Selective Immunoglobulin A Deficiency (SIgAD) is the most common primary immunodeficiency, defined as an isolated deficiency of IgA (less than 0.07 g/L). Although the majority of people born with IgA deficiency lead normal lives without significant pathology, there is nonetheless a significant association of IgA deficiency with mucosal infection, increased risks of atopic disease, and a higher prevalence of autoimmune disease. To explain these phenomena, we have performed an extensive literature review to define the geoepidemiology of IgA deficiency and particularly the relative risks for developing Systemic Lupus Erythematosus, hyperthyroidism, hypothyroidism, type 1 diabetes mellitus, Crohn's Disease, ulcerative colitis, rheumatoid arthritis, juvenile idiopathic arthritis, ankylosing spondylitis, and vitiligo; these diseases have strong data to support an association. We also note weaker associations with scleroderma, celiac disease, autoimmune hepatitis, immune thrombocytopenic purpura, and autoimmune hemolytic anemia. Minimal if any associations are noted with myasthenia gravis, lichen planus, and multiple sclerosis. Finally, more recent data provide clues on the possible immunologic mechanisms that lead to the association of IgA deficiency and autoimmunity; these lessons are important for understanding the etiology of autoimmune disease. 2 3 Introduction:

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A severe coronavirus disease 2019 patient admitted to our institution for medical management was enrolled in a randomized placebo-controlled trial of an investigational therapeutic for coronavirus disease 2019. We leveraged existing video-telecommunication equipment to obtain informed consent. We found video-telecommunication use closely mirrored person-to-person contact for research consent by maintaining engagement and ensuring understanding. Video-telecommunication use facilitated clinical research while minimizing unnecessary exposure to coronavirus disease 2019 and conserving personal protective equipment. Prior to the coronavirus disease 2019 pandemic, research regulatory agencies were essentially silent on the matter of video-telecommunication consent. Regulatory guidance became available during the pandemic in response to increased isolation and social distancing practices. Virtual health and telemedicine use expanded greatly during the pandemic, and this increase will likely persist after the pandemic ends. We anticipate video-telecommunication adoption and implementation for research consent will also continue to grow after the coronavirus disease 2019 pandemic is over.

An understanding of the variations in the blood supply of the foregut and midgut are of critical importance to surgeons performing transplants, liver and biliary surgery, resection of tumors and various gastrointestinal procedures, as well as to interventional radiologists engaged in vessel embolization. During the dissection of a 95-year-old female cadaver as part of a course in medical gross anatomy at the University of California at Davis a rare series of vascular variations were observed. The left gastric artery arose independently from the abdominal aorta at the location of a typical celiac trunk. The common hepatic artery and splenic artery branched from a common vessel originating from a hepatosplenomesenteric trunk. Just inferior to the hepatosplenic trunk a hepatocolic trunk, which gave rise to an accessory right hepatic artery, dorsal pancreatic artery and a wandering mesenteric artery, branched from the superior mesenteric artery. This rare combination of clinically relevant variations was likely due to the abnormal partitioning and regression of the primitive splanchnic arteries during embryonic development.