KdpD is a tandem serine histidine kinase that controls K pump KdpFABC transcriptionally and post-translationally.

Two-component systems, consisting of a histidine kinase and a response regulator, serve signal transduction in bacteria, often regulating transcription in response to environmental stimuli. Here, we identify a tandem serine histidine kinase function for KdpD, previously described as a histidine kinase of the KdpDE two-component system, which controls production of the potassium pump KdpFABC. We show that KdpD additionally mediates an inhibitory serine phosphorylation of KdpFABC at high potassium levels, using not its C-terminal histidine kinase domain but an N-terminal atypical serine kinase domain.

Care of Late-Stage Parkinsonism: Resource Utilization of the Disease in Five European Countries.

Background: Parkinson's disease (PD) is a neurodegenerative disease that leads to progressive disability. Cost studies have mainly explored the early stages of the disease, whereas late-stage patients are underrepresented.

Objective: The aim is to evaluate the resource utilization and costs of PD management in people with late-stage disease.

Depressive symptomatology in pregnant adolescents: considerations for care.

Purpose Of Review: Adolescents who are pregnant experience higher levels of depressive symptoms than nonpregnant peers and pregnant adults. Clinicians caring for youth are often the first point of clinical contact for pregnant adolescents but report low confidence in assessing and treating reproductive health concerns. In the current review, we outline risk factors for depressive symptoms among pregnant adolescents and provide guidance on best practices in assessment and treatment of depressive symptoms in this pediatric sub-population.

Goal-Directed Haemodynamic Therapy Improves Patient Outcomes in Kidney Transplantation.

Kidney transplant graft function depends on optimised haemodynamics. However, high fluid volumes risk hypervolaemic complications. The Edwards Lifesciences ClearSight™ device permits fluid titration through markers of preload and beat-to-beat blood pressure monitoring.

Automated prostate multi-regional segmentation in magnetic resonance using fully convolutional neural networks.

Objective: Automatic MR imaging segmentation of the prostate provides relevant clinical benefits for prostate cancer evaluation such as calculation of automated PSA density and other critical imaging biomarkers. Further, automated T2-weighted image segmentation of central-transition zone (CZ-TZ), peripheral zone (PZ), and seminal vesicle (SV) can help to evaluate clinically significant cancer following the PI-RADS v2.1 guidelines.

Rapid development of a ventilator for use during the COVID-19 pandemic: Clinical, human factor & engineering considerations.

The arrival of the COVID-19 pandemic in early 2020 threatened to overwhelm the NH ability to provide sufficient critical care support to patients in the UK. In response to a rapid rise in cases in March 2020, the UK Government issued a call to industry to rapidly design and develop additional ventilators to expand the UK's capacity for mechanical ventilation. Three NHS consultants working in conjunction with TTP Plc (The Technology Partnership), were at the forefront, evolving the Government brief and developing a safe and effective ventilator, the CoVent™, in less than 5 weeks.

Rationale and Initiative of the Impella in Cardiac Surgery (ImCarS) Register Platform.

Objectives: Cardiac support systems are being used increasingly more due to the growing prevalence of heart failure and cardiogenic shock. Reducing cardiac afterload, intracardiac pressure, and flow support are important factors. Extracorporeal membrane oxygenation (ECMO) and intracardiac microaxial pump systems (Impella) as non-permanent MCS (mechanical circulatory support) are being used increasingly.

Impact of Spatially Heterogeneous Trop-2 Expression on Prognosis in Oral Squamous Cell Carcinoma.

Oral cancer often presents with aggressive behavior and a high risk of recurrence and metastasis. For oral squamous cell carcinoma (OSCC), which is the most frequent histological subtype, therapy strategies include surgery, radiation therapy, chemotherapy, immune checkpoint inhibitors, and EGFR inhibitors. Recently, a Trop-2 antibody-drug conjugate (ADC) has been approved in the United States of America for the treatment of advanced triple-negative breast cancer.

Sorafenib Maintenance After Allogeneic Hematopoietic Stem Cell Transplantation for Acute Myeloid Leukemia With -Internal Tandem Duplication Mutation (SORMAIN).

Purpose: Despite undergoing allogeneic hematopoietic stem cell transplantation (HCT), patients with acute myeloid leukemia (AML) with internal tandem duplication mutation in the like tyrosine kinase 3 gene (ITD) have a poor prognosis, frequently relapse, and die as a result of AML. It is currently unknown whether a maintenance therapy using FLT3 inhibitors, such as the multitargeted tyrosine kinase inhibitor sorafenib, improves outcome after HCT.

Patients And Methods: In a randomized, placebo-controlled, double-blind phase II trial (SORMAIN; German Clinical Trials Register: DRKS00000591), 83 adult patients with ITD-positive AML in complete hematologic remission after HCT were randomly assigned to receive for 24 months either the multitargeted and FLT3-kinase inhibitor sorafenib (n = 43) or placebo (n = 40 placebo).

The Prevalence and Determinants of Neuropsychiatric Symptoms in Late-Stage Parkinsonism.

Background: Late-stage parkinsonism and Parkinson's disease (PD) are insufficiently studied population. Although neuropsychiatric symptoms (eg, psychosis, depression, anxiety, behavioral problems) are frequently present, their prevalence and clinical predictors remain unknown.

Objective: To determine the prevalence and predictors of neuropsychiatric symptoms in late-stage PD.

Optimizing Treatment in Undertreated Late-Stage Parkinsonism: A Pragmatic Randomized Trial.

Background: Treatment of patients with late-stage parkinsonism is often sub-optimal.

Objective: To test the effectiveness of recommendations by a movement disorder specialist with expertise in late-stage parkinsonism.

Methods: Ninety-one patients with late-stage parkinsonism considered undertreated were included in apragmatic a pragmatic multi-center randomized-controlled trial with six-month follow-up.

Examining the effects of different teaching strategies on metacognition and academic performance.

The purpose of this study was to evaluate the effect of different metacognitive interventions on knowledge and regulation of cognition, as well as academic performance (i.e., exam and final grades) in three sections of an undergraduate human anatomy and physiology course.

10 Hz tACS Over Somatosensory Cortex Does Not Modulate Supra-Threshold Tactile Temporal Discrimination in Humans.

Perception of physical identical stimuli can differ over time depending on the brain state. One marker of this brain state can be neuronal oscillations in the alpha band (8-12 Hz). A previous study showed that the power of prestimulus alpha oscillations in the contralateral somatosensory area negatively correlate with the ability to temporally discriminate between two subsequent tactile suprathreshold stimuli.

Severe Refractory Paraneoplastic Mucous Membrane Pemphigoid Successfully Treated With Rituximab.

Mucous membrane pemphigoid (MMP) is a rare autoimmune bullous disease of the mucous membranes, which can cause irreversible scarring and is discussed to be associated with cancer, if laminin-332-autoantibodies are present. MMP with severe ocular and laryngeal involvement is difficult to treat and can be treatment-refractory to conventional immunosuppressant therapy. A 67-year-old man with a history of prostate cancer presented to our clinic with sore throat, intraoral bullae, odynophagia, dysphonia, exertional dyspnea, and erosions of the glans penis.

Study protocol: Care of Late-Stage Parkinsonism (CLaSP): a longitudinal cohort study.

Background: Parkinson's disease (PD) is a chronic progressive disorder leading to increasing disability. While the symptoms and needs of patients in the early stages of their disease are well characterized, little information is available on patients in the late stage of the disease.

Methods/design: The Care of Late-Stage Parkinsonism (CLaSP) study is a longitudinal, multicenter, prospective cohort study to assess the needs and provision of care for patients with late stage Parkinsonism and their carers in six European countries (UK, France, Germany, Netherlands, Portugal, Sweden).

An Examination of Adolescent Athletes and Nonathletes on Baseline Neuropsychological Test Scores.

Context:   An estimated 15.3 million adolescent students are enrolled in US high schools, with approximately 7.8 million participating in athletics.

U-shaped Relation between Prestimulus Alpha-band and Poststimulus Gamma-band Power in Temporal Tactile Perception in the Human Somatosensory Cortex.

Neuronal oscillations are a ubiquitous phenomenon in the human nervous system. Alpha-band oscillations (8-12 Hz) have been shown to correlate negatively with attention and performance, whereas gamma-band oscillations (40-150 Hz) correlate positively. Here, we studied the relation between prestimulus alpha-band power and poststimulus gamma-band power in a suprathreshold tactile discrimination task.

Serum levels of 9α,11β-PGF and apolipoprotein A1 achieve high predictive power as biomarkers of anaphylaxis.

Anaphylaxis is a life-threatening hypersensitivity reaction. To identify biomarkers for the condition, we assessed serum levels of apolipoprotein (Apo)A and ApoE. We found a reduction of both lipoproteins in anaphylactic mice as well as in orally challenged food allergic patients.

Placebo-Controlled, Double-Blind, Prospective, Randomized Study on the Effect of Octreotide LAR in the Control of Tumor Growth in Patients with Metastatic Neuroendocrine Midgut Tumors (PROMID): Results of Long-Term Survival.

Background: Somatostatin analogs have been shown to control the growth of well-differentiated metastatic neuroendocrine tumors. Their effect on overall survival is a matter of debate. We analyzed the prognostic significance of early treatment with octreotide LAR and of hepatic tumor load in the PROMID trial cohort.

A Challenging Penetrating Trauma Case.

We present the prehospital management of a 23-year-old Australian Aboriginal man with an isolated knife stab wound to the posterior right chest. The lead author attended to the prehospital management of this young man during tenure as a registrar in retrieval medicine for CareFlight Medical Services (CMS) in North Queensland, Australia. The case is noteworthy because it involved a combination of a life-threatening injury with a superimposed iatrogenic injury.