Increasing SARS-CoV-2 seroprevalence among UK pediatric patients on dialysis and kidney transplantation between January 2020 and August 2021.

BACKGROUND: Coronavirus disease 2019 (COVID-19) was officially declared a pandemic by the World Health Organisation (WHO) on 11 March 2020, as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spread rapidly across the world. We investigated the seroprevalence of anti-SARS-CoV-2 antibodies in pediatric patients on dialysis or kidney transplantation in the UK. METHODS: Excess sera samples were obtained prospectively during outpatient visits or haemodialysis sessions and analysed using a custom immunoassay calibrated with population age-matched healthy controls. Two large pediatric centres contributed samples. RESULTS: In total, 520 sera from 145 patients (16 peritoneal dialysis, 16 haemodialysis, 113 transplantation) were analysed cross-sectionally from January 2020 until August 2021. No anti-SARS-CoV-2 antibody positive samples were detected in 2020 when lockdown and enhanced social distancing measures were enacted. Thereafter, the proportion of positive samples increased from 5% (January 2021) to 32% (August 2021) following the emergence of the Alpha variant. Taking all patients, 32/145 (22%) were seropositive, including 8/32 (25%) with prior laboratory-confirmed SARS-CoV-2 infection and 12/32 (38%) post-vaccination (one of whom was also infected after vaccination). The remaining 13 (41%) seropositive patients had no known stimulus, representing subclinical cases. Antibody binding signals were comparable across patient ages and dialysis versus transplantation and highest against full-length spike protein versus spike subunit-1 and nucleocapsid protein. CONCLUSIONS: Anti-SARS-CoV-2 seroprevalence was low in 2020 and increased in early 2021. Serological surveillance complements nucleic acid detection and antigen testing to build a greater picture of the epidemiology of COVID-19 and is therefore important to guide public health responses. A higher resolution version of the Graphical abstract is available as Supplementary information.

The Evolution of Scientific Visualisations: A Case Study Approach to Big Data for Varied Audiences.

Visual representations of complex data are a cornerstone of how scientific information is shared. By taking large quantities of data and creating accessible visualisations that show relationships, patterns, outliers, and conclusions, important research can be communicated effectively to any audience. The nature of animal cognition is heavily debated with no consensus on what constitutes animal intelligence. Over the last half-century, the methods used to define intelligence have evolved to incorporate larger datasets and more complex theories-moving from relatively simple comparisons of brain mass and body mass to explorations of brain composition and how neuron count changes between specific groups of animals. The primary aim of this chapter is therefore to explore how visualisation choice influences the accessibility of complex scientific information, using animal cognition as a case study. As the datasets concerned with animal intelligence have increased in both size and complexity, have the visualisations that accompany them evolved as well? We first investigate how the basic presentation of visualisations (figure legends, inclusion of statistics, use of colour, etc.) has changed, before discussing alternative approaches that might improve communication with both scientific and general audiences. By building upon the types of visualisation techniques that everyone is taught at school (bar charts, XY scatter plots, pie charts, etc.), we show how small changes can improve our communication with both scientific and general audiences. We suggest that there is no single right way to visualise data, but careful consideration of the audience and the specific message can help, even where communications are constrained by time, technology, or medium.

Montelukast: a novel therapeutic option in eosinophilic peritonitis.

BACKGROUND: Eosinophilic peritonitis is a recognised complication of peritoneal dialysis and has an incompletely understood pathophysiology. Current treatment options, including change of dialysate, change of peritoneal dialysis modality, steroids or antihistamines, are supported only by case reports with a lack of controlled trials or evidence-based guidelines. Leukotrienes are proinflammatory arachidonic acid metabolites produced by leucocytes and are involved in eosinophil chemotaxis. Montelukast is an orally administered leukotriene receptor antagonist commonly used in managing childhood atopic illnesses and theoretically safe for use in patients with renal failure. CASE DIAGNOSIS AND TREATMENT: We describe the first reported case of recurrent, symptomatic, eosinophilic peritonitis in a 15-year-old girl successfully treated with leukotriene receptor antagonist montelukast after changes in dialysate and treatment with antihistamines failed to adequately control eosinophilic peritoneal infiltrates or symptoms. CONCLUSIONS: Current scientific understanding of leukotrienes and eosinophil migration suggest that montelukast may be a well-tolerated, safe and efficacious treatment for eosinophilic peritonitis complicating peritoneal dialysis. Further cases and comparative studies are required to develop an evidence base for treatment of this condition.