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β-lactoglobulin (BLG) is the major whey protein with negative charges at neutral pH in aqueous media. Thus, the interaction with mucins, the major polyanionic component of mucus, is very weak due to the electrostatic repulsion between them. The present study postulates that cationization of BLG molecules may reverse the interaction characteristics between BLG and mucin from repulsive to associative. To this end, cationic-modified BLGs were prepared by grafting positively charged ethylenediamine (EDA) moieties into the negatively charged carboxyl groups on the aspartic and glutamic acid residues and compared with non-modified BLG upon mixing with porcine gastric mucin (PGM)...

Recessive desminopathies are rare and often present as severe early-onset myopathy. Here we report a milder phenotype in three unrelated patients from southern India (2 M, 1F) aged 16, 21, and 22 years, who presented with childhood-onset, gradually progressive, fatigable limb-girdle weakness, ptosis, speech and swallowing difficulties, without cardiac involvement. Serum creatine kinase was elevated, and repetitive nerve stimulation showed decrement in all. Clinical improvement was noted with pyridostigmine and salbutamol in two patients...

Deep learning (DL), a variant of the neural network algorithms originally proposed in the 1980s (Rumelhart et al., 1986), has made surprising progress in artificial intelligence (AI), ranging from language translation, protein folding (Jumper et al, 2021), autonomous cars, and, more recently, human-like language models (chatbots). All that seemed intractable until very recently. Despite the growing use of DL networks, little is understood about the learning mechanisms and representations that make these networks effective across such a diverse range of applications...

The Circumpolar region, comprising the Arctic territories encircling the North Pole, is home to diverse Indigenous cultures facing unique socio-economic challenges. Indigenous communities such as the Inuit, Sámi, Athabaskan, Gwitchin, and Russian Arctic groups exhibit rich traditions and adaptive practices tied to their environments. Environmental diversity, from icy tundra to boreal forests, influences livelihoods and biodiversity, while significant socio-economic disparities persist, impacting access to healthcare, education, and economic opportunities...

CONTEXT: Children and adolescents young adults (AYAs) undergoing treatment for oncologic diagnoses are frequently hospitalized and experience unwanted therapy-induced side effects that diminish quality of life. Osteopathic manipulative treatment (OMT) is a medical intervention that utilizes manual techniques to diagnose and treat body structures. Few studies have investigated the implementation of OMT in the pediatric oncology outpatient setting. To date, no studies have investigated the safety and feasibility of OMT in the pediatric oncology inpatient setting...

We describe a highly stereoconvergent radical epoxide allylation towards diastereomerically and enantiomerically enriched α-quaternary alcohols in two steps from olefins. Our approach combines the stereospecifity and enantioselectivity of the Shi epoxidation with the unprecedented Ti(III)-promoted intramolecular radical group transfer allylation of epoxides. A directional isomerization step via configurationally labile radical intermediates enables the selective preparation of all carbon quaternary stereocenters in a unique fashion...

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OBJECTIVES: Decisional conflict and regret about prenatal genetic screening and diagnostic tests may have important consequences in the current pregnancy and for future reproductive decisions. Identifying mechanisms that reduce conflict associated with the decision to use or decline these options is necessary for optimal patient counseling. METHODS: We conducted a cluster-randomized controlled trial of a shared decision-making tool (NEST) at the beginning of prenatal care...

We discuss two people with Parkinson's disease (PD), in whom tremor manifested directly following a severely stressful event. Both were initially misdiagnosed with a functional neurological disorder. These stories highlight that stress can trigger the onset of clinical manifestations of PD, by unveiling an underlying disease that had been unfolding for many years. Thus, the sudden symptom onset after a stressful event is not unique to functional disorders, and may lead to avoidable feelings of guilt if people wrongly attribute PD to this event...

BACKGROUND: Cerebral examination via CTA is always the first choice for patients with unexpected brain injury or different types of brain lesions to detect ruptured hemangiomas, vascular infarcts, or other brain tissue lesions. OBJECTIVE: This study innovated the acrylic gauge with five eccentric circles for computed tomography angiography (CTA) analysis to optimize the spatial resolution via Taguchi's methodology. METHODS: The customized gauge was revised from the V-shaped slit gauge and transferred into five eccentric circles' slit gauge...

The development of anti-adhesion hydrogels for preventing postoperative adhesions is an ongoing challenge, particularly in achieving a balance between exceptional antifouling properties and effective in situ tissue retention. In this study, we propose a unique approach with the design of a single-component Janus zwitterionic hydrogel patch featuring a bionic microstructure. The Janus patches were prepared through free radical polymerization of sulfobetaine methacrylate with N, N '-methylenebis(2-propenamide) as the cross-linker...

BACKGROUND: Clinical intensity modulated radiation therapy plans have been described using various complexity metrics to help identify problematic radiotherapy plans. Most previous studies related to the quantification of plan complexity and their utility have relied on institution-specific plans which can be highly variable depending on the machines, planning techniques, delivery modalities, and measurement devices used. In this work, 1723 plans treating one of only four standardized geometries were simultaneously analyzed to investigate how radiation plan complexity metrics vary across four different sets of common objectives...

Incorporation of secondary redox-inactive cations into heterobimetallic complexes is an attractive strategy for modulation of metal-centered redox chemistry, but quantification of the consequences of incorporating strongly Lewis acidic trivalent cations has received little attention. Here, a family of seven heterobimetallic complexes that pair a redox-active nickel center with La3+ , Y3+ , Lu3+ , Sr2+ , Ca2+ , K+ , and Na+ (in the form of their triflate salts) have been prepared on a heteroditopic ligand platform to understand how chemical behavior varies across the comprehensive series...

RATIONALE: Central nervous system lymphoma (CNSL) originating from the septum pellucidum is exceptionally rare, presenting unique diagnostic and therapeutic complexities. This case report aims to elucidate the diagnostic challenges, treatment strategies, and outcomes of this rare manifestation. By documenting this case, we seek to enhance understanding within the medical community and contribute valuable insights to the management of CNSL, particularly in atypical locations. PATIENT CONCERNS: A 45-year-old female presented with persistent headaches, blurred vision, and motor weakness, prompting a thorough neurological evaluation...

BACKGROUND: Severe protein-energy malnutrition (PEM) presents a significant clinical challenge, often compounded by comorbidities such as type 2 diabetes. This case report aims to elucidate the intricacies of managing severe PEM in conjunction with type 2 diabetes, emphasizing the importance of personalized interventions and multidisciplinary collaboration in achieving optimal outcomes. By addressing the unique challenges this complex clinical scenario poses, this report contributes valuable insights to the medical literature and guides clinicians in effectively managing similar cases...

The coexistence of diabetes mellitus (DM) and sickle cell anemia (SCA) poses significant challenges in clinical management due to the complex interactions and overlapping complications associated with both conditions. Managing diabetes in individuals with SCA requires a comprehensive approach that addresses the unique physiological and pathological aspects of both diseases. This paper reviews the challenges encountered in the management of DM in patients with SCA and explores therapeutic strategies and approaches to optimize patient care...

CASE: Capitate avascular necrosis should be entertained in a differential diagnosis of young, active adults with midcarpal wrist pain. We present a case study of a 30-year-old laborer who developed avascular necrosis (AVN) of his right proximal capitate. Grip strength and wrist motion were limited on examination, with advanced imaging confirming AVN. A diagnostic arthroscopy confirmed the pathology. Treatment was completed with a medial femoral trochlea vascularized flap for cartilaginous resurfacing...

Intermolecular pnictogen bonding (PnB) catalysis has received increased interest in non-covalent organocatalysis. It has been demonstrated that organic electron-deficient pnictogen atoms can act as prospective Lewis acids. Here, we present a catalytic approach for the asymmetric synthesis of chiral PIII compounds by combining intramolecular PnB interactions and carbene catalysis. Our design features a pre-chiral phosphorus molecules bearing two electron-withdrawing benzoyl groups, resulting in the formation of a σ-hole at the P atom...

In deep-sea cold seeps, microbial communities thrive on the geological seepage of hydrocarbons and inorganic compounds, differing from photosynthetically driven ecosystems. However, their biosynthetic capabilities remain largely unexplored. Here, we analyzed 81 metagenomes, 33 metatranscriptomes, and 7 metabolomes derived from nine different cold seep areas to investigate their secondary metabolites. Cold seep microbiomes encode diverse and abundant biosynthetic gene clusters (BGCs). Most BGCs are affiliated with understudied bacteria and archaea, including key mediators of methane and sulfur cycling...

[5,15-Bis(pentafluorophenyl)-10,20-diphenylporphinato]zinc(II) ( 1 ), a metalloporphyrin derivative that was recently reported as an efficient photocatalyst driven by blue LEDs by our group, was found to catalyze a red-light-promoted (630 nm LEDs) radical cascade reaction of N -3-arylpropionyloxyphthalimides with radicophiles including electron-deficient alkenes and alkynes, providing access to a range of functionalized tetralin and dialin derivatives. The radical cascade reaction catalyzed by 1 took place via an oxidative quenching cycle in DMSO, where no sacrificial electron donor was required, uncovering a unique solvent effect capable of promoting the porphyrin catalysis...