Secondary Dissemination Research Articles

Exploring the composition features of commercial gentrification - a case study of Taipei City

The phenomenon of commercial gentrification, marked by transformations in commercial spaces and retail patterns, is increasingly evident globally, significantly altering consumption spaces to cater to new residents and impacting main shopping areas. This study examines commercial gentrification in Taipei City, focusing on identifying affected areas and analyzing their environmental characteristics. Using secondary dissemination areas as spatial units, the research constructs quantifiable indicators to map the occurrence of commercial gentrification. Principal component analysis (PCA) is employed to explore the environmental factors correlated with this process. Taipei City's historical and economic evolution, characterized by significant infrastructure developments and commercial transformations, provides the context for this study. The threshold strategy revealed patterns of commercial gentrification within the Da'an, Zhongzheng, and Songshan districts, with Da'an displaying the most significant changes. The weighted results suggest that areas experiencing commercial gentrification showcase a high degree of diversity, a lower presence of vulnerable populations, and superior public transportation and amenities. This study aims to provide insights into the spatial dynamics and environmental impacts of commercial gentrification, offering a comprehensive understanding of its progression in Taipei City.

LGG-12. INTEGRATED CLINICAL AND MOLECULAR CHARACTERIZATION OF 200 DISSEMINATED PEDIATRIC LOW-GRADE GLIOMAS

Abstract Pediatric low-grade gliomas (PLGG) have excellent outcomes overall but are a major clinical challenge when disseminated. Diffuse leptomeningeal glioneuronal tumor (DLGNT) is a recognised entity both clinically and pathologically, however many disseminated LGG (DLGG) fall outside this diagnosis. To better understand the clinical and molecular features of DLGG as well as risk factors for dissemination, we assembled an international consortium of 30 sites, contributing over 200 patients with clinical annotation, along with genomic and methylation profiling. DLGG have worse progression-free (PFS) and overall survival (OS) than PLGG overall (p<0.0001). Seventy (35%) presented with a localized mass and secondary dissemination, including some with initial gross-total resection. The most common growth pattern observed (n=77, 40%) is a dominant suprasellar/optic pathway tumor with leptomeningeal drop-metastases involving the brainstem and spinal cord. Only 27 (14%) patients had diffuse tumors (without an identifiable dominant mass), and these had significantly worse OS (p=0.03). The most common pathologic diagnosis was pilocytic/pilomyxoid astrocytoma (n=92; 53%). DLGNT comprised a minority of cases (n=23, 14%), with a trend (p=0.056) towards worse survival compared to other diagnoses. The most frequent molecular alteration was BRAF fusion (78/151 with molecular testing; 52%), followed by FGFR mutations or fusions (18/151; 12%). BRAF V600E was underrepresented (14/151; 9%). 1p deletion was rare (17 patients) but highly associated with DLGNT. Methylation classification (n=70) was highly concordant with histologic diagnoses rather than clinical behavior. Importantly, patients who received upfront targeted therapies (TT; BRAF and/or MEK inhibition, n=9) had better PFS compared to those receiving chemotherapy (n=146, p=0.05). Furthermore, patients who were treated sequentially with chemo then TT had longer PFS on TT (p=0.011). This study presents the largest cohort of DLGG to date, expanding our understanding of the clinical, pathologic, and molecular features of this disease and supports the use of upfront targeted therapy.

Origin and dispersal of the Mycobacterium tuberculosis Haarlem genotype: Clues from its phylogeographic landscape and human migration

The Haarlem family belongs to the Euro-American phylogenetic lineage of Mycobacterium tuberculosis and is one of the globally spread genotypes of this important human pathogen. In spite of the sporadic observations on drug resistance and peculiar virulence profile, Haarlem remains in the shade of other M. tuberculosis genotypes. I analyzed genotyping data of the Haarlem genotype in light of its pathogenic properties and relevant human migration, to gain insight into its origin, evolutionary history, and current spread. Central Europe is marked with a very high prevalence of both major Haarlem subclades ancestral H3/SIT50 and derived H1, jointly making 33–41% in Czechia, Austria, and Hungary. There is a declining gradient of Haarlem beyond central Europe with 10–18% in Italy, France, Belgium, 10–13% in the Balkan countries and Turkey. Placing the available genetic diversity and ancient DNA data within the historical context, I hypothesize that M. tuberculosis Haarlem genotype likely originated in Central Europe and its primary long-term circulation occurred within the area of the former Austria/Austria-Hungary Empire in the 14th-19th centuries. The genotype is not highly transmissible and its spread was driven by long-term human migration. The European colonial expansion (when accompanied by a sufficient volume of migration) was a vehicle of its secondary dissemination. I conclude that human migration and its lack thereof (but not strain pathobiology) was a major driving force that shaped the population structure of this global lineage of M. tuberculosis. At the same time, Haarlem strains appear over-represented in some ethnic groups which warrants in-depth experimental research.

Innovative Surgical Approaches That Improve Individual Outcomes in Advanced Breast Cancer.

Breast cancer is the most common cause of cancer death in women and the second cause in the general population. The incidence has increased over time. Women in developing countries often present at an advanced stage where initial surgery is not feasible. Short disease-free intervals, the number of metastatic organs and liver metastasis were consistently associated with poor overall survival. Surgery is an integral part of the therapeutic plan for locally advanced breast cancer. The integration of surgical care into the management of patients with advanced cancer has changed substantially with the use of neoadjuvant chemotherapy. Also, more recently, neoadjuvant endocrine therapy and targeted therapies offer new opportunities to downsize the tumor burden and transform the role of surgery for this population from palliation to largely curative intent. Innovative surgical approach to the primary tumor in metastatic disease may provide survival benefits and local control in some patients. Similar to systemic therapy, surgical therapy for secondary dissemination should be considered in certain cases for improved individual outcomes. Advances in reconstructive techniques have improved the quality of life of these patients.

Big data background of county-level media “mobility” pressure cracking strategy

Abstract The construction of county-level integrated media is facing a communication dilemma, and it must alter the way and method of communication by using big data. In this paper, under the background of big data, the basic metric features of the users of integrated media communication are calculated by name similarity, one-hot coding features, following rate, etc., which are combined with the pixel statistical characteristics and avatar personality features to build a user portrait of integrated media communication. Taking the user’s profile as the anchor point of communication, the CD-VAE model is used to predict and analyze the early communication of integrated media content. Through case studies, the current characteristics of county-level integrated media and the trend of primary and secondary dissemination are examined. The first and second newspapers were distributed 278 times and 251 times, respectively, with a conversion rate of 12.61%. The primary and secondary dissemination of Jitterbug reached 303 and 284 times, respectively, as media in the era of mobile Internet. The use of big data technology can effectively analyze the development pain points of county-level integrated media.

Tuberculosis Mimicking-Musculoskeletal Tumor of The Hand: An Uncommon Case of Extrapulmonary Tuberculosis

Background: Musculoskeletal extrapulmonary tuberculosis is accounting for only 10-15% of all cases. Current attention has been focused on hand tuberculosis due to its increasing prevalence. This study describes an unusual case of extrapulmonary tuberculosis that manifested as a soft tissue tumor of the hand.Case Report: A 17-year-old male presented with a painful swollen part of the 3rd finger of the left hand. The mass was irregular and suppurative, with discoloration and foul smell. Laboratory results showed anemia and increased erythrocyte sedimentation rate. The computed tomography scan showed an isodense soft tissue (size 2.19 cm x 1.59 cm x 4.21cm) across the distal to the proximal part of 3rd phalanx bone to the metacarpal region with a decrease of phalanx bone density with no sign of bone destruction or any periosteal reaction. The histopathology study revealed a chronic granulomatous structure surrounded by epitheloid cells, datia Langhans cells, and caseating necrosis. The acid-fast staining confirmed the presence of bacilliform bacteria.Discussion: Extrapulmonary tuberculosis typically results from secondary hematogenous dissemination and reactivation of the main foci. There are no specific tests to diagnose musculoskeletal tuberculosis preoperatively, leading to delayed diagnosis. Histopathological examination and culture are needed to confirm the diagnosis.Conclusions: Slow progression and multiple differential diagnoses frequently result in a delayed diagnosis, which leads to complications. Initial radical excision and anti-tuberculosis multidrug therapy provide excellent functional outcomes and recurrence prevention.

Adrenal Abscesses: A Systematic Review of the Literature.

Objective: To summarize the existing knowledge about adrenal gland abscesses, including etiology, clinical presentation, common laboratory and imaging findings, management and overall morbidity and mortality. Design: Systematic literature review. Methods: We performed a search in the PubMed database using search terms: 'abscess and adrenal glands', 'adrenalitis', 'infection and adrenal gland', 'adrenal abscess', 'adrenal infection' and 'infectious adrenalitis'. Articles from 2017 to 2022 were included. We found total of 116 articles, and after applying exclusion criteria, data from 73 articles was included in the final statistical analysis. Results: Of 84 patients included in this review, 68 were male (81%), with a mean age of 55 years (range: 29 to 85 years). Weight loss was the most frequent symptom reported in 58.3% patients, followed by fever in 49%. Mean duration of symptoms was 4.5 months. The most common laboratory findings were low cortisol (51.9%), elevated ACTH (43.2%), hyponatremia (88.2%) and anemia (83.3%). Adrenal cultures were positive in 86.4% cases, with Histoplasma capsulatum (37.3%) being the leading causative agent. Blood cultures were positive in 30% of patients. The majority of the adrenal infections occurred through secondary dissemination from other infectious foci and abscesses were more commonly bilateral (70%). A total of 46.4% of patients developed long-term adrenal insufficiency requiring treatment. Abscess drainage was performed in 7 patients (8.3%) and adrenalectomy was performed in 18 (21.4%) patients. The survival rate was 92.9%. Multivariate analysis showed that the only independent risk factor for mortality was thrombocytopenia (p = 0.048). Conclusion: Our review shows that adrenal abscesses are usually caused by fungal pathogens, and among these, Histoplasma capsulatum is the most common. The adrenal glands are usually involved in a bilateral fashion and become infected through dissemination from other primary sources of infection. Long-term adrenal insufficiency develops in 46% of patients, which is more common than what is observed in non-infectious etiology of adrenal gland disorders. Mortality is about 7%, and the presence of thrombocytopenia is associated with worse prognosis. Further prospective studies are needed to better characterize optimal testing and treatment duration in patients with this relatively rare but challenging disorder.

LGG-12. CLINICAL AND MOLECULAR FEATURES OF DISSEMINATED PEDIATRIC LOW-GRADE GLIOMA

Abstract Although most pediatric LGG (PLGG) have excellent long-term survival, there is a subset of cases that disseminate throughout the neuraxis (DLGG) that have very poor outcomes. The reason for this aggressive behavior is unknown but we hypothesize that distinct and specific biological mechanisms underlie the metastatic ability. The methylation-based class of diffuse leptomeningeal glioneuronal tumor (DLGNT) is characterized by MAPK pathway activating fusions with chromosome 1p loss, 19q loss, and/or 1q gain. However, it is unknown what proportion of DLGG match the DLGNT group, and which other methylations classes are at risk of metastasis. To improve our understanding of this rare patient population, we created an international DLGG consortium. Data from the first 68 cases shows a broad age distribution and no sex predilection. As expected, DLGG has much worse prognosis than the overall PLGG population. Virtually all DLGG progress at 5 years, compared to a quarter of other PLGG, and DLGG are 5-times more likely to die at 10 years. We observe three patterns of dissemination – 35% present with a localized mass and have secondary dissemination, 50% with disseminated tumor and a clear dominant mass, and 15% with disseminated disease without a dominant mass. In 47 patients with molecular testing, BRAF fusions accounted for 64% of driver alterations. Additional alterations were identified less frequently, including BRAF V600E (9%), FGFR1 alterations (9%), and KRAS mutations (4%). In 25 patients with methylation profiling, 10 (40%) successfully classified with a calibrated score above 0.8, illustrating that many cases do not fit a defined methylation group. The most common methylation classification was pilocytic astrocytoma (5 patients), and surprisingly only two patients classified as DLGNT. In sum this study illustrates the variable clinical behaviour associated with metastasis in PLGG and expands the range of molecular driver alterations, including ones previously unreported in DLGNT.

Research on endogenous internet public opinion dissemination in Chinese universities based on SNIDR model

During an emergency, the negative Internet public opinion in colleges and universities, especially the negative endogenous public opinion, will have a serious impact on the reputation of colleges and universities. It is of great significance to find out the negative influencing factors of endogenous public opinion and explore the mechanism of public opinion dissemination for resolving the crisis of public opinion in universities. The existing research does not distinguish the endogenous Internet public opinion in colleges and universities from the general Internet public opinion in colleges and universities, and the SIR model adopted fails to fully reflect the difference between students and other dissemination subjects of endogenous public opinion in campus. In addition, various research methods and models currently used focus on the static expression of dissemination results, and the explanation of results is insufficient. The reason is that they do not well express the dynamic interaction mechanism between influencing factors and the dynamic conversion rate between roles. In this study, based on the improved infectious disease model and system dynamics theory, AnyLogic software is used to simulate the improved SNIDR model of infectious disease, to analyze the sensitivity of school supervision, school intervention, school response time and information transparency and to study the dynamic conversion rate between different roles. The SNIDR model effectively simulates the process of endogenous public opinion dissemination in colleges and universities after emergencies. The results show that, what has the greatest impact on the dissemination of public opinion is the school’s supervision and intervention efforts, which can suppress the dissemination from the source. Information transparency is an auxiliary variable and cannot function independently. During the dissemination period, the timelier the school responds, the faster the spreaders will drop to zero, and the better it will be to control the secondary dissemination of public opinion.

Non-Hodgkin’s Gastric Lymphoma: Case Report

More than 95% of gastric lymphomas are Non-Hodgkin’s lymphoma. It is very difficult to distinguish primary gastric lymphoma from secondary stomach dissemination. Here we reported a case of high-grade B cell type Non-Hodgkin’s gastric lymphoma. The patient presented with upper abdominal swelling associated with anorexia, vomiting, and weight loss. He was hemodynamically unstable and needed ICU support. But before starting R-CHOP chemotherapy he was expired. The diagnosis of gastric lymphoma can be delayed for many years due to the presence of nonspecific symptoms. High-grade Non-Hodgkin’s lymphoma is very aggressive, but treatment response is better than low-grade lymphoma. Here we suggest early diagnosis and management of high-grade Non-Hodgkin’s gastric lymphoma to save the patient’s life.

The eye and lymphoma: New concepts of an old acquaintance

AbstractIntraocular lymphoma (IOL) is a life‐threatening condition that results from the proliferation of malignant lymphocytic cells arising from either the central nervous system (CNS) (primary CNS lymphoma) or outside the CNS with secondary dissemination and metastasis to the eye (secondary IOL). Primary intraocular lymphoma (PIOL), also known as primary vitreoretinal lymphoma (PVRL), is a subset of PCNSL where the findings are ocular.PVRL is particularly feared because it can manifest as non‐specific uveitis, leading to a potentially fatal diagnostic delay. Although clinical and ancillary parameters can provide valuable diagnostic clues, the only valid confirmation comes from cytological analysis and molecular studies of clonality based on vitreous and/or (sub)retinal biopsies performed during vitrectomy. Standard three‐port twenty‐five‐gauge transconjunctival vitrectomy is the usual sampling technique; however, it is important to remember that the diagnostic yield of vitreous cells depends on the way samples are harvested, transported and analysed. Even when surgical recommendations are strictly followed and analyses performed by trained pathologists, the diagnostic yield of vitrectomy is not 100%.The objective of this course is to describe the clinical features of PVRL and its characteristics on ancillary exams in both typical and more challenging situations, and present the diagnostic procedures that are or will be available in the near future. Therapeutic management will be discussed later during this course.

34188 A case of systemic anaplastic large cell lymphoma with secondary cutaneous involvement

Systemic anaplastic large cell lymphoma (sALCL) is a rare, malignant T-cell lymphoma characterized by CD30 expression. There are 2 subtypes: ALK-positive sALCL and ALK-negative sALCL. In either condition, extranodal involvement is uncommon and secondary dissemination to the skin only occurs in about 20% of patients. We report a unique case in a 75-year-old woman who presented with multiple crops of pruritic papules in different stages of healing along her back for 3-4 weeks. Erythematous papules on her arms, as well as lymphadenopathy, were also present.

Bioinformatics analysis and experimental verification of Notch signalling pathway-related miRNA–mRNA subnetwork in extracellular vesicles during Echinococcus granulosus encystation

BackgroundEncystation of the protoscoleces (PSCs) of Echinococcus granulosus is the main cause of secondary hydatid dissemination in the intermediate host. Extracellular vesicles (EVs) can transfer miRNAs into parasite cells to regulate mRNA expression. However, loading of developmental pathway-related miRNAs, such as those related to the Notch signalling pathway in EVs is unclear. Thus, we screened the miRNA-mRNA subnetwork involved in the Notch pathway during E. granulosus encystation in vitro and assessed changes in expression in the parasite and EVs.MethodsmRNAs and miRNAs differentially expressed (DE) between PSCs and microcysts (MCs) were screened using high-throughput sequencing. DE mRNAs obtained from transcriptome analysis were intersected with mRNAs predicted to be targets of the conserved DE miRNAs of a small RNA library. DE miRNA functions were analysed using public databases, and a miRNA–mRNA subnetwork related to the Notch pathway was established. Notch pathway-related mRNA and miRNA expression of worms and EVs at different times was verified.ResultsIn total, 1445 DE mRNAs between MCs and PSCs were screened after the intersection between 1586 DE mRNAs from the transcriptome and 9439 target mRNAs predicted using 39 DE miRNAs from the small RNA library. The DE mRNAs were clustered into 94 metabolic pathways, including the Notch pathway. Five DE miRNAs, including the most significantly expressed new DE miRNA, egr-new-mir0694-3p, corresponding to four target mRNAs (EgrG_000892700, EgrG_001029400, EgrG_001081400 and EgrG_000465800) were all enriched in the Notch pathway. The expression of the above mRNAs and miRNAs was consistent with the results of high-throughput sequencing, and the expression of each miRNA in EVs was verified. Annotated as ADAM17/TACE in the Notch pathway, EgrG_000892700 was down-regulated during PSC encystation. egr-miR-4989-3p and egr-miR-277a-3p expression in EVs after encystation was nearly five times that in EVs before encystation, which might regulate the expression of EgrG_000892700.ConclusionsFive miRNAs corresponding to four target mRNAs may be involved in regulating the Notch pathway during the PSC encystation. EVs may regulate the expression of EgrG_000892700 in PSCs because of continuous targeting of egr-miR-4989-3p and egr-miR-277a-3p and participate in the regulation the Notch pathway. The study might expand new ideas for blocking the secondary infection of E. granulosus PSCs via EVs miRNAs.Graphical

Bibliometric study on creative and cultural industries (2010-2020)

The creative and cultural industries represent a brand-new topic when studying the local development as well as the economic and industrial growth, focused on attracting qualified personnel to generate knowledge. Its application has been extended to many industries, like the artistic and cultural ones, where goods and services are produced from sensory and symbolic objectives. Thus, it is important to know if the scientific community’s contributions are enough for the study of the subject and which opportunity areas exist for further and complementary studies. This paper aims to collect, review, and analyze the scientific production of articles on creative and cultural industries from 2010 to 2020, and to obtain the main bibliometric indicators such as co-authorship, quality and secondary dissemination indexes.

Kinetics of the Growth of Enterococcus spp. Biofilm Formed by Strains Isolated from Patients with Infectious Complications after Large joint Replacements.

We studied the kinetics of growth of biofilms and plankton forms of Enterococcus spp. strains isolated in implant-associated infection of large joints. The capacity for biofilm formation by enterococci was demonstrated. The following stages of biofilm formation were revealed: biofilm formation and maturation, its degradation, and secondary dissemination. These findings extend our understanding of the wound process caused by enterococci.

Gastrointestinal Tract Injury by Yttrium-90 Appears Largely Restricted to Resin Microspheres But Can Occur Years After Embolization.

Radioembolization therapy utilizes yttrium-90 (Y90) impregnated resin (SIR-Spheres) or glass (TheraSpheres) microspheres to selectively target hepatic lesions via transarterial radioembolization. Occasional cases of gastrointestinal tract injury, secondary to nontargeted delivery of microspheres, have been reported, but large descriptive pathology series are lacking. We identified 20 cases of histologically confirmed mucosal injury associated with Y90 from 17 patients and assessed the corresponding clinical and pathologic sequelae. The mucosal biopsies were obtained from 1 to 88 months following Y90 therapy (median: 5 mo). Most cases were gastric (17, 85%), while the remaining were duodenal. Endoscopic ulceration was seen in the majority of cases (16, 80%), and mucosal erythema in the remaining 4. Histologically, a majority (19, 95%) of cases showed rounded, dark blue to purple microspheres measuring 4 to 30 µm, consistent with resin microspheres. A single case with glass microspheres demonstrated 26 µm translucent beads. Histologic evidence of ulceration was appreciated in 14 (70%) cases, and the microspheres were clearly intravascular in 6 (30%). A foreign body giant cell reaction to the microspheres was uncommon (3 cases, 15%). We additionally performed a retrospective review of all gastrointestinal tissue obtained postprocedure from 784 sequential patients treated with Y90 microspheres. Three patients (0.4%) demonstrated the presence of resin microspheres upon histologic examination. No cases involving glass-based Y90 were identified ( P =0.0078), despite the majority of patients having received glass radioembolization (630, 80%). This increased risk of secondary sphere dissemination is likely related to the increased number of particles required per activity for resin versus glass microspheres. We conclude that Y90 microspheres may be encountered in the gastrointestinal tract years after initial liver-targeted therapy and, when present, are often associated with mucosal ulceration. This finding is less likely to be encountered in patients who received Y90 radioembolization utilizing glass microspheres.

Fibrin(ogen) engagement of S. aureus promotes the host antimicrobial response and suppression of microbe dissemination following peritoneal infection.

The blood-clotting protein fibrin(ogen) plays a critical role in host defense against invading pathogens, particularly against peritoneal infection by the Gram-positive microbe Staphylococcus aureus. Here, we tested the hypothesis that direct binding between fibrin(ogen) and S. aureus is a component of the primary host antimicrobial response mechanism and prevention of secondary microbe dissemination from the peritoneal cavity. To establish a model system, we showed that fibrinogen isolated from FibγΔ5 mice, which express a mutant form lacking the final 5 amino acids of the fibrinogen γ chain (termed fibrinogenγΔ5), did not support S. aureus adherence when immobilized and clumping when in suspension. In contrast, purified wildtype fibrinogen supported robust adhesion and clumping that was largely dependent on S. aureus expression of the receptor clumping factor A (ClfA). Following peritoneal infection with S. aureus USA300, FibγΔ5 mice displayed worse survival compared to WT mice coupled to reduced bacterial killing within the peritoneal cavity and increased dissemination of the microbes into circulation and distant organs. The failure of acute bacterial killing, but not enhanced dissemination, was partially recapitulated by mice infected with S. aureus USA300 lacking ClfA. Fibrin polymer formation and coagulation transglutaminase Factor XIII each contributed to killing of the microbes within the peritoneal cavity, but only elimination of polymer formation enhanced systemic dissemination. Host macrophage depletion or selective elimination of the fibrin(ogen) β2-integrin binding motif both compromised local bacterial killing and enhanced S. aureus systemic dissemination, suggesting fibrin polymer formation in and of itself was not sufficient to retain S. aureus within the peritoneal cavity. Collectively, these findings suggest that following peritoneal infection, the binding of S. aureus to stabilized fibrin matrices promotes a local, macrophage-mediated antimicrobial response essential for prevention of microbe dissemination and downstream host mortality.

How COVID-19 affects children: a review article

Coronavirus disease 2019 (COVID-19) has affected 550,369 confirmed cases, with 8,856 fatalities. COVID-19 was more common in adults over 15 during the early outbreak, and the proportion of confirmed cases among youngsters was relatively low. In addition, children with COVID-19 are asymptomatic or have mild clinical symptoms compared to adults. The present study reviewed the clinical features, signs, symptoms, and effect of COVID-19 in children. This review was performed through an electronic literature search for relevant studies identified using keywords on the MEDLINE database between 2020 and 2021, inclusive: COVID-19, COVID-19 in children, coronavirus, novel coronavirus in children, COVID-19 symptoms in children, COVID-19 effect in children. Similar keywords were used to peruse and identify relevant articles on Google Scholar. The articles were chosen based on defined inclusion criteria. The current review included papers published between 2020 and 2021. The review was written under specific titles in the discussion part. This review concluded that children of all ages are susceptible to getting COVID-19 due to human-to-human transmission. COVID-19 has a milder clinical course, quicker recovery, and a better prognosis in children than adults. Infants less than 1 year and children with underlying chronic disorders were at higher risk of having severe forms of COVID-19. Septic shock, toxic encephalopathy, multiple organ failure syndromes, disseminated intravascular coagulation, and status epilepticus were the most common consequences identified in children with severe forms of COVID-19. Infection prevention by isolation of diseased children is critical, as is thorough surveillance, early diagnosis of illness complications, and the ability to treat patients on time while preventing secondary dissemination.

Clinical and molecular features of disseminated pediatric low-grade glioma and glioneuronal tumors: a systematic review and survival analysis.

Disseminated pediatric low-grade gliomas and glioneuronal tumors (dpLGG/GNTs) are associated with a poorer prognosis than nondisseminated pLGG/GNTs. To date there is no comprehensive report characterizing the genome profile of dpLGG/GNTs and their relative survival. This systematic review aims to identify the pattern of genetic alterations and long-term outcomes described for dpLGG/GNT. A systematic review of the literature was performed to identify relevant articles. A quality and risk of bias assessment of articles was done using the GRADE framework and ROBINS-I tool, respectively. Fifty studies published from 1994 to 2020 were included in this review with 366 cases reported. There was sporadic reporting of genetic alterations. The most common molecular alterations observed among subjects were 1p deletion (75%) and BRAF-KIAA1549 fusion (55%). BRAF p.V600E mutation was found in 7% of subjects. A higher proportion of subjects demonstrated primary dissemination compared to secondary dissemination (65% vs 25%). First-line chemotherapy consisted of an alkylation-based regimen and vinca alkaloids. Surgical intervention ranged from biopsy alone (59%) to surgical resection (41%) and CSF diversion (28%). Overall, 73% of cases were alive at last follow-up. Survival did not vary by tumor type or timing of dissemination. All studies reviewed either ranked low or moderate for both quality and risk of bias assessments. Chromosome 1p deletion and BRAF-KIAA1549 fusion were the most common alterations identified in dpLGG/GNT cases reviewed. The relative molecular heterogeneity between DLGG and DLGNT, however, deserves further exploration and ultimately correlation with their biologic behavior to better understand the pathogenesis of dpLGG/GNT.

The lymphatic vasculature: An active and dynamic player in cancer progression.

The lymphatic vasculature has been widely described and explored for its key functions in fluid homeostasis and in the organization and modulation of the immune response. Besides transporting immune cells, lymphatic vessels play relevant roles in tumor growth and tumor cell dissemination. Cancer cells that have invaded into afferent lymphatics are propagated to tumor‐draining lymph nodes (LNs), which represent an important hub for metastatic cell arrest and growth, immune modulation, and secondary dissemination to distant sites. In recent years many studies have reported new mechanisms by which the lymphatic vasculature affects cancer progression, ranging from induction of lymphangiogenesis to metastatic niche preconditioning or immune modulation. In this review, we provide an up‐to‐date description of lymphatic organization and function in peripheral tissues and in LNs and the changes induced to this system by tumor growth and progression. We will specifically focus on the reported interactions that occur between tumor cells and lymphatic endothelial cells (LECs), as well as on interactions between immune cells and LECs, both in the tumor microenvironment and in tumor‐draining LNs. Moreover, the most recent prognostic and therapeutic implications of lymphatics in cancer will be reported and discussed in light of the new immune‐modulatory roles that have been ascribed to LECs.