Oral ulcers in a finger-sucking child after cutaneous wart therapy.

Common skin warts frequently appear on the fingers of children, a patient population in whom finger-sucking is a prevalent habit. Despite overlap between these two pediatric conditions, there are no well-reported specific precautions against the use of topical blistering wart treatments, such as trichloroacetic acid and cantharidin, in finger-sucking children with warts. We report the case of oral ulcers in a pediatric patient secondary to thumb-sucking after receiving treatment for multiple finger warts with combination cryotherapy, trichloroacetic acid, and cantharidin.

A 2-year-old girl with periprocedural anaphylaxis.

Periprocedural or perioperative anaphylaxis is rare, with an estimated incidence of 1 in 10,000 to 40,000 sedation cases. During such procedures, patients are often exposed to numerous medications, such as antimicrobials, neuromuscular blocking agents, sedative and/or hypnotics, and opioids. The most commonly implicated agents include antibiotics (in the United States) and neuromuscular blocking agents (in Europe). In this article, we explore the differential diagnosis and laboratory investigation of a case of periprocedural anaphylaxis.

Performance Evaluation of a Carbon Nanotube Sensor for Fatigue Crack Monitoring of Metal Structures.

This article describes research that investigated the ability of a carbon nanotube (CNT) sensor to detect and monitor fatigue crack initiation and propagation in metal structures. The sensor consists of a nonwoven carrier fabric with a thin film of CNT that is bonded to the surface of a structure using an epoxy adhesive. The carrier fabric enables the sensor to be easily applied over large areas with complex geometries. Furthermore, the distributed nature of the sensor improves the probability of detecting crack initiation and enables monitoring of crack propagation over time. Piezoresistivity of the sensor enables strains to be monitored in real time and the sensor, which is designed to fragment as fatigue cracks propagate, directly measures crack growth through permanent changes in resistance. The following laboratory tests were conducted to evaluate the performance of the sensor: (1) continuous crack propagation monitoring, (2) potential false positive evaluation under near-threshold crack propagation conditions, and (3) crack re-initiation detection at a crack-stop hole, which is a commonly used technique to arrest fatigue cracks. Real-time sensor measurements and post-mortem fractography show that a distinguishable resistance change of the sensor occurs due to fatigue crack propagation that can be quantitatively related to crack length. The sensor does not show false positive responses when the crack does not propagate, which is a drawback of many other fatigue sensors. The sensor is also shown to be remarkably sensitive to detecting crack re-initiation.

POPs Case Report: A 2-year-old girl with periprocedural anaphylaxis.

Periprocedural or perioperative anaphylaxis is rare, with an estimated incidence of 1 in 10,000 to 40,000 sedation cases.During such procedures, patients are often exposed to numerous medications, such as antimicrobials, neuromuscular blockingagents, sedative and/or hypnotics, and opioids. The most commonly implicated agents include antibiotics (in the UnitedStates) and neuromuscular blocking agents (in Europe). In this article, we explore the differential diagnosis and laboratoryinvestigation of a case of periprocedural anaphylaxis.

Salmonellosis Outbreak Detected by Automated Spatiotemporal Analysis - New York City, May-June 2019.

In May 2019, the New York City Department of Health and Mental Hygiene (NYCDOHMH) detected an unusual cluster of five salmonellosis patients via automated spatiotemporal analysis of notifiable diseases using free SaTScan software (1). Within 1 day of cluster detection, graduate student interviewers determined that three of the patients had eaten prepared food from the same grocery store (establishment A) located inside the cluster area. NYCDOHMH initiated an investigation to identify additional cases, establish the cause, and provide control recommendations. Overall, 15 New York City (NYC) residents with laboratory-diagnosed salmonellosis who reported eating food from establishment A were identified. The most commonly consumed food item was chicken, reported by 10 patients. All 11 clinical isolates available were serotyped as Salmonella Blockley, sequenced, and analyzed by core genome multilocus sequence typing; isolates had a median difference of zero alleles. Environmental assessments revealed food not held at the proper temperature, food not cooled properly, and potential cross-contamination during chicken preparation. Elevated fecal coliform counts were found in two of four ready-to-eat food samples collected from establishment A, and Bacillus cereus was detected in three. The outbreak strain of Salmonella was isolated from one patient's leftover chicken. Establishing automated spatiotemporal cluster detection analyses for salmonellosis and other reportable diseases could aid in the detection of geographically focused, community-acquired outbreaks even before laboratory subtyping results become available.

Large-scale chemical-genetics yields new M. tuberculosis inhibitor classes.

New antibiotics are needed to combat rising levels of resistance, with new Mycobacterium tuberculosis (Mtb) drugs having the highest priority. However, conventional whole-cell and biochemical antibiotic screens have failed. Here we develop a strategy termed PROSPECT (primary screening of strains to prioritize expanded chemistry and targets), in which we screen compounds against pools of strains depleted of essential bacterial targets. We engineered strains that target 474 essential Mtb genes and screened pools of 100-150 strains against activity-enriched and unbiased compound libraries, probing more than 8.5 million chemical-genetic interactions. Primary screens identified over tenfold more hits than screening wild-type Mtb alone, with chemical-genetic interactions providing immediate, direct target insights. We identified over 40 compounds that target DNA gyrase, the cell wall, tryptophan, folate biosynthesis and RNA polymerase, as well as inhibitors that target EfpA. Chemical optimization yielded EfpA inhibitors with potent wild-type activity, thus demonstrating the ability of PROSPECT to yield inhibitors against targets that would have eluded conventional drug discovery.

Cryo-EM-On-a-Chip: Custom-Designed Substrates for the 3D Analysis of Macromolecules.

The fight against human disease requires a multidisciplinary scientific approach. Applying tools from seemingly unrelated areas, such as materials science and molecular biology, researchers can overcome long-standing challenges to improve knowledge of molecular pathologies. Here, custom-designed substrates composed of silicon nitride (SiN) are used to study the 3D attributes of tumor suppressor proteins that function in DNA repair events. New on-chip preparation strategies enable the isolation of native protein complexes from human cancer cells. Combined techniques of cryo-electron microscopy (EM) and molecular modeling reveal a new modified form of the p53 tumor suppressor present in aggressive glioblastoma multiforme cancer cells. Taken together, the findings provide a radical new design for cryo-EM substrates to evaluate the structures of disease-related macromolecules.

Opposing reactions in coenzyme A metabolism sensitize Mycobacterium tuberculosis to enzyme inhibition.

Mycobacterium tuberculosis (Mtb) is the leading infectious cause of death in humans. Synthesis of lipids critical for Mtb's cell wall and virulence depends on phosphopantetheinyl transferase (PptT), an enzyme that transfers 4'-phosphopantetheine (Ppt) from coenzyme A (CoA) to diverse acyl carrier proteins. We identified a compound that kills Mtb by binding and partially inhibiting PptT. Killing of Mtb by the compound is potentiated by another enzyme encoded in the same operon, Ppt hydrolase (PptH), that undoes the PptT reaction. Thus, loss-of-function mutants of PptH displayed antimicrobial resistance. Our PptT-inhibitor cocrystal structure may aid further development of antimycobacterial agents against this long-sought target. The opposing reactions of PptT and PptH uncover a regulatory pathway in CoA physiology.

Cleidocranial Dysplasia with 6p21.1-p12.3 Microdeletion: A Case Report and Literature Review.

OBJECTIVE: The aim of this article is to publish a literature review and report on a new case of cleidocranial dysplasia syndrome with 6p21.1-p12.3 microdeletion. DESIGN: A PubMed search using "cleidocranial dysplasia syndrome (CCD)" or "6p microdeletion" was performed. Articles with information relevant to our case were obtained for review. A new case of cleidocranial dysplasia syndrome is presented to describe and discuss clinical manifestations, pathogenesis, clinical progression of cleidocranial dysplasia syndrome, and management. RESULTS: There were 22 articles with reports of cleidocranial dysplasia syndrome or 6p microdeletion. Cleidocranial dysplasia syndrome, a rare genetic disorder, documented to have an autosomal dominant inheritance pattern and caused by caused by mutations of the transcription factor RUNX2. RUNX2 has been mapped to chromosome 6p21. The anomalies in cleidocranial dysplasia syndrome can involve not only the clavicle and skull but the entire skeleton because the membranous as well as endochondral bone formation may be affected. Upon follow-up, our patient was found to have global developmental delay. CONCLUSIONS: We report a near-term neonate with characteristic features of cleidocranial dysplasia and a 6p21.1-p12.3 microdeletion. Cleidocranial dysplasia syndrome is a rare autosomal dominant skeletal dysplasia. The mutation of the RUNX2 gene results in cleidocranial dysplasia syndrome.

Isolation and characterization of a newly identified impurity in methamphetamine synthesized via reductive amination of 1-phenyl-2-propanone (P2P) made from phenylacetic acid/lead (II) acetate.

A trace processing impurity found in certain methamphetamine exhibits was isolated and identified as trans-N-methyl-4-methyl-5-phenyl-4-penten-2-amine hydrochloride (1). It was determined that this impurity was produced via reductive amination of trans-4-methyl-5-phenyl-4-penten-2-one (4), which was one of a cluster of related ketones generated during the synthesis of 1-phenyl-2-propanone (P2P) from phenylacetic acid and lead (II) acetate. This two-step sequence resulted in methamphetamine containing elevated levels of 1. In contrast, methamphetamine produced from P2P made by other methods produced insignificant (ultra-trace or undetectable) amounts of 1. These results confirm that 1 is a synthetic marker compound for the phenylacetic acid and lead (II) acetate method. Analytical data for 1 and 4, and a postulated mechanism for the production of 4, are presented. Copyright © 2015 John Wiley & Sons, Ltd.

VATER/VACTERL Association and Caudal Regression with Xq25-q27.3 Microdeletion: A Case Report.

We report a term female neonate with vertebral anomalies, anal and urethral atresia, esophageal atresia with tracheoesophageal fistula (TEF), renal agenesis, pulmonary hypoplasia, genital and sacral appendages, and a single umbilical artery. Genetic studies revealed a 20.91 Mb interstitial deletion of the long arm of X chromosome: Xq25-q27.3. This is a new case of VATER/VACTERL association with Xq25 microdeletion.

Lower-leg Kinesio tape reduces rate of loading in participants with medial tibial stress syndrome.

CONTEXT: Medial tibial stress syndrome (MTSS) is an overuse injury occurring among the physically active. Linked to increased strain on the medial tendons of the ankle, studies emphasize controlling medial foot loading in the management of this condition. Kinesio taping (KT) has gained popularity for treating musculoskeletal pathologies; however, its effect on MTSS remains uninvestigated. This study aimed to determine if healthy participants and patients with current or previous history of MTSS differ in the rate of loading, and if KT affects plantar pressures in these participants. METHODS: Twenty healthy participants and 20 participants with current or previous history of MTSS were recruited and walked across a plantar pressure mat prior to KT application, immediately after application, and after 24-h of continued use. Time-to-peak force was measured in 6 foot areas and compared across groups and conditions. RESULTS: ANOVA revealed a significant interaction between group, condition, and foot area (F = 1.990, p = 0.033). MTSS participants presented with lower medial midfoot time-to-peak force before tape application (95%CI: 0.014-0.160%, p = 0.021) that significantly increased following tape application (p < 0.05). CONCLUSIONS: These results suggest that KT decreases the rate of medial loading in MTSS patients. Future research might assess mechanisms by which this effect is achieved.

Validation of mathematical models for Salmonella growth in raw ground beef under dynamic temperature conditions representing loss of refrigeration.

Temperature is a primary factor in controlling the growth of microorganisms in food. The current U. S. Food and Drug Administration Model Food Code guidelines state that food can be kept out of temperature control for up to 4 h without qualifiers, or up to 6 h, if the food product starts at an initial 41 °F (5 °C) temperature and does not exceed 70 °F (21 °C) at 6 h. This project validates existing ComBase computer models for Salmonella growth under changing temperature conditions modeling scenarios using raw ground beef as a model system. A cocktail of Salmonella serovars isolated from different meat products ( Salmonella Copenhagen, Salmonella Montevideo, Salmonella Typhimurium, Salmonella Saintpaul, and Salmonella Heidelberg) was made rifampin resistant and used for all experiments. Inoculated samples were held in a programmable water bath at 4.4 °C (40 °F) and subjected to linear temperature changes to different final temperatures over various lengths of time and then returned to 4.4 °C (40 °F). Maximum temperatures reached were 15.6, 26.7, or 37.8 °C (60, 80, or 100 °F), and the temperature increases took place over 4, 6, and 8 h, with varying cooling times. Our experiments show that when maximum temperatures were lower (15.6 or 26.7 °C), there was generally good agreement between the ComBase models and experiments: when temperature increases of 15.6 or 26.7 °C occurred over 8 h, experimental data were within 0.13 log CFU of the model predictions. When maximum temperatures were 37 °C, predictive models were fail-safe. Overall bias of the models was 1.11. and accuracy was 2.11. Our experiments show the U.S. Food and Drug Administration Model Food Code guidelines for holding food out of temperature control are quite conservative. Our research also shows that the ComBase models for Salmonella growth are accurate or fail-safe for dynamic temperature conditions as might be observed due to power loss from natural disasters or during transport out of temperature control.

Seleniivibrio woodruffii gen. nov., sp. nov., a selenate- and arsenate-respiring bacterium in the Deferribacteraceae.

A Gram-type-negative, obligately anaerobic, selenate-respiring bacterium, strain S4(T), was isolated from activated sludge of a wastewater treatment plant in New Jersey after enrichment with 10 mM selenate as the sole electron acceptor. In addition to its selenate-respiring capability, strain S4(T) also respired arsenate with acetate as carbon source and electron donor. Fermentative growth was not observed. The optimum growth temperature was 37 °C and optimum pH was pH 7. Phylogenetic analysis of the 16S rRNA gene sequence revealed that strain S4(T) is a novel member of the family Deferribacteraceae, with the type strain of Denitrovibrio acetiphilus as its closest cultivated relative, with 91.5 % sequence similarity. The cellular fatty acid profile was composed predominantly of straight-chain fatty acids C14 : 0, C15 : 0, C16 : 0, C17 : 0 and C18 : 0, which distinguishes this organism from its closest relatives. The DNA G+C content was 47.7 mol%. Together, these findings support the conclusion that strain S4(T) represents a novel genus and species, for which the name Seleniivibrio woodruffii gen. nov., sp. nov. is proposed. The type strain of Seleniivibrio woodruffii is S4(T) ( = DSM 24984(T) = ATCC BAA-2290(T)).

Reliability and accuracy of a video analysis protocol to assess core ability.

OBJECTIVE: To develop and test a method to measure core ability in healthy athletes with 2-dimensional video analysis software (SiliconCOACH). Specific objectives were to: (1) develop a standardized exercise battery with progressions of increasing difficulty to evaluate areas of core ability in elite athletes; (2) develop an objective and quantitative grading rubric with the use of video analysis software; (3) assess the test-retest reliability of the exercise battery; (4) assess the interrater and intrarater reliability of the video analysis system; and (5) assess the accuracy of the assessment. DESIGN: Test-retest repeatability and accuracy. SETTING: Testing was conducted in the Stanford Human Performance Laboratory, Stanford University, Stanford, CA. PARTICIPANTS: Nine female gymnasts currently training with the Stanford Varsity Women's Gymnastics Team participated in testing. METHODS: Participants completed a test battery composed of planks, side planks, and leg bridges of increasing difficulty. Subjects completed two 20-minute testing sessions within a 4- to 10-day period. Two-dimensional sagittal-plane video was captured simultaneously with 3-dimensional motion capture. MAIN OUTCOME MEASUREMENTS: The main outcome measures were pelvic displacement and time that elapsed until failure occurred, as measured with SiliconCOACH video analysis software. Test-retest and interrater and intrarater reliability of the video analysis measures was assessed. Accuracy as compared with 3-dimensional motion capture also was assessed. RESULTS: Levels reached during the side planks and leg bridges had an excellent test-retest correlation (r(2) = 0.84, r(2) = 0.95). Pelvis displacements measured by examiner 1 and examiner 2 had an excellent correlation (r(2) = 0.86, intraclass correlation coefficient = 0.92). Pelvis displacements measured by examiner 1 during independent grading sessions had an excellent correlation (r(2) = 0.92). Pelvis displacements from the plank and from a set of combined plank and side plank exercises both had an excellent correlation with 3-dimensional motion capture measures (r(2) = 0.92, r(2) = 0.90). CONCLUSIONS: Core ability test battery with SiliconCOACH grading method is an accurate and reliable way to assess core ability exercise performance.

Kangiella spongicola sp. nov., a halophilic marine bacterium isolated from the sponge Chondrilla nucula.

A novel halophilic bacterium of the genus Kangiella was isolated from a marine sponge collected from the Florida Keys, USA. Strain A79(T), an aerobic, Gram-negative, non-motile, rod-shaped bacterium, grew in 2-15 % (w/v) NaCl, at a temperature of 10-49 °C and at pH 4.5-10. Phylogenetic analysis placed strain A79(T) in the family Alcanivoraceae in the class Gammaproteobacteria. Strain A79(T) showed 98.5 % 16S rRNA gene sequence similarity to Kangiella japonica KMM 3899(T), 96.6 % similarity to Kangiella koreensis DSM 16069(T) and 95.6 % similarity to Kangiella aquimarina DSM 16071(T). The major cellular fatty acids were iso-C(11 : 0), iso-C(11 : 0) 3-OH, iso-C(15 : 0), iso-C(17 : 0) and iso-C(17 : 1)ω9c and the G+C content of the genomic DNA was 44.9 mol%. On the basis of physiological, chemotaxonomic and phylogenetic comparisons, strain A79(T) represents a novel species in the genus Kangiella, for which the name Kangiella spongicola sp. nov. is proposed. The type strain is A79(T) ( = ATCC BAA-2076(T) = DSM 23219(T)).

Mucilaginibacter frigoritolerans sp. nov., Mucilaginibacter lappiensis sp. nov. and Mucilaginibacter mallensis sp. nov., isolated from soil and lichen samples.

Five cold-adapted bacteria belonging to the genus Mucilaginibacter were isolated from lichen and soil samples collected from Finnish Lapland and investigated in detail by phenotypic and phylogenetic analyses. Based on 16S rRNA gene phylogeny, the novel strains represent three new branches within the genus Mucilaginibacter. The strains were aerobic, chemo-organotrophic, non-motile rods and formed pigmented, smooth, mucoid colonies on solid media. The strains grew between 0 and 33 °C (optimum growth at 25 °C) and at pH 4.5-8.0 (optimum growth at pH 6.0). The main cellular fatty acids were iso-C(15 : 0), summed feature 3 (C(16 : 1)ω7c/iso-C(15 : 0) 2-OH) and iso-C(17 : 0) 3-OH and the major respiratory quinone was MK-7. The DNA G+C contents were 44.0-46.5 mol%. Based on phylogenetic, phenotypic and chemotaxonomic data, the strains represent three novel species of the genus Mucilaginibacter for which the names Mucilaginibacter frigoritolerans sp. nov. (type strain FT22(T) =ATCC BAA-1854(T) =LMG 25359(T)), Mucilaginibacter lappiensis sp. nov. (type strain ANJLI2(T) =ATCC BAA-1855(T) =LMG 25358(T)) and Mucilaginibacter mallensis sp. nov. (type strain MP1X4(T) =ATCC BAA-1856(T) =LMG 25360(T)) are proposed.

Experiencing a dilemma--accounts of working with PND.

Various ways of thinking about postnatal depression (PND) are evident from the literature. From the clinical-medical perspective, it is an illness of the individual mother. The social approach locates its cause in the environment Feminists/social constructionists have critiqued such models as problematising women--they see them as pressured by oppressive forces such as society's stereotype of 'the joy of motherhood'. From the psychoanalytic perspective it arises from unrecognised conflict and ambivalence, related to the re-emergence of conflict between the mother and her own parents. Health visitors working with PND--the frontline of health professionals in this aspect of maternal mental health--stand between the professional/academic accounts on the one hand, and the lay accounts of their clients on the other. The aim of this study was to examine how health visitors understand and make sense of PND. We adopted qualitative research methodology to analyse transcripts from interviews with eight health visitors about their work with PND. The findings demonstrate the diverse roles they have to adopt, and the complexity and lack of clarity of the very concept of PND itself. There were clearly ambiguities and dilemmas of thinking involved--not apparent from the literature, tensions with which the participants struggled. A subsequent paper will present training to address these issues.