BACKGROUND: The main objective of this study was to evaluate the neurological consequences of delayed pyridoxine administration in patients diagnosed with Pyridoxin Dependent Epilepsies (PDE).
METHODS: We reviewed 29 articles, comprising 52 genetically diagnosed PDE cases, ensuring data homogeneity. Three additional cases were included from the General Pediatric Operative Unit of San Marco Hospital. Data collection considered factors like age at the first seizure\'s onset, EEG reports, genetic analyses, and more. Based on the response to first-line antiseizure medications, patients were categorized into four distinct groups. Follow-up evaluations employed various scales to ascertain neurological, cognitive, and psychomotor developments.
RESULTS: Our study includes 55 patients (28 males and 27 females), among whom 15 were excluded for the lack of follow-up data. 21 patients were categorized as \"Responder with Relapse\", 11 as \"Resistant\", 6 as \"Pyridoxine First Approach\", and 2 as \"Responders\". The neurological outcome revealed 37,5 % with no neurological effects, 37,5 % showed complications in two developmental areas, 15 % in one, and 10 % in all areas. The statistical analysis highlighted a positive correlation between the time elapsed from the administration of pyridoxine after the first seizure and worse neurological outcomes. On the other hand, a significant association was found between an extended latency period (that is, the time that elapsed between the onset of the first seizure and its recurrence) and worse neurological outcomes in patients who received an unfavorable score on the neurological evaluation noted in a subsequent follow-up.
CONCLUSIONS: The study highlights the importance of early recognition and intervention in PDE. Existing medical protocols frequently overlook the timely diagnosis of PDE. Immediate administration of pyridoxine, guided by a swift diagnosis in the presence of typical symptoms, might improve long-term neurological outcomes, and further studies should evaluate the outcome of PDE neonates promptly treated with Pyridoxine.

BACKGROUND: The recent American College of Obstetricians and Gynecologists Practice Bulletin offers no guidance on the management of preeclampsia with severe features at <24 weeks of gestation. Historically, immediate delivery was recommended because of poor perinatal outcomes and high maternal morbidity. Recently, advances in neonatal resuscitation have led to increased survival at periviable gestational ages.
OBJECTIVE: This study aimed to report perinatal and maternal outcomes after expectant management of preeclampsia with severe features at <24 weeks of gestation.
METHODS: This was a retrospective case series of preeclampsia with severe features at <24 weeks of gestation at a level 4 center between 2017 and 2023. Individuals requiring delivery within 24 hours of diagnosis were excluded. Perinatal and maternal outcomes were analyzed. Categorical variables from our database were compared with previously published data using chi-square tests.
RESULTS: A total of 41 individuals were diagnosed with preeclampsia with severe features at <24 weeks of gestation. After the exclusion of delivery within 24 hours, 30 individuals (73%) were evaluated. The median gestational age at diagnosis was 22 weeks (interquartile range, 22-23). Moreover, 16% of individuals had assisted reproductive technology, 27% of individuals had chronic hypertension, 13% of individuals had pregestational diabetes mellitus, 30% of individuals had previous preeclampsia, and 73% of individuals had a body mass index of >30 kg/m2. The median latency periods at 22 and 23 weeks of gestation were 7 days (interquartile range, 4-23) and 8 days (interquartile range, 4-13). In preeclampsia with severe features, neonatal survival rates were 44% (95% confidence interval, 3%-85%) at 22 weeks of gestation and 29% (95% confidence interval, 1%-56%) at 23 weeks of gestation. There were 2 cases of acute kidney injury (7%) and 2 cases of pericardial or pleural effusions (7%). Overall perinatal survival at <24 weeks of gestation was 30% in our current study vs 7% in previous reports (P=.02).
CONCLUSIONS: For cases of expectant management of preeclampsia with severe features at <24 weeks of gestation, our findings showed an increased perinatal survival rate with decreased maternal morbidity compared with previously published data. This information may be used when counseling on expectant management of preeclampsia with severe features at <24 weeks of gestation.

Choriocarcinoma (CC) is a malignant neoplasm of the trophoblastic tissue, with a potential to metastasise to distant organs. Limited case of gestational CC develops after a long latent period. We report a 52-year-old postmenopausal woman who developed metastatic choriocarcinoma presumably of gestational origin, 8 years after the last pregnancy and 2 years after the last menstrual period. The patient was brought to the emergency room of a tertiary care centre in Muscat, Oman, in 2022 and was diagnosed with CC metastatic to the brain, spleen, lung and the kidney. The β-human chorionic gonadotrophin level was found to be raised (1,292,867 mIU/mL). The International Federation of Gynecologic Oncology risk score was calculated to be 14 (very high risk). The patient was initially treated with whole-brain radiotherapy and splenic artery embolisation because of a hemoperitoneum. Afterwards the patient received systemic treatment using the standard EMA/CO regimen till complete serological remission.

Ammonia plays a crucial role in the pathogenesis of hepatic encephalopathy. Ammonia is also involved in many other pathological conditions seen in cirrhosis, such as sarcopenia, liver fibrosis, hepatocellular injury, immune dysfunction, and hyperammonemia. Furthermore, the ammonia level of the veins is a useful prognostic factor for cirrhosis. In cirrhosis without hyperammonemia of the vein, however, covert hepatic encephalopathy has been reported. This discrepancy is because of the anatomical features of ammonia metabolism. There are two systems in the body for detoxifying ammonia: one is the urea cycle in the liver, and the other is the glutamine synthesis pathway in skeletal muscle and other tissues. The blood processed in the liver\'s urea cycle is then transported via arteries to various organs. Further processing occurs in the brain and skeletal muscle\'s glutamine synthesis pathway before entering the veins. When the urea cycle function decreases in cirrhosis, the ammonia levels in the artery increase. In response, the glutamine synthesis pathway compensates by increasing the capacity to process ammonia. Therefore, the ammonia concentration in the veins downstream of skeletal muscles does not increase immediately. However, the brain and skeletal muscles, which receive arterial blood, might be exposed to high ammonia concentrations. In addition, branched-chain amino acids in venous blood decrease. This period is the transition phase from early- to late-phase cirrhosis, and understanding the pathophysiology during this stage is extremely important for preventing the progression of cirrhosis.

White rot, caused by the fungus Coniella diplodiella, can severely reduce grapevine yields worldwide. Currently, white rot control mainly relies on fungicides applied on a calendar basis or following hailstorms that favor disease outbreaks; however, the control achieved with this strategy is often inconsistent or otherwise unsatisfactory. Realizing more rational control requires an improved understanding of white rot epidemiology. To this end, we conducted experiments with grapevine berries of two Vitis vinifera cultivars (either injured or not before artificial inoculation with a conidial suspension of C. diplodiella) to determine the effect of temperature on the length of latency (i.e., the time between infection and onset of mature pycnidia on berries) and the production of pycnidia and conidia. Sporulation occurred between 10 and 35°C, with the optimum detected at 20°C. The latency period (LP) was shorter at 25 to 35°C than at lower temperatures; the shortest LP was 120 h at 30°C on injured berries. Affected berries produced abundant conidia at 15 to 30°C (the optimum was 20°C) for more than 2 months following inoculation. Mathematical equations were developed that fit the data, with strong associations with temperature for the LP (R2 = 0.831) and for the production dynamics of secondary conidia (R2 = 0.918). These equations may contribute to the development of a risk algorithm to predict infection periods, which can inform risk-based disease control strategies rather than calendar-based disease control strategies.

OBJECTIVE: To investigate the efficacy of vaginal probiotics administration in combination with prophylactic antibiotics versus antibiotic prophylaxis only on perinatal outcomes in women with preterm premature rupture of membrane (PPROM).
METHODS: Four different databases were searched from inception till March 2023. We selected randomized controlled trials (RCTs) that compared vaginal probiotics along with antibiotics versus antibiotics only among pregnant women who were presented with PPROM between 24 and 34 weeks of gestation. We performed the meta-analysis using Revman software. Our primary outcomes were gestational age at birth and latency period duration. Our secondary outcomes were the rate of admission in the neonatal intensive care unit (NICU), infant birth weight, length of stay in the NICU, and neonatal complications.
RESULTS: Four RCTs, involving a total of 339 patients, were included in the meta-analysis. The gestational age at the time of delivery and latency period duration were significantly higher among probiotics + antibiotics group (p = 0.01 & p < 0.001). There was a significant reduction in the rate of NICU admission and length of NICU stay among the probiotics + antibiotics group compared to the antibiotics only group. A significant improvement in the infant birth weight after delivery was demonstrated among the probiotics + antibiotics group (p = 0.002). Although there was a decrease in the incidence of neonatal sepsis and respiratory distress syndrome within probiotics + antibiotics group versus antibiotics only group, these differences were not statistically significant (p > 0.05).
CONCLUSIONS: The combination of vaginal probiotics and antibiotic prophylaxis has been shown to effectively improve perinatal outcomes in women with PPROM. Further trials are needed to validate our findings.

The objectives of this study were to assess the effect of 2 different premilking stimulation regimens, with and without a latency period between tactile stimulation and the attachment of the milking unit, on the teat tissue condition and milking performance of dairy cows. In a randomized controlled crossover study, 145 Holstein cows milked 3 times daily were assigned to treatment (TRT) or control (CON) groups. Premilking udder preparation for the TRT group consisted of the application of a latency period resulting in a preparation lag time of 90 s. The only difference in the premilking udder preparation of the CON group was the absence of latency period; the milking unit was attached immediately after completion of the tactile stimulation. The average duration of total tactile stimulation in TRT and CON group was 8 ± 2 and 9 ± 2 s, respectively. The study lasted for 14 d and was split into 2 periods, each consisting of a 2-d adjustment period followed by 5 d of data collection. We assessed machine milking-induced short-term changes to the teat tissue by palpation and visual inspection postmilking. Electronic on-farm milk meters were used to assess milking characteristics (milk yield [kg/milking session], machine-on time [s], 2-min milk yield [kg], and duration of low milk flow rate [s]). Generalized linear mixed models were used to analyze the effect of treatment on the outcome variables. The odds of machine milking-induced short-term changes to the teat tissue were lower for cows that received a 90-s preparation lag time (TRT cows) compared with cows in the CON group (odds ratio [95% confidence interval; 95% CI] = 0.13 [0.08-0.20]). The least squares means (95% CI) values of cows in the TRT and CON groups were 15.4 (14.9-15.9) and 15.3 (14.8-15.8) kg, respectively, for milk yield, and 246 (239-253) and 253 (247-260) s for machine-on time. The 2-min milk yield was higher for the TRT compared with CON group cows at all the parity levels. The 2-min milk yields of animals in lactation 1, 2, and ≥3 were 5.7, 5.7, and 6.5 kg, respectively, in the TRT group and 4.6, 5.0, and 5.9 kg in the CON group. The TRT cows spent less time in low milk flow rate compared with CON cows at all parity levels. The durations of low milk flow rate of cows in lactation 1, 2, and ≥3 in the TRT group were 19, 17 and 13 s, respectively, and those in the CON group were 31, 22, and 15 s. In this study, cows that received a latency period, and thus were subjected to a 90-s preparation lag time had lower odds of exhibiting short-term changes to the teat tissue after machine milking, shorter machine-on time, higher 2-min milk yields, and lower durations of low milk flow rates. We conclude that consideration of latency period leading to a 90-s preparation lag time in the premilking stimulation regimen facilitated cows\' milk-ejection reflex. This latency period can alleviate the adverse effects of vacuum-induced forces on teat tissue during machine milking, improve udder health, and promote animal well-being.

Mycobacteriophages are viruses that infect members of genus Mycobacterium. Because of the rise in antibiotic resistance in mycobacterial diseases such as tuberculosis, mycobacteriophages have received renewed attention as alternative therapeutic agents. Mycobacteriophages are highly diverse, and, on the basis of their genome sequences, they are grouped into 30 clusters and 10 singletons. In this article, we have described the isolation and characterization of a novel mycobacteriophage Kashi-VT1 (KVT1) infecting Mycobacterium >smegmatis mc2 155 (M. smegmatis) and Mycobacterium fortuitum isolated from Varanasi, India. KVT1 is a cluster K1 temperate phage that belongs to Siphoviridae family as visualized in transmission electron microscopy. The phage genome is 61,010 base pairs with 66.5% Guanine/Cytosine (GC) content, encoding 101 putative open reading frames. The KVT1 genome encodes an immunity repressor, a tyrosine integrase, and an excise protein, which are the characteristics of temperate phages. It also contains genes encoding holin, lysin A, and lysin B involved in host cell lysis. The one-step growth curve demonstrated that KVT1 has a latency time of 90 min and an average burst size of 101 phage particles per infected cell. It can withstand a temperature of up to 45°C and has a maximum viability between pH 8 and 9. Some mycobacteriophages from cluster K are known to infect the pathogenic Mycobacterium tuberculosis (M. tuberculosis); hence, KVT1 holds potential for the phage therapy against tuberculosis, and it can also be engineered to convert into an exclusively lytic phage.

Bacteriophages are viral agents that infect and replicate within bacterial cells. Despite the increasing importance of phage ecology, environmental phages-particularly those targeting phyllosphere-associated bacteria-remain underexplored, and current genomic databases lack high-quality phage genome sequences linked to specific environmentally important bacteria, such as the ubiquitous sphingomonads. Here, we isolated three novel phages from a Danish wastewater treatment facility. Notably, these phages are among the first discovered to target and regulate a Sphingomonas genus within the wheat phyllosphere microbiome. Two of the phages displayed a non-prolate Siphovirus morphotype and demonstrated a narrow host range when tested against additional Sphingomonas strains. Intergenomic studies revealed limited nucleotide sequence similarity within the isolated phage genomes and to publicly available metagenome data of their closest relatives. Particularly intriguing was the limited homology observed between the DNA polymerase encoding genes of the isolated phages and their closest relatives. Based on these findings, we propose three newly identified genera of viruses: Longusvirus carli, Vexovirus birtae, and Molestusvirus kimi, following the latest ICTV binomial nomenclature for virus species. These results contribute to our current understanding of phage genetic diversity in natural environments and hold promising implications for phage applications in phyllosphere microbiome manipulation strategies.

Intergroup peer exclusion has been studied mainly from a pathological aspect. Currently, methods of diagnosis and treatment focus on this pathological point of view. Qualitative research has revealed that social intergroup peer exclusion has a role in the developmental task of the latency stage. The study\'s main aim was to develop and validate a quick and easy quantitative questionnaire for use in a school setting that reflects the social developmental variables exposed in previous qualitative research. The 32-item Latency Social-Psychological Developmental questionnaire (LSPD) and the Loneliness and Social Dissatisfaction Questionnaire were administered to 20 Grade 4 and Grade 5 classes at four co-ed public elementary schools (N = 373 participants). Factor analysis revealed six developmental factors, and correlations were found between these factors and loneliness. The LSPD is a tool for assessing latency stage development among children who experienced exclusion as well as the developmental status of the entire class. The LSPD can assist in identifying specific development areas to focus on in treatment and intervention.