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Antimicrobial resistance (AMR) poses an increasing threat to global health. To deliberate the distribution and transmission of environmental resistance in a wide geographic and longitudinal scope, standardization of the analytical methods is desperately required for the extensive implementation of large-scale environmental antibiotic resistance gene (ARGs) surveillance. In this review, a standardized surveillance method using metagenomic analysis, coupled with proper quantification tools and environmental reference materials as technical benchmarks, was established to facilitate the generation of comparable and informative resistome datasets. As global and long-term ARGs surveillance has recently been performed in various environmental compartments, increasing efforts are also needed for assessing the health risks of ARGs. The development of risk assessment schemes that incorporate factors including transfer potential, host species, viability, and absolute quantification is essential to the regulatory guidelines for high-risk priority ARGs. This review provides guidance to ARGs surveillance regarding the level and the risk of ARG exposure, especially to identify and address critical hotspots. [ABSTRACT FROM AUTHOR]

Introduction: Individuals who develop new‐onset diabetes have been identified as a high‐risk cohort for pancreatic cancer (PC), exhibiting an incidence rate nearly 8 times higher than the general population. Hence, the targeted screening of this specific cohort presents a promising opportunity for early pancreatic cancer detection. We aimed to develop and validate a novel model capable of identifying high‐risk individuals among those with new‐onset diabetes. Methods: Employing the UK Biobank cohort, we focused on those developing new‐onset diabetes during follow‐up. Genetic and clinical characteristics available at registration were considered as candidate predictors. We conducted univariate regression analysis to identify potential indicators and used a 5‐fold cross‐validation method to select optimal predictors for model development. Five machine learning algorithms were used for model development. Results: Among 12,735 patients with new‐onset diabetes, 100 (0.8%) were diagnosed with PC within 2 years. The final model (area under the curve, 0.897; 95% confidence interval, 0.865–0.929) included 5 clinical predictors and 24 single nucleotide polymorphisms. Two threshold cut‐offs were established: 1.28% and 5.26%. The recommended 1.28% cut‐off, based on model performance, reduces definitive testing to 13% of the total population while capturing 76% of PC cases. The high‐risk threshold is 5.26%. Utilizing this threshold, only 2% of the population needs definitive testing, capturing nearly half of PC cases. Conclusions: We, for the first time, combined clinical and genetic data to develop and validate a model to determine the risk of pancreatic cancer in patients with new‐onset diabetes using machine learning algorithms. By reducing the number of unnecessary tests while ensuring that a substantial proportion of high‐risk patients are identified, this tool has the potential to improve patient outcomes and optimize healthcare sources. [ABSTRACT FROM AUTHOR]

Many physicians have resigned themselves to working after hours to keep up with their in-basket, but it doesn't have to be this way. Many physicians have resigned themselves to working after hours to keep up with their in-basket, but it doesn't have to be this way. [ABSTRACT FROM AUTHOR]

Background: Despite increasing breastfeeding initiation rates in the United States, disparities in breastfeeding continuation and exclusivity by race and ethnicity persist. Research Aim: We aimed to understand the perceptions and experiences of Latina parents who received access to telelactation, and assessed the implications of integrating telelactation into pediatric settings. Methods: This cross-sectional qualitative study drew from participants enrolled in a randomized controlled trial about breastfeeding support. We recruited 20 participants from among those participating in a randomized controlled trial assessing the effect of telelactation on breastfeeding outcomes. The study design was informed by an Equity-Centered Model and authentic entry. We conducted a thematic content analysis through an iterative approach, where we systematically generated themes to describe code application patterns. Results: We identified three themes: (1) telelactation within the broader landscape of breastfeeding support; (2) perceptions of telelactation support; and (3) recommendations on the use of telelactation in the context of pediatric care. We found that participants had an escalation approach for seeking breastfeeding support and propose a new model: Breastfeeding Support Escalation Protocol, which can be applied to lactation support in pediatric care. Parents' perceptions and recommendations highlighted their desire for care coordination, expanded options for telelactation engagement, and care continuity, which are important reflections for pediatric offices considering integrating telelactation services into their practice. Conclusions: Latina parents found telehealth to be helpful and an acceptable alternative to in-person services. Pediatric offices can take steps toward becoming Breastfeeding-Friendly by partnering with telelactation services. More research is needed on the logistical implications and cost-effectiveness of telelactation services as part of the pediatric practice. [ABSTRACT FROM AUTHOR]

Background: Breastfeeding is crucial in providing infants with needed nutrition and immunity to foster their healthy growth and development; yet, optimal support from health workers is critical for it to be successful. Aim: To determine factors influencing tangible breastfeeding support among health workers in Nigeria. Methods: This cross-sectional study was conducted in Nigeria's six geopolitical zones between August 2022 and February 2023 among health workers (N = 2,922). Data were gathered through an interviewer-administered, validated questionnaire. Significant factors of tangible breastfeeding support were identified through multivariable logistic regression, and corresponding odds ratios with 95% confidence intervals were reported. Results: The mean age of the health workers was 28.6 (SD = 9.3) years. Just 45% (1,316) achieved optimal scores for tangible breastfeeding support. Only 31.4% (918) of lactation support providers/specialists practice tangible breastfeeding support and half (50.6%, 1,479) had a favorable attitude towards providing tangible breastfeeding support. About two-fifths (39.3%, 1,148) engaged caregivers in reviewing breast milk storage procedures, whereas, 54.6% (1,595) and 78.0% (2,279) of health workers assisted with breast pumps and breastfeeding attachment respectively. The odds of having optimal tangible breastfeeding support were higher for health workers aged 52 years or older compared to those aged under 20 years (aOR 1.88, 95% CI [1.13, 3.12]), a positive attitude (aOR 1.43, 95% CI [1.22, 1.69]), availability of a breastfeeding champion (aOR 1.47, 95% CI [1.21, 1.79]), 1.69]), provision of breast-pump videos (aOR; 2.33, 95% CI [1.85, 2.95]), and hand-expression videos (aOR; 1.41, 95% CI [1.02, 1.79]). (duplication) Conclusion: Health workers' tangible breastfeeding support in Nigeria is suboptimal and is driven by age, service level, attitude, availability of breastfeeding champions, and appropriate practice aids. Targeted interventions to improve health workers' attitudes, technical skills, provision of aids, and task shifting to non-specialists are needed for optimal tangible breastfeeding support. [ABSTRACT FROM AUTHOR]

It is recommended that infants are introduced to complementary foods from 6 months old, moving from a solely milk diet to eating a family diet by 12 months old. Although home cooking of family foods is recommended, a rapidly growing market producing baby food products (BFP) such as jars, pouches and snacks has developed. These are often accompanied by marketing claims around nutritional, health and developmental impacts despite research highlighting high sugar content. Although numerous studies have explored drivers of infant formula choice and use, little research has examined the drivers of BFP use. This study used an online survey for United Kingdom parents of infants aged 4–12 months to explore use of BFP alongside perceptions and drivers to purchase products. Overall, 271 parents participated (173 used BFP and 98 did not), with a descriptive analysis of closed items and a thematic analysis for open ended text conducted. The top motivators for using BFP were convenience, time saving, and baby's perceived enjoyment of products. The most purchased puree was fruit based and the most purchased baby snacks were vegetable puffs/sticks, with snack purchases being more common than purees in this sample. Aspects such as perceived healthiness drove choice, with snack foods being seen to enhance self‐feeding skills, appetite regulation and motor development. Those who did not use BFP did not trust them and preferred to feed their baby home cooked foods. The findings are important for professionals working with parents, to support them through the transition to solid foods, particularly around raising awareness of marketing techniques and how to check content of foods to make a more informed choice. Key messages: Parents had multiple reasons for using BFP. The most common motivators were convenience, time saving and infants' perceived enjoyment of them.Some parents perceive baby food products to have nutritional benefits due to health halo statements on packaging. Statements such as low in salt or high in fibre led to perceptions that the product was healthy.Baby snacks were the most common BFPs used, sometimes by parents who did not use purees as self‐feeding was seen to support development. Almost a quarter offered baby puffs daily compared to one in six using fruit purees daily. [ABSTRACT FROM AUTHOR]

With unprecedented and growing interest in data science education, there are limited educator materials that provide meaningful opportunities for learners to practice statistical thinking, as defined by Wild and Pfannkuch, with messy data addressing real-world challenges. As a solution, Nolan and Speed advocated for bringing applications to the forefront in undergraduate statistics curriculum with the use of in-depth case studies to encourage and develop statistical thinking in the classroom. Limitations to this approach include the significant time investment required to develop a case study—namely, to select a motivating question and to create an illustrative data analysis—and the domain expertise needed. As a result, case studies based on realistic challenges, not toy examples, are scarce. To address this, we developed the Open Case Studies (opencasestudies.org) project, which offers a new statistical and data science education case study model. This educational resource provides self-contained, multimodal, peer-reviewed, and open-source guides (or case studies) from real-world examples for active experiences of complete data analyses. We developed an educator's guide describing how to most effectively use the case studies, how to modify and adapt components of the case studies in the classroom, and how to contribute new case studies (opencasestudies.org/OCS_Guide). [ABSTRACT FROM AUTHOR]

Throughout history, many scientists considered time as the result of changing the world and believed that time is not true. Among those who say that time is not true, Einstein is the only one who was able to mathematically explain the relativity of time in the field of geometry (space time) and present his equations in relativistic physics. Although Einstein, like other scientists, did not provide a clear definition of time, he presented the relativity of time well. He showed that time is not independent of space and bends along with space. Also, Einstein used the speed of light to convert mass into energy to introduce the law of mass–energy equivalence. Currently, basic laws such as conservation of mass, conservation of energy and equivalence of mass and energy have been presented. Recently, due to the importance of time in the development of science, especially in the field of water and chemistry, "timemass equivalence law" has also been presented (by the author). In this research, with the aim of expanding the relativity of time in the flows of mass and energy (not the field of motion and geometry), while presenting new definitions of "phenomenon", "time" and "specific speed of transformation", in addition to the theory of "mass equivalence law" "Time" was completed, the general equations of equivalence of energy time—and timemass were introduced. Then, to check the results more accurately, the general masstime equation (in this study, absorption kinetics) by performing surface absorption experiments of heavy metals (Fe + 2, Pb + 2, Zn + 2, Ni + 2, Cd + 2, Cu + 2)) was investigated by the adsorbents of green walnut shell (GWH) and its biochar (GWHB), and the results are tested in different ways. [ABSTRACT FROM AUTHOR]

Following intensive care unit hospitalization, survivors of acute neurological injury often experience debilitating short-term and long-term impairments. Although the physical/motor impairments experienced by survivors of acute neurological injury have been described extensively, fewer studies have examined cognitive, mental health, health-related quality of life (HRQoL), and employment outcomes. This scoping review describes the publication landscape beyond physical and/or motor sequelae in neurocritical care survivors. Databases were searched for terms related to critical illness, intensive care, and outcomes from January 1970 to March 2022. English-language studies of critically ill adults with a primary neurological diagnosis were included if they reported on at least one outcome of interest: cognition, mental health, HRQoL or employment. Data extraction was performed in duplicate for prespecified variables related to study outcomes. Of 16,036 abstracts screened, 74 citations were identified for inclusion. The studies encompassed seven worldwide regions and eight neurocritical diagnosis categories. Publications reporting outcomes of interest increased from 3 before the year 2000 to 71 after. Follow-up time points included ≤ 1 (n = 15 [20%] citations), 3 (n = 28 [38%]), 6 (n = 28 [38%]), and 12 (n = 21 [28%]) months and 1 to 5 (n = 19 [26%]) and > 5 years (n = 8 [11%]), with 28 (38%) citations evaluating outcomes at multiple time points. Sixty-six assessment tools were used to evaluate the four outcomes of interest: 22 evaluating HRQoL (56 [76%] citations), 21 evaluating cognition (20 [27%] citations), 21 evaluating mental health (18 [24%] citations), and 2 evaluating employment (9 [12%] citations). This scoping review aimed to better understand the literature landscape regarding nonphysical outcomes in survivors of neurocritical care. Although a rising number of publications highlight growing awareness, future efforts are needed to improve study consistency and comparability and characterize outcomes in a disease-specific manner, including outlining of a minimum core outcomes set and associated assessment tools. [ABSTRACT FROM AUTHOR]

Acute kidney injury (AKI) is a multifactorial syndrome with a high risk of short- and long-term complications as well as increased health care costs. The traditional biomarkers of AKI, serum creatinine and urine output, have important limitations. The discovery of new functional and damage/stress biomarkers has enabled a more precise delineation of the aetiology, pathophysiology, site, mechanisms, and severity of injury. This has allowed earlier diagnosis, better prognostication, and the identification of AKI sub-phenotypes. In this review, we summarize the roles and challenges of these new biomarkers in clinical practice and research. [ABSTRACT FROM AUTHOR]

Background: In the past, there has been a clear conclusion regarding the sole impact of serum neurofilament light chain (sNfL) levels or type 2 diabetes mellitus (DM) on the risk of death. However, the combined effect of sNfL levels and type 2 DM on all-cause and cardiovascular mortality is still uncertain. Methods: This study was a prospective cohort study based on data from the National Health and Nutrition Examination Survey (NHANES). The sNfL levels were measured through immunological methods using blood samples collected during the survey. The diagnosis of diabetes was based on rigorous criteria, and participants' mortality data were followed up until December 31, 2019. Firstly, we separately examined the effects of sNfL and type 2 DM on all-cause and cardiovascular mortality, and finally studied the comprehensive impact of the combination of sNfL and type 2 DM on the risk of mortality. Cumulative Kaplan-Meier curves, multivariate logistic regression and sensitivity analysis were incorporated throughout the entire study. Results: Participants in the highest quartile of sNfL were observed. Multivariable COX regression model showed that increased sNfL levels and type 2 DM were respectively associated with an increased risk of all-cause and cardiovascular mortality. Furthermore, elevated sNfL levels were significantly associated with an increased risk of all-cause mortality and cardiovascular mortality after adjustment for confounding factors. When considering both elevated sNfL levels and type 2 DM, individuals had a significantly increased risk of mortality. Sensitivity analysis confirmed the robustness of the findings. Conclusions: These results suggest that elevated levels of sNfL and type 2 DM are associated with an increased risk of all-cause and cardiovascular mortality, and that participants with increased sNfL levels associated with type 2 DM have higher all-cause mortality and cardiovascular mortality. [ABSTRACT FROM AUTHOR]

Stress is a critical factor in the development of mental disorders such as addiction, underscoring the importance of stress resilience strategies. While the ketogenic diet (KD) has shown efficacy in reducing alcohol consumption in male mice without cognitive impairment, its impact on the stress response and addiction development, especially in females, remains unclear. This study examined the KD's effect on increasing ethanol intake due to vicarious social defeat (VSD) in female mice. Sixty-four female OF1 mice were divided into two dietary groups: standard diet (n = 32) and KD (n = 32). These were further split based on exposure to four VSD or exploration sessions, creating four groups: EXP-STD (n = 16), VSD-STD (n = 16), EXP-KD (n = 16), and VSD-KD (n = 16). KD-fed mice maintained ketosis from adolescence until the fourth VSD/EXP session, after which they switched to a standard diet. The Social Interaction Test was performed 24 h after the last VSD session. Three weeks post-VSD, the Drinking in the Dark test and Oral Ethanol Self-Administration assessed ethanol consumption. The results showed that the KD blocked the increase in ethanol consumption induced by VSD in females. Moreover, among other changes, the KD increased the expression of the ADORA1 and CNR1 genes, which are associated with mechanisms modulating neurotransmission. Our results point to the KD as a useful tool to increase resilience to social stress in female mice. [ABSTRACT FROM AUTHOR]

The Journal of Statistics & Data Science Education (JSDSE) has implemented requirements for authors to share deidentified data and code to promote reproducibility and open science. This document discusses the importance of sharing data in research and provides guidelines for selecting appropriate repositories for data sharing. It also addresses the challenges of sharing deidentified data, particularly in relation to privacy concerns and the potential for reidentification. The document suggests options such as removing sensitive demographic variables or creating synthetic data to protect privacy while still allowing for reproducibility. It concludes by emphasizing the importance of balancing privacy and sharing to foster better science. [Extracted from the article]

Economics has become increasingly empirical and, alongside this shift, has come more demand for improved transparency and reproducibility in empirical economic research. In this article, we distribute a survey to almost 1500 economics faculty from the top 161 liberal arts colleges with an economics major (according to U.S. News & World Report) in the United States to determine the prevalence of teaching reproducible methods in undergraduate economics, summarize the most-common methods of instruction, and determine the intended student learning objectives. We find that of the economics faculty at liberal arts colleges who teach these reproducible methods, most do so in advanced upper-level (42%) and basic econometrics (31%) courses. Those faculty report teaching reproducibility using the following methods: transparent coding (85%), organizational skills (78%), and producing replication documentation (47%) through individual research projects (82%), homework assignments (55%), and/or workshops (33%). We conclude with some qualitative text analysis to shed light on the intended learning objectives and find that research skills (59%) and the importance of reproducibility (37%) are the most common reasons cited for teaching these methods. [ABSTRACT FROM AUTHOR]

Small cell lung cancer (SCLC) is a highly aggressive malignancy characterized by rapid growth and early metastasis and is susceptible to treatment resistance and recurrence. Understanding the intra‐tumoral spatial heterogeneity in SCLC is crucial for improving patient outcomes and clinically relevant subtyping. In this study, a spatial whole transcriptome‐wide analysis of 25 SCLC patients at sub‐histological resolution using GeoMx Digital Spatial Profiling technology is performed. This analysis deciphered intra‐tumoral multi‐regional heterogeneity, characterized by distinct molecular profiles, biological functions, immune features, and molecular subtypes within spatially localized histological regions. Connections between different transcript‐defined intra‐tumoral phenotypes and their impact on patient survival and therapeutic response are also established. Finally, a gene signature, termed ITHtyper, based on the prevalence of intra‐tumoral heterogeneity levels, which enables patient risk stratification from bulk RNA‐seq profiles is identified. The prognostic value of ITHtyper is rigorously validated in independent multicenter patient cohorts. This study introduces a preliminary tumor‐centric, regionally targeted spatial transcriptome resource that sheds light on previously unexplored intra‐tumoral spatial heterogeneity in SCLC. These findings hold promise to improve tumor reclassification and facilitate the development of personalized treatments for SCLC patients. [ABSTRACT FROM AUTHOR]

With this study, our aim was to estimate the nutrient fluxes relevant for assessing nutrient sustainability as accurately as possible and to calculate nutrient balances for alternative forest management scenarios. Furthermore, we tested whether mapping units from existing geologic maps can serve as a basis for forest practitioners to estimate nutrient sustainability or whether more detailed data are needed. Positive fluxes include deposition and weathering, while negative fluxes include losses due to leaching and nutrient removal through timber harvesting in the balance. Weathering and leachate losses were modeled with a geochemical model. The SwissStandSim model was used to simulate the biomass growth under different harvesting and silvicultural strategies, allowing for sustainability to be assessed for each nutrient at a given intensity of use. This assessment was made per rotation period based on two criteria: (i) nutrient supply and (ii) total stocking volume. As a result, it can be noted that the accurate estimation of individual fluxes is essential for assessing the sustainability of forestry practices and that it needs detailed site-specific data. Various influencing factors turned out to be important, particularly the assumed depth of the root zone. [ABSTRACT FROM AUTHOR]

Background: Stroke has evolved to become a chronic disease and a major public health challenge. To adequately capture the full disease burden of stroke patients, the assessment of health-related quality of life (HRQoL) and thus the performance of respective measures is increasingly relevant. The aim of this analysis was to compare the measurement properties of two self-report instruments, the EQ-5D-5L and the Stroke Impact Scale 2.0. Methods: The data used for the analysis was derived from a quasi-experimental case management study for mildly to moderately affected incident stroke and transient ischemic attack (TIA) patients aged ≥ 18 in Germany. Data was collected patient-individually at 3, 6 and 12 months after initial stroke. The EQ-5D-5L and SIS 2.0 were compared in terms of feasibility, ceiling and floor effects, responsiveness and known-groups validity (Kruskal-Wallis H and Wilcoxon rank-sum test). Results: A response for all three follow-ups is available for n = 855 patients. The feasibility of the EQ-5D-5L is determined as good (completion rate: 96.4–96.6%, ≥ one item missing: 3.2 − 3.3%), whereas the SIS 2.0 is moderately feasible (overall completion rate: 44.9–46.1%, ≥ one item missing in domains: 4.7 − 28.7%). The SIS 2.0 shows substantial ceiling effects in comparable domains (physical function: 10.4 − 13%, others: 3.5–31.3%) which are mainly larger than ceiling effects in the EQ-5D-5L index (17.1–21.5%). In terms of responsiveness, the EQ-5D-5L shows small to moderate change while the SIS 2.0 presents with moderate to large responsiveness. The EQ-5D-5L index, mobility, usual activities and Visual Analogue Scale show known-groups validity (p < 0.05). Content-related domains of the SIS 2.0 show known-groups validity as well (p < 0.05). However, it is compromised in the emotion domain in both measures (p > 0.05). Conclusions: The EQ-5D-5L seems to be slightly more suitable for this cohort. Nonetheless, the results of both measures indicate limited suitability for TIA patients. Large-scale studies concerning responsiveness and known-groups validity are encouraged. Trial registration: The study was registered in the German Clinical Trials Register, retrospective registration on 21.09.2022. Registration ID: DRKS00030297. [ABSTRACT FROM AUTHOR]

Background: Biomarkers that reflect brain damage or predict functional outcomes may aid in guiding personalized stroke treatments. Serum neurofilament light chain (sNfL) emerges as a promising candidate for fulfilling this role. Methods: This prospective, observational cohort investigation included 319 acute ischemic stroke (IS) patients. The endpoints were the incidence of early neurological deterioration (END, an elevation of two or more points in the National Institute of Health stroke scale score within a week of hospitalization compared with the baseline) and functional outcome at 3 months (an mRS score of >2 at 3 months was categorized as an unfavorable/poor functional outcome). The association of sNfL, which was assessed within 24 h of admission, with END and unfavorable functional outcomes at follow-up was assessed via multivariate logistic regression, whereas the predictive value of sNfL for unfavorable functional outcomes and END was elucidated by the receiver operating characteristic curve (ROC). Results: Of 319 IS individuals, 89 (27.90%) suffered from END. sNfL not only reflects the severity of stroke measured by NIHSS score (p < 0.05) but also closely related to the severity of age-related white matter changes. Higher initial NIHSS score, severe white matter lesions, diabetes mellitus, and upregulated sNfL were significant predictors of END. Similarly, the multivariate logistic regression analysis results showed that elevated sNfL, a higher baseline NIHSS score, and severe white matter lesions were substantially linked with unfavorable outcomes for 3 months. Similarly, sNfL was valuable for the prediction of the 3 months of poor outcome (95%CI, 0.504-0.642, p = 0.044). Kaplan-Meier analysis shows that patients with elevated sNfL levels are more likely to reach combined cerebrovascular endpoints (log-rank test p < 0.05). Conclusion: This investigation suggests that sNfL can serve as a valuable biomarker for predicting END and 3-month poor functional outcomes after an IS and has the potential to forecast long-term cardiovascular outcomes. [ABSTRACT FROM AUTHOR]

The role that humans played in the extinction of Pleistocene proboscideans is highly controversial. Ethnohistoric records of elephant hunting, in concert with theoretical rationales, are often used as proxy evidence to support the view that ancient humans regularly and efficiently targeted large-sized proboscideans to the point of extinction. This paper examines the socioeconomic and technological contexts of elephant hunting in contemporary and ethnohistoric records to show how these circumstances influenced the scale of harvest, productivity, and valuation of elephants. Quantitative and qualitative evidence derived from some of these records are used to analyze the efficiency of elephant capture using traditional hunting technologies (spears, poisoned projectiles, traps, and drives). This analytical framework provides a systematic method for evaluating the productivity of proboscidean predation. Results show that prior to the widespread use of firearms in the eighteenth and nineteenth centuries, the acquisition of elephants, irrespective of the traditional hunting technology used, was a dangerous, high-cost activity often associated with a high-risk of hunting failure. In the ethnographic record, elephant hunting is consistently associated with prestige-seeking among egalitarian hunter-gatherers. Although the analysis presented here is derived from hunting episodes that involved modern elephants, the physical characteristics and abilities that make these animals expensive and risky to hunt were likely manifested by most Pleistocene proboscideans. Using ethnographic data, a framework for recognizing how prestige hunting is manifested under different ecological and sociopolitical circumstances is provided and offers an alternative and compelling explanation for zooarchaeological patterning of costly prey in the past. [ABSTRACT FROM AUTHOR]

Background: We aimed to study anxiety, depression and quality of life in smokers after stroke by sex. Methods: A longitudinal prospective study with a 24-month follow-up of acute stroke patients who were previously active smokers. Anxiety and depression were evaluated with the Hospital Anxiety and Depression scale, and quality of life was evaluated with the EQ-5D questionnaire. Results: One hundred and eighty patients participated (79.4% men); their mean age was 57.6 years. Anxiety was most prevalent at 3 months (18.9% in men and 40.5% in women) and depression at 12 months (17.9% in men and 27% in women). The worst perceived health occurred at 24 months (EQ-VAS 67.5 in men and 65.1 in women), which was associated with depression (p < 0.001) and Rankin Scale was worse in men (p < 0.001) and depression in women (p < 0.001). Continued tobacco use was associated with worse perceived health at 3 months in men (p = 0.034) and at 12 months in both sexes. Predictor variables of worse perceived health at 24 months remaining at 3 and 12 months were tobacco use in men and neurological damage in women. Conclusion: Differences by sex are observed in the prevalence of anxiety and depression and associated factors and in the predictive factors of perceived health. [ABSTRACT FROM AUTHOR]

Purpose: Few studies have compared patient characteristics, clinical management, and outcome of patients with COVID-19 between the different epidemic waves. In this study, we describe patient characteristics, treatment, and outcome of patients admitted for COVID-19 in the Antwerp University Hospital over the first three epidemic waves of 2020–2021. Methods: Retrospective observational study of COVID-19 patients in a Belgian tertiary referral hospital. All adult patients with COVID-19, hospitalized between February 29, 2020, and June 30, 2021, were included. Standardized routine medical data was collected from patient records. Risk factors were assessed with multivariable logistic regression. Results: We included 722 patients, during the first (n = 179), second (n = 347) and third (n = 194) wave. We observed the lowest disease severity at admission during the first wave, and more elderly and comorbid patients during the second wave. Throughout the subsequent waves we observed an increasing use of corticosteroids and high-flow oxygen therapy. In spite of increasing number of complications throughout the subsequent waves, mortality decreased each wave (16.6%,15.6% 11.9% in 1st, 2nd and 3rd wave respectively). C-reactive protein above 150 mg/L was predictive for the need for intensive care unit admission (odds ratio (OR) 3.77, 95% confidence interval (CI) 2.32–6.15). A Charlson comorbidity index ≥ 5 (OR 5.68, 95% CI 2.54–12.70) and interhospital transfers (OR 3.78, 95% CI 2.05–6.98) were associated with a higher mortality. Conclusions: We observed a reduction in mortality each wave, despite increasing comorbidity. Evolutions in patient management such as high-flow oxygen therapy on regular wards and corticosteroid use may explain this favorable evolution. [ABSTRACT FROM AUTHOR]

Prey metabarcoding has become a popular tool in molecular ecology for resolving trophic interactions at high resolution, from various sample types and animals. To date, most predator–prey studies of small‐sized animals (<1 mm) have met the problem of overabundant predator DNA in dietary samples by adding blocking primers/peptide nucleic acids. These primers aim to limit the PCR amplification and detection of the predator DNA but may introduce bias to the prey composition identified by interacting with sequences that are similar to those of the predator. Here we demonstrate the use of an alternative method to explore the prey of small marine copepods using whole‐body DNA extracts and deep, brute force metabarcoding of an 18S rDNA fragment. After processing and curating raw data from two sequencing runs of varying depths (0.4 and 5.4 billion raw reads), we isolated 1.3 and 52.2 million prey reads, with average depths of ~15,900 and ~120,000 prey reads per copepod individual, respectively. While data from both sequencing runs were sufficient to distinguish dietary compositions from disparate seasons, locations, and copepod species, greater sequencing depth led to better separation of clusters. As computation and sequencing are becoming ever more powerful and affordable, we expect the brute force approach to become a general standard for prey metabarcoding, as it offers a simple and affordable solution to consumers that is impractical to dissect or unknown to science. [ABSTRACT FROM AUTHOR]

The Moller experiment and the P2 experiment aim at measuring the weak mixing angle at low scales. The Moller experiment uses e - e - → e - e - -scattering, the P2 experiment uses e - N → e - N -scattering. In both cases, two-loop electroweak corrections have to be taken into account, and here in particular diagrams which give rise to large logarithms. In this paper we compute a set of two-loop electroweak Feynman integrals for point-like particles, which are obtained from a box integral by the insertion of a light fermion loop. By rationalising all occurring square roots we show that these Feynman integrals can be expressed in terms of multiple polylogarithms. We present the results in a form, which makes the large logarithms manifest. We provide highly efficient numerical evaluation routines for these integrals. [ABSTRACT FROM AUTHOR]

Purpose: Acute kidney injury (AKI) is frequent among in-hospital patients with high incidence and mortality. Implementing a series of evidence-based AKI care bundles may improve patient outcomes by reducing changeable standards of care. The aim of this meta-analysis was therefore to appraise the influences of AKI care bundles on patient outcomes. Materials and methods: We explored three international databases (PubMed, Embase, and Cochrane Central Register of Controlled Trials) and two Chinese databases (Wanfang Data and China National Knowledge Infrastructure) for studies from databases inception until November 30, 2022, comparing the impact of different AKI care bundles with usual standards of care in patients with or at risk for AKI. The study quality of non-randomized controlled trials and randomized controlled trials was evaluated by the NIH Study Quality Assessment Tool and the Cochrane risk of bias tool. Heterogeneity between studies was appraised by Cochran's Q test and I2 statistics. The possible origins of heterogeneity between studies were assessed adopting Meta-regression and subgroup analyses. Funnel plot asymmetry and Egger regression and Begg correlation tests were performed to discover potential publication bias. Data analysis was completed by software (RevMan 5.3 and Stata 15.0). The primary outcome was short- or long-term mortality. The secondary outcomes involved the incidence and severity of AKI. Results: Sixteen studies containing 25,690 patients and 25,903 AKI episodes were included. In high-risk AKI patients determined by novel biomarkers, electronic alert or risk prediction score, the application of AKI care bundles significantly reduced the AKI incidence (OR, 0.71; 95% CI, 0.53–0.96; p = 0.02; I2 = 84%) and AKI severity (OR, 0.59; 95% CI, 0.39–0.89; p = 0.01; I2 = 65%). No strong evidence is available to prove that care bundles can significantly reduce mortality (OR, 1.16; 95% CI, 0.58–2.30; p = 0.68; I2 = 97%). Conclusions: The introduction of AKI care bundles in routine clinical practice can effectively improve the outcomes of patients with or at-risk of AKI. However, the accumulated evidence is limited and not strong enough to make definite conclusions. [ABSTRACT FROM AUTHOR]

The AUD2IT-algorithm is a tool to structure the data, which is collected during an emergency treatment. The goal is on the one hand to structure the documentation of the data and on the other hand to give a standardised data structure for the report during handover of an emergency patient. AUD2IT-algorithm was developed to provide residents a documentation aid, which helps to structure the medical reports without getting lost in unimportant details or forgetting important information. The sequence of anamnesis, clinical examination, considering a differential diagnosis, technical diagnostics, interpretation and therapy is rather an academic classification than a description of the real workflow. In a real setting, most of these steps take place simultaneously. Therefore, the application of the AUD2IT-algorithm should also be carried out according to the real processes. A big advantage of the AUD2IT-algorithm is that it can be used as a structure for the entire treatment process and also is entirely usable as a handover protocol within this process to make sure, that the existing state of knowledge is ensured at each point of a team-timeout. PR-E-(AUD2IT)-algorithm makes it possible to document a treatment process that, in principle, does not have to be limited to the field of emergency medicine. Also, in the outpatient treatment the PR-E-(AUD2IT)-algorithm could be used and further developed. One example could be the preparation and allocation of needed resources at the general practitioner. The algorithm is a standardised tool that can be used by healthcare professionals of any level of training. It gives the user a sense of security in their daily work. [ABSTRACT FROM AUTHOR]

BACKGROUND: Liver hepatocellular cancer (LIHC) and stomach adenocarcinoma (STAD) are common malignancies with high lethal ratios worldwide. Great progress has been achieved by using diverse therapeutic strategies; however, these diseases still have an unfavourable prognosis. Ferroptosis inducer drugs, unlike apoptosis-related drugs, can overcome the resistance to cancer therapy caused by traditional chemicals. However, the relationship between overall survival (OS) and ferroptosis-related genes, as well as the mechanisms involved, are largely unclear. METHODS: The expression levels of AIFM2, GPX4, ACSL4, FTH1, NOS1, and PTGS2 in LIHC and STAD were obtained from UALCAN. The correlations of OS with these gene expression levels were obtained using the Kaplan-Meier Plotter database. The OS associated with genetic mutations of those genes compared to that of unchanged genes was analysed using the TIMER website. GO and KEGG enrichment analyses of ferroptosis-related genes and their coexpressed genes in LIHC and STAD were conducted using the STRING and DAVID databases. The relationship of PTGS2 and ACSL4 to immune cell infiltration was analysed using the TIMER website. The viability and GPX5 expression levels in LIHC cells treated with RSL3 and As2O3 were detected by MTT methods and western blotting, respectively. RESULTS: Our results showed that GPX4, FTH1 and AIFM2 were overexpressed in LIHC and STAD. High levels of GPX4, FTH1 and AIFM2 were prominently correlated with better prognosis in LIHC. However, GPX and FTH1 in STAD did not show significant correlations with OS. AIFM2 in STAD had the opposite trend with OS compared with that in LIHC. Moreover, a high mutation rate of these genes (35.74%) was also observed in LIHC patients, and genetic mutation of these genes was correlated with shorter OS. In contrast, the genetic mutation of these genes did not change OS in STAD. Enrichment analysis showed that the respiratory electron transport chain, cell chemotaxis and T-cell migration were related to ferroptosis. ASCL4 and PTGS2 coexpressed with cytokines associated with immune cell infiltration. Compared to RSL3 or As2O3 alone, As2O3 plus RSL3 significantly inhibited the growth of Huh7 cells. GPX4 was downregulated to an undetectable level when in combination with RSL3. CONCLUSIONS: Our results indicated that ferroptosis-related genes might play an important role in LIHC and STAD and might be risk factors for overall survival in LIHC and STAD. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the health-related quality of life(HRQoL)status of elderly patients with hypertensive stroke, to understand the factors influencing it, and to provide a basis for the development of health intervention policies. Patients and Methods: This study used the EQ-5D-3L scale to assess the HRQoL among elderly patients who experienced a stroke related to high blood pressure. Various analytical methods were employed to examine the factors that influenced the patient's quality of life. Univariate analysis, Tobit regression, random forest, and XGBoost models were applied to analyze the HRQoL of the patients. Furthermore, to interpret the machine learning results, the SHAP method was utilized. This method involved assessing the importance of each feature, examining the effect of each feature on the prediction result of a single sample, and determining the impact of individual features on the overall prediction. Results: The study found that the median health utility value for elderly patients with hypertensive stroke was 0.427, with an interquartile range of 0.186 to 0.745. The results of the Tobit regression model, Random Forest, and XGBoost model were compared. The results of the model evaluation show that the performance of the machine learning model and the Tobit regression model are not very different. The XGBoost model performs slightly better relative to the random forest model. The factors that strongly influenced the health utility value of patients included BMI, social activities, smoking, education level, alcohol consumption, urban/rural residence, annual income, physical activity level, and hours of sleep at night. Conclusion: Health-related quality of life in hypertensive stroke patients is influenced by a variety of factors. Health-related quality of life can be positively influenced by modifying these factors and making lifestyle adjustments. Maintaining a healthy weight, being socially active, quitting smoking, improving living conditions, increasing physical activity levels and getting enough sleep are recommended. Lifestyle changes need to be developed for each individual on a case-by-case basis and by medical advice. [ABSTRACT FROM AUTHOR]

Background: Ischemic stroke is a relevant cause of mortality in Brazil and worldwide. Anxiety symptoms after stroke are frequent and their predictors still need to be elucidated. The present research aims to investigate the frequency and predictors of post-stroke anxiety (PSA). Methods: A prospective cohort study was carried out in a tertiary centre of neurology, including 148 patients with acute ischemic stroke who were interviewed between January 2020 and February 2021. The first interview, during hospitalisation, included the investigation of clinical, sociodemographic, and radiological variables and the application of the Hospital Anxiety and Depression Scale (HADS). Subsequently, the HADS and the modified Rankin Scale were reapplied 90 days after stroke by phone interview. Predictor variables were investigated by applying univariate and multivariate linear regression. Data were expressed by ' Beta ', ' R square ' and ' P ' values. Variables that demonstrated P ≤ 0.20 in the univariate linear regression were included in a multivariate linear regression model. Results: The frequencies of anxiety symptoms during hospitalisation and 90 days after stroke were high (33.8 and 23.7%, respectively). Anxiety and depressive symptoms during hospitalisation (B : 0.441; P < 0.01 and B : 0.241; P < 0.01, respectively) and depression 90 days after stroke (B : 0.394; P < 0.01) were strong predictors of PSA. Conclusions: This study identified a high frequency of PSA. Psychiatric symptoms during hospitalisation was demonstrated to be a strong predictor of PSA. This highlights the importance of the early recognition of psychiatric symptoms, even during hospitalisation, to timely treat those patients who might experience a positive impact on their recovery. Ischemic stroke is a leading cause of mortality worldwide and anxiety symptoms after stroke are frequent. Symptoms of anxiety and depression during stroke hospitalisation are strongly associated with anxiety 90 days after stroke. Early identification of patients at greater risk of developing anxiety 90 days after stroke is relevant as it allows a timely diagnosis and appropriate treatment. [ABSTRACT FROM AUTHOR]

Simple Summary: Cordyceps militaris is an entomopathogenic fungus with potential health benefits. These benefits have made this fungus marketable. Employing the transcriptome-integrated genome-scale metabolic model approach using gene inactivity moderated by metabolism and expression framework (iPS1474-tiGSMM), this work reveals metabolic fluxes in correlation with the expressed genes involved in the cordycepin and carotenoid biosynthetic pathways of C. militaris under light exposure. Additionally, an analysis of reporter metabolites emphasizes central carbon, purine, and fatty acid metabolisms, uncovering crucial processes for C. militaris adaptation to light exposure. The genome-scale metabolic model (GSMM) of Cordyceps militaris provides a comprehensive basis of carbon assimilation for cell growth and metabolite production. However, the model with a simple mass balance concept shows limited capability to probe the metabolic responses of C. militaris under light exposure. This study, therefore, employed the transcriptome-integrated GSMM approach to extend the investigation of C. militaris's metabolism under light conditions. Through the gene inactivity moderated by metabolism and expression (GIMME) framework, the iPS1474-tiGSMM model was furnished with the transcriptome data, thus providing a simulation that described reasonably well the metabolic responses underlying the phenotypic observation of C. militaris under the particular light conditions. The iPS1474-tiGSMM obviously showed an improved prediction of metabolic fluxes in correlation with the expressed genes involved in the cordycepin and carotenoid biosynthetic pathways under the sucrose culturing conditions. Further analysis of reporter metabolites suggested that the central carbon, purine, and fatty acid metabolisms towards carotenoid biosynthesis were the predominant metabolic processes responsible in light conditions. This finding highlights the key responsive processes enabling the acclimatization of C. militaris metabolism in varying light conditions. This study provides a valuable perspective on manipulating metabolic genes and fluxes towards the target metabolite production of C. militaris. [ABSTRACT FROM AUTHOR]

The paper investigates the fiscal impact of natural disasters in the U.S. states. The focus is on state spending, state revenues, and federal transfers for the period from 1970 to 2015. Results show that a broad definition based on dollar damages from all emergency events and major disasters has a small effect on state-level fiscal conditions, which stands in contrast to prior studies. On the other hand, a narrower definition based on the occurrence of major disasters is associated with increased spending and transfers alongside spending effects that grow with disaster severity. [ABSTRACT FROM AUTHOR]

Immune thrombocytopenic purpura (ITP) is an immune-mediated disorder characterized by the destruction of platelets and megakaryocytes due to autoantibodies against the platelet surface proteins. ITP without any apparent cause of thrombocytopenia is defined as primary ITP, and ITP in the setting of SLE is secondary ITP, which can be diagnosed after excluding other causes of thrombocytopenia by history, physical examination, and laboratory testing. Patients with ITP associated with SLE have higher median platelet count and less bleeding manifestations compared to the patients with primary ITP. It can be very challenging to diagnose primary ITP in SLE patients as other causes of thrombocytopenia including drug-induced thrombocytopenia, antiphospholipid syndrome, and thrombotic microangiopathic process should be ruled out. Corticosteroids are the main modality of treatment. IVIG can be used in severe cases. Splenectomy was found to be less effective in ITP associated with SLE compared to primary ITP. Control of disease activity with immunosuppressive therapy can be helpful in some cases associated with active disease flares in SLE patients. [ABSTRACT FROM AUTHOR]

The text explores the Gillham abduction story, a significant event in the history of Madison County, Illinois. It discusses the historical accuracy of the story and its variations, as well as its portrayal of Euro-American relations with Indigenous peoples. The text also examines the genre of Indian captivity narratives and how the Gillham story fits into this literary tradition. It provides a summary of the Gillham abduction story as published in the 1850s, highlighting the differences between the various accounts. The article emphasizes the need for a historically situated examination to understand the complexities of the past. [Extracted from the article]