Successful Treatment of Recalcitrant Pediatric Pemphigus Vulgaris With Rituximab

Pemphigus vulgaris (PV) affecting the pediatric population is extremely rare, representing less than 3% of all PV cases. Conventional treatment with systemic steroids with or without adjuvant immunosuppressants used in adult cases of PV is often employed. However, pediatric cases often present a therapeutic challenge given their increased susceptibility to systemic therapy’s associated risks. To date, no specific guidelines regarding treatment strategies in this patient population exist. We describe a 14-year-old Hispanic female patient with severe, recalcitrant PV with suboptimal treatment response to systemic steroids and intravenous immunoglobulin (IVIG) successfully treated with rituximab (RTX), showing control of disease in as early as 2 weeks after treatment initiation. To our knowledge, only 45 cases of pediatric PV successfully treated with RTX have been reported in the literature, highlighting its use as a safe therapeutic option in this patient population

Spatiotemporal and Socioeconomic Risk Factors for Dengue at the Province Level in Vietnam, 2013-2015: Clustering Analysis and Regression Model.

Dengue is a serious infectious disease threat in Vietnam, but its spatiotemporal and socioeconomic risk factors are not currently well understood at the province level across the country and on a multiannual scale. We explore spatial trends, clusters and outliers in dengue case counts at the province level from 2011-2015 and use this to extract spatiotemporal variables for regression analysis of the association between dengue case counts and selected spatiotemporal and socioeconomic variables from 2013-2015. Dengue in Vietnam follows anticipated spatial trends, with a potential two-year cycle of high-high clusters in some southern provinces. Small but significant associations are observed between dengue case counts and mobility, population density, a province's dengue rates the previous year, and average dengue rates two years previous in first and second order contiguous neighbours. Significant associations were not found between dengue case counts and housing pressure, access to electricity, clinician density, province-adjusted poverty rate, percentage of children below one vaccinated, or percentage of population in urban settings. These findings challenge assumptions about socioeconomic and spatiotemporal risk factors for dengue, and support national prevention targeting in Vietnam at the province level. They may also be of wider relevance for the study of other arboviruses, including Japanese encephalitis, Zika, and Chikungunya

After the epidemic: Zika virus projections for Latin America and the Caribbean

Background: Zika is one of the most challenging emergent vector-borne diseases, yet its future public health impact remains unclear. Zika was of little public health concern until recent reports of its association with congenital syndromes. By 3 August 2017 ~217,000 Zika cases and ~3,400 cases of associated congenital syndrome were reported in Latin America and the Caribbean. Some modelling exercises suggest that Zika virus infection could become endemic in agreement with recent declarations from the The World Health Organisation. Methodology/Principal findings: We produced high-resolution spatially-explicit projections of Zika cases, associated congenital syndromes and monetary costs for Latin America and the Caribbean now that the epidemic phase of the disease appears to be over. In contrast to previous studies which have adopted a modelling approach to map Zika potential, we project case numbers using a statistical approach based upon reported dengue case data as a Zika surrogate. Our results indicate that ~12.3 (0.7–162.3) million Zika cases could be expected across Latin America and the Caribbean every year, leading to ~64.4 (0.2–5159.3) thousand cases of Guillain-Barré syndrome and ~4.7 (0.0–116.3) thousand cases of microcephaly. The economic burden of these neurological sequelae are estimated to be USD ~2.3 (USD 0–159.3) billion per annum. Conclusions/Significance: Zika is likely to have significant public health consequences across Latin America and the Caribbean in years to come. Our projections inform regional and federal health authorities, offering an opportunity to adapt to this public health challenge

Riparian plant litter quality increases with latitude

Plant litter represents a major basal resource in streams, where its decomposition is partly regulated by litter traits. Litter-trait variation may determine the latitudinal gradient in decomposition in streams, which is mainly microbial in the tropics and detritivore-mediated at high latitudes. However, this hypothesis remains untested, as we lack information on large-scale trait variation for riparian litter. Variation cannot easily be inferred from existing leaf-trait databases, since nutrient resorption can cause traits of litter and green leaves to diverge. Here we present the first global-scale assessment of riparian litter quality by determining latitudinal variation (spanning 107 degrees) in litter traits (nutrient concentrations; physical and chemical defences) of 151 species from 24 regions and their relationships with environmental factors and phylogeny. We hypothesized that litter quality would increase with latitude (despite variation within regions) and traits would be correlated to produce 'syndromes' resulting from phylogeny and environmental variation. We found lower litter quality and higher nitrogen: phosphorus ratios in the tropics. Traits were linked but showed no phylogenetic signal, suggesting that syndromes were environmentally determined. Poorer litter quality and greater phosphorus limitation towards the equator may restrict detritivore-mediated decomposition, contributing to the predominance of microbial decomposers in tropical streams.We thank the many assistants who helped with field work (Ana Chara-Serna, Francisco Correa-Araneda, Juliana Franca, Lina Giraldo, Stephanie Harper, Samuel Kariuki, Sylvain Lamothe, Lily Ng, Marcus Schindler, etc.), Cristina Grela Docal for helping with leaf chemical analyses, and Fernando Hiraldo (former director of EBD-CSIC) for his support. The study was funded by start-up funds from the Donana Biological Station (EBD-CSIC, Spain) and from Ikerbasque to LB, the Fundacao para a Ciencia e Tecnologia (FCT) strategic project ID/MAR/04292/2013 granted to MARE (Portugal), the 'BIOFUNCTION' project (CGL2014-52779-P) from the Spanish Ministry of Economy and Competitiveness (MINECO) and FEDER to LB and J. Pozo, and Basque Government funds (IT302-10) to J. Pozo

A genome scan for milk production traits in dairy goats reveals two new mutations in <i>Dgat1</i> reducing milk fat content

The quantity of milk and milk fat and proteins are particularly important traits in dairy livestock. However, little is known about the regions of the genome that influence these traits in goats. We conducted a genome wide association study in French goats and identified 109 regions associated with dairy traits. For a major region on chromosome 14 closely associated with fat content, the Diacylglycerol O-Acyltransferase 1 (DGAT1) gene turned out to be a functional and positional candidate gene. The caprine reference sequence of this gene was completed and 29 polymorphisms were found in the gene sequence, including two novel exonic mutations: R251L and R396W, leading to substitutions in the protein sequence. The R251L mutation was found in the Saanen breed at a frequency of 3.5% and the R396W mutation both in the Saanen and Alpine breeds at a frequencies of 13% and 7% respectively. The R396W mutation explained 46% of the genetic variance of the trait, and the R251L mutation 6%. Both mutations were associated with a notable decrease in milk fat content. Their causality was then demonstrated by a functional test. These results provide new knowledge on the genetic basis of milk synthesis and will help improve the management of the French dairy goat breeding program

Spatial distribution estimation of malaria in northern China and its scenarios in 2020, 2030, 2040 and 2050

© 2016 The Author(s). Background: Malaria is one of the most severe parasitic diseases in the world. Spatial distribution estimation of malaria and its future scenarios are important issues for malaria control and elimination. Furthermore, sophisticated nonlinear relationships for prediction between malaria incidence and potential variables have not been well constructed in previous research. This study aims to estimate these nonlinear relationships and predict future malaria scenarios in northern China. Methods: Nonlinear relationships between malaria incidence and predictor variables were constructed using a genetic programming (GP) method, to predict the spatial distributions of malaria under climate change scenarios. For this, the examples of monthly average malaria incidence were used in each county of northern China from 2004 to 2010. Among the five variables at county level, precipitation rate and temperature are used for projections, while elevation, water density index, and gross domestic product are held at their present-day values. Results: Average malaria incidence was 0.107 per annum in northern China, with incidence characteristics in significant spatial clustering. A GP-based model fit the relationships with average relative error (ARE) = 8.127 % for training data (R2 = 0.825) and 17.102 % for test data (R2 = 0.532). The fitness of GP results are significantly improved compared with those by generalized additive models (GAM) and linear regressions. With the future precipitation rate and temperature conditions in Special Report on Emission Scenarios (SRES) family B1, A1B and A2 scenarios, spatial distributions and changes in malaria incidences in 2020, 2030, 2040 and 2050 were predicted and mapped. Conclusions: The GP method increases the precision of predicting the spatial distribution of malaria incidence. With the assumption of varied precipitation rate and temperature, and other variables controlled, the relationships between incidence and the varied variables appear sophisticated nonlinearity and spatially differentiation. Using the future fluctuated precipitation and the increased temperature, median malaria incidence in 2020, 2030, 2040 and 2050 would significantly increase that it might increase 19 to 29 % in 2020, but currently China is in the malaria elimination phase, indicating that the effective strategies and actions had been taken. While the mean incidences will not increase even reduce due to the incidence reduction in high-risk regions but the simultaneous expansion of the high-risk areas

TOI-2046b, TOI-1181b, and TOI-1516b, three new hot Jupiters from TESS: planets orbiting a young star, a subgiant, and a normal star

We present the confirmation and characterization of three hot Jupiters, TOI-1181b, TOI-1516b, and TOI-2046b, discovered by the TESS space mission. The reported hot Jupiters have orbital periods between 1.4 and 2.05 d. The masses of the three planets are 1.18 ± 0.14 MJ, 3.16 ± 0.12 MJ, and 2.30 ± 0.28 MJ, for TOI-1181b, TOI-1516b, and TOI-2046b, respectively. The stellar host of TOI-1181b is a F9IV star, whereas TOI-1516b and TOI-2046b orbit F main sequence host stars. The ages of the first two systems are in the range of 2–5 Gyrs. However, TOI-2046 is among the few youngest known planetary systems hosting a hot Jupiter, with an age estimate of 100–400 Myrs. The main instruments used for the radial velocity follow-up of these three planets are located at Ondřejov, Tautenburg, and McDonald Observatory, and all three are mounted on 2–3 m aperture telescopes, demonstrating that mid-aperture telescope networks can play a substantial role in the follow-up of gas giants discovered by TESS and in the future by PLATO