014) whereas IgM detection was associated with a higher probability of death linked to AHA (p=.011).

The Ig pattern of AHA patients at diagnosis is widely heterogeneous and is at least partially associated with some underlying conditions. Our data supports the differential predictive significance for IgG1, IgG4 and IgM on bleeding severity and suggests that the early determination of Ig profile may help to identify AHA patients at higher risk of poorer outcomes.

The Ig pattern of AHA patients at diagnosis is widely heterogeneous and is at least partially associated with some underlying conditions. Our data supports the differential predictive significance for IgG1, IgG4 and IgM on bleeding severity and suggests that the early determination of Ig profile may help to identify AHA patients at higher risk of poorer outcomes.

Delay in diagnosis and treatment initiation can be associated with adverse outcomes in children with cancer. Diagnostic interval (DI) is defined as the time between the date of first health care contact for symptoms related to cancer to the date of cancer diagnosis, and treatment interval (TI) is defined as interval between the definitive cancer diagnosis and cancer treatment initiation. We aimed to determine the predictors of DI and TI in children with rhabdomyosarcoma (RMS) and their association with event-free survival (EFS) and overall survival (OS).

Using the Cancer in Young People in Canada (CYP-C) national population-based database, we conducted a retrospective cohort study of children (0-14.99years) newly diagnosed with RMS between 2001 and 2015 in Canada. Quantile regression was used to assess the predictors of DI and TI, and Cox regression was used to determine if these intervals were associated with EFS and OS.

Median DI and TI were 16.5days (interquartile range [IQR] 6.0-38.0) and 5days (IQR 0-12), respectively. DI and TI were not significantly associated with age at diagnosis, sex, race, tumor site, stage or histology, treatment region, distance from treatment center, income quintile or diagnosis year (all p>.05). DI and TI were not associated with EFS (DI hazard ratio [HR] 1.00, 95% CI 0.96-1.05, p=.871; TI HR 1.03, 95% CI 1.00-1.05, p=.053) or OS (DI HR 0.99, 95% CI 0.94-1.05, p=.797; TI HR 1.02, 95% CI 0.99-1.05, p=.155).

In the publicly funded Canadian health care system, DI and TI did not affect the survival of children with RMS.

In the publicly funded Canadian health care system, DI and TI did not affect the survival of children with RMS.A new phenotypic variant may appear first in organisms through plasticity, that is, as a response to an environmental signal or other nongenetic perturbation. If such trait is beneficial, selection may increase the frequency of alleles that enable and facilitate its development. Thus, genes may take control of such traits, decreasing dependence on nongenetic disturbances, in a process called genetic assimilation. Despite an increasing amount of empirical studies supporting genetic assimilation, its significance is still controversial. Whether genetic assimilation is widespread depends, to a great extent, on how easily mutation and recombination reduce the trait’s dependence on nongenetic perturbations. Previous research suggests that this is the case for mutations. Here we use simulations of gene regulatory network dynamics to address this issue with respect to recombination. We find that recombinant offspring of parents that produce a new phenotype through plasticity are more likely to produce the same phenotype without requiring any perturbation. They are also prone to preserve the ability to produce that phenotype after genetic and nongenetic perturbations. Our work also suggests that ancestral plasticity can play an important role for setting the course that evolution takes. In sum, our results indicate that the manner in which phenotypic variation maps unto genetic variation facilitates evolution through genetic assimilation in gene regulatory networks. Thus, we contend that the importance of this evolutionary mechanism should not be easily neglected.An approach comprising a novel fusion protein and inactivated virus, as a more efficacious vaccine against invading viruses is presented, using SARS-CoV-2 as a most prominent example. The fusion protein consists of the Hepatitis B surface antigen (HBsAg) conjugated to the N-terminal helix (NTH) of Angiotensin-Converting Enzyme 2 (ACE2), which is the receptor for SARS-CoV-2. For vaccination, this fusion protein is to be administered together with the whole killed virus. The NTH would bind to the Receptor Binding Domain (RBD) of the Spike protein of the killed virus. Due to HBsAg acting as a decoy, immune responses would be mounted. Neutralizing antibodies (NAbs) pre-existing in people already vaccinated with the recombinant Hepatitis B vaccine, fresh production of NAbs, and NAbs produced by memory B cells would bind to the HBsAg. This would lead to „presentation” of the killed virus to elements of the immune system at close range. Also, there would be enhanced opsonization and effective antigen presentation. This two-component vaccine could be a platform strategy, wherein HBsAg could be linked to the part of the cellular receptor that any new intractable virus binds to, and is administered together with whole inactivated virus. Now, the same fusion protein, administered by itself to persons with infection, would have therapeutic action, yet by harnessing elements of the immune system. NAbs would bind to the fusion protein as above, the NTH of which would bind to the RBDs of the infecting virus, which, in effect would be neutralized.Wheat allergy is a potentiallylife-threatening disease that affects millions of people around the world. Food processing has been shown to influence the allergenicity of wheat and other major foods. However, a comprehensive review evaluating whether or not food processing can be used to develop hypo-/nonallergenic wheat products is unavailable. There were three objectives for this study (1) to critically evaluate the evidence on the effect of fermentation, thermal processing, and enzyme or acid hydrolysis on wheat allergenicity so as to identify the potential for and challenges of using these methods to produce hypo-/nonallergenic wheat products; (2) to identify the molecular effects of food processing needed to create such products; and (3) to map the concept questions for future research and development to produce hypo-/nonallergenic wheat products. We performed literature research using PubMed and Google Scholar databases with various combinations of keywords to generate the data to accomplish these objectives. We found that (1) food processing significantly modulates wheat allergenicity; while some methods can reduce or even abolish the allergenicity, others can create mega allergens; and (2) fermentation and enzymatic hydrolysis hold the most potential to create novel hypo-/nonallergenic wheat products; however, preclinical validation and human clinical trials are currently lacking. We also identify five specific research concepts to advance the research to enable the creation of hypo-/nonallergenic wheat products for application in food, medical, and cosmetic industries.

Although good results have been reported with the use of normothermic regional perfusion (NRP) in controlled donation after circulatory death (cDCD) liver transplant (LT), there is a lack of evidence to demonstrate similar results to donation after brain death (DBD).

We present a single-center retrospective case-matched (12) study including 100 NRP cDCD LT and 200 DBD LT and a median follow up of 36 months. Matching was done according to donor age, recipient Model for End-Stage Liver Disease score and cold ischemia time.

Perioperative results were similar in both groups ALT peak 909 U/L in the DBD group and 836 U/L in the cDCD group and early allograft disfunction 21% and 19.2%, respectively. The 1 and 3-year overall graft survival for cDCD was 99% and 93%, respectively, vs 92% and 87%, respectively, for DBD (p 0.04). Of note, no cases of primary non function or ischemic type biliary lesion were observed among the cDCD grafts.

Our results confirm that NRP cDCD LT meets the same outcomes as those obtained with DBD LT and provide evidence to support the idea that cDCD donors „per se” should no longer be considered as „marginal donors” when recovered with NRP.

Our results confirm that NRP cDCD LT meets the same outcomes as those obtained with DBD LT and provide evidence to support the idea that cDCD donors „per se” should no longer be considered as „marginal donors” when recovered with NRP.In November 2018, theInternational Society of Paediatric Oncology (SIOP) launched a project to map African facilities providing pediatric oncology treatment. A 55-item digital survey was created in English, piloted in India, translated to French and Portuguese, and distributed by email, social media, or personal contacts. December 2019, 48/54 African countries responded (72% surveys completed and analyzed). Issues included incomplete responses, multiple entries for one facility with conflicting data for key services, and repeated entries with varied answers by the same respondent. The facility mapping project, now on-going program will serve as a global registry of global pediatric cancer centers.

The aim of this study was to determine the predictive risk factors for development of severe bronchiolitis in patients with acute bronchiolitis with no previous chronic disease.

Four hundred forty children aged 1-24months hospitalised with acute bronchiolitis, were examined between February 2018 and February 2019 in this prospective study.

Eighty-five cases were regarded as severe bronchiolitis and 355 as mild-moderate bronchiolitis. Statistically significant differences were observed between the severe and mild-moderate bronchiolitis groups in terms of weight-for-age z-scores, history of bronchiolitis, haemoglobin levels, and time elapsed between the onset of symptoms and admission. Weight-for-age z-scores, the mean time interval between the onset of symptoms and admission, and mean haemoglobin values were lower in the severe bronchiolitis group while the mean number of bronchiolitis attacks was higher than in the mild-moderate bronchiolitis group. Logistic regression analysis determined that a low weight-for-age z-score increased the risk of severe bronchiolitis development 0.56-fold (CI 0.409-0.760), a short duration between the onset of symptoms and admission increased the risk 0.62-fold (CI 0.519-0.735), a frequent history of bronchiolitis increased the risk 1.81-fold (CI 1.135-2.968) and low haemoglobin levels increased the risk 0.72-fold (CI 0.537-0.969).

Low weight-for-age z-scores, a short duration between the onset of symptoms and admission, a high number of previous attacks and low haemoglobin levels were identified as independent parameters of severe bronchiolitis development.

Low weight-for-age z-scores, a short duration between the onset of symptoms and admission, a high number of previous attacks and low haemoglobin levels were identified as independent parameters of severe bronchiolitis development.Recent manufacturing problems and increased utilization has created a shortage of 3.2% sodium citrate blood collection tubes used for coagulation testing, causing stakeholders such as hospitals, clinics and laboratories, to find suitable alternatives. Considerations for in-house citrate blood collection tube preparations or purchasing commercial products from unknown manufacturing sources is of particular concern to laboratories that perform coagulation testing. It is well recognized that variability exists between citrate blood collection tube manufacturers, thereby making any transition to new blood collection methods more challenging than simply switching to a new source. This document provides provisional guidance for validating alternative sources of sodium citrate blood collection tubes (commercial or in-house preparations) prior to clinical implementation.