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Background Currently, the treatment of refractory epilepsy (RE) in children is still a difficult point in epilepsy treatment. In China, pirenzapine (PER) is still a new drug for treating RE in children, and there is currently a lack of recommendations for adding PER to the treatment of RE in children. And in Chinese reports, the sample size of RE patients treated with PER is relatively small. Therefore, the efficacy of PER for pediatric RE, especially for young children with RE, still needs to be further studied with a large sample size. Objective To explore the efficacy, possible indications, adverse reactions, and tolerability of PER addition therapy for RE in children. Methods A self-control and retrospective analysis was conducted on children with RE aged 0-18 who were treated at the Women and Children's Hospital, Qingdao University from January 2022 to January 2023. The frequency of seizures at different observation points before and after the addition of PER treatment was compared, and the effective rate of PER was evaluated. Adverse drug reactions and drug retention rates were recorded, and the clinical characteristics of the effective and ineffective groups of PER were analyzed. Results A total of 192 study subjects were included. After adding PER treatment, the effective rates at 12, 24, and 36 weeks were 56.3% (108/192), 62.1% (113/182), and 69.7% (122/175), respectively, and the seizure free rates were 19.3% (37/192), 21.4% (39/182), and 24.6% (43/175). The incidence of adverse reactions was 16.1% (31/192), mainly including dizziness, irritability, weakness, and drowsiness. The last follow-up drug retention rate was 91.1% (175/192). There was a statistically significant difference in the onset age, duration of anti-epileptic treatment, type of origin, seizure form, frequency of seizures before the addition of PER, number of combined anti-epileptic drugs (ASMs), and ketogenic diet/surgical treatment between patients with RE who received continuous medication for 12 weeks (P

Pleurogenoides japonicus (Trematoda: Microphalloidea) is an important parasite in wood frogs with high infection rates and significant ecological, economic, and societal importance. The scarcity of molecular data for these parasites severely limits population genetics and phylogenetic studies. In the present study, for the first time, we determined and described the entire mitochondrial (mt) genome of P. japonicus as the first representative of the family Pleurogenidae. The entire mt genome of P. japonicus was circular, with 15,043 bp (GenBank accession number OR900118), containing 36 genes, comprising 12 protein‐coding genes (cox1–3, nad1–6, nad4L, cytb, and atp6), two ribosomal RNA genes, 22 transfer RNA genes, and two non‐coding regions. There were 23 intergenic spacers, ranging from 2 to 162 bp, and only one 40 bp overlap between nad4L and nad4 genes in the P. japonicus mt genome. The nucleotide composition of P. japonicus mt genome exhibited a strong AT bias with a 63.75% A + T content, while the AT‐ and GC‐skews were − 0.435 and 0.407, respectively. Comparative analysis demonstrated that the P. japonicus mt genome shared the most common characteristics with Microphalloidea trematodes, and the cox1 gene was the longest and most conserved gene in Microphalloidea trematodes. The gene arrangements of Xiphidiata trematodes were of the same order based on protein‐coding genes and rRNA genes, except for tRNA. More than two gene arrangement types exist in Echinostomata and Xiphidiata, and the gene rearrangement events mainly occurred in "trnE‐trnG" and "trnG‐trnE". Phylogenetic analysis suggested that trematodes of the family Pleurogenidae clustered more with Prosthogonimidae than Eucotylidae. The mt genome data of P. japonicus provide an accurate genetic marker for further studies of Xiphidiata trematodes. [ABSTRACT FROM AUTHOR]

Importance: Viral encephalitis is one of the main causes of the perisylvian syndrome, which can cause damage to children's language‐speech, feeding, and swallowing functions. Comprehensive assessment of language‐speech and swallowing function and comorbidity research on these children will help children's rehabilitation workers to better understand the disease and strengthen the systematic management of comorbid disorders. Objective: To describe speech and language pathology and the occurrence of comorbid disorders in children with perisylvian syndrome induced by viral encephalitis. Methods: Twenty‐two children with acquired perisylvian syndrome were recruited in this study. Language and speech functions, including oral motor function, swallowing function, language ability, and dysarthria were assessed in these patients. Craniocerebral magnetic resonance imaging (MRI), electroencephalogram examination, and intelligence evaluation were performed to determine brain lesions and comorbid disorders. Results: All children exhibited different degrees of oral movement, dysphagia, and speech and language disorders. There was a significant difference between expressive and receptive language ability (P < 0.05). There were 10, 8, and 12 children who had an intellectual disability, limb disability, and epilepsy, respectively. In addition to the damage of the peri‐tegmental cortex found in MRI, thalamus lesions occurred in 19 cases and white matter involvement in six cases. Interpretation: Children with acquired perisylvian syndrome caused by viral encephalitis are characterized by persistent pseudobulbar dysfunction, speech and language impairment, and orofacial diplegia. They have a high probability of secondary epilepsy and are prone to motor and cognitive impairment, which need systematic management. [ABSTRACT FROM AUTHOR]

Simple Summary: Cryptosporidium spp., Giardia duodenalis, and Enterocytozoon bieneusi are among the most common diarrhea-causing pathogens in humans and livestock. This was the first study to systematically and molecularly detect the prevalence of three intestinal protozoa in cattle in Heilongjiang Province, Northeast China. Our findings indicate that a variety of species/genotypes are prevalent in cattle in Heilongjiang Province and that some of them are zoonotic, indicating a risk of zoonotic disease transmission in endemic areas. This study helps to understand the epidemiology of Cryptosporidium spp., Giardia duodenalis, and Enterocytozoon bieneusi in cattle in Heilongjiang Province. Crytosporidium spp., Giardia duodenalis, and Enterocytozoon bieneusi are important diarrheal pathogens with a global distribution that threatens the health of humans and animals. Despite cattle being potential transmission hosts of these protozoans, the associated risks to public health have been neglected. In the present study, a total of 1155 cattle fecal samples were collected from 13 administrative regions of Heilongjiang Province. The prevalence of Cryptosporidium spp., G. duodenalis, and E. bieneusi were 5.5% (64/1155; 95% CI: 4.2–6.9), 3.8% (44/1155; 95% CI: 2.7–4.9), and 6.5% (75/1155; 95% CI: 5.1–7.9), respectively. Among these positive fecal samples, five Cryptosporidium species (C. andersoni, C. bovis, C. ryanae, C. parvum, and C. occultus), two G. duodenalis assemblages (E and A), and eight E. bieneusi genotypes (BEB4, BEB6, BEB8, J, I, CHS7, CHS8, and COS-I) were identified. Phylogenetic analysis showed that all eight genotypes of E. bieneusi identified in the present study belonged to group 2. It is worth noting that some species/genotypes of these intestinal protozoans are zoonotic, suggesting a risk of zoonotic disease transmission in endemic areas. The findings expanded our understanding of the genetic composition and zoonotic potential of Cryptosporidium spp., G. duodenalis, and E. bieneusi in cattle in Heilongjiang Province. [ABSTRACT FROM AUTHOR]

In viral evolution, a new mutation has to proliferate within the host (Stage I) in order to be transmitted and then compete in the host population (Stage II). We now analyze the intrahost single nucleotide variants (iSNVs) in a set of 79 SARS-CoV-2 infected patients with most transmissions tracked. Here, every mutation has two measures: 1) iSNV frequency within each individual host in Stage I; 2) occurrence among individuals ranging from 1 (private), 2–78 (public), to 79 (global) occurrences in Stage II. In Stage I, a small fraction of nonsynonymous iSNVs are sufficiently advantageous to rise to a high frequency, often 100%. However, such iSNVs usually fail to become public mutations. Thus, the selective forces in the two stages of evolution are uncorrelated and, possibly, antagonistic. For that reason, successful mutants, including many variants of concern, have to avoid being eliminated in Stage I when they first emerge. As a result, they may not have the transmission advantage to outcompete the dominant strains and, hence, are rare in the host population. Few of them could manage to slowly accumulate advantageous mutations to compete in Stage II. When they do, they would appear suddenly as in each of the six successive waves of SARS-CoV-2 strains. In conclusion, Stage I evolution, the gate-keeper, may contravene the long-term viral evolution and should be heeded in viral studies. [ABSTRACT FROM AUTHOR]

Summary: Flowering time is a key agronomic trait determining environmental adaptation and yield potential of crops. The regulatory mechanisms of flowering in maize still remain rudimentary.In this study, we combine expressional, genetic, and molecular studies to identify two homologous SQUAMOSA PROMOTER BINDING PROTEIN‐LIKE (SPL) transcription factors ZmSPL13 and ZmSPL29 as positive regulators of juvenile‐to‐adult vegetative transition and floral transition in maize.We show that both ZmSPL13 and ZmSPL29 are preferentially expressed in leaf phloem, vegetative and reproductive meristem. We show that vegetative phase change and flowering time are moderately delayed in the Zmspl13 and Zmspl29 single knockout mutants and more significantly delayed in the Zmspl13/29 double mutants. Consistently, the ZmSPL29 overexpression plants display precocious vegetative phase transition and floral transition, thus early flowering. We demonstrate that ZmSPL13 and ZmSPL29 directly upregulate the expression of ZmMIR172C and ZCN8 in the leaf, and of ZMM3 and ZMM4 in the shoot apical meristem, to induce juvenile‐to‐adult vegetative transition and floral transition.These findings establish a consecutive signaling cascade of the maize aging pathway by linking the miR156‐SPL and the miR172‐Gl15 regulatory modules and provide new targets for genetic improvement of flowering time in maize cultivars. [ABSTRACT FROM AUTHOR]