Unique active-site and subsite features in the arabinogalactan-degrading GH43 exo-β-1,3-galactanase from Phanerochaete chrysosporium

Arabinogalactan proteins (AGPs) are plant proteoglycans with functions in growth and development. However, these functions are largely unexplored, mainly because of the complexity of the sugar moieties. These carbohydrate sequences are generally analyzed with the aid of glycoside hydrolases. The exo-β-1,3-galactanase is a glycoside hydrolase from the basidiomycete Phanerochaete chrysosporium (Pc1,3Gal43A), which specifically cleaves AGPs. However, its structure is not known in relation to its mechanism bypassing side chains. In this study, we solved the apo and liganded structures of Pc1,3Gal43A, which reveal a glycoside hydrolase family 43 subfamily 24 (GH43_sub24) catalytic domain together with a carbohydrate-binding module family 35 (CBM35) binding domain. GH43_sub24 is known to lack the catalytic base Asp conserved among other GH43 subfamilies. Our structure in combination with kinetic analyses reveals that the tautomerized imidic acid group of Gln263 serves as the catalytic base residue instead. Pc1,3Gal43A has three subsites that continue from the bottom of the catalytic pocket to the solvent. Subsite -1 contains a space that can accommodate the C-6 methylol of Gal, enabling the enzyme to bypass the β-1,6-linked galactan side chains of AGPs. Furthermore, the galactan-binding domain in CBM35 has a different ligand interaction mechanism from other sugar-binding CBM35s, including those that bind galactomannan. Specifically, we noted a Gly → Trp substitution, which affects pyranose stacking, and an Asp → Asn substitution in the binding pocket, which recognizes β-linked rather than α-linked Gal residues. These findings should facilitate further structural analysis of AGPs and may also be helpful in engineering designer enzymes for efficient biomass utilization.

Elementary processes of DNA surface hybridization resolved by single-molecule kinetics: implication for macroscopic device performance

Direct monitoring of single-molecule reactions has recently become a promising means of mechanistic investigation. However, the resolution of reaction pathways from single-molecule experiments remains elusive, primarily because of interference from extraneous processes such as bulk diffusion. Herein, we report a single-molecule kinetic investigation of DNA hybridization on a metal surface, as an example of a bimolecular association reaction. The tip of the scanning tunneling microscope (STM) was functionalized with single-stranded DNA (ssDNA), and hybridization with its complementary strand on an Au(111) surface was detected by the increase in the electrical conductance associated with the electron transport through the resulting DNA duplex. Kinetic analyses of the conductance changes successfully resolved the elementary processes, which involve not only the ssDNA strands and their duplex but also partially hybridized intermediate strands, and we found an increase in the hybridization efficiency with increasing the concentration of DNA in contrast to the knowledge obtained previously by conventional ensemble measurements. The rate constants derived from our single-molecule studies provide a rational explanation of these findings, such as the suppression of DNA melting on surfaces with higher DNA coverage. The present methodology, which relies on intermolecular conductance measurements, can be extended to a range of single-molecule reactions and to the exploration of novel chemical syntheses.

Hybridization of a single DNA molecule on a surface was investigated by electrical conductance measurements. The hybridization efficiency increases with increasing the DNA concentration, in contrast to preceding studies with ensemble studies.

Quantum Criticality inside the Anomalous Metallic State of a Disordered Superconducting Thin Film

The field-induced superconductor-insulator transition (SIT) in two-dimensional (2D) systems is a famous example of a quantum phase transition. However, an emergence of an anomalous metallic state induced by field has been a long-standing problem in 2D superconductors. While theories predicted that the emergence is attributed to strong phase fluctuations of the superconducting order parameter due to quantum fluctuations, usual resistance measurements have not probed them directly. Here, using Nernst effect measurements, we uncover superconducting fluctuations in the vicinity of the field-induced metallic state in an amorphous Mo_{x}Ge_{1-x} thin film. The field range where the vortex Nernst signals are detectable remains nonzero toward zero temperature, and it locates inside the metallic state defined by the magnetoresistance, indicating that the metallic state results from quantum vortex liquid (QVL) with phase fluctuations due to quantum fluctuations. Slow decay of transport entropy of vortices in the QVL with decreasing temperature suggests that the metallic state originates from broadening of a quantum critical point in SIT.

GCT-44. A CASE OF INTRACRANIAL GERMINOMA WHICH RECURRED IN THE SPINAL CORD 13 YEARS AFTER THE INITIAL TREATMENT

BACKGROUND

Central nervous system germinoma occurs most often in early teens, accounting for 15% of childhood brain tumors. Here, we report a case of germinoma which recurred in the spinal cord 13 years after complete remission. CASE DESCRIPTION: A 15-year-old boy presented with diabetes insipidus (DI). MRI showed a pineal gland tumor and ventriculomegaly. Biopsy was performed and the histological examinations revealed PLAP and c-kit positive pure germinoma. Ki67 LI was 64.4%. Gamma knife radiosurgery and 3 courses of ICE chemotherapy brought disappearance of the tumor. However, it recurred in lateral ventricles. Forty-Gray whole brain radiation resulted in complete remission of the tumor. For the sake of DI treatment and MRI examinations, he kept periodical visit to our hospital. Thirteen years later, when he was 28y/o, he complained paresthesia in the right upper extremity. MRI demonstrated gadolinium-enhance mass lesion in the cervical spinal cord. Recurrence of the tumor and multiple sclerosis were the principal differential diagnosis. Pulse steroid therapy did not make any change, and radiation therapy to the cervical spinal cord led to tumor disappearance. Nevertheless, the tumor recurred on the dorsal medulla oblongata one and a half years later. Biopsy of the tumor clarified that the tumor was germinoma. ICE chemotherapy which was limited to three courses due to severe bone marrow suppression was carried out. MRI proved no enhanced mass lesion in the central nervous system.

DISCUSSION

Germinoma may recur even after long period of remission, demonstrating that long-term follow-up is indispensable.

SURG-05. AN AWAKE SURGERY FOR A CHILD SUFFERING FROM EPILEPSY DUE TO DYSEMBRYPLASTIC NEUROEPITHELIAL TUMOR LOCATED IN THE LEFT PARIETAL LOBE

BACKGROUND

An awake surgery is a useful measure to remove tumors located close to eloquent areas of the brain to reduce surgical complications and maximize the resection. However, it has some disadvantages compared to surgeries under general anesthesia. Generally speaking, applying it to a child under 15 years-old (y/o) is hesitating because of anxiety, poor tolerance, failure to cooperate in tasks and so forth. Here, we present a case of a 13y/o girl who underwent an awake surgery due to dysembryplastic neuroepithelial tumor (DNT) located in the left parietal lobe. CASE PRESENTATION: She consulted our hospital for epileptic seizures. MRI showed a multilocular mass lesion in the left parietal lobe. The tumor was located in or close to eloquent areas. The epilepsy was refractory even with multiple antiepileptic drugs (AEDs). A Wada examination revealed that her speech area is on the left hemisphere. The operations were performed in two stages. Prior to the operations, we had several thought-out simulations in the operating room and ICU with her, her parents, and our staff including nurses and lab technicians. The first operation was to perform tumor biopsy and place intracranial electrodes. The histological diagnosis was DNT. Video electroencephalogram showed that the epileptogenic lesion was around the tumor. The second operation resulted in total tumor resection and reduction of paroxysmal epileptic spikes without major complications. She is seizure free for more than three years with two AEDs.

CONCLUSION

Careful preparations may enable an awake surgery even for a child under 15y/o.

RONC-25. A CASE OF PEDIATRIC PONTINE GLIOMA TREATED WITH GAMMA KNIFE SURGERY

BACKGROUND

Pediatric brainstem gliomas rarely occur and are a heterogeneous group of diseases, which increases the difficulty of treatment strategy. Here, we present a case of pediatric pontine glioma treated with Gamma Knife surgery (GKS) after open biopsy. CASE DESCRIPTION: An 11-year-old boy presented with diplopia due to the left MLF syndrome. MRI showed a well-circumscribed, protruding tumor with partial gadolinium enhancement in the dorsal pons. An open biopsy was performed via the suprafacial triangle following midline suboccipital approach. Histological examinations revealed high cellularity and mild atypia. Immunohistochemistry demonstrated positive stain for GFAP and Olig2 antibodies, and negative for p53 protein. The Ki67-labeling index was 6.8%. Pyrosequence analysis indicated IDH1/2 wild type (wt), BRAF V600 wt, H3F3A K27 wt, FGFR1 wt, and TERT wt. The final diagnosis was pediatric diffuse astrocytoma, WHO grade II, pons. GKS was performed one month after the biopsy. After transient worsening of the symptom, it disappeared gradually. The tumor is stable for three years with mild shrinkage of the size. DISCUSSION: Gross total resection (GTR) of pediatric low-grade, brainstem gliomas may result in a good prognosis. However, unlike pilocytic astrocytoma, diffuse astrocytoma is not easy to perform GTR without any complications. There are some reports regarding GKS for brainstem gliomas, which prove an increase in progression free survival rate. No marked tumor regression is achieved in our case, but tumor growth is well-controlled so far.

CONCLUSION

GKS after biopsy can be a useful treatment option for pediatric low-grade brainstem gliomas.

Implementation of Kenyan comprehensive school health program: improvement and association with students' academic attainment

There is growing evidence supporting the effectiveness of a comprehensive school health program. However, implementation in developing countries is a challenge. Furthermore, the available information on the association between a comprehensive school health program and students' academic attainment is limited. In Kenya, a project to verify the effects of a comprehensive school health program was carried out in Mbita sub-county, Homa Bay County from September 2012 to August 2017. This study aimed to clarify the improvement of school health during the project years and the association between school health and students' academic attainment. Primary schools in Mbita sub-county were selected as study sites. We assessed 44 schools' scores on a school health checklist developed from the Kenyan Comprehensive School Health Program, the students' mean score on the Kenya Certificate of Primary Education (KCPE), and absenteeism during the project years (2013-16). The mean school health checklist score (n = 44 schools) was 135.6 in 2013, 169.9 in 2014, 158.2 in 2015 and 181.3 in 2016. The difference of the mean score between 2013 and 2016 was significant. In addition, correlation analysis showed a significant association between mean KCPE score in the project years and school health checklist score (Pearson's coefficient was 0.43, p = 0.004). The results of this study suggest improvements of school health by the implementation of the Kenyan Comprehensive School Health Program and students' academic attainment.

Dynamics of serological responses to defined recombinant proteins during Schistosoma mansoni infection in mice before and after the treatment with praziquantel

To eliminate schistosomiasis, appropriate diagnostic tests are required to monitor its prevalence and transmission, especially in the settings with low endemicity resulting from the consecutive mass drug administration. Antibodies that react with either crude soluble schistosome egg antigens or soluble worm antigen preparations have been used to monitor infection in low-prevalence regions. However, these detection methods cannot discriminate current and past infections and are cross-reactive with other parasites because both antigens contain numerous proteins and glycans from schistosomes, and standard preparations need maintenance of the life cycle of the schistosome. To evaluate the potential utility of nine recombinant Schistosoma mansoni proteins as single defined antigens for serological diagnosis, we monitored the kinetics of antibodies to each antigen during S. mansoni infection in mice before and after the treatment with praziquantel. C57BL/6 mice were infected with 50 cercariae. The levels of immunoglobulin G (IgG) raised against five recombinant antigens (RP26, sm31, sm32, GST, and LAP1) significantly increased as early as 2-4 weeks after infection and rapidly declined by 2 weeks after the treatment, whereas those raised against crude S. mansoni egg antigens or other antigens remained elevated long after the treatment. The IgG1 raised against RP26, sm31, and serpin decreased after the treatment with praziquantel, whereas the IgE raised against serpin declined strikingly after the treatment. This study clarifies the dynamics of the serological responses to recombinant S. mansoni proteins during infection and after the treatment with praziquantel and identifies several candidate antigens with potential utility in the monitoring and surveillance of schistosomiasis toward the elimination of schistosomiasis.

A dose-finding approach for genomic patterns in phase I trials

Precision medicine is an emerging approach for disease treatment and prevention that accounts for individual variability in genes, environment, and lifestyle. Cancer is a genomic disease; therefore, the dose-efficacy and dose-toxicity relationships for molecularly targeted agents in cancer most likely differ, based on the genomic mutation pattern. The individualized optimal dose - the maximal efficacious dose with a clinically acceptable safety profile - may vary depending on the genomic mutation patterns and should be determined prior to the use of these agents in precision medicine. In addition, genes that influence the individualized optimal doses should be identified in early-phase development. In this study, we propose a novel dose-finding approach to identify the individualized optimal dose for molecularly targeted agents in phase I cancer trials. Individualized optimal dose determination and gene selection were conducted simultaneously based on L ₁ and L ₂ penalized regression. Similar to most reported dose-finding approaches, this study considers non-monotonic patterns for dose-efficacy and dose-toxicity relationships, as well as correlations between efficacy and toxicity outcomes based on multinomial distribution. Our dose-finding algorithm is based on the predictive probability calculated with an estimated penalized regression model. We compare the operating characteristics between the proposed and existing methods by simulation studies under various scenarios.

Prevalence and risk factors of Schistosoma mansoni infection among children under two years of age in Mbita, Western Kenya

Despite growing evidence that infants and very young children can be infected with schistosomes, the epidemiological features and risk factors are not well described in this age group. We aimed to assess the prevalence of S. mansoni infection in children under two years of age from a population with a known high burden of infection in school-aged children and adults and thus inform the need for interventions in this potentially vulnerable age group. In a cross-sectional study in Mbita Sub-county, along the east coast of Lake Victoria, Western Kenya, we enrolled 361 children aged 6-23 months. The prevalence of S. mansoni infection was detected using the Kato-Katz stool examination and a point-of-care test for urinary circulating cathodic antigen (POC-CCA) (Rapid Medical Diagnostics, Pretoria, South Africa). Three-hundred and five (305) children had complete data of whom 276 (90.5%, 95%CI: 86.6-93.5) children were positive for S. mansoni by the POC-CCA test, while 11 (3.6%, 95%CI: 1.8-6.4) were positive by the Kato-Katz method. All Kato-Katz positive cases were also positive by the POC-CCA test. In multivariable analysis, only geographical area, Rusinga West (AOR = 7.1, 95%CI: 1.4-35.2, P = 0.02), was associated with S. mansoni infection using Kato-Katz test. Independent associations for POC-CCA positivity included age, (12-17 months vs 6-11 months; AOR = 7.8, 95%CI: 1.8-32.6, P = 0.002) and breastfeeding in the previous 24 hours (AOR = 3.4, 95%CI: 1.3-9.0, P = 0.009). We found a potentially very high prevalence of S. mansoni infection among children under two years of age based on POC-CCA test results in Mbita Sub-county, Kenya, which if confirmed strongly supports the need to include infants in public health strategies providing universal prophylactic treatment in high burden settings. Further research is required to determine the accuracy of diagnostic tools to detect light infection among very young children and possible long-term health impacts.

Tolerance to Stretching in Thiol-Terminated Single-Molecule Junctions Characterized by Surface-Enhanced Raman Scattering

We investigated the change in the metal-molecule interaction in a 1,4-benzenedithiol (BDT) single-molecule junction using a combination of surface-enhanced Raman scattering spectra and current-voltage curves. During the stretching process, the conductance of the junction systematically decreased, accompanied by an increase in the vibrational energy of the CC stretching mode. By analyzing the current-voltage curves and Raman spectra, we found that the interaction between the π orbital of BDT and the electronic states of Au was diminished by the orientation change of BDT during the stretching process. A comparison with a 4,4'-bipyridine single-molecule junction revealed that the reduction of coupling of the Au-S contacts was smaller than that of Au-pyridine contacts. Therefore, the electronic states originating from the contact geometry are responsible for the tolerance to the stretching of thiol-terminated molecular junctions.

Domain architecture divergence leads to functional divergence in binding and catalytic domains of bacterial and fungal cellobiohydrolases

Cellobiohydrolases directly convert crystalline cellulose into cellobiose and are of biotechnological interest to achieve efficient biomass utilization. As a result, much research in the field has focused on identifying cellobiohydrolases that are very fast. Cellobiohydrolase A from the bacterium Cellulomonas fimi (CfCel6B) and cellobiohydrolase II from the fungus Trichoderma reesei (TrCel6A) have similar catalytic domains (CDs) and show similar hydrolytic activity. However, TrCel6A and CfCel6B have different cellulose-binding domains (CBDs) and linkers: TrCel6A has a glycosylated peptide linker, whereas CfCel6B's linker consists of three fibronectin type 3 domains. We previously found that TrCel6A's linker plays an important role in increasing the binding rate constant to crystalline cellulose. However, it was not clear whether CfCel6B's linker has similar function. Here we analyze kinetic parameters of CfCel6B using single-molecule fluorescence imaging to compare CfCel6B and TrCel6A. We find that CBD is important for initial binding of CfCel6B, but the contribution of the linker to the binding rate constant or to the dissociation rate constant is minor. The crystal structure of the CfCel6B CD showed longer loops at the entrance and exit of the substrate-binding tunnel compared with TrCel6A CD, which results in higher processivity. Furthermore, CfCel6B CD showed not only fast surface diffusion but also slow processive movement, which is not observed in TrCel6A CD. Combined with the results of a phylogenetic tree analysis, we propose that bacterial cellobiohydrolases are designed to degrade crystalline cellulose using high-affinity CBD and high-processivity CD.

Aberrant Accumulation of BRCA1 in Alzheimer Disease and Other Tauopathies

BRCA1 plays an important roles in several biological events during the DNA damage response (DDR). Recently, some reports have indicated that BRCA1 dysfunction is involved in the pathogenesis of Alzheimer disease (AD). Furthermore, it has also been reported that BRCA1 accumulates within neurofibrillary tangles (NFTs) in the AD brain. In this study, we examined the immunohistochemical distribution of BRCA1 and another DDR protein, p53-Binding Protein 1 (53BP1), in AD, Pick disease (PiD), progressive supranuclear palsy (PSP), corticobasal degeneration, and frontotemporal dementia with parkinsonism linked to chromosome 17. In control subjects, neither BRCA1 nor phosphorylated BRCA1 (pBRCA1; Ser1524) immunoreactivity was observed in neurons or glial cells; and that for pBRCA1 (Ser1423) and 53BP1 were slightly detected in neuronal nuclei. The immunoreactivity for both BRCA1 and pBRCA1 (Ser1423) was localized within phosphorylated tau inclusions in all tauopathies, whereas that for pBRCA1 (Ser1524) was mainly associated with Pick bodies in PiD and to a lesser extent with NFTs in AD. On the other hand, 53BP1-immunoreactive deposits tended to be increased in the nucleus of neurons in AD and PSP compared with those in control cases. Our results suggest that DDR dysfunction due to cytoplasmic sequestration of BRCA1 could be involved in the pathogenesis of tauopathies.

Examining the appropriateness and reliability of the strategy of the Kenyan Comprehensive School Health Program

The Kenyan government established the Kenyan Comprehensive School Health Program (KCSHP) on the basis of Kenyan National School Health Policy. A KCSHP pilot project was carried out in eight primary schools in Mbita Sub-County of Homa Bay County in the Nyanza Region from 2012 to 2017. This pilot project provided health facilities and support for evaluation with a school health checklist, and organized teacher training on health education, a child health club, and school-based health check-ups. The present study aimed to examine the appropriateness and reliability of the strategy of the second KCSHP pilot project in Kenya. We analyzed data from self-administered questionnaires targeted at pupils in seventh-grade in the eight primary schools. The questionnaire consisted of questions on health-related knowledge, attitudes and practices, self-evaluated physical and mental health status, self-awareness of health control, subjective happiness, recognition on the importance of learning about health in school, absenteeism, and sense of school belongingness. The project contributed to improving health-related knowledge, attitudes and practices, self-evaluated health status, sense of school belongingness, recognition on the importance of learning about health in school, self-awareness of health control, and absenteeism. On the contrary, subjective happiness did not improve significantly.

Effect of C-6 Methylol Groups on Substrate Recognition of Glucose/Xylose Mixed Oligosaccharides by Cellobiose Dehydrogenase from the Basidiomycete Phanerochaete chrysosporium

Cellobiose dehydrogenase (CDH) is a flavocytochrome catalyzing oxidation of the reducing end of cellobiose and cellooligosaccharides, and has a key role in the degradation of cellulosic biomass by filamentous fungi. Here, we use a lineup of glucose/xylose-mixed β-1,4-linked disaccharides and trisaccharides, enzymatically synthesized by means of the reverse reaction of cellobiose phosphorylase and cellodextrin phosphorylase, to investigate the substrate recognition of CDH. We found that CDH utilizes β-D-xylopyranosyl-(1→4)-D-glucopyranose (Xyl-Glc) as an electron donor with similar K_m and k_cat values to cellobiose. β-D-Glucopyranosyl-(1→4)-D-xylopyranose (Glc-Xyl) shows a higher K_m value, while xylobiose does not serve as a substrate. Trisaccharides show similar behavior; i.e., trisaccharides with cellobiose and Xyl-Glc units at the reducing end show similar kinetics, while the enzyme was less active towards those with Glc-Xyl, and inactive towards those with xylobiose. We also use docking simulation to evaluate substrate recognition of the disaccharides, and we discuss possible molecular mechanisms of substrate recognition by CDH.

Evaluation of Ammonia Pretreatment for Enzymatic Hydrolysis of Sugarcane Bagasse to Recover Xylooligosaccharides

Sugarcane bagasse is a useful biomass resource. In the present study, we examined the efficacy of ammonia pretreatment for selective release of hemicellulose from bagasse. Pretreatment of bagasse with aqueous ammonia resulted in significant loss of xylan. In contrast, pretreatment of bagasse with anhydrous ammonia resulted in almost no xylan loss. Aqueous ammonia or anhydrous ammonia-pretreated bagasse was then subjected to enzymatic digestion with a xylanase from the glycoside hydrolase (GH) family 10 or a xylanase from the GH family 11. The hydrolysis rate of xylan in bagasse pretreated with aqueous ammonia was approximately 50 %. In contrast, in the anhydrous ammonia-treated bagasse, xylan hydrolysis was > 80 %. These results suggested that anhydrous ammonia pretreatment would be an effective method for preparation of sugarcane bagasse for enzymatic hydrolysis to recover xylooligosaccharides.

Structure and Electron Transport at Metal Atomic Junctions Doped with Dichloroethylene

We have investigated the structure and electron transport at dichloroethylene-doped metal atomic junctions at low temperatures (20 K) in ultra-high vacuum, using Fe, Ni, Pd, Cu, Ag, and Au. The metal atomic junctions were fabricated using the mechanically controllable break junction technique. After introducing the dichloroethylene (DCE), the conductance behavior of Fe, Ni, and Pd junctions was considerably changed, whereas little change was observed for Cu, Ag, and Au. For the Pd and Cu junctions, a clear peak was observed in their conductance histograms, showing that the single-molecule junction was selectively formed. To investigate the structure of the metal atomic junctions further, their plateau lengths were analyzed. The length analysis revealed that the Au atomic wire was elongated, and the metal atomic wires were formed for the other transition metals: those that do not normally form metal atomic wires without DCE doping, as DCE adsorption stabilized the metal atomic states. There is a strong interaction between DCE and the metals, where DCE supports the formation of the metal atomic wire for Fe, Ni, and Pd.

Genetic screening for potassium channel mutations in Japanese autosomal dominant spinocerebellar ataxia

Spinocerebellar ataxia (SCA) is a genetically heterogeneous disease characterized by cerebellar ataxia. Many causative genes have been identified to date, the most common etiology being the abnormal expansion of repeat sequences, and the mutation of ion channel genes also play an important role in the development of SCA. Some of them encode calcium and potassium channels. However, due to limited reports about potassium genes in SCA, we screened 192 Japanese individuals with dominantly inherited SCA who had no abnormal repeat expansions of causative genes for potassium channel mutations (KCNC3 for SCA13 and KCND3 for SCA19/SCA22) by target sequencing. As a result, two variants were identified from two patients: c.1973G>A, p.R658Q and c.1018G>A, p.V340M for KCNC3, and no pathogenic variant was identified for KCND3. The newly identified p.V340M exists in the extracellular domain, and p.R658Q exists in the intracellular domain on the C-terminal side, although most of the reported KCNC3 mutations are present at the transmembrane site. Adult-onset and slowly progressive cerebellar ataxia are the main clinical features of SCA13 and SCA19 caused by potassium channel mutations, which was similar in our cases. SCA13 caused by KCNC3 mutations may present with deep sensory loss and cognitive impairment in addition to cerebellar ataxia. In this study, mild deep sensory loss was observed in one case. SCA caused by potassium channel gene mutations is extremely rare, and more cases should be accumulated in the future to elucidate its pathogenesis due to channel dysfunction.

Case Report: Bacillus pumilus-Caused Bacteremia in a Patient with Food Poisoning

Bacillus pumilus has rarely been reported as a cause of human infections. We report a case of a B. pumilus causing food poisoning in an adult male. A 51-year-old Japanese man complained of severe abdominal cramps, fever with chills, diarrhea, dizziness, and loss of appetite after eating reheated rice with stewed minced meat purchased from a Kenyan restaurant. Bacillus pumilus was isolated from blood culture and was identified using a biochemical test and 16S rRNA gene sequencing analysis. The patient was treated with probiotics and ciprofloxacin and recovered after 3 days. To our knowledge, this is the first report describing the potential role of B. pumilus as a foodborne pathogen in Kenya and highlights the importance of good hygiene and food preparation practices.

P2865Mutation specific clinical characteristics in long QT syndrome type 8; severe phenotype in Timothy syndrome patients

Background

Long QT syndrome type 8 (LQT8) caused by mutations in CACNA1C has been classified as a very rare and severe type of long QT syndrome accompanied with Timothy syndrome (TS) with extra-cardiac phenotype. Recently, various mutations in CACNA1C have been identified in non-TS patients. However, mutation specific severity in LQT8 has not been elucidated yet, especially for non-TS patients.

Purpose

We aimed to clarify the clinical characteristics of LQT8 patients.

Methods

The study consists of 26 LQT8 patients (21 probands and 5 family members). We evaluated their phenotype.

Results

Table summarizes the clinical characteristics of LQT8 patients. TS patients diagnosed in younger age than those of non-TS. Four TS and one non-TS patients were diagnosed at the age of 0, though the non-TS patient was a son of a patient and asymptomatic. Nine patients suffered symptoms including 7 with cardiac arrest. We identified three TS mutations; classical p.G406R in two and p.G402S in two, and a new TS mutation, p.412M in one. Four of TS patients were symptomatic and two died suddenly at the age of 4 and 5. In contrast, no one died in non-TS patients. Five non-TS patients suffered symptoms in the age of 4,9,15,54 and 64, and the mutations were p.S643F, p.R858H (2 patients), p.K1518E and p.K1591T.

Characteristics of TS and non-TS patient TS Non-TS P N (male) 5 (2) 21 (9) Age (range) 0 (0–7) 12 (0–64) 0.004 Symptom Syncope 4 5 0.034 CPA 3 4 0.101 ECG characteristics   QT interval 603±40 507±14 0.011   T wave alternans 5 2 <0.001   AV Block 4 1 0.002 Therapy (4 unknown)   Beta-blocker 4 7 0.311   Mexiletine 3 1 0.024   ICD implantation 2 2 0.21

Conclusions

Although TS patients showed severe phenotype, most of the non-TS patients were asymptomatic. The phenotype in LQT8 are diversely different depend on the mutations, especially between patients with TS and non-TS.

P2850Time to isolation guided hot balloon ablation for pulmonary vein isolation

Background

One disadvantage of hot balloon ablation (HBA) system is that real time monitoring of pulmonary vein (PV) potential is technically impossible. Therefore, the optimal radiofrequency-generated thermal energy application duration and application number are not completely established.

Purpose

The aim of this study is to evaluate the utility of 2Fr 4-electrode unidirectional catheter inserted into PV along with HB for real time monitoring of PV potential and investigate the time to isolation (TTI) guided optimal application strategy for HB based PV isolation in the acute phase.

Methods

We evaluated 23 consecutive patients who performed PV isolation using HBA system. Real time monitoring of PV potential was performed by 2Fr 4-electrode unidirectional catheter inserted into PV along with HB (Figure1A). After HBA applications, PV isolation was validated by high-resolution mapping with the 20-pole steerable mapping (PENTARAY) catheter as a standard. PV potentials during HBA application were categorized into five patterns. PV potentials disappeared during HBA applications and not emerged again (acute isolation), disappeared but verified by PENTARAY catheter (pseudo isolation), once disappeared but emerged again during the same application (acute reconnection), visible but not disappeared (ineffective application) and Invisible (Figure1B).

TTI, difference between TTI and time to reach target temperature (TTRT), balloon temperature at isolation and ablation time after isolation were examined for each applications.

Results

Out of 92 PVs, 69/92 (75.0%) PVs were isolated using HBA and 23/92 (25.0%) PVs required touch up ablation. In total, 120 applications were performed. Real time monitoring of the PV activity was obtained in 114 of 120 applications (95.0%). The distribution of PV potential patterns were 64/120 (53.3%), 2/120 (1.7%), 27/120 (22.5%), 23/120 (19.2%), for acute isolation, pseudo isolation, acute reconnection, ineffective application, respectively.

TTI and difference between TTI and TTRT were significantly shorter in the acute isolation group. Balloon temperature at isolation was significantly lower, TTRT and ablation time after isolation was significantly longer in the acute isolation group. Among them, TTI and difference between TTI and TTRT were highly predictive by receiver operation characteristics curve analysis. TTI <36.5s predicted successful application with sensitivity 83.9% and specificity 79.3%. Difference between TTI and TTRT <6.5s predicted with sensitivity 82.3% and specificity 89.7%.

Figure 1

Conclusions

In HBA system, real time monitoring of PV potentials can be obtained using 2Fr 4-electrode unidirectional catheter and accuracy to confirm an ostial PV isolation is relatively high.

TTI <36.5s and difference between TTI and TTRT <6.5s could be a suitable target for effective application.

P2590A liver-derived secretory protein, selenoprotein P causes pressure overload-induced cardiac hypertrophys

Background

Hepatokine selenoprotein P (SeP) contributes to insulin resistance and hyperglycemia in patients with type 2 diabetes. Inhibition of SeP protects the heart from ischemia reperfusion injury and serum levels of SeP are elevated in patients with heart failure with reduced ejection fraction.

Objective

We investigated the role of SeP in the regulation of cardiac remodeling in response to pressure overload.

Methods and results

To examine the role of SeP in cardiac remodeling, transverse aortic constriction (TAC) was subjected to SeP knockout (KO) and wild-type (WT) mice for 2 weeks. Hepatic expression of SeP in WT was significantly increased by TAC. LV weight/tibial length (TL) was significantly smaller in SeP KO mice than in WT mice (6.75±0.24 vs 8.33±0.32, p<0.01). Lung weight/TL was significantly smaller in SeP KO than in WT mice (10.46±0.44 vs 16.38±1.12, p<0.05). TAC-induced cardiac upregulation of the fetal type genes, including atrial and brain natriuretic factors, was significantly attenuated in SeP KO compared to WT. Furthermore, azan staining revealed that there was significantly less interstitial fibrosis in hearts after TAC in SeP KO than in WT mice. To determine whether hepatic overexpression of SeP affects TAC-induced cardiac hypertrophy, a hydrodynamic injection method was used to generate mice that overexpress SeP mRNA in the liver. Hepatic overexpression of SeP in SeP KO mice lead to a significant increase in LV weight/TL and Lung weight/TL after TAC compared to that in other SeP KO mice.

Conclusions

These results suggest that cardiac pressure overload induced hepatic expression of SeP and the absence of endogenous SeP attenuated cardiac hypertrophy, dysfunction and fibrosis in response to pressure overload in mice. SeP possibly plays a maladaptive role against progression of heart failure through the liver-heart axis.

Is there a gap between health education content and practice toward schistosomiasis prevention among schoolchildren along the shores of Lake Victoria in Kenya?

Despite provision of preventive measures against schistosomiasis such as mass drug administration (MDA), the prevalence of Schistosoma mansoni remains high in communities living near Lake Victoria. This study aimed to analyse the status of schistosomiasis, including its prevalence, health education, knowledge, attitudes, and practices (KAP) among pupils, and water use in schools in Mbita situated along the shores of Lake Victoria. Four primary schools were selected as target schools and pupils in classes six and seven were recruited as study participants. The prevalence of S. mansoni was examined by Kato-Katz method. Simultaneously, a KAP survey toward schistosomiasis was conducted among the pupils. Health education contents were extracted from textbooks. All primary schools in the study site were surveyed regarding how each secured water used for daily school life. The prevalence of S. mansoni was 56% and 36% in 2015 and 2016, respectively. 60–70% of pupils chose a correct answer for the mode of transmission. More than 70% of pupils answered that bathing in Lake Victoria causes Schistosoma infection; however, more than 70% of pupils bathed in Lake Victoria sometimes or every day. According to the science textbook, “avoiding contact with contaminated water” is the way to prevent schistosomiasis; however, 66% of schools asked pupils to bring water from Lake Victoria. The prevalence of S. mansoni among pupils remains high. Schoolchildren are taught to avoid contact with contaminated water but are often asked to fetch water from the lake. From the school health viewpoint, health education that reflects the social and cultural context of the community in the contents and teaching methods are needed. In addition to this, provision of sanitation infrastructure is needed. A comprehensive and innovative approach which harmonises central and local governments and other stakeholders, as well as community is important to prevent schistosomiasis.

According to WHO, it is estimated that at least 206 million people required preventive treatment for schistosomiasis in 2016 and of those at least 90% live in Africa. Moreover, school-age children are most affected by this worm. In Kenya, despite preventive measures against schistosomiasis such as mass drug administration (MDA) in primary schools, it remains a major public health problem, especially along the shores of Lake Victoria. Our study revealed that the prevalence of Schistosoma mansoni was high among pupils despite their knowledge about schistosomiasis transmission. This can be attributed to lack of safe water supply and latrines. A comprehensive approach which harmonises central and local governments and other stakeholders, as well as community is needed to prevent schistosomiasis. For example, the combination of health education (in which schools play as focal point) with provision of water infrastructure, encouragement to use and construct toilets in both schools and community/households, snail control, and MDA with monitoring can be employed to control and prevent schistosomiasis. From the school health viewpoint, it is necessary to develop health education contents and teaching methods that reflect the social and cultural context of the community in order to improve their behaviour and change the social norm.

Field testing of a lightweight, inexpensive, and customisable 3D-printed mosquito light trap in the UK

Mosquito surveillance is a fundamental component of planning and evaluating vector control programmes. However, logistical and cost barriers can hinder the implementation of surveillance, particularly in vector-borne disease-endemic areas and in outbreak scenarios in remote areas where the need is often most urgent. The increasing availability and reduced cost of 3D printing technology offers an innovative approach to overcoming these challenges. In this study, we assessed the field performance of a novel, lightweight 3D-printed mosquito light trap baited with carbon dioxide (CO₂) in comparison with two gold-standard traps, the Centers for Disease Control and Prevention (CDC) light trap baited with CO₂, and the BG Sentinel 2 trap with BG-Lure and CO₂. Traps were run for 12 nights in a Latin square design at Rainham Marshes, Essex, UK in September 2018. The 3D-printed trap showed equivalent catch rates to the two commercially available traps. The 3D-printed trap designs are distributed free of charge in this article with the aim of assisting entomological field studies across the world.

Investigation of Ag and Cu Filament Formation Inside the Metal Sulfide Layer of an Atomic Switch Based on Point-Contact Spectroscopy

The atomic switches have attracted wide attention owing to their applications in nonvolatile electric devices. The atomic switch is operated by the formation and dissipation of a metallic filament inside a metal sulfide film, which is controlled by a solid electrochemical reaction. Although the metallic filament is considered to consist of metal atoms, the chemical species of the metallic filament are difficult to be identified due to challenges in observing the metallic filament inside the solid. In this study, we report the investigation on the metallic filament in the atomic switch with metal sulfide based on point-contact spectroscopy (PCS). By cooling the atomic switch, the switch voltage increased to 1 V, which allowed for the PCS measurement. The PCS revealed that the metallic filament was composed of Ag atoms in the case of the Pt/Ag₂S/Ag atomic switch. We applied this technique to the Pt/Cu₂S/Ag and Pt/Ag₂S/Cu atomic switches to uncover the formation process of the metallic filament. In both atomic switches, the chemical species of the metallic filament were Ag. The metal atoms were supplied from both the metal electrode and the sulfide layer.

Correlates of exclusive breastfeeding practices in rural and urban Niger: a community-based cross-sectional study

Background

Exclusive breastfeeding (EBF) can prevent death and disease among young children. The proportion of EBF is low in Niger. This study aimed to identify the prevalence and correlates of exclusive breastfeeding.

Methods

We conducted a community-based cross-sectional study in urban and rural areas of Niger among mothers of infants under 7 months old. We used a structured questionnaire to investigate breastfeeding practices, sociodemographic factors, and health service use. We used multivariate analysis to explore the correlates of EBF since birth.

Results

The study involved 234 urban and 283 rural mothers. Colostrum was almost universally given to newborns (98.7% [231/234] urban and 97.9% [277/283] rural) and many mothers started breastfeeding within an hour of giving birth (69.2% [162/234] and 90.5% [256/283]). The proportion of EBF since birth in urban and rural areas was 15.8% (37/234) and 54.4% (154/283), respectively. Among mothers who had ceased EBF, proportion of prelacteal feeding was 85.3% (168/197) in urban areas and 62.0% (80/129) in rural areas, while 93.4% (183/196) and 72.7% (88/121) had stopped EBF within 1 week after birth respectively. The median duration of EBF was 1 week in urban and 2 months in rural areas. In urban areas, EBF was more likely in mothers with infants 3 months old or younger (Adjusted Odds Ratio [AOR] 2.78; 95% Confidence Interval 95% [CI] 1.07, 7.21) and problems with delivery including Caesarean section (AOR 3.60; 95% CI 1.17, 11.01). In rural areas, lower socioeconomic status (AOR 1.89; 95% CI 1.12, 3.18), early initiation of breastfeeding (AOR 4.04; 95% CI 1.50, 10.83) and delivery assisted by a traditional birth attendant (AOR 3.49; 95% CI 1.37, 8.89) were correlated with exclusive breastfeeding.

Conclusions

Exclusive breastfeeding was uncommon. Most mothers ceased EBF within 1 week after birth. Adequate information about EBF by health professionals around delivery seems to encourage its use. To encourage EBF in Niger, it is important to educate health professionals, including traditional birth attendants, and enable them to discuss the practice with mothers through individual counselling or group education.

Electronic supplementary material

The online version of this article (10.1186/s13006-019-0226-9) contains supplementary material, which is available to authorized users.

Identifying the molecular adsorption site of a single molecule junction through combined Raman and conductance studies

Single-molecule junctions are ideal test beds for investigating the fundamentals of charge transport at the nanoscale. Conducting properties are strongly dependent on the metal-molecule interface geometry, which, however, is very poorly characterized due to numerous experimental challenges. We report on a new methodology for characterizing the adsorption site of single-molecule junctions through the combination of surface enhanced Raman scattering (SERS), current-voltage (I-V) curve measurements, and density functional theory simulations. This new methodology discriminates between three different adsorption sites for benzenedithiol and aminobenzenethiol junctions, which cannot be identified by solo measurements of either SERS or I-V curves. Using this methodology, we determine the interface geometry of these two prototypical molecules at the junction and its time evolution. By modulating the applied voltage, we can change and monitor the distribution of adsorption sites at the junction.

Relationship between dietary patterns and stunting in preschool children: a cohort analysis from Kwale, Kenya

OBJECTIVES

Stunting is a significant cause of poor cognitive performance and lower school achievement. Stunting is observed among pre-school children in several areas in Africa; however, not all children are affected, and children with and without stunting are seen in the same communities. Therefore, this study aimed to identify nutritional and other factors that prevent stunting that may exist in local communities.

STUDY DESIGN

This is a prospective cohort study.

METHODS

Data were extracted from the Health and Demographic Surveillance System conducted in Kwale County, Kenya. The cohort consisted of all households with children less than five years old, within a radius of 2.2 km from a local health centre. A dietary pattern (DP) survey with a semi-quantitative food frequency questionnaire was conducted on caretakers of children who were voluntary participated from the cohort between June 2012 and August 2012. Using cluster analysis, the children were assigned to a DP group. Logistic regression analysis was applied to calculate the adjusted odds ratios (aORs) of DPs for stunting controlling for other factors.

RESULTS

In total, 402 children were included in the analysis. By cluster analysis, three DPs were identified: protein-rich DP; traditional DP; and traditional DP complemented by breastfeeding. The aOR of a child becoming stunted from a normal height during the study period among children who received a traditional DP compared with those who had a protein-rich DP was 2.78 (95% confidence interval [CI]: 1.02-7.55). However, the aOR for children who were already stunted at the start of the study and had a traditional DP was 1.49 (95% CI: 0.82-2.72). Increased aORs of stunting were observed among children aged over 12 months compared with children aged 6-11 months, and the effects of DPs were modified by age in months from 12 to 35 months; however, the effects were near the null value for children over 36 months of age, although these were not statistically significant.

CONCLUSIONS

We found that the traditional DP showed a higher risk for stunting compared with the protein-rich DP, and the most vulnerable age range for stunting was between 12 and 35 months. Interventions to prevent stunting should focus on providing 12- to 35-month-old children with locally available, protein-rich foods.

Highly Reproducible Formation of a Polymer Single-Molecule Junction for a Well-Defined Current Signal

Single-molecule devices attract much interest in the development of nanoscale electronics. Although a variety of functional single molecules for single-molecule electronics have been developed, there still remains the need to implement sophisticated functionalization toward practical applications. Given its superior functionality encountered in macroscopic materials, a polymer could be a useful building block in the single-molecule devices. Therefore, a molecular junction composed of polymer has now been created. Furthermore, an automated algorithm was developed to quantitatively analyze the tunneling current through the junction. Quantitative analysis revealed that the polymer junction exhibits a higher formation probability and longer lifetime than its monomer counterpart. These results suggest that the polymer provides a unique opportunity to design both stable and highly functional molecular devices for nanoelectronics.

Novel pathogenic XK mutations in McLeod syndrome and interaction between XK protein and chorein

Objective

To identify XK pathologic mutations in 6 patients with suspected McLeod syndrome (MLS) and a possible interaction between the chorea-acanthocytosis (ChAc)- and MLS-responsible proteins: chorein and XK protein.

Methods

Erythrocyte membrane proteins from patients with suspected MLS and patients with ChAc, ChAc mutant carriers, and normal controls were analyzed by XK and chorein immunoblotting. We performed mutation analysis and XK immunoblotting to molecularly diagnose the patients with suspected MLS. Lysates of cultured cells were co-immunoprecipitated with anti-XK and anti-chorein antibodies.

Results

All suspected MLS cases were molecularly diagnosed with MLS, and novel mutations were identified. The average onset age was 46.8 ± 8 years, which was older than that of the patients with ChAc. The immunoblot analysis revealed remarkably reduced chorein immunoreactivity in all patients with MLS. The immunoprecipitation analysis indicated a direct or indirect chorein-XK interaction.

Conclusions

In this study, XK pathogenic mutations were identified in all 6 MLS cases, including novel mutations. Chorein immunoreactions were significantly reduced in MLS erythrocyte membranes. In addition, we demonstrated a possible interaction between the chorein and XK protein via molecular analysis. The reduction in chorein expression is similar to that between Kell antigens and XK protein, although the chorein-XK interaction is a possibly noncovalent binding unlike the covalent Kell-XK complex. Our results suggest that reduced chorein levels following lack of XK protein are possibly associated with molecular pathogenesis in MLS.

Investigation on the formation process of metal atomic filament for metal sulfide atomic switches by electrical measurement

We have studied the formation process of the metal atomic filament for metal sulfide atomic switches by electrical measurement. The switching between ON and OFF states of the atomic switch is controlled by the application of the bias voltage for the atomic switches. The SET (OFF → ON) and RESET (ON → OFF) voltages were investigated for the atomic switch where the Ag₂S or Cu₂S layer were sandwiched between the Pt and Ag or Cu electrodes. The SET and RESET voltages of the Ag/Cu₂S/Pt and Cu/Ag₂S/Pt were close to those of the Ag/Ag₂S/Pt atomic switch, and different from those of the Cu/Cu₂S/Pt atomic switch. These results indicated that the dominant chemical species of the making and breaking part of the metal filament was Ag, and that the source of the metal filament was both the sulfide layer and the metal electrode.

Functional Characterization of the GH10 and GH11 Xylanases from Streptomyces olivaceoviridis E-86 Provide Insights into the Advantage of GH11 Xylanase in Catalyzing Biomass Degradation

We functionally characterized the GH10 xylanase (SoXyn10A) and the GH11 xylanase (SoXyn11B) derived from the actinomycete Streptomyces olivaceoviridis E-86. Each enzyme exhibited differences in the produced reducing power upon degradation of xylan substrates. SoXyn10A produced higher reducing power than SoXyn11B. Gel filtration of the hydrolysates generated by both enzymes revealed that the original substrate was completely decomposed. Enzyme mixtures of SoXyn10A and SoXyn11B produced the same level of reducing power as SoXyn10A alone. These observations were in good agreement with the composition of the hydrolysis products. The hydrolysis products derived from the incubation of soluble birchwood xylan with a mixture of SoXyn10A and SoXyn11B produced the same products as SoXyn10A alone with similar compositions. Furthermore, the addition of SoXyn10A following SoXyn11B-mediated digestion of xylan produced the same products as SoXyn10A alone with similar compositions. Thus, it was hypothesized that SoXyn10A could degrade xylans to a smaller size than SoXyn11B. In contrast to the soluble xylans as the substrate, the produced reducing power generated by both enzymes was not significantly different when pretreated milled bagasses were used as substrates. Quantification of the pentose content in the milled bagasse residues after the enzyme digestions revealed that SoXyn11B hydrolyzed xylans in pretreated milled bagasses much more efficiently than SoXyn10A. These data suggested that the GH10 xylanases can degrade soluble xylans smaller than the GH11 xylanases. However, the GH11 xylanases may be more efficient at catalyzing xylan degradation in natural environments (e.g. biomass) where xylans interact with celluloses and lignins.

Abstract TP523: A Randomized Controlled Trial Evaluating the Effectiveness of Pretreatment With the Free Radical Scavenger, Edaravone, Before Carotid Artery Stenting

Objective: Cerebral hyperperfusion syndrome (CHS) is likely to occur after carotid revascularization in patients with severe hemodynamic failure. It is important to control cerebral hyperperfusion phenomenon (CHP) to prevent the development of CHS. To determine whether pretreatment with the free radical scavenger, edaravone, could prevent the onset of CHP after carotid artery stenting (CAS).

Methods: Patients with severe carotid artery stenosis were randomized to receive either pretreatment with edaravone immediately before CAS or the common CAS procedure. Cerebral blood flow (CBF) was assessed in the affected middle cerebral artery (MCA) region and in the ipsilateral cerebellum using single-photon emission computed tomography (SPECT) of the brain before and immediately after CAS. Cerebrovascular reactivity (CVR) in the MCA region was also evaluated using the stereotactic extraction estimation based on the Japanese extracranial-intracranial bypass trial (SEE-JET) program and classified as reduced when it was <18.4%. The ratio of MCA to cerebellar activity was defined as the CBF in the affected MCA region divided by the CBF in the ipsilateral cerebellar hemisphere. CHP was defined as an increase in the ratio of MCA to cerebellar activity after CAS ≥10%.

Results: Of the 52 patients recruited in this study, 26 were assigned to the pretreatment with edaravone group and 26 were assigned to the treatment as the usual group. Eleven patients showed reduced CVR. CHP occurred in 0 of 6 patients in the edaravone group and in 4 of 5 patients in the usual group (0% vs. 80%, p=0.0152). However, there was no significant difference in the overall patient population between the two groups.

Conclusion: Pretreatment with edaravone could reduce the incidence of CHP after CAS in patients with reduced CVR.

Stretch dependent electronic structure and vibrational energy of the bipyridine single molecule junction

Change in the molecular orbital energy and vibrational energy of the bipyridine single molecule junction as a function of stretch distance.

Structural characterization of hemicellulose released from corn cob in continuous flow type hydrothermal reactor

Hydrothermal reaction is known to be one of the most efficient procedures to extract hemicelluloses from lignocellulosic biomass. We investigated the molecular structure of xylooligosaccharides released from corn cob in a continuous flow type hydrothermal reactor designed in our group. The fraction precipitable from the extract with four volumes of ethanol was examined by ¹H-NMR spectroscopy and MALDI-TOF MS before and after enzymatic treatment with different purified enzymes. The released water-soluble hemicellulose was found to correspond to a mixture of wide degree of polymerization range of acetylarabinoglucuronoxylan fragments (further as corn cob xylan abbreviated CX). Analysis of enzymatic hydrolyzates of CX with an acetylxylan esterase, GH3 β-xylosidase, GH10 and GH11 xylanases revealed that the main chain contains unsubstituted regions mixed with regions of xylopyranosyl residues partially acetylated and occasionally substituted by 4-O-methyl-d-glucuronic acid and arabinofuranose esterified with ferulic or coumaric acid. Single 2- and 3-O-acetylation was accompanied by 2,3-di-O-acetylation and 3-O-acetylation of Xylp residues substituted with MeGlcA. Most of the non-esterified arabinofuranose side residues were lost during the hydrodynamic process. Despite reduced branching, the acetylation and ferulic acid modification of pentose residues contribute to high yields and high solubility of the extracted CX. It is also shown that different enzyme treatments of CX may lead to various types of xylooligosaccharides of different biomedical potential.

Leishmaniasis recidivans by Leishmania tropica in Central Rift Valley Region in Kenya

OBJECTIVES

This study sought to determine the endemic Leishmania species, the clinical features of cutaneous leishmaniasis (CL) in the Central Rift Valley in Kenya and to give an account on unresponsiveness to treatment in the region.

METHODS

Participants were clinically identified and grouped into untreated, classical and recidivate based on clinical manifestation and clinical data. Leishmaniasis recidivans lesions were scaly hyperemic papules that appeared before the classic lesion had healed or after healing. The demographics and socio-economic data were recorded and lesion scraping samples screened through microscopy and Internal Transcribed Spacer 1-PCR. Leishmania species were identified using Restriction Fragment Length Polymorphism.

RESULTS

A total of 52 participants were sampled, of which, 44.2% of the cases were recidivate and L. tropica the only species identified. All patients had been treated using sodium stibogluconate (SSG) which is the recommended first-line drug in Kenya. 60% of the patients experienced prolonged exposure to the drug (>30 days).

CONCLUSION

L. tropica is the endemic Leishmania species for CL leading to classical and leishmaniasis recidivans. Treatment of CL in the area is not effective hence, alternative measures/therapy should be considered to cope with the unresponsiveness.

Typical features of Parkinson disease and diagnostic challenges with microdeletion 22q11.2

OBJECTIVE

To delineate the natural history, diagnosis, and treatment response of Parkinson disease (PD) in individuals with 22q11.2 deletion syndrome (22q11.2DS), and to determine if these patients differ from those with idiopathic PD.

METHODS

In this international observational study, we characterized the clinical and neuroimaging features of 45 individuals with 22q11.2DS and PD (mean follow-up 7.5 ± 4.1 years).

RESULTS

22q11.2DS PD had a typical male excess (32 male, 71.1%), presentation and progression of hallmark motor symptoms, reduced striatal dopamine transporter binding with molecular imaging, and initial positive response to levodopa (93.3%). Mean age at motor symptom onset was relatively young (39.5 ± 8.5 years); 71.4% of cases had early-onset PD (<45 years). Despite having a similar age at onset, the diagnosis of PD was delayed in patients with a history of antipsychotic treatment compared with antipsychotic-naive patients (median 5 vs 1 year, p = 0.001). Preexisting psychotic disorders (24.5%) and mood or anxiety disorders (31.1%) were common, as were early dystonia (19.4%) and a history of seizures (33.3%).

CONCLUSIONS

Major clinical characteristics and response to standard treatments appear comparable in 22q11.2DS-associated PD to those in idiopathic PD, although the average age at onset is earlier. Importantly, treatment of preexisting psychotic illness may delay diagnosis of PD in 22q11.DS patients. An index of suspicion and vigilance for complex comorbidity may assist in identifying patients to prioritize for genetic testing.

X chromosome protects against bladder cancer in females via a KDM6A-dependent epigenetic mechanism

Men are much more likely than women to develop bladder cancer (BCa), but the underlying cause of this gender disparity remains poorly defined. Using sex-reversed mice, we show that the sex chromosome complement is an independent cause and, moreover, amplifies the biasing effects of sex hormones. We also show that the X-linked lysine demethylase 6A (KDM6A) is a sexually dimorphic gene. Wild-type but not catalytically dead KDM6A confers sustained tumor suppressor activity in vitro. Knockout of mouse Kdm6a reduces expression of Cdkn1a and Perp, canonical gene targets of the tumor suppressor p53. Consistently, loss of Kdm6a increases BCa risk in female mice, and mutations or reduced expression of human KDM6A predicts poor prognosis of female BCa patients. Collectively, the study reveals that the X chromosome protects against BCa among females via a KDM6A-dependent epigenetic mechanism and further suggests that KDM6A is a prototypical sex-biasing tumor suppressor with both demethylase-dependent and demethylase-independent activities.

Purification, Cloning, Functional Expression, Structure, and Characterization of a Thermostable β-Mannanase from Talaromyces trachyspermus B168 and Its Efficiency in Production of Mannooligosaccharides from Coffee Wastes

Highly thermostable β-mannanase, belonging to glycoside hydrolase family 5 subfamily 7, was purified from the culture supernatant of Talaromyces trachyspermus B168 and the cDNA of its transcript was cloned. The recombinant enzyme showed maximal activity at pH 4.5 and 85 °C. It retained more than 90 % of its activity below 60 °C. Obtaining the crystal structure of the enzyme helped us to understand the mechanism of its thermostability. An antiparallel β-sheet, salt-bridges, hydrophobic packing, proline residues in the loops, and loop shortening are considered to be related to the thermostability of the enzyme. The enzyme hydrolyzed mannans such as locust bean gum, carob galactomannan, guar gum, konjac glucomannan, and ivory nut mannan. It hydrolyzed 50.7 % of the total mannans from coffee waste, producing mannooligosaccharides. The enzyme has the highest optimum temperature among the known fungal β-mannanases and has potential for use in industrial applications.

Endogenous protein and enzyme fragments induce immunoglobulin E-independent activation of mast cells via a G protein-coupled receptor, MRGPRX2

Mast cells play a central role in inflammatory and allergic reactions by releasing inflammatory mediators through 2 main pathways, immunoglobulin E-dependent and E-independent activation. In the latter pathway, mast cells are activated by a diverse range of basic molecules (collectively known as basic secretagogues) through Mas-related G protein-coupled receptors (MRGPRs). In addition to the known basic secretagogues, here, we discovered several endogenous protein and enzyme fragments (such as chaperonin-10 fragment) that act as bioactive peptides and induce immunoglobulin E-independent mast cell activation via MRGPRX2 (previously known as MrgX2), leading to the degranulation of mast cells. We discuss the possibility that MRGPRX2 responds various as-yet-unidentified endogenous ligands that have specific characteristics, and propose that MRGPRX2 plays an important role in regulating inflammatory responses to endogenous harmful stimuli, such as protein breakdown products released from damaged or dying cells.

Adjunctive perampanel in partial-onset seizures: Asia-Pacific, randomized phase III study

OBJECTIVES

To evaluate the efficacy, safety, and tolerability of perampanel, a selective, non-competitive, α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptor antagonist, as an adjunctive treatment for patients with refractory partial-onset seizures (POS) from Asia-Pacific.

MATERIALS & METHODS

This multicenter, randomized, double-blind, placebo-controlled trial (ClinicalTrials.gov identifier: NCT01618695) involved patients aged ≥12 years with refractory POS (receiving 1-3 antiepileptic drugs). Patients were randomized (1:1:1:1) to receive once-daily placebo or perampanel 4, 8, or 12 mg over a 6-week titration and 13-week maintenance double-blind period. Enzyme-inducing antiepileptic drugs were equally stratified between groups. The primary efficacy endpoint was percent change in POS frequency per 28 days (double-blind phase vs baseline). Other efficacy endpoints included ≥50% responder rate and seizure freedom. Treatment-emergent adverse events (TEAEs) were also monitored.

RESULTS

Of 710 randomized patients, seizure frequency data were available for 704 patients. Median percent changes in POS frequency per 28 days indicated dose-proportional reductions in seizure frequency: -10.8% with placebo and -17.3% (P = .2330), -29.0% (P = .0003), and -38.0% (P < .0001) with perampanel 4, 8, and 12 mg, respectively. In total, 108 (15.3%) patients discontinued treatment; 44 (6.2%) due to TEAEs. TEAEs occurring in ≥5% of patients, and reported at least twice as frequently with perampanel vs placebo, included dizziness and irritability.

CONCLUSIONS

Adjunctive perampanel (8 and 12 mg/d) significantly improved seizure control in patients with refractory POS. Safety and tolerability were acceptable at daily doses of perampanel 4-12 mg.

Enhanced Azidolysis by the Formation of Stable Ser-His Catalytic Dyad in a Glycoside Hydrolase Family 10 Xylanase Mutant

Glycoside hydrolases require carboxyl groups as catalysts for their activity. A retaining xylanase from Streptomyces olivaceoviridis E-86 belonging to glycoside hydrolase family 10 possesses Glu128 and Glu236 that respectively function as acid/base and nucleophile. We previously developed a unique mutant of the retaining xylanase, N127S/E128H, whose deglycosylation is triggered by azide. A crystallographic study reported that the transient formation of a Ser–His catalytic dyad in the reaction cycle possibly reduced the azidolysis reaction. In the present study, we engineered a catalytic dyad with enhanced stability by site-directed mutagenesis and crystallographic study of N127S/E128H. Comparison of the Michaelis complexes of N127S/E128H with pNP-X₂ and with xylopentaose showed that Ser127 could form an alternative hydrogen bond with Thr82, which disrupts the formation of the Ser–His catalytic dyad. The introduction of T82A mutation in N127S/E128H produces an enhanced first-order rate constant (6 times that of N127S/E128H). We confirmed the presence of a stable Ser–His hydrogen bond in the Michaelis complex of the triple mutant, which forms the productive tautomer of His128 that acts as an acid catalyst. Because the glycosyl azide is applicable in the bioconjugation of glycans by using click chemistry, the enzyme-assisted production of the glycosyl azide may contribute to the field of glycobiology.

Aberrant accumulation of ErbB4 in progressive supranuclear palsy

AIMS

The human epidermal growth factor receptor family consists of four members that belong to the ErbB lineage of proteins (ErbB1-4). Neuregulin-1 (NRG1)/ErbB signalling regulates brain development and function. Abnormalities in this signalling have been implicated in the aetiology or development of neurodegenerative diseases such as Alzheimer's disease, Parkinson's disease and amyotrophic lateral sclerosis. So, we aimed at investigating whether the expression of NRG1 or ErbB proteins are altered in progressive supranuclear palsy (PSP).

METHODS

The brains of 10 PSP and six control patients were investigated by immunohistochemical analysis.

RESULTS

Whereas C-terminal ErbB4 immunoreacitivity was partially but distinctly present in the cytoplasm and/or in the nucleus of neurons in control patients, it was rarely observed in the neuronal nuclei in PSP patients. In contrast, neurofibrillary tangles, coiled bodies and threads were robustly immunoreactive for C-terminal ErbB4 in PSP. Double immunofluorescence for C-terminal ErbB4 and phospho-tau revealed co-localization of these proteins within neuronal and glial inclusions. To the contrary, there was no difference in the subcellular localization of NRG1, ErbB1, ErbB2, and N-terminal ErbB4 between control and PSP patients. These proteins were localized in the cytoplasm of neurons.

CONCLUSIONS

Our present results suggest that NRG1/ErbB4 signalling could be an important event in the pathogenesis of PSP.