Microsurgical Debridement for Persistent Ulcers Due to Rare Fungus Infection: Case Report and Literature Review.

A patient suffered from chronic ulcer due to recalcitrant fungal infection for 3.5 years. Five antifungal agents and 40 times of debridement-all failed. Finally, radical microscopic debridement was performed for eradication of fungal conidiospores. Since then, there was no recurrence at 2 years of follow-up. Scopulariopsis brevicaulis is one of the rarest pathogens of cutaneous fungal infections, for which multidrug resistance increased the complexity and difficulty of treatment. Radical excision, especially microscopic debridement, was the key for eradication of fungal conidiospores in this case.

Effect of dietary ß-mannanase supplementation on broiler performance.

This study was conducted to investigate the effect of graded levels of ß-mannanase supplementation in broiler diets on growth performance, energy digestibility, and lesion scores in d-old birds fed mash, corn-soybean meal-based diets and raised to 42 d. Five dietary treatments were investigated: 1) positive control diet (PC) containing standard energy; 2) negative control (NC) with 100 kcal/kg diet reduction in AME compared to PC; 3) NC supplemented with 30 U/g ß-mannanase (NC + 30 U); 4) NC supplemented with 60 U/g ß-mannanase (NC + 60 U); and 5) NC supplemented with 90 U/g ß-mannanase (NC + 90 U). Each treatment had 6 replicate pens with 52 chicks per replicate. Data was analyzed using 1-way ANOVA, and means were separated by LSMEANS. Reduction of 100 kcal/kg feed (NC) resulted in an overall body weight gain reduction of 51 g (P < 0.05) and feed conversion loss of approximately 4 points (P < 0.05) compared to PC at 42 d of age. At the same time, supplementing ß-mannanase at 60 and 90 U/g improved growth performance parameters compared to NC, while 30 U/g did not result in significant improvements beyond NC; body weight gain was improved (P < 0.05) by 87, and 106 g when ß-mannanase was supplemented at 60 and 90 U/g, respectively, compared to NC. This corresponded to an improvement by 6 and 7 points in feed conversion for 60 and 90 U/g supplementation, respectively, compared to NC. Furthermore, AMEn was improved (P < 0.05) by 15, 97, and 116 kcal/kg at 42 d when ß-mannanase was added to NC at 30, 60, and 90 U/g, respectively. Digesta viscosity measured at 42 d was decreased (P < 0.05) by ß-mannanase supplementation of 60 and 90 U/g, compared to NC, while 42 d lesion scores were improved (P < 0.05) by ß-mannanase supplementation compared to NC. Data demonstrated that dietary supplementation of ß-mannanase improved growth performance, energy digestibility, and reduced viscosity and lesion scores when supplemented with diets with a reduced energy content of 100 kcal/kg compared to a standard energy diet.

Positioning System of Infrared Sensors Based on ZnO Thin Film.

Infrared sensors incorporating suspended zinc oxide (ZnO) pyroelectric films and thermally insulated silicon substrates are fabricated using conventional MEMS-based thin-film deposition, photolithography, and etching techniques. The responsivity of the pyroelectric film is improved via annealing at 500 °C for 4 h. The voltage response of the fabricated sensors is evaluated experimentally for a substrate thickness of 1 µm over a sensing range of 30 cm. The results show that the voltage signal varies as an inverse exponential function of the distance. A positioning system based on three infrared sensors is implemented in LabVIEW. It is shown that the position estimates obtained using the proposed system are in excellent agreement with the actual locations. In general, the results presented in this study provide a useful source of reference for the further development of MEMS-based pyroelectric infrared sensors.

Mental health symptoms of youth initiating psychiatric care at different phases of the COVID-19 pandemic.

OBJECTIVE: To examine differences in caregiver and youth reported mental health symptoms for youth initiating mental health treatment through phases of the Coronavirus Disease (COVID-19) pandemic, compared with symptomology reported the prior year. STUDY DESIGN: This retrospective study analyzes group differences in mental health symptoms (Pediatric Symptom Checklist; PSC-35) based on 7874 youth seeking treatment in publicly funded mental health treatment programs during California's Stay-At-Home order (March-May, 2020) and the prolonged pandemic (May-December, 2020) phases of the COVID-19 pandemic as compared with matching groups in 2019. RESULTS: Youth entering mental health treatment services, and their caregivers, reported significantly increased internalizing, externalizing, and attention-related symptoms during the prolonged pandemic phase, but not during the acute stay-at-home phase of the COVID-19 pandemic, and with small effect sizes. Group comparison analyses did not detect a significantly larger effect for Sexual and Gender Diverse (SGD) youth who identify as lesbian, gay, bisexual, asexual, transgender, Two-Spirit, queer, and/or intersex, and Black, Indigenous, People of Color (BIPOC). CONCLUSIONS: A large-scale comparison of youth mental health symptoms before and during the COVID-19 pandemic suggests that mental health was disrupted for youth seeking treatment as the pandemic prolonged throughout 2020.

Effect of Different Combinations of Dietary Vitamin A, Protein Levels, and Monensin on Inflammatory Markers and Metabolites, Retinol-Binding Protein, and Retinoid Status in Periparturient Dairy Cows.

The objective of this study was to determine the effect of feeding different combinations of dietary vitamin A supplementation (0 or 110 IU/kg body weight), protein (10.3% or 12.2%), and an ionophore (monensin at 0 or 400 mg/day) on retinoid metabolism and immune function of dairy cows. Eighty multiparous Holstein dairy cows were studied from d -35 to +21 relative to expected parturition in a complete randomized block design with a 2 × 2 × 2 factorial arrangement of treatments. The significance of treatments was declared at p ≤ 0.05. Dairy cows receiving high crude protein (CP) diets with monensin had a greater retinol-binding protein serum concentration than cows receiving high CP diets without monensin (p = 0.04). Animals supplemented with vitamin A showed lower SCC (p = 0.04) and a higher thiobarbituric acid reactive substances concentration (p = 0.06) than cows non-supplemented. Moreover, cows receiving low crude protein diets had a greater haptoglobin concentration (p = 0.01). In addition, cows fed a high crude protein diet had a greater TNF-α expression in peripheral blood mononuclear cells (p = 0.04). Animals fed diets without monensin had a greater serum haptoglobin on day 3 postpartum than those fed monensin (p = 0.01). Moreover, dietary vitamin A increased serum 13-cis retinoic acid postpartum. We conclude that vitamin A, crude protein levels, and monensin fed during the close-up period affect milk somatic cell count, some vitamin statuses, and inflammatory markers during early lactation.

Effects of 2,4-thiazolidinedione (TZD) on milk fatty acid profile and serum vitamins in dairy goats challenged with intramammary infusion of Streptococcus uberis.

The study included two experiments. In the first, 24 lactating Saanen dairy goats received low-energy diet without vitamin supplements. Twelve goats received a daily IV injection of 2,4- thiazolidinedione (TZD), others received saline injection. A week later, 6 goats from each treatment were challenged with intramammary infusion (IMI) of saline (CTRL) or Streptococcus uberis. In the second experiment, 12 Saanen lactating dairy goats received supplemental vitamins to reach NRC recommendation level. Six goats in each group were injected with TZD or saline daily, and 14 d later received Streptococcus uberis IMI in the right half of the udder. The hypotheses were (1) TZD does not affect the level of retinol in blood, and (2) the fatty acid profile is affected by the interaction between mammary infection and TZD in dairy goats. In the first experiment blood samples were collected on d -7, -2, 1, 2, 12 and milk samples were collected on d -8, 1, 4, 7, and 12, both relative to IMI. In the second experiment, blood samples were collected on d -15, 0, 1, and 10 relative to IMI. Milk and serum samples were analyzed for retinol, α-tocopherol and fatty acid profile. Serum retinol and ß-carotene concentrations were higher in the second experiment compared to the first. Serum ß-carotene and α-tocopherol were greater in TZD than CTRL and there was a TZD × time interaction in the first experiment. In addition, the TZD × time interaction showed that the milk fatty acid were reduced in C16 : 0 while C18 : 3 n3 while total omega 3 fatty acids were increased, as well as with minor effect on preventing a transient increase in α-tocopherol in milk. Overall, the TZD may affect the lipid-soluble vitamins and fatty acid profile, potentially altering immune responses, during mastitis in dairy goats.

The effects of elevated subcutaneous fat stores on fatty acid composition and gene expression of proinflammatory markers in periparturient dairy cows.

During the periparturient period, elevated circulating nonesterified fatty acids (NEFA) from excessive lipid mobilization affect not only the circulating fatty acid (FA) composition, but also that of the peripheral blood mononuclear cells (PBMC) and polymorphonuclear leukocytes (PMNL). However, the changes to specific lipid fractions remain unknown. We hypothesized that elevated lipid mobilization will alter FA profiles and gene expression of selected proinflammatory mediators in PBMC and PMNL. Starting -28 d relative to expected calving (d 0), treatment cows (n = 18) received a dry cow ration plus an additional 10 kg of corn/head per day, while the control cows (n = 16) received the dry cow ration (no additional corn) supplemented with 400 mg of monensin/head per day to minimize lipid mobilization. Postpartum, treatment cows were feed deprived for 8 h on d +3. For FA analysis, serum was collected on d -28 and -7 relative to expected parturition and d +1, +3, +6, +15, and +21 postpartum, in addition to milk samples. Immune cells, PBMC and PMNL, were isolated on d -28, +3, +12, and +21 for FA analysis and gene expression analysis by reverse-transcription PCR. Serum, PBMC, and PMNL lipids were fractionated into NEFA and phospholipids (PL). The FA composition of milk, serum, PBMC, and PMNL was analyzed by gas chromatography. Data were analyzed as repeated measures ANOVA using mixed model procedures in SAS (9.3) with significance declared at P ≤ 0.05. Several FA varied by treatment and across time and parity. Within the serum PL fraction, FA associated with altered immune function, C18:3n-6, C20:4, C20:5, total n-3, and the ratio of n-6 to n-3 varied significantly by a treatment × parity × time interaction. Overall, FA composition of NEFA and PL fractions from PBMC and PMNL did not significantly reflect FA of serum. Gene expression for IL-1ß in PBMC was greater for control, whereas ICAM, IL-1ß, IL-6, and TNF-α were greater in primiparous than multiparous cows, without a detectable treatment effect. Whereas gene expression of CASP, IL-8R, and SELL in PMNL changed over time, no treatment effect was detected. In summary, high-energy prepartal diets altered FA profile in serum, milk, PBMC, and PMNL lipids; however, gene expression of selected proinflammatory mediators was not significantly affected.

DNA Aptamers against Taiwan Banded Krait α-Bungarotoxin Recognize Taiwan Cobra Cardiotoxins.

Bungarus multicinctus α-bungarotoxin (α-Bgt) and Naja atra cardiotoxins (CTXs) share a common structural scaffold, and their tertiary structures adopt three-fingered loop motifs. Four DNA aptamers against α-Bgt have been reported previously. Given that the binding of aptamers with targeted proteins depends on structural complementarity, in this study, we investigated whether DNA aptamers against α-Bgt could also recognize CTXs. It was found that N. atra cardiotoxin 3 (CTX3) reduced the electrophoretic mobility of aptamers against α-Bgt. Analysis of the changes in the fluorescence intensity of carboxyfluorescein-labeled aptamers upon binding toxin molecules revealed that CTX3 and α-Bgt could bind the tested aptamers. Moreover, the aptamers inhibited the membrane-damaging activity and cytotoxicity of CTX3. In addition to CTX3, other N. atra CTX isotoxins also bound to the aptamer against α-Bgt. Taken together, our data indicate that aptamers against α-Bgt show cross-reactivity with CTXs. The findings that aptamers against α-Bgt also suppress the biological activities of CTX3 highlight the potential utility of aptamers in regard to the broad inhibition of snake venom three-fingered proteins.

Antibacterial and membrane-damaging activities of mannosylated bovine serum albumin.

The aim of this study was to test whether mannosylated BSA (Man-BSA) exerts antibacterial activity on Escherichia coli (gram-negative bacteria) and Staphylococcus aureus (gram-positive bacteria) via its membrane-damaging effect. Man-BSA caused inhibition of growth of E. coli and S. aureus. Moreover, bactericidal action of Man-BSA on E. coli and S. aureus positively correlated with the increase in membrane permeability of the bacterial cells. Morphological examination showed that Man-BSA disrupted bacterial membrane integrity. Destabilization of the lipopolysaccharide (LPS) layer and inhibition of lipoteichoic acid (LTA) biosynthesis in the cell wall increased the bactericidal effect of Man-BSA on E. coli and S. aureus. Man-BSA also induced leakage and fusion of membrane-mimicking liposomes in E. coli and S. aureus. Man-BSA showed similar binding affinity for LPS and LTA. LPS and LTA strongly suppressed the membrane-damaging activity of Man-BSA, whereas an increase in the Man-BSA concentration attenuated the inhibitory action of LPS and LTA. Taken together, our data indicate that Man-BSA's bactericidal activity depends strongly on its ability to induce membrane permeability. Moreover, the bactericidal action of Man-BSA proven in this study suggests that Man-BSA may serve as a prototype for the development of anti-infective agents targeting E. coli and S. aureus.

[Nursing care for a lung cancer patient with brain metastasis using the family resiliency model].

This article describes the experience of the author in providing nursing care to a lung cancer patient with brain metastasis who was unable to care for herself. The period of care ran from July 26th to August 7th, 2012. The focus of the article is on the problems of disease adaptation and the coping strategies of the patient and her primary caregivers. The author used the Family Resiliency Model to collect information via physical examination, observation, and interviews. Five major nursing problems were identified in this case: risk of aspiration, self-care deficits, adjustment disorder, caregiver role strain, and family coping ineffectiveness. Based on these problems, the author constructed an individualized care plan to: 1) improve the self-care ability of the patient, 2) enhance the skills of the primary caregiver, 3) recruit the timely assistance of other family members, 4) and reduce the burden of the primary caregiver. The primary goal of this care plan was to promote the quality of life of the patient and her family.

Effectiveness of a work-related stress management program in patients with chronic schizophrenia.

OBJECTIVE: The purpose of this study was to examine the effect of a work-related stress management program on perceived work-related stress in patients with chronic schizophrenia. METHOD: A single-blind, randomized crossover design was used. Twenty-nine patients undergoing vocational training while working at paid part-time jobs in a psychiatric center were randomly assigned to receive 12 weeks of a work-related stress management program followed by 12 weeks of no treatment, or the reverse. The Work-Related Stress Questionnaire for Chronic Psychiatric Patients (WSQP) was developed for this study and used to examine the treatment effect. RESULTS: The decrease in stress was significantly greater when the participants were undergoing the program compared to the decrease of stress when they were not (t = 2.93, p = .0034, r = .49). CONCLUSION: The results show that the work-related stress management program had large short-term positive effects on the patients' perceived work-related stress. These findings support providing this type of program to employed patients with chronic schizophrenia.