Lyme Carditis Presenting With Complete Heart Block and Wide Complex Escape Rhythm

A 19-year-old woman with newly diagnosed Lyme disease presented with complete heart block and an accompanying escape rhythm with a right bundle branch block morphology. With antibiotics, her dysrhythmia resolved completely within 24 hours of presentation. This case highlights an unusual electrocardiographic manifestation of Lyme carditis.     

Muscle Architectural and Force-Velocity Curve Adaptations following 10 Weeks of Training with Weightlifting Catching and Pulling Derivatives

The aims of this study were to examine the muscle architectural, rapid force production, and force-velocity curve adaptations following 10 weeks of resistance training with either submaximal weightlifting catching (CATCH) or pulling (PULL) derivatives or pulling derivatives with phase-specific loading (OL). 27 resistance-trained men were randomly assigned to the CATCH, PULL, or OL groups and completed pre- and post-intervention ultrasound, countermovement jump (CMJ), and isometric mid-thigh pull (IMTP). Vastus lateralis and biceps femoris muscle thickness, pennation angle, and fascicle length, CMJ force at peak power, velocity at peak power, and peak power, and IMTP peak force and force at 100-, 150-, 200-, and 250 ms were assessed. There were no significant or meaningful differences in muscle architecture measures for any group (p > 0.05). The PULL group displayed small-moderate (g = 0.25-0.81) improvements in all CMJ variables while the CATCH group displayed trivial effects (g = 0.00-0.21). In addition, the OL group displayed trivial and small effects for CMJ force (g = -0.12-0.04) and velocity variables (g = 0.32-0.46), respectively. The OL group displayed moderate (g = 0.48-0.73) improvements in all IMTP variables while to PULL group displayed small-moderate (g = 0.47-0.55) improvements. The CATCH group displayed trivial-small (g = -0.39-0.15) decreases in IMTP performance. The PULL and OL groups displayed visible shifts in their force-velocity curves; however, these changes were not significant (p > 0.05). Performing weightlifting pulling derivatives with either submaximal or phase-specific loading may enhance rapid and peak force production characteristics. Strength and conditioning practitioners should load pulling derivatives based on the goals of each specific phase, but also allow their athletes ample exposure to achieve each goal. Key points

• There were no significant or practically meaningful changes in vastus lateralis or biceps femoris muscle thickness, pennation angle, or fascicle length for any group.
• The PULL group produced the greatest CMJ force at peak power, velocity at peak power, and peak power adaptations.
• The PULL and OL groups produced similar benefits in rapid force production; however, peak force adaptations favored the OL group.
• Despite visible shifts in the force-velocity curves of the PULL and OL groups, none of the changes were statistically significant.

Key words: Weightlifting, Olympic weightlifting, countermovement jump, isometric-mid thigh pull, force-velocity profile, rate of force development     

Improved control of SARS-CoV-2 by treatment with a nucleocapsid-specific monoclonal antibody

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike protein is the main antigen in all approved COVID-19 vaccines and is also the only target for monoclonal antibody (mAb) therapies. Immune responses to other viral antigens are generated after SARS-CoV-2 infection, but their contribution to the antiviral response remains unclear. Here, we interrogated whether nucleocapsid-specific antibodies can improve protection against SARS-CoV-2. We first immunized mice with a nucleocapsid-based vaccine and then transferred sera from these mice into naive mice, followed by challenge with SARS-CoV-2. We show that mice that received nucleocapsid-specific sera or a nucleocapsid-specific mAb exhibited enhanced control of SARS-CoV-2. Nucleocapsid-specific antibodies elicited NK-mediated, antibody-dependent cellular cytotoxicity (ADCC) against infected cells. To our knowledge, these findings provide the first demonstration in the coronavirus literature that antibody responses specific to the nucleocapsid protein can improve viral clearance, providing a rationale for the clinical evaluation of nucleocapsid-based mAb therapies to treat COVID-19.     

Repeated exposure to heterologous hepatitis C viruses associates with enhanced neutralizing antibody breadth and potency

A prophylactic hepatitis C virus (HCV) vaccine that elicits neutralizing antibodies could be key to HCV eradication. However, the genetic and antigenic properties of HCV envelope (E1E2) proteins capable of inducing anti-HCV broadly neutralizing antibodies (bNAbs) in humans have not been defined. Here, we investigated the development of bNAbs in longitudinal plasma of HCV-infected persons with persistent infection or spontaneous clearance of multiple reinfections. By measuring plasma antibody neutralization of a heterologous virus panel, we found that the breadth and potency of the antibody response increased upon exposure to multiple genetically distinct infections and with longer duration of viremia. Greater genetic divergence between infecting strains was not associated with enhanced neutralizing breadth. Rather, repeated exposure to antigenically related, antibody-sensitive E1E2s was associated with potent bNAb induction. These data reveal that a prime-boost vaccine strategy with genetically distinct, antibody-sensitive viruses is a promising approach to inducing potent bNAbs in humans.     

Aurone-derived 1,2,3-triazoles as potential fluorescence molecules in vitro

Aurones are a class of well-studied natural compounds primarily responsible for the yellow pigment in flowering plants and have been shown to have fluorescent properties as well as beneficial biological effects. Traditionally, aurones can be easily synthesized through a Knoevenagel condensation of benzofuranones with arylaldehydes. Recently, Kafle et al. unexpectedly synthesized a new aurone derivative containing a 1,2,3-triazole within its backbone. Since, 1,2,3-triazole containing structures have been shown to be useful as fluorophores with large Stokes shifts, we hypothesized that these new aurone-derived triazole compounds (ATs) could be utilized as potential fluorophores. Here we describe a newly-synthesized fluorescent compound which has potential for use as a live-cell probe, having a large Stokes shift of 118.3 ± 1.01 nm in phosphate-buffered saline with the benefit of increased fluorescence in protic environments, which is uncommon in aurone-derived fluorophores.

Aurones are a class of naturally occurring compounds with fluorescent derivatives. Here we show a newly synthesized derivative of aurones containing a 1,2,3-triazole which is fluorescent in aqueous environments and has potential to be used as a probe in vitro.     

Determinants of the competing outcomes of intrauterine infection,abruption, or spontaneous preterm birth after preterm premature rupture of membranes*

Objective: Patients with PPROM are at risk for a variety of outcomes, including chorioamnionitis (CA), placental abruption (PA), or preterm labor (PTL). Competing risk regression can analyze a cohort’s risk of individual outcomes while accounting for ongoing deliveries secondary to competing events.

Methods: A secondary analysis of the subjects from MFMU BEAM study of neuroprotection after preterm birth (BEAM) with conservative PPROM management. Deliveries were categorized as: PA, CA, PTL, “elective” or “indicated”. The association between outcomes of PA, CA or PTL and clinical predictors of twins, ethnicity, parity, gestational age at rupture, bleeding, contractions, cervical dilation, preterm birth history, weight, and genitourinary infections were evaluated via competing risk regression.

Result: 1970 subjects were included. The significance and directionality of predictors varied according to specific outcomes. Patients with twins had an increased PTL hazard (1.85) though reductions in CA- (0.66) or PA-specific (0.56) hazards. Decreased latency in African-Americans was almost entirely due to an increased CA hazard (1.44) without a significant association with PTL. Increasing gestational age at membrane rupture was associated with a decreasing hazard of CA although increasing hazard of PTL.

Conclusions: For patients with PPROM, the hazards associated with different clinical predictors vary according to exact outcomes.     

The Effect of Intramural Myomas Without an Intracavity Component on In Vitro Fertilization Outcomes in Single Fresh Blastocyst Transfer Cycles

Study Objective

To assess clinical pregnancy rate (CPR) and live birth rate (LBR) in the presence of non–cavity-deforming intramural myomas in single fresh blastocyst transfer cycles.

Paraneoplastic syndromes in patients with laryngeal neuroendocrine carcinomas: clinical manifestations and prognostic significance

Paraneoplastic syndromes are associated with a variety of malignant neoplasms and are systemic and non-metastatic manifestations that develop in a minority of cancer patients. This review examines all published cases of paraneoplastic syndromes associated with neuroendocrine carcinomas of the larynx. There are a total of ten patients reported with paraneoplastic syndromes associated with laryngeal neuroendocrine carcinomas in the literature. Of these, nine died and the tenth is alive with liver metastases. There were five cases of small-cell neuroendocrine carcinoma, four cases of moderately differentiated neuroendocrine carcinoma, and one case of well-differentiated neuroendocrine carcinoma associated with paraneoplastic syndromes. As these syndromes have significant clinical relevance, physicians should be aware of the possible presence of paraneoplastic syndromes in the diagnostic process of patients with neuroendocrine carcinoma of the larynx.     

Meta-analytic activation maps can help identify affective processes captured by contrast-based task fMRI: the case of threat-related facial expressions

Meta-analysis of functional magnetic resonance imaging (fMRI) data is an effective method for capturing the distributed patterns of brain activity supporting discrete cognitive and affective processes. One opportunity presented by the resulting meta-analysis maps (MAMs) is as a reference for better understanding the nature of individual contrast maps (ICMs) derived from specific task fMRI data. Here, we compared MAMs from 148 neuroimaging studies representing emotion categories of fear, anger, disgust, happiness and sadness with ICMs from fearful > neutral and angry > neutral faces from an independent dataset of task fMRI (n = 1263). Analyses revealed that both fear and anger ICMs exhibited the greatest pattern similarity to fear MAMs. As the number of voxels included for the computation of pattern similarity became more selective, the specificity of MAM–ICM correspondence decreased. Notably, amygdala activity long considered critical for processing threat-related facial expressions was neither sufficient nor necessary for detecting MAM–ICM pattern similarity effects. Our analyses suggest that both fearful and angry facial expressions are best captured by distributed patterns of brain activity, a putative neural correlate of threat. More generally, our analyses demonstrate how MAMs can be leveraged to better understand affective processes captured by ICMs in task fMRI data.