Evaluation of the Effect of a Recent Comparative Intradermal Tuberculin Test on the Humoral Diagnosis of Paratuberculosis Using Serum and Milk Samples from Goats.

Paratuberculosis (PTB) and tuberculosis (TB) are two mycobacterial diseases with a severe economic and health impact on domestic ruminants. The ante mortem diagnosis of PTB is hampered, among other factors, by the limited sensitivity of all the available diagnostic techniques. Since TB-infected goats subjected to the comparative intradermal tuberculin test (CITT) may experience a booster effect on their antibody titer and a potential enhancement to the sensitivity of humoral techniques for tuberculosis, in the present study we aimed to evaluate this diagnostic strategy on the humoral diagnosis of PTB in serum and milk samples collected from a caprine herd that was TB free and PTB infected. The results from 120 goats indicated a significant increase (p < 0.001) in the quantitative response detected using an ELISA technique, conducted using serum and milk samples taken 15 and 30 days after performing a CITT (day 0 of the study); although, it did not translate into a significant increase in the number of reactors during any of the testing events (0, 3,15, 30 and 60 days post-CITT). Additionally, the number of ELISA-positive animals was higher for the serum versus the milk samples at both 15 and 30 days post-CITT. The increase in the quantitative ELISA result suggested a diagnostic strategy that maximizes ELISA sensitivity, mainly using serum samples, in PTB-infected herds; although, it may depend on individual differences and the interpretation criteria.

Effect of a recent intradermal test on the specificity of P22 ELISA for the diagnosis of caprine tuberculosis.

Caprine tuberculosis (TB) is a zoonotic disease caused by members of the Mycobacterium tuberculosis complex. TB eradication programs in goats are based on the single and comparative intradermal tuberculin tests (SITT and CITT, respectively). Antibody-based diagnostic techniques have emerged as potential diagnostic tools for TB. P22 ELISA has been previously evaluated using samples collected after the intradermal tuberculin tests to maximize the sensitivity, a phenomenon known as booster effect. However, there is no information available on whether the use of this diagnostic strategy could lead to a decrease of its specificity (Sp). The aim of the present study was to elucidate the interference effect of a recent CITT on the Sp of the P22 ELISA in serum and milk samples collected at different times after the CITT from a TB-free herd (n = 113). The number of reactors to P22 ELISA was significantly higher (p < 0.01) on serum samples collected 15 days post-CITT compared to day 0, showing a decrease in Sp from 99.1% (95% CI; 95.2-99.8%) to 88.5% (95% CI; 81.3-93.2%). The number of reactors and the quantitative values of P22 ELISA were significantly higher (p < 0.01) in serum samples compared to milk. No significant (p > 0.05) changes in the Sp of the P22 ELISA were observed throughout the different time samplings using milk No significant (p > 0.05) changes were observed on days 30 and 60 post-CITT. In conclusion, the booster effect strategy may significantly decrease the Sp of P22 ELISA in TB-free herds when serum samples are used but not when milk is tested.

Molecular magnetic resonance imaging of myeloperoxidase activity identifies culprit lesions and predicts future atherothrombosis.

Aims: Unstable atherosclerotic plaques have increased activity of myeloperoxidase (MPO). We examined whether molecular magnetic resonance imaging (MRI) of intraplaque MPO activity predicts future atherothrombosis in rabbits and correlates with ruptured human atheroma. Methods and results: Plaque MPO activity was assessed in vivo in rabbits (n = 12) using the MPO-gadolinium (Gd) probe at 8 and 12 weeks after induction of atherosclerosis and before pharmacological triggering of atherothrombosis. Excised plaques were used to confirm MPO activity by liquid chromatography-tandem mass spectrometry (LC-MSMS) and to determine MPO distribution by histology. MPO activity was higher in plaques that caused post-trigger atherothrombosis than plaques that did not. Among the in vivo MRI metrics, the plaques' R1 relaxation rate after administration of MPO-Gd was the best predictor of atherothrombosis. MPO activity measured in human carotid endarterectomy specimens (n = 30) by MPO-Gd-enhanced MRI was correlated with in vivo patient MRI and histological plaque phenotyping, as well as LC-MSMS. MPO-Gd retention measured as the change in R1 relaxation from baseline was significantly greater in histologic and MRI-graded American Heart Association (AHA) type VI than type III-V plaques. This association was confirmed by comparing AHA grade to MPO activity determined by LC-MSMS. Conclusion: We show that elevated intraplaque MPO activity detected by molecular MRI employing MPO-Gd predicts future atherothrombosis in a rabbit model and detects ruptured human atheroma, strengthening the translational potential of this approach to prospectively detect high-risk atherosclerosis.

Reflections on Cross-Modal Correspondences: Current Understanding and Issues for Future Research.

The past two decades have seen an explosion of research on cross-modal correspondences. Broadly speaking, this term has been used to encompass associations between and among features, dimensions, or attributes across the senses. There has been an increasing interest in this topic amongst researchers from multiple fields (psychology, neuroscience, music, art, environmental design, etc.) and, importantly, an increasing breadth of the topic's scope. Here, this narrative review aims to reflect on what cross-modal correspondences are, where they come from, and what underlies them. We suggest that cross-modal correspondences are usefully conceived as relative associations between different actual or imagined sensory stimuli, many of these correspondences being shared by most people. A taxonomy of correspondences with four major kinds of associations (physiological, semantic, statistical, and affective) characterizes cross-modal correspondences. Sensory dimensions (quantity/quality) and sensory features (lower perceptual/higher cognitive) correspond in cross-modal correspondences. Cross-modal correspondences may be understood (or measured) from two complementary perspectives: the phenomenal view (perceptual experiences of subjective matching) and the behavioural response view (observable patterns of behavioural response to multiple sensory stimuli). Importantly, we reflect on remaining questions and standing issues that need to be addressed in order to develop an explanatory framework for cross-modal correspondences. Future research needs (a) to understand better when (and why) phenomenal and behavioural measures are coincidental and when they are not, and, ideally, (b) to determine whether different kinds of cross-modal correspondence (quantity/quality, lower perceptual/higher cognitive) rely on the same or different mechanisms.

MR Fingerprinting for Contrast Agent-free and Quantitative Characterization of Focal Liver Lesions.

Purpose To evaluate the feasibility of liver MR fingerprinting (MRF) for quantitative characterization and diagnosis of focal liver lesions. Materials and Methods This single-site, prospective study included 89 participants (mean age, 62 years ± 15 [SD]; 45 women, 44 men) with various focal liver lesions who underwent MRI between October 2021 and August 2022. The participants underwent routine clinical MRI, non-contrast-enhanced liver MRF, and reference quantitative MRI with a 1.5-T MRI scanner. The bias and repeatability of the MRF measurements were assessed using linear regression, Bland-Altman plots, and coefficients of variation. The diagnostic capability of MRF-derived T1, T2, T2*, proton density fat fraction (PDFF), and a combination of these metrics to distinguish benign from malignant lesions was analyzed according to the area under the receiver operating characteristic curve (AUC). Results Liver MRF measurements showed moderate to high agreement with reference measurements (intraclass correlation = 0.94, 0.77, 0.45, and 0.61 for T1, T2, T2*, and PDFF, respectively), with underestimation of T2 values (mean bias in lesion = -0.5%, -29%, 5.8%, and -8.2% for T1, T2, T2*, and PDFF, respectively). The median coefficients of variation for repeatability of T1, T2, and T2* values were 2.5% (IQR, 3.6%), 3.1% (IQR, 5.6%), and 6.6% (IQR, 13.9%), respectively. After considering multicollinearity, a combination of MRF measurements showed a high diagnostic performance in differentiating benign from malignant lesions (AUC = 0.92 [95% CI: 0.86, 0.98]). Conclusion Liver MRF enabled the quantitative characterization of various focal liver lesions in a single breath-hold acquisition. Keywords: MR Imaging, Abdomen/GI, Liver, Imaging Sequences, Technical Aspects, Tissue Characterization, Technology Assessment, Diagnosis, Liver Lesions, MR Fingerprinting, Quantitative Characterization Supplemental material is available for this article. © RSNA, 2023.

Uncovering the Role of Hormones in Enhancing Antioxidant Defense Systems in Stressed Tomato (Solanum lycopersicum) Plants.

Tomato is one of the most important fruits worldwide. It is widely consumed due to its sensory and nutritional attributes. However, like many other industrial crops, it is affected by biotic and abiotic stress factors, reducing its metabolic and physiological processes. Tomato plants possess different mechanisms of stress responses in which hormones have a pivotal role. They are responsible for a complex signaling network, where the antioxidant system (enzymatic and non-enzymatic antioxidants) is crucial for avoiding the excessive damage caused by stress factors. In this sense, it seems that hormones such as ethylene, auxins, brassinosteroids, and salicylic, jasmonic, abscisic, and gibberellic acids, play important roles in increasing antioxidant system and reducing oxidative damage caused by different stressors. Although several studies have been conducted on the stress factors, hormones, and primary metabolites of tomato plants, the effect of endogenous and/or exogenous hormones on the secondary metabolism is still poorly studied, which is paramount for tomato growing management and secondary metabolites production. Thus, this review offers an updated overview of both endogenous biosynthesis and exogenous hormone application in the antioxidant system of tomato plants as a response to biotic and abiotic stress factors.

Assessing mechanisms behind crossmodal associations between visual textures and temperature concepts.

In the last decades, there has been a growing interest in crossmodal correspondences, including those involving temperature. However, only a few studies have explicitly examined the underlying mechanisms behind temperature-related correspondences. Here, we investigated the relative roles of an underlying affective mechanism and a semantic path (i.e., regarding the semantic knowledge related to a single common source identity or meaning) in crossmodal associations between visual textures and temperature concepts using an associative learning paradigm. Two online experiments using visual textures previously shown to be associated with low and high thermal effusivity (Experiment 1) and visual textures with no consensual associations with thermal effusivity (Experiment 2) were conducted. Participants completed a speeded categorization task before and after an associative learning task, in which they learned mappings between the visual textures and specific affective or semantic stimuli related to low and high temperatures. Across the two experiments, both the affective and semantic mappings influenced the categorization of visual textures with the hypothesized temperatures, but there was no influence on the reaction times. The effect of learning semantic mappings was larger than that of affective ones in both experiments, suggesting that a semantic path has more weight than an affective mechanism in the formation of the associations studied here. The associations studied here could be modified through associative learning establishing correlations between visual textures and either affective or semantic stimuli. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Integrated care for older multimorbid heart failure patients: protocol for the ESCAPE randomized trial and cohort study.

ESCAPE: Evaluation of a patient-centred biopsychosocial blended collaborative care pathway for the treatment of multimorbid elderly patients. THERAPEUTIC AREA: Healthcare interventions for the management of older patients with multiple morbidities. AIMS: Multi-morbidity treatment is an increasing challenge for healthcare systems in ageing societies. This comprehensive cohort study with embedded randomized controlled trial tests an integrated biopsychosocial care model for multimorbid elderly patients. HYPOTHESIS: A holistic, patient-centred pro-active 9-month intervention based on the blended collaborative care (BCC) approach and enhanced by information and communication technologies can improve health-related quality of life (HRQoL) and disease outcomes as compared with usual care at 9 months. METHODS: Across six European countries, ESCAPE is recruiting patients with heart failure, mental distress/disorder plus ≥2 medical co-morbidities into an observational cohort study. Within the cohort study, 300 patients will be included in a randomized controlled assessor-blinded two-arm parallel group interventional clinical trial (RCT). In the intervention, trained care managers (CMs) regularly support patients and informal carers in managing their multiple health problems. Supervised by a clinical specialist team, CMs remotely support patients in implementing the treatment plan-customized to the patients' individual needs and preferences-into their daily lives and liaise with patients' healthcare providers. An eHealth platform with an integrated patient registry guides the intervention and helps to empower patients and informal carers. HRQoL measured with the EQ-5D-5L as primary endpoint, and secondary outcomes, that is, medical and patient-reported outcomes, healthcare costs, cost-effectiveness, and informal carer burden, will be assessed at 9 and ≥18 months. CONCLUSIONS: If proven effective, the ESCAPE BCC intervention can be implemented in routine care for older patients with multiple morbidities across the participating countries and beyond.

Single-heartbeat cardiac cine imaging via jointly regularized nonrigid motion-corrected reconstruction.

The aim of the current study was to develop a novel approach for 2D breath-hold cardiac cine imaging from a single heartbeat, by combining cardiac motion-corrected reconstructions and nonrigidly aligned patch-based regularization. Conventional cardiac cine imaging is obtained via motion-resolved reconstructions of data acquired over multiple heartbeats. Here, we achieve single-heartbeat cine imaging by incorporating nonrigid cardiac motion correction into the reconstruction of each cardiac phase, in conjunction with a motion-aligned patch-based regularization. The proposed Motion-Corrected CINE (MC-CINE) incorporates all acquired data into the reconstruction of each (motion-corrected) cardiac phase, resulting in a better posed problem than motion-resolved approaches. MC-CINE was compared with iterative sensitivity encoding (itSENSE) and Extra-Dimensional Golden Angle Radial Sparse Parallel (XD-GRASP) in 14 healthy subjects in terms of image sharpness, reader scoring (range: 1-5) and reader ranking (range: 1-9) of image quality, and single-slice left ventricular assessment. MC-CINE was significantly superior to both itSENSE and XD-GRASP using 20 heartbeats, two heartbeats, and one heartbeat. Iterative SENSE, XD-GRASP, and MC-CINE achieved a sharpness of 74%, 74%, and 82% using 20 heartbeats, and 53%, 66%, and 82% with one heartbeat, respectively. The corresponding results for reader scoring were 4.0, 4.7, and 4.9 with 20 heartbeats, and 1.1, 3.0, and 3.9 with one heartbeat. The corresponding results for reader ranking were 5.3, 7.3, and 8.6 with 20 heartbeats, and 1.0, 3.2, and 5.4 with one heartbeat. MC-CINE using a single heartbeat presented nonsignificant differences in image quality to itSENSE with 20 heartbeats. MC-CINE and XD-GRASP at one heartbeat both presented a nonsignificant negative bias of less than 2% in ejection fraction relative to the reference itSENSE. It was concluded that the proposed MC-CINE significantly improves image quality relative to itSENSE and XD-GRASP, enabling 2D cine from a single heartbeat.

Combined Effect of the Potassium Dose and Plant Biofertilization by Acinetobacter calcoaceticus on the Growth, Mineral Content, Nutritional Quality, Antioxidant Activity, and Metabolomic Features of Tomatillo Fruits (Physalis ixocarpa Brot.).

An Acinetobacter calcoaceticus UTMR2 strain was evaluated in tomatillo plants (Physalis ixocarpa Brot.) using a factorial design with different potassium doses (100, 75, 50 and 0% of the recommended dose). In addition to the agronomic parameters, an analysis of the physicochemical, antioxidant, and metabolomic properties of the fruit was performed. The application of the inoculant affected several parameters of the plant (chlorophyll, weight, and contents of several mineral elements) as well as of the fruit (yield, maturity index, FRAP antioxidant capacity, and contents of protein, fiber, and fat). A multivariate analysis was performed by means of a PCA and a heatmap, indicating that the inoculant induced a strong modulating activity in tomatillo plants for the evaluated parameters, with a remarkable effect at low K doses (0 and 50%). The inoculated treatment at 75% of the K dose resulted in similar plant and fruit characteristics to the fully fertilized control. On the other hand, the biofertilized treatment with no K addition resulted in the highest values in the plant and fruit parameters. In addition, from the metabolomics analysis of the fruits at 75% of the K dose, the up-regulation of 4,4″-bis(N-feruloyl)serotonin, salvianolic acid K, and chlorogenic acid was observed, which may have a role in anti-senescence and resistance mechanisms. In conclusion, the rhizobacterial strain had a positive effect on plant growth, nutritional quality, bioactive compounds, and antioxidant activity of tomatillo fruits at reduced doses of K fertilizer, which gives support for its consideration as an effective biofertilizer strain.

Evaluation of Pretreatments and Extraction Conditions on the Antifungal and Antioxidant Effects of Garlic (Allium sativum) Peel Extracts.

This study aimed to evaluate the effect of pretreatments and extraction conditions on the antioxidant and antifungal characteristics of garlic peel extracts. The effect of pretreatments (fermentation and steam cooking) on the yield, antifungal (Colletotrichum gloeosporioides and Botrytis cinerea), and antioxidant (total phenolic compounds, total flavonoids, and antioxidant capacity) properties of garlic peel extracts were evaluated. A selected pretreatment was applied to evaluate the extraction conditions (solvent, solvent concentration, temperature, and time) on the antifungal activity of garlic peel extracts. At last, garlic peel extracts obtained under specific conditions was applied to papaya and strawberry fruits as preventive and curative treatments against Colletotrichum gloeosporioides and Botrytis cinerea, respectively. Steam cooking pretreatment significantly increased the antifungal and antioxidant capacities of garlic peel extracts compared to the fermentation process. Garlic peel extracts obtained with methanol (60%) for 18 h (25 °C) showed the highest antifungal activity against both microorganisms assessed (57.57% and 75.76% for B. cinerea and C. gloeosporioides, respectively,) on in vitro assays. Moreover, in vivo results indicated that preventive treatment significantly reduced rot disease in papaya (88.95%) and strawberry (54.13%) fruits. Although more studies about the antifungal mechanisms of garlic peel extracts are needed, these results indicated that garlic peel extracts could be used as an antifungal agent.

Crossmodal associations between visual textures and temperature concepts.

Visual textures are critical in how individuals form sensory expectations about objects, which include somatosensory properties such as temperature. This study aimed to uncover crossmodal associations between visual textures and temperature concepts. In Experiment 1 (N = 193), we evaluated crossmodal associations between 43 visual texture categories and different temperature concepts (via temperature words such as cold and hot) using an explicit forced-choice test. The results revealed associations between striped, cracked, matted, and waffled visual textures and high temperatures and between crystalline and flecked visual textures and low temperatures. In Experiment 2 (N = 247), we conducted six implicit association tests (IATs) pairing the two visual textures most strongly associated with low (crystalline and flecked) and high (striped and cracked) temperatures with the words cold and hot as per the results of Experiment 1. When pairing the crystalline and striped visual textures, the results revealed that crystalline was matched to the word cold, and striped was matched to the word hot. However, some associations found in the explicit test were not found in the IATs. In Experiment 3 (N = 124), we investigated how mappings between visual textures and concrete entities may influence crossmodal associations with temperature and these visual textures. Altogether, we found a range of association strengths and automaticity levels. Importantly, we found evidence of relative effects. Furthermore, some of these crossmodal associations are partly influenced by indirect mappings to concrete entities.

Highly efficient free-breathing 3D whole-heart imaging in 3-min: single center study in adults with congenital heart disease.

BACKGROUND: Three dimensional, whole-heart (3DWH) MRI is an established non-invasive imaging modality in patients with congenital heart disease (CHD) for the diagnosis of cardiovascular morphology and for clinical decision making. Current techniques utilise diaphragmatic navigation (dNAV) for respiratory motion correction and gating and are frequently limited by long acquisition times. This study proposes and evaluates the diagnostic performance of a respiratory gating-free framework, which considers respiratory image-based navigation (iNAV), and highly accelerated variable density Cartesian sampling in concert with non-rigid motion correction and low-rank patch-based denoising (iNAV-3DWH-PROST). The method is compared to the clinical dNAV-3DWH sequence in adult patients with CHD. METHODS: In this prospective single center study, adult patients with CHD who underwent the clinical dNAV-3DWH MRI were also scanned with the iNAV-3DWH-PROST. Diagnostic confidence (4-point Likert scale) and diagnostic accuracy for common cardiovascular lesions was assessed by three readers. Scan times and diagnostic confidence were compared using the Wilcoxon-signed rank test. Co-axial vascular dimensions at three anatomic landmarks were measured, and agreement between the research and the corresponding clinical sequence was assessed with Bland-Altman analysis. RESULTS: The study included 60 participants (mean age ± [SD]: 33 ± 14 years; 36 men). The mean acquisition time of iNAV-3DWH-PROST was significantly lower compared with the conventional clinical sequence (3.1 ± 0.9 min vs 13.9 ± 3.9 min, p < 0.0001). Diagnostic confidence was higher for the iNAV-3DWH-PROST sequence compared with the clinical sequence (3.9 ± 0.2 vs 3.4 ± 0.8, p < 0.001), however there was no significant difference in diagnostic accuracy. Narrow limits of agreement and mean bias less than 0.08 cm were found between the research and the clinical vascular measurements. CONCLUSIONS: The iNAV-3DWH-PROST framework provides efficient, high quality and robust 3D whole-heart imaging in significantly shorter scan time compared to the standard clinical sequence.

Manejo del cáncer de vejiga invasor de músculo con enfoque preservador de órgano: terapia trimodal / Management of muscle-invasive bladder cancer with an organ-sparing approach: trimodal therapy

El cáncer de vejiga es una patología frecuente del tracto genitourinario, cuyo tratamiento acarrea morbilidad y alteración de la calidad de vida y en particular en el subgrupo de pacientes con tumores vesicales clasificados como invasores de músculo. En los últimos años se han venido buscando alternativas terapéuticas para la cistectomía radical + linfadenectomía pélvica extendida, que es en la actualidad el estándar de manejo para los pacientes con carcinoma de vejiga invasor de músculo. Con el advenimiento de perfiles de manejo oncológico menos ablativos pero sin sacrificar resultados oncológicos y con las nuevas técnicas de radioterapia y quimioterapia, las modalidades terapéuticas preservadoras de órgano como la terapia trimodal (resección transuretral de tumor vesical + quimioterapia + radioterapia) se convierte en una alternativa terapéutica viable y con resultados oncológicos satisfactorios a largo plazo. Objetivo y metodología: Con esta revisión se pretende mostrar la actualidad de la terapia trimodal en el manejo de los tumores vesicales con invasión muscular, definir los mejores pacientes a considerar para recibir esta terapia, exponer los resultados oncológicos comparados con el estándar de manejo y los resultados en calidad de vida. También se propone un algoritmo de manejo y se presentar las recomendaciones al respecto en guías de práctica clínica. Conclusiones: La terapia trimodal es una alternativa al estándar de manejo que conduce a resultados oncológicos aceptables y puede considerarse una opción de tratamiento en pacientes bien seleccionados.

Introduction: Bladder cancer is a frequent pathology of the genitourinary tract, whose treatment causes morbidity and impaired quality of life, particularly in the subgroup of patients with bladder tumors classified as muscle invaders. In recent years, therapeutic alternatives have been sought for radical cystectomy + extended pelvic lymphadenectomy, which is currently the standard of care for patients with muscle-invasive bladder carcinoma. With the advent of less ablative oncological management profiles but without sacrificing oncological results and with new radiotherapy and chemotherapy techniques, organ-sparing therapeutic modalities such as trimodal therapy (transurethral resection of bladder tumor + chemotherapy + radiotherapy) becomes a viable therapeutic alternative with satisfactory long-term oncological results. Objective and methodology: This review aims to show the current status of trimodal therapy in the management of muscle-invasive bladder tumors, define the best patients to consider for receiving this therapy, present the oncological results compared with the management standard and the results in quality of life. A management algorithm is also proposed and recommendations in this regard are presented in clinical practice guidelines. Conclusions: Trimodal therapy is an alternative to standard management that leads to acceptable oncological outcomes and can be considered a treatment option in well-selected patients.

Abordaje quirúrgico de la aorta para urólogos / Surgical approach to the aorta for urologists

A propósito de un caso clínico surgió la pregunta, ¿los urólogos estamos familiarizados con el abordaje de las lesiones de la aorta abdominal o una de sus ramas? Teniendo en cuenta que dentro de nuestro accionar quirúrgico podríamos llegar a estar inmersos en una complicación de tipo vascular, es fundamental que conozcamos con detalle estas maniobras.

A clinical case raised the question: are urologists familiar with the approach to lesions of the abdominal aorta or one of its branches? Bearing in mind that in our surgical actions we could be involved in a vascular complication, it is essential that we know these maneuvers in detail.

Strongyloides stercoralis en la médula ósea de una persona que vive con VIH: reporte de caso

Strongyloides stercoralis es un nemátodo que se caracteriza por causar infección intestinal, usualmente asintomática, en pacientes inmunocompetentes. Sin embargo, en aquellos que viven con VIH, y de acuerdo con su estado inmune, puede generar un síndrome de hiperinfección con complicaciones diversas por diseminación a diferentes órganos. Se presenta el caso de un paciente de 30 años con diagnóstico de novo de infección por el virus de la inmunodeficiencia humana, con documentación de enfermedad linfoproliferativa. En los estudios complementarios se documenta la presencia de Strongyloides stercoralis de manera inusual en la médula ósea. A pesar de contar con un recuento de linfocitos T CD4+ mayor a 400 células/ µL y de haberse iniciado el manejo para esta condición con ivermectina, el paciente fallece por un estado séptico asociado al síndrome de hiperinfección, por lo cual se considera que este es un caso inusitado que obliga al clínico a tener en cuenta la presencia del nemátodo en pacientes que viven con VIH.

Summary Strongyloides stercoralis is a nematode that is characterized by causing a usually asymptomatic intestinal infection in immunocompetent individuals. However, in patients living with HIV and depending on their immune status, it can generate a hyperinfection syndrome with various complications due to dissemination to different organs. We present the case of a 30-year-old patient with a de novo diagnosis of human immunodeficiency virus infection and lymphoproliferative disease. Within the laboratory workup, the presence of Strongyloides stercoralis was documented in the bone marrow. Despite having a CD4+ T lymphocyte count greater than 400 cells/microliter and having started treatment for this condition with ivermectin, the patient died due to a septic state associated with hyperinfection syndrome, which is why this is considered an unusual case that alerts the clinician to take into account the presence of the nematode in patients living with HIV.

Effect of a recent parenteral dexamethasone and ketoprofen administration on the immunological diagnosis of tuberculosis in goats.

Caprine tuberculosis (TB) is a zoonosis caused by members of the Mycobacterium tuberculosis complex (MTBC). Caprine TB eradication programmes are based mainly on intradermal tuberculin tests and slaughterhouse surveillance. Different factors may affect the performance of the TB diagnostic tests used in caprine herds and, therefore, their ability to detect infected animals. The present study evaluates the effect of the fraudulent administration of two anti-inflammatory substances, dexamethasone and ketoprofen, on the performance of the TB diagnostic techniques used in goats, as well as the suitability of high performance liquid chromatography (HPLC) for their detection in hair samples. The animals (n = 90) were distributed in three groups: (1) a group treated with dexamethasone (n = 30); a second group treated with ketoprofen (n = 30); and a third non-treated control group (n = 30). Both dexamethasone and ketoprofen groups were subjected to intramuscular inoculation with the substances 48 h after the administration of bovine and avian purified protein derivatives (PPDs), that is, 24 h before the tests were interpreted. All the animals were subjected to the single and comparative intradermal tuberculin (SIT and CIT, respectively) tests, interferon-gamma release assay (IGRA) and P22 ELISA. The number of SIT test reactors was significantly lower in the dexamethasone (p = 0.001) and ketoprofen (p < 0.001) groups 72 h after the bovine PPD inoculation compared with the control group. A significantly higher number of positive reactors to IGRA was detected within the dexamethasone group (p = 0.016) 72 h after PPD administration compared to the control group. Dexamethasone and ketoprofen detection in either hair or serum samples was challenging when using HPLC since these substances were not detected in animals whose skin fold thickness (SFT) was reduced, what could be an issue if they are used for fraudulent purposes. In conclusion, the parenteral administration of dexamethasone or ketoprofen 48 h after the PPDs administration can significantly reduce the increase in SFT (mm) and subsequently the number of positive reactors to SIT test.

Spontaneous coronary artery dissection and acute myocardial infarction in women.

Spontaneous coronary artery dissection (SCAD) is increasingly recognized as a cause of acute coronary syndrome, acute myocardial infarction, and sudden death in young patients, particularly women, presenting to the emergency department with chest pain. It is the most common cause of nonatherosclerotic coronary artery disease in women <50 years of age. Current guidelines for SCAD management come from case series that have demonstrated low success rates and high rates of complications with percutaneous coronary intervention. Expert consensus suggests conservative care, and observation is preferred in many patients. However, patients with ongoing symptoms of cardiac ischemia or hemodynamic or electrical instability with compromised myocardial perfusion remain challenging. With this case report, we aim to increase awareness of SCAD and critical aspects of its diagnostic and therapeutic approach. Further investigation is needed to clarify the ideal candidates for revascularization to optimize outcomes and limit morbidity and mortality.

Potential use of banana peel (Musa cavendish) as ingredient for pasta and bakery products.

The consumption of fruits and vegetables involves the disposal of the inedible parts, conveying challenges such as waste management and environment pollution. In recent years, there have been multiple studies aimed at finding alternatives that reduce the negative impact of food/agricultural waste. Since most studies done with by-products recommend their careful selection, the aim of this study was to verify if discarded banana peels could be disinfected until microbiologically safe and to determine if they could still provide nutrients to formulate food products with sensory characteristics acceptable to a consumer market after disinfection. Banana peels were collected from markets, restaurants, and greengrocers. They were disinfected, dried, and pulverized to obtain a flour which was subjected to microbiological and proximal analysis. Once its microbial safety was assured, this flour was incorporated into bakery and pasta products, replacing wheat flour with 5-20% banana peel flour (BPF). The sensory evaluation of the different products was carried out and, after verifying that the products were sensory acceptable, the proximal analysis was implemented. The formulated products were suitable for the addition of BPF up to 10%, in which the Acceptability Index was higher than 80% and significant increases in fiber and fat were achieved. We conclude that waste banana peel flour can be incorporated into bread and pasta products for human consumption to provide nutrients which might contribute to reduce this type of waste and to recover nutrients from otherwise disposed banana peels.

Artificial intelligence in cardiac magnetic resonance fingerprinting.

Magnetic resonance fingerprinting (MRF) is a fast MRI-based technique that allows for multiparametric quantitative characterization of the tissues of interest in a single acquisition. In particular, it has gained attention in the field of cardiac imaging due to its ability to provide simultaneous and co-registered myocardial T1 and T2 mapping in a single breath-held cardiac MRF scan, in addition to other parameters. Initial results in small healthy subject groups and clinical studies have demonstrated the feasibility and potential of MRF imaging. Ongoing research is being conducted to improve the accuracy, efficiency, and robustness of cardiac MRF. However, these improvements usually increase the complexity of image reconstruction and dictionary generation and introduce the need for sequence optimization. Each of these steps increase the computational demand and processing time of MRF. The latest advances in artificial intelligence (AI), including progress in deep learning and the development of neural networks for MRI, now present an opportunity to efficiently address these issues. Artificial intelligence can be used to optimize candidate sequences and reduce the memory demand and computational time required for reconstruction and post-processing. Recently, proposed machine learning-based approaches have been shown to reduce dictionary generation and reconstruction times by several orders of magnitude. Such applications of AI should help to remove these bottlenecks and speed up cardiac MRF, improving its practical utility and allowing for its potential inclusion in clinical routine. This review aims to summarize the latest developments in artificial intelligence applied to cardiac MRF. Particularly, we focus on the application of machine learning at different steps of the MRF process, such as sequence optimization, dictionary generation and image reconstruction.