Iatrogenic Budd-Chiari Syndrome Secondary to Transhepatic Hemodialysis Catheterization.

Hepatic vein thrombosis (HVT), or Budd-Chiari syndrome, is a rare disorder resulting from the obstruction of blood flow from the liver to the inferior vena cava and eventually back to the heart. HVT can lead to extensive hepatocellular injury and portal hypertension and may require liver transplantation in patients. We present a rare cause of HVT and subsequent liver failure secondary to transhepatic venous catheterization for hemodialysis (HD) in a patient with end-stage renal disease (ESRD).

Development of Shingles on Tofacitinib Despite Completion of Recombinant Varicella-Zoster Virus Vaccine Series.

Shingles, also known as herpes zoster, is caused by the reactivation of the varicella-zoster virus (VZV). The risk of developing shingles increases with age, as well as in patients with weakened immune systems. Tofacitinib is a reversible Janus kinase inhibitor that suppresses the immune system and is used to treat autoimmune diseases, such as ulcerative colitis. Recombinant VZV vaccine is recommended for individuals taking tofacitinib and is highly effective at reducing the risk of shingles. This case report describes a patient with severe, refractory ulcerative colitis who developed shingles while on tofacitinib, despite prior vaccination with the recombinant VZV vaccine.

Pyroluria: Fact or Fiction?

Objective: The term "Mauve factor" (pyrroluria) dates back to 1958 when Dr. Abram Hoffer defined the condition as elevated levels of pyrroles in the urine, currently called hydroxyhemepyrrolin-2-one (HPL). It was suggested that the raised pyrrole levels lead to depletions in zinc and vitamin B6, which, in turn, were hypothesized to result in a range of psychiatric disorders, such as schizophrenia, anxiety, and depression. Treatment implications are supplementation with zinc and B6. This article aimed to review the scientific literature associating pyrroluria with psychiatric symptoms, explore the validity of HPL testing, explore the role of nutrients as treatment options for pyrroluria, and discuss future research directions. Methods: A PRISMA review was conducted using search results from electronic databases PubMed, MEDLINE, PsycINFO, EMBASE from inception to February 2020 using the following keywords: hydroxyhemepyryrrolin (HPL), kryptopyrrole (KP), mauve factor, pyroluria, pyrroluria, monopyrroles. Article reference lists were also scanned and included where relevant. Results: Seventy-three articles were identified of which only three studies identified significantly higher HPL levels in a psychiatric population compared with controls, and there were no placebo-controlled treatment trials directed at pyrroluria. The other 13 clinical studies either showed no association or did not provide adequate data to show group differences in HPL levels. Despite an extensive history of practitioners diagnosing and treating a wide variety of mental health conditions associated with pyrroluria as well as clinical observations of elevated HPL being associated with psychiatric disorders, there was no clear research that showed the following: (1) elevated HPL is robustly associated with increased mental health symptoms, (2) elevated HPL in urine is associated with increased urine excretion of zinc and B6, and (3) high-dose zinc and B6 are an efficacious treatment for mental health problems associated with elevated HPL. Conclusions: Elevated HPL is a clinically observed, but poorly researched biomarker with unclear associations with mental disorders. Based on current evidence, HPL testing is not recommended as a screening or treatment tool. Further research is required in the following areas: establishment of which specific clinical populations exhibit elevated HPL, validation of the chemistry and validity of testing, and controlled trials to establish efficacy of high-dose zinc and B6 as treatment of elevated pyrroles.

Effects of Applied Interfacial Pressure on Li-Metal Cycling Performance and Morphology in 4 M LiFSI in DME.

Lithium-metal anodes can theoretically enable 10× higher gravimetric capacity than conventional graphite anodes. However, Li-metal anode cycling has proven difficult due to porous and dendritic morphologies, extensive parasitic solid electrolyte interphase reactions, and formation of dead Li. We systematically investigate the effects of applied interfacial pressure on Li-metal anode cycling performance and morphology in the recently developed and highly efficient 4 M lithium bis(fluorosulfonyl)imide in 1,2-dimethoxyethane electrolyte. We present cycling, morphology, and impedance data at a current density of 0.5 mA/cm2 and a capacity of 2 mAh/cm2 at applied interfacial pressures of 0, 0.01, 0.1, 1, and 10 MPa. Cryo-focused ion beam milling and cryo-scanning electron microscopy imaging in cross section reveal that increasing the applied pressure during Li deposition from 0 to 10 MPa leads to greater than a fivefold reduction in thickness (and therefore volume) of the deposited Li. This suggests that pressure during cycling can have a profound impact on the practical volumetric energy density for Li-metal anodes. A "goldilocks zone" of cell performance is observed at intermediate pressures of 0.1-1 MPa. Increasing pressure from 0 to 1 MPa generally improves cell-to-cell reproducibility, cycling stability, and Coulombic efficiency. However, the highest pressure (10 MPa) results in high cell overpotential and evidence of soft short circuits, which likely result from transport limitations associated with increased pressure causing local pore closure in the separator. All cells exhibit at least some signs of cycling instability after 50 cycles when cycled to 2 mAh/cm2 with thin 50 µm Li counter electrodes, though instability decreases with increasing pressure. In contrast, cells cycled to only 1 mAh/cm2 perform well for 50 cycles, indicating that capacity plays an important role in cycling stability.

Cryogenic electron microscopy reveals that applied pressure promotes short circuits in Li batteries.

Li metal anodes are enticing for batteries due to high theoretical charge storage capacity, but commercialization is plagued by dendritic Li growth and short circuits when cycled at high currents. Applied pressure has been suggested to improve morphology, and therefore performance. We hypothesized that increasing pressure would suppress dendritic growth at high currents. To test this hypothesis, here, we extensively use cryogenic scanning electron microscopy to show that varying the applied pressure from 0.01 to 1 MPa has little impact on Li morphology after one deposition. We show that pressure improves Li density and preserves Li inventory after 50 cycles. However, contrary to our hypothesis, pressure exacerbates dendritic growth through the separator, promoting short circuits. Therefore, we suspect Li inventory is better preserved in cells cycled at high pressure only because the shorts carry a larger portion of the current, with less being carried by electrochemical reactions that slowly consume Li inventory.

Natural estrogens in surface waters of a catchment with intensive livestock farming in Switzerland.

Natural estrogens such as 17α-estradiol (E2α), 17ß-estradiol (E2ß), estrone (E1), and estriol (E3), released to surface waters from both urban and agricultural sources, are endocrine disrupting for fish. Here, we assess the prevalence of livestock farming derived natural estrogens in tributaries and ponds in the agriculturally dominated catchment of Lake Baldegg, Switzerland. Passive samplers were deployed in the main tributary and daily time-proportional water samples were collected in five tributaries for 30 days at the beginning of the vegetation period. Furthermore, we took grab samples of 12 ponds in the catchment. Aqueous samples were liquid-liquid extracted, derivatized, and analysed with LC-MS/MS and stream water samples additionally with ERα-CALUX, a bioassay for assessing total estrogenic activity. Natural estrogens were regularly detected, with mean concentrations ranging from below the limit of detection to 0.55 ng L-1 for E2ß and E1, respectively, and passive sampling and bioassay results largely confirmed these findings. Monte Carlo simulated mean natural estrogen concentrations underestimated measured ones by a factor of three to 11. An agricultural area's hydrological contribution and connectivity to surface waters seemed to be more important for the development of estrogen concentrations in streams than livestock densities in a catchment or the actual loads of slurry applied. Pond water occasionally contained natural estrogens in concentrations up to 8.6 ng L-1 for E2α. The environmental quality standards of the European Union (0.4 ng L-1 for E2ß and 3.6 ng L-1 for E1) were never exceeded for longer than a day in tributaries, but E1 reached critical concentrations for aquatic organisms in ponds.

Prevalence and Concentration of Salmonella on Raw, Shelled Peanuts in the United States.

Recalls and outbreaks associated with Salmonella contamination in peanut-containing products have been reported over the past several years. Very limited data existed on the prevalence and concentration of Salmonella on raw, shelled peanuts in the United States. An initial study was completed in 2012 to estimate the prevalence and concentration of Salmonella on Runner- and Virginia-type raw, shelled peanuts in the United States from the 2008 through 2011 crop years, which were proportionately sampled from each growing region based on 2007 production volume. That study was extended to include samples of Runner- and Virginia-type peanuts from 2013, 2014, and 2015 crop years proportionately sampled from each growing region on the basis of the 2008 through 2010 volumes. Of the total 2,506 raw, shelled peanut samples, 41 (1.63%) were positive for Salmonella by the VIDAS SLM assay. Salmonella serovars identified in this study included Agona, Anatum, Bardo, Braenderup, Cannstatt, Dessau, Gaminara, Litchfield, Hartford, Inverness, Mbandaka, Meleagridis, Muenchen, Newport, Pakistan, Rodepoort, Rubislaw, Tennessee, and Tornow. The concentration levels of Salmonella in positive samples, as determined by most probable number (MPN), ranged from <0.003 to 2.4 MPN/g. These data will be useful when designing and validating processes for the reduction or elimination of Salmonella in peanuts or peanut-containing products or both.

Survival of Shigella sonnei on smooth tomato surfaces, in potato salad and in raw ground beef.

This study investigated the survival of a five-strain Shigella sonnei cocktail on smooth tomato surfaces, in potato salad and in raw ground beef. All inocula were resistant to the antibiotic rifampicin to allow simple detection of the target culture among the indigenous microflora of the food samples. Inoculated tomatoes were stored at 13 degrees C/85% relative humidity, the standard holding conditions for mature, green tomatoes. Inoculated potato salad and ground beef samples were stored at 2.5 degrees C and 8.0 degrees C to study the effects of varied refrigerated temperatures. Surviving populations were estimated using a three-tube most probable number (MPN) method. Tryptic soy broth tubes supplemented with 100 ppm rifampicin were inoculated with appropriate dilutions of the recovered inocula and scored for growth after overnight enrichment. S. sonnei populations declined rapidly to undetectable levels (2 days) when dried on smooth surfaces of tomatoes. S. sonnei populations did not decrease in potato salad and ground beef stored at 2.5 degrees C and 8.0 degrees C over the shelf-life of the products.

Detection of salmonella by flow-through immunocapture real-time PCR in selected foods within 8 hours.

This study investigated flow-through immunocapture (FTI), using the Pathatrix device, followed by plating on xylose lysine desoxycholate (XLD) agar (FTI-XLD) or analysis by real-time PCR (FTI-PCR) for the detection of Salmonella on smooth tomato surfaces and in potato salad and ground beef within 8 h. Food samples were inoculated with an appropriate dilution of a five-serovar Salmonella cocktail and enriched for 5 h. Following enrichment, samples were analyzed by the FTI-XLD and FTI-PCR methods. Food samples were also analyzed by a modified U.S. Food and Drug Administration Bacteriological Analytical Manual (BAM) Salmonella culture method for comparison. Salmonella inoculated at 10(0) CFU per tomato or 10(0) CFU/25 g was detected by the FTI-XLD method in 6, 8, and 4 of 10 samples for tomatoes, potato salad, and ground beef, respectively. Salmonella inoculated at 10(0) CFU per tomato or 10(0) CFU/25 g was detected by the FTI-PCR method in 8, 9, and 9 of 10 samples for tomatoes, potato salad, and ground beef, respectively. The FTI-PCR method achieved significantly higher (P < 0.05) detection of Salmonella on tomatoes, whereas the FTI-XLD method achieved significantly lower (P < 0.05) detection of Salmonella in ground beef when compared with the modified BAM Salmonella culture method; however, all other comparisons to the modified BAM method were not significantly different. The FTI-XLD method demonstrated the ability to isolate presumptive Salmonella colonies up to 48 hfaster than did the modified BAM Salmonella culture method.

Quantitative pretreatment CT volumetry: Association with oncologic outcomes in patients with T4a squamous carcinoma of the larynx.

BACKGROUND: The purpose of this study was to determine the impact of CT-determined pretreatment primary tumor volume on survival and disease control in T4a laryngeal squamous cell carcinoma (SCC). METHODS: We retrospectively reviewed 124 patients with T4a laryngeal cancer from 2000-2011. Tumor volume measurements were collected and correlated with outcomes. RESULTS: Five-year overall survival (OS) for patients with tumor volume ≥21 cm3 treated with larynx preservation (n = 26 of 41) was significantly inferior compared to <21 cm3 (42% vs 64%, respectively; P = .003). Five-year OS for patients with tumor volumes ≥21 cm3 in the cohort treated with total laryngectomy followed by radiotherapy (RT; n = 42 of 83) was not statistically significant when compared to <21 cm3 (50% vs 63%, respectively; P = .058). On multivariate analysis, tumor volume ≥21 cm3 was a significant independent correlate of worse disease-specific survival (DSS; P = .004), event-free survival (P = .005), recurrence-free survival (RFS; P = .04), noncancer cause-specific survival (P = .02), and OS (P = .0002). CONCLUSION: Pretreatment CT-based tumor volume is an independent prognostic factor of outcomes in T4a laryngeal cancer.

Preliminary evaluation of flow-through immunocapture followed by real-time PCR for the detection of Salmonella serovars on tomato surfaces within 8 hours.

This study reports a preliminary evaluation of flow-through immunocapture (FTI) followed by real-time PCR (FTI-PCR) for the detection of Salmonella serovars on tomato surfaces within 8 h. The FTI-PCR method was compared with real-time PCR, direct plating of FTI beads on xylose lysine desoxycholate (XLD), and the conventional culture method for Salmonella found in the U.S. Food and Drug Administration's (FDA) Bacteriological Analytical Manual (BAM). Unwaxed green tomatoes were spot inoculated with a five-serovar Salmonella cocktail on smooth surfaces at levels of 10(0) to 10(4) CFU per tomato and washed in lactose broth (LB) using a shake-rub method. The resulting LB rinse was incubated at 37 degrees C for 4 h prior to analysis by FTI-XLD, real-time PCR, or FTI-PCR and for 24 h as the first step in the BAM Salmonella culture method. For FTI-XLD, the observed lowest detection level (LDL) was 4.6 x 10(1) CFU per tomato. There was no significant difference in performance between the FTI-XLD method and the BAM Salmonella culture method (P > 0.05); however, the FTI-XLD method reduced the overall assay time by 48 h. For real-time PCR and FTI-PCR, the observed LDLs were 4.6 x 10(1) and 9.2 x 10(0) CFU per tomato, respectively. The FTI-PCR method was superior to the BAM Salmonella culture method (P < 0.05) for the detection of Salmonella serovars on tomato surfaces and was completed within 8 h.

Complete DNA Sequence of Pseudomonas syringae pv. actinidiae, the Causal Agent of Kiwifruit Canker Disease.

Pseudomonas syringae pv. actinidiae is the causal agent of bacterial canker of kiwifruit, a disease that has rapidly spread worldwide. We have fully sequenced and assembled the chromosomal and plasmid DNA from P. syringae pv. actinidiae ICMP 18884 using the PacBio RS II platform.

Engineering the anthocyanin regulatory complex of strawberry (Fragaria vesca).

The woodland strawberry, Fragaria vesca is a model fruit for a number of rosaceous crops. We have engineered altered concentrations of anthocyanin in F. vesca, to determine the impact on plant growth and fruit quality. Anthocyanin concentrations were significantly increased by over-expression or decreased by knock-down of the R2R3 MYB activator, MYB10. In contrast, a potential bHLH partner for MYB10 (bHLH33) did not affect the anthocyanin pathway when knocked down using RNAi constructs. Metabolic analysis of fruits revealed that, of all the polyphenolics surveyed, only cyanidin, and pelargonidin glucoside, and coumaryl hexose were significantly affected by over-expression and knock down of MYB10. Using the F. vesca genome sequence, members of the MYB, bHLH, and WD40 families were examined. Global analysis of gene expression and targeted qPCR analysis of biosynthetic genes and regulators confirmed the effects of altering MYB10 expression, as well as the knock-down of bHLH33. Other members of the MYB transcription factor family were affected by the transgenes. Transient expression of strawberry genes in Nicotiana benthamiana revealed that MYB10 can auto-regulate itself, and potential repressors of MYB10. In tobacco, MYB10's activation of biosynthetic steps is inhibited by the strawberry repressor MYB1.

Prevalence and concentration of Salmonella on raw shelled peanuts in the United States.

Recalls and/or outbreaks associated with Salmonella contamination in peanut-containing products were reported over the past several years. There are very limited data available on the prevalence and concentration of Salmonella on raw shelled peanuts in the United States. The objectives of this study were to estimate the prevalence of Salmonella on raw shelled peanuts in the United States and to estimate that concentration of Salmonella. Samples of Runner- and Virginia-type raw shelled peanuts from the 2008, 2009, and 2010 crop years were proportionately sampled from each growing region, based on 2007 production volume. Of 944 raw shelled peanut samples (375 g each), 22 (2.33%) were positive for Salmonella by the VIDAS Salmonella assay. Salmonella serovars identified in this study included Agona, Anatum, Braenderup, Dessau, Hartford, Meleagridis, Muenchen, Rodepoort, Tennessee, and Tornow. The concentration levels of Salmonella in positive samples, as determined by a most-probable-number assay, were <0.03 to 2.4 MPN/g. These data will be useful when designing and validating processes for the reduction or elimination of Salmonella in peanuts and/or peanut-containing products.