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Introduction: Isolated oculomotor nerve palsy after mild traumatic brain injury is unusual and prognostically significant due to unclear mechanisms and recovery challenges. We present a case of isolated oculomotor nerve palsy following minor head trauma, shedding light on this unusual occurrence. Case Report: A 24-year-old male experienced severe vision loss and right-sided oculomotor nerve palsy after a motor vehicle collision. Initial imaging showed a hemorrhagic focus in the left posterior fossa and a contusion in the corpus callosum, yet no direct cause for the nerve palsy was found. Partial recovery was observed after 12 months. Conclusion: This case underscores the importance of maintaining a heightened suspicion for occult intracranial findings, especially when the initial non-contrast computed tomography was inconclusive. Timely clinical assessment and appropriate radiological investigations by emergency physicians are crucial for improving the prognosis.

Introduction: Isolated oculomotor nerve palsy after mild traumatic brain injury is unusual and prognostically significant due to unclear mechanisms and recovery challenges. We present a case of isolated oculomotor nerve palsy following minor head trauma, shedding light on this unusual occurrence.Case Report: A 24-year-old male experienced severe vision loss and right-sided oculomotor nerve palsy after a motor vehicle collision. Initial imaging showed a hemorrhagic focus in the left posterior fossa and a contusion in the corpus callosum, yet no direct cause for the nerve palsy was found. Partial recovery was observed after 12 months.Conclusion: This case underscores the importance of maintaining a heightened suspicion for occult intracranial findings, especially when the initial non-contrast computed tomography was inconclusive. Timely clinical assessment and appropriate radiological investigations by emergency physicians are crucial for improving the prognosis.

The current global severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has magnified the risk to healthcare providers when inititiating airway management, and safe tracheal intubation has become of paramount importance. Mitigation of risk to frontline providers requires airway management to be an orchestrated exercise based on training and purposeful simulation. Role allocation and closed-loop communication form the foundation of this exercise. We describe a methodical, 10-step approach from decision-making and meticulous drug and equipment choices to donning of personal protective equipment, and procedural concerns. This bundled approach will help reduce unplanned actions, which in turn may reduce the risk of aerosol transmission during airway management in resource-limited settings.

The current global severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has magnified the risk to healthcare providers when inititiating airway management, and safe tracheal intubation has become of paramount importance. Mitigation of risk to frontline providers requires airway management to be an orchestrated exercise based on training and purposeful simulation. Role allocation and closed-loop communication form the foundation of this exercise. We describe a methodical, 10-step approach from decision-making and meticulous drug and equipment choices to donning of personal protective equipment, and procedural concerns. This bundled approach will help reduce unplanned actions, which in turn may reduce the risk of aerosol transmission during airway management in resource-limited settings.

Nanoparticles (NPs) can be used to accomplish antigen-specific immune tolerance in allergic and autoimmune disease. The available options for custom-designing tolerogenic NPs include the use of nanocarriers that introduce antigens into natural tolerogenic environments, such as the liver, where antigen presentation promotes tolerance to self- or foreign antigens. Here, we demonstrate the engineering of a biodegradable polymeric poly(lactic- co-glycolic acid) (PLGA) nanocarrier for the selective delivery of the murine allergen, ovalbumin (OVA), to the liver. This was accomplished by developing a series of NPs in the 200-300 nm size range as well as decorating particle surfaces with ligands that target scavenger and mannose receptors on liver sinusoidal endothelial cells (LSECs). LSECs represent a major antigen-presenting cell type in the liver capable of generating regulatory T-cells (Tregs).  In vitro exposure of LSECs to NPOVA induced abundant TGF-β, IL-4, and IL-10 production, which was further increased by surface ligands. Animal experiments showed that, in the chosen size range, NPOVA was almost exclusively delivered to the liver, where the colocalization of fluorescent-labeled particles with LSECs could be seen to increase by surface ligand decoration. Moreover, prophylactic treatment with NPOVA in OVA-sensitized and challenged animals (aerosolized inhalation) could be seen to significantly suppress anti-OVA IgE responses, airway eosinophilia, and TH2 cytokine production in the bronchoalveolar lavage fluid. The suppression of allergic airway inflammation was further enhanced by attachment of surface ligands, particularly for particles decorated with the ApoB peptide, which induced high levels of TGF-β production in the lung along with the appearance of Foxp3+ Tregs. The ApoB-peptide-coated NPs could also interfere in allergic airway inflammation when delivered postsensitization. The significance of these findings is that liver and LSEC targeting PLGA NPs could be used for therapy of allergic airway disease, in addition to the potential of using their tolerogenic effects for other disease applications.

Background: Studies conducted in interstitial lung disease (ILD) patients to assess diaphragmatic excursion and thickening fraction suggest a weak to strong correlation with pulmonary function parameters. However, diaphragmatic excursion velocity, a novel imaging marker, has not been correlated with pulmonary function and high-resolution computed tomography (HRCT) fibrosis score in ILD patients previously. Methods: We conducted a cross-sectional analytical study in 40 ILD patients during quiet (QB) and deep breathing (DB) to measure diaphragmatic thickening, excursion and excursion velocity using transthoracic ultrasound and correlated them with pulmonary function parameters and HRCT fibrosis score. Results: Most diaphragm parameters in DB correlated more strongly with lung function parameters compared to quiet breathing. Right diaphragmatic excursion, during QB and DB, showed positive correlations with forced vital capacity (FVC) z-score (r = 0.591, 0.676) and diffusion capacity of the lung for carbon monoxide (DLCO) z-score (r = 0.437, 0.438), and negative correlations with HRCT fibrosis score (r = -0.439, -0.425), respectively. In addition, right diaphragmatic velocity exhibited positive correlations with FVC z-score (r = 0.388, 0.667) and DLCO z-score (r = 0.139, 0.412), and negative correlations with HRCT fibrosis score (r = -0.454, -0.445). Right diaphragm thickening fraction showed positive correlations with FVC z-score (r = 0.330, 0.460) and DLCO z-score (r = 0.400, 0.426), and negative correlations with HRCT fibrosis score (r = -0.199, -0.237). Similarly, right diaphragmatic thickness indicated positive correlations with FVC z-score (r = 0.526, 0.614) and DLCO z-score (r = 0.298, 0.298), and negative correlations with HRCT fibrosis score (r = -0.398, -0.401). Conclusion: Diaphragmatic excursion velocity during DB showed a weak to moderate correlation with pulmonary function parameters and HRCT fibrosis score and may be utilized as a surrogate marker in ILD patients unable to perform pulmonary function tests or undergo sequential HRCT thorax in follow-up. [ABSTRACT FROM AUTHOR]

Byline: Ganesh. Sanjan, Liza. Das, Chirag. Ahuja, Sivashanmugam. Dhandapani, Naresh. Sachdeva, Sandeep. Grover, Pinaki. Dutta Impulse control disorders (ICDs) are less-emphasized adverse effects of dopamine agonists. Evidence on prevalence and [...]

Manganese (Mn) is an essential heavy metal in the human body, while excess Mn leads to neurotoxicity, as observed in this study, where 100 µM of Mn was administered to the human neuroblastoma (SH-SY5Y) cell model of dopaminergic neurons in neurodegenerative diseases. We quantitated pathway and gene changes in homeostatic cell-based adaptations to Mn exposure. Utilizing the Gene Expression Omnibus, we accessed the GSE70845 dataset as a microarray of SH-SY5Y cells published by Gandhi et al. (2018) and applied statistical significance cutoffs at p < 0.05. We report 74 pathway and 10 gene changes with statistical significance. ReactomeGSA analyses demonstrated upregulation of histones (5 out of 10 induced genes) and histone deacetylases as a neuroprotective response to remodel/mitigate Mn-induced DNA/chromatin damage. Neurodegenerative-associated pathway changes occurred. NF-κB signaled protective responses via Sirtuin-1 to reduce neuroinflammation. Critically, Mn activated three pathways implicating deficits in purine metabolism. Therefore, we validated that urate, a purine and antioxidant, mitigated Mn-losses of viability in SH-SY5Y cells. We discuss Mn as a hypoxia mimetic and trans-activator of HIF-1α, the central trans-activator of vascular hypoxic mitochondrial dysfunction. Mn induced a 3-fold increase in mRNA levels for antioxidant metallothionein-III, which was induced 100-fold by hypoxia mimetics deferoxamine and zinc. [ABSTRACT FROM AUTHOR]

To date, 55 species of bats have been recorded over a wide range of altitudes from 64 to 4,154 m above sea level (a.s.l.) in Nepal. One third of Nepal, including eight protected areas, most of the Higher Mountain region and the western part of the country, has yet to be surveyed. In this study, mist netting, harp trapping, roost and acoustic surveys revealed a total of 34 species of bats belonging to 22 genera from nine districts of Nepal. Coelops frithii and Harpiocephalus harpia were noted for the first time from the country. Bats were recorded at altitudes from 240 to 3,232 m, with 25 species recorded from middle elevation ranges (1,001–2,000 m a.s.l.), 21 species from higher elevation ranges (2,001–3,232 m a.s.l.), and 20 species from lower elevation ranges (240–1,000 m a.s.l.). The distribution patterns across different ranges were species-specific (e.g., irregular in Myotis csorbai, hump-shaped in Submyotodon caliginosus, and linear in Nyctalus noctula), with high species richness observed at elevations from 501 to 1,000 m a.s.l. (22 species), followed by 1,001–1,500 m a.s.l. (21 species). These data are expected to guide the designation of new survey and monitoring areas in the future. Consequently, further detailed surveys and monitoring, particularly in western Nepal and the Higher Mountain regions, are likely to yield new distribution records of bats, both nationally and globally. [ABSTRACT FROM AUTHOR]

The acorn barnacle (Cirripedia: Balanomorpha) is a sessile crustacean arthropod, distributing around the intertidal areas of tropical and temperate regions worldwide. Current practices for taxonomic identification are based on shell morphology and light microscopy, together with the use of scanning electron microscopy for arthropodal characters, which the latter technique requires complicated procedures. Through the recent technology of confocal light-sheet microscopy, here we demonstrate a clear description of Caudoeuraphia caudata (Pilsbry, 1916), a new record of its presence in eastern Thailand. This type of microscopy enables the high acquisition of fluorescent imaging of a whole barnacle’s body and arthropodal structures, including cirri and mouthpart imaging in three dimensions, with simple procedures for sample preparation and through harboring autofluorescence of their own barnacle structures. Hence, this technology could potentially be an alternative way for identifying acorn barnacles at the species-level and visualizing the diversity of these marine arthropods.

Coronavirus disease 2019 (COVID-19) was an impetus for a multitude of transformations – from the ever-changing clinical practice frameworks, to changes in our execution of education and research. It called for our decisiveness, innovativeness, creativity, and adaptability in many circumstances. Even as care for our patients was always top priority, we tried to integrate, where possible, educational and research activities in order to ensure these areas continue to be harnessed and developed. COVID-19 provided a platform that stretched our ingenuity in all these domains. One of the mnemonics we use at SingHealth in responding to crisis is PACERS: P: Preparedness (in responding to any crisis, this is critical) A: Adaptability (needed especially with the ever-changing situation) C: Communications (the cornerstone in handling any crisis) E: Education (must continue, irrespective of what) R: Research (new opportunities to share and learn) S: Support (both physical and psychological). This article shares our experience integrating the concept of simulation-based training, quality improvement, and failure mode analysis.

This study deals with the mitigation of current harmonics, which is primarily important to alleviate power quality problems in modern times. Current harmonics produced by different widely used loads have been evaluated and related parameters have been tabled. Using the data obtained, a non-linear load was modelled to serve as the test load. Different mitigation solutions and techniques were studied to select an appropriate filter design for domestic single-phase application. The Active Power Filter (APF)'s steady-state and dynamic output was evaluated with reference current extraction techniques like PQ and SRF theories in Simulink. For a fair comparison, various parameters related to the filter design were kept identical between the tests conducted; and to test the dynamic performance, a highly inductive load was connected halfway through simulation. The reactive power compensation offered by the filter was studied by using various waveforms and parameters are investigated and tabulated. The study was carried out to identify a reference current extraction technique that yields the best performance and understand the implementation of the same to identify inherent issues that can sometimes be overlooked because of their simplicity and ease of implementation. The performance of two commonly used reference current extraction techniques were analyzed by subjecting it to highly non-linear and highly inductive loads that were modelled based on various loads that were analyzed.

Aim: Lung ultrasound (LUS) has been extensively used in the evaluation of acute respiratory distress syndrome (ARDS) in the critical care setting. In our study, we aim to assess the utility of point-of-care ultrasound (POCUS)-LUS in the initial assessment of ARDS patients presenting to the emergency department (ED). Subjects and Methods: We evaluated a prospective convenience sample of 73 adult patients presenting to the ED. The bedside LUS was performed by the trained emergency physician on patients with undifferentiated dyspnea with a clinical diagnosis of ARDS according to the Berlin's criteria. The four major LUS findings were examined on structured 12-zone LUS. The observed profile consisted of A lines, well-separated B lines, coalescent B lines, and consolidation among patients who were clinically diagnosed as ARDS. These LUS findings may vary depending on the severity of ARDS. The findings were analyzed using IBM SPSS Statistics for Windows, Version 24.0 (IBM Corp., Armonk, NY, USA). Results: Of the 73 study individuals, majority were male 46 (63%). The distributions of study individuals were as follows: 27% – mild ARDS, 37% – moderate ARDS, and 36% – severe ARDS. Coalescent B lines are present in about 70.4% and 92.3% of moderate and severe ARDS patients, respectively. Consolidations are predominantly present in moderate (100%) and severe (92.3%) ARDS. Conclusion: LUS in the initial assessment of patients' with ARDS yielded significant findings in the three clinically designated categories. This study opens up the possibility of using POCUS as an adjunct in the initial assessment of ARDS patient in the ED.

Nepal Himalayas combine Oriental and Sino-Japanese zoogeographic realms as well as those of the eastern and western Himalayas. Physiography coupled with the diverse local climates has enriched the biodiversity of the Nepal Himalayas. The order Chiroptera constitutes more than 25% of the mammalian fauna and forms the most speciose group of mammals in Nepal, where bats are recorded within a wide range of elevations from 64m to 4154m. Climate variation in the past has been observed and projected change has been predicted, and an evaluation of the climate change impact on biodiversity and habitats has been initiated. However, none of the studies has assessed the impact of climate change on bats in the Himalayan range including Nepal, despite bats represent the largest mammalian group in the country. Through Species Distribution Modelling (SDM), we describe the present distribution range for five common species, further assess their response to future climatic changes. Specifically, the occurrence of bats against 10 environmental variables were projected under different climate scenarios; present, Representative Concentration Pathways (RCPs) 4.5 and 8.5 for 2050 and 2070 deploying maximum entropy modeling (MaxEnt). We prepared predicted distribution range maps and estimated area using Arc GIS 10.7.1. Among 10 uncorrelated bioclimatic variables, six contribute to the SDM significantly. Annual precipitation (bio12) is the most common variable for all five species. Two species shows wider present distribution ranges compared to other three. Under the climate change scenarios, although predictions varied among species, similar trends of the range shifting toward northern latitudes and higher elevations are observed. Since the larger part of the current potential distribution range lies outside protected areas, a landscape level conservation approach prioritizing bat conservation is needed. Future surveys should target ground truthing in the western region of the country.

ABSTRACT RNA degradation is an important process that influences the ultimate concentration of individual proteins inside cells. While the main enzymes that facilitate this process have been identified, global maps of RNA turnover are available for only a few species. Even in these cases, there are few sequence elements that are known to enhance or destabilize a native transcript; even fewer confer the same effect when added to a heterologous transcript. To address this knowledge gap, we assayed genome-wide RNA degradation in the cyanobacterium Synechococcus sp. strain PCC 7002 by collecting total RNA samples after stopping nascent transcription with rifampin. We quantified the abundance of each position in the transcriptome as a function of time using RNA-sequencing data and later analyzed the global mRNA decay map using machine learning principles. Half-lives, calculated on a per-ORF (open reading frame) basis, were extremely short, with a median half-life of only 0.97 min. Despite extremely rapid turnover of most mRNA, transcripts encoding proteins involved in photosynthesis were both highly expressed and highly stable. Upon inspection of these stable transcripts, we identified an enriched motif in the 3′ untranslated region (UTR) that had similarity to Rho-independent terminators. We built statistical models for half-life prediction and used them to systematically identify sequence motifs in both 5′ and 3′ UTRs that correlate with stabilized transcripts. We found that transcripts linked to a terminator containing a poly(U) tract had a longer half-life than both those without a poly(U) tract and those without a terminator. IMPORTANCE RNA degradation is an important process that affects the final concentration of individual mRNAs, affecting protein expression and cellular physiology. Studies of how RNA is degraded increase our knowledge of this fundamental process as well as enable the creation of genetic tools to manipulate RNA stability. By studying global transcript turnover, we searched for sequence elements that correlated with transcript (in)stability and used these sequences to guide tool design. This study probes global RNA turnover in a cyanobacterium, Synechococcus sp. strain PCC 7002, that both has a unique array of RNases that facilitate RNA degradation and is an industrially relevant strain that could be used to convert CO2 and sunlight into useful products.

Occurrence of Scotophilus kuhlii was speculated throughout the southern plain (Tarai) of Nepal. However, there was no record of voucher specimen of the species from Nepal. We collected a specimen from the Tikulia tole, Pakali Village Development Committee, Sunsari District of southeastern Nepal and deposited at Central Department of Zoology (CDZ) Museum, Tribhuvan University, Kathmandu. The specimen was identified as S. kuhlii based on measurement of external body, cranial, dental parts and detail description of the species. This is the first specific locality record of the species from Nepal that confirms its presence in the country.

Pangolin populations are declining globally due to illicit trade for meat and ethno-medicinal practices. We performed semi-structured interviews to analyze scenario of trade activities and documented the ethno-medicinal importance of pangolins in four districts of eastern Nepal. Out of 106 respondents, 78.3% had seen live pangolins, 90.6% had seen their burrows and 66% respondents speculated their decreasing population. Although 64% of the respondents were aware that pangolin is protected species, 44% of respondents had eaten its meat. We found the trade as an organized network where poachers of one village supply pangolins and its parts to poachers of another village and so on until it reaches the international border. Trade flow was more across the Chinese border via different routes where the prices varied from US$ 500–625/kg or even more. For this illegal trade, poachers provoke unemployed youths especially from ethnic communities. Most people hunt pangolins merely for trade without knowing its exact medicinal value. Some people, however, use meat and scales to supposedly cure gastro-intestinal disease, skin disease, cardiac problem, pregnancy pains, back pain; and also for making rings, bags, jackets, purses and musical instruments. As most pangolin habitats lie outside protected areas, illicit trade is increasing rapidly. We recommend immediate strategic plans, effective monitoring techniques and inter-border cooperation to thwart the trade, and raise awareness of their importance.