Search

A method of generating THz radiation by nonlinear mixing of lasers obliquely incident on a finite slab of overdense plasma is formulated analytically. The incoming laser beam exerted a ponderomotive force on free electrons, which started oscillating at a frequency equal to the frequency difference of two laser beams. This results in a nonlinear current leading to THz radiation generation at the reflection as well as at the transmission side of the plasma slab. We have seen the effect of incident angle on the amplitudes of reflected and transmitted amplitudes of generated THz radiation. It is observed that the thickness of the slab and plasma density are the contributing parameters for the intensity of THz radiation generation.

This study describes the relativistic q-Gaussian laser beam's stimulated Raman scattering (SRS) in an unmagnetized plasma. Moreover, the influence of the pump laser's relativistic self-focusing on the SRS process has been investigated. Using variational theory, we derived analytical solutions to the coupled nonlinear wave equations describing the pump, EPW, and scattered waves. The resulting equations were numerically solved to see the impacts of laser and plasma characteristics on the dynamics of the pump beam and its influence on the power of scattered waves. The power of the scattered wave was observed to be significantly altered via the self-focusing action of the pump beam, where when the effect of self-focus increases, it leads to an increase in the effect of stimulated Raman scattering. The stimulated Raman scattering yield is investigated based on the laser beam's and plasma's intensity. The main finding is that as q increases, the SRS yield increases, and as the intensity of the laser beam and plasma density increase, the SRS yield also increases. The scattering of the self-focused beam takes place at a greater distance than the beam of the pump, due to the relatively diminished level of scattered power. The value of the integrated reflection increases with the increase of q and the growth rate.

The application of liquid bacterial inoculants along with the recommended dose of chemical fertilization improved the quality of forage oats at Bathinda and Ludhiana. The best quality attributes were observed with the treatment T11 (RDF + B. seminalis + S. maltophilia) with significant improvement in the crude protein (9.23 and 8.92%), ADF content (33.10 and 33.50%) and IVDMD (71.66 and 70.20%) at Bathinda and Ludhiana respectively. Further, correlation studies showed positive and significant correlation between ADF and NDF and the negative correlation with the rest of the quality attributes. Therefore, it is believed that liquid bacterial inoculants can play a significant role in ameliorating the forage oats quality, thus can help to enhance the overall animal productivity. In addition, potential of these liquid bacterial inoculants can be explored in integrated nutrient management or organic cultivation of forage oats as well as in other crops.

Nitrous oxide is a commonly used inhaled anesthetic for medical procedures, as well as a drug of abuse throughout the world. Excessive nitrous oxide inhalation has been shown to cause a functional vitamin B12 deficiency and hyperhomocysteinemia, which can lead to peripheral neuropathy and hypercoagulability, respectively. While the development of neurologic toxicity from chronic nitrous oxide abuse (i.e., encephalopathy, myelopathy, and neuropathy) has been previously described, the thrombotic potential of chronic nitrous oxide abuse is less known. The authors report two cases of nitrous oxide abuse leading to both neurologic and thrombotic complications.

Abstract Background Encephaloceles are herniation of brain parenchyma through the defect in the dura and the skull bones. This case report reveals a rare association of frontonasal encephalocele, subependymal nodular heterotopias and cerebellar dysplasia with review of literature. Case presentation Frontonasal encephalocele is a rare entity. We report an 18-months-old male child who presented to the department of pediatrics with chief complaint of congenital swelling in the region of forehead. Swelling was increasing in size as told by the parents of the child. The child was born full term with normal vaginal delivery. There was no history of any obstetrical complications. The swelling was soft, transilluminant and pulsatile in nature. He was referred to the department of radio diagnosis for imaging evaluation. His CT and MRI images revealed defect in the anterior cranial fossa with herniation of meninges and brain parenchyma through it. There was also evidence of subependymal nodular heterotopias in this patient along with hypoplasia of left cerebellar hemisphere and left middle cerebellar peduncle with left cerebellar dysplasia. Conclusions This case report describes the coexistence of frontonasal encephaloceles, subependymal nodular heterotopias and cerebellar dysplasia, which is a very rare association.

Rural school principals often face issues of professional isolation and lack of access to leadership development opportunities. To address these challenges, the Elgin Children’s Foundation launched its Principal Support Program (PSP) in 2017 to support the development of effective school leaders in three states with high rural student populations in the Appalachian region. The PSP posited four components as essential for principal development: professional development, networking, mentoring, and learning plans. The aim of this qualitative study was to determine what PSP participants believed to be the most effective in terms of principal development. Results indicate that because of PSP training, rural principals grew from managers to instructional leaders and changed their mindsets and practices regarding shared leadership. Principals believed that they benefited most from the networking and coaching that the PSP provided. Future professional development for rural principals should consider a focus on opportunities to learn with and through others.

Objectives: Quality of life (QOL) among caregivers of cancer patients is often diminished. For lower-income caregivers, the deterioration in QOL may be of greater impact. We aimed to evaluate QOL among lower-income cancer caregivers in Delhi, India and to comprehensively review similar investigations conducted internationally. Methods: A Hindi-version of the Caregiver Quality of Life Cancer (CQOLC) index was administered to 89 caregivers of lung cancer patients. Bivariate analyses were employed to evaluate associations between baseline demographics and CQOLC index scores. A systematic review of PubMed, EMBASE, and PsychInfo was undertaken. Results: Reduced QOL was observed for caregivers residing in homes earning less than our center’s median annual income per capita (p < 0.01) and for caregivers providing aid for 4 months or longer (p < 0.01). The burden of caregiving contributed most to summative index scores (p < 0.01). Eleven studies were selected by systematic review. Lower-income caregivers in Asia and the Middle East experience reduced QOL and increased burden. Available evidence does not suggest that lower-income caregivers in Europe and North America share worse QOL. Conclusion: Lower-income caregivers suffer loss in QOL, particularly in the developing world. Resourceful interventions are warranted to mitigate burden for this underappreciated population.

Plant-based bioactive compounds have been utilized to cure diseases caused by pathogenic microorganisms and as a substitute to reduce the side effects of chemically synthesized drugs. Therefore, in the present study, Azadirachta indica oil nanohydrogel was prepared to be utilized as an alternate source of the antimicrobial compound. The total phenolic compound in Azadirachta indica oil was quantified by chromatography analysis and revealed gallic acid (0.0076 ppm), caffeic acid (0.077 ppm), and syringic acid (0.0129 ppm). Gas chromatography–mass spectrometry analysis of Azadirachta indica oil revealed the presence of bioactive components, namely hexadecenoic acid, heptadecanoic acid, ç-linolenic acid, 9-octadecanoic acid (Z)-methyl ester, methyl-8-methyl-nonanoate, eicosanoic acid, methyl ester, and 8-octadecane3-ethyl-5-(2 ethylbutyl). The nanohydrogel showed droplet size of 104.1 nm and −19.3 mV zeta potential. The nanohydrogel showed potential antimicrobial activity against S. aureus, E. coli, and C. albicans with minimum inhibitory, bactericidal, and fungicidal concentrations ranging from 6.25 to 3.125 (µg/mL). The nanohydrogel showed a significantly (p < 0.05) higher (8.40 log CFU/mL) value for Gram-negative bacteria E. coli compared to Gram-positive S. aureus (8.34 log CFU/mL), and in the case of pathogenic fungal strain C. albicans, there was a significant (p < 0.05) reduction in log CFU/mL value (7.79–6.94). The nanohydrogel showed 50.23–82.57% inhibition in comparison to standard diclofenac sodium (59.47–92.32%). In conclusion, Azadirachta indica oil nanohydrogel possesses great potential for antimicrobial and anti-inflammatory activities and therefore can be used as an effective agent.

Here, we report on a phase IIa study to determine the intubation rate, survival, viral clearance, and development of endogenous Abs in patients with COVID-19 pneumonia treated with convalescent plasma (CCP) containing high levels of neutralizing anti–SARS-CoV-2 Abs. Radiographic and laboratory evaluation confirmed all 51 treated patients had COVID-19 pneumonia. Fresh or frozen CCP from donors with high titers of neutralizing Abs was administered. The nonmechanically ventilated patients (n = 36) had an intubation rate of 13.9% and a 30-day survival rate of 88.9%, and the overall survival rate for a comparative group based on network data was 72.5% (1625/2241). Patients had negative nasopharyngeal swab rates of 43.8% and 73.0% on days 10 and 30, respectively. Patients mechanically ventilated had a day-30 mortality rate of 46.7%; the mortality rate for a comparative group based on network data was 71.0% (369/520). All evaluable patients were found to have neutralizing Abs on day 3 (n = 47), and all but 1 patient had Abs on days 30 and 60. The only adverse event was a mild rash. In this study on patients with COVID-19 disease, we show therapeutic use of CCP was safe and conferred transfer of Abs, while preserving endogenous immune response.

Introduction: Neonatal septicaemia is a significant cause of morbidity and mortality in newborn infants. It often presents a diagnostic challenge in the resource poor setting of most developing countries. Aim: To determine the efficacy of C-Reactive Protein (CRP) and Immature Neutrophil Count (INC) to Total Neutrophil Count (TNC) ratio (I/T ratio) in the early diagnosis of neonatal sepsis. Materials and Methods: This prospective observational study included all term and preterm babies inborn and out born referred cases. The babies less than seven days of age with clinical symptoms and signs of suspected neonatal sepsis were included. Significant values for screening tests were taken as Total Leucocyte Count (TLC) of >25,000/0.2 and CRP positive (>0.6 mg/dL). Sepsis screen was considered positive for two or more positive tests. Blood culture was used as gold standard. The statistical analysis was done by Chi-square, Fisher’s exact and ANOVA tests using SPSS 20.0 version. Results: A total number of 60 subjects were included in the study with 45 (75%) as outborn neonates. Most of the neonates presented with tachypnea 27 (45%), 11(18.3%) with difficulty in feeding and 10 (16.7 %) with lethargy. Significant p-values were observed using CRP and ITR as independent sepsis screening markers. The combination of CRP with I/T ratio showed positive correlation with blood culture (p-value 0.016). Conclusion: Sepsis screen in neonates is required for detection of infection as blood culture may be negative and even positive result takes few hours. C-reactive protein showed high sensitivity while I/T ratio was found to be highly specific.

Introduction. Early-onset neonatal sepsis is a major cause of morbidness and death in newborn children. Its timely diagnosis is usually a challenge in developing countries like India. Aim. To study the efficacy of C-reactive protein (CRP), micro-ESR, and gastric aspirate for polymorphs in the diagnosis of early-onset neonatal sepsis. Materials and Methods. This study included sixty term and preterm children, inborn and referred cases. The children who presented before day seven of life with clinical suspicion of sepsis or who were at high risk of developing sepsis were included. These were further investigated. Significant values for screening tests were taken as C−reactive protein>0.6 mg/dl, micro-ESR—after 1 hour, fall in the column of blood in capillary tube was measured, and result was taken as mm fall in 1 hr, and gastric aspirate for polymorphs>5 polymorphs/HPF. Sepsis screen positive result was 2 or more positive tests. The statistical evaluation was done using Fisher, and ANOVA tests using SPSS 20.0 version. Results. Sixty children were included in the study with forty as the referred ones. Most of them had tachypnea (45%). CRP showed high sensitivity, whereas micro-ESR and gastric aspirate for polymorphs showed high specificity. Conclusions. Neonatal sepsis screening is required for the detection of infection as the blood culture report may not be positive in all the cases, and even if positive, the result takes few hours. CRP showed high sensitivity, whereas micro-ESR and gastric aspirate for polymorphs showed high specificity independently as well as when combined.

The rising demand for popcorn necessitates improving the popping quality with higher yield of popcorn cultivars. Towards this direction several Quantitative Traits Loci (QTLs) for popping traits have been identified. However, identification of accurate and consistent QTLs across different genetic backgrounds and environments is necessary to effectively utilize the identified QTLs in marker-assisted breeding. In the current study, 99 QTLs related to popping traits reported in 8 different studies were assembled and projected on the reference map "Genetic 2005" using BioMercator v4.2 to identify metaQTLs with consistent QTLs. Total ten metaQTLs were identified on chromosome 1 (7 metaQTLs) and 6 (3 metaQTLs) with physical distance ranging between 0.43 and 12.75 Mb, respectively. Four identified metaQTLs, viz., mQTL1_1, mQTL1_5, mQTL1_7 and mQTL6_2 harboured 5-8 QTL clusters with moderately high R2 value. The clustered QTLs were from two or more experiments. Based on the expression pattern in endosperm and pericarp tissues, a total of 229 genes were selected. Nineteen of these genes are involved in carbohydrate metabolism. Of the 19 genes specifically involved in carbohydrate metabolism, 11 of them were in these regions, implying the importance of these clustered QTLs. MetaQTL1_1 at bin location 1.01 coincided with the reported QTLs related to various agronomic traits like stalk diameter, tassel length, leaf area and plant height. The identified metaQTLs can be further explored for fine mapping and candidate gene identification, which can be validated by loss or gain of function. Identified metaQTLs can be used for introgression of popping traits towards enhancing the popping ability.

Aim of the study: High-resolution ultrasonography of the tibial nerve is a fast and non invasive tool for diagnosis of diabetic peripheral neuropathy. Our study was aimed at finding out the correlation of the cross sectional area and maximum thickness of nerve fascicles of the tibial nerve with the presence and severity of diabetic peripheral neuropathy. Material and methods: 75 patients with type 2 diabetes mellitus clinically diagnosed with diabetic peripheral neuropathy were analysed, and the severity of neuropathy was determined using the Toronto Clinical Neuropathy Score. 58 diabetic patients with no clinical suspicion of diabetic peripheral neuropathy and 75 healthy non-diabetic subjects were taken as controls. The cross sectional area and maximum thickness of nerve fascicles of the tibial nerves were calculated 3 cm cranial to the medial malleolus in both lower limbs. Results: The mean cross sectional area (22.63 +/– 2.66 mm2 ) and maximum thickness of nerve fascicles (0.70 mm) of the tibial nerves in patients with diabetic peripheral neuropathy compared with both control groups was significantly larger, and statistically significant correlation was found with the Toronto Clinical Neuropathy Score (p < 0.001). The diabetic patients with no signs of peripheral neuropathy had a larger mean cross sectional area (14.40 +/– 1.72 mm2 ) and maximum thickness of nerve fascicles of the tibial nerve (0.40 mm) than healthy non-diabetic subjects (12.42 +/– 1.01 mm2 and 0.30 mm respectively). Conclusion: The cross sectional area and maximum thickness of nerve fascicles of the tibial nerve is larger in diabetic patients with or without peripheral neuropathy than in healthy control subjects, and ultrasonography can be used as a good screening tool in these patients.

Pummelo (Citrus maxima L.) is a natural, mono-embryonic and a true fruit species of genus Citrus cultivated widely in India. The study aimed at developing in vitro technique for conservation of Citrus maxima germplasm using shoot tip and nodal section as explants. Various concentrations and combination of hormones were used for successful in-vitro conservation. The shoots sprouted within 9-20 days when inoculated on MS medium supplemented with 0.5 mg/l BAP + 0.1 mg/l NAA growth hormones and above 86% germination was obtained with maximum numbers of shoots (8) and nodes (8.67). Highest shoot elongation (82%) was observed in MS medium supplemented with concentration of 0.6 mg/l GA3 in combination with 0.2 mg/l BAP, shoot length ranged between 1.17 to 6.90 cm and the number of nodes was 2.33-8.33 per plantlet. 1/2 MS medium supplemented with 0.5 mg/l BAP +1.0 mg/l NAA along with 2.5 g phytagel showed best result for rooting (78.33%). The regenerated plantlets did not show any detectable morphological variation at genetic level as evidenced by SSR profiles of plantlets. The developed protocol can be successfully employed for large-scale multiplication and conservation of Pummelo germplasm.

West Nile Virus (WNV) first arrived in Ontario, Canada in 2001 and has since spread throughout most of the province, causing disease in humans. The provincial government established a province-wide surveillance program to monitor WNV transmission throughout the 36 regional health units. Here we have acquired records of WNV human and mosquito surveillance from 2002 to 2013 to describe seasonal and geographic trends in WNV activity in southern Ontario. Additionally, we obtained climate data from seven municipalities to investigate how temperature and precipitation affect WNV transmission dynamics. We identified a strong quadratic relationship between the number of confirmed human cases and positive Culex mosquito pools recorded at the end of each year (R2 = 0.9783, p < 0.001). Using Spearman rank correlation tests, we identified that the minimum infection rate of Culex pipiens/restuans pools are the strongest predictor of human cases at a 1 week lag period. We also identified positive correlations between minimum infection rates, temperature, vector abundance, and cumulative precipitation. Global Moran's I index indicates strong positive autocorrelation and clustering of positive Culex pool counts in southern Ontario. Local indicators of spatial association tests revealed a total of 44 high-high and 1 high-low trap locations (n = 680). In the current work we have identified when and where hot spots of WNV activity have occurred in southern Ontario. The municipalities surrounding the western shore of the Lake Ontario and Windsor-Essex County have the largest records of positive mosquitoes and human cases. We identified that positive mosquitoes are a strong indicator of human cases to follow in the coming weeks. An epidemic action threshold of cumulative positive Culex pools was established, allowing Ontario public health officials to predict an epidemic at epidemiological week 34 (rho = 0.90, p < 0.001). These data have the potential to contribute to more efficient larvicide programs and awareness campaigns for the public.

Post herpetic neuralgia (PHN) is a chronic neuropathic pain in the region of the herpes zoster (HZ) rash, persisting after the cutaneous lesions have healed. Despite numerous treatment advances, many patients remain refractory to the current therapies and continue to have pain, physical and psychological distress. In this review, we will discuss the current strategies for prevention and management of this disease, as also the insight into the future probabilities.

It is beyond debate that the way one perceives oneself is influenced by the way one speaks to oneself. Becoming aware of the conversations that take place within the mind has the potential to assist one in recognizing whether the internal voice is self-limiting or self-encouraging. Making classrooms places where teachers and learners are inviting to themselves and each other is a key aspect of invitational theory and practice. My intent in this paper is to (1) discuss the influential role of the inner voice in shaping the experiences of teachers and students in classrooms, (2) introduce the art of transformation in their internal dialogue through ongoing self-reflection, monitoring, and revisions to the ways they speak to themselves, and (3) highlight the practical implications in classroom settings. The paper invites teachers and students to envision themselves in positive ways by promoting the transformation of negative, unhealthy, and irrational self-talk to inner communication that is positive, productive, and rational.

This study involved the development, implementation, and assessment of a comprehensive schoolwide mailing program as a practical tool to communicate enthusiasm towards writing to children and actively engage them in letter writing. The author played the dual role of teacher-researcher and worked for one school year with one teacher from each grade level from grade 1 to grade 5. The objective of the study was to explore the relationship between an innovative mailing program and children's attitudes towards letter writing. This study employed both qualitative (conference with teachers) and quantitative (survey) methods. The author initiated the study with a presentation to the teachers (during a staff meeting) and to the children (in an assembly), systematically collected feedback from teachers to assess the program throughout the year, informed parents (through school newsletters), and assessed children's attitudes towards both writing and letter writing at the beginning and end of the program. It was anticipated that the program would provide children with authentic writing experiences, foster positive attitudes towards writing, enhance their literacy skills, and in turn strengthen a "friendship culture" in the school by being coparticipants as readers and writers in the letter writing process. Data analysis indicated that children enjoyed the responsive letter writing process and that their self-perceptions as writers and their writing skills improved. Results support the introduction of an elementary school mailing program as a means to cultivate and strengthen positive relationships between pupils and invite family participation.

Background: The present investigation was accepted to study the impact of liquid microbial inoculants on the quality parameters of forage cowpea (Vigna unguiculata). There upon, the field experiment was conducted during kharif 2018 at Punjab Agricultural University, Regional Research Station, Bathinda and at Department of Plant Breeding and Genetics, Punjab Agricultural University, Ludhiana, Punjab respectively. Methods: The experiment was laid out in randomized complete block design with a total of eleven treatment combinations of liquid microbial inoculants (Burkholderia seminalis, Burkholderia sp. and Bradyrhizobium sp.) with 75% and 100% RDF and replicated thrice. The qualitative properties including crude protein (CP), neutral detergent fibre (NDF), acid detergent fibre (ADF), in-vitro dry matter digestibility (IVDMD), total soluble sugars and ash content were determined on the forage samples. Result: The results indicated that the treatment T10 (75% RDF + Burkholderia sp. + Burkholderia seminalis) has reduced ADF% and NDF% at both the locations. Forage with high ADF and NDF% content tends to have low digestibility, low ADF and NDF% is desirable. In addition, treatment T10 showed significantly (p<0.05) improved IVDMD (79.98%) and total sugars (15.82 mg/g) at Ludhiana and at Bathinda, T10 treatment significantly escalated crude protein (19.93%), total ash content (11.55%), total chlorophyll content (2.07 mg/g) and total sugars (15.80 mg/g). Further correlation studies showed highly significant positive correlation among ADF% and NDF% and there negative correlation with all other quality components at both the locations. Consequently, liquid microbial inoculants can play pertinent role in ameliorating fibre quality and interrelation between the various quality parameters proposed that forage with low ADF% and NDF% can be selected for simultaneous amelioration in different attributes of quality. [ABSTRACT FROM AUTHOR]

It is beyond debate that the way one perceives oneself is influenced by the way one speaks to oneself. Becoming aware of the conversations that take place within the mind has the potential to assist one in recognizing whether the internal voice is self-limiting or self-encouraging. Making classrooms places where teachers and learners are inviting to themselves and each other is a key aspect of invitational theory and practice. My intent in this paper is to (1) discuss the influential role of the inner voice in shaping the experiences of teachers and students in classrooms, (2) introduce the art of transformation in their internal dialogue through ongoing self-reflection, monitoring, and revisions to the ways they speak to themselves, and (3) highlight the practical implications in classroom settings. The paper invites teachers and students to envision themselves in positive ways by promoting the transformation of negative, unhealthy, and irrational self-talk to inner communication that is positive, productive, and rational. [ABSTRACT FROM AUTHOR]

We carried out deconvolution of the molecular weight distribution curves from gel permeation chromatography for polyolefins into individual active sites considering Flory distribution by an evolutionarycomputingbased realcoded genetic algorithm, a nonlinear multivariate optimization algorithm. We applied the deconvolution to homopolymers of 1octene synthesized using heterogeneous Ziegler–Natta catalysts with different amounts of hydrogen. The molecular weight distribution was deconvoluted in to five Flory distributions, which showed a sensitivity to hydrogen amounts. With no hydrogen presence, the peaks corresponding to highmolecularweight fractions were intense. As the amount of hydrogen was increased, not only did the intensities of the highmolecularweight peaks decrease, but also peaks corresponding to lowmolecularweight fractions were observed. The method allowed us to determine the active site distribution of the polymer molecular weight distribution obtained from gel permeation chromatography. © 2010 Wiley Periodicals, Inc. J Appl Polym Sci, 2010 [ABSTRACT FROM AUTHOR]

This study involved the development, implementation and assessment of a comprehensive home-reading program as a practical means to communicate reading strategies to parents and actively engage them in their children's reading at home. The author played the dual role of teacher-researcher, and worked with parents and students from a Grade 1 classroom during a one-year time frame. The objective of the study was to explore the relationship between parental support at home in a home-reading program and children's reading levels. Employing both qualitative and quantitative methods, the author initiated the study with an interactive literacy night presentation, provided guidance to parents through monthly classroom newsletters, systematically collected feedback from parents throughout the year and assessed children's reading at the end of each term. It was anticipated that parents would feel informed by the reading strategies being taught in the classroom and in turn be empowered to take an active role in assisting their children with their reading at home. Data interpretation indicated that parents welcomed guidance from teachers in supporting their children with reading at home and that student reading levels were positively influenced through their active involvement. Results support the importance of parent involvement at home in children's early reading. [ABSTRACT FROM AUTHOR]

Summary Birinapant is a smac-mimetic (SM) in clinical trials for treating cancer. SM antagonize inhibitor of apoptosis (IAP) proteins and simultaneously induce tumor necrosis factor (TNF) secretion to render cancers sensitive to TNF-induced killing. To enhance SM efficacy, we screened kinase inhibitors for their ability to increase TNF production of SM-treated cells. We showed that p38 inhibitors increased TNF induced by SM. Unexpectedly, even though p38 is required for Toll-like receptors to induce TNF, loss of p38 or its downstream kinase MK2 increased induction of TNF by SM. Hence, we show that the p38/MK2 axis can inhibit or promote TNF production, depending on the stimulus. Importantly, clinical p38 inhibitors overcame resistance of primary acute myeloid leukemia to birinapant. [ABSTRACT FROM AUTHOR]

A 70-year-old woman with lung metastases from a breast cancer presented with worsening cough and dyspnoea. She recently had a pleurodesis for a malignant pleural effusion. Chest CT scans demonstrated various radiological changes leading to diagnostic challenges. Differential diagnoses included empyema, pleural disease progression, pulmonary oedema, pneumonitis, lymphangitis and atypical infections. She deteriorated despite a multimodality treatment strategy. Postmortem examination confirmed that lung changes were consistent with a bronchoalveolar carcinoma unrelated to the known metastatic breast cancer. The eventual knowledge of this diagnosis was reassuring to the treating medical team and a comfort to the relatives who witnessed the lack of response to standard treatment., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2018. No commercial re-use. See rights and permissions. Published by BMJ.)

Peptido-mimetic inhibitor of apoptosis protein (IAP) antagonists (Smac mimetics (SMs)) can kill tumour cells by depleting endogenous IAPs and thereby inducing tumour necrosis factor (TNF) production. We found that interferon-γ (IFNγ) synergises with SMs to kill cancer cells independently of TNF- and other cell death receptor signalling pathways. Surprisingly, CRISPR/Cas9 HT29 cells doubly deficient for caspase-8 and the necroptotic pathway mediators RIPK3 or MLKL were still sensitive to IFNγ/SM-induced killing. Triple CRISPR/Cas9-knockout HT29 cells lacking caspase-10 in addition to caspase-8 and RIPK3 or MLKL were resistant to IFNγ/SM killing. Caspase-8 and RIPK1 deficiency was, however, sufficient to protect cells from IFNγ/SM-induced cell death, implying a role for RIPK1 in the activation of caspase-10. These data show that RIPK1 and caspase-10 mediate cell death in HT29 cells when caspase-8-mediated apoptosis and necroptosis are blocked and help to clarify how SMs operate as chemotherapeutic agents.