptc1-Ptc7) of the protein phosphatase 2C family in the yeast Saccharomyces cerevisiae. In contrast to other type 2C phosphatases, the cellular role of this isoform is poorly understood. We present here a comprehensive characterization of this gene product. Cells lacking Ptc6 are sensitive to zinc ions, and somewhat tolerant to cell-wall damaging agents and to Li+. Ptc6 mutants are sensitive to rapamycin, albeit to lesser extent than ptc1 cells. This phenotype is not rescued by overexpression of PTC1 and mutation of ptc6 does not reproduce the characteristic geneti

Methylphenidate Normalizes Fronto-Striatal Underactivation During Interference Inhibition in Medication-Naïve Boys with Attention-Deficit Hyperactivity Disorder

Youth with attention deficit hyperactivity disorder (ADHD) have deficits in interference inhibition, which can be improved with the indirect catecholamine agonist methylphenidate (MPH). Functional magnetic resonance imaging was used to investigate the effects of a single dose of MPH on brain activation during interference inhibition in medication-naïve ADHD boys. Medication-naïve boys with ADHD were scanned twice, in a randomized, double-blind design, under either a single clinical dose of MPH or placebo, while performing a Simon task that measures interference inhibition and controls for the oddball effect of low-frequency appearance of incongruent trials. Brain activation was compared within patients under either drug condition. To test for potential normalization effects of MPH, brain activation in ADHD patients under either drug condition was compared with that of healthy age-matched comparison boys. During incongruent trials compared with congruent–oddball trials, boys with ADHD under placebo relative to controls showed reduced brain activation in typical areas of interference inhibition, including right inferior prefrontal cortex, left striatum and thalamus, mid-cingulate/supplementary motor area, and left superior temporal lobe. MPH relative to placebo upregulated brain activation in right inferior prefrontal and premotor cortices. Under the MPH condition, patients relative to controls no longer showed the reduced activation in right inferior prefrontal and striato-thalamic regions. Effect size comparison, furthermore, showed that these normalization effects were significant. MPH significantly normalized the fronto-striatal underfunctioning in ADHD patients relative to controls during interference inhibition, but did not affect medial frontal or temporal dysfunction. MPH therefore appears to have a region-specific upregulation effect on fronto-striatal activation

Prescribing indicators at primary health care centers within the WHO African region: a systematic analysis (1995-2015)

Abstract Background Rational medicine use is essential to optimize quality of healthcare delivery and resource utilization. We aim to conduct a systematic review of changes in prescribing patterns in the WHO African region and comparison with WHO indicators in two time periods 1995–2005 and 2006–2015. Methods Systematic searches were conducted in PubMed, Scopus, Web of science, Africa-Wide Nipad, Africa Journals Online (AJOL), Google scholar and International Network for Rational Use of Drugs (INRUD) Bibliography databases to identify primary studies reporting prescribing indicators at primary healthcare centres (PHCs) in Africa. This was supplemented by a manual search of retrieved references. We assessed the quality of studies using a 14-point scoring system modified from the Downs and Black checklist with inclusions of recommendations in the WHO guidelines. Results Forty-three studies conducted in 11 African countries were included in the overall analysis. These studies presented prescribing indicators based on a total 141,323 patient encounters across 572 primary care facilities. The results of prescribing indicators were determined as follows; average number of medicines prescribed per patient encounter = 3.1 (IQR 2.3–4.8), percentage of medicines prescribed by generic name =68.0 % (IQR 55.4–80.3), Percentage of encounters with antibiotic prescribed =46.8 % (IQR 33.7–62.8), percentage of encounters with injection prescribed =25.0 % (IQR 18.7–39.5) and the percentage of medicines prescribed from essential medicines list =88.0 % (IQR 76.3–94.1). Prescribing indicators were generally worse in private compared with public facilities. Analysis of prescribing across two time points 1995–2005 and 2006–2015 showed no consistent trends. Conclusions Prescribing indicators for the African region deviate significantly from the WHO reference targets. Increased collaborative efforts are urgently needed to improve medicine prescribing practices in Africa with the aim of enhancing the optimal utilization of scarce resources and averting negative health consequences