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Modeling and experimental data were used to evaluate how monocytes would respond to dual TLR4/TLR5 and dual TLR4/TLR7 signaling analogous to how the cells would respond to simultaneously encountering different types of pathogens. Both TLR4/TLR5 and TLR4/TLR7 signaling resulted in a decreased NFkB response relative to signaling through a single TLR. The NFkB response also decreased when all three signaling cascades were triggered. The model suggested that competition between the signaling pathways led to the impaired response when the cells were exposed to multiple TLR agonists, however adjusting the level of IRAKs and TABs in the model was insufficient to overcome competition between the signaling pathways. To experimentally examine how modifying TLR signaling proteins would impact the NFkB response to multiple TLR agonists, cells were pre-conditioned with lipopolysaccharide and the response to single, dual, and triple TLR signaling was followed. Pre-conditioning led to a reduction in the NFkB response to all three agonists, likely a consequence of decreased tlr4, tlr5, tlr7, nfkb, tab1, tab2, and tab3 expression. Collectively, the model supported exploration of the effects of multiple agonists on the signaling pathways and the effectiveness of adjusting the level of TLR signaling proteins in improving the NFkB response. These experiments and data show the importance of having a model capable of integrating multiple TLR signaling cascades since data generated by the model of a single TLR signaling cascade could not predict how the cells would respond when multiple TLR signaling cascades were activated.

The spotted lanternfly is an emerging global invasive insect pest. Due to a lack of natural enemies where it is invasive, human intervention is required. Extensive management has been applied but the spread continues. Recently, the idea of bird-based biological controls has re-emerged and shown effective in studies. However, it is questionable, if birds are able to effectively control unfamiliar and occasionally toxic invasive pests in short timeframes. Unless, perhaps, the birds are effective social learners and toxicity of the invaders is rare. Here, we introduce a mathematical model for social learning in a great tit-like bird to investigate conditions for the emergence of a collective biological control of a pest that is occasionally toxic, like the lanternfly. We find that the social observation rate relative to the proportion of toxic lanternfly dictate when collective biological controls will emerge. We also implement the social learning model into a model of collective motion in bird-like animals, and find that it produces results consistent with the mathematical model. Our work suggests that social birds may be useful in managing the spotted lanternfly, and that removing the toxicity-inducing preferred host of the lanternfly should be a priority to facilitate this.

Cor triatriatum is a rare congenital heart disease (0.1% of all congenital cardiac defects). Most patients are identified shortly after birth with the evaluation of a distressed or cyanotic neonate. However, when the presentation is delayed, primary symptoms may mimic reactive airway disease. We present an 11-year-old adolescent male who presented with obstructive sleep apnea-like features initially, on further evaluation showed features of severe pneumonia. There was clinical and radiological dissociation with the findings.

Misuse of organophosphate insecticides, even in case of domestic application, can be life threatening. We report a case of accidental consumption of organophosphorus substance by a 3-year-old female child presented to us with unconsciousness and nicotinic manifestation of organophosphate poisoning unlike classical toxidrome of muscarinic manifestation.

The diagnosis of lymphangitic carcinomatosis is challenging due to the manifestation of nonspecific symptoms and radiographic abnormalities that bear similarity to those of interstitial lung disease. Herein, we report the case of a 53-year-old woman diagnosed with lymphangitic carcinomatosis from metastatic gastric adenocarcinoma, 3 months after her initial presentation.