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To induce remission in luminal paediatric Crohn's disease (CD), the ESPGHAN/ECCO guideline recommends treatment with exclusive enteral nutrition (EEN) or oral corticosteroids. In newly diagnosed moderate-to-severe paediatric CD patients, we determined the proportion of patients in which EEN or corticosteroids induced remission and maintained remission on azathioprine monotherapy. We included patients from the "TISKids" study assigned to the conventional treatment arm. Patients were aged 3–17 years and had new-onset, untreated luminal CD with weighted paediatric CD activity index (wPCDAI) > 40. Induction treatment consisted of EEN or oral corticosteroids; all received azathioprine maintenance treatment from start of treatment. The primary outcome of this study was endoscopic remission defined as a SES-CD score < 3 without treatment escalation at week 10. Secondary outcomes included proportion of patients without treatment escalation at week 52. In total, 27/47 patients received EEN and 20/47 corticosteroids. At baseline, patient demographics and several inflammation parameters were similar between the two treatment groups. At 10 weeks, clinical remission rates were 7/23 (30%) for EEN and 7/19 (37%) for corticosteroids (p = 0.661). Twenty-nine of 47 consented to endoscopy at 10 weeks, showing endoscopic remission rates without treatment escalation in 2/16 (13%) of EEN-treated patients and in 1/13 (8%) of corticosteroid-treated patients (p = 1.00). At week 52, 23/27 (85%) EEN-treated patients received treatment escalation (median 14 weeks) and 13/20 (65%) corticosteroid-treated patients (median 27 weeks), p = 0.070. Conclusion: In children with moderate-to-severe newly diagnosed CD, induction treatment with EEN or CS regularly is insufficient to achieve endoscopic remission without treatment escalation at week 10. Trial registration number: NCT02517684 What is Known: • Endoscopic remission is associated with a low risk of disease progression. • FL-IFX was superior to conventional treatment in achieving and maintaining remission in paediatric patients with moderate-to-severe CD the first year from diagnosis. What is New: • In children with newly diagnosed moderate-to-severe CD, clinical remission rates and endoscopic remission rates without treatment escalation at week 10 were 30% and 13% after EEN and 37% and 8% after corticosteroid induction treatment. • The current treatment target was often not achieved by either EEN or corticosteroid induction treatment after bridging to azathioprine. [ABSTRACT FROM AUTHOR]

Chapter 14 of the book "Advances in Botanical Research: Plant Innate Immunity," Volume 51, edited by L.C. Van Loon is presented. It focuses on the biochemistry and molecular biology perspectives of plant volatiles emitted during herbivore- or pathogen-induced stress and discusses its role in plant defenses. It discloses on direct defense, indirect defense, and plant-plant communication as the three different roles of plant volatiles in plant-herbivore and plant-pathogen interactions.

Background: In the recent era of growing availability of biological agents, the role of thiopurines needs to be reassessed with the focus on toxicity. Aims: We assessed the incidence and predictive factors of thiopurine-induced adverse events (AE) resulting in therapy cessation in pediatric inflammatory bowel disease (IBD), related to thiopurine metabolites and biochemical abnormalities, and determined overall drug survival. Methods: We performed a retrospective, single-center study of children diagnosed with IBD between 2000 and 2019 and treated with thiopurine therapy. The incidence of AE and overall drug survival of thiopurines were evaluated using the Kaplan–Meier method. Correlations between thiopurine metabolites and biochemical tests were computed using Spearman's correlation coefficient. Results: Of 391 patients with IBD, 233 patients (162 Crohn's disease, 62 ulcerative colitis, and 9 IBD-unclassified) were prescribed thiopurines (230 azathioprine and 3 mercaptopurine), of whom 50 patients (22%) discontinued treatment, at least temporary, due to thiopurine-induced AE (median follow-up 20.7 months). Twenty-six patients (52%) were rechallenged and 18 of them (70%) tolerated this. Sixteen patients (6%) switched to a second thiopurine agent after azathioprine intolerance and 10 of them (63%) tolerated this. No predictive factors for development of AE could be identified. Concentrations of 6-thioguanine nucleotides (6-TGN) were significantly correlated with white blood cell and neutrophil count, 6-methylmercaptopurine (6-MMP) concentrations with alanine aminotransferase and gamma-glutamyltranspeptidase. Conclusions: Approximately 20% of pediatric patients with IBD discontinued thiopurine treatment due to AE. A rechallenge or switch to mercaptopurine is an effective strategy after development of AE. Concentrations of 6-TGN and 6-MMP are associated with biochemical abnormalities. [ABSTRACT FROM AUTHOR]

The article presents answers to questions in a quiz about acute kidney injury in a girl with Crohn's disease.

Female-emitted volatile sex pheromones in most moths are composed of biosynthetically related blends of fatty acid derivatives, such as aldehydes, acetate esters and alcohols. In many moths, as in the noctuid Heliothis (Chloridea) virescens, the pheromone gland contains alcohols (e.g., (Z)-11-hexadecen-1-ol, hereafter Z11-16:OH) that may serve dual functions as pheromone components as well as precursors of other pheromone components. The relative importance of Z11-16:OH to male attraction in H. virescens has been controversial. It occurs in the pheromone gland in relatively large amounts, but several studies could neither detect Z11-16:OH in gland emissions nor attribute any conspecific behavioral function to it in flight- tunnel assays. Trapping assays in the field, however, have more consistently documented that the addition of Z11-16:OH increased trap catch. Using a short section of thick film megabore column, in combination with derivatization and GC-CI-SIM-MS, we determined that Z11-16:OH is emitted from the sex pheromone gland during calling. Field trapping studies demonstrated that trap catch increased when Z11-16:OH was added to a 2-component minimal blend and to a 6-component blend. Behavioral observations in the field confirmed that more males responded to a pheromone blend that contained a low blend ratio of Z11-16:OH, but ≥5% Z11-16:OH depressed both male behavior and trap catch. We conclude that Z11-16:OH should be considered a component of the sex pheromone of H. virescens females. [ABSTRACT FROM AUTHOR]

Insects rely on olfaction to guide a wide range of adaptive behaviors, including mate and food localization, mate choice, oviposition site selection, kin recognition, and predator avoidance. 1 In nocturnal insects, such as moths 2 and cockroaches, 3 mate finding is stimulated predominantly by long-range species-specific sex pheromones, typically emitted by females. During courtship, at close range, males in most moth species emit a blend of pheromone compounds from an everted, often large, pheromone gland. While long-distance communication with sex pheromones has been remarkably well characterized in thousands of moth species, 2,4 close-range chemosensory sexual communication remains poorly understood. We reveal that in the moth Chloridea virescens , the male pheromone consists of three distinct classes of compounds: de novo biosynthesized alcohols, aldehydes, acetates, and carboxylic acids that resemble the female's emissions; newly identified compounds that are unique to the male pheromone, such as aliphatic polyunsaturated hydrocarbons; and sequestered plant secondary compounds and hormone derivatives, including methyl salicylate (MeSA). Thus, males employ a mosaic pheromone blend of disparate origins that may serve multiple functions during courtship. We show that two olfactory receptors in female antennae are tuned to MeSA, which facilitates female acceptance of the male. Because MeSA is emitted by plants attacked by pathogens and herbivores, 5 the chemosensory system of female moths was likely already tuned to this plant volatile, and males appear to exploit the female's preadapted sensory bias. Interestingly, while female moths (largely nocturnal) and butterflies (diurnal) diverged in their use of sensory modalities in sexual communication, 6 MeSA is used by males of both lineages. [Display omitted] • The courtship pheromone of male Chloridea virescens moths was re-examined • The pheromone constitutes a mosaic of type I, type II, and plant-derived compounds • Methyl salicylate (MeSA) is an aphrodisiac that improves mating success • Two olfactory receptors contribute to high olfactory sensitivity of females to MeSA Liu et al. identify novel chemicals, including methyl salicylate (MeSA), that male moths use during courtship to increase mating success. Two olfactory receptors on female antennae detect MeSA. The male sex pheromone is a mosaic blend that includes fatty acid derivatives, unsaturated hydrocarbons, and sequestered plant-derived compounds. [ABSTRACT FROM AUTHOR]

Objectives The Reflux Finding Score for Infants (RFS-I) was developed to assess signs of laryngopharyngeal reflux (LPR) in infants. With flexible laryngoscopy, moderate inter- and highly variable intraobserver reliability was found. We hypothesized that the use of rigid laryngoscopy would increase reliability and therefore evaluated the reliability of the RFS-I for flexible versus rigid laryngoscopy in infants. Methods We established a set of videos of consecutively performed flexible and rigid laryngoscopies in infants. The RFS-I was scored twice by 4 otorhinolaryngologists, 2 otorhinolaryngology fellows, and 2 inexperienced observers. Cohen's and Fleiss' kappas ( k ) were calculated for categorical data and the intraclass correlation coefficient (ICC) was calculated for ordinal data. Results The study set consisted of laryngoscopic videos of 30 infants (median age 7.5 (0–19.8) months). Overall interobserver reliability of the RFS-I was moderate for both flexible (ICC = 0.60, 95% CI 0.44–0.76) and rigid (ICC = 0.42, 95% CI 0.26–0.62) laryngoscopy. There were no significant differences in reliability of overall RFS-I scores and individual RFS-I items for flexible versus rigid laryngoscopy. Intraobserver reliability of the total RFS-I score ranged from fair to excellent for both flexible (ICC = 0.33–0.93) and rigid (ICC = 0.39–0.86) laryngoscopies. Comparing RFS-I results for flexible versus rigid laryngoscopy per observer, reliability ranged from no to substantial ( k  = −0.16–0.63, mean k  = 0.22), with an observed agreement of 0.08–0.35. Conclusion Reliability of the RFS-I was moderate and did not differ between flexible and rigid laryngoscopies. The RFS-I is not suitable to detect signs or to guide treatment of LPR in infants, neither with flexible nor with rigid laryngoscopy. [ABSTRACT FROM AUTHOR]

A quiz about a case of acute kidney injury in a 15-year-old girl with Crohn's disease is presented.