Submucosal Epstein-Barr Virus Positive Polymorphic B-cell Lymphoproliferative Disorder of the Larynx: A Case Report.

Epstein-Barr virus (EBV) belongs to the group of human herpes virus and can cause clinical and subclinical infections. Although EBV-related disease presentations are similar, they can lead to oncogenic transformation with various clinical manifestations. A thorough workup with morphology, immunohistochemistry, and molecular studies is crucial for the diagnosis of EBV-positive polymorphic B-cell lymphoproliferative disorder, not otherwise specified (NOS), which is a new entity introduced by International Consensus Classification in 2022. We describe an interesting presentation of EBV-positive polymorphic B-cell lymphoproliferative disorder with laryngeal involvement to bring awareness to this entity and we would like to address the need for more accessible treatment options.

Purposeful parenting by Mexican-heritage mothers: Advancing school readiness through social-emotional competence.

OBJECTIVES: We investigate how Mexican-heritage mothers' socialization beliefs and strategies contribute to their preschool children's school readiness. While Latinx children typically start kindergarten with strong social competencies, they also start with less strong early literacy and math skills, in comparison with their non-Latinx peers. We propose that-paralleling Lareau's (2003) theory of "concerted cultivation," whereby White, middle-class parents purportedly display great intentionality in nurturing the academic and extracurricular skills of their children-Mexican-heritage mothers purposefully cultivate their children's social-emotional skills. METHODS: Using structured interviews and home observations over a 14-month period, we follow 23 Mexican-heritage mothers and their 24 preschool children. RESULTS: Drawing on ecocultural theory, Mexican-heritage mothers engage their preschool children in a concerted fashion to develop their social-emotional competence. Specifically, they: (a) articulate the role of children's social-emotional skills vis-à-vis academic skills related to school readiness; (b) delineate the character of their children's social-emotional skills; and (c) promote social-emotional skills through intention-filled parenting practices relevant to their cultural contexts. CONCLUSIONS: Understanding parents' "concerted cultivation" in differing cultural contexts may facilitate teachers' use of practices that better align with families' home practices and more effectively support the learning of Latinx children across academic domains. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Racial and Ethnic Disparities in Early Childhood Obesity: Growth Trajectories in Body Mass Index.

OBJECTIVE: The aims of this study are to describe growth trajectories in the body mass index (BMI) among the major racial and ethnic groups of US children and to identify predictors of children's BMI trajectories. METHODS: The Early Childhood Longitudinal Study-Birth Cohort (ECLS-B) was used to identify predictors of BMI growth trajectories, including child characteristics, maternal attributes, home practices related to diet and social behaviors, and family sociodemographic factors. Growth models, spanning 48 to 72 months of age, were estimated with hierarchical linear modeling via STATA/Xtmixed methods. RESULTS: Approximately one-third of 4-year-old females and males were overweight and/or obese. African-American and Latino children displayed higher predicted mean BMI scores and differing mean BMI trajectories, compared with White children, adjusting for time-independent and time-dependent predictors. Several factors were significantly associated with lower mean BMI trajectories, including very low birth weight, higher maternal education level, residing in a two-parent household, and breastfeeding during infancy. Greater consumption of soda and fast food was associated with higher mean BMI growth. Soda consumption was a particularly strong predictor of mean BMI growth trajectory for young Black children. Neither the child's inactivity linked to television viewing nor fruit nor vegetable consumption was predictive of BMI growth for any racial/ethnic group. CONCLUSION: Significant racial and ethnic differences are discernible in BMI trajectories among young children. Raising parents' and health practitioners' awareness of how fast food and sweetened-beverage consumption contributes to early obesity and growth in BMI-especially for Blacks and Latinos-could improve the health status of young children.

Home activities of Mexican American children: structuring early socialization and cognitive engagement.

The question of how home activities advance the early social and cognitive development of Latino children receives growing attention from psychologists and social scientists. Some scholars and practitioners, focused on promoting "school readiness," frame the problem as weak parenting, signaled by insufficient rich language or academic skills. Other theorists, rooted in ecocultural theory, argue that early socialization and cognitive engagement are culturally situated within routine home activities. These activity structures vary and change over time as families acculturate, adapting to local social ecologies. Little is known empirically about the activity structures within Latino homes, including how young children participate. We detail the social architecture and cognitive engagement pertaining to 6 prevalent home activities in which 24 Mexican American 4-year-olds were engaged over 14 months. We then report how children participate in these 6 activities, and their potential relevance to the cognitive skills gap seen at school entry. We found that children's activities reproduced heritage language, symbols, and knowledge less often than suggested in prior literature; children's typical level of cognitive engagement varied greatly among tasks; and the distribution of time spent in activities is associated with the mother's school attainment and home language.

Early growth of Mexican-American children: lagging in preliteracy skills but not social development.

Latino toddlers fall behind White peers at 24 months of age in oral language and interactive skills with their mothers in English or Spanish. But Latino children enter kindergarten with social skills that rival White peers, despite social-class disparities. We ask whether cognitive trajectories widen during the 24-48 month period, how these patterns differ for Latinos, especially Mexican-Americans, and whether similar gaps in social-emotional growth appear. We analyzed growth patterns for a nationally representative birth sample (n = 4,690) drawn in 2001, estimating levels of change in development from 24 to 48 months of age, focusing on Latino subgroups. The mean gap in cognitive processing for Mexican-American children, already wide at 24-months of age relative to Whites (three-fourths of a standard deviation), remained constant at 48 months. But differences in social-emotional status were statistically insignificant at both 24 and 48 months. Mexican-American mothers were observed to be equally warm and supportive relative to White peers during interaction tasks. Yet the former group engaged less frequently in cognitive facilitation, oral language, and preliteracy activities in the home. Growth in both cognitive and social domains was considerably lower in larger families, placing children raised in poor or Spanish-speaking homes within a large household at greater risk of delays. Pediatricians and practitioners must carefully gauge the social-emotional well-being of Latino children, in developmental surveillance activities. Growth in cognitive and social domains unfolds independently for children of Mexican heritage, even when raised in economically poor families.

The significance of "indefinite for dysplasia" grading in Barrett metaplasia.

CONTEXT: For a confident diagnosis of dysplasia in Barrett metaplasia, the epithelial atypia should also involve the surface epithelium. However, pathologists are often faced with biopsies where the crypts show dysplasia, but the surface epithelium is either uninvolved or unevaluable. We previously grouped these cases with indefinite for dysplasia (IND). OBJECTIVE: To determine the clinical significance of IND grading in Barrett metaplasia. DESIGN: All biopsies from 276 prospectively followed patients with Barrett metaplasia, who did not have high-grade dysplasia (HGD) or esophageal adenocarcinoma (EAC) on initial biopsy, were graded as negative for dysplasia, IND, low-grade dysplasia (LGD), HGD, and EAC. Biopsies with multifocal IND or LGD were graded as INDM or LGDM, respectively. RESULTS: Only 3 of 193 patients (2%) with an initial diagnosis of negative for dysplasia and only 1 of 48 patients (2%) diagnosed with IND progressed to HGD or EAC. By contrast, 1 of 7 patients (14%) with INDM, 2 of 21 (10%) with LGD, and 1 of 7 (14%) with LGDM progressed to HGD or EAC. There was no significant difference in progression rate between patients with an initial diagnosis of negative for dysplasia and those diagnosed IND nor were there significant differences among patients with initial diagnoses of INDM, LGD, or LGDM. Kaplan-Meier analysis showed that patients with INDM, LGD, or LGDM on initial biopsy (group 1) were more likely to progress to HGD or EAC than were those patients who were diagnosed negative for dysplasia or IND (group 2; log-rank test, P < .001). CONCLUSIONS: Multifocal IND in an esophageal biopsy from a patient with Barrett metaplasia has the same clinical implication as LGD.

Commands, competence, and cariño: maternal socialization practices in Mexican American families.

Early research on the socialization of Latino children has posited that mothers exercise authoritarian practices, compared with lateral reasoning (authoritative) strategies emphasized by Anglo mothers. This work aimed to categorize fixed types of parenting practices tied to the mother's personality rather than to culturally bounded contexts; it often ignored the emotional warmth or harshness present in compliance attempts and relied on interview questions rather than naturalistic observation. We built from ecocultural theory to observe daily home activities in which Mexican American mothers attempted to correct their young child's behavior or encourage completion of a task (compliance attempt). We observed 24 first- or second-generation mothers and their 4-year-old children and analyzed the activity contexts and multiple forms of 1,477 compliance attempts. Mothers typically led with direct verbal commands in their attempt to achieve compliance. Many blended commands with other compliance strategies, rather than repeating simple behaviors. Drawing on Crockenberg and Litman's (1990) differentiation of variable compliance strategies, we find that most mothers relied on low power-assertive methods, including verbal commands, rather than inductive strategies that involved reasoning. Few compliance episodes prompted high power-assertive or harsh strategies. The degree of reliance on verbal commands and the complexity of mothers' repertoires appear to be related to their education and acculturation levels.

Maternal practices that influence Hispanic infants' health and cognitive growth.

OBJECTIVES: Infants born to immigrant mothers, including Hispanic mothers, display birth weight and mortality advantages, compared with other disadvantaged groups. We examined prenatal biological factors and maternal practices that account for this advantage. Then we estimated the extent to which healthy birth outcomes, along with maternal and family factors, contribute to the health and cognitive functioning of Hispanic infants. METHODS: A representative US sample of 8114 newborns, including 1450 newborns of Hispanic mothers, was drawn randomly in 2001. We compared the mean attributes of infants in subgroups that vary in maternal practices, family attributes, and acculturation levels. We accounted for variations in newborns' gestational age and size for gestational age and their health status and cognitive functioning at 9 months of age. RESULTS: Mexican-heritage and less-acculturated mothers were no more likely than white mothers to bear premature or small-for-gestational age infants, despite large social class disparities, which was explained in part by Hispanic women's low level of prenatal tobacco use. Parenting practices and lower class status of Hispanic mothers then began to slow infants' cognitive development, compared with white infants, because of weaker maternal education and cognitive facilitation during interaction tasks and larger family size. CONCLUSIONS: These findings extend earlier research, detailing healthy births among most immigrant Hispanic women. Robust birth outcomes contribute to the early health and cognitive growth of Hispanic infants, but risk factors linked to maternal and home practices overtake these early protective factors by late infancy. Robust births and early health indicators displayed by Hispanic infants should not distract pediatricians from attending to uneven cognitive growth.

The health and cognitive growth of Latino toddlers: at risk or immigrant paradox?

Epidemiologists have shown how birth outcomes are generally robust for immigrant Latina mothers, despite often situated in poor households, advanced by their strong prenatal and nutritional practices. But little is known about (1) how these protective factors may differ among Latino subgroups, (2) the extent to which birth outcomes, ongoing maternal practices, and family supports advance Latino toddlers' health and physical growth, and (3) whether the same processes advance toddlers' early cognitive growth. We drew on a national probability sample of 8,114 infants born in 2001, including 1,450 of diverse Latino origins. Data come from birth records, maternal interviews when the child was 9 and 24 months of age, and direct assessments of health status, physical growth, and cognitive proficiencies. Descriptive analyses compared Mexican-heritage and other Latino mothers and toddlers relative to middle-class whites. Multivariate regression techniques identified predictors of child health, weight, and BMI, as well as cognitive proficiencies at 24 months. Infants of Mexican-heritage or less acculturated Latina mothers displayed robust birth outcomes, compared with other ethnic groups. The low incidence of premature births and low birthweight among these mothers continued to advance their cognitive growth through 24 months of age. Yet Latino children overall displayed smaller gains in cognitive proficiencies between 9 and 24 months, compared with middle-class populations, attributable to Latinas' lower levels of maternal education, weaker preliteracy practices, and a higher ratio of children per resident adult. Health practitioners should recognize that many Latina mothers display healthy prenatal practices and give birth to robust infants. But these early protective factors do not necessarily advance early cognitive growth. Screening practices, early interventions, and federal policy should become more sensitive to these countervailing dynamics.

Goblet cell mimickers in esophageal biopsies are not associated with an increased risk for dysplasia.

CONTEXT: Identification of intestinal-type goblet cells (ITGCs) in hematoxylin-eosin-stained sections of esophageal biopsies is essential for the diagnosis of Barrett metaplasia. However, we have seen cases diagnosed as Barrett metaplasia based solely on cells that pose morphologic similarity to ITGCs on hematoxylin-eosin staining or stain positive with Alcian blue. OBJECTIVE: To determine the clinical significance of goblet cell mimickers. DESIGN: Initial biopsies from 78 patients with original diagnosis of Barrett metaplasia negative for dysplasia and a mean follow-up of 72 months were reviewed and reclassified into 3 categories: (1) ITGCs, (2) goblet cell mimickers, or (3) neither. Sections from available paraffin blocks were stained with Alcian blue at pH 2.5. The presence of the different types of cells and positive Alcian blue staining were correlated with each other and evaluated for their significance as predictors of progression to dysplasia. RESULTS: Goblet cell mimickers were present in 35 cases and were associated with ITGCs in the same biopsy in 23 (66%) of these cases. Intestinal-type goblet cells were present in 56 cases, and the remaining 10 cases, although called Barrett on the original report, did not show either ITGCs or goblet cell mimickers. Only the presence of ITGCs was associated with significant risk for dysplasia (P = .008). Positive Alcian blue staining was not associated with a significant risk for dysplasia. CONCLUSIONS: Our results indicate that the diagnosis of Barrett metaplasia should be rendered with confidence only when ITGCs are identified on routine hematoxylin-eosin-stained sections.

Brief report: associations of parental warmth, peer support, and gender with adolescent emotional distress.

This is an exploratory study of the associations among parental warmth, peer support, gender, and emotional distress in a sample of 308 adolescents in the United States. Parental warmth was associated with less emotional distress, whereas turning to peers for support during family conflict was associated with more emotional distress. Gender moderated these associations in multivariate analyses. Emotional distress was highest among females who reported low levels of parental warmth and who turned to peers for support, in comparison with females who also turned to peers for support but had higher parental warmth. Findings contribute to a growing literature on contextual factors associated with adolescent psychosocial well-being.

Expression of the high mobility group proteins HMGI(Y) correlates with malignant progression in Barrett's metaplasia.

Expression of the high mobility group proteins HMGI(Y) has been shown to be a marker of malignancy in thyroid and pancreatic lesions and to correlate significantly with malignant progression in the colon. The aim of this study was to determine whether HMGI(Y) expression is associated with malignant progression in Barrett's metaplasia (BM). Immunoperoxidase staining for HMGI(Y) was performed on sections of formalin-fixed paraffin-embedded endoscopic esophageal biopsies from 42 patients with BM. These consisted of 19 biopsies negative for dysplasia (ND), 16 with low-grade dysplasia (LGD)/indeterminate for dysplasia (IND), and 7 with high-grade dysplasia (HGD)/adenocarcinoma (CA). The percentage of positive cells was recorded, and nuclear HMGI(Y) immunoreactivity in >10% of the cells was considered positive. Statistical analysis was performed using Fisher's exact test. Positive HMGI(Y) staining was detected in 2 of 19 (11%) cases ND, 5 of 16 (30%) LGD/IND cases, and 7 of 7 (100%) HGD/CA cases. Biopsies with HGD/CA were significantly more likely to be positive for HMGI(Y) than biopsies ND (P < 0.0001) or with LGD/IND (P = 0.0046). We conclude that HMGI(Y) expression is significantly associated with malignant progression in BM. Additional studies are needed to determine whether BM biopsies that are ND or LGD/IND and positive for HMGI(Y) are more likely to progress to adenocarcinoma.