Atypical Patterns Research Articles

Dermatoscopia del carcinoma epidermoide: de la queratosis actínica a las formas invasivas

When performing the dermoscopy of squamous cell carcinoma and its precursors we differentiate among keratin-related, vascular, and pigment-related criteria. Non-pigmented actinic keratoses are characterized by the “strawberry pattern”. Pigmented actinic keratosis shows a significant dermatoscopic overlap with lentigo maligna, but the presence of pigmented scales, erythema, and prominent follicles favors its diagnosis. Bowen's disease is characterized by clustered glomerular vessels, white-yellowish scales, and brown or grey dots arranged in lines in its pigmented variant. Finally, dermoscopy allows us to detect invasive squamous cell carcinoma in its early stages and differentiate it from its precursors. Furthermore, its presentation may vary depending on the degree of differentiation, with keratin-associated criteria predominating in well-differentiated tumors, while the atypical vascular pattern will predominate in poorly differentiated tumors.

The spatial ecology of Mojave rattlesnakes (Crotalus scutulatus), prairie rattlesnakes (Crotalus viridis), and their hybrids in southwestern New Mexico

Abstract Hybridization between species provides unique opportunities to understand evolutionary processes that are linked to reproductive isolation and, ultimately, speciation. However, the extrinsic factors that limit hybridization are poorly understood for most animal systems. Although the spatial ecology of individuals in natural habitats is fundamental to shaping reproductive success and survival, analyses of the spatial ecology of hybrids and their parental groups are rarely reported. Here, we used radiotelemetry to monitor wild rattlesnakes across an interspecific hybrid zone (Crotalus scutulatus and Crotalus viridis) and measured movement parameters and space use (utilization distributions) of individuals to evaluate the hypothesis that hybridization resulted in transgressive or atypical movement patterns. Unexpectedly, of the spatial metrics we investigated, we found that hybrids were very similar to parental individuals. Nonetheless, hybrids did show increased patchiness of core utilization distributions, but this result is likely to be driven by increased habitat patchiness in the hybrid zone. Overall, we did not find evidence for overt extrinsic barriers to hybridization associated with spatial ecology; thus, we suggest that the close evolutionary history between the two parental species and their ecological and behavioural similarities are likely to increase the probability of hybridization events in this unique region of New Mexico.

Characterizing ambulatory function in children with PPP2R5D-related neurodevelopmental disorder

BackgroundIndividuals with PPP2R5D-related neurodevelopmental disorder have an atypical gait pattern characterized by ataxia and incoordination. Structured, quantitative assessments are needed to further understand the impact of these impairments on function. Research questionHow do gait parameters and ambulatory function of individuals with PPP2R5D-related neurodevelopmental disorder compare to age and sex matched healthy norms? MethodsTwenty-six individuals with PPP2R5D pathogenic genetic variants participated in this observational, single visit study. Participants completed at least one of the following gait assessments: quantitative gait analysis at three different speeds (preferred pace walking (PPW), fast paced walking (FPW) and running, six-minute walk test (6MWT), 10-meter walk run (10MWR), and timed up and go (TUG). Descriptive statistics were used to summarize gait variables. Percent of predicted values were calculated using published norms. Paired t-tests and regression analyses were used to compare gait variables. ResultsThe median age of the participants was 8 years (range 4–27) and eighteen (69.2 %) were female. Individuals with PPP2R5D-related neurodevelopmental disorder walked slower and with a wider base of support than predicted for their age and sex. Stride velocity ranged from 48.9 % to 70.1 % and stride distance from 58.5 % to 81.9 % of predicted during PPW. Percent of predicted distance walked on the 6MWT ranged from 30.6 % to 71.1 % representing varied walking impairment. Increases in stride distance, not cadence, were associated with changes in stride velocity in FPW (R2 = 0.675, p =< 0.001) and running conditions (R2 = 0.918, p =< 0.001). SignificanceWe quantitatively assessed the abnormal gait in individuals with PPP2R5D-related neurodevelopmental disorder. These impairments may affect ability to adapt to environmental changes and participation in daily life.Rehabilitative interventions targeting gait speed and balance may improve function and safety for individuals with PPP2R5D-related neurodevelopmental disorder.

Abstract 1743: Pan-cancer review of TP53 somatic alterations as a function of tumor type: Sometimes lost, sometimes gained, frequently altered

Abstract Background: TP53 is the gene most frequently disrupted by somatic alterations in cancer. Mutations include single nucleotide variants resulting in functional alterations, as well as premature stop codons, splice variants, and cryptic alterations. TP53 gene dosage is disrupted by heterozygous and homozygous deletions, copy-neutral loss of heterozygosity, and other structural changes such as intragenic deletions and fusions. TP53 is altered by epigenetic events and viral oncogenes, such as E6 expressed by the human papillomavirus. The readout of altered TP53 includes decreased gene expression of either variant or wild-type alleles. Epistatic alteration of TP53 pathway components have also been described, with the E3 ubiquitin ligase MDM2 being the canonical example. Depending on the type of TP53 alteration, there may be differential signaling consequences, ranging from loss of function and dominant negative to oncogenic signaling. Hypothesis: Patterns of TP53 mutations will vary based on tumor type. Differential alterations of TP53 will suggest differential pathway dependence and downstream pathophysiology that may be relevant to signaling and therapeutic potential. Methods: We analyzed extensive cancer genomics repositories, such as the Pan-Cancer Atlas (10,000+ tumors, &amp;gt;30 cancer types) from The Cancer Genome Atlas project and the International Cancer Genome Consortium. Assessing genes in the TP53 pathway, we examined somatic mutations, copy number alterations, structural changes, and gene expression. Epigenetic data was considered when available. Results: A significant pattern amongst sarcomas, prostate cancers, and urothelial carcinomas emerged, revealing that certain tumors exhibited a predominant classic tumor suppressor gene genotype. This genotype featured frequent homozygous deletions, inactivating mutations, and relatively low TP53 gene expression, often accompanied by epistatic MDM2 amplification. By contrast, other tumors demonstrate an atypical pattern in which TP53 mutations were rarely if ever associated with loss of TP53 gene expression with low levels of homozygous TP53 gene deletion. Likewise, atypical TP53 mutant tumor types rarely demonstrated MDM2 amplifications, and in opposition to typical TP53 cases, MDM2 amplification was positively associated with TP53 mutation rather than anti-correlated. Head and neck squamous cell carcinoma, uterine carcinoma, and pancreatic adenocarcinoma followed this pattern. Investigation within selected tumor types such as lung squamous cell carcinoma suggested that both typical and atypical TP53 mutation patterns could be observed. Conclusions: TP53 mutation patterns were strongly associated with tumor type and may suggest differential pathway activation according to the somatic alteration status. Citation Format: Ubaid A. Tanveer, David N. Hayes, Julie George, Jeremiah R. Holt, Martin Peifer, Roman Thomas. Pan-cancer review of TP53 somatic alterations as a function of tumor type: Sometimes lost, sometimes gained, frequently altered [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 1743.

Transcatheter Arterial Embolization with Bleomycin-Lipiodol of Hepatic Hemangiomas: Safety, Efficacy and Predictors of Response.

To evaluate the safety, efficacy and predictors of response of transcatheter arterial embolization (TAE) to treat hepatic hemangiomas (HHs). A retrospective analysis was conducted of consecutive HH patients who received TAE with bleomycin-Lipiodol emulsion and gelatin sponge particles at three institutions from January 2014 to January 2021. TAE effectiveness was defined as more than 50% reduction of tumor volume. The effectiveness, safety, and CT changes of hemangiomas after TAE were assessed. Factors affecting TAE efficacy on tumor size were analyzed with logistic regression analysis. A total of 102 patients with 109 HHs were included. After treatment, both the tumor diameter and volume were significantly reduced from 8.5 ± 3.9 to 5.9 ± 3.8cm (P < 0.001) and 412.6 ± 742.3cm3 to 102.0 ± 232.7cm3 (P < 0.001), respectively. TAE effectiveness was achieved in 80.7% (88/109) of hemangiomas, which was characterized by progressive reduction in tumor volume over time with Lipiodol retention. Atypical enhancement pattern (tiny enhancing dots in the hepatic arterial and portal venous phase) (p = 0.001) and central arterioportal shunt (APS) (p = 0.002) associated with the tumor were independent predictors of TAE ineffectiveness. Postembolization syndrome and transient increase in liver enzymes were common without severe complications and death. TAE was safe and effective in reducing HH size. Lesion enhancement pattern and APS type were associated with TAE efficacy on tumor shrinkage. Level 3, non-controlled retrospective cohort study.

Conserved patterns of sequence diversification provide insight into the evolution of two-component systems in Enterobacteriaceae.

Two-component regulatory systems (TCSs) are a major mechanism used by bacteria to sense and respond to their environments. Many of the same TCSs are used by biologically diverse organisms with different regulatory needs, suggesting that the functions of TCS must evolve. To explore this topic, we analysed the amino acid sequence divergence patterns of a large set of broadly conserved TCS across different branches of Enterobacteriaceae, a family of Gram-negative bacteria that includes biomedically important genera such as Salmonella, Escherichia, Klebsiella and others. Our analysis revealed trends in how TCS sequences change across different proteins or functional domains of the TCS, and across different lineages. Based on these trends, we identified individual TCS that exhibit atypical evolutionary patterns. We observed that the relative extent to which the sequence of a given TCS varies across different lineages is generally well conserved, unveiling a hierarchy of TCS sequence conservation with EnvZ/OmpR as the most conserved TCS. We provide evidence that, for the most divergent of the TCS analysed, PmrA/PmrB, different alleles were horizontally acquired by different branches of this family, and that different PmrA/PmrB sequence variants have highly divergent signal-sensing domains. Collectively, this study sheds light on how TCS evolve, and serves as a compendium for how the sequences of the TCS in this family have diverged over the course of evolution.

Atypical Pre-excitation Pattern in Asymptomatic Wolff-Parkinson-White—A Hallmark for High Risk?

Abstract Introduction Delta wave morphology during sinus rhythm on 12 lead ECG usually allows for a relatively precise prediction of the anatomic location of an accessory pathway (AP) provided that the rhythm is fully pre-excited. However, the pre-excitation pattern during sinus rhythm usually offers little information about sudden cardiac death (SCD) risk in adult patients with asymptomatic Wolf-Parkinson-White (WPW). Case Presentation A 42-year-old policeman was referred for an asymptomatic WPW pattern with an unusual delta wave. Initial mapping showed that atrio-ventricular (A-V) fusion on the lateral mitral annulus and radiofrequency (RF) ablation induced a shift in the pre-excitation pattern. Re-mapping identified A-V fusion on the left postero-septal area. Another RF application eliminated pre-excitation. Re-mapping identified A-V fusion on the postero-septal aspect of the mitral annulus and another RF application almost instantaneously induced an A-V split and loss of pre-excitation. Post-ablation testing proved normal anterograde A-V conduction without pre-excitation and no ventriculo-atrial conduction. Serial ECGs proved the persistent loss of pre-excitation at one-month of follow-up. Conclusion This case highlights the diagnostic challenges associated with atypical pre-excitation patterns and the importance of a thorough evaluation in asymptomatic individuals. Patients with atypical pre-excitation may harbor multiple accessory pathways (MAPs) and should be carefully assessed to mitigate the risk of SCD.

Recognizing, Evaluating, and Prioritizing the Fundamental Factors Influencing the Growing Prevalence of Transgender and Non-Binary Gender Identity in the Pediatric Population

This review observes the growing demographic of individuals identifying as transgender or non-binary, which currently represents approximately 1.3% (depending on the source) of the U.S. population. This population is shown to skew younger.Environmental xenobiotics, particularly those containing endocrine-disrupting chemicals (EDCs), are scrutinized for their role in affecting hormonal regulation crucial for gender identity differentiation. The research also highlights how exposure to pharmaceuticals with endocrine-disrupting properties may induce atypical patterns in gender identity development, suggesting that a variety of exogenous elements could impact neuroendocrine sexual differentiation.Medical disorders associated with altered androgen levels, such as congenital adrenal hyperplasia (CAH) and androgen insensitivity syndrome (AIS), are considered for their potential influence on gender identity from a biological perspective. Moreover, the role of diet and nutrition, particularly plant-based diets rich in phytoestrogens and conditions linked to obesity and metabolic syndrome, are explored for their effects on hormonal balance and, consequently, gender identity expression.This review acknowledges the significant impact of media representation and societal norms on shaping attitudes concerning gender expression and identity.The article points to psychological assessments and somatic markers as tools to explore prenatal hormone influences on gender identity, though emphasizing that they are not definitive. Furthermore, genetic and epigenetic findings offer a more in-depth understanding but lack diagnostic application. The identification and recognition of transgender and non-binary individuals continue to be self-determined processes that defy objective measurement by current medical standards.

A Convolutional Deep Neural Network Approach to Predict Autism Spectrum Disorder Based on Eye-Tracking Scan Paths

Autism spectrum disorder (ASD) is a developmental disorder that encompasses difficulties in communication (both verbal and non-verbal), social skills, and repetitive behaviors. The diagnosis of autism spectrum disorder typically involves specialized procedures and techniques, which can be time-consuming and expensive. The accuracy and efficiency of the diagnosis depend on the expertise of the specialists and the diagnostic methods employed. To address the growing need for early, rapid, cost-effective, and accurate diagnosis of autism spectrum disorder, there has been a search for advanced smart methods that can automatically classify the disorder. Machine learning offers sophisticated techniques for building automated classifiers that can be utilized by users and clinicians to enhance accuracy and efficiency in diagnosis. Eye-tracking scan paths have emerged as a tool increasingly used in autism spectrum disorder clinics. This methodology examines attentional processes by quantitatively measuring eye movements. Its precision, ease of use, and cost-effectiveness make it a promising platform for developing biomarkers for use in clinical trials for autism spectrum disorder. The detection of autism spectrum disorder can be achieved by observing the atypical visual attention patterns of children with the disorder compared to typically developing children. This study proposes a deep learning model, known as T-CNN-Autism Spectrum Disorder (T-CNN-ASD), that utilizes eye-tracking scans to classify participants into ASD and typical development (TD) groups. The proposed model consists of two hidden layers with 300 and 150 neurons, respectively, and underwent 10 rounds of cross-validation with a dropout rate of 20%. In the testing phase, the model achieved an accuracy of 95.59%, surpassing the accuracy of other machine learning algorithms such as random forest (RF), decision tree (DT), K-Nearest Neighbors (KNN), and multi-layer perceptron (MLP). Furthermore, the proposed model demonstrated superior performance when compared to the findings reported in previous studies. The results demonstrate that the proposed model can accurately classify children with ASD from those with TD without human intervention.

Atypical Presentation of Metastatic Castrate-resistant Prostate Cancer in a Middle Aged African Male with Good Response to Radioligand Therapy.

Prostate cancer typically follows a characteristic pattern of metastatic spread to the pelvic lymph nodes and bone. Atypical patterns of metastasis are rare but have been documented. In African men, this disease tends to follow a more aggressive course, with the possibility of an atypical site of metastatic spread. We present a case of a 58-year- old African male with metastatic castrate-resistant prostate cancer who presented with both typical and atypical patterns of metastatic disease detected by a fluorine 18 prostate-specific membrane antigen positron emission tomography/computed tomography scan. This patient also had a good response to radioligand therapy.

Deciphering complexity: TULP1 variants linked to an atypical retinal dystrophy phenotype.

Introduction: TULP1 exemplifies the remarkable clinical and genetic heterogeneity observed in inherited retinal dystrophies. Our research describes the clinical and molecular characteristics of a patient manifesting an atypical retinal dystrophy pattern, marked by the identification of both a previously unreported and a rarely encountered TULP1 variant. Methods: Whole-exome sequencing was performed to identify potential causative variants. The pathogenicity of the identified TULP1 variants was evaluated through in silico predictors and a minigene splice assay, specifically designed to assess the effect of the unreported TULP1 variant. Results: We identified two TULP1 gene variants in a patient exhibiting unusual and symmetrical alterations in both retinas, characterized by an increase in autofluorescence along the distribution of retinal vessels. These variants included a known rare missense variant, c.1376T>C, and a novel splice site variant, c.822G>T. For the latter variant (c.822G>T), we conducted a minigene splice assay that demonstrated the incorporation of a premature stop codon. This finding suggests a likely activation of the nonsense-mediated mRNA decay mechanism, ultimately resulting in the absence of protein production from this allele. Segregation analysis confirmed that these variants were in trans. Discussion: Our data support that individuals with biallelic TULP1 variants may present with a unique pattern of macular degeneration and periarteriolar vascular pigmentation. This study highlights the importance of further clinical and molecular characterization of TULP1 variants to elucidate genotype-phenotype correlations in the context of inherited retinal dystrophies.

Exploring Biochemical and Hematological Variations in Malaria Cases: A Retrospective Analysis at a Health Center at Mumbai City India

Introduction: In Mumbai, an overpopulated metropolis with tropical conditions, malaria poses a persistent challenge, particularly in damp slum areas. Despite reported declines in death and incidence rates, the city faces a significant burden. Our project focuses on an unusual aspect: a heightened incidence among males, especially during sporadic monsoon outbreaks and in areas undergoing extensive redevelopment. Through an epidemiological survey of infected populations in municipal clinics, supported by microscopic, hematological, and microbiological evidence, we aim to provide insights into this atypical pattern. Materials and Methods: A cross-sectional, partly retrospective study was designed with participants being sourced from regional slums and chawls, during the immediately preceding three-year period of project completion. Patients attending OPDs were randomly selected from amongst those with febrile symptoms related to malarial disease and tested. Symptomatic individuals were tested for malaria microscopically using peripheral blood smear (PBS) and confirmed by employing the malaria antigen test (RMAT). Blood urea by enzymatic method and serum creatinine by Jaffes method. Results: Out of 1651 participants, 8.18% were malaria-positive, predominantly males (87.41%). P. vivax was the main parasite (87.41%), followed by P. falciparum (6.67%) and mixed infections (5.93%). ANOVA revealed significant RBC count differences (F = 6.32, p = 0.003). Tukey's HSD test showed P. vivax patients had higher RBC counts than mixed infection (p = 0.002), while P. falciparum counts were similar to P. vivax (p = 0.089) but higher than mixed infection (p = 0.014). Predominance of P. vivax emphasizes its impact on RBC counts and diagnostic complexities. The p values indicate that for all parameters, except serum creatinine in males, there is a statistically significant difference in the mean values between the malaria positive and negative groups Conclusion: This study highlights high malaria prevalence in urban India, with males more susceptible, possibly due to increased mosquito exposure. P. vivax is predominant, aligning with national data, emphasizing the need for tailored control measures. Surprisingly, P. vivax is associated with higher RBC counts than P. falciparum or mixed infection, suggesting differences in erythrocytic cycles. These findings have critical implications for regional malaria management, prompting further research into underlying mechanisms.

Comprehensive analysis of antigenic variations and genomic properties of hepatitis B virus in clinical samples in the mid-north east region of Bangladesh

This investigation delineates an exhaustive analysis of the clinical, immunological, and genomic landscapes of hepatitis B virus (HBV) infection across a cohort of 22 verified patients. The demographic analysis unveiled a pronounced male bias (77.27%), with patient ages spanning 20 to 85 years and durations of illness ranging from 10 days to 4 years. Predominant clinical manifestations included fever, fatigue, anorexia, abdominal discomfort, and arthralgia, alongside observed co-morbidities such as chronic renal disorders and hepatocellular carcinoma. Antigenic profiling of the HBV envelope proteins elucidated significant heterogeneity among the infected subjects, particularly highlighted by discordances in the detection capabilities of small and large HBsAg assays, suggesting antigenic diversity. Quantitative assessment of viral loads unveiled a broad spectrum, accompanied by atypical HBeAg reactivity patterns, challenging the reliability of existing serological markers. Correlative studies between viral burden and antigenicity of the envelope proteins unearthed phenomena indicative of diagnostic evasion. Notably, samples demonstrating robust viral replication were paradoxically undetectable by the large HBsAg ELISA kit, advocating for more sophisticated diagnostic methodologies. Genotypic examination of three HBV isolates classified them as genotype D (D2), with phylogenetic alignment to strains from various global origins. Mutational profiling identified pivotal mutations within the basic core promoter and preS2/S1 regions, associated with an augmented risk of hepatocellular carcinoma. Further, mutations discerned in the small HBsAg and RT/overlap regions were recognized as contributors to vaccine and/or diagnostic escape mechanisms. In summation, this scholarly discourse elucidates the intricate interplay of clinical presentations, antigenic diversity, and genomic attributes in HBV infection, accentuating the imperative for ongoing investigative endeavors to refine diagnostic and therapeutic modalities.

Tissue-Based Diagnostic Biomarkers of Aggressive Variant Prostate Cancer: A Narrative Review.

Prostate cancer (PC) is a common malignancy among elderly men, characterized by great heterogeneity in its clinical course, ranging from an indolent to a highly aggressive disease. The aggressive variant of prostate cancer (AVPC) clinically shows an atypical pattern of disease progression, similar to that of small cell PC (SCPC), and also shares the chemo-responsiveness of SCPC. The term AVPC does not describe a specific histologic subtype of PC but rather the group of tumors that, irrespective of morphology, show an aggressive clinical course, dictated by androgen receptor (AR) indifference. AR indifference represents an adaptive response to androgen deprivation therapy (ADT), driven by epithelial plasticity, an inherent ability of tumor cells to adapt to their environment by changing their phenotypic characteristics in a bi-directional way. The molecular profile of AVPC entails combined alterations in the tumor suppressor genes retinoblastoma protein 1 (RB1), tumor protein 53 (TP53), and phosphatase and tensin homolog (PTEN). The understanding of the biologic heterogeneity of castration-resistant PC (CRPC) and the need to identify the subset of patients that would potentially benefit from specific therapies necessitate the development of prognostic and predictive biomarkers. This review aims to discuss the possible pathophysiologic mechanisms of AVPC development and the potential use of emerging tissue-based biomarkers in clinical practice.

Neonatal brain dynamic functional connectivity in term and preterm infants and its association with early childhood neurodevelopment

Brain dynamic functional connectivity characterises transient connections between brain regions. Features of brain dynamics have been linked to emotion and cognition in adult individuals, and atypical patterns have been associated with neurodevelopmental conditions such as autism. Although reliable functional brain networks have been consistently identified in neonates, little is known about the early development of dynamic functional connectivity. In this study we characterise dynamic functional connectivity with functional magnetic resonance imaging (fMRI) in the first few weeks of postnatal life in term-born (n = 324) and preterm-born (n = 66) individuals. We show that a dynamic landscape of brain connectivity is already established by the time of birth in the human brain, characterised by six transient states of neonatal functional connectivity with changing dynamics through the neonatal period. The pattern of dynamic connectivity is atypical in preterm-born infants, and associated with atypical social, sensory, and repetitive behaviours measured by the Quantitative Checklist for Autism in Toddlers (Q-CHAT) scores at 18 months of age.

Globalisation and current employment situation in South Africa: An exploratory enquiry

Globalisation is a broad concept that has continuously impacted various aspects of human endeavours. Globalisation has influenced the realignment of business strategies as well as impacted the availability of jobs in many countries. In modern organisations, managers must understand how current globalisation impacts employment situations. Since the dawn of contemporary globalisation in the early 1990s, several path breaking advances have emerged. These advances have also impacted the ways works are coordinated in the workplace. For instance, recently the use of independent contractors has increased as opposed to permanent appointed employees. As a matter of fact, globalisation has impacted employment situations in several ways. Hence, the current paper is an attempt to explore how globalisation has impacted employment situations in South Africa. The main finding of the paper revealed that there is a rising trend in job insecurity in most organisations owing to advanced sophisticated technologies and the utilisation of more atypical employment pattern in the form of casualisation.

Divergent maturational patterns of the infant bacterial and fungal gut microbiome in the first year of life are associated with inter-kingdom community dynamics and infant nutrition

BackgroundThe gut microbiome undergoes primary ecological succession over the course of early life before achieving ecosystem stability around 3 years of age. These maturational patterns have been well-characterized for bacteria, but limited descriptions exist for other microbiota members, such as fungi. Further, our current understanding of the prevalence of different patterns of bacterial and fungal microbiome maturation and how inter-kingdom dynamics influence early-life microbiome establishment is limited.ResultsWe examined individual shifts in bacterial and fungal alpha diversity from 3 to 12 months of age in 100 infants from the CHILD Cohort Study. We identified divergent patterns of gut bacterial or fungal microbiome maturation in over 40% of infants, which were characterized by differences in community composition, inter-kingdom dynamics, and microbe-derived metabolites in urine, suggestive of alterations in the timing of ecosystem transitions. Known microbiome-modifying factors, such as formula feeding and delivery by C-section, were associated with atypical bacterial, but not fungal, microbiome maturation patterns. Instead, fungal microbiome maturation was influenced by prenatal exposure to artificially sweetened beverages and the bacterial microbiome, emphasizing the importance of inter-kingdom dynamics in early-life colonization patterns.ConclusionsThese findings highlight the ecological and environmental factors underlying atypical patterns of microbiome maturation in infants, and the need to incorporate multi-kingdom and individual-level perspectives in microbiome research to improve our understandings of gut microbiome maturation patterns in early life and how they relate to host health.5AtmDGbifCkZAT-p1B-BuFVideo

Covid-19 Pneumonia Presenting as a ‘Typical Radiological Bronchopneumonia’ Pattern in Clinical-Radiological-Pathological Phenotype with Transient Hyperglycemia

Radiological phenotypes are radiological patterns or observable characteristics of COVID19 pneumonia. Various phenotypic classifications have been reported in literature. CT severity radiological phenotypes are widely used and universally accepted radiological phenotypic methods. Radiological CT severity phenotypic differentiation has documented very crucial role in initial assessment and during triaging of these cases in indoor and outdoor setting. Typical COVID-19 lung parenchymal involvement described as predominant ground glass opacities (GGOs) and consolidations in peripheral and subpleural portion of any lobe, predominantly involving lower lobes. Atypical Radiological patterns in COVID-19 has been documented as bronchopneumonia, multifocal consolidations, necrotizing pneumonia, cavitations with GGOs with or without consolidations. In present case report, 43-year male, presented with acute febrile respiratory illness with acute hypoxic respiratory failure documented as oxygen saturation of 80% at room air with tachypnea and respiratory distress. HRCT thorax was showing Pleural based, peripheral, central, multifocal patchy, confluent &amp; ill-defined GGOs and consolidations in bilateral lung fields in upper, middle and lower lobes. These typical radiological features suggestive of bronchopneumonia like radiological pattern which was very unusual for typical COVID-19 radiology. His laboratory parameters have shown abnormally raised inflammatory markers like CRP, Ferritin, LDH, D-Dimer and IL-6. Importantly, his random blood sugars were raised with abnormally raised HbA1c levels to label as diabetes mellitus. He was diagnosed with diabetes mellitus this time with COVID-19 illness without use of steroids. He was treated with standardized COVID-19 management institutional protocol with combination of low molecular weight heparin, methylprednisolone, remdesivir, meropenem and teicoplanin. Patient required BIPAP support with higher oxygen requirement with nasals canula for one week due to advanced radiological disease with more anatomical involvement. We have documented successful treatment outcome with use of rational treatment in timely by predicting disease severity with use of composite analysis of clinical, laboratory and radiological markers of illness. Transient hyperglycemia is known to occur and reported after COVID-19 illness due to virus induced inflammatory response and pancreatopathy with beta cell dysfunction. Transient hyperglycemia can be easily managed with insulin during hospitalization and oral anti-diabetic agents after discharge for few weeks. Dietary and lifestyle modification will help in majority with complete reversal of abnormally high sugar levels with restoration of normal HbA1c levels to non-diabetic range.

Work hours, weekend working, nonstandard work schedules and sleep quantity and quality: findings from the UK household longitudinal study

BackgroundAtypical temporal work patterns such as working longer than the standard 35–40 h/ week, weekend working, and nonstandard work schedules (i.e. outside of the typical 9–5, including but not restricted to shiftwork) are increasingly prevalent in the UK. Aside from occupation-specific studies, little is known about the effects of these atypical temporal work patterns on sleep among workers in the UK, even though poor sleep has been linked to adverse health problems, lower workplace productivity, and economic costs.MethodWe used regression models to investigate associations between three types of atypical temporal work patterns (long and short weekly work hours, weekend working, and nonstandard schedules) and sleep duration and disturbance using data from over 25,000 employed men and women from 2012–2014 and/or 2015–2017 in the UK Household Longitudinal Study, adjusting for potential confounders and psychosocial work factors.ResultsWe found that relative to a standard 35–40 h/week, working 55 h/week or more was related to short sleep (less than 7 h/night) and sleep disturbance. Working most/all weekends compared to non-weekends was associated with short sleep, long sleep (more than 8 h/night), and sleep disturbance, as was working nonstandard schedules relative to standard schedules (fixed day-time schedules). Further analyses suggested some gender differences.ConclusionsThese results should prompt employers and policymakers to recognise the need for rest and recovery, consider how the timing and scheduling of work might be improved to better support workers’ health and productivity, and consider appropriate compensation for anyone required to work atypical temporal work patterns.

Atypical pattern separation memory and its association with restricted interests and repetitive behaviors in autistic children.

Memory challenges remain understudied in childhood autism. Our study investigates one specific aspect of memory function, known as pattern separation memory, in autistic children. Pattern separation memory refers to the critical ability to store unique memories of similar stimuli; however, its role in childhood autism remains largely uncharted. Our study first uncovered that the pattern separation memory was significantly reduced in autistic children, and then showed that reduced memory performance was linked to their symptoms of repetitive, restricted interest and behavior. We also identified distinct subgroups with profiles of reduced and increased generalization for pattern separation memory. More than 72% of autistic children showed a tendency to reduce memory generalization, focusing heavily on unique details of objects for memorization. This focus made it challenging for them to identify commonalities across similar entities. Interestingly, a smaller proportion of autistic children displayed an opposite pattern of increased generalization, marked by challenges in differentiating between similar yet distinct objects. Our findings advance the understanding of memory function in autism and have practical implications for devising personalized learning strategies that align with the unique memory patterns exhibited by autistic children. This study will be of broad interest to researchers in psychology, psychiatry, and brain development as well as teachers, parents, clinicians, and the wider public.