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Our comparative assessment is the first study to investigate microplastic body burden in native (Cambarus appalachiensis) and non-native (Faxonius cristavarius) crayfish along a semi-rural and urban stream across different seasons. Crayfish, sediment, and surface water were collected, processed, and characterized using µRaman spectroscopy to compare microplastic polymer types and shapes across compartments. Average surface water concentrations were significantly higher in our urban stream compared to our semi-rural stream (17.3 ± 2.4 particles/L and 9.9 ± 1.3 particles/L, respectively; P = 0.015). Average sediment concentrations were similar between urban and semi-rural streams (140 ± 14.5 particles/kg and 139 ± 22.5 particles/kg, respectively; P = 0.957). Our findings showed a significant interactive effect of season, site, and nativity (i.e., species) regarding microplastic body burden in crayfish (P = 0.004). The smaller, non-native crayfish amassed more microplastic particles than the native crayfish (0.4-2.0 particles/g versus 0.4-0.8 particles/g, respectively). Fibers and fragments were the most common polymer shapes across compartments, with white and black being the dominant particle colors. Our study identified 13 plastic polymer types in crayfish and three in surface water and sediment; polypropylene was the most common polymer across compartments. This study provides evidence that crayfish body burden of microplastics can differ across species, seasons, and locations, highlighting the need for future studies to consider that sublethal impacts associated with microplastic body burden may vary by region and species.

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Tidal flooding is increasingly common in low-lying coastal regions as sea levels rise. This type of flooding can occur on sunny days with no rainfall and may transport street-associated debris, such as microplastics (MPs) including tire wear particles (TWPs), to coastal systems. This research aimed to quantify MP abundance in tidal floodwater and investigate their fate. Three locations around Charleston, SC (USA) were sampled during 12 tidal floods, and their adjacent tidal creeks were sampled before and after 5 floods. Floodwater contained an average of 342 ± 60 MP/L. Most MPs in floodwater were low-density TWP (86.5 %). MP abundance in tidal creek surface water following flooding did not change, suggesting that MPs were not immediately transferred to coastal waterways but deposited in adjacent marsh sediment. Elucidating transport routes of MPs in coastal environments is critical to understanding and preventing this type of contamination in the face of a changing climate.

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Germline pathogenic variants in DDX41 have recently been described in association with myelodysplastic syndrome and acute myeloid leukemia in older populations. However, this pathogenic variant has rarely been described in the pediatric population. This report represents a novel case of newly diagnosed myeloid neoplasm in a 9-year-old patient presenting with essential thrombocythemia-like features and was proven to have JAK2 V617F pathogenic variant, constitutional balanced paracentric inversion on q-arm of chromosome 7, and a germline heterozygous DDX41 pathogenic variant. This is the first reported case of a pediatric patient who presented with the constellation of these clinical features, histologic findings, and genetic alterations.

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Microplastics (<5 mm) are well documented across shorelines worldwide; however, high variability in microplastic abundance is often observed within and among field studies. The majority of microplastic surveys to date consist of single sampling events that do not consider spatiotemporal variability as a potential confounding factor in the interpretation of their results. Therefore, these surveys may not accurately capture or reflect levels of microplastic contamination in the environment. Here, we provide the first investigation of small-scale spatial and temporal variability of microplastic abundance, distribution, and composition in the intertidal zone of an urbanized US estuary to better understand the short-term, daily spatiotemporal variability of microplastics in dynamic coastal environments. Intertidal sediment was collected from both the low and high intertidal zones of a sandy estuarine beach located in South Carolina, southeastern US every 1 to 2 days at low tide over 17 days (12 sampling events; total n = 72). Study-wide, microplastic abundance ranged from 44 to 912 microplastics/m2 and consisted primarily of polyethylene, nylon, polyester, and tire (or tyre) wear particles. High temporal variability was observed, with microplastic abundance differing significantly among sampling events (p = 0.00025), as well as among some consecutive tidal cycles occurring within 12 h of each other (p = 0.007). By contrast, low spatial variability was observed throughout the study with no significant differences in microplastic abundance detected between the low and high intertidal zones (p = 0.76). Of the environmental factors investigated, wind direction on the day of sampling had the greatest effect on temporal microplastic variability. Our results demonstrate that there can be significant temporal variability of microplastic abundance in estuarine intertidal sediments and are important for informing the methods and interpretation of future microplastic surveys in dynamic coastal environments worldwide.

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(1) Background: Cryptococcus neoformans is mostly known for causing meningitis, with or without disseminated disease. (2) Case presentation: An immunocompromised 75-year-old gentleman presented post renal transplant with generalized weakness, altered mental status, hypoxemia, and hyponatremia, and was found to have disseminated cryptococcal infection. After an initial improvement, the patient became suddenly hypotensive, and passed away soon after. The autopsy revealed widespread cryptococcal involvement, with the most severely affected organs being the brain, lungs, pancreas, adrenal glands, and spleen. The pancreas and one of the adrenal glands revealed diffuse granulomatous cryptococcal infection, with large areas of necrosis. The spleen also showed a large area of cryptococcal necrosis. In addition, the patient had chylous ascites, without histologically identifiable organisms. (3) Conclusions: This is a rare case of disseminated cryptococcal infection with severe necrotizing adrenalitis and pancreatitis, in addition to significant spleen, lung, and central nervous system involvement. The early recognition and treatment of the adrenal gland and pancreas cryptococcosis with surgical interventions may lead to better outcomes in affected patients. Furthermore, steroid treatment and diabetes mellitus may be risk factors for adrenal gland involvement. Additionally, clinicians should keep cryptococcal infection in their differential diagnosis for isolated adrenal gland and pancreas lesions.

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Although it is generally assumed that green household consumer products (HCPs) contain individual compounds that are less toxic and/or more degradable than conventional HCPs, little research on this topic has been conducted. In our assessments, larval grass shrimp (Palaemon pugio) were used in a biodegradation study and juvenile freshwater cladocerans, Daphnia magna, were used in a photodegradation study. In each study, organisms were exposed to nondegraded and degraded treatments consisting of one green HCP and two conventional HCPs in six different categories (laundry detergent, dish detergent, mouthwash, insecticide, dishwasher gel, and all-purpose cleaner). Sensitivity to these products were assessed using 48-h static acute toxicity tests, and the median lethal concentrations (LC50s) then compared using an LC50 ratio test. For grass shrimp, only one green HCP (insecticide) was less toxic than both conventional HCPs. In one category (laundry detergent), the green HCP was the more toxic than either conventional HCP. Following a biodegradation treatment, none of the green product formulations became less toxic, whereas 44.4% of the conventional HCPs demonstrated decreased toxicity. For daphnids, green HCPs in three categories (dish detergent, insecticide, and all-purpose cleaner) were less toxic than both conventional products tested. Following a photodegradation treatment, two green product formulations (dish detergent and dishwasher gel) became less toxic (33.3%), whereas 87.5% of the conventional HCPs demonstrated decreased toxicity. The present study demonstrates that green HCPs are not necessarily less toxic and/or more degradable than their conventional counterparts. These results also suggest that the toxicity and degradability of end-product formulations need to be considered in the overall framework for green product evaluation. Environ Toxicol Chem 2022;41:2444-2453. © 2022 The Authors. Environmental Toxicology and Chemistry published by Wiley Periodicals LLC on behalf of SETAC.

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Mantle cell lymphoma (MCL) is a rare and aggressive non-Hodgkin's B cell lymphoma characterized by the translocation t(11;14) (q13;32) and overexpression of CCND1. MCL is immunophenotypically identified as CD20+, CD5+, CyclinD1+, CD43+, CD10-, BCL6-, and CD23-. It is often distinguished from B cell lymphomas of germinal center cell origin by the absence of CD10 expression. Here we report the unique clinicopathologic features of a patient with CD10+ MCL with gastrointestinal involvement and review current literature identifying this unique immunophenotype.

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Background: Plasmablastic lymphoma (PBL) is a rare, highly aggressive lymphoma of plasma cell differentiation. It commonly presents as an Epstein-Barr virus (EBV)+ oral lesion in an immunodeficient patient, predominately human immunodeficiency virus (HIV)+ patients. These aggressive lesions often demonstrate an immunoblastic or plasmablastic morphology with a typical immunohistochemical profile. The current case is unique due to the location at presentation, immunohistochemical features, and unknown presence of HIV infection in a young adult male. Case Presentation: We present an unexpected case of PBL found in a rare extra-oral location in a young adult male with undiagnosed HIV infection presenting as a perianal hemorrhoid mass/abscess. Swift treatment for HIV and the PBL resulted in complete remission and markedly improved CD4 counts. Conclusions: This case highlights the importance of testing for HIV along with acquiring a thorough social/clinical history when a PBL is encountered. Although the overall prognosis of PBL is dismal with a median survival of about 6-11 months, a timely accurate diagnosis and prompt chemotherapy with an appropriate regimen along with antiretroviral therapy (ART) may still achieve a successful outcome with a relatively reasonable long-term remission like in our reported case.

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Along the South Carolina coast (U.S.) where the ecologically and economically important eastern oyster (Crassostrea virginica) forms extensive intertidal reefs, recent surface water surveys found that fibers, fragments, and microscopic tire particles represented 43.6%, 30.9%, and 17.7% of the total microplastics, respectively. The aim of this study was to characterize accumulation and depuration of these particles in eastern oysters. Oysters were exposed to purple polyethylene fibers, green nylon fragments, or micronized crumb rubber at a concentration of 5000 microplastics/L, and sacrificed after 0, 24, 48, and 96 h to characterize uptake. Following 96 h, remaining oysters were transferred to microplastic-free brackish water and sacrificed at 24, 48, and 96 h to characterize depuration. For fibers and fragments, levels increased in a nonlinear fashion reaching 1.61 ± 0.6 particles/g w. w. (mean ± SE) and 0.46 ± 0.1 particles/g w. w. after 96 h, respectively. Conditional uptake clearance rate constants (ku) were estimated to be 0.0084 and 0.0025 mL/g*h for fibers and fragments, respectively. For crumb rubber, levels increased in a linear fashion reaching 3.62 ± 0.8 particles/g w. w. after 96 h, and the ku value was estimated to be 0.0077 mL/g*h. Depuration was best described using a two-compartment (double exponential) model suggesting the presence of fast and slow compartments. Conditional depuration rate constants (kd) for the slow compartments were 0.0084, 0.0205, and 0.0048/h for fibers, fragments, and crumb rubber, respectively. These results demonstrate accumulation and depuration of microplastics in eastern oysters is size-and shape-dependent. Depuration, which is a common practice for shellfish safety, is an effective way to reduce microplastic loads in eastern oysters, but the minimum recommended time of 44 h would only reduce loads of these particles by 55.5-67.6%.

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Due to the ubiquity of microplastic contamination in coastal waters, there is potential for adverse impacts to organism development. One organism of interest is the daggerblade grass shrimp, Palaemon pugio, an ecologically important species in estuaries along the east coast of North America. We exposed larval grass shrimp to virgin polyethylene microbeads (35 and 58 µm) at a high (0.375 and 1.95 mg/L), medium (0.0375 and 0.195 mg/L), and a low concentration (0.00375 and 0.0195 mg/L), respectively for 23 days to assess mortality, transformation time from larval to juvenile stage, and weight. Average percent mortality was 3.7 to 4.8 times higher in the experimental treatments compared to controls. The greatest proportion of mortality was observed in the first 11 days. Median time for transformation ranged from 20.2 to 20.8 days. Shrimp exposed to the 35 µm beads in the high treatment (20.2 days) transformed significantly faster than the control shrimp (20.8 days). Although development was not delayed and size of the shrimp did not differ, the acute toxicity of microplastics on grass shrimp is a concern due to their role in energy cycling within tidal-creeks. These findings suggest potential population and community level effects following microplastic exposure.

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A variety of antibiotics are ubiquitous in all freshwater ecosystems that receive wastewater. A wide variety of antibiotics have been developed to kill problematic bacteria and fungi through targeted application, and their use has contributed significantly to public health and livestock management. Unfortunately, a substantial fraction of the antibiotics applied to humans, pets and livestock end up in wastewater, and ultimately many of these chemicals enter freshwater ecosystems. The effect of adding chemicals that are intentionally designed to kill microbes, on freshwater microbial communities remains poorly understood. There are reasons to be concerned, as microbes play an essential role in nutrient uptake, carbon fixation and denitrification in freshwater ecosystems. Chemicals that reduce or alter freshwater microbial communities might reduce their capacity to degrade the excess nutrients and organic matter that characterize wastewater. We performed a laboratory experiment in which we exposed microbial community from unexposed stream sediments to three commonly detected antibiotics found in urban wastewater and urban streams (sulfamethoxazole, danofloxacin, and erythromycin). We assessed how the form and concentration of inorganic nitrogen, microbial carbon, and nitrogen cycling processes changed in response to environmentally relevant doses (10 µg/L) of each of these antibiotics individually and in combination. We expected to find that all antibiotics suppressed rates of microbial mineralization and nitrogen transformations and we anticipated that this suppression of microbial activity would be greatest in the combined treatment. Contrary to our expectations we measured few significant changes in microbially mediated functions in response to our experimental antibiotic dosing. We found no difference in functional gene abundance of key nitrogen cycling genes nosZ, mcrA, nirK, and amoA genes, and we measured no treatment effects on NO3- uptake or N2O, N2, CH4, CO2 production over the course of our seven-day experiment. In the mixture treatment, we measured significant increases in NH4+ concentrations over the first 24 hours of the experiment, which were indistinguishable from controls within six hours. Our results suggest remarkable community resistance to pressure antibiotic exposure poses on naïve stream sediments.

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The aim of this study is to present an elusive case of primary thyroid lymphoma (PTL), initially thought to be anaplastic thyroid carcinoma, then Rosai Dorfman disease, before the final diagnosis of PTL was made. An elderly female with hypothyroidism presented with compressive airway symptoms secondary to an enlarging neck mass. Imaging was suggestive of undifferentiated thyroid cancer. The initial biopsy was unexpectedly consistent with a lymphoproliferative disorder such as Rosai-Dorfman disease. A repeat biopsy with immunohistochemical analysis yielded a diagnosis of diffuse large B-cell lymphoma of germinal center subtype. The patient was spared thyroid surgery and started on appropriate chemotherapy. PTL is within the differential diagnosis that physicians must consider in a patient with a rapidly-enlarging neck mass. A clinical index of suspicion and early accurate diagnosis may spare the patient from unnecessary surgery that is required of most other non-hematopoeitic thyroid malignancies.

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Antibiotic pollution in aquatic systems is a concern for human and environmental health. The concern is largely due to the global occurrence of antibiotic-resistant bacteria. From 2017 to 2018 in the NC Piedmont, 15 ion masses associated with antibiotics were detected in rural streams and groundwater. Four of these masses were confirmed to be antibiotics through target analysis (sulfamethoxazole, sulfamerazine, erythromycin, danofloxacin). Concentrations of antibiotics were as high as 1.8 µg/L. As a follow-up, antibiotic residues in urban streams sites in Greensboro, NC, USA, were investigated. Urban streams are heavily influenced by the dense populations surrounding them. In the fall, winter, and spring seasons, surface water was collected from eight sites along two urban streams. Sampling was conducted at streams sites above and below municipal hospitals and wastewater treatment facilities in the study area. At the conclusion of the survey, nine ion masses associated with antibiotics used in both human and veterinary medicine were detected from surface water collected. Three of the four antibiotics targeted in rural stream samples were detected and confirmed in urban stream samples (sulfamerazine, danofloxacin, and erythromycin). Detection frequencies of the three antibiotics ranged from 0 to 46%. Concentrations of each target antibiotic was as followed: SMX (0 to <10 ng/L), SMR (0 to <11 ng/L), DAN (0 to <20 ng/L), and ETM (0 to <15 ng/L). Each target antibiotic concentration was below our methods quantification limits. Our risk assessment analysis showed that the target antibiotics posed no risk to fish, daphnia, and green algae within this region of NC (RQ < 0.1). Compared to rural streams in this region of NC, antibiotic pollution is less prevalent in urban streams. The differences between urban and rural streams may be driven by the varying land use and suggest more research should be dedicated to monitoring these contaminants in rural areas of the United States. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40201-021-00688-9.

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Hematologic malignancies are known to be associated with numerous cytogenetic and molecular genetic changes. In addition to morphology, immunophenotype, cytochemistry and clinical characteristics, these genetic alterations are typically required to diagnose myeloid, lymphoid, and plasma cell neoplasms. According to the current World Health Organization (WHO) Classification of Tumors of Hematopoietic and Lymphoid Tissues, numerous genetic changes are highlighted, often defining a distinct subtype of a disease, or providing prognostic information. This review highlights how these molecular changes can alter mitochondrial bioenergetics, cell death pathways, mitochondrial dynamics and potentially be related to mitochondrial genetic changes. A better understanding of these processes emphasizes potential novel therapies.

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LMX1B haploinsufficiency causes Nail-patella syndrome (NPS; MIM 161200), characterized by nail dysplasia, absent/hypoplastic patellae, chronic kidney disease, and glaucoma. Accordingly in mice, Lmx1b has been shown to play crucial roles in the development of the limb, kidney and eye. Although one functional allele of Lmx1b appears adequate for development, Lmx1b null mice display ventral-ventral distal limbs with abnormal kidney, eye and cerebellar development, more disruptive, but fully concordant with NPS. In Lmx1b functional knockouts (KOs), Lmx1b transcription in the limb is decreased nearly 6-fold, indicating autoregulation. Herein, we report on two conserved Lmx1b-associated cis-regulatory modules (LARM1 and LARM2) that are bound by Lmx1b, amplify Lmx1b expression with unique spatial modularity in the limb, and are necessary for Lmx1b-mediated limb dorsalization. These enhancers, being conserved across vertebrates (including coelacanth, but not other fish species), and required for normal locomotion, provide a unique opportunity to study the role of dorsalization in the fin to limb transition. We also report on two NPS patient families with normal LMX1B coding sequence, but with loss-of-function variations in the LARM1/2 region, stressing the role of regulatory modules in disease pathogenesis.

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The present study investigated 16 residential, rural well sites and respective nearby streams in the Piedmont of North Carolina over three different seasons to determine antibiotic presence and concentration. Fifteen antibiotics were detected in stream surface water, groundwater, and stream sediment compartments. Antibiotics detected representing penicillin, sulfonamide, macrolide, aminoglycoside, lincosamide, and quinolone groups. Sulfamethoxazole (SMX), sulfamerazine (SMR), danofloxacin (DAN), and erythromycin (ETM) were the most commonly detected among samples throughout the sampling period. Concentrations reported in the study ranged from 0 to 1740 ng/L in surface water and groundwater, and 0t378 µg/kg in stream sediment. There was a seasonal influence on antibiotic concentrations in each environmental compartment. Fall had the highest antibiotic concentrations for surface water and stream sediments overall, and groundwater concentrations were highest in the winter. Principal component analysis (PCA) was used to assess the correlation between environmental variables. Antibiotic concentrations correlated with groundwater pH, surface water pH, and surface water temperature. Non-metric multidimensional scaling (NMDS), used to display seasonal and environmental compartment data, demonstrated no discernible trend in the distribution of antibiotics over time. Human health risk assessments based on risk quotients (RQs). RQs from groundwater assessment shown no risk to children 6-11 years old, or adults 18 years old or older. Results from this study illustrate that the occurrence of antibiotics in streams and groundwater in the Piedmont of North Carolina is widespread and provide a basis for future studies investigating the occurrence of antibiotics in rural areas, especially where animal density is high. This work is important because it contributes to the paucity of information on antibiotic pollution in rural areas, and because it illustrates the importance of using a combined targeted and non-targeted approach to antibiotic pollution in streams and groundwater.

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Here we report on the distribution of microplastic contamination in two developed estuaries in the Southeastern United States. Average concentration in intertidal sediments of Charleston Harbor and Winyah Bay, both located in South Carolina, U.S.A., was 413.8 ±â€¯76.7 and 221.0 ±â€¯25.6 particles/m2, respectively. Average concentration in the sea surface microlayer of Charleston Harbor and Winyah Bay was 6.6 ±â€¯1.3 and 30.8 ±â€¯12.1 particles/L, respectively. Concentration in intertidal sediments of the two estuaries was not significantly different (p = 0.58), however, Winyah Bay contained significantly more microplastics in the sea surface microlayer (p = 0.02). While microplastic concentration in these estuaries was comparable to that reported for other estuaries worldwide, Charleston Harbor contained a high abundance of black microplastic fragments believed to be tire wear particles. Our research is the first to survey microplastic contamination in Southeastern U.S. estuaries and to provide insight on the nature and extent of contamination in these habitats.

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The incidence of microplastics in marine environments has been increasing over the past several decades. The objective of the present study was to characterize the size- and shape-dependent effects of microplastic particles (spheres, fibers, and fragments) on the adult daggerblade grass shrimp (Palaemonetes pugio). Grass shrimp were exposed to 11 sizes of plastic: spheres (30, 35, 59, 75, 83, 116, and 165 µm), fragments (34 and 93 µm), and fibers (34 and 93 µm) at a concentration of 2000 particles/400 mL (= 50 000 particles/L) for 3 h. Following exposure, grass shrimp were monitored for survival, ingested and ventilated microplastics, and residence time. Mortality ranged from 0% to 55%. Spheres and fragments <50 µm were not acutely toxic. Mortality rates in experiments with spheres and fragments >50 µm ranged from 5% to 40%. Mortality was significantly higher in the exposure to 93-µm fibers than other sizes tested (p < 0.001). The shape of the particle had a significant influence on the number of particles ingested by the shrimp (p < 0.001). The residence time of particles in the gut ranged from 27 to 75 h, with an average of 43.0 ± 13.8 h. Within the gills, the residence time ranged from 27 to 45 h, with an average of 36.9 ± 5.4 h. The results suggest that microplastic particles of various sizes and shapes can be ingested and ventilated by adult daggerblade grass shrimp, resulting in acute toxicity. Environ Toxicol Chem 2017;36:3074-3080. © 2017 SETAC.

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As part of the degradation process, it is believed that most plastic debris becomes brittle over time, fragmenting into progressively smaller particles. The smallest of these particles, known as microplastics, have been receiving increased attention because of the hazards they present to wildlife. To understand the process of plastic degradation in an intertidal salt marsh habitat, strips (15.2 cm × 2.5 cm) of high-density polyethylene, polypropylene, and extruded polystyrene were field-deployed in June 2014 and monitored for biological succession, weight, surface area, ultraviolet (UV) transmittance, and fragmentation. Subsets of strips were collected after 4 wk, 8 wk, 16 wk, and 32 wk. After 4 wk, biofilm had developed on all 3 polymers with evidence of grazing periwinkles (Littoraria irrorata). The accreting biofilm resulted in an increased weight of the polypropylene and polystyrene strips at 32 wk by 33.5% and 167.0%, respectively, with a concomitant decrease in UV transmittance by approximately 99%. Beginning at 8 wk, microplastic fragments and fibers were produced from strips of all 3 polymers, and scanning electron microscopy revealed surface erosion of the strips characterized by extensive cracking and pitting. The results suggest that the degradation of plastic debris proceeds relatively quickly in salt marshes and that surface delamination is the primary mechanism by which microplastic particles are produced in the early stages of degradation. Environ Toxicol Chem 2016;35:1632-1640. © 2016 SETAC.

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Dentoalveolar injuries are an important and common component of craniomaxillofacial trauma. The dentition serves as a vertical buttress of the face and fractures to this area may result in malalignment of facial subunits. Furthermore, the dentition is succedaneous with 3 phases-primary dentition, mixed dentition, and permanent dentition-mandating different treatment protocols. This article is written for nondental providers to diagnose and treat dentoalveolar injuries.

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