A red herring CVA with unexpected outcome: illustrative case

BACKGROUND Disruptions to the integrity of the inner table and trabeculae of the calvaria are rare phenomena. Increasingly rare is the phenomenon of herniation of brain parenchyma through the defects in the skull causing neurological deficit. Surgical intervention is commonly performed but is fraught with risk of brain tissue loss. OBSERVATIONS The authors present a case of a 78-year-old White male presenting with strokelike symptoms who was found to have an intradiploic encephalocele that was successfully treated with surgical intervention and neuroplastic reconstruction of the anatomical deficit. The patient had a marked recovery and had near-complete resolution of symptoms. LESSONS This notably rare phenomenon resolved with neurosurgical intervention, sparing the parenchyma, and provided the patient with perceivably normal contour of the head using a collaborative approach with neuroplastic intervention.

2-Imidazolidinone Benzofurans as Unexpected Outcome of the Lewis Acid-Mediated Nenitzescu Reaction

The Lewis acid mediated Nenitzescu reaction with piperazinone enaminoesters surprisingly afforded rearranged 2-imidazolidinone 5-hydroxybenzofurans. The reaction was optimised and a scope study was performed. A one-pot two-step procedure was realised...

Influence of Massage and Skin Hydration on Dermal Penetration Efficacy of Nile Red from Petroleum Jelly—An Unexpected Outcome

The study aimed at comparing the influence of direct and indirect skin hydration as well as massage on the dermal penetration efficacy of active compounds. Nile red was used as a lipophilic drug surrogate and was incorporated into Vaseline (petroleum jelly). The formulation was applied with and without massage onto either dry skin or pre-hydrated, moist skin. It was expected that the occlusive properties of Vaseline in combination with massage and enhanced skin hydration would cause a superposition of penetration-enhancing effects, which should lead to a tremendous increase in the dermal penetration efficacy of the lipophilic drug surrogate. Results obtained were diametral to the expectations, and various reasons were identified for causing the effect observed. Firstly, it was found that Vaseline undergoes syneresis after topical application. The expulsed mineral oil forms a film on top of the skin, and parts of it penetrate into the skin. The lipophilic drug surrogate, which is dissolved in the mineral oil, enters the skin with the mineral oil, i.e., via a solvent drag mechanism. Secondly, it was found that massage squeezes the skin and causes the expulsion of water from deeper layers of the SC. The expulsed water can act as a water barrier that prevents the penetration of lipophilic compounds and promotes the penetration of hydrophilic compounds. Based on the data, it is concluded that dermal penetration is a complex process that cannot only be explained by Fick’s law. It is composed of at least three different mechanisms. The first mechanism is the penetration of active ingredients with their solvents into the skin (convection, solvent drag), the second mechanism is the penetration of the active ingredient via passive diffusion, and the third mechanism can involve local penetration phenomena, e.g., the formation of liquid menisci and particle-associated penetration enhancement, which occur upon the evaporation of water and/or other ingredients from the formulation on top of the skin.

TXNRD1: A Key Regulator Involved in the Ferroptosis of CML Cells Induced by Cysteine Depletion In Vitro

Cysteine metabolism plays a critical role in cancer cell survival. Cysteine depletion was reported to inhibit tumor growth and induce pancreatic cancer cell ferroptosis. Nevertheless, the effect of cysteine depletion in chronic myeloid leukemia (CML) remains to be explored. In this work, we showed that cysteine depletion can induce K562/G01 but not K562 cell death in the form of ferroptosis. However, the glutathione (GSH)/glutathione peroxidase 4 (GPX4) pathways of the two CML cell lines were both blocked after cysteine depletion. This unexpected outcome guided us to perform RNA-Seq to screen the key genes that affect the sensitivity of CML cells to cysteine depletion. Excitingly, thioredoxin reductase 1 (TXNRD1), which related to cell redox metabolism, was significantly upregulated in K562/G01 cells after cysteine depletion. We further inferred that the upregulation is negatively feedback by the enzyme activity decrease of TXNRD1. Then, we triggered the ferroptosis by applying TXNRD1 shRNA and TXNRD1 inhibitor auranofin in K562 cells after cysteine depletion. In summary, we have reason to believe that TXNRD1 is a key regulator involved in the ferroptosis of CML cells induced by cysteine depletion in vitro. These findings highlight that cysteine depletion serves as a potential therapeutic strategy for overcoming chemotherapy resistance CML.

Ovarian hyperstimulation syndrome: cardiac arrest with an unexpected outcome

We describe the acute deterioration of a 29-year-old undergoing in vitro fertilisation. Late-onset critical ovarian hyperstimulation syndrome triggered a massive pulmonary embolism and subsequent cardiac arrest. While the prognosis was deemed to be poor, the patient made a full recovery. The potential reasons for this are explored.

An Act of Particular Providence - Newcomen’s Speedy Vacuum

Comparison of the only known account of the invention of cold water injection to activate an atmospheric engine with contemporary texts on experimental methodology reveals that Newcomen and Calley’s inventive process corresponds with the design of experiments prescribed by Robert Hooke for the Royal Society. Consequently, when an unexpected outcome occurred, they were able to make full application of the findings. Differences between the steam piston experiments of Newcomen and Denis Papin are explored, suggesting that the inventors may have been working in parallel.

CRISIS AND CRISIS MANAGEMENT IN ORGANIZATIONS, THE IMPORTANCE OF CRISIS AND CRISIS LEADERSHIP, THE EFFECTS OF THE COVID-19 PANDEMIC CRISIS PROCESS ON THE TURKISH ECONOMY

Crisis (crisis) are difficult situations that threaten the high-level goals and business methods of an organization, or put the organization's existence in a dangerous situation, require quick decisions, and neutralize problem prevention systems. In other words, crisis can be defined as an unexpected situation or events that have an unexpected outcome (Sikich, 2002). Crises are a turning point for businesses by enabling organizations to gain new experiences and acquire new knowledge, and to turn this situation into an opportunity (Demirtaş, 2000). The ability of organizations to achieve their goals and to maintain their existence depends on their ability to adapt to their environment and to regulate their business skills depending on the expectations of the environment. The constantly changing environment creates major problems for businesses that cannot adapt to these changes and cannot balance. The success of organizations depends to a large extent on their ability to recognize and assess these dangers beforehand. Organizations can face many threats that can come from within the business or from the business environment. Because of its negative effects, organization managers' ability to cope with these threats is of great importance for businesses (Can, 2002). Organization managers' leadership, experience, knowledge and skills are most needed in times of crisis. Because the most important responsibility of a leader manager is to successfully prevent the crisis that occurs in the organization. Managers exist to manage unexpected conditions and solve problems in organizations. For this reason, administratorship is the problem management process in organizations. The manager is the person who prevents this problem. Therefore, leading managers appear and show themselves especially in times of crisis (Peker & Ayturk, 2000). In this study, the characteristics of the crisis in organizations, the reasons for the emergence of the crisis and the crisis management processes in organizations are mentioned. Crisis management processes of organizations in potential crisis situations are examined.