Case report: Aggressive progression of acute heart failure due to juvenile tuberculosis-associated Takayasu arteritis with aortic stenosis and thrombosis

BackgroundTakayasu arteritis (TA) is a chronic granulomatous vasculitis with unknown pathophysiology. TA with severe aortic obstruction has a poor prognosis. However, the efficacy of biologics and appropriate timing of surgical intervention remain controversial. We report a case of tuberculosis (TB)-associated TA with aggressive acute heart failure (AHF), pulmonary hypertension (PH), thrombosis, and seizure, who failed to survive after surgery.Case presentationA 10-year-old boy who developed a cough with chest tightness, shortness of breath, hemoptysis with reduced left ventricular ejection fraction, PH, and increased C-reactive protein and erythrocyte sedimentation rate was hospitalized at the pediatric intensive care unit of our hospital. He had strongly positive purified protein derivative skin test and interferon-gamma release assay result. Computed tomography angiography (CTA) showed occlusion of proximal left subclavian artery and stenosis of descending aorta and upper abdominal aorta. His condition did not improve after administration of milrinone, diuretics, antihypertensive agents, and intravenous methylprednisolone pulse followed by oral prednisone. Intravenous tocilizumab was administered for five doses, followed by two doses of infliximab, but his HF worsened, and CTA on day 77 showed complete occlusion of the descending aorta with large thrombus. He had a seizure on day 99 with deterioration of renal function. Balloon angioplasty and catheter-directed thrombolysis were performed on day 127. Unfortunately, the child's heart function continued to deteriorate and died on day 133.ConclusionTB infection may be related to juvenile TA. The biologics, thrombolysis, and surgical intervention failed to achieve the anticipated effect in our case with aggressive AHF due to severe aortic stenosis and thrombosis. More studies are needed to determine the role of biologics and surgery in such dire cases

Prenatal Detection of Aneuploidy and Imbalanced Chromosomal Arrangements by Massively Parallel Sequencing

Fetal chromosomal abnormalities are the most common reasons for invasive prenatal testing. Currently, G-band karyotyping and several molecular genetic methods have been established for diagnosis of chromosomal abnormalities. Although these testing methods are highly reliable, the major limitation remains restricted resolutions or can only achieve limited coverage on the human genome at one time. The massively parallel sequencing (MPS) technologies which can reach single base pair resolution allows detection of genome-wide intragenic deletions and duplication challenging karyotyping and microarrays as the tool for prenatal diagnosis. Here we reported a novel and robust MPS-based method to detect aneuploidy and imbalanced chromosomal arrangements in amniotic fluid (AF) samples. We sequenced 62 AF samples on Illumina GAIIx platform and with averagely 0.01× whole genome sequencing data we detected 13 samples with numerical chromosomal abnormalities by z-test. With up to 2× whole genome sequencing data we were able to detect microdeletion/microduplication (ranged from 1.4 Mb to 37.3 Mb of 5 samples from chorionic villus sampling (CVS) using SeqSeq algorithm. Our work demonstrated MPS is a robust and accurate approach to detect aneuploidy and imbalanced chromosomal arrangements in prenatal samples

Antifungal Peptide P852 Controls Fusarium Wilt in Faba Bean (Viciafaba L.) by Promoting Antioxidant Defense and Isoquinoline Alkaloid, Betaine, and Arginine Biosyntheses

Green pesticides are highly desirable, as they are environmentally friendly and efficient. In this study, the antifungal peptide P852 was employed to suppress Fusarium wilt in the Faba bean. The disease index and a range of physiological and metabolomic analyses were performed to explore the interactions between P852 and the fungal disease. The incidence and disease index of Fusarium wilt were substantially decreased in diseased Faba beans that were treated with two different concentrations of P852 in both the climate chamber and field trial. For the first time, P852 exhibited potent antifungal effects on Fusarium in an open field condition. To explore the mechanisms that underlie P852′s antifungal effects, P852 treatment was found to significantly enhance antioxidant enzyme capacities including guaiacol peroxidase (POD), superoxide dismutase (SOD), catalase (CAT), and the activities of antifungal enzymes including chitinase and β-1,3-glucanase, as well as plant dry and fresh weights, and chlorophyll content compared to the control group (p ≤ 0.05). Metabolomics analysis of the diseased Faba bean treated with P852 showed changes in the TCA cycle, biological pathways, and many primary and secondary metabolites. The Faba bean treated with a low concentration of P852 (1 μg/mL, IC50) led to upregulated arginine and isoquinoline alkaloid biosynthesis, whereas those treated with a high concentration of P852 (10 μg/mL, MFC) exhibited enhanced betaine and arginine accumulation. Taken together, these findings suggest that P852 induces plant tolerance under Fusarium attack by enhancing the activities of antioxidant and antifungal enzymes, and restoring plant growth and development

High Electromechanical Coupling Coefficient of Longitudinally Excited Shear Wave Resonator Based on Optimized Bragg Structure

In this work, a longitudinally excited shear-wave resonator (YBAR) based on single-crystalline lithium tantalate (LiTaO3, LT) thin film is proposed. The YBAR has a 200 nm X-cut thin film and molybdenum electrode. A high effective electromechanical coupling coefficient (k2eff) of up to 19% for the suspension-type structure was obtained. Furthermore, a Bragg reflector (SiO2/Pt) with optimized layer thickness ratio was employed to improve the performance of the YBAR. Compared to the acoustic wave resonators with the conventional quarter-wave (λ/4) Bragg reflector, the proposed YBAR with an optimized Bragg reflector can reflect both the longitudinal and shear waves efficiently, and resonators with spurious-free response and high quality (Q) value were achieved. This work provides a potential solution to enabling high coupling micro-acoustic resonators with high Q factor in the 5G/6G communication system

Data_Sheet_1_Short-term effectiveness of baricitinib in children with refractory and/or severe juvenile dermatomyositis.xlsx

ObjectiveTo determine the short-term effectiveness safety of baricitinib in children with refractory and/or severe juvenile dermatomyositis (rsJDM) in a real-world setting.MethodsThis was a single-center retrospective study, including 20 children with rsJDM. They were all treated using baricitinib combined with steroids and other immunosuppressive agents. The childhood myositis assessment scale (CMAS) and PRINTO remission criteria were used to evaluate the disease severity and treatment outcome at 0, 4, 12, and 24 weeks after initiation of baricitinib.ResultsThe skin rash improved in 95% of patients (19/20) at week 24, with a significant decrease of skin-DAS at weeks 12 (6.0 vs. 2.0, p ConclusionBaricitinib combined with traditional immunosuppressants treatment was efficacious in rsJDM. Add-on therapy of baricitinib was helpful for tapering CS dose. No serious side effects were observed in this study.</p

Raw data and UR% of chromosome 21, 18, 13, X, Y of 62 AF sample.

<p>Raw data and UR% of chromosome 21, 18, 13, X, Y of 62 AF sample.</p

Pathogenic chromosomal copy number changes and imbalance rearrangements identified by SeqSeq analysis which have been validated by arrayCGH.

<p>Pathogenic chromosomal copy number changes and imbalance rearrangements identified by SeqSeq analysis which have been validated by arrayCGH.</p

The normalized UR% value per chromosome between different samples.

<p>11 trisomy samples have a normalized UR% value of 1.5 and 2 cases of 45 XO have a normalized UR% value of 0.5.</p

z-scores of 62 AF samples for chromosome 21,18 and X determined by MPS.

<p>Broken lines indicate the z score cut-off value of ±3 for trisomy 21 and trisomy 18. All 11 trisomy cases have a z-score value greater than 3 and the 2 cases of Tuner syndrome have a z-score value less than minus 3.</p