Correction: Emergence of Prions Selectively Resistant to Combination Drug Therapy.

[This corrects the article DOI: 10.1371/journal.ppat.1008581.].

Topical Turmeric Ointment in the Treatment of Diabetic Foot Ulcers: A Randomized, Placebo-Controlled Study.

Diabetic foot is a serious complication of diabetes which has significant medical and socioeconomic impacts. Turmeric is a popular Indian spice that has been used for centuries in herbal medicines for the treatment of a variety of ailments such as rheumatism, diabetic ulcers, anorexia, cough and sinusitis. Curcumin is the main ingredient presents in turmeric and responsible for its yellow color. We report here a randomized, placebo-controlled investigation into the effectiveness of topical turmeric ointment in the treatment of diabetic foot ulcers. Seventy-six patients enrolled in the study. They were randomly divided into two groups, one of which received topical turmeric ointment and the other received placebo. Preparations were applied twice daily after irrigation of the wound by normal saline and dressed. Image analysis software was used to evaluate photographs of the ulcers and quantify the difference between treatment and placebo groups. Topical turmeric ointment demonstrated statistically significant reduction (p < .001) in the size of diabetic ulcers at five weeks compared to placebo, independently of fasting blood sugar and HbA1C levels. Turmeric ointment may be an effective treatment for diabetic foot ulcers.

Progress towards a Miniaturised PIV System.

Particle image velocimetry is an important optical flow diagnostic tool due to its capacity for investigating a whole flow field without introducing disturbances. However, a significant drawback of PIV methods is their requirement for optical access, making capturing data in closed cavities and confined spaces extremely challenging. A potential approach to overcome this difficulty is miniaturising the system and placing the optical components inside the model. Conventional cross-correlation PIV methods do not allow this due to the size of current PIV cameras. In this study, a miniaturised autocorrelation-based stereo PIV system, which is volumetrically 1.2% of the conventional PIV cameras, was developed and tested. The miniature system is compared with a conventional stereo PIV in wind tunnel experiments up to 16 m/s free stream velocity and a 1.6% velocity difference is observed in the boundary layer flow. Despite a comparatively slow measurement rate of 4.5 Hz, the miniature PIV system demonstrates the ability to measure inside confined spaces and cavities and the ability to be mounted on board models and vehicles. However, limitations remain around conducting measurements with large velocity ranges and with regions of reversed flow due to the challenge of resolving a velocity of 0 m/s.

Intelligibility of speech produced by sighted and blind adults.

PURPOSE: It is well known that speech uses both the auditory and visual modalities to convey information. In cases of congenital sensory deprivation, the feedback language learners have access to for mapping visible and invisible orofacial articulation is impoverished. Although the effects of blindness on the movements of the lips, jaw, and tongue have been documented in francophone adults, not much is known about their consequences for speech intelligibility. The objective of this study is to investigate the effects of congenital visual deprivation on vowel intelligibility in adult speakers of Canadian French. METHOD: Twenty adult listeners performed two perceptual identification tasks in which vowels produced by congenitally blind adults and sighted adults were used as stimuli. The vowels were presented in the auditory, visual, and audiovisual modalities (experiment 1) and at different signal-to-noise ratios in the audiovisual modality (experiment 2). Correct identification scores were calculated. Sequential information analyses were also conducted to assess the amount of information transmitted to the listeners along the three vowel features of height, place of articulation, and rounding. RESULTS: The results showed that, although blind speakers did not differ from their sighted peers in the auditory modality, they had lower scores in the audiovisual and visual modalities. Some vowels produced by blind speakers are also less robust in noise than those produced by sighted speakers. CONCLUSION: Together, the results suggest that adult blind speakers have learned to adapt to their sensory loss so that they can successfully achieve intelligible vowel targets in non-noisy conditions but that they produce less intelligible speech in noisy conditions. Thus, the trade-off between visible (lips) and invisible (tongue) articulatory cues observed between vowels produced by blind and sighted speakers is not equivalent in terms of perceptual efficiency.

Care of patients with mental health issues in the emergency department: a quality improvement project.

Mental health issues have increased significantly over the past decade in the US and emergency departments (EDs) often serve as a safety net to protect and support patients with mental health issues. However, many EDs in the US are not equipped to provide the level of advanced care that patients experiencing a mental health crisis require. This article describes a quality improvement project conducted in an ED in Colorado, US, to identify and address deficiencies in the care provided to patients with mental health issues. The care of patients with mental health issues in the ED can be enhanced through measures such as implementing a validated suicide risk assessment tool, reducing ligature risks, improving the physical environment and training staff in de-escalation techniques.

Identification of a homology-independent linchpin domain controlling mouse and bank vole prion protein conversion.

Prions are unorthodox pathogens that cause fatal neurodegenerative diseases in humans and other mammals. Prion propagation occurs through the self-templating of the pathogenic conformer PrPSc, onto the cell-expressed conformer, PrPC. Here we study the conversion of PrPC to PrPSc using a recombinant mouse PrPSc conformer (mouse protein-only recPrPSc) as a unique tool that can convert bank vole but not mouse PrPC substrates in vitro. Thus, its templating ability is not dependent on sequence homology with the substrate. In the present study, we used chimeric bank vole/mouse PrPC substrates to systematically determine the domain that allows for conversion by Mo protein-only recPrPSc. Our results show that that either the presence of the bank vole amino acid residues E227 and S230 or the absence of the second N-linked glycan are sufficient to allow PrPC substrates to be converted by Mo protein-only recPrPSc and several native infectious prion strains. We propose that residues 227 and 230 and the second glycan are part of a C-terminal domain that acts as a linchpin for bank vole and mouse prion conversion.

A Genome-Wide CRISPR/Cas9 Screen Reveals that Riboflavin Regulates Hydrogen Peroxide Entry into HAP1 Cells.

Extracellular hydrogen peroxide can induce oxidative stress, which can cause cell death if unresolved. However, the cellular mediators of H2O2-induced cell death are unknown. We determined that H2O2-induced cytotoxicity is an iron-dependent process in HAP1 cells and conducted a CRISPR/Cas9-based survival screen that identified four genes that mediate H2O2-induced cell death: POR (encoding cytochrome P450 oxidoreductase), RETSAT (retinol saturase), KEAP1 (Kelch-like ECH-associated protein-1), and SLC52A2 (riboflavin transporter). Among these genes, only POR also mediated methyl viologen dichloride hydrate (paraquat)-induced cell death. Because the identification of SLC52A2 as a mediator of H2O2 was both novel and unexpected, we performed additional experiments to characterize the specificity and mechanism of its effect. These experiments showed that paralogs of SLC52A2 with lower riboflavin affinities could not mediate H2O2-induced cell death and that riboflavin depletion protected HAP1 cells from H2O2 toxicity through a specific process that could not be rescued by other flavin compounds. Interestingly, riboflavin mediated cell death specifically by regulating H2O2 entry into HAP1 cells, likely through an aquaporin channel. Our study results reveal the general and specific effectors of iron-dependent H2O2-induced cell death and also show for the first time that a vitamin can regulate membrane transport.IMPORTANCE Using a genetic screen, we discovered that riboflavin controls the entry of hydrogen peroxide into a white blood cell line. To our knowledge, this is the first report of a vitamin playing a role in controlling transport of a small molecule across the cell membrane.

Emergence of prions selectively resistant to combination drug therapy.

Prions are unorthodox infectious agents that replicate by templating misfolded conformations of a host-encoded glycoprotein, collectively termed PrPSc. Prion diseases are invariably fatal and currently incurable, but oral drugs that can prolong incubation times in prion-infected mice have been developed. Here, we tested the efficacy of combination therapy with two such drugs, IND24 and Anle138b, in scrapie-infected mice. The results indicate that combination therapy was no more effective than either IND24 or Anle138b monotherapy in prolonging scrapie incubation times. Moreover, combination therapy induced the formation of a new prion strain that is specifically resistant to the combination regimen but susceptible to Anle138b. To our knowledge, this is the first report of a pathogen with specific resistance to combination therapy despite being susceptible to monotherapy. Our findings also suggest that combination therapy may be a less effective strategy for treating prions than conventional pathogens.

Cofactor and glycosylation preferences for in vitro prion conversion are predominantly determined by strain conformation.

Prion diseases are caused by the misfolding of a host-encoded glycoprotein, PrPC, into a pathogenic conformer, PrPSc. Infectious prions can exist as different strains, composed of unique conformations of PrPSc that generate strain-specific biological traits, including distinctive patterns of PrPSc accumulation throughout the brain. Prion strains from different animal species display different cofactor and PrPC glycoform preferences to propagate efficiently in vitro, but it is unknown whether these molecular preferences are specified by the amino acid sequence of PrPC substrate or by the conformation of PrPSc seed. To distinguish between these two possibilities, we used bank vole PrPC to propagate both hamster or mouse prions (which have distinct cofactor and glycosylation preferences) with a single, common substrate. We performed reconstituted sPMCA reactions using either (1) phospholipid or RNA cofactor molecules, or (2) di- or un-glycosylated bank vole PrPC substrate. We found that prion strains from either species are capable of propagating efficiently using bank vole PrPC substrates when reactions contained the same PrPC glycoform or cofactor molecule preferred by the PrPSc seed in its host species. Thus, we conclude that it is the conformation of the input PrPSc seed, not the amino acid sequence of the PrPC substrate, that primarily determines species-specific cofactor and glycosylation preferences. These results support the hypothesis that strain-specific patterns of prion neurotropism are generated by selection of differentially distributed cofactors molecules and/or PrPC glycoforms during prion replication.

Molecular and epigenetic profiles of BRCA1-like hormone-receptor-positive breast tumors identified with development and application of a copy-number-based classifier.

BACKGROUND: BRCA1-mutated cancers exhibit deficient homologous recombination (HR) DNA repair, resulting in extensive copy number alterations and genome instability. HR deficiency can also arise in tumors without a BRCA1 mutation. Compared with other breast tumors, HR-deficient, BRCA1-like tumors exhibit worse prognosis but selective chemotherapeutic sensitivity. Presently, patients with triple negative breast cancer (TNBC) who do not respond to hormone endocrine-targeting therapy are given cytotoxic chemotherapy. However, more recent evidence showed a similar genomic profile between BRCA1-deficient TNBCs and hormone-receptor-positive tumors. Characterization of the somatic alterations of BRCA1-like hormone-receptor-positive breast tumors as a group, which is currently lacking, can potentially help develop biomarkers for identifying additional patients who might respond to chemotherapy. METHODS: We retrained and validated a copy-number-based support vector machine (SVM) classifier to identify HR-deficient, BRCA1-like breast tumors. We applied this classifier to The Cancer Genome Atlas (TCGA) and Molecular Taxonomy of Breast Cancer International Consortium (METABRIC) breast tumors. We assessed mutational profiles and proliferative capacity by covariate-adjusted linear models and identified differentially methylated regions using DMRcate in BRCA1-like hormone-receptor-positive tumors. RESULTS: Of the breast tumors in TCGA and METABRIC, 22% (651/2925) were BRCA1-like. Stratifying on hormone-receptor status, 13% (302/2405) receptor-positive and 69% (288/417) triple-negative tumors were BRCA1-like. Among the hormone-receptor-positive subgroup, BRCA1-like tumors showed significantly increased mutational burden and proliferative capacity (both P < 0.05). Genome-scale DNA methylation analysis of BRCA1-like tumors identified 202 differentially methylated gene regions, including hypermethylated BRCA1. Individually significant CpGs were enriched for enhancer regions (P < 0.05). The hypermethylated gene sets were enriched for DNA and chromatin conformation (all Bonferroni P < 0.05). CONCLUSIONS: To provide insights into alternative classification and potential therapeutic targeting strategies of BRCA1-like hormone-receptor-positive tumors we developed and applied a novel copy number classifier to identify BRCA1-like hormone-receptor-positive tumors and their characteristic somatic alteration profiles.

SEC24A identified as an essential mediator of thapsigargin-induced cell death in a genome-wide CRISPR/Cas9 screen.

Endoplasmic reticulum (ER) stress from accumulated misfolded proteins in the ER can activate the unfolded protein response (UPR). The UPR acts either to restore proteostasis or to activate cell death pathways if the stress cannot be resolved. The key downstream effectors in these pathways have been studied extensively. However, in comparison, stressor-specific key mediators are not as well characterized. In this study, we sought to identify and compare the genes that are necessary for cell death induced by three classic pharmacological ER stressors with different mechanisms of action: thapsigargin, tunicamycin, and brefeldin A. We conducted genome-wide CRISPR/Cas9-based loss-of-function screens against these agents in HAP1 cells, which are a near-haploid cell line. Our screens confirmed that MFSD2A and ARF4, which were identified in previous screens, are necessary for tunicamycin- and brefeldin A-induced cytotoxicity, respectively. We identified a novel gene, SEC24A, as an essential gene for thapsigargin-induced cytotoxicity in HAP1 cells. Further experiments showed that the ability of SEC24A to facilitate ER stress-induced cell death is specific to thapsigargin and that SEC24A acts upstream of the UPR. These findings show that the genes required for ER stress-induced cell death are specific to the agent used to induce ER stress and that the resident ER cargo receptor protein SEC24A is an essential mediator of thapsigargin-induced UPR and cell death.

Miniaturisation of Pressure-Sensitive Paint Measurement Systems Using Low-Cost, Miniaturised Machine Vision Cameras.

Measurements of pressure-sensitive paint (PSP) have been performed using new or non-scientific imaging technology based on machine vision tools. Machine vision camera systems are typically used for automated inspection or process monitoring. Such devices offer the benefits of lower cost and reduced size compared with typically scientific-grade cameras; however, their optical qualities and suitability have yet to be determined. This research intends to show relevant imaging characteristics and also show the applicability of such imaging technology for PSP. Details of camera performance are benchmarked and compared to standard scientific imaging equipment and subsequent PSP tests are conducted using a static calibration chamber. The findings demonstrate that machine vision technology can be used for PSP measurements, opening up the possibility of performing measurements on-board small-scale model such as those used for wind tunnel testing or measurements in confined spaces with limited optical access.

The evolution and population diversity of human-specific segmental duplications.

Segmental duplications contribute to human evolution, adaptation and genomic instability but are often poorly characterized. We investigate the evolution, genetic variation and coding potential of human-specific segmental duplications (HSDs). We identify 218 HSDs based on analysis of 322 deeply sequenced archaic and contemporary hominid genomes. We sequence 550 human and nonhuman primate genomic clones to reconstruct the evolution of the largest, most complex regions with protein-coding potential (n=80 genes/33 gene families). We show that HSDs are non-randomly organized, associate preferentially with ancestral ape duplications termed "core duplicons", and evolved primarily in an interspersed inverted orientation. In addition to Homo sapiens-specific gene expansions (e.g., TCAF1/2), we highlight ten gene families (e.g., ARHGAP11B and SRGAP2C) where copy number never returns to the ancestral state, there is evidence of mRNA splicing, and no common gene-disruptive mutations are observed in the general population. Such duplicates are candidates for the evolution of human-specific adaptive traits.

The E2F4 prognostic signature predicts pathological response to neoadjuvant chemotherapy in breast cancer patients.

BACKGROUND: Neoadjuvant chemotherapy is a key component of breast cancer treatment regimens and pathologic complete response to this therapy varies among patients. This is presumably due to differences in the molecular mechanisms that underlie each tumor's disease pathology. Developing genomic clinical assays that accurately categorize responders from non-responders can provide patients with the most effective therapy for their individual disease. METHODS: We applied our previously developed E2F4 genomic signature to predict neoadjuvant chemotherapy response in breast cancer. E2F4 individual regulatory activity scores were calculated for 1129 patient samples across 5 independent breast cancer neoadjuvant chemotherapy datasets. Accuracy of the E2F4 signature in predicting neoadjuvant chemotherapy response was compared to that of the Oncotype DX and MammaPrint predictive signatures. RESULTS: In all datasets, E2F4 activity level was an accurate predictor of neoadjuvant chemotherapy response, with high E2F4 scores predictive of achieving pathologic complete response and low scores predictive of residual disease. These results remained significant even after stratifying patients by estrogen receptor (ER) status, tumor stage, and breast cancer molecular subtypes. Compared to the Oncotype DX and MammaPrint signatures, our E2F4 signature achieved similar performance in predicting neoadjuvant chemotherapy response, though all signatures performed better in ER+ tumors compared to ER- ones. The accuracy of our signature was reproducible across datasets and was maintained when refined from a 199-gene signature down to a clinic-friendly 33-gene panel. CONCLUSION: Overall, we show that our E2F4 signature is accurate in predicting patient response to neoadjuvant chemotherapy. As this signature is more refined and comparable in performance to other clinically available gene expression assays in the prediction of neoadjuvant chemotherapy response, it should be considered when evaluating potential treatment options.

Filamentous fungal carbon catabolite repression supports metabolic plasticity and stress responses essential for disease progression.

Aspergillus fumigatus is responsible for a disproportionate number of invasive mycosis cases relative to other common filamentous fungi. While many fungal factors critical for infection establishment are known, genes essential for disease persistence and progression are ill defined. We propose that fungal factors that promote navigation of the rapidly changing nutrient and structural landscape characteristic of disease progression represent untapped clinically relevant therapeutic targets. To this end, we find that A. fumigatus requires a carbon catabolite repression (CCR) mediated genetic network to support in vivo fungal fitness and disease progression. While CCR as mediated by the transcriptional repressor CreA is not required for pulmonary infection establishment, loss of CCR inhibits fungal metabolic plasticity and the ability to thrive in the dynamic infection microenvironment. Our results suggest a model whereby CCR in an environmental filamentous fungus is dispensable for initiation of pulmonary infection but essential for infection maintenance and disease progression. Conceptually, we argue these data provide a foundation for additional studies on fungal factors required to support fungal fitness and disease progression and term such genes and factors, DPFs (disease progression factors).

Application of RNAi-induced gene expression profiles for prognostic prediction in breast cancer.

Homologous recombination (HR) is the primary pathway for repairing double-strand DNA breaks implicating in the development of cancer. RNAi-based knockdowns of BRCA1 and RAD51 in this pathway have been performed to investigate the resulting transcriptomic profiles. Here we propose a computational framework to utilize these profiles to calculate a score, named RNA-Interference derived Proliferation Score (RIPS), which reflects cell proliferation ability in individual breast tumors. RIPS is predictive of breast cancer classes, prognosis, genome instability, and neoadjuvant chemosensitivity. This framework directly translates the readout of knockdown experiments into potential clinical applications and generates a robust biomarker in breast cancer.

Fabrication and characterization of electrospun zein/Ag nanocomposite mats for wound dressing applications.

Wound dressing is a very important factor in the process of wound healing as proper wound care can accelerate the recovery of the wound. In this study, zein nanofibrous mats with fiber diameters around 350-500 nm were prepared by electrospinning and silver (Ag) nanoparticles around 20 nm were concurrently synthesized in situ into the mats. The electrospun nanofibers were characterized by Field Emission-Scanning Electron Microscopy (FE-SEM), Transmission Electron Microscopy (TEM), Fourier Transform Infrared Spectroscopy (FTIR) and X-ray photoelectron spectroscopy (XPS) analysis. Cell viability and activity of fibroblasts cells in zein/Ag mats were also evaluated and results demonstrated good cytocompatibility and attachment of cells on the composite nanofibers. Also, the bactericidal activity of the fabricated mats against gram-positive Staphylococcus aureus (S. aureus) and gram-negative Escherichia coli (E. coli) was investigated via zone of inhibition test and results showed high anti-bacterial performance.

Pressure-sensitive paint measurements of transient shock phenomena.

Measurements of the global pressure field created by shock wave diffraction have been captured optically using a porous pressure-sensitive paint. The pressure field created by a diffracting shock wave shows large increases and decreases in pressure and can be reasonably accurately captured using CFD. The substrate, a thin-layer chromatography (TLC) plate, has been dipped in a luminophore solution. TLC plates are readily available and easy to prepare. Illumination comes from two high-intensity broadband Xenon arc light sources with short-pass filters. The sample is imaged at 100 kHz using a Vision Research Phantom V710 in conjunction with a pair of long and short pass filters, creating a band. The PSP results are compared with numerical simulations of the flow using the commercial CFD package Fluent as part of ANSYS 13 for two Mach numbers.

Refinement and discovery of new hotspots of copy-number variation associated with autism spectrum disorder.

Rare copy-number variants (CNVs) have been implicated in autism and intellectual disability. These variants are large and affect many genes but lack clear specificity toward autism as opposed to developmental-delay phenotypes. We exploited the repeat architecture of the genome to target segmental duplication-mediated rearrangement hotspots (n = 120, median size 1.78 Mbp, range 240 kbp to 13 Mbp) and smaller hotspots flanked by repetitive sequence (n = 1,247, median size 79 kbp, range 3-96 kbp) in 2,588 autistic individuals from simplex and multiplex families and in 580 controls. Our analysis identified several recurrent large hotspot events, including association with 1q21 duplications, which are more likely to be identified in individuals with autism than in those with developmental delay (p = 0.01; OR = 2.7). Within larger hotspots, we also identified smaller atypical CNVs that implicated CHD1L and ACACA for the 1q21 and 17q12 deletions, respectively. Our analysis, however, suggested no overall increase in the burden of smaller hotspots in autistic individuals as compared to controls. By focusing on gene-disruptive events, we identified recurrent CNVs, including DPP10, PLCB1, TRPM1, NRXN1, FHIT, and HYDIN, that are enriched in autism. We found that as the size of deletions increases, nonverbal IQ significantly decreases, but there is no impact on autism severity; and as the size of duplications increases, autism severity significantly increases but nonverbal IQ is not affected. The absence of an increased burden of smaller CNVs in individuals with autism and the failure of most large hotspots to refine to single genes is consistent with a model where imbalance of multiple genes contributes to a disease state.

Detection of structural variants and indels within exome data.

We report an algorithm to detect structural variation and indels from 1 base pair (bp) to 1 Mbp within exome sequence data sets. Splitread uses one end-anchored placements to cluster the mappings of subsequences of unanchored ends to identify the size, content and location of variants with high specificity and sensitivity. The algorithm discovers indels, structural variants, de novo events and copy number-polymorphic processed pseudogenes missed by other methods.