Molecular Study of Pneumocystis jirovecii in Respiratory Samples of HIV Patients in Chile.

Pneumocystis is an opportunistic fungus that causes potentially fatal pneumonia (PCP) in immunocompromised patients. The objective of this study was to determine the prevalence of P. jirovecii in HIV patients through phenotypic and molecular study, to investigate the genetic polymorphisms of P. jirovecii at the mitochondrial gene mtLSU and at the nuclear dihydropteroate synthase gene (DHPS), and by analysis of molecular docking to study the effect of DHPS mutations on the enzymatic affinity for sulfamethoxazole. A PCP prevalence of 28.3% was detected, with mtLSU rRNA genotypes 3 (33.3%) and 2 (26.6%) being the most common. A prevalence of 6.7% (1/15) mutations in the DHPS gene was detected, specifically at codon 55 of the amino acid sequence of dihydropteroate synthase. Molecular docking analysis showed that the combination of mutations at 55 and 98 codons is required to significantly reduce the affinity of the enzyme for sulfamethoxazole. We observed a low rate of mutations in the DHPS gene, and molecular docking analysis showed that at least two mutations in the DHPS gene are required to significantly reduce the affinity of dihydropteroate synthase for sulfamethoxazole.

Image Translation for Estimating Two-Dimensional Axial Amyloid-Beta PET From Structural MRI.

BACKGROUND: Amyloid-beta and brain atrophy are hallmarks for Alzheimer's Disease that can be targeted with positron emission tomography (PET) and MRI, respectively. MRI is cheaper, less-invasive, and more available than PET. There is a known relationship between amyloid-beta and brain atrophy, meaning PET images could be inferred from MRI. PURPOSE: To build an image translation model using a Conditional Generative Adversarial Network able to synthesize Amyloid-beta PET images from structural MRI. STUDY TYPE: Retrospective. POPULATION: Eight hundred eighty-two adults (348 males/534 females) with different stages of cognitive decline (control, mild cognitive impairment, moderate cognitive impairment, and severe cognitive impairment). Five hundred fifty-two subjects for model training and 331 for testing (80%:20%). FIELD STRENGTH/SEQUENCE: 3 T, T1-weighted structural (T1w). ASSESSMENT: The testing cohort was used to evaluate the performance of the model using the Structural Similarity Index Measure (SSIM) and Peak Signal-to-Noise Ratio (PSNR), comparing the likeness of the overall synthetic PET images created from structural MRI with the overall true PET images. SSIM was computed in the overall image to include the luminance, contrast, and structural similarity components. Experienced observers reviewed the images for quality, performance and tried to determine if they could tell the difference between real and synthetic images. STATISTICAL TESTS: Pixel wise Pearson correlation was significant, and had an R2 greater than 0.96 in example images. From blinded readings, a Pearson Chi-squared test showed that there was no significant difference between the real and synthetic images by the observers (P = 0.68). RESULTS: A high degree of likeness across the evaluation set, which had a mean SSIM = 0.905 and PSNR = 2.685. The two observers were not able to determine the difference between the real and synthetic images, with accuracies of 54% and 46%, respectively. CONCLUSION: Amyloid-beta PET images can be synthesized from structural MRI with a high degree of similarity to the real PET images. EVIDENCE LEVEL: 3 TECHNICAL EFFICACY: Stage 1.

Infrared Signatures for Phase Identification in Hafnium Oxide Thin Films.

Phase identification in HfO2-based thin films is a prerequisite to understanding the mechanisms stabilizing the ferroelectric phase in these materials, which hold great promise in next-generation nonvolatile memory and computing technology. While grazing-incidence X-ray diffraction is commonly employed for this purpose, it has difficulty unambiguously differentiating between the ferroelectric phase and other metastable phases that may exist due to similarities in the d-spacings, their low intensities, and the overlapping of reflections. Infrared signatures provide an alternative route. However, their use in phase identification remains limited because phase control has overwhelmingly been accomplished via substituents, thereby convoluting infrared signatures between the substituents and the phase changes that they induce. Herein, we report the infrared optical responses of three undoped hafnium oxide films where annealing conditions have been used to create films consisting primarily of the ferroelectric polar orthorhombic Pca21, antipolar orthorhombic Pbca, and monoclinic P21/c phases, as was confirmed via transmission electron microscopy (TEM), UV-visible optical properties, and electrical property measurements. Vibrational signatures acquired from synchrotron nano-Fourier transform infrared spectroscopy (nano-FTIR) are shown to be capable of differentiating between the phases in a nondestructive, rapid, and nanoscale manner. The utility of nano-FTIR is illustrated for a film exhibiting an antiferroelectric polarization response. In this sample, it is proven that this behavior results from the Pbca phase rather than the often-cited tetragonal phase. By demonstrating that IR spectroscopy can unambiguously distinguish phases in this material, this work establishes a tool needed to isolate the factors dictating the ferroelectric phase stability in HfO2-based materials.

Local treatment in oligometastasis from breast cancer: an overview

Oligometastasic breast cancer (OMBC) consists of breast cancer patient with a limited number of systemic metastases (≤ 5), all of them candidates for local ablative treatment with the intention of achieving long-term control of the metastasis and, eventually, an increase in survival The first consensus for the management of patients with oligometastatic breast cancer (OMBC) was published in 2007, establishing that a more aggressive multidisciplinary strategy is recommended in order to increase the survival while maintaining a good quality of life. The current scientific evidence is based on observational studies, mainly retrospective, systematic reviews and meta-analyses, and only a randomized nonexclusive study of oligometastatic (OM) published. All trials with Stereotactic Body Radiation Therapy (SBRT) in OM cancer have shown excellent tolerance and good local control, although first trials on Lung SBRT did not prove so excellent tolerance and had some deaths due to bronchus irradiation and secondary hemoptysis. There are multiple ongoing studies researching the benefit of SBRT in oligometastatic breast cancer. Despite the lack of impact on survival seen in the NRG BR-002 Trial, SBRT probably allows the delay of the systemic treatment until progression, and so, improves the quality of life of patients. We have to wait for the results of the ongoing and future studies for clarification of the role of local treatment in OMBC (AU)

Multiparametric Flow Cytometry for Determination of Viability, Caspase 3 and 7 Activity, and Lipid Peroxidation Adduct (4-Hydroxynonenal) in Equine Spermatozoa.

Flow cytometry is a powerful tool for the analysis of cell samples formed of multipopulations, such as spermatozoa. In recent years, multiparametric cytometers have evolved, allowing the study of different cellular characteristics, such as protein expression, DNA analysis, or mitochondrial activity. Whether using traditional fluorescent dyes or fluorophore-conjugated antibodies, each cell or cellular component is individually stained, the sample is analyzed at high velocities, and then is displayed and interpreted in a dot-plot. We hereby describe the procedure to perform a multiparametric flow cytometry analysis in equine spermatozoa using three sources of excitation and polychromatic flow cytometry for the detection of 4HNE, a lipid peroxidation adduct (by anti-4HNE antibody), apoptotic markers (by caspases 3 and 7 activity), and live/dead spermatozoa (by ethidium-homodimer) excluding the debris with Hoechst 33342 staining and gating. This multiparametric analysis allows the simultaneous detection of different spermatic parameters, providing useful information for the characterization of a seminal sample and fertility estimation. © 2023 Wiley Periodicals LLC. Basic Protocol: Determination of viability, caspase 3 and 7 activity, and 4-hydroxynonenal in equine spermatozoa by flow cytometry.

Caradiophyodidae, a New Family of Micro-Wasps (Hymenoptera: Platygastroidea) Based on the Description of Caradiophyodus saradae gen. et sp. nov. in Mid-Cretaceous Burmese Amber.

The female micro-wasp in mid-Cretaceous Burmese amber is described as a new genus and species in the extinct family Caradiophyodidae fam. nov. (Hymenoptera: Platygastroidea). Features of the specimen are its small body size (1.3 mm), no elbows, elongated, 15-segmented antennae, a deep cleft in the top of its head, a tarsal formula of 5-5-5, a reduced venation with a small pterostigma but no uncus in the forewing, no anal lobe in the hind wing, and a possible coiled ovipositor in the metasoma. Large unidentified expanded structures, considered to be possible seeds, plant secretions, or host eggs, are attached to each antenna.

Local treatment in oligometastasis from breast cancer: an overview.

Oligometastasic breast cancer (OMBC) consists of breast cancer patient with a limited number of systemic metastases (≤ 5), all of them candidates for local ablative treatment with the intention of achieving long-term control of the metastasis and, eventually, an increase in survival The first consensus for the management of patients with oligometastatic breast cancer (OMBC) was published in 2007, establishing that a more aggressive multidisciplinary strategy is recommended in order to increase the survival while maintaining a good quality of life. The current scientific evidence is based on observational studies, mainly retrospective, systematic reviews and meta-analyses, and only a randomized nonexclusive study of oligometastatic (OM) published. All trials with Stereotactic Body Radiation Therapy (SBRT) in OM cancer have shown excellent tolerance and good local control, although first trials on Lung SBRT did not prove so excellent tolerance and had some deaths due to bronchus irradiation and secondary hemoptysis. There are multiple ongoing studies researching the benefit of SBRT in oligometastatic breast cancer. Despite the lack of impact on survival seen in the NRG BR-002 Trial, SBRT probably allows the delay of the systemic treatment until progression, and so, improves the quality of life of patients. We have to wait for the results of the ongoing and future studies for clarification of the role of local treatment in OMBC.

Clinical Validation of Siemens' Syngo.via Automatic Contouring System.

Purpose: The manual delineation of organs at risk is a process that requires a great deal of time both for the technician and for the physician. Availability of validated software tools assisted by artificial intelligence would be of great benefit, as it would significantly improve the radiation therapy workflow, reducing the time required for segmentation. The purpose of this article is to validate the deep learning-based autocontouring solution integrated in syngo.via RT Image Suite VB40 (Siemens Healthineers, Forchheim, Germany). Methods and Materials: For this purpose, we have used our own specific qualitative classification system, RANK, to evaluate more than 600 contours corresponding to 18 different automatically delineated organs at risk. Computed tomography data sets of 95 different patients were included: 30 patients with lung, 30 patients with breast, and 35 male patients with pelvic cancer. The automatically generated structures were reviewed in the Eclipse Contouring module independently by 3 observers: an expert physician, an expert technician, and a junior physician. Results: There is a statistically significant difference between the Dice coefficient associated with RANK 4 compared with the coefficient associated with RANKs 2 and 3 (P < .001). In total, 64% of the evaluated structures received the maximum score, 4. Only 1% of the structures were classified with the lowest score, 1. The time savings for breast, thorax, and pelvis were 87.6%, 93.5%, and 82.2%, respectively. Conclusions: Siemens' syngo.via RT Image Suite offers good autocontouring results and significant time savings.

Direct machine learning reconstruction of respiratory variation waveforms from resting state fMRI data in a pediatric population.

In many functional magnetic resonance imaging (fMRI) studies, respiratory signals are unavailable or do not have acceptable quality due to issues with subject compliance, equipment failure or signal error. In large databases, such as the Human Connectome Projects, over half of the respiratory recordings may be unusable. As a result, the direct removal of low frequency respiratory variations from the blood oxygen level-dependent (BOLD) signal time series is not possible. This study proposes a deep learning-based method for reconstruction of respiratory variation (RV) waveforms directly from BOLD fMRI data in pediatric participants (aged 5 to 21 years old), and does not require any respiratory measurement device. To do this, the Lifespan Human Connectome Project in Development (HCP-D) dataset, which includes respiratory measurements, was used to both train a convolutional neural network (CNN) and evaluate its performance. Results show that a CNN can capture informative features from the BOLD signal time course and reconstruct accurate RV timeseries, especially when the subject has a prominent respiratory event. This work advances the use of direct estimation of physiological parameters from fMRI, which will eventually lead to reduced complexity and decrease the burden on participants because they may not be required to wear a respiratory bellows.

[Paraneoplastic hemolytic anemia associated with prostate cancer. A case report].

Paraneoplastic syndromes are a group of tumor-related symptoms not directly attributable to tumors or metastasis. Symptoms are caused by secretion of substances by the tumor or the production of antibodies from immune cross-reactivity between tumor and normal tissues. Among hematological paraneoplastic syndromes, cancer-associated hemolytic anemias associated are rare, particularly in solid tumors. We present the case of a patient with localized bladder (high-grade infiltrating papillary carcinoma pT1) and prostate (Gleason 7) cancer who developed warm antibody autoimmune hemolytic anemia during radiation therapy for prostate cancer. It was resolved with prednisone (1 mg/Kg/day, tapering schedule). To the best of our knowledge, this is the first time an autoimmune hemolytic anemia is described in the literature as a paraneoplastic syndrome in such early stages of tumor disease.

Measurement of Protein Kinetics Using a Liquid Phase-Based Biosensing Platform.

Macromolecular association is crucial to many fields in biomedical sciences, including drug development, gene editing, and diagnostics. In particular, protein-protein association and dissociation rate constants are typically determined using surface plasmon resonance systems, which require costly instrumentation and cumbersome procedures (e.g., blocking, washing, and separation). Herein, we demonstrate that protein-binding constants can be readily determined using a real-time biosensing platform facilitated by graphene oxide-modified microwell plates and fluorophore-labeled proteins, where the fluorescent probes remain highly fluorescent during protein association, whereas fluorescent bioprobes that are not associated with their counterparts are quenched by graphene oxide. Binding data of three pairs of proteins were systematically determined employing this single-step platform and compared with those data reported by the suppliers or the literature, suggesting that this approach is comparable and consistent with the existing ones. Such pairs include (i) human immunoglobulin G (H-IgG)-fluorophore-labeled anti-H-IgG, (ii) prostate-specific antigen (PSA)-quantum dot-labeled anti-PSA, and (iii) anti-RBD-fluorophore-labeled SARS-CoV-2 spike receptor-binding domain recombinant protein. We also offer an open-source software that automatically determines the binding kinetics constants of proteins. This Technical Note introduces a simple, yet effective, platform to determine relevant information on protein kinetics, which can be performed using a microwell plate reader and economical materials like graphene oxide. We foresee a new generation of diagnostics based on our affordable protein kinetics analysis.

Penicillium digitatum, First Clinical Report in Chile: Fungal Co-Infection in COVID-19 Patient.

Penicillium digitatum is one of the most important phytopathogens. It causes deterioration and rotting of citrus fruits, generating significant economic losses worldwide. As a human pathogen, it is extremely rare. We present a case of pulmonary co-infection in a patient diagnosed with pneumonia due to SARS-CoV-2. A 20-year-old female patient, primigravid, 36 weeks of gestation, without comorbidities, and diagnosed with severe pneumonia due to the SARS-CoV-2, showed rapid lung deterioration for which their pregnancy was interrupted by surgery. The patient was hospitalized in the Intensive Care Unit (ICU), connected to mechanical ventilation and receiving corticosteroids and antibiotics. The diagnosis of pulmonary fungal infection was made through bronchoalveolar lavage (BAL) culture, and the species identification was performed by sequencing of ß-tubulin. Phylogenetic analysis with related species was performed for the confirmation of species identification. Antifungal susceptibility tests were performed for itraconazole (4 µg/mL), voriconazole (2 µg/mL), and amphotericin B (2 µg/mL). The patient was successfully treated with itraconazole. This is the second worldwide report of pulmonary infection by P. digitatum and the first in Chile. Although it is a fungus that rarely infects humans, it could represent an emerging opportunistic fungal pathogen, with associated risk factors that should be considered in the differential diagnosis of Penicillium species isolated from infections in humans.

Anemia hemolítica paraneoplasica asociada a cáncer de próstata. A propósito de un caso / Paraneoplastic hemolytic anemia associated with prostate cancer. A case report

Los síndromes paraneoplásicos son un conjunto de síntomas asociados a los tumores, no atribuibles al efecto directo del tumor o de sus metástasis. Estos síntomas pueden ser secundarios a sustancias secretadas por el tumor, o a la producción de anticuerpos contra tejido tumoral que presenta reacción cruzada con tejidos normales. Dentro de los síndromes paraneoplásicos hematológicos, las anemias hemolíticas son poco frecuentes, especialmente en tumores sólidos. Presentamos el caso de un paciente con tumores localizados de vejiga (carcinoma papilar infiltrante de alto grado pT1) y próstata (Gleason 7) que durante el tratamiento radioterápico de este último desarrolló una anemia hemolítica autoinmune por anticuerpos calientes, que se resolvió con tratamiento con prednisona (1 mg/Kg/día en pauta descendente). Este sería la primera descripción en la literatura de anemia hemolítica autoinmune como síndrome paraneoplásico en un estadio tan precoz de la enfermedad tumoral.(AU)

Paraneoplastic syndromes are a group of tumor-related symptoms not directly attributable to tumors or metastasis. Symptoms are caused by secretion of substances by the tumor or the production of antibodies from immune cross-reactivity between tumor and normal tissues. Among hematological paraneoplastic syndromes, cancer-associated hemolytic anemias associated are rare, particularly in solid tumors. We present the case of a patient with localized bladder (high-grade infiltrating papillary carcinoma pT1) and prostate (Gleason 7) cancer who developed warm antibody autoimmune hemolytic anemia during radiation therapy for prostate cancer. It was resolved with prednisone (1 mg/Kg/day, tapering schedule). To the best of our knowledge, this is the first time an autoimmune hemolytic anemia is described in the literature as a paraneoplastic syndrome in such early stages of tumor disease.(AU)

ECMO venovenoso durante procedimiento endoscópico de permeabilización de la vía aérea central en pacientes con riesgo vital: reporte de 2 casos / Use of venovenous extracorporeal membrane oxygenation (ECMO) during endoscopic treatment of central airway obstruction and vital risk: report of 2 cases

Resumen: La oxigenación por membrana extracorpórea (ECMO) es de gran utilidad al proveer soporte ventilatorio a pacientes con hipoxia, pero su utilidad en el manejo de pacientes con obstrucción central de la vía aérea y riesgo vital no ha sido frecuentemente usada. La broncoscopía intervencional como terapia bajo ventilación convencional es de alto riesgo en este tipo de pacientes, pero es posible lograr excelentes resultados al ser asociada a ECMO. Comunicamos el caso clínico de 2 pacientes que presentaban disnea en reposo y falla ven1ila1oria aguda ca1as1rófica debido a una obstrucción casi total del lumen traqueal, de causa tumoral. En ambos pacientes en forma urgente se inició soporte circulatorio mediante ECMO VV, mientras se efectuaba la resección tumoral broncoscópica. Luego de terminada la cirugía traqueal, en ambos pacientes se retiró el soporte, siendo decanulados sin eventos y con una buena evolución clínica posterior. Se discute el beneficio del soporte ECMO en este tipo de pacientes.

Abstract: In patients with severe central airway stenosis bronchoscopy-guided intervention therapy under conventional ventilation conveys a high risk. Extracorporeal membrane oxygenation (ECMO) provides very good cardiopulmonary support, but is rarely used in bronchoscopy-guided interventional therapy. We report 2 patients with resting dyspnea due to severe tumor tracheal obstruction and acute pulmonary failure with imminent vital risk. Both patients were cannulated and the ECMO circuit installed on a nearly emergency basis. Tumors were excised, and the patients weaned from cardiopulmonary bypass uneventfully. Subsequent clinical course was satisfactory in both cases. A brief discussion of this condition is included.

A deep image-to-image network organ segmentation algorithm for radiation treatment planning: principles and evaluation.

BACKGROUND: We describe and evaluate a deep network algorithm which automatically contours organs at risk in the thorax and pelvis on computed tomography (CT) images for radiation treatment planning. METHODS: The algorithm identifies the region of interest (ROI) automatically by detecting anatomical landmarks around the specific organs using a deep reinforcement learning technique. The segmentation is restricted to this ROI and performed by a deep image-to-image network (DI2IN) based on a convolutional encoder-decoder architecture combined with multi-level feature concatenation. The algorithm is commercially available in the medical products "syngo.via RT Image Suite VB50" and "AI-Rad Companion Organs RT VA20" (Siemens Healthineers). For evaluation, thoracic CT images of 237 patients and pelvic CT images of 102 patients were manually contoured following the Radiation Therapy Oncology Group (RTOG) guidelines and compared to the DI2IN results using metrics for volume, overlap and distance, e.g., Dice Similarity Coefficient (DSC) and Hausdorff Distance (HD95). The contours were also compared visually slice by slice. RESULTS: We observed high correlations between automatic and manual contours. The best results were obtained for the lungs (DSC 0.97, HD95 2.7 mm/2.9 mm for left/right lung), followed by heart (DSC 0.92, HD95 4.4 mm), bladder (DSC 0.88, HD95 6.7 mm) and rectum (DSC 0.79, HD95 10.8 mm). Visual inspection showed excellent agreements with some exceptions for heart and rectum. CONCLUSIONS: The DI2IN algorithm automatically generated contours for organs at risk close to those by a human expert, making the contouring step in radiation treatment planning simpler and faster. Few cases still required manual corrections, mainly for heart and rectum.

Indium Tin Oxide-Free Inverted Organic Photovoltaics Using Laser-Induced Forward Transfer Silver Nanoparticle Embedded Metal Grids.

Laser-induced forward transfer (LIFT) printing has emerged as a valid digital printing technique capable of transferring and printing a wide range of electronic materials. In this paper, we present for the first time LIFT printing as a method to fabricate silver (Ag) nanoparticle (np) grids for the development of indium tin oxide (ITO)-free inverted PM6:Y6 nonfullerene acceptor organic photovoltaics (OPVs). Limitations of the direct use of LIFT-printed Ag np grids in inverted ITO-free OPVs are addressed through a Ag grid embedding process. The embedded laser-printed Ag grid lines have high electrical conductivity, while the Ag metal grid transparency is varied by altering the number of Ag grid lines within the inverted OPVs' ITO-free bottom electrode. Following the presented Ag-grid embedding (EMP) process, metal-grid design optimizations, and device engineering methods incorporating an EMB-nine-line Ag np grid/PH500/AI4083/ZnO bottom electrode, we have demonstrated inverted ITO-free OPVs incorporating laser-printed Ag grids with 11.0% power conversion efficiency.