Yellow Circles Research Articles

First Report of Aspergillus westerdijkiae Causing Leaf Blight on Rehmannia glutinosa in China.

Rehmannia glutinosa (also known as Chinese foxglove) is a perennial dicotyledonous herb, which plays an important role in traditional Chinese medicine. Its active ingredients have a wide range of pharmacological effects on the blood system, endocrine system, immune system, cardiovascular system, and nervous system (Zhang et al. 2008). In May 2022, leaf blight was observed on 45-day-old R. glutinosa in a seedling nursery in Jiaozuo City (35°01'44.20″N, 113°05'30.63″E), Henan Province, China with an approximate disease incidence up to 54% (~1,300 plants). Irregular brown lesion initially appeared on the tips of basal leaves, then progressed to the entire leaf causing leaf drying out (Supple. Fig. 1-A, B, C). The same symptoms appeared successively in the leaves from the base to the top of the plant, which eventually caused the whole plant to die. To identify the pathogen, eight symptomatic leaves were randomly collected from eight individual plants, and cut into small pieces (5 × 5 mm) at the border of lesions. The pieces were surface disinfected in 75% ethanol for 15 s, followed by 1% NaClO for 1 min, rinsed in sterile water three times, and placed on potato dextrose agar (PDA) medium in the dark for 3 days at 25℃. Finally, 12 purified isolates (DHY1-DHY12) were obtained by using single spore method. Leaves of R. glutinosa seedlings were inoculated with conidial suspension (106 conidia/ml), three plants were inoculated per isolate. Controls were treated with sterilized water. All inoculated and control plants were incubated in a greenhouse at 25℃ under 80 ± 10% humidity and a 8-h/16-h dark/light cycle. This experiment was repeated three times. After 5 days, similar symptoms to those of diseased leaves in the seedling nursery appeared on leaves inoculated with DHY4-DHY10, while plants inoculated with DHY1-DHY3, DHY11-DHY12, and the controls remained asymptomatic (Supple. Fig.1-D, E). The same fungi were re-isolated from diseased leaves, fulfilling Koch's postulates. The causal agents DHY4 to DHY10, showed similar morphology, which were morphologically identified as Aspergillus sp. (Visagie et al. 2014). Isolate DHY5 was selected for further study. On PDA plates, the colonies were covered with white velutinous mycelia (Supple. Fig.1-F). Conidia were ochre yellow and outwards concentric circles. Vesicles were globose, and about 20.1-26.6 μm in diameter (Supple. Fig.1-G). Conidiophore stipes were smooth walled and hyaline, with conidial heads radiating. The conidia were light yellow to orange, exudate clear to orange droplets. The conidia were (2.53-3.25) μm × (2.58-3.47) μm in diameter (n=50) (Supple. Fig.1-H). For further molecular identification, the ITS and TUB gene sequences were amplified with primer pairs ITS1/ITS4 and BT2a/BT2b (Glass and Donaldson. 1995), respectively. BLASTn searches of the ITS (PP355445) and TUB (PP382788) sequences showed 100% and 98.42% similarity to those of A. westerdijkiae (OP237108 and OP700424), respectively. Phylogenetic analysis based on the concatenated sequences of ITS and TUB confirmed that the fungus was A. westerdijkiae, (Supple. Fig.2). A. westerdijkiae was mainly reported on its secondary metabolite ochratoxin A contamination of agricultural products, fruits, and various food products, such as coffee beans (Alvindia et al 2016), grapes (Díaz et al. 2009), oranges and fruit juice (Marino et al. 2009), etc. To our knowledge, this is the first report of A. westerdijkiae causing leaf blight on R. glutinosa in China.

A reflection on Hong Kong’s yellow economic circle

ABSTRACT Emerged from the anti-extradition law amendment bill movement in 2019, the yellow economic circle (YEC) is the first ever widely adopted political consumerism in post-handover Hong Kong, where people buycott yellow (pro-movement) and boycott blue (anti-movement/ pro-Beijing/ pro-HKSAR-government) businesses. The reflection’s prominence lies in the popular engagement in YEC, and the political consumerism still lingers in the city even after the abrupt end of the 2019 movement. Existing research lacks the exploration of the meanings YEC entailed in relation to the context of Hong Kong and the lessons YEC can impart to the city’s civil society development. By classifying YEC into “sign” and “process,” the article first examines the particular juncture at which YEC emerged to show how Beijing has tried to govern Hong Kong through the market. It subsequently delves into a discourse analysis, scrutinizing how Beijing has constructed a civility for the market, which is later reshaped by YEC. Drawing on Chantal Mouffe’s theorization of “politics” as well as Hardt and Negri’s discussion of “identitarian love,” the article continues by shedding light on the identity politics and oxymoron of liberal democracy inherent in the political consumerism. It also addresses the narrow democratic imagination reflected in different incidents arising from YEC, which may be symptomatic of Hong Kong’s current political struggle. The exploration concludes with suggestions on how the YEC can strengthen Hong Kong’s civil society after Beijing’s crackdown.

The PIVOT App: A User Guide

Background: While the pivot shift examination is often regarded as the gold standard test for diagnosis of anterior cruciate ligament (ACL) injury, one of the pitfalls of the pivot shift test is that it lacks standardization among physicians. The PIVOT App is a validated application to quantify the amount of tibial translation during the pivot shift maneuver and improve standardization of clinical measurement. Indications: The PIVOT App can be used in both clinic and operating room settings for patients who sustained injury to the ACL. The PIVOT App may assist in identifying the amount of rotatory knee laxity in patients with ACL deficiency or following ACL reconstruction. Technique Description: The PIVOT App works by quantifying the amount of translation in the lateral tibia relative to a marker on the lateral femoral epicondyle. To use the PIVOT App, 3 yellow circle stickers are placed on the bony prominences of the lateral knee: the lateral epicondyle, Gerdy’s tubercle, and the “pivot point” 3 cm posterior to Gerdy’s tubercle parallel to the joint line. Once placed, the pivot shift flexion maneuver can be recorded in the PIVOT App and analyzed to identify both the distance of spontaneous tibial reduction during the pivot shift maneuver and the time of reduction in seconds. The most common problems encountered while using the application include (1) improper marker placement, (2) interference of marker tracking with yellow color in the background, (3) interference of marker tracking with overhead lighting, and (4) extraneous data collection before and after pivot shift flexion. Results: Previous studies have validated the PIVOT App to accurately distinguish normal, low-grade, and high-grade pivot shifts with resultant increasing tibial translation in the lateral compartment of the knee. The PIVOT App has been used at institutions worldwide to quantify and standardize measurement of the pivot shift. Conclusion: The PIVOT App is a validated application to quantify the amount of lateral tibial translation and reduction during the pivot shift maneuver. Proper use and avoidance of complications while using the application can aid clinicians in accurate diagnosis of rotatory knee laxity in patients following ACL injury. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.

Augmented reality technology shortens aneurysm surgery learning curve for residents

Objectives We aimed to prospectively investigate the benefit of using augmented reality (AR) for surgery residents learning aneurysm surgery. Materials and methods Eight residents were included, and divided into an AR group and a control group (4 in each group). Both groups were asked to locate an aneurysm with a blue circle on the same screenshot after their viewing of surgery videos from both AR and non-AR tests. Only the AR group was allowed to inspect and manipulate an AR holographic representation of the aneurysm in AR tests. The actual location of the aneurysm was defined by a yellow circle by an attending physician after each test. Localization deviation was determined by the distance between the blue and yellow circle. Results Localization deviation was lower in the AR group than in the control group in the last 2 tests (AR Test 2: 2.7 ± 1.0 mm vs. 5.8 ± 4.1 mm, p = 0.01, non-AR Test 2: 2.1 ± 0.8 mm vs. 5.9 ± 5.8 mm, p < 0.001). The mean deviation was lower in non-AR Test 2 as compared to non-AR Test 1 in both groups (AR: p < 0.001, control: p = 0.391). The localization deviation of the AR group decreased from 8.1 ± 3.8 mm in Test 2 to 2.7 ± 1.0 mm in AR Test 2 (p < 0.001). Conclusion AR technology provides an effective and interactive way for neurosurgery training, and shortens the learning curve for residents in aneurysm surgery.

ARTIFICIAL INTELLIGENCE AS A LEARNING MEDIA IN ENGLISH EDUCATION: BIBLIOMETRIC USING BIBLIOSHINY ANALYSIS (2009-2023)

This research examines the publication trends and emerging keywords within the domain of artificial intelligence applied to English education. Analyzing 74 documents sourced from Scopus using RStudio and Vosviewer revealed distinct patterns. Notably, the year 2021 marked a significant milestone with 26 articles, constituting 35.14% of total publications, while the preceding decade (2009-2020) contributed only 13 articles, representing less than 18%. However, the period from 2021 to 2023 experienced a noteworthy surge, introducing over 80% of the total publications, incorporating 60 new articles. Esteemed institutions like Hebei University of Engineering in China and three other affiliates each contributed 4 publications. The prominence of the ACM International Conference Proceedings Series underscores the influential role of technology conferences in shaping discussions around artificial intelligence in English education. An influential article, cited 20 times, focused on the integration of 5G and AI technologies to reform English education at universities, considering the necessity of cutting-edge technological infrastructure. Visual analysis highlights specific keywords such as speech recognition, quality control, teaching systems, and learning algorithms within yellow circles, suggesting potential areas for further research in the intersection of artificial intelligence and English education.

Quantifier processing and semantic flexibility in patients with aphasia.

Processing of quantifiers such as "many" and "few" relies on number knowledge, linguistic abilities, and working memory. Negative quantifiers (e.g., "few," "less than half") induce higher processing costs than their positive counterparts. Furthermore, the meaning of some quantifiers is flexible and thus adaptable. Importantly, in neurotypical individuals, changing the meaning of one quantifier also leads to a generalized change in meaning for its polar opposite (e.g., the change of the meaning of "many" leads to the change of that of "few"). Here, we extended this research to patients with fluent and non-fluent aphasia after stroke. In two experiments, participants heard sentences of the type "Many/few of the circles are yellow/blue," each followed by a picture with different quantities of blue and yellow circles. The participants judged whether the sentence adequately described the picture. Each experiment consisted of three blocks: a baseline block to assess the participants' criteria for both quantifiers, a training block to shift the criteria for "many," and a test block, identical to the baseline to capture any changes in quantifier semantics. In Experiment 1, the change of the meaning of "many" was induced by using adaptation to small numbers (20-50%) of circles of the named color. In Experiment 2, explicit feedback was given in the training block after each response to rate proportions of 40% (or higher) as "many," whereas 40% is normally rather rated as "few." The objective was to determine whether people with fluent or non-fluent aphasia were able to process quantifiers appropriately and whether generalized semantic flexibility was present after brain damage. Sixteen out of 21 patients were able to perform the task. People with fluent aphasia showed the expected polarity effect in the reaction times and shifted their criteria for "many" with generalization to the untrained quantifier "few." This effect, however, was only obtained after explicit feedback (Experiment 2) but not by mere adaptation (Experiment 1). In contrast, people with non-fluent aphasia did not change the quantifier semantics in either experiment. This study contributes to gaining new insights into quantifier processing and semantic flexibility in people with aphasia and general underlying processing mechanisms.

Evidence that proactive distractor suppression does not require attentional resources.

Does the suppression of irrelevant visual features require attentional resources? McDonald et al. (2023, Psychonomic Bulletin & Review, 30, 224-234) proposed that suppression processes are unavailable while a person is busy performing another task. They reported the absence of the PD (believed to index suppression) when two tasks were presented close together in time. We looked for converging evidence using established behavior measures of suppression. Following McDonald et al., our participants performed a rapid serial visual presentation (RSVP) task followed by a search task. For the RSVP task, participants determined whether the target digit 4 or 6 appeared within a string of other digits. The search display appeared at a lag of 2 or 8 digits after the RSVP target. Participants searched for a yellow target circle amongst nine background circles, which included a uniquely colored distractor for some trials. The main question was whether distractor suppression would occur at Lag 2, while attentional resources were still processing the RSVP target. Suppression was assessed using the capture-probe paradigm. On 30% of trials, probe letters appeared inside the colored circles and participants reported those letters. Probe recall accuracy was lower at locations with distractor colors than those with neutral colors (the baseline), suggesting proactive suppression. Critically, this difference in probe recall accuracy was similar at Lag 2 and Lag 8, suggesting that the ability to proactively suppress distractors remains intact while dual-tasking. We argue that although reactive suppression likely requires attentional resources, proactive suppression-an implicit process-does not.

Research Development on Management of Child-Friendly Schools (CFS) in Elementary School: A Bibliometric Analysis Using VOSviewer

The purpose of this study was to analyze the research trends development of management on child-friendly schools (CFS) management at the elementary school. The research method used is bibliometric analysis. Data was obtained from the Google Scholar database in the form of papers published in international journals from 2017-2022. Data processing was carried out in three stages, 1) data collection, 2) data selection and 3) data analysis using VOSviewer. The results showed that the trend of research development on management of child-friendly school was highest in 2013 with 162 publications. The results of the overlay analysis shown in yellow circles indicate research topics that are often used in recent research, namely young child, early childhood education, children, appropriate education, need, school closure, learning, pandemic, covid, parent and home. While topics that are rarely used are clinician, school climate, school closure, disability, anxiety, autism spectrum disorder, women. The results of this study illustrate that the research topic for management of child-friendly school can be developed towards the term model of friendly schools for women and disabilities, development of a child-friendly school climate, and friendly schools for children with special needs.

Diverse changes of ramus coronary artery on computed tomography derived fractional flow reserve due to ramus artery in normal coronary artery disease

Abstract Funding Acknowledgements Type of funding sources: None. Background The ramus artery contributes to the development of turbulence, which may influence computed tomography (CT) derived fractional flow reserve (FFRCT) even without coronary artery disease. The relationship between ramus-induced turbulence and FFRCT is unclear. Purpose To investigate the effect of the ramus artery on FFRCT in normal coronary arteries. Methods A total of 120 consecutive patients who underwent both CT angiography including FFRCT and invasive coronary angiography, resulting in &amp;lt; 20% coronary artery stenosis were evaluated. The patients were divided into three groups: absent-ramus (n = 72), small-ramus that could not be analysed by FFRCT (n = 18), and large-ramus that could be analysed by FFRCT (n = 30). FFRCT was measured at the proximal and distal segments of the left anterior descending (LAD), left circumflex (LCX), and ramus artery (in absent-ramus group, FFRCT was measured at just above the bifurcation between LAD and LCX) were measured. The proximal FFRCT segment (proximal LAD, yellow circle; proximal Ramus or just above the bifurcation angle, yellow square; proximal LCX, yellow triangle) was measured at the same level of each vessel and the distal segment (distal LAD, white circle; distal ramus, white square; distal LCX, white triangle) was measured at obtained by the FFRCT analysis (Figure 1). Vessel morphology (vessel length, lumen volume, plaque volume), bifurcation angle, and left ventricular mass were assessed. Results In the absent-ramus group, proximal FFRCT showed no significant difference between three vessels (LAD, 0.96 ± 0.02; MID, 0.97 ± 0.02; LCX, 0.97 ± 0.02). However, in small and large-ramus groups, proximal FFRCT was significantly higher in the ramus artery than LAD and LCX (small-ramus: LAD = 0.95 ± 0.03, Ramus = 0.97 ± 0.02, LCX = 0.95 ± 0.03; large-ramus: LAD = 0.95 ± 0.03, ramus = 0.98 ± 0.01; LCX = 0.96 ± 0.03; p &amp;lt; 0.05) (Figure 2). A large ramus was associated with a higher prevalence of a distal FFRCT ≤0.80 (odds ratio 7.0, 95% CI 1.2–40.1. p = 0.03). A proximal ramus diameter predicted distal FFRCT ≤ 0.80 (cut-off 2.1 mm, AUC 0.76, sensitivity 100%, specificity 52%, 95% CI 0.61–0.90). Conclusions The presence of a large-ramus artery may cause an FFRCT decline in normal coronary arteries.

Strong surface winds in Storm Eunice. Part 1: storm overview and indications of sting jet activity from observations and model data

Strong surface winds in Storm <i>Eunice</i>. Part 1: storm overview and indications of sting jet activity from observations and model data

A Bibliometric Analysis of Instructional Technological Leadership Research Using VOSviewer

This study aims to analyze the development of research on technology-related instructional leadership. The research method used is bibliometric analysis. The articles used in this study were sourced from the Google Schooler database with the help of the Publication of Perish from 2015-2022; 498 papers were found. Data analysis using the VOSviewer application. The results showed that the number of publications decreased yearly, where the most occurred in 2015, namely 102 publications. The results of the density visualization analysis shown in yellow circles indicate the themes most frequently used in recent research, namely instructional technology, technology integration, instructional leadership practice, school leader, transformational leadership, covid, time and student. Meanwhile, based on network visualization, the topic of instructional leadership has a relationship with the term development, effect, effectiveness, instructional leader, instructional leadership, instructional leadership practice, leader, leadership, model, principal, research, school, school leader, school leadership, school principal and transformational leadership. These results illustrate that technology-based instructional leadership can be developed by referring to instructional technology, technology integration, as a term rarely used based on visualization overlay.

On preventing capture: Does greater salience cause greater suppression?

It has been proposed that salient objects have high potential to disrupt target performance, and so people learn to proactively suppress them, thereby preventing these salient distractors from capturing attention in the future. Consistent with this hypothesis, Gaspar et al. (Proceedings of the National Academy of Sciences, 113(13), 3693-3698, 2016) reported that the PD (believed to index suppression) was larger for high-salient color distractors than for low-salient color distractors. The present study looked for converging evidence that salience triggers suppression using established behavior measures of suppression. Following Gaspar et al., our participants searched for a yellow target circle among nine background circles, which sometimes included one circle with a unique color. The distractor was either high or low in salience with respect to the background circles. The question was whether the high-salient color would be proactively suppressed more strongly than the low-salient color. This was assessed using the capture-probe paradigm. On 33% of trials, probe letters appeared inside colored circles and participants were to report those letters. If high-salient colors are more strongly suppressed, then probe recall accuracy should be lower at locations with the high-salient color than those with the low-salient color. Experiment 1found no such effect. A similar finding was observed in Experiment 2after addressing possible floor effects. These findings suggest that proactive suppression is not caused by salience. We propose that the PD reflects not only proactive suppression but also reactive suppression.

Acquired Cutaneous Lymphangiectasia of Vulva: A Novel Dermoscope Finding.

A 61-year-old woman presented with a 1-year history of multiple, oozy, raised pruritic lesions over the genitalia. Four years back, she had undergone radical hysterectomy followed by loco-regional radiotherapy for her stage IIA carcinoma cervix. On physical examination, she had multiple, grouped, translucent, thin-walled vesicles resembling “frogspawn” on the bilateral labia majora [Figure 1]. Histopathological examination showed a hyperkeratotic epidermis with multiple dilated lymphatic channels in the superficial and deep dermis. Dermoscopy (Dermlite 4) revealed clustered, translucent, reddish-white lacunae surrounded by whitish septa. Few lacunae showed radially arranged, hairpin-like vessels [Figure 2]. The features were consistent with acquired cutaneous lymphangiectasia of vulva (ACLV). Radiofrequency ablation of the lesions was performed and she was under regular follow-up.Figure 1: Multiple, grouped, translucent to flesh-colored, fluid-filled vesicles - ”frogspawn appearance” on labia majoraFigure 2: Dermoscopy (Dermlite 4: Polarized view, 10× magnification) showing clustered, translucent, reddish-white lacunae surrounded by whitish septa (yellow circle). Few lacunae showed radially arranged hairpin-like vessels (black circles)ACLV is a rare entity, which occurs secondary to conditions like trauma, surgery, keloids, radiation, scleroderma, pregnancy, malignancies, Crohn’s disease, or infections like erysipelas, tuberculosis, filariasis, and lymphogranuloma venereum. These conditions cause destruction of lymph nodes and impair lymphatic flow thereby resulting in the accumulation of lymph in dermal lymphatics producing vesicles.[1] The differential diagnosis includes lymphangioma circumscriptum, syringoma, condyloma, herpes, warts, molluscum contagiosum, and benign hemangioendothelioma.[12] Errichetti et al.[3] in their dermoscopy of ACLV reported a vascular pattern with well-demarcated, round to oval red lacunae surrounded by white areas/lines with several punctiform and a few irregular vessels. In addition, we have observed radially arranged hairpin-like vessels in our case. In dermoscopy, similar hairpin-like vessels are found in seborrheic keratosis, keratoacanthoma, squamous cell carcinoma, amelanotic melanoma, superficial basal cell carcinoma (BCC), nodular BCC, eccrine poroma, porocarcinoma, and pilomatrixoma.[4] We report this case for the novel dermoscopic finding. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.

Dermoscopy of Crusted Scabies: Revisiting the New and Old Signs.

Dear Editor, Scabies is a common ectoparasitosis in India caused by the eight-legged mite, Sarcoptes scabiei var. hominis. Crusted scabies occurs predominantly in immunosuppressed individuals and presents with diffuse hyperkeratotic scales, crusts, or even erythroderma. It is highly contagious because crusted scabies patient may harbor millions of mites on their body in contrast to 10–12 mites found in classical scabies.[1] It may often be misdiagnosed due to the absence of typical nocturnal pruritus and atypical clinical presentations. Dermoscopy is extremely useful in the diagnosis of this uncommon variant of the common parasitosis. We present a case of crusted scabies showing the classical and newly described dermoscopic signs. A 38-year-old female, case of mixed connective tissue disease, on treatment with daily prednisolone (10 mg) along with azathioprine 100 mg and admitted to the medical ward due to cirrhosis and ascites, presented with skin rash of 1 month duration. On clinical examination, generalized erythematous rash with scaly papules and crusting was seen along with multiple dry crusted hyperkeratotic plaques (showing wet sand appearance) predominantly over the bony prominences, trunk, limbs, and scalp [Figure 1].Figure 1: (a) multiple dry crusted hyperkeratotic plaques with erythematous scaly papules and crusting. (b) scaly crusted plaque involving the scalp. (c) “wet sandpaper” appearance of crusted plaquesDermoscopic examination showed numerous burrows in a “noodle-like pattern” with multiple brownish triangular structures (delta glider sign) [Figure 2a]. These burrows showed the “gray-edged line sign”, which is a gray-brownish line on the outer edges of the burrow (Figure 2b) and wake sign [Figure 3]. Potassium hydroxide (KOH) mount of scales revealed numerous scabies mites and eggs [Figure 4]. On histopathology, hyperkeratosis, parakeratosis, acanthosis, and scabies mites in the stratum corneum were seen [Figure 5]. The patient was advised topical application of 5% permethrin cream every third day for 2 weeks along with oral ivermectin 12 mg to be taken on day 1, 2, and 8.Figure 2: Dermoscopy showing (a) “noodle-like pattern” consisting of accumulation of several curvilinear burrows displaying the “gray-edged line sign” [blue arrowhead (in fig b also)]. (Heine delta NC1, polarized, 10×) (b) brown-colored triangular structure (yellow arrow) that simulates a delta glider trailed by the jet contrail (inset). (Dinolite Videodermoscope polarized non-contact 50x)Figure 3: Wake sign—the burrow (black lines) and the wake-shaped scale (dashed line) together presenting a Y-shaped lesion. (Higher magnification Dinolite Videodermoscope polarized non-contact 50×)Figure 4: Potassium hydroxide mount showing numerous mites (red arrows), eggs (blue arrowhead), and scybala (yellow circles)Figure 5: Multiple scabies mites (black arrow) in stratum corneum (H & E 10x)Burrows are the pathognomonic lesions of scabies; however, they are difficult to be seen on naked eyes, especially in brown skin and in patients with excoriations. Various eponymous dermoscopic signs of scabies include “Delta sign”/“hang glider sign”/“triangle sign” (brownish triangular structures in the shape of hang glider) corresponding to the head and anterior legs of the mite and “Jetliner with contrail sign” (where the mite body appears translucent and air-filled burrow resembles a jetliner with contrail).[2] “Noodle pattern” or “millipede-like structure” (showing numerous burrows) as seen in our case is a characteristic dermoscopy sign of crusted scabies.[3] “Gray-edged line sign” on dermoscopy is a recently described sign where the dark line is often seen on the outer wall of the curved burrow and is supposed to form mainly due to the melanin containing fecal material of the mite, which gets deposited on the outer wall by the tail end of the mite as it crosses the curved burrow.[4] “Wake sign” is described as a pattern of scale reminiscent of the “wake” left on the water surface by a moving object.[5] All the dermoscopic signs were seen in our case. Thus dermoscopy is an extremely useful, rapid, and noninvasive in vivo tool for the diagnosis of crusted scabies. This case is interesting as the dermoscopic signs of noodle pattern and gray-edged line sign have not been previously described in Indian patients. Declaration of patients consent The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient has given his consent for his images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.

1899. The magnitude and durability of the antibody response to mRNA-based vaccination among SARS-CoV-2 seronegative and seropositive healthcare personnel

Abstract Background Development of robust vaccination guidelines against SARS-CoV-2 requires an understanding of the longitudinal antibody (Ab) response to vaccination and interactions with natural infection. Here, we leveraged an observational cohort study of healthcare personnel (HCP) to study the impact of prior SARS-CoV-2 infection on Ab binding and neutralization after mRNA-based vaccination over a 13 month period. Methods From July 2020 to February 2022, HCP at an academic medical center provided blood samples biweekly for 12 weeks and monthly thereafter. First and second vaccine doses became available in mid-December 2021 and boosters were available starting in October 2021. Individuals were excluded if they did not provide any samples, if baseline serostatus was unknown, and if they received a monoclonal Ab treatment for COVID. ELISA measured total immunoglobulin (Ig) and IgG binding to SARS-CoV-2 RBD. Neutralization was measured by live virus Nanoluc SARS-CoV-2ic assay. Demographics, serostatus, and vaccinations for the total study population and the sub-sample of participants with pre- and post-vaccination antibody measurements. Results Of 213 participants, 192 met inclusion criteria. A majority had detectable IgG levels 8 months after a second dose. Prior to vaccination, median total Ig was higher among seropositive vs. seronegative participants (3.7 vs 1.0, p&amp;lt; 0.001). After a first dose, the median total Ig response was two-fold higher in seropositive compared to seronegative participants (13.8 vs. 7.0, p=0.009). A similar pattern was noted with IgG binding and neutralization. After the second dose, median IgG increased to similar levels in both seropositive and seronegative participants (22.1 vs. 21.2, p=0.8). Neutralization after the second dose was slightly higher in seropositive vs. seronegative participants (log10 3.1 vs. 2.5, p=0.075). Durability of IgG responses after second dose of mRNA-based vaccination against SARS-CoV-2 IgG P/N measurements after 5 days post-V2 for the entire study cohort (incident seropositive: yellow circles, prevalent seropositive (red circles), seronegative (open circles) are shown. The solid lines represent Loess curves for incident and prevalent seropositive participants combined (orange line) and those who were seronegative (grey line). SARS-CoV-2-specific total Ig and IgG subtype responses among healthcare personnel before and after vaccination against SARS-CoV-2 with an mRNA-based vaccine. Total Ig P/N ratios at pre-vaccine, post-V1, post-vaccine 2 (post-V2), and post-booster dose (post-boost) timepoints by serostatus (seronegative: n(-), seropositive: n(+)) are shown in the left panel. For the pre-vaccine time point, the most recent antibody level prior to vaccination (for those who were vaccinated) or most recent antibody level overall (for those who were not vaccinated) is shown. For the post-vaccine time points, the first measurement after 5 days post-vaccination is included. Individuals who were infected with SARS-CoV-2 at any time after the first vaccine dose are shown as open circles with black outlines. The black numbers next to the circles indicate the number of days between vaccination and sample collection for seropositive individuals. SARS-CoV-2 specific IgG P/N ratios respectively at pre-vaccine, post-V1, post-V2, and post-boost timepoints by serostatus (seronegative: n(-), seropositive: n(+)) are shown in the right panel. One individual tested positive for SARS-CoV-2 by PCR shortly after the second vaccine dose (V2); post-V2 results were excluded for this participant. For the pre-vaccine time point, the most recent antibody level prior to vaccination (for those who were vaccinated) or most recent antibody level overall (for those who were not vaccinated) is shown. For the post-vaccine time points, the first measurement after 5 days post-vaccination is included. The dotted line is a P/N ratio of 2.4, the cut-off associated with 99.3% specificity (SARS-CoV-2 IgG-positive above the line, IgG-negative below). Individuals who were infected with SARS-CoV-2 at any time after the first vaccine dose are shown as open circles with black outlines. The black numbers next to the circles indicate the number of days between vaccination and sample collection for seropositive individuals. SARS-CoV-2 D614G live virus neutralization among healthcare personnel by serostatus prior to vaccination. Example neutralization curves are shown in Panel A. Panel B shows the SARS-CoV-2 D614G live virus neutralization titers displayed as EC50 for seropositive (prevalent and incident) individuals and a subset of seronegative individuals. Samples for seronegative individuals were selected by matching on age and time between vaccination and sample collection to the samples from seropositive individuals. Conclusion Antibody responses after SARS-CoV-2 vaccination persist up to 1 year with wide individual variability. Though prior infection was associated with greater Ab responses after a first dose, it did not significantly modify responses after second and third doses. Still, we observed overall slightly higher Ab levels among individuals that had a prior infection before any one of the 3 doses of vaccine. These results suggest that immunity against SARS-CoV-2 prior to vaccination has a role in initial response but does not significantly modify circulating Ab titers after multiple doses of vaccination. Disclosures All Authors: No reported disclosures.

S2408 A Case of Advanced Esophageal Carcinosarcoma

Introduction: The majority of esophageal cancers are classified histologically as squamous cell carcinomas or adenocarcinomas. We present a case of a 69-year-old man, presented with progressive dysphagia, found to have an esophageal carcinosarcoma, a rare etiology of esophageal cancer. Case Description/Methods: A 69-year-old man, an everyday smoker with a history of ongoing alcohol use, presented for the evaluation of unintentional weight loss and progressive dysphagia of 2 months duration. Upper endoscopy revealed a large, 6 cm in diameter, partially obstructing ulcerating mass in the mid esophagus. PET/CT revealed intense FDG uptake in the esophageal mass, mediastinal lymph nodes, T6 and T10 ribs suggestive of metastatic disease. Surgical pathology of the tumor was consistent with a high grade squamous cell carcinoma mixed with a high grade spindle cell sarcoma (carcinosarcoma). The patient was started on chemoradiation including Paclitaxel, Carboplatin. Improvement of symptoms and CT findings was documented with treatment (Figure). Discussion: Esophageal cancer ranks seventh in incidence and sixth in cancer-related mortality. The majority of esophageal cancers are classified histologically as squamous cell carcinomas or adenocarcinomas. When 2 distinct malignant components, both carcinomatous and sarcomatous are present histologically, the tumor is classified as esophageal carcinosarcoma (ECS). The pathogenesis is debatable, with some arguing that it is an initial carcinoma, facilitating a simultaneous secondary development of sarcoma, while others hypothesize a single cell origin. Carcinosarcomas were documented in tumors of the uterus, breast, thyroid, lung and gastrointestinal tract. ECSs have a rare incidence, accounting for approximately 1.5% of all esophageal tumors. It has been noted that ECS tumors have different clinical behaviors when compared to squamous cell carcinomas or adenocarcinomas. ECS tumors were noted to have a calculated doubling time of 2.2 months, with predominantly exogenous polypoid growth, perhaps explaining the earlier symptom of dysphagia, earlier diagnosis and more favorable 5 year survival rate. Given their rarity, no standard protocol has been developed to treat ECS tumors. Resection, regional lymph node dissection, radiotherapy and chemotherapy have all been utilized. Our case presentation further enriches the literature regarding rare, advanced esophageal adenocarcinoma tumors responding to systemic therapy.Figure 1.: A, B - Endoscopic findings. A large protruding, 6 cm in diameter partially obstructing ulcerating mass in the mid esophagus. C - Intense FDG uptake by the esophageal tumor in the esophagus (green arrow) and intense FDG uptake in the posterior/lateral aspect of the right T6 rib (yellow circle). D - Intensely avid subcarinal lymph node (yellow circle).

S2047 Is It Anal or Rectal? A Rare Case of Squamous Cell Carcinoma

Introduction: Primary rectal squamous cell carcinomas (SCC) are extremely rare and difficult to distinguish from anal cancers. The majority of rectal SCC are secondary to anal SCC extension and detected at an advanced stage. Although rectal and anal cancers are anatomically close, they are distinct entities with risk factors, different histologic features, patterns of spread, staging systems, and treatment pathways. We present a rare case of a middle-aged man with AIDS who presented with bloody diarrhea, eventually found to have a primary rectal SCC. Case Description/Methods: A 59-year-old-male with a history of AIDS presented with bloody diarrhea and fevers. He denied abdominal or rectal pain. Physical exam only revealed mild tenderness of the abdomen. Labs were unremarkable. Gastrointestinal PCR revealed shigella, enteroaggregative E. Coli, enterotoxigenic E. coli, and enteropathogenic E. coli infection. Computed tomography of the abdomen and pelvis revealed pancolitis and left irregular rectal wall thickening, concerning for rectal carcinoma. He was started on IV ciprofloxacin and metronidazole with improvement in symptoms. Colonoscopy revealed a non-obstructing mass in the rectum. Pathology demonstrated high-grade anal intraepithelial lesion (AIN-3) and focally invasive squamous cell carcinoma, with acute and chronically inflamed rectal mucosa. Given the incongruence between colonoscopy and pathology, it was uncertain whether a primary lesion of the rectum with spread to anus existed or if 2 separate pathologies were present. Repeat colonoscopy to define the anatomic location of the mass revealed a severely ulcerated, friable, rectal lesion, discontinuous from an area of anal inflammation, separated by normal mucosa. Repeat pathology revealed invasive and in situ SCC of the rectum. The patient was referred for chemoradiation with 5-fluorouracil and mitomycin (Figure). Discussion: Primary rectal SCC accounts for 0.01% of all colo-rectal carcinomas. Risk is increased in patients with a history of Human Papilloma virus infection. The diagnosis of primary rectal SCC requires 3 criteria: (i) exclusion of metastasis, (ii) no squamous-lined fistulous tract involving the affected rectum, and (iii) exclusion of anal SCC with proximal extension (absence of continuity between the tumor and the normal anal squamous epithelium). Our patient ultimately fulfilled all these criteria. Primary rectal SCC should be considered a differential diagnosis in patients with HIV/AIDS, presenting with bloody diarrhea and a rectal mass.Figure 1.: CT of the abdomen and pelvis (A) revealing an irregular, asymmetric rectal wall thickening centered laterally on the left, highly concerning for rectal carcinoma, in addition to a focal left-sided outpouching from the rectum, suggesting a thick-walled diverticulum. Colonoscopy showing a rectal mass with ulcerated and friable mucosa (B&D). Area of anal inflammation (yellow circle, C) discontinuous from rectal mass with an adjacent small area of normal epithelium.

Redefining consumer nationalism: The ambiguities of shopping yellow during the 2019 Hong Kong Anti-ELAB movement

An iconic characteristic of Hong Kong’s social unrest in 2019 was the establishment of the so-called “yellow economic circle”—a networked system of retailers and consumers linked by shared political values. Movement sympathizers chose to consume products from retailers perceived as supporting movement aims and boycotted retailers thought to be in favor of closer ties with China. This research focuses on the challenges of the yellow economic circle through the lenses of class and consumer nationalism. Drawing on social media posts and interviews with pro-democracy individuals from different socio-economic backgrounds, we highlight challenges to the sustainability of the “yellow economic circle.” Class-based purchasing power represented an obstacle to the success of the yellow economic circle; however, it was not the biggest challenge. Instead, an inherent incompatibility between the movement’s aims and the means for achieving these aims posed the biggest hurdle. Navigating this incompatibility represented an opportunity for movement participants to develop innovations in thinking about consumer nationalism and the role purchasing power may play in participation. We conclude that the way participants defined consumer nationalism determined whether the yellow economic circle could be understood to engender a shared “Hong Kong identity” and eliminate existing class differences.

Testing the memory reconsolidation hypothesis in a fear extinction paradigm: The effects of ecological and arbitrary stimuli.

Various studies demonstrated that extinction training taking place shortly after the activation of the acquired fear could weaken the conditioned fear. The procedure is called post-retrieval extinction (PRE). However, from the time it emerged, it has suffered from inconsistencies in the ability of researchers to replicate the seemingly established effects. Extant literature implies that conditioned fear might be differentially sensitive to the nature of conditioned stimuli (CS) used. The aim of the present study, therefore, is threefold. First, we aimed to replicate Schiller et al. (Nature, 463, 49-53. 2010) procedure in which the PRE had produced positive results with arbitrary CSs only. Also, we examined the PRE as a function of CS type (ecological-fear-relevant (images of spider and snake) vs. arbitrary (images of yellow and blue circles)). Finally, we aimed to investigate the long-term effects of the PRE (i.e., 24 h, 15 d, and 3 mo). The study consisted of acquisition, re-activation and extinction, and re-extinction phases. Dependent measure was the recovery of fear responses as indexed by the skin conductance responses (SCRs) and arousal ratings of the participants at the last trial of the extinction and the first trial of the re-extinction. All groups showed significant acquisition and extinction patterns, compared to the other two groups (i.e., 6 h after the activating CS and without an activating stimulus) only the group that undertook extinction trials 10 min after the activating CS showed a sustained extinction. Thus, our findings provided further evidence for the robustness of the PRE paradigm in preventing the recovery of extinguished fears behaviorally, both with ecological and arbitrary stimuli.

Enacting cross-platform (buy/boy)cotts: Yellow Economic Circle and the new citizen-consumer politics in Hong Kong

While existing studies assert that citizens actively use digital media to exert their political agency, the various roles and impacts of digital media should be further unpacked. Building on the notions of ‘digital democratic affordance’ and ‘cross-platform play’, this article uniquely theorises political consumerism as a multi-scalar mode of human–non-human interactions. The concept of multi-scalar cross-platform affordances is formulated to demonstrate how different digital platforms – large or small, corporate or amateur, global or local – co-constitute an environment in which citizens are progressively channelled to engage in multiple platforms, reinvent them in concert with one another and participate in political consumption across time and space. In the case of the Yellow Economic Circle, against the backdrop of Hong Kong’s 2019–2020 Anti-Extradition Law Amendment Bill (Anti-ELAB) movement, we examine such cross-platform dynamics and their multi-scalar enactment of everyday political consumption practices across four stages: deliberation, crowdsourcing, materialisation and habituation.