An analysis of LysM domain function in LytE when fulfilling the D,L-endopeptidase requirement for viability in Bacillus subtilis

The D,L-endopeptidase requirement states that Bacillus subtilis requires either the activity of the LytE or the CwlO enzyme for viability, therefore proving that these two enzymes can complement for each other despite their very different N-terminal domains. Here, we show that another D,L-endopeptidase, LytF, can also fulfill the D,L-endopeptidase requirement for viability, when expressed from the cwlO promoter. Both LytE and LytF contain N-terminally located LysM domains, three and five respectively. However, cells expressing another very similar D,L-endopeptidase CwlS, with four LysM domains were not viable. This led us to investigate whether a LytE protein with any one of its three LysM domains permuted can fulfill the D,L-endopeptidase requirement for viability. We found that the three LysM domains are not functionally equivalent and that the N-terminally located LysM domain plays a greater role for functioning of the LytE enzyme than the subsequent domains. Based on an investigation of orthologous enzymes in 19 B. subtilis species we propose an evolutionary model describing the development of the LytE-, CwlS- and LytF-type D,L-endopeptidases and their LysM domain repeats. In summary, these results show that the LytE enzyme has been optimized to fulfill the D,L-endopeptidase requirement for cell viability of B. subtilis with regard to the number and properties of LysM domains that mediate peptidoglycan-binding.

Distribution and Source Sites of Nonlinear Internal Waves Northeast of Hainan Island

The distribution and source sites of nonlinear internal waves (NLIWs) northeast of Hainan Island were investigated using satellite observations and a wavefront propagation model. Satellite observations show two types of NLIWs (here referred to as type-S and type-D waves). The type-S waves are spaced at a semidiurnal tidal period and the type-D waves are spaced at a diurnal tidal period. The spatial distribution of the two types of NLIWs displays a sandwich structure in which the middle region is influenced by both types of NLIWs, and the northern and southern regions are governed by the type-S and type-D waves, respectively. Solving the wavefront model yields good agreement between simulated and observed wavefronts from the Luzon Strait to Hainan Island. We conclude that the NLIWs originate from the Luzon Strait.

CD8+ mycosis fungoides: A wolf in sheep’s clothing?

Sir, CD8+ mycosis fungoides (MF) is a rare form of MF with an indolent course. Herein, we report a rare case of CD8+ fungoid mycosis preceded by lymphomatoid papulosis type D with an aggressive course. A 36-year-old female presented with several papular lesions on the trunk and extremities with a relapsing–remitting course. Histopathology and an immunohistochemical study confirmed CD8-positive lymphomatoid papulosis type D and methotrexate at 25 mg/week was initiated. After a temporary clinical improvement, the lesions worsened, became infiltrated, and grouped as vaguely annular and angular patches with serpiginous borders (Fig. 1). A second scalp biopsy was performed and a diagnosis of CD8+ MF was established. An extension workup was normal, and MF was classified as stage IB. PUVA therapy was started with acitretin at 25 mg/day. After four weeks from the beginning of treatment, the patches completely disappeared but with the concomitant appearance of four subcutaneous tumors. The evolution was spectacular in fifteen days, with the tumors rapidly increasing in size, becoming ulcerative and necrotic, and one being localized in the left cervical area compressing the upper respiratory tract (Fig. 2). A subsequent biopsy revealed massive epidermal and dermal large cell infiltration (Fig. 3a); the tumor cells were positive for CD3, CD8, and CD7 (Fig. 3b) and negative for CD4, CD5, CD3, CD2, and CD30. Antigen Ki-67 was expressed by more than 80% of T-cells (Fig. 3c). A cerebral and thoraco-abdominal CT scan revealed multiple axillary lymph nodes with hypermetabolism on a PET scan. An osteomedullar biopsy was normal, and lactate dehydrogenase (LDH) was increased to 358 U/L. Chemotherapy was performed, but the patient died after two cycles of CHOEP. In contrast to classical CD4+ mycosis fungoides, CD8+ MF is a rare cytotoxic phenotype constituting about 5% of all cases of MF [1]. It belongs to the first group of primary cytotoxic cutaneous lymphomas (PCCL) with a good prognosis, an indolent course, and a slow progression of the lesions over several years [2]. However, rare cases with a more aggressive course have been reported in the literature [3]. The main differential diagnosis of aggressive CD8+ MF is an aggressive epidermotropic cutaneous CD8+ lymphoma that is a rare cutaneous lymphoma with a poor prognosis due to rapid extracutaneous dissemination [4]. The prognosis of the CD8+ subtype of mycosis fungoides (MF) is controversial. More studies are necessary to clarify this subject.

The Role of Type D Personality in Acute Coronary Syndrome

Introduction: Acute Coronary Syndrome (ACS) is one of the most common causes of death in patients with Cardiovascular Diseases (CVD). In addition to the known physical factors influencing the incidence of CVD, some psychologists have pointed to the role of psychological factors such as personality type. Objective: This study aimed to determine the role of type D personality in ACS patients in Iran in 2019. Materials and Methods: In a case-control study, 112 participants were included. A total of 56 patients with ACS were compared with 56 matched people without ACS. They were selected by the convenience sampling method. Type D scale 14 (DS14) was used to assess the type D personality. The Chi-squared test, independent t-test, and multivariate logistic regression were used to analyze the obtained data. Results: The Mean±SD age in the case group was 57.23±8.562 years, and in the Mean±SD age in the control group was 57.25±8.529 years. Also, most participants in both groups were men (71.4%). The result showed that type D personality was more prevalent in patients with ACS (26% vs 7.1%; P=0.006). Based on multivariate regression analysis and after controlling for demographic and clinical risk factors, type D personality was independently associated with ACS (OR=5.323, 95% CI; 0.987-28/712, P=0.052). Also, after investigating subscales, only social inhibition had a significant association with ACS (P=0.008). Conclusion: Type D personality is an independent risk factor of the ACS. Thus, type D personality may make people vulnerable to the ACS. Therefore, besides medical interventions, clinicians must consider behavioral interventions to reduce the incidence of ACS.

Association between Type-D Personality and Affective (Anxiety, Depression, Post-traumatic Stress) Symptoms and Maladaptive Coping in Breast Cancer Patients: A Longitudinal Study

Background: Type-D (distressed) personality has not been prospectively explored for its association with psychosocial distress symptoms in breast cancer patients. Objective: The objective of the study was to test the hypothesis that Type-D personality can be associated with psychosocial distress variables in cancer over a 2-point period (6 month-follow-up). Aims: The aim of the study was to analyze the role of Type-D personality in relation to anxiety, depression, post-traumatic stress symptoms, general distress, and maladaptive coping among cancer patients. Methods: 145 breast cancer patients were assessed within 6 months from diagnosis (T0) and again 6 months later (T1). The Type-D personality Scale, the Hospital Anxiety and Depression Scale, Depression subscale (HAD-D), the Brief Symptom Inventory (BSI-18) Anxiety subscale, the Distress Thermometer (DT), the Post-traumatic Symptoms (PTS) Impact of Event Scale (IES), and the Mini Mental Adjustment to Cancer (Mini-MAC) Anxious Preoccupation and Hopelessness scales were individually administered at T0 and T1. Results: One-quarter of cancer patients met the criteria for Type-D personality, which was stable over the follow-up time. The two main constructs of Type-D personality, namely social inhibition (SI) and negative affectivity (NA), were related to anxiety, depression, PTS, BSI-general distress and maladaptive coping (Mini-MAC anxious preoccupation and hopelessness). In regression analysis, Type-D SI was the most significant factor associated with the above-mentioned psychosocial variables, both at T0 and T1. Conclusion: Likewise other medical disorders (especially cardiology), Type-D personality has been confirmed to be a construct significantly related to psychosocial distress conditions and maladaptive coping that are usually part of assessment and intervention in cancer care. More attention to personality issues is important in oncology.

Surgical treatment of glossopharyngeal nerve schwannomas: Results of two-center study (14 patients included) and literature review

Objective: This study is aimed to analyze the outcomes of surgical treatment of glossopharyngeal schwannomas based on pre- and postoperative neurological status assessment. Materials and methods: This paper is a retrospective analysis of examination and surgical treatment of 14 patients who were operated on in two large clinics from 2018 to 2021 inclusive. When analyzing the collected data, gender, age, disease symptoms, tumor size and location, surgical approach, tumor to cranial nerves (CN) ratio, jugular foramen (JF) condition, and tumor removal volume were taken into account. All tumors were divided into groups depending on tumor location relative to the JF. Particular attention was paid to assessing cranial nerves functions. Facial nerve function was assessed as per House-Brackmann Scale (HBS), hearing function as per Gardner-Robertson Scale (GRS). Results: 3 (21.4%) patients had total tumor removal: 2 patients had type A tumors and one had type B tumor. Subtotal resection took place in 7 (50%) cases. In 4 cases, a tumor was partially removed: 3 patients had type D tumors and one had type B tumor. 3 (21.4%) patients had preoperative FN deficit (HBS Grade II) and mild dysfunction. 5 (35.7%) patients had postoperative facial nerve deficit: HBS ІІ, 2; ІІІ, 1; V, 2. Preoperative sensorineural type hearing impairment on the affected side was diagnosed in 13 (92.6%) patients. Before surgery, 6 patients had non-serviceable hearing, which remained at the same level after surgery. None of the patients with grade I or II hearing before surgery had any hearing impairment postoperatively. In 2 (14.3%) cases, hearing improved from grade V to grade III after surgery. 6 (42.9%) patients developed new neurological deficit in the caudal group CN. Postoperative deficit of the caudal group CN occurred in type D tumors in 3 patients, type A tumors 2 patients, and type B tumors one patient. Conclusions: Applying a retrosigmoid approach only makes it possible to achieve total tumor removal in case of type A tumors. To remove other tumor types, it is necessary to select approaches that enable access to the jugular foramen and infratemporal fossa. Intraoperative neurophysiological monitoring is an extremely important tool in glossopharyngeal schwannoma surgery. The most common postoperative complication is a developed or increased deficit of the caudal CN group, which can lead to persistent impairments in the patients’ quality of life. Preservation of the CN VII and VIII function in most cases is a feasible task and shall be ensured as a standard for this pathology.

Relationship of Type D Personality to Adverse Health Outcomes in People with Type 2 Diabetes: Parallel Mediating Effects of Diabetes Distress and Social Isolation

Background: This study aims to investigate the relationship of Type D personality to glycated hemoglobin (HbA1c) and health-related quality of life (HRQOL) directly, and also indirectly via diabetes distress and social isolation in people with type 2 diabetes.Methods: Secondary data analysis of a cross-sectional survey was used. Data on 524 people with type 2 diabetes from outpatient clinics were obtained from June 2020 to February 2021. The hypotheses of this study were tested using the PROCESS macro with 10,000 bootstrapping iterations to estimate 95% confidence intervals (CIs) for indirect (mediating) effects.Results: Type D personality was present in 31.3% of the participants, and exerted a significant direct effect on HRQOL but not on HbA1c. Type D personality exerted a significant indirect effects on HbA1c via diabetes distress and social isolation (95% CI = 0.014 to 0.163 and 0.007 to 0.121, respectively), and on HRQOL via diabetes distress and social isolation (95% CI = -0.335 to -0.178 and -0.056 to -0.008, respectively). The indirect effects of Type D personality on HRQOL via diabetes distress had a greater magnitude than that via social isolation.Conclusion: It is necessary for health professionals to monitor people with type 2 diabetes to determine whether Type D personality is present. Those with Type D personality should be provided with interventions to reduce diabetes distress and alleviate social isolation in order to improve their glycemic control and HRQOL.

The Importance of Type D Personality in the Development of Temporomandibular Disorders (TMDs) and Depression in Students during the COVID-19 Pandemic

Background: a type D personality is a factor in a person’s susceptibility to general mental stress, especially during the COVID-19 pandemic. Although many studies were conducted on the relationships among stressful situations, an individual’s personality, depression, and the occurrence of various diseases, e.g., cardiovascular disease or cancer, there are no analogous data on people with temporomandibular disorders (TMDs). Aim: the assessment of TMDs and depression symptoms in students with type D personality. Material and Methods: the research was carried out with the participation of 240 physiotherapy students. The study group (G1) consisted of 120 participants with type D personalities, the control group (G2) consisted of the same number of participants, without “stress” personalities. All subjects were assessed for the occurrence of TMD symptoms, as well as for depression and anxiety symptoms, using the Beck Depression Inventory (BDI), based on the proprietary questionnaire. Results: in students with type D personality symptoms, TMDs occurred significantly more often and in greater number (p = 0.00) than in those without stress personalities. The exception was the symptom of increased muscle tension, which showed no statistical difference (p = 0.22). Among the 240 respondents, depression was found in 128 people (53.3%). In the group of students with type D personalities, depression was significantly more frequent than in the group without type D personalities (p = 0.00). In participants with depression, TMD symptoms were more common, i.e., headaches, neck, and shoulder girdle pain, TMJ acoustic symptoms, increased masticatory muscle tension, teeth clenching, and teeth grinding. There was no significant difference between the incidence of depression and TMJ pain and jaw locking. There was a significant interaction between the occurrence of headaches and acoustic symptoms and the occurrence of depression. For headache and depression interactions, the OR was >1; based on the results, we may assume that a headache depends more on the occurrence of depression rather than it being a symptom of a TMJ disorder in people with type D personalities. Conclusion: type D personality and depression may contribute to the development of TMD symptoms.