Severe kerion Celsi caused by Trichophyton quinckeanum: Severe kerion Celsi due to Trichophyton quinckeanum.

We report a severe case of kerion Celsi of the scalp in a previously healthy 13-year-old girl due to Trichophyton quinckeanum, an emerging dermatophyte species in Europe. The species was definitely identified by DNA sequencing and the patient was successfully treated by oral terbinafine for 6 weeks. Kerion Celsi is a severe inflammatory form of tinea capitis, which is characterised by a purulent discharge and alopecia [1]. It typically occurs in children infected with zoophilic dermatophytes, such as Trichophyton mentagrophytes, and an increasing number of cases caused by other Trichophyton species has recently been reported [2]. Herein we report a severe case of kerion Celsi of the scalp caused by the emerging species Trichophyton quinckeanum, which was successfully treated by oral antifungal.

Bright and ultrafast electron point source made of LaB6 nanotip.

The development of time-resolved transmission electron microscopy (TEM), ultrafast electron spectroscopy and pulsed X-ray sources relies on the realization of stable and high brightness sources of ultra-short electron bunches with a long service time. The flat photocathodes implanted in thermionic electron guns have been replaced by Schottky-type or cold-field emission sources driven by ultra-fast laser. Recently, lanthanum hexaboride (LaB6) nanoneedles have been reported to have high brightness and high emission stability when working in a continuous emission mode. Here, we prepare nano-field emitters from bulk LaB6 and we report on their use as ultra-fast electron sources. Using a high repetition rate laser in the infrared range, we present different field emission regimes as a function of the extraction voltage and laser intensity. The properties of the electron source (brightness, stability, energy spectrum and emission pattern) are determined for the different regimes. Our results show that LaB6 nanoneedles can be used as ultrafast and ultra-bright sources for time-resolved TEM, with better performances as compared to metallic ultra-fast field-emitters.

Multicentric Analysis of the Species Distribution and Antifungal Susceptibility of Clinical Isolates from Aspergillus Section Circumdati.

The clinical involvement and antifungal susceptibility of Aspergillus section Circumdati are poorly known. We analyzed 52 isolates, including 48 clinical isolates, belonging to 9 species inside the section Circumdati. The whole section exhibited, by the EUCAST reference method, a poor susceptibility to amphotericin B, but species/series-specific patterns were observed for azole drugs. This underlines the interest in getting an accurate identification inside the section Circumdati to guide the choice of antifungal treatment in clinical practice.

Influence and Mechanisms of Action of Environmental Stimuli on Work Near and Above the Severe Domain Boundary (Critical Power).

The critical power (CP) concept represents the uppermost rate of steady state aerobic metabolism during work. Work above CP is limited by a fixed capacity (W') with exercise intensity being an accelerant of its depletion rate. Exercise at CP is a considerable insult to homeostasis and any work done above it will rapidly become intolerable. Humans live and exercise in situations of hypoxia, heat, cold and air pollution all of which impose a new environmental stress in addition to that of exercise. Hypoxia disrupts the oxygen cascade and consequently aerobic energy production, whereas heat impacts the circulatory system's ability to solely support exercise performance. Cold lowers efficiency and increases the metabolic cost of exercise, whereas air pollution negatively impacts the respiratory system. This review will examine the effects imposed by environmental conditions on CP and W' and describe the key physiological mechanisms which are affected by the environment.

Water in an External Electric Field: Comparing Charge Distribution Methods Using ReaxFF Simulations.

The growing interest in the effects of external electric fields on reactive processes requires predictive methods that can reach longer length and time scales than quantum mechanical simulations. Recently, many studies have included electric fields in ReaxFF, a widely used reactive molecular dynamics method. In the case of modeling an external electric field, the charge distribution method used in ReaxFF is critical. The most common charge distribution method used in previous studies of electric fields is the charge equilibration (QEq) method, which assumes that the system is a contiguous conductor and that charge transfer can occur across any distance. In contrast, many systems of interest are insulators or semiconductors, and long-distance charge transfer should not occur in response to a small difference in potential. This study focuses on the limitations of the QEq method in the context of water in an external electric field. We demonstrate that QEq can predict unphysical charge distributions and exhibits properties that do not converge as a function of system size. Furthermore, we show that electric fields within the recently developed atom-condensed Kohn-Sham density functional theory (DFT) approximated to the second-order (ACKS2) approach address the major limitations of electric fields in QEq. With ACKS2, we observe more physical charge distributions and properties that converge as a function of system size. We do not suggest that ACKS2 is perfect in all circumstances but rather show specific cases where it addresses the major shortcomings of QEq in the context of an external electric field.

Elevated peak systolic blood pressure in endurance-trained athletes: Physiology or pathology?

Blood pressure is a function of cardiac output and peripheral vascular resistance. During graded exercise testing (GXT), systolic blood pressure (SBP) is expected to increase gradually along with work rate, oxygen consumption, heart rate, and cardiac output. Individuals exposed to chronic endurance training attain a greater exercise SBP than in their untrained state and sedentary counterparts, but it is currently unknown what is considered a safe upper limit. This review discusses key studies examining blood pressure response in sedentary individuals and athletes. We highlight the physiological characteristics of highly fit individuals in terms of cardiovascular physiology and exercise blood pressure and review the state of the current literature regarding the safety of high SBP during exercise in this particular subgroup. Findings from this review indicate that a consensus on what is a normal SBP response to exercise in highly fit subjects and direct causation linking high GXT SBP to pathology is lacking. Consequently, applying GXT SBP guidelines developed for a "normal" population to endurance-trained individuals appears unsupported at this time. Lack of evidence for poor outcomes leads us to infer that elevated peak SBP in this subgroup could more likely reflect an adaptive response to training, rather than a pathological outcome. Future studies should track clinical outcomes of those achieving elevated SBP and develop athlete-specific guidelines.

Unexpected mould diversity in clinical isolates from French Guiana and associated identification difficulties.

New mold species are increasingly reported in invasive fungal infections. However, these fungi are often misdiagnosed or undiagnosed due to the use of inappropriate laboratory diagnostic tools. Tropical countries, such as French Guiana, harbor a vast diversity of environmental fungi representing a potential source of emerging pathogens. To assess the impact of this diversity on the accuracy of mold-infection diagnoses, we identified mold clinical isolates in French Guiana during a five-month follow-up using both microscopy and matrix-assisted laser desorption ionization time-of-flight mass spectrometry. In total, 38.8% of the 98 obtained molds isolates could not be identified and required a DNA-based identification. Fungal diversity was high, including 46 species, 26 genera, and 13 orders. Fungal ecology was unusual, as Aspergillus species accounted for only 27% of all isolates, and the Nigri section was the most abundant out of the six detected Aspergillus sections. Macromycetes (orders Agaricales, Polyporales, and Russulales) and endophytic fungi accounted for respectively 11% and 14% of all isolates. Thus, in tropical areas with high fungal diversity, such as French Guiana, routine mold identification tools are inadequate. Molecular identifications, as well as morphological descriptions, are necessary for the construction of region-specific mass spectrum databases. These advances will improve the diagnosis and clinical management of new fungal infections. LAY SUMMARY: In French Guiana, environmental fungal diversity may be a source of emerging pathogens. We evaluated microscopy and mass spectrometry to identify mold clinical isolates. With 39% of unidentified isolates, a region-specific mass spectrum database would improve the diagnosis of new fungal infections.

A photonic atom probe coupling 3D atomic scale analysis with in situ photoluminescence spectroscopy.

Laser enhanced field evaporation of surface atoms in laser-assisted Atom Probe Tomography (APT) can simultaneously excite photoluminescence in semiconductor or insulating specimens. An atom probe equipped with appropriate focalization and collection optics has been coupled with an in situ micro-photoluminescence (µPL) bench that can be operated during APT analysis. The photonic atom probe instrument we have developed operates at frequencies up to 500 kHz and is controlled by 150 fs laser pulses tunable in energy in a large spectral range (spanning from deep UV to near IR). Micro-PL spectroscopy is performed using a 320 mm focal length spectrometer equipped with a CCD camera for time-integrated and with a streak camera for time-resolved acquisitions. An example of application of this instrument on a multi-quantum well oxide heterostructure sample illustrates the potential of this new generation of tomographic atom probes.

Multicentric Analysis of the Species Distribution and Antifungal Susceptibility of Cryptic Isolates from Aspergillus Section Fumigati.

The antifungal susceptibility of Aspergillus cryptic species is poorly known. We assessed 51 isolates, belonging to seven Fumigati cryptic species, by the EUCAST reference method and the concentration gradient strip (CGS) method. Species-specific patterns were observed, with high MICs for azole drugs, except for Aspergillus hiratsukae and Aspergillus tsurutae, and high MICs for amphotericin B for Aspergillus lentulus and Aspergillus udagawae Essential and categorical agreements between EUCAST and CGS results were between 53.3 and 93.3%.

Species Distribution and Comparison between EUCAST and Gradient Concentration Strips Methods for Antifungal Susceptibility Testing of 112 Aspergillus Section Nigri Isolates.

Aspergillus niger, the third species responsible for invasive aspergillosis, has been considered as a homogeneous species until DNA-based identification uncovered many cryptic species. These species have been recently reclassified into the Aspergillus section Nigri However, little is yet known among the section Nigri about the species distribution and the antifungal susceptibility pattern of each cryptic species. A total of 112 clinical isolates collected from 5 teaching hospitals in France and phenotypically identified as A. niger were analyzed. Identification to the species level was carried out by nucleotide sequence analysis. The MICs of itraconazole, voriconazole, posaconazole, isavuconazole, and amphotericin B were determined by both the EUCAST and gradient concentration strip methods. Aspergillus tubingensis (n = 51, 45.5%) and Aspergillus welwitschiae (n = 50, 44.6%) were the most common species while A. niger accounted for only 6.3% (n = 7). The MICs of azole drugs were higher for A. tubingensis than for A. welwitschiae The MIC of amphotericin B was 2 mg/liter or less for all isolates. Importantly, MICs determined by EUCAST showed no correlation with those determined by the gradient concentration strip method, with the latter being lower than the former (Spearman's rank correlation tests ranging from 0.01 to 0.25 depending on the antifungal agent; P > 0.4). In conclusion, A. niger should be considered as a minority species in the section Nigri The differences in MICs between species for different azoles underline the importance of accurate identification. Significant divergences in the determination of MIC between EUCAST and the gradient concentration strip methods require further investigation.

Electronic transport properties of a lithium-decorated ZrTe5 thin film.

Through a combination of single crystal growth, experiments involving in situ deposition of surface adatoms, and complimentary modeling, we examine the electronic transport properties of lithium-decorated ZrTe5 thin films. We observe that the surface states in ZrTe5 are robust against Li adsorption. Both the surface electron density and the associated Berry phase are remarkably robust to adsorption of Li atoms. Fitting to the Hall conductivity data reveals that there exist two types of bulk carriers: those for which the carrier density is insensitive to Li adsorption, and those whose density decreases during initial Li depositions and then saturates with further Li adsorption. We propose this dependence is due to the gating effect of a Li-adsorption-generated dipole layer at the ZrTe5 surface.

Fusarium volatile, a new potential pathogen from a human respiratory sample.

We describe the isolation and characterization of Fusarium volatile from a bronchoalveolar lavage (BAL) sample of a female patient living in French Guiana with underlying pulmonary infections. Phylogenetic analysis of fragments of the calmodulin (cmdA), translation elongation factor (tef1), RNA polymerase second largest subunit (rpb2), and ß-tubulin (tub) loci revealed that strain CBS 143874 was closely related to isolate NRRL 25615, a known but undescribed phylogenetic species belonging to the African clade of the Fusarium fujikuroi species complex. The fungus differed phylogenetically and morphologically from related known species, and is therefore described as the new taxon Fusarium volatile. Antifungal susceptibility testing suggested that the new species is resistant to echinocandins, fluconazole, itraconazole with lower MICs against amphotericin B, voriconazole and posaconazole.

Comparison of matrix-assisted laser desorption ionization time of flight mass spectrometry (MALDI-TOF MS) systems for the identification of moulds in the routine microbiology laboratory.

OBJECTIVES: The purpose of this study was to compare the efficiency of mould identification of two matrix-assisted laser desorption ionization time of flight mass spectrometry (MALDI-TOF MS) systems - Vitek MS (VMS) and Microflex LT (MLT) - and the MSI application. METHODS: Moulds were collected retrospectively and prospectively to display epidemiological diversity of a microbiology laboratory. All of them were identified via sequencing. Strains were then identified using the VMS v3.0, the MLT, and the MSI software applied on MLT spectra. Rates of correct identifications to the species, to the complex, and to the genus level were compared with the molecular reference standard. RESULTS: A total of 102 isolates were collected. The rate of correct identification to the species level with the MLT was 42.2% (43/102) with a threshold of 1.7 (vs. 16.7% (17/102) with a threshold of 2.0, p < 0.05). The VMS performed better than the MLT with a threshold of 1.7 for species (49.0% (50/102), p 0.33) and complex level identifications (71.6% (73/102) vs. 54.9% (56/102), p < 0.05). However the highest performances were observed when the MLT spectra were analysed via the Mass Spectrometry Identification (MSI) software reaching 90.2% (92/102) of correct identification to the species, 92.2% (94/102) to the species complex and 94.1% (96/102) to the genus level. CONCLUSIONS: The VMS performed better than the MLT for mould identification. However, it remains of utmost importance to expand commercial databases, as performances of the MLT highly improved when using the MSI software and its extended database, reaching far above the VMS system. Thus the VMS could benefit from the use of this online tool.

Optimizing recovery to support multi-evening cycling competition performance.

Road criterium and track bicycle racing occur at high speeds, demand repeated high power outputs, last 10-90 min, and offer little chance for recovery after the event. Consecutive evenings of criterium and track racing are respectively known as speed-week or six-day events and take place in evening hours over the course of a week. Given the schedule and timing of these competitions, return to homeostasis can be compromised. No recommendations exist on how to optimize recovery for cyclists participating in these types of repeated evening competitions. Criterium and track cyclists spend considerable time, near and above the individual lactate threshold and therefore mostly utilize carbohydrate as their chief energy substrate. Henceforth, pre - and post-race nutrition and hydration is examined and recommendations are brought forward for carbohydrate, protein, and fluid intake. As evening high-intensity exercise perturbs sleep, strategies to optimize sleep are discussed and recommendations for an optimal sleep environment are given. Active recovery is examined, and the benefits of a short duration low intensity exercise reviewed. Passive recovery methods such as compression garments and cold water immersion are recommended, while evidence for massage, pneumatic compression devices, and neuromuscular electrical stimulation is still lacking. Optimizing recovery strategies will facilitate a return to the resting state following strenuous night competition.

Kinetics-Controlled Degradation Reactions at Crystalline LiPON/Lix CoO2 and Crystalline LiPON/Li-Metal Interfaces.

Detailed understanding of solid-solid interface structure-function relationships is critical for the improvement and wide deployment of all-solid-state batteries. The interfaces between lithium phosphorous oxynitride (LiPON) solid electrolyte material and lithium metal anode, and between LiPON and Lix CoO2 cathode, have been reported to generate solid-electrolyte interphase (SEI)-like products and/or disordered regions. Using electronic structure calculations and crystalline LiPON models, we predict that LiPON models with purely P-N-P backbones are kinetically inert towards lithium at room temperature. In contrast, transfer of oxygen atoms from low-energy Lix CoO2 (104) surfaces to LiPON is much faster under ambient conditions. The mechanisms of the primary reaction steps, LiPON structural motifs that readily reacts with lithium metal, experimental results on amorphous LiPON to partially corroborate these predictions, and possible mitigation strategies to reduce degradations are discussed. LiPON interfaces are found to be useful case studies for highlighting the importance of kinetics-controlled processes during battery assembly at moderate processing temperatures.

Nucleotide Sequence Database Comparison for Routine Dermatophyte Identification by Internal Transcribed Spacer 2 Genetic Region DNA Barcoding.

Conventional dermatophyte identification is based on morphological features. However, recent studies have proposed to use the nucleotide sequences of the rRNA internal transcribed spacer (ITS) region as an identification barcode of all fungi, including dermatophytes. Several nucleotide databases are available to compare sequences and thus identify isolates; however, these databases often contain mislabeled sequences that impair sequence-based identification. We evaluated five of these databases on a clinical isolate panel. We selected 292 clinical dermatophyte strains that were prospectively subjected to an ITS2 nucleotide sequence analysis. Sequences were analyzed against the databases, and the results were compared to clusters obtained via DNA alignment of sequence segments. The DNA tree served as the identification standard throughout the study. According to the ITS2 sequence identification, the majority of strains (255/292) belonged to the genus Trichophyton, mainly T. rubrum complex (n = 184), T. interdigitale (n = 40), T. tonsurans (n = 26), and T. benhamiae (n = 5). Other genera included Microsporum (e.g., M. canis [n = 21], M. audouinii [n = 10], Nannizzia gypsea [n = 3], and Epidermophyton [n = 3]). Species-level identification of T. rubrum complex isolates was an issue. Overall, ITS DNA sequencing is a reliable tool to identify dermatophyte species given that a comprehensive and correctly labeled database is consulted. Since many inaccurate identification results exist in the DNA databases used for this study, reference databases must be verified frequently and amended in line with the current revisions of fungal taxonomy. Before describing a new species or adding a new DNA reference to the available databases, its position in the phylogenetic tree must be verified.

Evaluation of the DiversiLab® automated repetitive sequence-based PCR system for the characterization of Candida albicans and Candida glabrata isolates.

The objective of our study was to assess the DiversiLab® automated repetitive sequence-based PCR (rep-PCR) system for typing C. albicans and C. glabrata isolates and to compare it with two proven and routinely used typing methods. A total of 39 isolates from 11 patients with candidaemia or tissue candidiasis (two to six isolates per patient) were analyzed with three typing methods: DiversiLab® rep-PCR, multilocus sequence typing and multilocus microsatellite typing. DiversiLab® rep-PCR results were consistent with those obtained using the two other typing methods for C. albicans, but not for C. glabrata. Thanks to its simplicity of use, rapidity, standardization and reproducibility, the DiversiLab® rep-PCR system is an interesting tool to investigate C. albicans infections.

Species Identification and In Vitro Antifungal Susceptibility of Aspergillus terreus Species Complex Clinical Isolates from a French Multicenter Study.

Aspergillus section Terrei is a species complex currently comprised of 14 cryptic species whose prevalence in clinical samples as well as antifungal susceptibility are poorly known. The aims of this study were to investigate A. Terrei clinical isolates at the species level and to perform antifungal susceptibility analyses by reference and commercial methods. Eighty-two clinical A. Terrei isolates were collected from 8 French university hospitals. Molecular identification was performed by sequencing parts of beta-tubulin and calmodulin genes. MICs or minimum effective concentrations (MECs) were determined for 8 antifungal drugs using both EUCAST broth microdilution (BMD) methods and concentration gradient strips (CGS). Among the 79 A. Terrei isolates, A. terreus stricto sensu (n = 61), A. citrinoterreus (n = 13), A. hortai (n = 3), and A. alabamensis (n = 2) were identified. All strains had MICs of ≥1 mg/liter for amphotericin B, except for two isolates (both A. hortai) that had MICs of 0.25 mg/liter. Four A. terreus isolates were resistant to at least one azole drug, including one with pan-azole resistance, yet no mutation in the CYP51A gene was found. All strains had low MECs for the three echinocandins. The essential agreements (EAs) between BMD and CGS were >90%, except for those of amphotericin B (79.7%) and itraconazole (73.4%). Isolates belonging to the A section Terrei identified in clinical samples show wider species diversity beyond the known A. terreus sensu stricto Azole resistance inside the section Terrei is uncommon and is not related to CYP51A mutations here. Finally, CGS is an interesting alternative for routine antifungal susceptibility testing.