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RESUMO A Síndrome de Vohwinkel ou ceratodermia hereditária mutilante é uma ceratodermia palmoplantar rara, que se manifesta na infância e se torna mais evidente nas fases de adolescência e idade adulta. Doença de herança preferencialmente autossômica dominante, acomete mais mulheres e caucasianos. A hiperceratose palmoplantar difusa, com aparência de favo de mel; as faixas constritivas digitais conhecidas como pseudoainhum, e as placas ceratósicas em forma de estrela-do-mar no dorso de mãos e pés, podendo acometer cotovelos e joelhos, são os achados clínicos característicos da Síndrome. O presente trabalho trata de um relato de caso de uma paciente com Síndrome de Vohwinkel e a terapêutica cirúrgica realizada nas faixas constritivas. ABSTRACT Vohwinkel syndrome, also known as hereditary mutilating keratoderma, is a rare palmoplantar keratoderma that manifests in childhood and becomes more evident in adolescence and adulthood. This preferential autosomal dominant disease affects more women and Caucasians. Its clinical features are diffuse palmoplantar keratoderma with the appearance of honeycomblike constricting rings in the fingers and toes known as pseudo-ainhum, and starfish-shaped keratotic plaques on the dorsal aspect of the hands and feet that can affect the elbows and knees. The present report describes a case report of a patient with Vohwinkel syndrome and surgical correction of the constrictive bands.

Necroptosis is a regulated necrotic cell death pathway involved in development and disease. Its signaling cascade results in the formation of disulfide bond-dependent amyloid-like polymers of mixed lineage kinase domain-like protein (MLKL), which mediate proinflammatory cell membrane disruption. We screened compound libraries provided by the National Cancer Institute and identified a small-molecule inhibitor of necroptosis named necroptosis-blocking compound 1 (NBC1). Biotin-labeled NBC1 specifically conjugates to heat shock protein Hsp70. NBC1 and PES-Cl, a known Hsp70 substrate-binding inhibitor, block the formation of MLKL polymers, but not MLKL tetramers in necroptosis-induced cells. In vitro, recombinant Hsp70 interacts with the N-terminal domain (NTD) of MLKL and promotes NTD polymerization, which has been shown to mediate the cell killing activity. Furthermore, the substrate-binding domain (SBD) of Hsp70 is sufficient to promote MLKL polymerization. NBC1 covalently conjugates cysteine 574 and cysteine 603 of the SBD to block its function. In addition, an SBD mutant with both cysteines mutated to serines loses its ability to promote MLKL polymerization. Interestingly, knockdown of Hsp70 in cells leads to MLKL destabilization, suggesting that MLKL might also be a client protein of Hsp70. In summary, using NBC1, an inhibitor of necroptosis, we identified Hsp70 as a molecular chaperone performing dual functions in necroptosis. It stabilizes MLKL protein under normal condition and promotes MLKL polymerization through its substrate-binding domain during necroptosis.

Background The SunSafe Student Ambassador Program (SSSAP) in Australia uses the peer-to-peer learning environment to educate high-school students about sun-safety. Aims To assess whether the SSSAP would improve knowledge, attitudes and behaviours towards sun safety in high-school students and whether this would be sustained at 3 months. Methods An assessment survey was delivered before, immediately after and 3 months after participation in the SSSAP in 2019. Results In total, 503 participants completed the pre-presentation survey, 274 completed the post-presentation survey, and 218 completed both. Immediately following presentation, the total composite score for all 18 knowledge questions increased from a mean ± SD of 11.8 ± 3.5 to 13.8 ± 4.7 (P < 0.001). There was strong evidence for an improvement in one attitude-based question ‘Is it healthy to have a tan?’ (P < 0.01) and one behaviour question about wearing sunscreen daily (P = 0.02). After 3 months, 235 students were matched to their pre-presentation survey. The composite score of all knowledge questions had improved from 11.2 ± 3.5 to 12.1 ± 4.5 (out of a total of 18) (P < 0.01). There was also an improvement in two attitude questions ‘Do you feel better when you have a tan?’ (P = 0.03) and ‘Is it healthy to have a tan?’ (very strong evidence: P < 0.001), and evidence for a reduction in time spent outdoors on a weekday (P = 0.04). Conclusion The SSSAP was associated with improvements in knowledge, attitude and behaviour towards sun safety immediately and at 3 months post-presentation. Further research is required to determine whether these positive effects are sustained and whether they ultimately reduce skin cancers.

For patients who do not achieve adequate disease control on biologic monotherapy, or monotherapy with an oral-systemic agent such as methotrexate, combination biologic therapy may be considered. To the best of our knowledge, we report the first case assessing the safety and efficacy of the combination of an interleukin-23 (IL-23) inhibitor (risankizumab) with a tumour necrosis factor-α (TNF-α) inhibitor (golimumab) in the treatment of psoriasis and psoriatic arthritis. After twelve months of treatment with risankizumab and golimumab, our patient experienced a significant improvement in his psoriasis and psoriatic arthritis without any adverse effects to date.

Necroptosis is a regulated necrotic cell death pathway, mediated by a supermolecular complex called the necrosome, which contains receptor-interacting protein kinase 1 and 3 (RIPK1, RIPK3) and mixed-lineage kinase domain-like protein (MLKL). Phosphorylation of human RIPK3 at serine 227 (S227) has been shown to be required for downstream MLKL binding and necroptosis progression. Tandem immunoprecipitation of RIPK3 reveals that casein kinase 1 (CK1) family proteins associate with the necrosome upon necroptosis induction, and this interaction depends on the kinase activity of RIPK3. In addition, CK1 proteins colocalize with RIPK3 puncta during necroptosis. Importantly, CK1 proteins directly phosphorylate RIPK3 at S227 in vitro and in vivo. Loss of CK1 proteins abolishes S227 phosphorylation and blocks necroptosis. Furthermore, a RIPK3 mutant with mutations in the CK1 recognition motif fails to be phosphorylated at S227, does not bind or phosphorylate MLKL, and is unable to activate necroptosis. These results strongly suggest that CK1 proteins are necrosome components which are responsible for RIPK3-S227 phosphorylation.

Introduction: Sepsis is a major health problem, and the incidence is still increasing. Generally, sepsis occurs in about 2% of all inpatients in developed countries. The immunologic response that causes sepsis is a systemic inflammatory response that causes activation of the inflammatory and coagulation pathways. If sepsis untreated, it can lead to organ failure then death. Organ dysfunction is expressed as an acute change of Sequential Organ Failure Assesment (SOFA) score >2 points as a consequence of infection.Methods: This is a cohort prospective’s study. Prothrombin time (PT), activated partial thromboplastin time (aPTT), Thrombin time (TT), Fibrinogen, D-dimer were examined 3 times (first, second, third day), and then assessed to see its relation with the corresponding SOFA score. Twenty-four subjects of the study were ICU patients in H. Adam Malik Hospital who matched the inclusion and exclusion criteria.Results: There were significant differences of PT on the first, second and third day (p =0.03). There were no significant differences in aPTT, TT, Fibrinogen, D-dimer on the first, second, third day. There were no significant correlations of PT, aPTT, TT, Fibrinogen with the corresponding SOFA score on the first, second, third day. There was a moderate positive correlation between D-dimer and SOFA score in the first, second and third day of examinations (p Conclusion: PT changes occurred significantly on the first, second, third day of sepsis and D-dimers can be used to asses the risk of organ failure in septic patients.

The main treatment of primary cutaneous melanoma is surgery. This review aims to assess the width of excision margin that minimises the risk of adverse outcome from surgery, locoregional recurrence, distant recurrence, and death.PRISMA guidelines were followed. MEDLINE, EMBASE, and four other databases were searched by using the term "melanoma", "margin", and limiting the search to randomised clinical trials (RCTs).Seven RCTs involving 4579 patients data were analysed. No statistically significant difference was found in locoregional recurrence RR 1.09 (95%CI 0.98-1.22, p = 0.12), local recurrence RR 1.20 (95%CI 0.66-2.21, p = 0.55), in-transit metastasis RR1.30 (95%CI 0.86-1.97, p = 0.21), regional nodal metastasis RR 1.04 (95%CI 0.91-1.18, p = 0.56), distant metastasis RR 0.95 (95%CI 0.72-1.24, p = 0.68), death RR 1.00 (95%CI 0.93-1.07, p = 0.97), death from melanoma RR 1.11 (95%CI 0.96-1.28, p = 0.16), wound infection RR 1.22 (95%CI 0.68-2.17, p = 0.50), and wound dehiscence RR 0.96 (95%CI 0.54-1.71, p = 0.88) when narrow (1-2 cm) versus wide (3-5 cm) excision margins were compared. In contrast, patients with narrow excision margins had a significant reduction in complex surgical reconstruction RR 0.30 (95%CI 0.19-0.49, p 00001). When studies were excluded because of high risk of bias the only significant difference was death due to melanoma RR 1.25 (95%CI1.01-1.55, P = 0.04).No significant difference between narrow and wide excision margins in locoregional or distant recurrence, metastasis, death, or death due to melanoma. Wide margins (2-5 cm) increased the need for surgical reconstruction. Further studies are needed to assess optimal excision margins with regards to Breslow thickness and other prognostic factors and are in progress.

In den letzten 20 Jahren hat die Forschung zu nonverbalen Signalen für Roboter angefangen, animationsbasierte Techniken in den Designprozess einzubinden. Eines dieser Animationsprinzipien, welches erst wenige Forscher in diesem Kontext eingesetzt haben, ist Übertreibung. In dieser Arbeit sollen Fragen zu der Erstellung, Lesbarkeit und Wahrnehmung von übertrieben und nicht übertrieben dargestellten nonverbalen Signalen für den Roboter Pepper beantwortet werden. Die ausgewählten nonverbalen Signale Nicken, nach vorne Lehnen, Kopfschütteln und Gestiken wurden mit drei verschiedenen Methoden erstellt. Um die Forschungsfragen zu Lesbarkeit und Wahrnehmung zu beantworten, wurden zwei Online-Umfragen, welche Videos von dem Roboter beinhalten, und vier semi-strukturierte Interviews durchgeführt. Die erste Online-Umfrage konzentrierte sich auf Lesbarkeit von nonverbalen Signalen, welche von dem Roboter Pepper dargestellt wurden, und verglich verschiedene Methoden der Erstellung, sowie übertrieben mit nicht übertrieben dargestellten Signalen. Die zweite Online-Umfrage untersuchte, wie diese nonverbalen Signale beeinflussten, wie der Roboter von Menschen wahrgenommen wurde. Hierbei wurden zufällige, kontextbezogene und übertriebene Bewegungen mit Hilfe des Godspeed-Fragebogens verglichen. Die Interviews konzentrierten sich darauf, einen tiefergehenden Einblick in die Eindrücke von ausgewählten Umfrage-Teilnehmer*innen zu gewinnen, die die Videos, im Zuge derer der Roboter Pepper unterschiedliche nonverbale Signale darstellt, angeschaut hatten. Die zwei Godspeed-Variablen Animacy und Perceived Safety, welche mit Belebtheit und Wahrgenommener Sicherheit übersetzt werden können, waren statistisch signifikant. Sie zeigten eine höhere Bewertung von übertriebenen und kontextbezogenen nonverbalen Signalen gegenüber zufälligen nonverbalen Signalen. Diese Ergebnisse wurden durch aus den Interviews gewonnene quantitative Daten bestätigt., Over the last two decades, research on non-verbal cues for robots has started to include animation-based techniques in the design process. One of the animation principles that only few researchers have used in this context is exaggeration. This work seeks to answer questions about the creation, readability and perception of exaggerated and non-exaggerated non-verbal cues for the robot Pepper. The selected non-verbal cues nodding, leaning, head shaking and gestures were created using three different methods. To answer the research questions about readability and perception, two online surveys, each containing videos of the robot, and four semi-structured interviews were conducted. The first online survey focused on readability of non-verbal cues performed by Pepper and compared different methods of creation as well as exaggerated with non-exaggerated cues. The second online survey investigated how these non-verbal cues changed people’s perception of the robot by comparing random, contextual and exaggerated movements, measured with the Godspeed questionnaire. The interviews centered around gaining more insight into people’s experiences when watching the videos of the robot performing different non-verbal cues. The two Godspeed variables animacy and perceived safety were found to be statistically significant and showed higher scores for exaggerated cues as well as for contextual rather than for random cues. These results were supported by quantitative data from the interviews.

Poverty has been a long outstanding crisis at global scale and poverty alleviation has become one of the primary national developmental agendas. Conventional microfinance programmes have received growing attentions due to its capability to improve standard of living and social inclusiveness. Arguably, however, these conventional microcredit programmes do not effectively alleviate poverty as the borrowers remain into an interest-base debt cycle which may worsen the financial burdens. Meanwhile, Islamic microfinance by way of Mudharabah financing is equity based financing structure which is perceived to have a fair borrower-lender agreement. It promotes an effective wealth redistributive mechanism to reach the poor, to encourage their participation in productive real economic sectors. This not only alleviates poverty, but also enhances standards of living. This research discusses the applications of conventional and Islamic microfinance models currently practiced globally and proposes an enhanced Mudharabah microfinance model to be adopted.

Despite the potential importance of black carbon (BC) to radiative forcing of the Arctic atmosphere, vertically-resolved measurements of the particle light scattering coefficient (Bsp) and light absorption coefficient (Bap) in the springtime Arctic atmosphere are infrequent, especially measurements at latitudes at or above 80oN. Here, relationships among vertically-distributed aerosol optical properties Bap, Bsp, and single scattering albedo or SSA), particle microphysics and particle chemistry are examined for a region of the Canadian archipelago between 79.9oN and 83.4oN from near the surface to 500 hPa. Airborne data collected during April, 2015, are combined with ground-based observations from the observatory at Alert, Nunavut and simulations from the GEOS-Chem-TOMAS model (Kodros et al., 2018) to increase our knowledge of the effects of BC on light absorption in the Arctic troposphere. The results are constrained for Bsp less than 15 Mm-1, which represent 98% of the observed Bsp, because the single scattering albedo (SSA) has a tendency to be lower at lower Bsp, resulting in a larger relative contribution to Arctic warming. At 18.4 m2 g-1, the average BC mass absorption coefficient (MAC) from the combined airborne and Alert observations is substantially higher than the two averaged modelled MAC values (9.5 m2 g-1 and 7.0 m2 g-1) for two different internal mixing assumptions, the latter of which is based on previous observations. The higher observed MAC value may be explained by an underestimation of BC and possible differences in BC microphysics and morphologies between the observations and model. We present Bap and SSA based on the assumption that Bap is overestimated in the observations in addition to the assumption that the higher MAC is explained. Median values of the measured Bap, rBC and organic component of particles all increase by a factor of 1.8±0.1 going from near-surface to 750 hPa, and values higher than the surface persist to 600 hPa. Modelled BC, organics, and Bap agree with the near-surface measurements, but do not reproduce the higher values observed between 900 hPa and 600 hPa. The differences between modelled and observed optical properties follow the same trend as the differences between the modelled and observed concentrations of the carbonaceous components (black and organic). Some discrepancies in the model may be due to the use of a relatively low imaginary refractive index of BC as well as by the ejection of biomass burning particles only into the boundary layer at sources. For the assumption of the higher observed MAC value, the SSA range between 0.88 and 0.94, which is significantly lower than other recent estimates for the Arctic, in part reflecting the constraint of Bsp

Background: Viral gastroenteritis is a leading cause of morbidity worldwide. Evolving epidemiology, in part due to vaccines, has made identifying specific stool pathogens more relevant for clinical and public health providers. Molecular testing for gastrointestinal viruses is sensitive and effective for rapid identification of viruses from stool samples. In this study we report the prevalence of key viral pathogens in diarrheal stool specimens from a pediatric population. Methods: From February 2014 to March 2017, remnant stool samples from patients presenting to a healthcare provider with diarrhea were examined for both bacteria (Salmonella species, Shigella species, Campylobacter species, and Shiga toxins 1 and 2) and viruses (norovirus, sapovirus, astrovirus, adenovirus, and rotavirus). Detection of targets was performed using and FDA-approved platform (BD Max™) with PCR/sequencing serving as the reference method. Results: Of the 386 samples tested, at least one potential pathogen (viral and/or bacterial) was detected in 41.2% of specimens. 136 (35.2%%) samples tested positive for at least one virus; 34 (8.8%) samples tested positive for at least one bacterium. There were 28 dual infections. Conclusions: The most commonly detected targets were viruses. Norovirus and sapovirus were the most prevalent stool pathogens, especially in very young patients. Shigella species was the most prevalent bacteria and third most detected target overall. Rotavirus prevalence was low, but still detected in 15 (3.9%) of the samples. This may indicate that while vaccine has reduced its prevalence, it should still be considered in clinical evaluation of this population. Of note, the majority (59%) of samples were negative for viral pathogens. Providers should also consider parasites and noninfectious causes such as inflammatory bowel disease when evaluating diarrhea in a pediatric patient.

The Canadian Earth System Model version 5 (CanESM5) is a global model developed to simulate historical climate change and variability, to make centennial scale projections of future climate, and to produce initialized seasonal and decadal predictions. This paper describes the model components and their coupling, as well as various aspects of model development, including tuning, optimization and a reproducibility strategy. We also document the stability of the model using a long control simulation, quantify the model's ability to reproduce large scale features of the historical climate, and evaluate the response of the model to external forcing. CanESM5 is comprised of three dimensional atmosphere (T63 spectral resolution/2.8°) and ocean (nominally 1°) general circulation models, a sea ice model, a land surface scheme, and explicit land and ocean carbon cycle models. The model features relatively coarse resolution and high throughput, which facilitates the production of large ensembles. CanESM5 has a notably higher equilibrium climate sensitivity (5.7 K) than its predecessor CanESM2 (3.8 K), which we briefly discuss, along with simulated changes over the historical period. CanESM5 simulations are contributing to the Coupled Model Intercomparison Project Phase 6 (CMIP6), and will be employed for climate science and service applications in Canada.

BackgroundIn December 2013, a multicomponent meningococcal serogroup B (4CMenB) vaccine was used before licensure on the basis of special consideration by the Food and Drug Administration to respond to an outbreak of Neisseria meningitidis B at a U.S. university. Data suggested that vaccination would control the outbreak because isolates expressed antigens that were closely related to the vaccine antigens (factor H–binding protein [fHbp] and neisserial heparin-binding antigen). We quantified the immune responses induced by 4CMenB during the outbreak. MethodsWe conducted a seroprevalence survey among students to assess vaccination status and collect serum specimens to quantify titers of serum bactericidal antibodies (SBA) with an assay that included human complement (hSBA). We compared the proportion of vaccinated and unvaccinated participants who were seropositive for the outbreak strain and for one closely related reference strain (44/76-SL, which included fHbp) and one mismatched reference strain (5/99,...

Modelling studies suggest that the climate and the hydrological cycle are sensitive to the concentrations of ice-nucleating particles (INPs). However, the concentrations, composition, and sources of INPs in the atmosphere remain uncertain. Here we report daily concentrations of INPs and tracers of mineral dust (Al, Fe, Ti, and Mn), sea spray aerosol (Na+ and Cl−), and anthropogenic aerosol (Zn, Pb, NO3−, NH4+, and non-sea-salt SO42−) at Alert, Canada during a three-week campaign in March 2016. The average INP concentrations measured in the immersion freezing mode were approximately 0.005 ± 0.002 L−1, 0.020 ± 0.004 L−1, and 0.186 ± 0.040 L−1 at −15 ºC, −20 ºC, and −25 ºC, respectively. These concentrations are within the range of concentrations measured previously in the Arctic at ground level or sea level. Mineral dust tracers all correlated with INPs at −25 ºC (correlation coefficient, R, ranged from 0.70 to 0.76), suggesting that mineral dust was a major contributor to the INP population. Particle dispersion modelling suggests that the source of the mineral dust may have been the long-range transported dust from the Gobi desert. Sea spray tracers were anti-correlated with INPs at −25 ºC (R = −0.56). In addition, INP concentrations at −25 ºC divided by mass concentrations of aluminum were anti-correlated with sea spray tracers (R = −0.51 and −0.55 for Na+ and Cl−, respectively), suggesting that the components of sea spray aerosol suppressed the ice-nucleating ability of mineral dust in the immersion freezing mode. Correlations between INPs and anthropogenic aerosol tracers were not statistically significant. These results will improve our understanding of INPs in the Arctic during spring.

Despite growing evidence that the ocean is an important source of ice nucleating particles (INPs) in the atmosphere, our understanding of the properties and concentrations of INPs in ocean surface waters remain limited. We have investigated the properties and concentrations of INPs in sea surface microlayer and bulk seawater samples collected in the Canadian Arctic during the summer of 2016. We observed that 1) INPs were ubiquitous in the microlayer and bulk waters; 2) heat and filtration treatments reduced INP activity, indicating that the INPs were likely heat-labile biological materials between 0.2 and 0.02 μm in diameter; 3) there was a strong negative correlation between salinity and freezing temperatures, possibly due to INPs associated with melting sea ice; and 4) concentrations of INPs could not be explained by satellite-derived chlorophyll a concentrations. Although the spatial patterns of INPs and salinities were similar in 2014 and 2016, we did observe some differences between the years, notably: 1) the concentrations of INPs were higher on average in 2016 compared to 2014; and 2) INP concentrations were enhanced in the microlayer compared to bulk seawater in several samples collected in 2016, which was not the case in 2014.

Amyloid or amyloid-like fibers have been associated with many human diseases, and are now being discovered to be important for many signaling pathways. The ability to readily detect the formation of these fibers under various experimental conditions is essential for understanding their potential function. Many methods have been used to detect the fibers, but not without some drawbacks. For example, electron microscopy (EM), or staining with Congo Red or Thioflavin T often requires purification of the fibers. On the other hand, semi-denaturing detergent agarose gel electrophoresis (SDD-AGE) allows detection of the SDS-resistant amyloid-like fibers in the cell extracts without purification. In addition, it allows the comparison of the size difference of the fibers. More importantly, it can be used to identify specific proteins within the fibers by Western blotting. It is less time consuming and more easily accessible to a wider number of labs. SDD-AGE results often show variable degree of heterogeneity. It raises the question whether part of the heterogeneity results from the dissociation of the protein complex during the electrophoresis in the presence of SDS. For this reason, we have employed a second dimension of SDD-AGE to determine if the size heterogeneity seen in SDD-AGE is truly a result of fiber heterogeneity in vivo and not a result of either degradation or dissociation of some of the proteins during electrophoresis. This method allows fast, qualitative confirmation that the amyloid or amyloid-like fibers are not partially dissociating during the SDD-AGE process.

Total-Fix, Cary-Blair, and Para-Pak SVT parasite transport systems were compared to 10% formalin with the BD MAX Enteric Parasite Panel, using clinical and contrived samples to determine comparability and limits of detection. The three transport systems have equal or superior limits of detection for all pathogens tested compared to 10% formalin.

Despite the importance of ice-nucleating particles (INPs) for climate and precipitation, our understanding of these particles is far from complete. Here, we investigated INPs at three coastal marine sites in Canada, two at mid-latitude (Amphitrite Point and Labrador Sea), and one in the Arctic (Lancaster Sound). At all three sites, the ice-nucleating efficiency on a per number basis (expressed as the fraction of aerosol particles acting as an INP) was strongly dependent on the size. For example, at diameters of around 0.2 µm, approximately 1 in 106 particles acted as an INP at −25 ºC, while at diameters of around 8 µm, approximately 1 in 10 particles acted as an INP at −25 ºC. The ice-nucleating efficiency on a per surface area basis (expressed as the surface active site density, ns) was also dependent on the size, with larger particles being more efficient at nucleating ice. The ns values of supermicron particles at Amphitrite Point and Labrador Sea were larger than previously measured ns values of sea spray aerosol, suggesting that sea spray aerosol was not a major contributor to the supermicron INP population at these two sites. Consistent with this observation, a global model of INP concentrations under-predicted the INP concentrations when assuming only marine organics as INPs. On the other hand, assuming only K-feldspar as INPs, the same model was able to reproduce the measurements at a freezing temperature of −25 ºC, but under-predicted INP concentrations at −15 ºC, suggesting that the model is missing a source of INPs active at a freezing temperature of −15 ºC.

Background The BD MAX™ Enteric Bacterial Panel (BDM-EBP) is designed and FDA-cleared to detect Salmonella, Shigella, Campylobacter, and Shiga toxin genes stx1/2 from stool samples. However, rectal swabs, which are not FDA-cleared for clinical testing with the BDM-EBP, are common specimens received from pediatric patients for enteric pathogen testing. The purpose of this study was to evaluate the ability of the BDM-EBP to detect stool pathogens from rectal swabs. Methods Routine cultures, Shiga toxin testing, and molecular testing with BDM-EBP were performed on 272 sequential rectal swabs collected from August 2015 to December 2015. Discrepant test results were resolved using Verigene® Enteric Pathogens Nucleic Acid Test (EP). 36 challenge samples (13 Salmonella spp., 3 Shigella spp., 10 Campylobacter spp., and 10 Shiga toxin positive Escherichia coli) were tested using reference strains (American Type Culture Collection) and previous patient isolates diluted to103-104 cfu/ml in saline then added to Sample Buffer Tube (SBT) with negative stool matrix delivered via a swab. Limit of detection testing was performed by serial 10 fold dilutions in saline then added to SBT with negative stool matrix provided via a swab. Results A total of 272 rectal swab specimens were evaluated and 89 were positive by culture and/or MAX EBP. All discrepant results were BDM-EBP positive and culture negative. 21 of 31 (68%) of the apparent false positive BDM-EBP discrepant results resolved as positive with Nanosphere’s Verigene® EP. After resolution of the discordant results, the Positive Percent Agreement (PPA) and Negative Percent Agreement (NPA) are as follows for each target: Salmonella (n = 4) 100%, PPA and 100%, NPA; Shigella (n = 79) 100%, PPA and 95.3%, NPA; Campylobacter (n = 4) 100%, PPA and 99.6%, NPA; and Shiga toxin producing organisms (n = 2) 100%, PPA and 100%, NPA. 8.8% of the patient samples did not initially yield a result on the BDM-System. Upon repeat, half of the problematic samples resolved, and 4.4% of the total specimen tested did not yield a result. All organisms in the challenge samples were detected. Limits of detection for BDM-EBP testing of rectal swabs were as follows (in cfu/ml in SBT): Salmonella-1.44 × 102; Shigella-5.10 × 100; Campylobacter-1.51 × 101; and Shiga Toxin-1.13 ×103. Conclusion Rectal swabs are acceptable samples for detecting Salmonella, Shigella, Campylobacter, and Shiga toxin using BDM-EBP.

Rapidly rising temperatures and loss of snow and ice cover have demonstrated the unique vulnerability of the high Arctic to climate change. There are major uncertainties in modelling the chemical depositional and scavenging processes of Arctic snow. To that end, fresh snow samples collected on average every four days at Alert, Nunavut, from September 2014 to June 2015 were analyzed for black carbon, major ions, and metals, and their concentrations and fluxes reported. Comparison with simultaneous measurements of atmospheric aerosol mass loadings yields effective deposition velocities which encompass all processes by which the atmospheric species are transferred to the snow. It is inferred from these values that dry deposition is the dominant removal mechanism for several compounds over the winter while wet deposition increased in importance in the fall and spring, probably due to enhanced scavenging by mixed-phase clouds. Black carbon aerosol was the least efficiently deposited species to the snow. These measurements are a unique data set for comparison to models that incorporate deposition to high Arctic snow.

Background Conventional bacterial stool culture is one of the more time-consuming tests in a routine clinical microbiology laboratory. In addition, less than 5 % of stool cultures yield positive results. A molecular platform, the BD MAX™ System (BD Diagnostics, Sparks, MD) offers the potential for significantly more rapid results and less hands-on time. Time-motion analysis of the BD MAX Enteric Bacterial Panel (EBP) (BD Diagnostics, Quebec, Canada) on the BD MAX System was compared to conventional stool culture in the microbiology laboratory of a tertiary care pediatric hospital. Methods The process impact analysis of time-motion studies of conventional cultures were compared to those of EBP with 86 stool specimens. Sample flow, hands-on time, processing steps, and overall turnaround time were determined and analyzed. Data were obtained and analyzed from both standard operating procedures and direct observation. A regression analysis was performed to ensure consistency of measurements. Time and process measurements started when the specimens were logged into the accessioning area of the microbiology laboratory and were completed when actionable results were generated. Results With conventional culture, negative culture results were available from 41:14:27 (hours:minutes:seconds) to 54:17:19; with EBP, positive and negative results were available from 2:28:40 to 3:33:39. Conclusions This study supports the suggestion that use of the EBP to detect commonly encountered stool pathogens can result in significant time savings and a shorter time-to-result for patients with acute bacterial diarrhea.

Objective: This study aimed to provide a description of the psychosocial process involved in regular dental attendance. Methods: The study design was a qualitative cross-sectional study using unstructured and semistructured interviews and observations of regular dental visits. The study participants included 12 men and 18 women attending general dental practices and six men and four women attending an emergency dental service. The data were systematically recorded and subjected to line-by-line grounded theory coding around the main concerns of those attending the dentist. Results: The main concern of those attending for a regular dental visit was checking their oral health. The six-month recall was conceptualized as a checking cycle in six phases: recalling, responding, inducing (i), waiting, inducing (ii), and telling. The possible outcomes of the cycle were maintaining oral health, sustaining oral health, and a further checking cycle. Variations in checking cycles resulted from reordering and normalizing pressures within participants' lifestyles. Conclusions: The findings of this study suggest that people's patterns of dental attendance are similar to those of other chronic illnesses. An understanding of the dynamic psychosocial processes involved in frequent dental attendance may be achieved when further research into this phenomenon is conducted.

A Síndrome de Parry-Romberg, também conhecida como atrofia hemifacial progressiva, é uma doença rara caracterizada por lenta e progressiva atrofia de hemiface. O tratamento ofertado para a síndrome, geralmente, visa melhorar o aspecto estético. Os enxertos gordurosos, as injeções de silicone ou as próteses de acrílico são alternativas sugeridas para correção da atrofia facial. Atualmente, a técnica recomendada para correção da atrofia facial é cirurgia dermatológica cosmética com lipoenxertia autóloga. O objetivo deste estudo é relatar um caso de SPR e demonstrar que a cirurgia dermatológica pode aliviar danos sérios à anatomia do paciente, a partir da discussão dos aspectos terapêuticos da síndrome, com ênfase na lipoenxertia autóloga Parry-Romberg syndrome, also known as progressive hemifacial atrophy, is a rare disorder characterized by slow and progressive hemifacial atrophy. The treatment offered for the syndrome generally aims at improving aesthetics. Fat grafts, silicone injections or acrylic prosthesis are alternatives suggested for correction of facial atrophy. Currently, the recommended technique for correction of facial atrophy is cosmetic dermatologic surgery with autologous fat grafting. This study reports a case of Parry-Romberg syndrome and demonstrates that dermatologic surgery can relieve serious damage to the patient's anatomy, starting from the discussion of the therapeutic aspects of the syndrome with emphasis on autologous fat grafting

Parry-Romberg syndrome, also known as progressive hemifacial atrophy, is a rare disorder characterized by slow and progressive hemifacial atrophy. The treatment offered for the syndrome generally aims at improving aesthetics. Fat grafts, silicone injections or acrylic prosthesis are alternatives suggested for correction of facial atrophy. Currently, the recommended technique for correction of facial atrophy is cosmetic dermatologic surgery with autologous fat grafting. This study reports a case of Parry-Romberg syndrome and demonstrates that dermatologic surgery can relieve serious damage to the patient's anatomy, starting from the discussion of the therapeutic aspects of the syndrome with emphasis on autologous fat grafting.