A genomic variant of ALPK2 is associated with increased liver fibrosis risk in HIV/HCV coinfected women.

HIV coinfection is associated with more rapid liver fibrosis progression in hepatitis C (HCV) infection. Recently, much work has been done to improve outcomes of liver disease and to identify targets for pharmacological intervention in coinfected patients. In this study, we analyzed clinical data of 1,858 participants from the Women's Interagency HIV Study (WIHS) to characterize risk factors associated with changes in the APRI and FIB-4 surrogate measurements for advanced fibrosis.

Second-Generation Antipsychotic Use in Pediatric Emergency Medicine.

In recent years, the number of patients presenting to the emergency department with mental health complaints has been growing, alongside an increase in second-generation antipsychotic (SGAs) prescriptions for a variety of mental health conditions. Children treated with SGAs may have abnormalities, such as rapid weight gain and central adiposity, glucose intolerance, dyslipidemia, and hypertension; they may present to the pediatric emergency department with components of metabolic syndrome or type 2 diabetes, and a subsequent significant risk for cardiovascular complications later in life. Pediatric emergency department providers may serve as a safety net for patients to detect SGA-related metabolic complications, especially among vulnerable populations lacking access to primary care or psychiatric services.

Les accès de frissonnement: Un phénomène bénin chez l'enfant.

Un enfant de 2 ans est récemment venu à ma clinique en raison d'épisodes répétés de raidissements du cou et de mouvements de frissons aux épaules et aux bras. Les épisodes durent de 4 à 5 secondes et se produisent plus de 10 fois par jour, sans modèle apparent, outre une fréquence accrue à l'heure des repas. Même s'il n'a pas eu de perte de conscience, les parents s'inquiétaient qu'il ait des convulsions.

Shuddering attacks: A benign phenomenon in children.

Question: A 2-year-old child was recently brought into my office for repeated episodes of neck stiffening and shivering movements of the shoulders and arms. The episodes last 4 to 5 seconds and occur more than 10 times per day, with no apparent pattern except increased frequency at mealtime. Although there has never been loss of consciousness, the parent was worried that these were seizures.

Expression of the Extracellular Sulfatase Affects Survival of Head and Neck Squamous Cell Carcinoma Patients.

Sulfation of heparan sulfate proteoglycans (HSPG) regulates signaling of growth factor receptors specific interactions with the sulfate groups. 6--Sulfation of HSPG is an impactful modification regulated by the activities of dedicated extracellular endosulfatases. Specifically, extracellular sulfatase Sulf-2 (SULF2) removes 6--sulfate from HS chains, modulates affinity of carrier HSPG to their ligands, and thereby influences activity of the downstream signaling pathway.

No Detectable Electroencephalographic Activity After Clinical Declaration of Death Among Tibetan Buddhist Meditators in Apparent Tukdam, a Putative Postmortem Meditation State.

Recent EEG studies on the early postmortem interval that suggest the persistence of electrophysiological coherence and connectivity in the brain of animals and humans reinforce the need for further investigation of the relationship between the brain's activity and the dying process. Neuroscience is now in a position to empirically evaluate the extended process of dying and, more specifically, to investigate the possibility of brain activity following the cessation of cardiac and respiratory function. Under the direction of the Center for Healthy Minds at the University of Wisconsin-Madison, research was conducted in India on a postmortem meditative state cultivated by some Tibetan Buddhist practitioners in which decomposition is putatively delayed.

Computational analyses reveal spatial relationships between nuclear pore complexes and specific lamins.

Nuclear lamin isoforms form fibrous meshworks associated with nuclear pore complexes (NPCs). Using datasets prepared from subpixel and segmentation analyses of 3D-structured illumination microscopy images of WT and lamin isoform knockout mouse embryo fibroblasts, we determined with high precision the spatial association of NPCs with specific lamin isoform fibers. These relationships are retained in the enlarged lamin meshworks of Lmna-/- and Lmnb1-/- fibroblast nuclei.

The cost-effectiveness of preimplantation genetic testing for aneuploidy in the United States: an analysis of cost and birth outcomes from 158,665 in vitro fertilization cycles.

Background: A controversial and unresolved question in reproductive medicine is the utility of preimplantation genetic testing for aneuploidy as an adjunct to in vitro fertilization. Infertility is prevalent, but its treatment is notoriously expensive and typically not covered by insurance. Therefore, cost-effectiveness is critical to consider in this context.

Continuous positive airway pressure for obstructive sleep apnea in children.

Question: A 12-year-old child underwent adenotonsillectomy for treatment of obstructive sleep apnea (OSA) but continues to snore at night and struggles with attentiveness at school. The child's parent uses a continuous positive airway pressure (CPAP) machine at night and wonders whether the same therapy could be used in children.

Answer: Unlike in adults, pediatric OSA is commonly related to adenotonsillar hypertrophy and is often amenable to treatment with adenotonsillectomy.

Fertility education: what's trending on Instagram.

Objective: To determine the prevalence, authorship, and types of fertility-related information shared on Instagram targeted toward a new patient interested in fertility options using hashtag and content analysis. Secondary outcomes included comparison of post content stratified by author type (physicians versus patients).

Methods: A list of ten hashtags consisting of fertility terms for the new patient was derived.

A content and quality evaluation of ACGME-accredited reproductive endocrinology and infertility fellowship program webpages.

Purpose: To analyze the content of websites of ACGME-accredited REI fellowship programs in the USA and to determine whether there are differences in content across geographic regions.

Methods: All ACGME-accredited REI fellowship websites active as of September 2020 were evaluated and reviewed using 20 criteria in the following nine domains: program overview, contact information, application information, curriculum, current fellows, research, alumni, faculty, and fellowship benefits. Website content was compared across geographic regions (Northeast, Midwest, South, and West) of the USA.

Impact of Lymph Node Yield in Patients Undergoing Total Laryngectomy and Neck Dissection.

Objectives: To determine the impact of lymph node yield (LNY) in patients undergoing neck dissection at the time of total laryngectomy (TL). To determine the impact of radiation therapy (RT) on LNY.

Methods: Retrospective review of LNY and clinical outcomes in 232 patients undergoing primary or salvage total laryngectomy (TL) with ND.

N- and O-Glycosylation of the SARS-CoV-2 Spike Protein.

Covid-19 pandemic outbreak is the reason of the current world health crisis. The development of effective antiviral compounds and vaccines requires detailed descriptive studies of SARS-CoV-2 proteins. The SARS-CoV-2 spike (S) protein mediates virion binding to the human cells through its interaction with the ACE2 cell surface receptor and is one of the prime immunization targets.

Henoch-Schönlein purpura in children: Use of corticosteroids for prevention and treatment of renal disease.

Question: A few patients have previously presented to my clinic with palpable purpura, joint inflammation, and severe abdominal pain characteristic of Henoch-Schönlein purpura (HSP). Considering that renal injury is the primary long-term complication of HSP, are corticosteroids effective in preventing or treating renal disease in children with HSP?

Answer: Henoch-Schönlein purpura is self-limiting in 94% of children, but permanent renal injury is reported in one-fifth of children with nephritic or nephrotic features. Corticosteroids have been considered as candidates for preventing and treating renal involvement in HSP.

Pediatric influenza in the emergency department: diagnosis and management.

Influenza in children is a significant cause of morbidity and mortality. Presenting symptoms of influenza vary greatly among children; clinical presentation should be assessed for severity of illness and potential complications. Available clinical and laboratory findings should be used to guide treatment for young children with fever.

An APEX2 proximity ligation method for mapping interactions with the nuclear lamina.

The nuclear lamina (NL) is a meshwork found beneath the inner nuclear membrane. The study of the NL is hindered by the insolubility of the meshwork and has driven the development of proximity ligation methods to identify the NL-associated/proximal proteins, RNA, and DNA. To simplify and improve temporal labeling, we fused APEX2 to the NL protein lamin-B1 to map proteins, RNA, and DNA.

Finding the Needle in the Hay Stack: Population-based Study of Prediagnostic Symptomatic Interval in Children With CNS Tumors.

Central nervous system (CNS) tumors in children are a devastating diagnosis and delay in diagnosis is well documented in the literature. The aim of this study was to document and characterize time to diagnosis of CNS tumors among children 0 to 17 years of age in a pediatric center. A retrospective chart review was conducted of medical records of children with CNS tumors from 2000 to 2016 in British Columbia, Canada and 148 reports were available for review.

Factors associated with parents' willingness to enroll their children in trials for COVID-19 vaccination.

The coronavirus disease 2019 (COVID-19) pandemic has taken an unprecedented global toll and vaccination is needed to restore healthy living. Timely inclusion of children in vaccination trials is critical. We surveyed caregivers of children seeking care in 17 Emergency Departments (ED) across 6 countries during the peak of the pandemic to identify factors associated with intent to participate in COVID-19 vaccine trials.

Fluid management in children with diabetic ketoacidosis.

Question: Previous research has indicated that rapid rehydration in children with type 1 diabetes who present with diabetic ketoacidosis could result in cerebral edema. I have been treating patients with diabetic ketoacidosis with gradual fluid replacement. With the risk of cerebral injury in these patients, should I continue management with slow fluid rehydration?

Answer: Recent research has shown that neither fluid infusion rate nor sodium chloride concentration increases risk of cerebral injury.

Paediatric patients seen in 18 emergency departments during the COVID-19 pandemic.

Background: Public health mitigation strategies in British Columbia during the pandemic included stay-at-home orders and closure of non-essential services. While most primary physicians' offices were closed, hospitals prepared for a pandemic surge and emergency departments (EDs) stayed open to provide care for urgent needs. We sought to determine whether ED paediatric presentations prior and during the COVID-19 pandemic changed and review acuity compared with seasonal adjusted prior year.