A Case of Subcutaneous Panniculitis-Like T-cell Lymphoma With Hemophagocytic Lymphohistiocytosis in an HIV Patient.

Subcutaneous panniculitis-like T-cell lymphoma (SPTL) is a rare subtype of non-Hodgkin lymphoma that manifests as panniculitis-like skin lesions. It frequently co-occurs with hemophagocytic lymphohistocytosis, a life-threatening hyperinflammatory syndrome. The majority of SPTL cases express αß T-cell receptors (SPTL-AB) and have a favorable prognosis with oral immunosuppressive agents. We report a 37-year-old male patient with HIV infection who had a history of low-grade fever for one year, multiple tender subcutaneous nodules on both thighs, and cytopenia. He received several courses of antibiotics without significant improvement. A random skin biopsy showed lobular panniculitis and he was treated with steroids, but his fever recurred after steroid withdrawal. A second skin biopsy confirmed the diagnosis of SPTL. A bone marrow examination revealed hemophagocytic lymphohistiocytosis. He was successfully treated with cyclosporin A and prednisolone and achieved a complete response after one year of drug discontinuation. Panniculitis-like skin lesions have various etiologies and may present as a clinical mimic of lupus erythematosus panniculitis. The selection of an optimal site for skin biopsy is crucial to avoid erroneous diagnoses and adverse outcomes. We report a case of SPTL in an HIV-positive patient, which illustrates this diagnostic challenge.

Why Chuño Matters: Rethinking the History of Technology in Latin America.

This article examines the over-attention historians pay to innovation and high technology compared to local production through a brief review of the historiography of technology in twentieth-century Latin America. Following Svante Lindqvist's approach to "technological landscapes," it argues that the current history of technology in the region favors change over continuity, thus perpetuating a modernist and industrial perspective of technological dynamics. Based on a case study of chuño (frozendehydrated potatoes) production and consumption on the Altiplano of Peru and Bolivia, this article shows how historians could incorporate local and long-standing knowledge and use into the history-of-technology canon.

Post-Pandemic Telehealth Policy for Primary Care: An Equity Perspective.

National telehealth policy thus far has focused on broadening access to service, specialties, and originating sites. Yet telehealth policy can further equity by providing system-level change needed to reduce structural determinants that hamper telehealth access in historically marginalized, low income, and limited English-speaking populations. The authors propose policy solutions for states and CMS to help address these structural determinants of telehealth care. A telehealth "ecosystem" grounded in the following core components would ensure equitable access to care: use of technology inclusive of economically marginalized patients, access to the technology and broadband for completing virtual visits, and concrete support for patients as they develop their digital and telehealth skills.

Genetic Modification of Cyanobacteria by Conjugation Using the CyanoGate Modular Cloning Toolkit.

Cyanobacteria are a diverse group of prokaryotic photosynthetic organisms that can be genetically modified for the renewable production of useful industrial commodities. Recent advances in synthetic biology have led to development of several cloning toolkits such as CyanoGate, a standardized modular cloning system for building plasmid vectors for subsequent transformation or conjugal transfer into cyanobacteria. Here we outline a detailed method for assembling a self-replicating vector (e.g., carrying a fluorescent marker expression cassette) and conjugal transfer of the vector into the cyanobacterial strains Synechocystis sp. PCC 6803 or Synechococcus elongatus UTEX 2973. In addition, we outline how to characterize the performance of a genetic part (e.g., a promoter) using a plate reader or flow cytometry.

Emerging Species and Genome Editing Tools: Future Prospects in Cyanobacterial Synthetic Biology.

Recent advances in synthetic biology and an emerging algal biotechnology market have spurred a prolific increase in the availability of molecular tools for cyanobacterial research. Nevertheless, work to date has focused primarily on only a small subset of model species, which arguably limits fundamental discovery and applied research towards wider commercialisation. Here, we review the requirements for uptake of new strains, including several recently characterised fast-growing species and promising non-model species. Furthermore, we discuss the potential applications of new techniques available for transformation, genetic engineering and regulation, including an up-to-date appraisal of current Clustered Regularly Interspaced Short Palindromic Repeats/CRISPR associated protein (CRISPR/Cas) and CRISPR interference (CRISPRi) research in cyanobacteria. We also provide an overview of several exciting molecular tools that could be ported to cyanobacteria for more advanced metabolic engineering approaches (e.g., genetic circuit design). Lastly, we introduce a forthcoming mutant library for the model species Synechocystis sp. PCC 6803 that promises to provide a further powerful resource for the cyanobacterial research community.

Hidden diversity within the depauperate genera of the snake tribe Lampropeltini (Serpentes, Colubridae).

Accurate representation of lineage diversity through complete taxon sampling is crucial to understanding the evolution of biodiversity, particularly when using molecular phylogenetics to estimate evolutionary relationships. In this interest, taxonomic diversity is often used as a proxy for lineage diversity even though the two concepts are not synonymous. We explore this within the snake tribe Lampropeltini which includes some of the most conspicuous and heavily studied snakes in North America. Both the taxonomy and hypothesized relationships within this tribe have been in flux. The number of species has increased from 23 to 51 over the last thirty years, predominately within three of the nine genera (Lampropeltis, Pantherophis, Pituophis). The remaining six depauperate genera (Arizona, Bogertophis, Cemophora, Pseudelaphe, Rhinocheilus, and Senticolis) have been poorly represented in phylogenetic studies. To estimate evolutionary relationships and determine if the dichotomy in depauperate and speciose genera within Lampropeltini is a function of taxon sampling or truly represents the lineage diversity, we estimated the phylogeny of this group using nuclear and mitochondrial loci in a concatenated and coalescent framework with the largest sampling of the six depauperate genera to date. In addition, we estimated the divergence dates among the genera to assess whether the instability of Lampropeltini phylogenetic relationships is due to an adaptive radiation. While some nodes still remain unresolved, the generic-level relationships we recovered agree with those of a recent next-generation study that used a much larger set of loci for fewer individuals. We also tested two putative species, Arizona pacata and Pseudelaphe phaescens, for the first time phylogenetically and find evidence that they are distinct lineages. Overall, we find that the taxonomic and genetic diversity are not correlated in Lampropeltini and that representing putative diversity in phylogenies will lead to a better estimate of evolutionary histories, especially in groups with complex radiations.

Calidad de vida relacionada con la salud bucal en adultos mayores que consultan a la IPS Universitaria de Medellín y sus factores asociados / Oral health related quality of life in older adults assisting "IPS Universitaria" of Medellin and associated factors

Introducción y objetivo: Este estudio pretende analizar la relación existente entre la calidad de vida relacionada con la salud bucal (CVRSB) con indicadores de salud general y salud bucal autopercibida en la población adulta mayor que consulta a la IPS Universitaria y explorar los factores sociodemográficos asociados. Materiales y métodos: Estudio transversal en 100 adultos mayores que consultaron servicios de salud en la IPS (2012) mediante encuesta con información sociodemográfica, salud general y bucal. Aplicación del instrumento OHIP-14 (Perfil de Impacto de la Salud Oral en la Calidad de Vida). Descripción del OHIP-14 general y según diferentes variables sociodemográficas y de salud y cálculo de Razones de Prevalencia crudas y ajustadas mediante modelos multivariados. Resultados: Las mayores respuestas se concentraron en las opciones nunca o casi nunca, ocupando porcentajes superiores al 70%. Los peores indicadores de prevalencia se presentaron en mujeres, mayores de 75 años, bajo nivel educativo, estratos socioeconómicos bajos y en la población soltera. En general un poco más de la tercera parte reportaron 1 o más impactos en las dimensiones de la calidad de vida, con un promedio de 0,86 (IC95% 0,53- 1,19) y un puntaje total de severidad de 7,61 (IC95% 5,98- 9,24). Conclusión: Aunque en la mayoría de la población encuestada, su condición bucal no ejercía una influencia negativa en su calidad de vida, al analizar en profundidad se encontraron gradientes de desigualdad según factores sociodemográficos.

Introduction and objective: We aim to analyze the relationship between the oral health related quality of life, and self-perceived general and oral health indicators in elderly population assisted in the "IPS Universitaria" and to explore socio-demographic related factors. Materials and methods: Cross-sectional study in 100 elderlies assisting health services in the IPS (2012), by means of surveys with socio-demographic, general and oral health information. The OHIP-14 (Oral health impact profile) was carried out. A descriptive analysis of the OHIP-14 was conducted for different variables and Prevalence Ratio were measure by means of multivariate models. Results: Higher response rates (up to 70%) were found in the dimensions "never" and "almost never" in OHIP-14. Worst indicators of impact prevalence of the OHIP-14 were found in women, population > 75 years, with low educative and socioeconomic status and in singles. A little more of third part of participants reported 1 or more impacts in the oral health related quality of life dimensions (0.86; 95%CI 0.53- 1.19) and a severity score of 7.61 (95%CI 5.98- 9.24). Conclusions: Although in the majority of the respondents, their oral conditions did not execute a negative influence in the quality of life. In-depth analysis has shown inequalities gradients according to socio-demographic factors.