Idiopathic hypereosinophilic syndrome presenting as cardiac tamponade and multiorgan dysfunction.

Idiopathic hypereosinophilic syndrome is characterised by the overproduction of eosinophils with tissue infiltration, leading to multiorgan dysfunction. Its heterogenous presentation makes the diagnosis challenging and easy to miss. A woman in her 70s was admitted with chest pain and shortness of breath. Diagnostic testing showed elevated cardiac enzymes, an ejection fraction of 45% and pericardial effusion. Pericardiocentesis helped her symptoms significantly. Cardiac catheterisation revealed patent coronary arteries. She was diagnosed with myopericarditis and discharged on non-steroidal anti-inflammatory drugs. She returned the following week with worsening chest pain, dyspnoea and diarrhoea. Chest imaging showed bilateral infiltrates. Diagnostic testing showed eosinophilic predominance in peripheral blood (59%), pericardial fluid (37%) and bronchoalveolar lavage (31%). After a negative infectious workup, she was started on glucocorticoids and responded favourably. She was discharged on steroids. Mepolizumab was initiated outpatient, and steroids were discontinued. Mepolizumab was discontinued after 2 years while monitoring her symptoms and eosinophil counts.

An Uncommon Presentation of Pulmonary Tularemia: A Case Report and Literature Review.

Francisella tularensis is a re-emerging organism causing more significant outbreaks of tularemia and fear of bioterrorism. It can be challenging to recognize tularemia due to its variable presentation, especially in low-incidence areas. Physicians must be mindful of this life-threatening infectious disease and consider it a differential diagnosis in patients with fever of unknown origin. We encountered a case of pulmonary tularemia with a unique presentation of severe headache and fever.

Neural correlates of subordinate-level categorization of own- and other-race faces in infancy.

Perceptual narrowing is a domain-general process in which infants move from a broad sensitivity to a wide range of stimuli to developing expertise within often experienced native stimuli (Maurer & Werker, 2014). One outcome of this is the own-race bias, characterized by an increasing difficulty in discriminating other-race faces with age and experience for those raised in a racially homogenous environment (Anzures, Quinn, Pascalis, Slater, Tanaka, & Lee, 2013). Theorists have proposed that this is due to a categorization-individuation process, wherein infants begin to categorize non-native stimuli but continue to individuate native stimuli (Hugenberg, Young, Bernstein, & Sacco, 2010; Nelson, 2001). Exposure to multiple exemplars during initial learning has been found to facilitate infant categorization of other-species faces while exposure to a single exemplar does not (Dixon, Reynolds, Romano, Roth, Stumpe, Guy, & Mosteller, 2019). The goal of this study was to investigate the effects of initial learning conditions on infants' ability to individuate and categorize own- and other-race faces. Ten-month-old infants were familiarized with a single exemplar or multiple exemplars of own- or other-race faces. Event-related potentials (ERPs) were recorded while infants were presented with the familiar face(s) they were exposed to during familiarization, novel faces from the same race used during familiarization, and novel faces from a race other than the one used in familiarization. Infants familiarized with a single exemplar, regardless of race, showed significant differences in both the Nc component (Negative central, associated with visual attention) and the LSW (late slow wave, associated with recognition memory) between familiar and novel faces at the subordinate-level category of race. No differences were found across familiarization conditions for the P400 component associated with face processing. Infants familiarized with multiple exemplars showed no evidence of discriminating faces at the categorical or individual level. Results suggest that, in contrast to other-species faces, infants at this age may process human faces more efficiently when familiarized with a single exemplar. The implications of the current findings are discussed in relation to the impact of initial learning conditions on infants' ability to individuate and categorize own- and other-species faces and social implications of infants' processing of other-race faces.

Infant selective attention to native and non-native audiovisual speech.

The current study utilized eye-tracking to investigate the effects of intersensory redundancy and language on infant visual attention and detection of a change in prosody in audiovisual speech. Twelve-month-old monolingual English-learning infants viewed either synchronous (redundant) or asynchronous (non-redundant) presentations of a woman speaking in native or non-native speech. Halfway through each trial, the speaker changed prosody from infant-directed speech (IDS) to adult-directed speech (ADS) or vice versa. Infants focused more on the mouth of the speaker on IDS trials compared to ADS trials regardless of language or intersensory redundancy. Additionally, infants demonstrated greater detection of prosody changes from IDS speech to ADS speech in native speech. Planned comparisons indicated that infants detected prosody changes across a broader range of conditions during redundant stimulus presentations. These findings shed light on the influence of language and prosody on infant attention and highlight the complexity of audiovisual speech processing in infancy.

Reverse Transcription Loop-Mediated Isothermal Amplification Assay for Ultrasensitive Detection of SARS-CoV-2 in Saliva and Viral Transport Medium Clinical Samples.

The COVID-19 pandemic has underscored the shortcomings in the deployment of state-of-the-art diagnostics platforms. Although several polymerase chain reaction (PCR)-based techniques have been rapidly developed to meet the growing testing needs, such techniques often need samples collected through a swab, the use of RNA extraction kits, and expensive thermocyclers in order to successfully perform the test. Isothermal amplification-based approaches have also been recently demonstrated for rapid severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) detection by minimizing sample preparation while also reducing the instrumentation and reaction complexity. In addition, there are limited reports of saliva as the sample source, and some of these indicate inferior sensitivity when comparing reverse transcription loop-mediated isothermal amplification (RT-LAMP) with PCR-based techniques. In this paper, we demonstrate an improved sensitivity assay from saliva using a two-step RT-LAMP assay, where a short 10 min RT step is performed with only B3 and backward inner primers before the final reaction. We show that while the one-step RT-LAMP demonstrates satisfactory results, the optimized two-step approach allows detection of only few molecules per reaction and performs significantly better than the one-step RT-LAMP and conventional two-step RT-LAMP approaches with all primers included in the RT step. We show control measurements with RT-PCR, and importantly, we demonstrate RNA extraction-free RT-LAMP-based assays for detection of SARS-CoV-2 from viral transport media and saliva clinical samples.

Patient-Reported Outcomes in Sinonasal and Skull Base Malignancy: An Assessment of Study Quality and Clinical Relevance.

BACKGROUND: Sinonasal and skull base malignancies can cause significant adverse effects on functional status and survival. OBJECTIVE: The goal of this study was to systematically review the published literature of patient-reported outcomes pertaining to treatment of sinonasal and skull base malignancy. METHODS: A systematic literature search of Medline was conducted with PubMed to identify studies that assessed patient-reported outcomes in patients with sinonasal or skull base malignancy. Patient-reported outcomes studies with at least 10 patients published in English from January 2000 to April 2017 were included. Criteria from International Society for Quality of Life guidelines and criteria unique to sinonasal and skull base malignancies were used to calculate a composite score for each article. Studies with the top 33% of scores were categorized as high quality articles. RESULTS: Twenty-two articles met inclusion/exclusion criteria. Three studies (14%) reported a priori hypothesis. Eleven (50%) assessed specific quality of life domains and 10 studies (45%) performed statistical analysis on these domains. Specific symptoms were assessed in up to 32% of studies. Eight studies were characterized as high quality; these studies had higher sample sizes and more often assessed patient-reported outcomes prior to treatment compared to low quality studies. CONCLUSIONS: The goal of the current study was to evaluate the quality of the current patient-reported outcomes literature on sinonasal and skull base malignancies. Areas of improvement for future studies include analysis of individual domains and disease-specific symptoms, reporting a priori hypotheses, and collecting preoperative and longitudinal patient-reported outcomes data.

Functional Brain Changes During Mindfulness-Based Cognitive Therapy Associated With Tinnitus Severity.

Mindfulness-based therapies have been introduced as a treatment option to reduce the psychological severity of tinnitus, a currently incurable chronic condition. This pilot study of twelve subjects with chronic tinnitus investigates the relationship between measures of both task-based and resting state functional magnetic resonance imaging (fMRI) and measures of tinnitus severity, assessed with the Tinnitus Functional Index (TFI). MRI was measured at three time points: before, after, and at follow-up of an 8-week long mindfulness-based cognitive therapy intervention. During the task-based fMRI with affective sounds, no significant changes were observed between sessions, nor was the activation to emotionally salient compared to neutral stimuli significantly predictive of TFI. Significant results were found using resting state fMRI. There were significant decreases in functional connectivity among the default mode network, cingulo-opercular network, and amygdala across the intervention, but no differences were seen in connectivity with seeds in the dorsal attention network (DAN) or fronto-parietal network and the rest of the brain. Further, only resting state connectivity between the brain and the amygdala, DAN, and fronto-parietal network significantly predicted TFI. These results point to a mostly differentiated landscape of functional brain measures related to tinnitus severity on one hand and mindfulness-based therapy on the other. However, overlapping results of decreased amygdala connectivity with parietal areas and the negative correlation between amygdala-parietal connectivity and TFI is suggestive of a brain imaging marker of successful treatment.

Neural correlates of individuation and categorization of other-species faces in infancy.

The goal of this study was to investigate 9-month-old infants' ability to individuate and categorize other-species faces at the subordinate level. We were also interested in examining the effects of initial exposure conditions on infant categorization and individuation processes. Infants were either familiarized with a single monkey face in an individuation procedure or familiarized with multiple exemplars of monkey faces from the same species in a categorization procedure. Event-related potentials were recorded while the infants were presented: familiar faces, novel faces from the familiar species, or novel faces from a novel species. The categorization group categorized monkey faces by species at the subordinate level, whereas the individuation group did not discriminate monkey faces at the individual or subordinate level. These findings indicate initial exposure to multiple exemplars facilitates infant processing of other-species faces, and infants are efficient at subordinate-level categorization at 9 months of age.

The Development of Attentional Biases for Faces in Infancy: A Developmental Systems Perspective.

We present an integrative review of research and theory on major factors involved in the early development of attentional biases to faces. Research utilizing behavioral, eye-tracking, and neuroscience measures with infant participants as well as comparative research with animal subjects are reviewed. We begin with coverage of research demonstrating the presence of an attentional bias for faces shortly after birth, such as newborn infants' visual preference for face-like over non-face stimuli. The role of experience and the process of perceptual narrowing in face processing are examined as infants begin to demonstrate enhanced behavioral and neural responsiveness to mother over stranger, female over male, own- over other-race, and native over non-native faces. Next, we cover research on developmental change in infants' neural responsiveness to faces in multimodal contexts, such as audiovisual speech. We also explore the potential influence of arousal and attention on early perceptual preferences for faces. Lastly, the potential influence of the development of attention systems in the brain on social-cognitive processing is discussed. In conclusion, we interpret the findings under the framework of Developmental Systems Theory, emphasizing the combined and distributed influence of several factors, both internal (e.g., arousal, neural development) and external (e.g., early social experience) to the developing child, in the emergence of attentional biases that lead to enhanced responsiveness and processing of faces commonly encountered in the native environment.

Atomic layer deposition and abrupt wetting transitions on nonwoven polypropylene and woven cotton fabrics.

Atomic layer deposition (ALD) of aluminum oxide on nonwoven polypropylene and woven cotton fabric materials can be used to transform and control fiber surface wetting properties. Infrared analysis shows that ALD can produce a uniform coating throughout the nonwoven polypropylene fiber matrix, and the amount of coating can be controlled by the number of ALD cycles. Upon coating by ALD aluminum oxide, nonwetting hydrophobic polypropylene fibers transition to either a metastable hydrophobic or a fully wetting hydrophilic state, consistent with well-known Cassie-Baxter and Wenzel models of surface wetting of roughened surfaces. The observed nonwetting/wetting transition depends on ALD process variables such as the number of ALD coating cycles and deposition temperature. Cotton fabrics coated with ALD aluminum oxide at moderate temperatures were also observed to transition from a natural wetting state to a metastable hydrophobic state and back to wetting depending on the number of ALD cycles. The transitions on cotton appear to be less sensitive to deposition temperature. The results provide insight into the effect of ALD film growth mechanisms on hydrophobic and hydrophilic polymers and fibrous structures. The ability to adjust and control surface energy, surface reactivity, and wettability of polymer and natural fiber systems using atomic layer deposition may enable a wide range of new applications for functional fiber-based systems.

Regulation of NAB2 mRNA 3'-end formation requires the core exosome and the Trf4p component of the TRAMP complex.

The nuclear exosome functions in a variety of pathways catalyzing formation of mature RNA 3'-ends or the destruction of aberrant RNA transcripts. The RNA 3'-end formation activity of the exosome appeared restricted to small noncoding RNAs. However, the nuclear exosome controls the level of the mRNA encoding the poly(A)-binding protein Nab2p in a manner requiring an A(26) sequence in the mRNA 3' untranslated regions (UTR), and the activities of Nab2p and the exosome-associated exoribonuclease Rrp6p. Here we show that the A(26) sequence inhibits normal 3'-end processing of NAB2 mRNA in vivo and in vitro, and makes formation of the mature 3'-end dependent on trimming of the transcript by the core exosome and the Trf4p component of the TRAMP complex from a downstream site. The detection of mature, polyadenylated transcripts ending at, or within, the A(26) sequence indicates that exosome trimming sometimes gives way to polyadenylation of the mRNA. Alternatively, Rrp6p and the TRAMP-associated Mtr4p degrade these transcripts thereby limiting the amount of Nab2p in the cell. These findings suggest that NAB2 mRNA 3'-end formation requires the exosome and TRAMP complex, and that competition between polyadenylation and Rrp6p-dependent degradation controls the level of this mRNA.

The nuclear exosome contributes to autogenous control of NAB2 mRNA levels.

The RNA-processing exosome is a complex of riboexonucleases required for 3'-end formation of some noncoding RNAs and for the degradation of mRNAs in eukaryotes. The nuclear form of the exosome functions in an mRNA surveillance pathway that retains and degrades improperly processed precursor mRNAs within the nucleus. We report here that the nuclear exosome controls the level of NAB2 mRNA, encoding the nuclear poly(A)+-RNA-binding protein Nab2p. Mutations affecting the activity of the nuclear, but not the cytoplasmic, exosome cause an increase in the amount of NAB2 mRNA. Cis- and trans-acting mutations that inhibit degradation by the nuclear-exosome subunit Rrp6p result in elevated levels of NAB2 mRNA. Control of NAB2 mRNA levels occurs posttranscriptionally and requires a sequence of 26 consecutive adenosines (A26) in the NAB2 3' untranslated region, which represses NAB2 3'-end formation and sensitizes the transcript to degradation by Rrp6p. Analysis of NAB2 mRNA levels in a nab2-1 mutant and in the presence of excess Nab2p indicates that Nab2p activity negatively controls NAB2 mRNA levels in an A26- and Rrp6p-dependent manner. These findings suggest a novel regulatory circuit in which the nuclear exosome controls the level of NAB2 mRNA in response to changes in the activity of Nab2 protein.

Phototropism and gravitropism in lateral roots of Arabidopsis.

Gravitropism and, to a lesser extent, phototropism have been characterized in primary roots, but little is known about structural/functional aspects of these tropisms in lateral roots. Therefore, in this study, we report on tropistic responses in lateral roots of Arabidopsis thaliana. Lateral roots initially are plagiogravitropic, but when they reach a length of approximately 10 mm, these roots grow downward and exhibit positive orthogravitropism. Light and electron microscopic studies demonstrate a correlation between positive gravitropism and development of columella cells with large, sedimented amyloplasts in wild-type plants. Lateral roots display negative phototropism in response to white and blue light and positive phototropism in response to red light. As is the case with primary roots, the photoresponse is weak relative to the graviresponse, but phototropism is readily apparent in starchless mutant plants, which are impaired in gravitropism. To our knowledge, this is the first report of phototropism of lateral roots in any plant species.