Effects of feed particle size on energy values for broiler chickens at various ages

The objective of this study was to evaluate the effects of various geometric mean diameters (GMDs) of particles of corn, pelleted soybean meal and a corn-soy mixture in the proportion of 70% and 30%, respectively, on the nutritional value of the feeds. The study evaluated energy consumption, the contents of apparent metabolizable energy (AME) and AME corrected for nitrogen balance (AMEn) and the metabolizability coefficients for broiler chickens at various ages. A total of 540 Cobb 500 male broilers were housed in metabolic cages (experimental units). Trials were performed separately with each feed. A completely randomized design was used with four treatments, namely corn with 573, 636, 851, and 1012 μm GMDs; pelleted soybean meal with 538, 550, 665, and 741 μm GMDs; and the corn-soy mixture with 627, 658, 893, and 1040 μm GMDs. Birds were evaluated on days 1 - 10, 11 - 20, 21 - 30, and 31 - 40. Larger GMDs resulted in lower energy consumption. From 1 to 10 days, birds consumed less metabolizable energy than older birds. Birds fed corn from days 1 to 10 had higher metabolizable energy (P <0.05) with increasing GMD up to 1042 μm. However, the results varied, depending on the feed and its combinations. The use of coarse particles could reduce the costs of grinding, and would have few effects on the metabolizable energy of broiler chickens.

K-ras Mutation Subtypes in NSCLC and Associated Co-occuring Mutations in Other Oncogenic Pathways

INTRODUCTION

Although KRAS mutations in NSCLC have been considered mutually exclusive driver mutations for a long time, there is now growing evidence that KRAS-mutated NSCLC represents a genetically heterogeneous subgroup. We sought to determine genetic heterogeneity with respect to cancer-related co-mutations and their correlation with different KRAS mutation subtypes.

METHODS

Diagnostic samples from 4507 patients with NSCLC were analyzed by next-generation sequencing by using a panel of 14 genes and, in a subset of patients, fluorescence in situ hybridization. Next-generation sequencing with an extended panel of 14 additional genes was performed in 101 patients. Molecular data were correlated with clinical data. Whole-exome sequencing was performed in two patients.

RESULTS

We identified 1078 patients with KRAS mutations, of whom 53.5% had at least one additional mutation. Different KRAS mutation subtypes showed different patterns of co-occurring mutations. Besides mutations in tumor protein p53 gene (TP53) (39.4%), serine/threonine kinase 11 gene (STK11) (19.8%), kelch like ECH associated protein 1 gene (KEAP1) (12.9%), and ATM serine/threonine kinase gene (ATM) (11.9%), as well as MNNG HOS Transforming gene (MET) amplifications (15.4%) and erb-b2 receptor tyrosine kinase 2 gene (ERBB2) amplifications (13.8%, exclusively in G12C), we found rare co-occurrence of targetable mutations in EGFR (1.2%) and BRAF (1.2%). Whole-exome sequencing of two patients with co-occurring phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha gene (PIK3CA) mutation revealed clonality of mutated KRAS in one patient and subclonality in the second, suggesting different evolutionary backgrounds.

CONCLUSION

KRAS-mutated NSCLC represents a genetically heterogeneous subgroup with a high frequency of co-occurring mutations in cancer-associated pathways, partly associated with distinct KRAS mutation subtypes. This diversity might have implications for understanding the variability of treatment outcome in KRAS-mutated NSCLC and for future trial design.

Clinical and Pathological Characteristics of KEAP1- and NFE2L2-Mutated Non-Small Cell Lung Carcinoma (NSCLC)

Purpose:KEAP1 and NFE2L2 mutations are associated with impaired prognosis in a variety of cancers and with squamous cell carcinoma formation in non-small cell lung cancer (NSCLC). However, little is known about frequency, histology dependence, molecular and clinical presentation as well as response to systemic treatment in NSCLC.Experimental Design: Tumor tissue of 1,391 patients with NSCLC was analyzed using next-generation sequencing (NGS). Clinical and pathologic characteristics, survival, and treatment outcome of patients with KEAP1 or NFE2L2 mutations were assessed.Results:KEAP1 mutations occurred with a frequency of 11.3% (n = 157) and NFE2L2 mutations with a frequency of 3.5% (n = 49) in NSCLC patients. In the vast majority of patients, both mutations did not occur simultaneously. KEAP1 mutations were found mainly in adenocarcinoma (AD; 72%), while NFE2L2 mutations were more common in squamous cell carcinoma (LSCC; 59%). KEAP1 mutations were spread over the whole protein, whereas NFE2L2 mutations were clustered in specific hotspot regions. In over 80% of the patients both mutations co-occurred with other cancer-related mutations, among them also targetable aberrations like activating EGFR mutations or MET amplification. Both patient groups showed different patterns of metastases, stage distribution and performance state. No patient with KEAP1 mutation had a response on systemic treatment in first-, second-, or third-line setting. Of NFE2L2-mutated patients, none responded to second- or third-line therapy.Conclusions:KEAP1- and NFE2L2-mutated NSCLC patients represent a highly heterogeneous patient cohort. Both are associated with different histologies and usually are found together with other cancer-related, partly targetable, genetic aberrations. In addition, both markers seem to be predictive for chemotherapy resistance. Clin Cancer Res; 24(13); 3087-96. ©2018 AACR.

Impaired detection and differentiation of briefly presented facial emotions in adults with high-functioning autism and asperger syndrome

Although deficits in the recognition of emotional facial expressions are considered a hallmark of autism spectrum disorder (ASD), characterization of abnormalities in the differentiation of emotional expressions (e.g., sad vs. angry) has been rather inconsistent, especially in adults without intellectual impairments who may compensate for their deficits. In addition, previous research neglected the ability to detect emotional expressions (e.g., angry vs. neutral). The present study used a backward masking paradigm to investigate, a) the detection of emotional expressions, and b) the differentiation of emotional expressions in adults diagnosed with high functioning autism or Asperger syndrome (n = 23) compared to neurotypical controls (n = 25). Compensatory strategies were prevented by shortening the stimulus presentation time (33, 67, and 100 ms). In general, participants with ASD were significantly less accurate in detecting and differentiating emotional expressions compared to the control group. In the emotion differentiation task, individuals with ASD profited significantly less from an increase in presentation time. These results reinforce theoretical models that individuals with ASD have deficits in emotion recognition under time constraints. Furthermore, first evidence was provided that emotion detection and emotion differentiation are impaired in ASD.

Hypo-methylation mediates chromosomal instability in pancreatic NET

DAXX and or ATRX loss occur in 40% of pancreatic neuroendocrine tumors (PanNETs). PanNETs negative for DAXX or ATRX show an increased risk of relapse. The tumor-associated pathways activated upon DAXX or ATRX loss and how this event may induce chromosomal instability (CIN) and alternative lengthening telomeres (ALT) are still unknown. Both DAXX and ATRX are involved in DNA methylation regulation. DNA methylation of heterochromatin and of non-coding sequences is extremely important for the maintenance of genomic stability. We analyzed the association of DAXX and/or ATRX loss and CIN with global DNA methylation in human PanNET samples and the effect of DAXX knock-down on methylation and cell proliferation. We assessed LINE1 as well as global DNA methylation in 167 PanNETs, and we found that DAXX and or ATRX-negative tumors and tumors with CIN were hypomethylated. DAXX knock-down in PanNET cell lines blocked cells in G1/G0 phase and seemed to increase CIN in QGP-1 cells. However, no direct changes in DNA methylation were observed after DAXX knock-down in vitro In conclusion, our data indicate that epigenetic changes are crucial steps in the progression of PanNETs loss and suggest that DNA methylation is the mechanism via which CIN is induced, allowing clonal expansion and selection.

[A child with a fever and rash]

A 1-year-old boy with flu-like symptoms and red papules, vesicles and macules around the mouth, on the extremities, on the palms of his hands and soles of the feet was seen at the outpatient clinic. He was diagnosed with an atypical form of hand, foot, and mouth disease, which can present itself in various forms.

Determinação dos valores energéticos e aminoacídicos da silagem de grãos úmidos de milho para frangos de corte

Para a determinação dos valores energéticos da silagem de grãos úmidos de milho (SGUM), foram utilizados 120 frangos de corte machos, linhagem Cobb Slow, de 21 a 31 dias de idade, com peso médio inicial de 765,0±1,7 g, distribuídos em um delineamento inteiramente casualizado, com cinco tratamentos (ração referência-RR e níveis de substituição da SGUM de 10, 20, 30 e 40 %), seis repetições e quatro aves por unidade experimental. O período experimental teve duração de dez dias, sendo cinco de adaptação e cinco de coleta. O método de análise foi o de coleta total de excretas, para posterior análises de energia metabolizável aparente (EMA) e EMA corrigida pelo balanço de nitrogênio (EMAn) da SGUM. Para a determinação dos valores de aminoácidos, foi usada a técnica de alimentação forçada em 12 galos Leghorn cecectomizados, com peso médio de 1912,10±133,73 g. Seis animais receberam a SGUM e os outros seis permaneceram em jejum. Ao final do período de coleta de excretas, foi determinado o perfil de aminoácidos essenciais, coeficientes de digestibilidade verdadeira e o conteúdo digestível verdadeiro dos aminoácidos no alimento. A SGUM apresentou valores médios de EMA e EMAn de 2283 de 2272 kcal/kg, respectivamente, sendo que os valores energéticos foram negativamente influenciados pelos níveis de inclusão da SGUM. A cistina apresentou o menor coeficiente de digestibilidade, enquanto a leucina e a glutamina apresentaram os maiores valores de aminoácidos digestíveis.

Digestibilidade de nutrientes em rações de frangos de corte suplementadas com promotores de crescimento

Um experimento foi realizado para avaliar o efeito da utilização de diferentes promotores de crescimento sobre o metabolismo de frangos de corte em crescimento. Foram avaliadas duas dietas, uma atendendo às exigências nutricionais de frangos de corte (normal) e uma dieta reduzida, com 5% a menos da exigência nutricional (reduzida), suplementadas ou não com antibióticos e prebióticos. Foram utilizados 180 pintos de corte criados em galpão convencional, com cama de maravalha, até os 21 dias de idade. Em seguida, foram divididos em 36 gaiolas, distribuídos em delineamento experimental inteiramente ao acaso, utilizando método tradicional de coleta de excretas. Houve interação (P<0,05) entre dieta e promotores de crescimento para os coeficientes de digestibilidade ileal da matéria seca (CDIMS), da proteína bruta (CDIPB) e do extrato etéreo (CDIEE). A dieta reduzida contendo antibiótico apresentou menor CDIMS. A dieta normal contendo antibiótico apresentou maior CDIPB (P<0,05), enquanto a dieta reduzida contendo prebiótico apresentou melhor CDIPB e CDIEE (P<0,05). Os valores dos coeficientes de digestibilidade total da matéria seca (CDTMS), da proteína bruta (CDTPB) e do extrato etéreo (CDTEE) apresentaram interação (P<0,05) entre dietas e promotores de crescimento, em que a dieta reduzida contendo antibiótico apresentou menor CDTMS e CDTEE. A dieta normal apresentou maiores valores de energia metabolizável aparente (EMA) e EMA corrigida para balanço de nitrogênio (EMAn) (P<0,05). Concluiu-se que, ao se reduzir a exigência nutricional da ração, a digestibilidade dos nutrientes foi reduzida, no entanto os óleos essenciais promoveram aumento nos coeficientes de digestibilidade ileal da matéria seca, da proteína bruta e do extrato etéreo.

One-pot synthesis of an indole-substituted 7,8-dicarba-nido-dodecahydroundecaborate(-1)

Carbaboranes are increasingly used as pharmacophores to replace phenyl substituents in established drug molecules. In contrast to traditional organic chemistry, elaborate procedures to introduce functionality frequently fail in the case of carbaboranes and their chemistry is often hampered by degradation of the cluster. Herein, the development of a one-pot synthesis of a water-soluble N-nido-dicarbaborato indole is presented, including a proposed mechanism for the reaction sequence. These studies provide useful synthetic tools for the conjugation of two important pharmacophores, indoles and carbaboranes.

Acute loss of vision in a young woman: A case report on psychogenic blindness

Background

Acute loss of vision needs urgent attention and treatment. We report on a young Ethiopian woman who experienced acute bilateral blindness. In the presence of normal ophthalmological findings psychogenic blindness has to be considered.

Case Details

A 21 years old woman was admitted to the psychiatry clinic at Jimma University specialized Hospital, Jimma, South West Ethiopia. She had not been able to see for a few days. Ophthalmological and neurological examinations showed normal findings. No severe psychopathology was found. Stressful life events had preceded the appearance of the symptoms. An attitude of accepting the perspective of the patient of a seemingly organic disease is a precondition for a successful intervention. Treatment aimed at a gradual return to normal functioning. The patient regained her sight and fully recovered. The final psychiatric diagnosis was psychogenic blindness.

Conclusion

The psychosocial intervention was successful and encouraging for the patient and clinicians.

Fetal skeletal dysplasias in a tertiary care center: radiology, pathology, and molecular analysis of 112 cases

Fetal skeletal dysplasias are a heterogeneous group of rare genetic disorders, affecting approximately 2.4-4.5 of 10,000 births. We performed a retrospective review of the perinatal autopsies conducted between the years 2002-2011 at our center. The study population consisted of fetuses diagnosed with skeletal dysplasia with subsequent termination, stillbirth and live-born who died shortly after birth. Of the 2002 autopsies performed, 112 (5.6%) were diagnosed with skeletal dysplasia. These 112 cases encompassed 17 of 40 groups of Nosology 2010. The two most common Nosology groups were osteogenesis imperfecta [OI, 27/112 (24%)] and the fibroblast growth factor receptor type 3 (FGFR3) chondrodysplasias [27/112 (24%)]. The most common specific diagnoses were thanatophoric dysplasia (TD) type 1 [20 (17.9%)], and OI type 2 [20 (17.9%)]. The combined radiology, pathology, and genetic investigations and grouping the cases using Nosology 2010 resulted in a specific diagnosis in 96 of 112 cases.

Concordance of measures of left-ventricular hypertrophy in pediatric hypertension

The American Academy of Pediatrics (AAP) recommends that any child diagnosed with hypertension have an echocardiogram to evaluate for the presence of left-ventricular (LV) hypertrophy (LVH) and advocates that LVH is an indication to initiate or intensify antihypertensive therapy. However, there is no consensus on the ideal method of defining LVH in the pediatric population. Many pediatric cardiologists rely on wall-thickness z-score of the LV posterior wall and/or interventricular septum to determine LVH. Yet, the AAP advocates using LV mass indexed to 2.7 (LVMI(2.7)) ≥ 51 g/m(2.7) to diagnose LVH. Recently, age-specific reference values for LVMI ≥ 95% were developed. The objective of the study was to determine the concordance between diagnosis of LVH by wall-thickness z-score and diagnosis by LVMI(2.7) criteria. A retrospective chart review was performed for subjects diagnosed with hypertension at a single tertiary care center (2009-2012). Echocardiogram reports were reviewed, and assessment of LVH was recorded. Diagnosis of LVH was assigned to each report reviewed according to three criteria: (1) LV wall-thickness z-score > 2.00; (2) age-specific reference values for LVMI(2.7) > 95th percentile; and (3) LVMI(2.7) > 51 g/m(2.7). Cohen's kappa statistic was used as a measurement of agreement between diagnosis by wall-thickness z-score and diagnosis using LVMI(2.7). A total of 159 echocardiograms in 109 subjects were reviewed. Subjects included 31 females and 77 males, age 13.2 ± 4.4 years, and 39 (42%) with a diagnosis of secondary hypertension. LVH was diagnosed in 31 cases (20%) based on increased wall-thickness z-score. Using LVMI(2.7) > 95%, LVH was found in 75 (47%) cases (mean LVMI(2.7)42.3 ± 17.2 g/m(2.7) [range 11.0-111 g/m(2.7)]). The wall-thickness z-score method agreed with LVMI(2.7) > 95% diagnosis 71% of the time (kappa 0.4). Using LVH criteria of LVMI(2.7) ≥ 51 g/m(2.7), 33 (21%) subjects were diagnosed with LVH. There was 79% agreement in the diagnosis of LVH between the wall-thickness z-score method and LVMI(2.7) > 51 g/m(2.7) (kappa 0.37). There is poor concordance between the diagnosis of LVH on echocardiogram reports using wall-thickness z-score and diagnosis of LVH using LVMI(2.7) criteria. It is important to establish a consensus method for diagnosing LVH because of the high frequency of cardiovascular complications in children with hypertension.

Second-line immunosuppressive treatment of childhood nephrotic syndrome: a single-center experience

Objective

Most cases of idiopathic nephrotic syndrome in childhood are responsive to corticosteroids. However, there is a small group of children that demonstrate steroid resistance (steroid-resistant nephrotic syndrome; SRNS), steroid dependence, or that frequently relapse (frequent-relapse steroid-sensitive nephrotic syndrome; FR-SSNS) which are more clinically difficult to treat. Therefore, second-line immunosuppressants, such as alkylating agents, calcineurin inhibitors, antimetabolites and, more recently, rituximab, have been used with varying success. The objective was to evaluate the response rates of various second-line therapies in the treatment of childhood nephrotic syndrome.

Study Design

A retrospective chart review of pediatric subjects with idiopathic nephrotic syndrome was conducted at a single tertiary care center (2007-2012). Drug responses were classified as complete response, partial response, and no response.

Results

Of the 188 charts reviewed, 121 children were classified as SSNS and 67 children as SRNS; 58% were classified as FR-SSNS. Sixty-five subjects were diagnosed with focal segmental glomerulosclerosis via biopsy. Follow-up ranged from 6 months to 21 years. The combined rate of complete and partial response for mycophenolate mofetil (MMF) was 65% (33/51) in SSNS and 67% (6/9) in SRNS. For tacrolimus, the response rate was 96% (22/23) for SSNS and 77% (17/22) for SRNS. Eighty-three percent (5/6) of SSNS subjects treated with rituximab went into complete remission; 60% relapsed after B-cell repletion. Eight refractory subjects were treated with combined MMF/tacrolimus/corticosteroid therapy with a 75% response rate.

Conclusion

Our experience demonstrates that older medications can be replaced with newer ones such as MMF, tacrolimus, and rituximab with good outcomes and better side effect profiles. The treatment of refractory cases with combination therapy is promising.

Pneumococcal phosphoglycerate kinase interacts with plasminogen and its tissue activator

Streptococcus pneumoniae is not only a commensal of the nasopharyngeal epithelium, but may also cause life-threatening diseases. Immune-electron microscopy studies revealed that the bacterial glycolytic enzyme, phosphoglycerate kinase (PGK), is localised on the pneumococcal surface of both capsulated and non-capsulated strains and colocalises with plasminogen. Since pneumococci may concentrate host plasminogen (PLG) together with its activators on the bacterial cell surface to facilitate the formation of plasmin, the involvement of PGK in this process was studied. Specific binding of human or murine PLG to strain-independent PGK was documented, and surface plasmon resonance analyses indicated a high affinity interaction with the kringle domains 1-4 of PLG. Crystal structure determination of pneumococcal PGK together with peptide array analysis revealed localisation of PLG-binding site in the N-terminal region and provided structural motifs for the interaction with PLG. Based on structural analysis data, a potential interaction of PGK with tissue plasminogen activator (tPA) was proposed and experimentally confirmed by binding studies, plasmin activity assays and thrombus degradation analyses.

Manipulating Y receptor subtype activation of short neuropeptide Y analogs by introducing carbaboranes

Short selective neuropeptide Y (NPY) analogs are highly attractive because of their facile synthesis. Based on the reduced-size NPY analog [Pro(30), Nle(31), Bpa(32), Leu(34)]NPY 28-36 position 32 was identified as a key position to alter the preferential activation pattern of the human neuropeptide Y receptors (hYRs). By replacing benzoylphenylalanine (Bpa) by a biphenylalanine (Bip) the photostability was first improved while the biological activity was maintained. SAR-studies showed that both aromatic rings have a high influence on the preferential hYR subtype activation. Interestingly, replacement of Bpa(32) by a strongly hydrophobic moiety changed the hYR subtype preference of the analog. Whereas the parent compound is able to activate the human neuropeptide Y1 receptor (hY1R) subtype, the introduction of an N(ε)-ortho-carbaboranyl propionic acid modified lysine resulted in a loss of activity at the hY1R but in an increased activity at both the hY2R and the hY4R. However, subsequent receptor internalization studies with this novel analog revealed that receptor internalization can neither be triggered at the hY2R nor at the hY4R suggesting a biased ligand. Surprisingly, investigations by (1)H NMR spectroscopy revealed structural changes in the side chains of residues Pro(30) and Leu(34) which nicely correlates with the shift from hY1R/hY4R to hY2R/hY4R activation preference. Thus, position 32 has been identified to switch the bioactive conformation and subsequently influences receptor subtype activation behavior.

Male circumcision for HIV prevention in Papua New Guinea: a summary of research evidence and recommendations for public health following a national policy forum

In 2005, a clinical trial in South Africa found that circumcision of young men could reduce their risk of acquiring HIV (human immunodeficiency virus) infection by over 60%. In the following year, two more trials in Africa confirmed this finding, leading the World Health Organization to recommend male circumcision as a public health strategy for HIV prevention in high-incidence countries. In order to inform public health policy in Papua New Guinea (PNG), two major research projects were initiated with the goals of investigating the status of penile cutting practices and assessing understandings, acceptability, feasibility and cost-effectiveness of male circumcision for HIV prevention. In addition, behavioural surveillance surveys systematically asked questions on penile cutting practices and an ethnographic literature review informed historical perspectives of penile cutting in PNG. Key findings from these research activities were presented at a National Policy Forum on Male Circumcision for HIV Prevention held in Port Moresby in November 2011. The Forum made three key recommendations: (1) the formation of a joint National Department of HealthlNational AIDS Council Secretariat Policy Committee on male circumcision; (2) the establishment of an integrated harm reduction program; and (3) that future policy on wide-scale roll-out of male circumcision for HIV prevention in PNG be informed by a combination of data from (a) male circumcision intervention pilot programs and (b) research on the potential protective effect of other forms of penile cutting.