bluuebunny/crossref_metadata_2025 huggingface dataset:
Probabilistic projections of future warming and climate sensitivity trajectories
Authors: Goodwin Philip
Published: July 2021

Projections of future global mean surface warming for a given forcing scenario remain uncertain, largely due to uncertainty in the climate sensitivity. The ensemble of Earth system models from the Climate Model Intercomparison Project phase 6 (CMIP6) represents the dominant tools for projecting future global warming. However, the distribution of climate sensitivities within the CMIP6 ensemble is not representative of recent independent probabilistic estimates, and the ensemble contains significant variation in simulated historic surface warming outside agreement with observational datasets. Here, a Bayesian approach is used to infer joint probabilistic projections of future surface warming and climate sensitivity for shared socio-economic pathway (SSP) scenarios. The projections use an efficient climate model ensemble filtered and weighted to encapsulate observational uncertainty in historic warming and ocean heat content anomalies. The probabilistic projection of climate sensitivity produces a best estimate of 2.9°C, and 5th–95th percentile range of 1.5–4.6°C, in line with previous estimates using multiple lines of evidence. The joint projection of surface warming over the period 2030–40 has a 50% or greater probability of exceeding 1.5°C above preindustrial for all SSPs considered: 119, 126, 245, 370 and 585. Average warming by the period 2050–60 has a >50% chance of exceeding 2°C for SSPs 245, 370 and 585. These results imply that global warming is no longer likely to remain under 1.5°C, even with drastic and immediate mitigation, and highlight the importance of urgent action to avoid exceeding 2°C warming.
11Feminisms
Authors: Thurman Deborah
Published: July 2021

This chapter reviews a selection of new work in the field of feminist critical and cultural theory published in the year 2020. The chapter consists of five sections: 1. Introduction, which addresses the context of the Covid-19 pandemic for the reception and application of feminist thought; 2. Feminist Technologies, which reviews Legacy Russell’s Glitch Feminism: A Manifesto and Catherine D’Ignazio and Lauren F. Klein’s Data Feminism; 3. Archival Bodies, which reviews Cait McKinney’s Information Activism: A Queer History of Lesbian Media Technologies and Samantha Pinto’s Infamous Bodies: Early Black Women’s Celebrity and the Afterlives of Rights; 4. From Resilience to Revolution, which reviews Angela McRobbie’s Feminism and the Politics of Resilience: Essays on Gender, Media and the End of Welfare and Revolutionary Feminisms: Conversations on Collective Action and Radical Thought, edited by Brenna Bhandar and Rafeef Ziadah; 5. Conclusion, which highlights three generative preoccupations within contemporary feminist thought.
Integrative taxonomy of West African Magelona (Annelida: Magelonidae): species with thoracic pigmentation
Authors: Mortimer Kate , Kongsrud Jon Anders , Willassen Endre
Published: July 2021

Benthic samples collected during several cruises from shelf areas along the West African coast from Morocco to Angola, have highlighted a huge diversity of magelonid species (over 20 species), many of which are undescribed. The majority of samples were taken as part of two large-scale projects in the region: the Canary Current Large Marine Ecosystem project (CCLME) and the Guinea Current Large Marine Ecosystem project (GCLME). Six magelonid species bearing posterior thoracic pigmentation have been highlighted, Magelona alleni and five species new to science: Magelona fasciata sp. nov., Magelona guineensis sp. nov., Magelona mackiei sp. nov., Magelona nanseni sp. nov. and Magelona picta sp. nov. West African magelonids and comparative material from the UK and Norway have been investigated using COI, 16S and 28S markers. An integrated taxonomic approach is used to delineate species of Magelona carrying posterior thoracic pigmentation. These species from West African waters constitute a well-supported monophyletic group, with the species M. alleni being sister to the new species herein described. Our 41 COI DNA-barcode-sequences had between species distances from 9.3 to 26.8% and were allocated to ten different BINs in Boldsystems.org.
Viral Reservoir Capacity of Wild Prunus Alternative Hosts of Plum Pox Virus Through Multiple Cycles of Transmission and Dormancy
Authors: Collum Tamara D. , Stone Andrew L. , Sherman Diana J. , Damsteegt Vernon D. , Schneider William L. , Rogers Elizabeth E.
Published: July 2021

Plum pox virus (PPV) is a significant pathogen of Prunus worldwide and is known for having a broad experimental host range. Many of these hosts represent epidemiological risks as potential wild viral reservoirs. A comparative study of the PPV reservoir capacity of three commonly found native North American species, western choke cherry (Prunus virginiana var. demissa), black cherry (Prunus serotina), and American plum (Prunus americana) was conducted. Pennsylvania isolates of PPV-D were transmitted from the original host peach (Prunus persica cv. GF305) to all three species. Viral accumulation and transmission rates to alternative hosts and peach were monitored over the course of five vegetative growth and cold induced dormancy (CID) cycles. The three alternative host species demonstrated differences in their ability to maintain PPV-D and the likelihood of transmission to additional alternative hosts or back transmission to peach. Western choke cherry had low (5.8%) initial infection levels, PPV-D was not transmissible to additional western choke cherry, and transmission of PPV-D from western choke cherry to peach was only possible before the first CID cycle. Black cherry had intermediate initial infection levels (26.6%) but did not maintain high infection levels after repeated CID cycles. Conversely, American plum had a high level (50%) of initial infection that was not significantly different from initial infection in peach (72.2%) and maintained moderate levels (15 to 25%) of infection and PPV-D transmission to both American plum and peach through all five cycles of CID. Our results indicate that American plum has the greatest potential to act as a reservoir host for Pennsylvania isolates of PPV-D.
Localization and Mechanical Transmission of Tomato Brown Rugose Fruit Virus in Tomato Seeds
Authors: Salem N. M. , Sulaiman A. , Samarah N. , Turina M. , Vallino M.
Published: July 2021

Tomato brown rugose fruit virus (ToBRFV), belonging to the genus Tobamovirus, is a highly virulent emerging virus, causing disease outbreaks and significant crop losses worldwide. The growing number of ToBRFV epidemic episodes prompted the investigation of the role of seeds in the dissemination of the virus as an important aspect in the overall disease management. Therefore, the objectives of this study were to determine the localization of ToBRFV within tomato seeds and to evaluate its seed transmission characteristics. Seeds extracted from naturally ToBRFV-infected tomato fruits were tested for the presence of the virus using serological, molecular, and biological assays. Three immunolocalization techniques were used to determine the localization and distribution of ToBRFV within the different tissues and parts of tomato seeds. To evaluate seed transmission of ToBRFV, two grow-out experiments were conducted to assess the rate of both vertical (seeds to progeny seedlings) and possible horizontal transmission (plant to plant) based on serological and molecular assays. Seeds extracted from ToBRFV-infected fruits had a 100% contamination rate. The localization of ToBRFV in tomato seeds is only external on the seed coat (testa). Seed transmission rate from seeds to their seedlings was very low (0.08%), while no transmission was recorded from plants to plants in a small-scale greenhouse experimental setup. In conclusion, ToBRFV is a seedborne virus located externally on tomato seed coat and transmitted mechanically from ToBRFV-contaminated tomato seeds to seedlings, which could initiate a disease foci and eventually drive further dissemination and spread of the disease in a new growing area.
Characterization, Pathogenicity, Phylogeny, and Comparative Genomic Analysis ofPseudomonas tolaasiiStrains Isolated from Various Mushrooms in China
Authors: Liu Zhenghui , Zhao Yitong , Sossah Frederick L. , Okorley Benjamin A. , Amoako Daniel G. , Liu Peibin , Sheng Hongyan , Li Dan , Li Yu
Published: July 2021

Since 2016, devastating bacterial blotch affecting the fruiting bodies of Agaricus bisporus, Cordyceps militaris, Flammulina filiformis, and Pleurotus ostreatus in China has caused severe economic losses. We isolated 102 bacterial strains and characterized them polyphasically. We identified the causal agent as Pseudomonas tolaasii and confirmed the pathogenicity of the strains. A host range test further confirmed the pathogen’s ability to infect multiple hosts. This is the first report in China of bacterial blotch in C. militaris caused by P. tolaasii. Whole-genome sequences were generated for three strains: Pt11 (6.48 Mb), Pt51 (6.63 Mb), and Pt53 (6.80 Mb), and pangenome analysis was performed with 13 other publicly accessible P. tolaasii genomes to determine their genetic diversity, virulence, antibiotic resistance, and mobile genetic elements. The pangenome of P. tolaasii is open, and many more gene families are likely to emerge with further genome sequencing. Multilocus sequence analysis using the sequences of four common housekeeping genes (glns, gyrB, rpoB, and rpoD) showed high genetic variability among the P. tolaasii strains, with 115 strains clustered into a monophyletic group. The P. tolaasii strains possess various genes for secretion systems, virulence factors, carbohydrate-active enzymes, toxins, secondary metabolites, and antimicrobial resistance genes that are associated with pathogenesis and adapted to different environments. The myriad of insertion sequences, integrons, prophages, and genome islands encoded in the strains may contribute to genome plasticity, virulence, and antibiotic resistance. These findings advance understanding of the determinants of virulence, which can be targeted for the effective control of bacterial blotch disease.
Association of Teaching Status and Mortality After Cancer Surgery
Authors: Lam Miranda B. , Riley Kristen E. , Mehtsun Winta , Phelan Jessica , Orav E. John , Jha Ashish K. , Burke Laura G.
Published: July 2021

Objective:

To examine patient outcomes for 9 cancer-specific procedures performed in teaching versus nonteaching hospitals.

Background:

Few contemporary studies have evaluated patient outcomes in teaching versus nonteaching hospitals across a comprehensive set of cancer-specific procedures.

Methods:

Use of national Medicare data to compare 30-, 60-, and 90-day mortality rates in teaching and nonteaching hospitals for cancer-specific procedures. Risk-adjusted 30-day, all-cause, postoperative mortality overall and for each specific surgery, as well as overall 60- and 90-day mortality rates, were assessed.

Results:

The sample consisted of 159,421 total cancer surgeries at 3151 hospitals. Overall 30-day mortality rates, adjusted for procedure type, state, and invasiveness of procedure were 1.3% lower at major teaching hospitals (95% confidence interval [CI], −1.6% to −1.1%; P < 0.001) relative to nonteaching hospitals. After accounting for patient characteristics, major teaching hospitals continued to demonstrate lower mortality rates compared with nonteaching hospitals (−1.0% difference [95% CI, −1.2% to −0.7%]; P < 0.001). Further adjustment for surgical volume as a mediator reduced the difference to −0.7% (95% CI, −0.9% to −0.4%; P < 0.001). Cancer surgeries for 4 of the 9 disease sites (bladder, lung, colorectal, and ovarian) followed this overall trend. Sixty- and 90-day overall mortality rates, adjusted for procedure type, state, and invasiveness of procedure showed that major teaching hospitals had a 1.7% (95% CI, −2.1% to −1.4%; P < 0.001) and 2.0% (95% CI, −2.4% to −1.6%; P < 0.001) lower mortality relative to nonteaching hospitals. These trends persisted after adjusting for patient characteristics.

Conclusions:

Among cancer-specific procedures for Medicare beneficiaries, major teaching hospital status was associated with lower 30-, 60-, and 90-day mortality rates overall and across 4 of the 9 cancer types.
Short-Term Outcomes of Secondary Liver Surgery for Initially Unresectable Colorectal Liver Metastases Following Modern Induction Systemic Therapy in the Dutch CAIRO5 Trial
Authors: Bolhuis Karen , Grosheide Lodi , Wesdorp Nina J. , Komurcu Aysun , Chapelle Thiery , Dejong Cornelis H. C. , Gerhards Michael F. , Grünhagen Dirk J. , van Gulik Thomas M. , Huiskens Joost , De Jong Koert P. , Kazemier Geert , Klaase Joost M. , Liem Mike S. L. , Molenaar I. Quintus , Patijn Gijs A. , Rijken Arjen M. , Ruers Theo M. , Verhoef Cornelis , de Wilt Johannes H. W. , Punt Cornelis J. A. , Swijnenburg Rutger-Jan
Published: July 2021

Objective:

To present short-term outcomes of liver surgery in patients with initially unresectable colorectal liver metastases (CRLM) downsized by chemotherapy plus targeted agents.

Background:

The increase of complex hepatic resections of CRLM, technical innovations pushing boundaries of respectability, and use of intensified induction systemic regimens warrant for safety data in a homogeneous multicenter prospective cohort.

Methods:

Patients with initially unresectable CRLM, who underwent complete resection after induction systemic regimens with doublet or triplet chemotherapy, both plus targeted therapy, were selected from the ongoing phase III CAIRO5 study (NCT02162563). Short-term outcomes and risk factors for severe postoperative morbidity (Clavien Dindo grade ≥ 3) were analyzed using logistic regression analysis.

Results:

A total of 173 patients underwent resection of CRLM after induction systemic therapy. The median number of metastases was 9 and 161 (93%) patients had bilobar disease. Thirty-six (20.8%) 2-stage resections and 88 (51%) major resections (>3 liver segments) were performed. Severe postoperative morbidity and 90-day mortality was 15.6% and 2.9%, respectively. After multivariable analysis, blood transfusion (odds ratio [OR] 2.9 [95% confidence interval (CI) 1.1–6.4], P = 0.03), major resection (OR 2.9 [95% CI 1.1–7.5], P = 0.03), and triplet chemotherapy (OR 2.6 [95% CI 1.1–7.5], P = 0.03) were independently correlated with severe postoperative complications. No association was found between number of cycles of systemic therapy and severe complications (r = −0.038, P = 0.31).

Conclusion:

In patients with initially unresectable CRLM undergoing modern induction systemic therapy and extensive liver surgery, severe postoperative morbidity and 90-day mortality were 15.6% and 2.7%, respectively. Triplet chemotherapy, blood transfusion, and major resections were associated with severe postoperative morbidity.
Current Role of Reverse Total Shoulder Arthroplasty for Fractures of the Proximal Humerus
Authors: Saunders Patrick E. , Walker J. Brock , Lederman Evan , McKee Michael D.
Published: July 2021

Treatment of proximal humeral fractures can be challenging. The surgeon's options include nonoperative treatment, open reduction internal fixation, humeral hemiarthroplasty, or reverse shoulder arthroplasty. Reverse shoulder arthroplasty adds an option that can lead to predictable pain relief and good functional outcomes in treating challenging fractures in elderly patients and managing fracture complications and sequelae.

Level of Evidence:

Therapeutic Level V. See Instructions for Authors for a complete description of levels of evidence.
Giant Pilomatrical Tumor With Broad Epidermal Components: An Example of Histological Diversity and a Potential Diagnostic Pitfall of Tumors With Pilomatrical Differentiation
Authors: Terada Kazuhiro , Yamada Yosuke , Fujimoto Masakazu , Usui Shunya , Kogame Toshiaki , Kaku Yo , Moriyoshi Koki , Haga Hironori
Published: July 2021

The diagnosis of pilomatricoma, the most common matrical tumor, is generally straightforward; however, it exhibits diverse histology associated with various morphological stages and several clinical variants, and matrical differentiation can occur in various neoplastic diseases. A 56-year-old man was admitted to our hospital to resect an 11.0-cm skin tumor on his right shoulder. Because of its large size and surface irregularities, including multiple erosions and ulcers, cutaneous malignancies were clinically suspected. Histologically, the tumor formed numerous nodules with marked matrical differentiation in the superficial to deep dermis. Although the tumor was macroscopically asymmetrical and irregular, each nodule was microscopically round-shaped and consisted of basaloid cells without marked atypia, atypical mitoses, or lymphovascular invasion. Immunohistochemically, the tumor cells were positive for beta-catenin, LEF-1, and PHLDA-1, consistent with their pilomatrical differentiation. We diagnosed the case as a giant pilomatrical tumor with uncertain malignant potential, considering its “contradictory” features, namely, the worrisome histoarchitecture, such as the asymmetrical silhouette, but bland-looking cytological appearance. Unlike typical pilomatrical tumors, this tumor contained numerous epidermal components with features similar to those of the dermal components, resulting in a unique macroscopic and histological appearance. Our case broadens the known histological diversity of pilomatrical tumors.
Orbital TFE3-Rearranged Perivascular Epithelioid Cell Tumor: A Case Report and Review of the Literature
Authors: Feu-Basilio Silvia , Matas Jessica , Dotti-Boada Marina , Toll Agustin , Larque Ana-Belen , Pigem Ramon , Ortiz-Perez Santiago
Published: July 2021

Perivascular epithelioid cell tumors (PEComas) are infrequent mesenchymal neoplasms that have particular histological and immunohistochemical features. Only a few cases have been described in the eye and orbit. This report presents a 28-year-old man who consulted for a painless left orbital mass. With the presumptive diagnosis of cavernous hemangioma, a surgical excisional biopsy was performed. Histopathological examination showed a well-delimited tumor composed of epithelioid cells with an eosinophilic cytoplasm and oval nucleus. The tumor cells stained diffusely for HMB-45 and transcription factor E3 (TFE3) and were focally positive for actin. There was no reactivity to S100 or desmin. Genetic testing revealed a TFE3 rearrangement. Based on these results, an extremely rare orbital TFE3-rearranged PEComa was diagnosed. Although no recurrence was seen at last follow-up, a review of the literature shows experience is limited regarding orbital PEComas and their malignant potential. Further research is needed to establish management guidelines, their association with the tuberous sclerosis complex, and the role of genetic mutations such as TFE3 rearrangement.
Proliferative Clonal T-Cell Infiltrate Mimicking a Cutaneous T-Cell Lymphoma Arising in Active Regression of Melanoma
Authors: Siref Andrew , Kitahara Sumire , Balzer Bonnie
Published: July 2021

Complete melanoma regression is an uncommon phenomenon involving a complex interplay of the tumor microenvironment and host immune response. We report a case of an 84-year-old woman with a history of colon and breast cancers who presented with a right forearm tumor, which was found to be a nodular melanoma; focal features of regression were noted in the biopsy. Approximately 6 weeks later, surgical resection of the site revealed no gross evidence of tumor, and histologic sections showed an extensive lymphoid infiltrate with prominent epidermotropism. Rare residual melanoma cells were present in the dermis, best visualized on immunohistochemical stains. T cells predominated in the infiltrate with an inverted CD4:CD8 ratio at approximately 1:2. There was no appreciable loss of pan‒T-cell antigens. T-cell receptor beta and gamma gene rearrangements were performed by polymerase chain reaction and demonstrated clonality in each assay. Although a synchronous cutaneous T-cell lymphoma was considered, the overall clinicopathologic features are more in line with an exaggerated host immune response leading to near complete regression of the tumor.
Acquired Perforating Dermatosis Induced by PD-1 Inhibitor: A Case Report
Authors: Liu Xiaoyan , Wang Huayang , Wan Yinsheng , Guo Ying , Shan Shi-Jun
Published: July 2021

Acquired perforating dermatoses (APDs) are a group of diverse skin disorders in patients with systemic disease, most commonly chronic renal failure and diabetes mellitus. APD induced by medication has seldom been reported. Anti–PD-1 monoclonal antibody has recently been used as a broad-spectrum, effective, durable, and relatively safe antitumor therapy for various malignancies. Thus far, known side effects involving skin have included rash, pruritus, and vitiligo. Here, we present a rare case of a unilateral linear eruption with histopathologic features of APD in a 36-year-old man during treatment with Terepril monoclonal antibody. To the best of our knowledge, APD induced by the PD-1 inhibitor has not been described in the medical literature.
Inter-rater Reliability and Repeatability of Manual Anterior Segment Optical Coherence Tomography Image Grading in Keratoconus
Authors: Lin Anna N. , Mohammed Isa S. K. , Munir Wuqaas M. , Munir Saleha Z. , Alexander Janet L.
Published: July 2021

Objectives:

To determine the repeatability of corneal measurements from anterior segment optical coherence tomography (AS-OCT) images using ImageJ software in healthy eyes compared with eyes with keratoconus.

Methods:

Anterior segment OCT images of 25 eyes from 14 healthy subjects and 25 eyes from 15 subjects with keratoconus between the ages of 20 and 80 years were evaluated. Two trained observers used ImageJ to measure the central corneal cross-sectional area and anterior and posterior corneal arc lengths. MedCalc statistical software was used to generate the intraclass correlation coefficient (ICC) and Bland–Altman plots (BAPs) for observer measurements.

Results:

Observer measurements of the central corneal cross-sectional area and anterior and posterior corneal arc lengths yielded an ICC >0.7. The ICC comparing the 3 parameters ranged from 0.75 to 0.84 for the control and 0.96 to 0.98 for the keratoconus group. No systematic proportional bias was detected by the BAPs. There were minimal differences between the 2 observer's measurements, with a mean of the difference of 0.3 mm2, 0 mm, and 0 mm, for the 3 measurements, respectively.

Conclusions:

This study suggests that ImageJ software is a repeatable and reliable tool in the analysis of corneal parameters from AS-OCT images among patients with keratoconus and may be applicable to AS-OCT imaging protocol development, an area of active keratoconus research.
Dexamethasone-Eluting Contact Lens for the Prevention of Postphotorefractive Keratectomy Scar in a New Zealand White Rabbit Model
Authors: Soeken Timothy A. , Ross Amy E. , Kohane Daniel S. , Kuang Liangju , Legault Gary L. , Caldwell Matthew C. , Brundridge Wesley L. , Merkley Michael B. , Ciolino Joseph B. , Townley J. Richard
Published: July 2021

Purpose:

To evaluate the safety and efficacy of an experimental dexamethasone-eluting contact lens (DCL) for the prevention of postphotorefractive keratectomy (PRK) corneal haze in a New Zealand White (NZW) rabbit model.

Methods:

Both eyes of 29 NZW rabbits underwent PRK. The rabbits were randomized to one of the 5 study arms for 4 weeks: tarsorrhaphy only, tarsorrhaphy and bandage contact lens (BCL) replaced weekly, tarsorrhaphy and BCL for 1 week plus topical 0.1% dexamethasone ophthalmic solution (drops) for 4 weeks, tarsorrhaphy and BCL replaced weekly plus topical dexamethasone for 4 weeks, and tarsorrhaphy and DCL changed weekly for 4 weeks. Each week for 4 consecutive weeks postoperatively, the tarsorrhaphies were opened, the eyes underwent evaluation and imaging, and the tarsorrhaphies were replaced. Contact lenses were cultured on removal. Central corneal haze was assessed weekly with corneal densitometry. After 4 weeks, the animals were killed, and the eyes were enucleated for histopathologic analysis.

Results:

The tarsorrhaphy only group displayed more haze with a greater change in optical densitometry from pre-op compared with the other treatment groups. There was no difference between the DCL group and the groups receiving a BCL and dexamethasone drops in densitometry or histopathology. No NZW rabbits developed clinical signs of infection, and cultures from DCLs and BCLs grew similar organisms.

Conclusions:

In the post-PRK rabbit model, DCLs worn weekly for 4 weeks were safe and as effective at preventing corneal haze as 0.1% dexamethasone drops applied 4 times a day for 4 weeks.
Persistence of Immunity Following 2-Dose Priming with a 10-Valent Pneumococcal Conjugate Vaccine at 6 and 10 Weeks or 6 and 14 Weeks of Age in Nepalese Toddlers
Authors: Gurung Meeru , Bijukchhe Sanjeev M. , Hariri Parisa , Voysey Merryn , Kandasamy Rama , Thorson Stephen , Maskey Pratistha , Pandit Raju , Shrestha Biplav , Gautam Madhav Chandra , Maharjan Mamata , Lama Laxmi , Acharya Baikuntha , Basi Ruby , K.C. Manisha , O’Reilly Peter , Shrestha Sonu , Ansari Imran , Shah Ganesh P. , Kelly Sarah , O’Brien Katherine L. , Goldblatt David , Kelly Dominic F. , Murdoch David R. , Pollard Andrew J. , Shrestha Shrijana
Published: July 2021

Background:

The pneumococcal conjugate vaccine has had a substantial impact on invasive pneumococcal disease. Previously, we compared immunity following vaccination with the 10-valent pneumococcal conjugate vaccine (PCV10) administered at 2 slightly different schedules: at 6 and 10 weeks of age, and at 6 and 14 weeks of age, both followed by a 9-month booster. In this study, we followed up those participants to evaluate the medium-term persistence of serotype-specific pneumococcal immunity at 2-3 years of age.

Method:

Children from the previous studies were contacted and after taking informed consent from their parents, blood samples and nasopharyngeal swabs were collected. Serotype-specific IgG antibody concentrations were determined by enzyme-linked immunosorbent assay, for the 10 vaccine serotypes, at a WHO pneumococcal serology reference laboratory.

Findings:

Two hundred twenty of the 287 children who completed the primary study returned at 2–3 years of age to provide a blood sample and nasopharyngeal swab. The nasopharyngeal carriage rate of PCV10 serotypes in the 6 + 14 group was higher than the 6 + 10 group (13.4% vs. 1.9%). Nevertheless, the proportion of toddlers with serum pneumococcal serotype-specific IgG greater than or equal to 0.35 µg/mL was comparable for all PCV10 serotypes between the 6 + 10 week and 6 + 14 week groups. Similarly, the geometric mean concentrations of serum pneumococcal serotype-specific IgG levels were similar in the 2 groups for all serotypes, except for serotype 19F which was 32% lower in the 6 + 10 group than the 6 + 14 group.

Conclusion:

Immunization with PCV10 at 6 + 10 weeks or 6 + 14 weeks, with a booster at 9 months in each case, results in similar persistence of serotype-specific antibody at 2-3 years of age. Thus, protection from pneumococcal disease is expected to be similar when either schedule is used.
Adolescent pain, anxiety, and depressive problems: a twin study of their co-occurrence and the relationship to substance use
Authors: Scaini Simona , Michelini Giorgia , De Francesco Stefano , Fagnani Corrado , Medda Emanuela , Stazi Maria Antonietta , Battaglia Marco
Published: July 2021

Data on the etiological factors underlying the co-occurrence of common adolescent pain with anxiety and depression symptoms are very limited. Opioid prescriptions for adolescent pain problems are on the rise in North America and constitute a risk factor for diversion, misuse, and substance use. In this study, we aimed to investigate the phenotypic and etiological association among pain, depression, and anxiety and to test their link to substance use in adolescents. By taking advantage of the Italian National Twin Registry and of the relatively low incidence of opioid prescriptions in Italy, we applied multivariate modelling analyses to 748 Italian adolescent twins (374 pairs, mean age 16 ± 1.24 years). Twins' responses to the Achenbach Youth Self-Report questionnaire were used to build a composite adolescent pain index and to measure anxiety, depression, and substance use. All monozygotic within-pair correlations were higher than the dizygotic correlations, indicating genetic influences for adolescent pain, anxiety, and depressive problems. A common latent liability factor influenced by genetic and environmental elements shared among pain, depression, and anxiety provided the best fit to explain the co-occurrence of adolescent pain, anxiety, and depression problems. A common phenotypic factor capturing all 3 phenotypes was positively associated (β = 0.19, P < 0.001, confidence interval: 0.10-0.27) with substance use. These findings indicate that several intertwined mechanisms, including genetic factors, can explain a shared liability to common adolescent pain, anxiety, and depression problems. Their association with substance use remains traceable even in societies with relatively low prevalence of opioid prescriptions.
Pattern and Prevalence of Liver Involvement in Pediatric Acute Lymphoblastic and Myeloid Leukemia at Diagnosis
Authors: Sandart Amelie , Harila‐Saari Arja , Arnell Henrik , Fischler Björn , Vakkila Jukka
Published: July 2021

Objectives:

The prevalence and significance of liver involvement at diagnosis was studied in pediatric acute lymphoblastic (ALL) and myeloid leukemia (AML).

Methods:

A population based cohort of 122 pre B‐ALL, 22 T‐ALL and 45 AML patients was formed from the Nordic Society of Pediatric Hematology and Oncology leukemia registries (years 2005–2017). Hepatomegaly, elevated alanine aminotransferase, high INR, hypoalbuminemia and conjugated hyperbilirubinemia at diagnosis were used as markers for liver involvement. Minimal residual disease (MRD), time to relapse and overall survival (OS) were correlated with liver involvements.

Results:

The pattern of liver involvement was significantly different between leukemia subtypes (P = 0.025). The proportion of patients without liver abnormalities was 50.0% in AML and 44.8% in pre B‐ALL and 23.5% in T‐ALL patients. Hepatomegaly characterized lymphatic leukemia being present in 41.8% and 58.8% of pre B‐ and T‐ALL patients. Liver dysfunction was most common in AML (29.5%) and least frequent in pre B‐ALL (7.4%,) (P = 0.001). Conjugated hyperbilirubinemia was present in less than 5% of patients. Hepatomegaly correlated positively with age in pre B‐ALL (P = 0.036) and white blood cell count (WBC) in AML (P = 0.010). Hepatic dysfunction was related with high WBC in pre B‐ALL (P = 0.037) and AML (P = 0.001). Liver involvement in patients with ALL was not associated with toxicity or outcome. Patients with AML without liver involvement demonstrated superior OS.

Conclusions:

Liver involvement is frequent at diagnosis in pediatric leukemia and its prevalence is related with leukemia subtype, age and WBC. In AML, but not in ALL, it associates with suboptimal prognosis.
Mindfulness and Attention Deficit Hyperactivity Disorder
Authors: Gu Yingqi , Zhu Yi , Brown Kirk Warren
Published: July 2021

Understanding the underlying mechanisms of mindfulness has been a hot topic in recent years, not only in clinical fields but also in neuroscience. Most neuroimaging findings demonstrate that critical brain regions involved in mindfulness are responsible for cognitive functions and mental states. However, the brain is a complex system operating via multiple circuits and networks, rather than isolated brain regions solely responsible for specific functions. Mindfulness-based treatments for attention deficit hyperactivity disorder (ADHD) have emerged as promising adjunctive or alternative intervention approaches. We focus on four key brain circuits associated with mindfulness practices and effects on symptoms of ADHD and its cognitive dysfunction, including executive attention circuit, sustained attention circuit, impulsivity circuit, and hyperactivity circuit. We also expand our discussion to identify three key brain networks associated with mindfulness practices, including central executive network, default mode network, and salience network. We conclude by suggesting that more research efforts need to be devoted into identifying putative neuropsychological mechanisms of mindfulness on how it alleviates ADHD symptoms.
Call for Action: High Rates of Depression in the Pediatric Celiac Disease Population Impacts Quality of Life
Authors: Jericho Hilary , Khan Narmeen , Cordova Jonathan , Sansotta Naire , Guandalini Stefano , Keenan Kate
Published: July 2021

Objective:

To test the impact of celiac disease (CD) and depression symptoms on quality of life in adolescent patients.

Methods:

We conducted a prospective survey of 12- to 18-year-old celiac patients and their caregivers between January 2015 and November 2016. Enrolled parents and youth completed standard measures of adjustment to celiac disease, depression, and quality of life.

Results:

We enrolled 105 patients with CD and their parents. Both parents and youth reported high levels of depression symptoms. There were no associations between age, duration of CD, or following a gluten-free diet (GFD) and quality of life. No significant associations were found between adolescent perception of CD state and quality of life; parental report of adolescent’s adjustment to CD; and youth report of quality of life were modestly associated (r = 0.19, P ≤ 0.05). Moderate associations were observed between adolescent reports of depression and quality of life (r = 0.59, P < 0.01) and between parental reports of adolescent depression and quality of life (r = 0.41, P = 0.01). Only depressive symptoms by youth and parent report, however, and not adjustment to celiac, explained unique variance in quality of life.

Conclusion:

Adolescents with CD report levels of depression comparable to those reported by adolescents seeking mental health services. Length of time living with CD, or on GFD, age at diagnosis and perception of disease state do not appear to contribute to depression. High rates of depression may impact CD prognosis, therefore, screening for depression in adolescents with CD appears critical. Identification and intervention of depression may lead to improved adherence to the GFD during emerging adulthood.
Acute Liver Failure in a Healthy Young Female With COVID-19
Authors: Orandi Babak John , Li Geling , Dhall Deepti , Bajpai Prachi , Manne Upender , Arora Nitin , Lu Ailing , Coronado Ana Carolina , Kassel Rachel , Pinninti Swetha , Lewis Cora Elizabeth , Chapleau Christopher , Locke Jayme Elizabeth , Gutierrez Sanchez Luz Helena
Published: July 2021

Several well-described manifestations of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been reported. Among them, a transient elevation of liver enzymes is the typical presentation of coronavirus disease 2019 (COVID-19) liver-related injury. The mechanism of liver involvement is likely a combination of viral injury and immune-mediated inflammation. In contrast, acute liver failure in the setting of COVID-19 has rarely been reported. Herein, we report a case of pediatric acute liver failure in a previously healthy female adolescent infected with SARS-CoV-2 with biopsy evidence of replicating virus in hepatocytes, which has not been previously reported.
Chest Computed Tomography Features of Nontuberculous Mycobacterial Pulmonary Disease Versus Asymptomatic Colonization
Authors: Garcia Bryan , Wilmskoetter Janina , Grady Abigail , Mingora Christina , Dorman Susan , Flume Patrick
Published: July 2021

Background:

Asymptomatic colonization by nontuberculous mycobacteria (NTM) found in sputum isolates are commonly encountered and clinicians lack a biomarker for prognosticating the risk of transition asymptomatic colonization to active clinical disease. Chest computed tomography (CT) imaging is commonly obtained in this patient population and may serve a role for this purpose.

Methods:

We conducted a single-center, cross-sectional study of patients followed in the NTM clinic at our center between August 2019 and August 2020. All patients had a history of NTM isolated from their airways and were cohorted as either nontuberculous mycobacteria-pulmonary disease (NTM-PD) if they met ATS/IDSA guidelines for treatment or as nontuberculous mycobacteria-colonized (NTM-C) if they did not meet ATS/IDSA criteria for NTM treatment. Patients with a chest CT were included in the analysis and CT scans were assessed for features including bronchiectasis, nodules, and cavities. Bronchiectasis severity was calculated using the modified Reiff scoring system. Univariate analyses were conducted to compare patients with NTM-C and NTM-PD.

Results:

Eighty-four patients were included in the analysis and 27 were classified as NTM-C and 57 as NTM-PD. NTM-PD patients had a greater median number of lung lobes affected by bronchiectatic airways (6 [1] NTM-PD vs. 5 [3] NTM-C P=0.005) and a greater frequency of cystic bronchiectasis (17.5% NTM-PD vs. 0% NTM-PD, P=0.016). Bronchiectasis severity was higher for NTM-PD patients (7 [9] NTM-PD vs. 5 [1.5] NTM-C, P<0.001).

Conclusions:

Patients with NTM-PD have greater bronchiectatic airway involvement and the forms of bronchiectasis present are more severe compared with NTM-C patients. In addition, cavitation of lung parenchyma was a radiographic feature solely associated with NTM-PD. Features identified on chest CT may be useful as a prognostic biomarker for the risk of transition from NTM-C to NTM-PD.
Late Presenting Multi-Suture Craniosynostosis
Authors: Dibbs Rami P. , Beh Han Zhuang , Donoho Daniel A. , Davies Lesley W. , Ferry Andrew M. , Bauer David F. , Buchanan Edward P.
Published: July 2021

The authors provide the case of a 6-year-old male who presented late with multi-suture craniosynostosis and chronically elevated intracranial pressures (ICPs). He was surgically managed with frontal orbital advancement. This particular case illustrates the significant bleeding and unique bony pathology that can occur in patients with high ICP with concomitant venous collateralization. At 1-month follow-up, he demonstrated significant improvement with maintained expansion and no signs of elevated ICP despite delayed intervention. Frontal orbital advancement serves as an effective method for cranial vault expansion and correction of frontal deformities caused by craniosynostosis.
Optical Coherence Tomography Is Associated With Cognitive Impairment in Multiple Sclerosis
Authors: Dreyer-Alster Sapir , Gal Aviva , Achiron Anat
Published: July 2021

Background:

Optical coherence tomography (OCT) is a sensitive method for quantifying retinal neuronal and axonal structures. Reductions in retinal nerve fiber layer (RNFL) and ganglion cell inner plexiform layer (GCIPL) thicknesses have a reported association with white and grey matter atrophy in multiple sclerosis (MS). We hypothesized that the thinning of intraretinal layer measurements associates with cognitive decline in MS patients with no prior event of optic neuritis (ON).

Methods:

OCT and NeuroTrax computerized cognitive assessments were performed in 204 relapsing remitting MS patients with no history of ON or other conditions affecting the eye. Data were collected between 2010 and 2020 and retrospectively analyzed. Correlations were examined between cognitive performance and a lower RNFL or GCIPL thickness. A multilinear regression model was generated to assess the significance of these correlations regarding the disability score and disease duration.

Results:

The 204 study participants had a mean age of 40.52 ± 11.8 years (mean ± SD) and disease duration of 9.80 ± 9.40 years. The mean RNFL thickness in this whole cohort was 82.22 ± 10.85 μm and the global cognitive score was 95.32 ± 12.32. The mean GCIPL thickness measured in a subgroup of 104 patients was 74.27 ± 10.37 μm. The RNFL and GCIPL both correlated with the global cognitive score (r = 0.174, P = 0.013 and r = 0.29, P = 0.03, respectively), and with various cognitive domains. However, the GCIPL showed stronger correlations than RNFL, particularly with executive function (r = 0.29, P = 0.003), attention (r = 0.332, P = 0.001), and the information processing speed (r = 0.25, P = 0.012). These correlations remained significant after correcting for confounders.

Conclusion:

OCT measurements correlate with cognitive performance in MS patients. OCT can thus be used to evaluate central nervous system neurodegeneration in MS, as reflected by cognitive decline.
A trimodular family 16 glycoside hydrolase from the cellulosome of Ruminococcus flavefaciens displays highly specific licheninase (EC 3.2.1.73) activity
Authors: Mondal Sunetra , Thakur Abhijeet , Fontes Carlos M. G. A. , Goyal Arun
Published: July 2021

Cellulosomes are highly complex cell-bound multi-enzymatic nanomachines used by anaerobes to break down plant carbohydrates. The genome sequence of

Ruminococcus flavefaciens

revealed a remarkably diverse cellulosome composed of more than 200 cellulosomal enzymes. Here we provide a detailed biochemical characterization of a highly elaborate

R. flavefaciens

cellulosomal enzyme containing an N-terminal dockerin module, which anchors the enzyme into the multi-enzyme complex through binding of cohesins located in non-catalytic cell-bound scaffoldins, and three tandemly repeated family 16 glycoside hydrolase (GH16) catalytic domains. The DNA sequence encoding the three homologous catalytic domains was cloned and hyper-expressed in

Escherichia coli

BL21 (DE3) cells. SDS-PAGE analysis of purified His6 tag containing RfGH16_21 showed a single soluble protein of molecular size ~89 kDa, which was in agreement with the theoretical size, 89.3 kDa. The enzyme RfGH16_21 exhibited activity over a wide pH range (pH 5.0–8.0) and a broad temperature range (50–70 °C), displaying maximum activity at an optimum pH of 7.0 and optimum temperature of 55 °C. Substrate specificity analysis of RfGH16_21 revealed maximum activity against barley β-d-glucan (257 U mg−1) followed by lichenan (247 U mg−1), but did not show significant activity towards other tested polysaccharides, suggesting that it is specifically a β-1,3-1,4-endoglucanase. TLC analysis revealed that RfGH16_21 hydrolyses barley β-d-glucan to cellotriose, cellotetraose and a higher degree of polymerization of gluco-oligosaccharides indicating an endo-acting catalytic mechanism. This study revealed a fairly high, active and thermostable bacterial endo-glucanase which may find considerable biotechnological potentials.
Stronger Microstructural Damage Revealed in Multiple Sclerosis Lesions with Central Vein Sign by Quantitative Gradient Echo MRI
Authors: Levasseur Victoria A. , Xiang Biao , Salter Amber , Yablonskiy Dmitriy A. , Cross Anne H.
Published: July 2021

Background

Multiple sclerosis (MS) lesions typically form around a central vein that can be visualized with FLAIR* MRI, creating the central vein sign (CVS) which may reflect lesion pathophysiology. Herein we used Gradient Echo Plural Contrast Imaging (GEPCI) MRI to simultaneously visualize CVS and measure tissue damage in MS lesions. We examined CVS in relation to tissue integrity in white matter (WM) lesions and among MS subtypes.

Subjects and Methods

Thirty relapsing–remitting MS (RRMS) subjects and 38 progressive MS (PMS) subjects were scanned with GEPCI protocol. GEPCI T2*-SWI images were generated to visualize CVS. Two investigators independently evaluated WM lesions for CVS and measured lesion volumes. To estimate tissue damage severity, total lesion volume, mean lesion volume, R2t*-based tissue damage score (TDS) of individual lesions and tissue damage load (TDL) were measured for CVS+, CVS-, and confluent lesions. Spearman correlations were made between MRI and clinical data. A paired t-test was used to compare measurements of CVS+ versus CVS- lesions in each individual.

Results

398 of 548 lesions meeting inclusion criteria showed CVS. Most patients had ≥ 40% CVS+ lesions. CVS+ lesions were present in similar proportion among MS subtypes. Interobserver agreement was high for CVS detection. CVS+ and confluent lesions had higher average and total volumes versus CVS- lesions. CVS+ and confluent lesions had more tissue damage than CVS- lesions based on TDL and mean TDS.

Conclusion

CVS occurred in RRMS and PMS in similar proportions. CVS+ lesions had greater tissue damage and larger size than CVS- lesions.
Visual and refractive status of children with Down’s syndrome and nystagmus
Authors: Zahidi Asma A A , McIlreavy Lee , Erichsen Jonathan T , Woodhouse J Margaret
Published: July 2021

Background/Aims

Children with Down’s syndrome (DS) are known to have poorer visual acuity that neurotypical children. One report has shown that children with DS and nystagmus also have poor acuity when compared to typical children with nystagmus. What has not been established, is the extent of any acuity deficit due to nystagmus and whether nystagmus impacts on refractive error is within a population with DS.

Methods

Clinical records from The Cardiff University Down’s Syndrome Vision Research Unit were examined retrospectively. Binocular visual acuity and refraction data were available for 50 children who had DS and nystagmus (DSN) and 176 children who had DS but no nystagmus. Data were compared between the two groups, and with published data for neurotypical children with nystagmus.

Results

The study confirms the deficit in acuity in DS, compared to neurotypical children, of approximately 0.2 LogMAR and shows a further deficit attributable to nystagmus of a further 0.2 logMAR beyond the first year of life. Children with DS and no nystagmus appear to have acuity that mirrors that of typical children with nystagmus, while children with both DS and nystagmus have a significant additional impairment. Children with DS have a wide range of refractive errors, but nystagmus increases the likelihood of myopia. Prevalence and axis direction of astigmatism, on the other hand appears unaffected by nystagmus.

Conclusion

Nystagmus confers an additional visual impairment on children with Down’s syndrome and must be recognised as such by families and educators. Children with both DS and nystagmus clearly need targeted support.