Desmin gene expression is not ubiquitous in all upper airway myofibers and the pattern differs between healthy and sleep apnea subjects.

BACKGROUND: Desmin is a major cytoskeletal protein considered ubiquitous in mature muscle fibers. However, we earlier reported that a subgroup of muscle fibers in the soft palate of healthy subjects and obstructive sleep apnea patients (OSA) lacked immunoexpression for desmin. This raised the question of whether these fibers also lack messenger ribonucleic acid (mRNA) for desmin and can be considered a novel fiber phenotype. Moreover, some fibers in the OSA patients had an abnormal distribution and aggregates of desmin. Thus, the aim of the study was to investigate if these desmin protein abnormalities are also reflected in the expression of desmin mRNA in an upper airway muscle of healthy subjects and OSA patients. METHODS: Muscle biopsies from the musculus uvulae in the soft palate were obtained from ten healthy male subjects and six male patients with OSA. Overnight sleep apnea registrations were done for all participants. Immunohistochemistry, in-situ hybridization, and reverse transcription-quantitative polymerase chain reaction (RT-qPCR) techniques were used to evaluate the presence of desmin protein and its mRNA. RESULTS: Our findings demonstrated that a group of muscle fibers lacked expression for desmin mRNA and desmin protein in healthy individuals and OSA patients (12.0 ± 5.6% vs. 23.1 ± 10.8%, p = 0.03). A subpopulation of these fibers displayed a weak subsarcolemmal rim of desmin accompanied by a few scattered mRNA dots in the cytoplasm. The muscles of OSA patients also differed from healthy subjects by exhibiting muscle fibers with reorganized or accumulated aggregates of desmin protein (14.5 ± 6.5%). In these abnormal fibers, the density of mRNA was generally low or concentrated in specific regions. The overall quantification of desmin mRNA by RT-qPCR was significantly upregulated in OSA patients compared to healthy subjects (p = 0.01). CONCLUSIONS: Our study shows evidence that muscle fibers in the human soft palate lack both mRNA and protein for desmin. This indicates a novel cytoskeletal structure and challenges the ubiquity of desmin in muscle fibers. Moreover, the observation of reorganized or accumulated aggregates of desmin mRNA and desmin protein in OSA patients suggests a disturbance in the transcription and translation process in the fibers of the patients.

Temperature-induced effects on development, reproduction, and predation of Harmonia axyridis fed on first instar larvae Spodoptera litura.

Since metabolism, survival, and reproduction in hexapods are closely related to temperatures; changes in the mean and variance of temperature are major aspects of global climate change. In the typical context of biological control, understanding how predator-prey systems are impacted under thermal conditions can make pest control more effective and resilient. With this view, this study investigated temperature-mediated development and predation parameters of the predator Harmonia axyridis against the potential prey Spodoptera litura. The age-stage, two-sex life table of the predator was constructed at four temperatures (i.e. 15, 20, 25, and 30°C) by feeding on the first instar larvae of S. litura. Our results showed that the mean generation time (T) decreased but the intrinsic rate of increase (r) and the finite rate of increase (λ) increased with increased temperature. The mean duration of the total preadult stage decreased with higher temperatures. The T and r were 70.47 d and 0.0769 d-1 at 15°C; 58.41 d and 0.0958 d-1 at 20°C; 38.71 d and 0.1526 d-1 at 25°C; and 29.59 d and 0.1822 d-1 at 30°C, respectively. The highest net reproductive rate (R0) and fecundity were obtained at 25°C. The highest λ (1.1998 d-1) and lowest T (29.59 d) were obtained at 30°C, whereas the maximum net predation rate (C0) was at 25°C. Total population and predation rates projections were the highest at 30°C. Based on these findings, we anticipate that biological control strategies for this predator release against S. litura should be attuned to warming scenarios to achieve better biocontrol functions.

Curcuma longa essential oils: toxicity and repellency against imported fire ants (Formicidae: Hymenoptera).

Curcuma longa L. (Zingiberales: Zingiberaceae) leaf and rhizome essential oils were evaluated for their toxicity and repellency against invasive fire ants: red imported fire ants (RIFA), Solenopsis invicta Buren, black imported fire ants (BIFA), Solenopsis richteri Forel, and a reproductively functional hybrid (HIFA). Ar-turmerone was the major constituent of leaf (42.4%) and rhizome (40.4%) essential oils. A range of concentrations starting from 156 µg/g until the failure of treatment were used. Removal of treated sand in digging bioassay was used as a criterion for repellency. Leaf essential oil showed significantly higher repellency at concentrations of 19.5, 9.8, and 4.9 µg/g against RIFA, BIFA, and HIFA workers, respectively, as compared with control whereas rhizome essential oil was active at 39, 19.5, and 4.9 µg/g against BIFA, RIFA, and HIFA, respectively. Ar-turmerone exhibited repellency at 19.5 µg/g against HIFA workers whereas DEET (N,N-diethyl-meta-toluamide) failed at 39 µg/g. Leaf essential oil showed LC50 values of 85.8, 97.7, and 182.7µg/g against RIFA, BIFA and HIFA workers, whereas the rhizome essential oil had LC50 values of 127, 109.9, and 151.2 µg/g against these species, respectively. Ar-turmerone, tested only against HIFA, with LC50 value of 57.2 was the most active compound. Bifenthrin, a commonly used pyrethroid, with LC50 of 0.03, 0.32, and 0.018 µg/g was toxic against RIFA, BIFA, and HIFA workers, respectively. Both the essential oils and ar-turmerone showed toxicity and repellency against imported fire ants. Different formulations of these natural products will be tested to explore the use potential of these natural products under field conditions.

Botanical biopesticides have an influence on tomato quality through pest control and are cost-effective for farmers in developing countries.

Synthetic insecticides heavily applied to manage agricultural pests are highly hazardous to the environment and non-target organisms. Their overuse through repeated treatments in smallholder farming communities is frequent. Botanical biopesticides are ideal for sustainable pest management in agricultural environments by keeping synthetic insecticide use at a minimum. Here we evaluated a locally prepared neem seed extract (NSE) alongside emamectin benzoate against both lepidopteran pests Helicoverpa armigera (Hübner) and Spodoptera exigua (Hübner) on tomato Lycopersicon esculentum Mill under natural field conditions in Pakistan. We compared pest severity, fruit injury, quality, marketability, and cost:benefit ratio (CBR) between treatments. The concentration of azadirachtin A in the NSE was 26.5 ppm. NSE at 2% (20 mL/L) and the emamectin benzoate at the recommended field rate in Pakistan were sprayed weekly throughout the fruiting stage. The pest larvae were significantly more abundant on fruits than on flowers and leaves. Fruit injury and losses were significantly more important in untreated control compared to NSE and emamectin benzoate treatments. NSE efficacy varied with respect to the cultivars used and the seasons. Cultivar Eden harboured more pests than Adventa, and emamectin benzoate suppressed more pest individuals than NSE. Both the insecticidal treatments were comparable in terms of marketable yield productions as well as unmarketable, uninjured, and recovered fruit yields. NSE generated a higher CBR (1: 9.26) than emamectin benzoate (1: 3.23). NSE suppressed pests by acting as an antifeedant, similar to its synthetic counterpart. Smallholder growers can thus use NSE as a cost-effective solution in tomato pest management in Pakistan.

Baccharis Species Essential Oils: Repellency and Toxicity against Yellow Fever Mosquitoes and Imported Fire Ants.

Essential oils from five Baccharis species were screened for their toxicity and biting deterrence/repellency against yellow fever mosquito, Aedes aegypti (L.), and imported fire ants, including Solenopsis invicta Buren (RIFA), Solenopsis richteri Forel (BIFA) and their hybrids (HIFA). Baccharis microdonta DC. and B. punctulata DC. at 10 µg/cm2 showed biting deterrence similar to DEET, N, N-diethyl-meta-toluamide at 25 nmol/cm2, whereas the repellency of B. pauciflosculosa DC., B. sphenophylla Dusén ex Malme and B. reticularioides Deble & A.S. Oliveira essential oils was significantly lower than DEET against mosquitoes. Two major compounds from the active essential oils, kongol and spathulenol, also exhibited biting deterrence similar to DEET against mosquitoes. The highest toxicity exhibited against mosquitoes was by Baccharis punctulata essential oil (LC50 = 20.4 ppm), followed by B. pauciflosculosa (LC50 = 31.9 ppm), B. sphenophylla (LC50 = 30.8 ppm), B. microdonta (LC50 = 28.6 ppm), kongol (LC50 = 32.3 ppm), spathulenol (LC50 = 48.7 ppm) and B. reticularioides essential oil (LC50 = 84.4 ppm). Baccharis microdonta essential oil showed repellency against RIFA, BIFA and HIFA at 4.9, 4.9 and 39 µg/g, respectively. Baccharis microdonta essential oil also showed toxicity with LC50 of 78.9, 97.5 and 136.5 µg/g against RIFA, BIFA and HIFA, respectively, at 24 h post treatment.

Repellency of Carvacrol, Thymol, and Their Acetates against Imported Fire Ants.

In the United States, imported fire ants are commonly referred to as red imported fire ants (Solenopsis invicta Buren), black imported fire ants (S. richteri Forel), and hybrid imported fire ants (S. invicta × S. richteri). They are significant pests, and their control heavily relies on synthetic insecticides. The extensive use of insecticides has led to public concern about their potential negative effects on human health and the well-being of wildlife and the environment. As an alternative, plant-derived natural compounds, particularly essential oils (EOs) and their main constituents, show promise as safe and environmentally friendly products for controlling fire ants. Repellants are useful in managing fire ants, and plant-derived natural repellants may serve as a safer and more environmentally friendly option. This study investigates the repellency of EO-derived compounds carvacrol, thymol, and their acetates against imported fire ant workers. The results revealed that carvacrol, a GRAS compound (Generally Recognized As Safe), was the most potent repellent against S. invicta, S. richteri, and their hybrid, with minimum repellent effective doses (MREDs) of 0.98 µg/g, 7.80 µg/g, and 0.98 µg/g, respectively. Thymol also exhibited strong repellency, with MREDs of 31.25 µg/g, 31.25 µg/g, and 7.8 µg/g, respectively. Furthermore, thyme-red essential oil, characterized by a thymol chemotype containing 48.8% thymol and 5.1% carvacrol, was found to effectively repel the hybrid ants with an MRED of 15.6 µg/g. In contrast, thyme essential oil, characterized by a linalool chemotype lacking thymol and carvacrol, did not exhibit any repellent effect, even at the highest tested dose of 125 µg/g. This study provides the first evidence of the potent repellency of carvacrol and thymol against imported fire ant workers, indicating their potential as promising repellents for fire ant control.

Regioselective Claisen-Schmidt Adduct of 2-Undecanone from Houttuynia cordata Thunb as Insecticide/Repellent against Solenopsis invicta and Repositioning Plant Fungicides against Colletotrichum fragariae.

The U.S. Department of Agriculture (USDA) has established research programs to fight the phytopathogen Colletotrichum fragariae and the invasive red imported fire ant, Solenopsis invicta. C. fragariae is known to cause anthracnose disease in fruits and vegetables, while S. invicta is known for its aggressive behavior and painful stings and for being the cause of significant damage to crops, as well as harm to humans and animals. Many plants have been studied for potential activity against C. fragariae and S. invicta. Among the studied plants, Houttuynia cordata Thunb has been shown to contain 2-undecanone, which h is known for its antifungal activity against Colletotrichum gloesporioides. Based on the mean amount of sand removed, 2-undecanone showed significant repellency at 62.5 µg/g, similar to DEET (N,N-diethyl-meta-toluamide), against S. invicta. The 2-Undecanone with an LC50 of 44.59 µg/g showed toxicity against S. invicta workers. However, neither H. cordata extract nor 2-undecanone had shown activity against C. fragariae despite their known activity against C. gloesporioides, which in turn motivates us in repositioning 2-undecanone as a selected candidate for a Claisen-Schmidt condensation that enables access to several analogs (2a-f). Among the prepared analogs, (E)-1-(3-methylbenzo[b]thiophen-2-yl)dodec-1-en-3-one (2b) and (E)-1-(5-bromothiophen-2-yl)dodec-1-en-3-one (2f) showed promising activity against C. fragariae, revealing a distinctive structural activity relationship (SAR). The generated analogs revealed a clear regioselectivity pattern through forming the C=C alkene bond at position C-1. These data open the window for further lead optimization and product development in the context of managing C. fragariae and S. invicta.

Matricaria chamomilla Essential Oils: Repellency and Toxicity against Imported Fire Ants (Hymenoptera: Formicidae).

Matricaria chamomilla flower essential oils (EOs) blue Egyptian (EO-1), chamomile German CO2 (EO-2), and chamomile German (EO-3) and the pure compound α-bisabolol were evaluated against red imported fire ants (RIFA), Solenopsis invicta Buren, black imported fire ants, S. richteri Forel (BIFA), and hybrid imported fire ants (HIFA) for their repellency and toxicity. A series of serial dilutions were tested starting from 125 µg/g until the failure of the treatment. Based on the amount of sand removed, EO-1 showed significant repellency at dosages of 7.8, 7.8, and 31.25 µg/g against RIFA, BIFA, and HIFA, respectively. EO-3 was repellent at 3.9, 7.8, and 31.25 µg/g against BIFA, RIFA, and HIFA, whereas α-bisabolol was active at 7.8, 7.8, and 31.25 µg/g against BIFA, HIFA, and RIFA, respectively. DEET (N, N-diethyl-meta-toluamide) was active at 31.25 µg/g. Toxicity of EOs and α-bisabolol was mild to moderate. For EO-1, LC50 values were 93.6 and 188.11 µg/g against RIFA and BIFA; 98.11 and 138.4 µg/g for EO-2; and 142.92 and 202.49 µg/g for EO-3, respectively. The LC50 of α-bisabolol was 159.23 µg/g against RIFA. In conclusion, M. chamomilla EOs and α-bisabolol offer great potential to be developed as imported fire ant repellents.

Organic farming of maize crop enhances species evenness and diversity of hexapod predators.

Arthropod species diversity enhances ecosystem productivity and sustainability by increasing pollination and biological control services. Although, it is declining rapidly due to conventional agricultural intensification, organic agriculture with reduced reliance on agronomic inputs can regenerate ecosystems' resilience and restore them. Here, we report whether hexapod communities differ on both types of farming systems in small-scale field plot experiments, wherein Maize variety AG-589 was grown organically and conventionally in the 2020 and 2021 seasons. Livestock manure was applied in organic fields, whereas nitrogen and phosphorous were used as synthetic fertilizers in conventional fields. Hexapods were sampled three weeks after sowing once a week from the middle rows of subplots from both organically and conventionally grown maize. Twelve species of herbivores and four species of predators were recorded. Hexapod abundance overall and that of herbivores only was higher in conventionally cultivated maize, while predator abundance was higher in organic maize. Herbivores species diversity and evenness were significantly higher in conventional maize. Predator species diversity and evenness were significantly higher in organic maize fields. We noted predator abundance, diversity, and evenness as strong predictors to lower herbivore populations. These findings suggest that organic farming conserves natural enemies' biodiversity and regulates herbivores with increased provision of suitable habitats and prey resources for natural enemies, leading to enhanced relative abundance in their specialized niches. Thus, organic agriculture can potentially mediate better ecosystem services.

Unique fiber phenotype composition and metabolic properties of the stapedius and tensor tympani muscles in the human middle ear.

The middle ear muscles have vital roles, yet their precise function in hearing and protection remains unclear. To better understand the function of these muscles in humans, the morphology, fiber composition, and metabolic properties of nine tensor tympani and eight stapedius muscles were analyzed with immunohistochemical, enzyme-histochemical, biochemical, and morphometric techniques. Human orofacial, jaw, extraocular, and limb muscles were used as references. The immunohistochemical analysis showed that the stapedius and tensor tympani muscles were markedly dominated by fibers expressing fast contracting myosin heavy chain MyHC-2A and MyHC-2X (79 ± 6% vs. 86 ± 9%, respectively, p = 0.04). In fact, the middle ear muscles had one of the highest proportions of MyHC-2 fibers ever reported for human muscles. Interestingly, the biochemical analysis revealed a MyHC isoform of unknown identity in both the stapedius and tensor tympani muscles. Muscle fibers containing two or more MyHC isoforms were relatively frequently observed in both muscles. A proportion of these hybrid fibers expressed a developmental MyHC isoform that is normally absent in adult human limb muscles. The middle ear muscles differed from orofacial, jaw, and limb muscles by having significantly smaller fibers (220 vs. 360 µm2 , respectively) and significantly higher variability in fiber size, capillarization per fiber area, mitochondrial oxidative activity, and density of nerve fascicles. Muscle spindles were observed in the tensor tympani muscle but not in the stapedius muscle. We conclude that the middle ear muscles have a highly specialized muscle morphology, fiber composition, and metabolic properties that generally showed more similarities to orofacial than jaw and limb muscles. Although the muscle fiber characteristics in the tensor tympani and stapedius muscles suggest a capacity for fast, fine-tuned, and sustainable contractions, their difference in proprioceptive control reflects different functions in hearing and protection of the inner ear.

Effect of temperature on the life cycle of Harmonia axyridis (Pallas), and its predation rate on the Spodoptera litura (Fabricius) eggs.

Biological control is one of the strategies of pest control which is determined by the biological fitness and metabolic rates of the predator species used. Temperature and resource are important factors which influence the role of insects as biocontrol agents. Harmonia axyridis is a cosmopolitan and non-specific polyphagous predator. It can survive ecologically diverse environments and exploit multiple preys. This study investigated the effects of temperature on the population parameters of H. axyridis and its predation on the eggs of prey Spodoptera litura. For this purpose, an age-stage, two-sex life table of the predator was constructed at four constant temperatures, i.e. 15, 20, 25 and 30 °C, under laboratory settings of: 70 ± 5% RH, and 16:8 h (L: D) photoperiod. A computer simulation was then used to project the population and predation responses with respect to temperatures tested. We found that the development of larvae and adult (male/female) stages of H. axyridis decreased with colder temperatures (i.e., 15 and 20 °C) but increased with warmer temperatures (25 and 30 °C). The intrinsic rate of increase (r) and mean generation time (T) were 0.0662 d-1 and 79.84 d at 15 °C, 0.0843 d-1 and 64.90 d at 20 °C, 0.1067 d-1 and 48.89 d at 25 °C, and 0.1378 d-1 and 35.55 d at 30 °C, respectively. The mean duration of the total pre-adult stage was 44.26, 32.91, 20.63, and 15.39 d at 15, 20, 25, and 30 °C, respectively. At 30 °C. the finite rate of increase (1.1477 d-1) was the highest and the mean generation time (35.55 d) was the shortest. The net predation rate (C0) was 7935.54, 10,466.28, 10,139.38, and 7126.36 eggs at 15, 20, 25, and 30 °C, respectively. Population and predation projections were proportional to temperature. These findings are important for modelling the population responses of H. axyridis to climate change and tailoring integrated pest management strategies to altered climates.

Functional Response of Harmonia axyridis to the Larvae of Spodoptera litura: The Combined Effect of Temperatures and Prey Instars.

Functional responses are central to predator-prey dynamics and describe how predation varies with prey abundance. Functional responses often are measured without regard to prey size (i.e., body mass) or the temperature dependence of feeding rates. However, variation in prey size within populations is ubiquitous, and predation rates are often both size and temperature-dependent. Here, we assessed functional responses of larvae and adult Harmonia axyridis on the 1st, 2nd, and 3rd instars of the prey Spodoptera litura across a range of temperatures (i.e., 15, 20, 25, 30, and 35°C). The type and parameters of the functional responses were determined using logistic regression and fitted to the Roger's random predator equation. The magnitude of predation varied with the predator and prey stage, but prey predation increased with warming and predator age. Predation by the female and 4th instar of H. axyridis on the 1st instar of prey was greater, followed by the 2nd and 3rd instar of prey S. litura. No predation occurred on the larger prey for the 1st, 2nd, and 3rd instars of H. axyridis. The larvae and adult H. axyridis produced a type II (hyperbolic) functional response curve across all temperatures and the three prey types they consumed. Space clearance rates, handling time, and maximum predation rates of H. axyridis changed with temperature and prey size, increasing with temperature and decreasing with prey size, suggesting more predation will occur on younger prey. This study indicates an interactive role of temperature and prey/predator size in shaping functional responses, which might complicate the planning of effective biocontrol strategies against this serious pest.

Myopathy of the upper airway in snoring and obstructive sleep apnea.

Objective: Previous reports of muscle changes in the upper airways of obstructive sleep apnea (OSA) patients have primarily been attributed to acquired nerve lesions due to snoring vibrations. The aim of this study was to investigate whether alterations reflecting muscle fiber injuries also occur in the upper respiratory tract of snoring and OSA patients and if these changes relate to upper airway dysfunction. Methods: Muscle changes in biopsies from the soft palate of 20 patients suffering from snoring and OSA were investigated with enzyme, immunohistochemical, and morphometric techniques. Biopsies from eight healthy non-snoring subjects were used as controls. Swallowing dysfunction was assessed with videoradiography. Results: Fourteen patients had various degrees of swallowing dysfunction. The muscle samples from all the patients showed changes typical for both motor-nerve lesions and muscle fiber injuries. The most common alterations reflecting myopathy were fibers having aggregates and disorganization of cytoskeletal proteins (15.5 ± 10.7%). Other changes were fibers with vacuole-like structures (5.0 ± 4.4%), centrally positioned myonuclei (7.9 ± 4.8%), subsarcolemmal accumulations of nuclei, and various forms and sizes of ring fibers, that is, fibers where the myofilaments were disorganized peripherally (2.8 ± 2.8%). Conclusion: The results show that muscle changes mirroring both myopathy and neuropathy co-exist in the upper airway of snoring OSA patients. These findings suggest muscle weakness as a contributing factor to the upper airway dysfunction in OSA patients.

A Novel Case of Yamaguchi Syndrome in a Hispanic Male.

Yamaguchi syndrome or apical hypertrophic cardiomyopathy (HCM) is a unique variant of HCM. It is characterized by localized hypertrophy involving the left ventricular apex rather than the left ventricular septum. This syndrome has been traditionally seen in the Asian population, particularly those of Japanese descent. We present an interesting case of Yamaguchi syndrome seen in a Hispanic male. A 48-year-old Hispanic male presented with epigastric tenderness and was admitted to the hospital for a non-ST-segment elevation myocardial infarction. His diagnostic catheterization revealed no significant coronary artery disease. However, his echocardiogram revealed apical hypertrophy and narrowing of the left ventricular cavity at the apex, consistent with Yamaguchi syndrome. Case reports such as ours serve to help clinicians broaden their differential diagnoses when approaching patients with acute coronary syndrome-like symptoms to include diagnoses such as Yamaguchi syndrome.

Neuromyelitis Optica in a Healthy Female After Severe Acute Respiratory Syndrome Coronavirus 2 mRNA-1273 Vaccine.

Neuromyelitis optica spectrum disorder is an autoimmune demyelinating disease with high relative prevalence in the East Asian population. Clinical manifestations include optic neuritis, longitudinally extensive transverse myelitis, area postrema syndrome, brainstem syndromes, and diencephalic syndromes. In this case report, we present a case of neuromyelitis optica spectrum disorder that developed 10 days after the first dose of the severe acute respiratory syndrome coronavirus 2 mRNA-1273 vaccine. The patient was a previously healthy White female, completely independent and functional at baseline. She presented with bilateral lower-extremity numbness/tingling, weakness, and urinary retention. Although her neuromyelitis optica IgG was negative, the MRI was consistent with neuromyelitis optica involving and spanning longitudinally the C6-T2 vertebrae. She was treated with IV steroids and her symptoms improved. Given the novelty of the COVID-19 vaccines and the paucity of literature regarding their adverse effects, case reports such as ours provide unique information that aids healthcare providers in accurately diagnosing and treating patients, ultimately minimizing long-term neurologic deficits.

A Retrospective Cohort Study on Predictors for Rehospitalizations With Recurrence of Atrial Fibrillation Post-Catheter Ablation for Atrial Fibrillation.

Atrial fibrillation (AF) is the most common cardiac arrhythmia and is increasing in prevalence due to an aging population. Although medications for rhythm and rate control remain the first-line treatment options for many patients, difficulties can include arrhythmia relapse and drug side effects. Catheter ablation or radiofrequency is an alternative treatment modality that can isolate where ectopic arrhythmic sites originate. Several previous studies have examined post-ablation complications and hospitalization rates for arrhythmia recurrence. However, many of these studies used patient data from before 2015. We examined the following data using recent records: pre-procedural patient characteristics, rates of post-procedural hospitalizations with documented recurrence of AF, and patient risk factors associated with these recurrences.

Is All Hypocalcemia Due to Low Parathyroid Hormone?: An Unusual Case of Pseudohypoparathyroidism in a Young and Healthy Patient.

Pseudohypoparathyroidism is a rare disorder that is characterized by hypocalcemia and hyperphosphatemia that are unresponsive to the parathyroid hormone. We present a unique case of pseudohypoparathyroidism seen in a 33-year-old male who presented with abnormal laboratory findings including hypocalcemia, hypokalemia, hypomagnesemia, hyperphosphatemia, and positive Trousseau's sign. Pseudohypoparathyroidism is a rare phenomenon, with an estimated prevalence between 0.3 and 1.1 cases per 100,000. Genetic mutations have been noted to play a role in the presentation of pseudohypoparathyroidism. Clinical phenotypical manifestations can include brachydactyly, short stature, a stocky build, and a round face. Similar routine follow-up and treatment as traditional hypoparathyroidism is practiced. This case highlights a unique endocrinologic pathology that clinicians should be more aware of, as it can be confused with hypoparathyroidism.

Functional response of Harmonia axyridis preying on Acyrthosiphon pisum nymphs: the effect of temperature.

In the current study, we investigated the functional response of Harmonia axyridis adults and larvae foraging on Acyrthosiphon pisum nymphs at temperatures between 15 and 35 °C. Logistic regression and Roger's random predator models were employed to determine the type and parameters of the functional response. Harmonia axyridis larvae and adults exhibited Type II functional responses to A. pisum, and warming increased both the predation activity and host aphid control mortality. Female and 4th instar H. axyridis consumed the most aphids. For fourth instar larvae and female H. axyridis adults, the successful attack rates were 0.23 ± 0.014 h-1 and 0.25 ± 0.015 h-1; the handling times were 0.13 ± 0.005 h and 0.16 ± 0.004 h; and the estimated maximum predation rates were 181.28 ± 14.54 and 153.85 ± 4.06, respectively. These findings accentuate the high performance of 4th instar and female H. axyridis and the role of temperature in their efficiency. Further, we discussed such temperature-driven shifts in predation and prey mortality concerning prey-predator foraging interactions towards biological control.

Wernicke Encephalopathy in an Elderly Patient Due to Chronic Malnutrition From an Atypical Diet.

Wernicke encephalopathy has traditionally been associated with chronic alcohol abuse leading to thiamine deficiency. Clinical symptoms include mentation change, gait ataxia, and oculomotor abnormalities. However, it is often an underdiagnosed condition in patients suffering from chronic malnutrition, especially in the West. We examine a unique case of non-alcoholic Wernicke encephalopathy in an elderly patient. The patient had a long history of chronic malnutrition due to her atypical diet, consuming an unbalanced diet deprived of thiamine, unbeknownst to her. She presented with symptoms of encephalopathy, recurrent falls, and pupillary changes. After exhausting all other therapeutic interventions, she received a thiamine infusion; her mentation and other symptoms improved dramatically.  Thiamine deficiency can lead to severe complications, including Wernicke encephalopathy and cardiomyopathy. Wernicke encephalopathy can progress to Korsakoff syndrome, which is characterized by amnesia and confabulation. Case reports, such as ours, may remind clinicians to keep thiamine deficiency as a viable differential while evaluating acute encephalopathy, especially in the malnourished geriatric population.

Obstructive Sleep Apnea and Pulmonary Hypertension: A Review of Literature.

Obstructive sleep apnea (OSA) is a disease process involving recurrent pharyngeal collapse during sleep, resulting in apneic episodes. Clinically, symptoms can include snoring, sudden awakening with a choking-like sensation, excessive somnolence, non-restorative sleep, difficulty in starting or maintaining sleep, and fatigue. It results in impaired gas exchange, subsequently causing various cardiovascular, metabolic, and neurocognitive pathologies. Historically, OSA has been underdiagnosed and undertreated, especially in women. OSA is associated with WHO (World Health Organization) class III pulmonary hypertension (PH) or PH due to lung disease. PH is a concerning complication of OSA and thought to occur in roughly 20% of individuals with OSA. The pathogenesis of PH in OSA can include pulmonary artery vasoconstriction and remodeling. Patients suffering from OSA who develop PH tend to have worse cardiovascular and pulmonary changes. We present a thorough review of the literature examining the interplay between OSA and PH.