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IntroductionWe conducted an extensive, sex-oriented real-world data analysis to explore the impact and safety of non-steroidal anti-inflammatory drugs (NSAIDs) and selective COX-2 inhibitors (coxibs) on cancer treatment outcomes. This is particularly relevant given the role of the COX-2/PGE2 pathway in tumor cell resistance to chemotherapy and radiotherapy.MethodsThe study applied a retrospective cohort design utilizing the TriNetX research database consisting of patients receiving cancer treatment in 2008-2022. The treated cohorts included patients who were prescribed with coxibs, aspirin or ibuprofen, while individuals in the control cohort did not receive these medicines during their cancer treatment. A 1:1 propensity score matching technique was used to balance the baseline characteristics in the treated and control cohorts. Then, Cox proportional hazards regression and logistic regression were applied to assess the mortality and morbidity risks among patient cohorts in a 5-year follow-up period.ResultsUse of coxibs (HR, 0.825; 95% CI 0.792-0.859 in females and HR, 0.884; 95% CI 0.848-0.921 in males) and ibuprofen (HR, 0.924; 95% CI 0.903-0.945 in females and HR, 0.940; 95% CI 0.917-0.963 in males) were associated with improved survival. Female cancer patients receiving aspirin presented increased mortality (HR, 1.078; 95% CI 1.060-1.097), while male cancer patients also had improved survival when receiving aspirin (HR, 0.966; 95% CI 0.951-0.980). Cancer subtype specific analysis suggests coxibs and ibuprofen correlated with survival, though ibuprofen and aspirin increased emergency department visits’ risk. Secondary analyses, despite limited by small cohort sizes, suggest that COX inhibition post-cancer diagnosis may benefit patients with specific cancer subtypes.DiscussionSelective COX-2 inhibition significantly reduced mortality and emergency department visit rates. Further clinical trials are needed to determine the optimal conditions for indication of coxibs as anti-inflammatory adjuvants in cancer treatment.

Background: The annual meetings hosted by the American Shoulder and Elbow Surgeons (ASES) present the latest prepublication literature in shoulder and elbow surgery, facilitating early dissemination of novel findings that impact clinical decision-making. Evaluating the publication rate of presented abstracts at ASES conferences becomes crucial in assessing the quality of research showcased, as these presentations often precede the peer-review process. Methods: The ASES conference programs from 2015-2019 were reviewed to identify presented abstracts. For each abstract, the title, author(s), conference year, and meeting type (open vs. closed) were recorded. The names of the author(s) of each abstract were searched in the PubMed and Google Scholar databases to determine if there was an associated published manuscript. For each identified manuscript, the title, author(s), date of publication, publishing journal, impact factor of the publishing journal, level of evidence, and number of citations were recorded. Results: A total of 316 abstracts were presented as podium lectures at ASES open and closed meetings between 2015 and 2019. Within 3 years of presentation, 240 (75.9%) of the presented abstracts resulted in publication. There was an increase in the proportion of abstracts resulting in publication within 3 years of the presentation from 2015-2019 (R = 0.8733, P = .053). Overall, the proportion of presented abstracts that went on to publication in peer-reviewed journals also increased (R = 0.8907, P = .043). Manuscripts of abstracts presented at open meetings had a shorter time to publication (8.78 vs. 11.82 months; P = .0160) and were cited more often (40.89 vs. 30.11, P = .0099) than those presented at closed meetings. Conclusion: There has been an increase in the publication rate of abstracts presented at ASES annual meetings in the study period. Published manuscripts of abstracts presented at ASES open conferences were published faster, and were cited more often, than closed conferences. ASES conferences allow for the presentation of high-quality prepublication literature in shoulder and elbow surgery.

Abstract The electrical characterisation of classical and quantum devices is a critical step in the development cycle of heterogeneous material stacks for semiconductor spin qubits. In the case of silicon, properties such as disorder and energy separation of conduction band valleys are commonly investigated individually upon modifications in selected parameters of the material stack. However, this reductionist approach fails to consider the interdependence between different structural and electronic properties at the danger of optimising one metric at the expense of the others. Here, we achieve a significant improvement in both disorder and valley splitting by taking a co-design approach to the material stack. We demonstrate isotopically purified, strained quantum wells with high mobility of 3.14(8) × 105 cm2 V−1 s−1 and low percolation density of 6.9(1) × 1010 cm−2. These low disorder quantum wells support quantum dots with low charge noise of 0.9(3) μeV Hz−1/2 and large mean valley splitting energy of 0.24(7) meV, measured in qubit devices. By striking the delicate balance between disorder, charge noise, and valley splitting, these findings provide a benchmark for silicon as a host semiconductor for quantum dot qubits. We foresee the application of these heterostructures in larger, high-performance quantum processors.

Abstract Wildlife space use is a key component to consider when determining effective conservation and management practices. Home range size and resource selection can vary temporally and spatially depending on mortality risks in the area and access to food resources. Lands used for coal mining can contain unique mortality risks and food resources for American black bears (Ursus americanus) relative to surrounding landscapes due to hunting restrictions, vegetation planted as part of the reclamation process, and other anthropogenic food resources. We examined the influence of mining sites on resource selection of female black bears in southern West Virginia, USA, during 2007 and 2008. We estimated home range size with Brownian Bridge movement models and evaluated variation in home range size with mixed‐effects linear regression. We evaluated resource selection with mixed‐effects Poisson point process models. On mine sites, the mean 95% home range for female black bears was 1,996 ha (SD = 2,633) in the autumn and 544 ha (SD = 238) in the spring, and on non‐mine sites the mean 95% home range was 1,926 ha (SD = 1,292) in the autumn and 771 ha (SD = 480) in the spring. Our resource selection model indicated black bears used nonhunting zones associated with mine lands much greater than their availability, and that black bears in mine areas disproportionately used areas in close proximity to anthropogenic structures. Interannual variation in home range size was likely associated with mast conditions, because smaller home ranges were associated with high mast production. Our data suggest black bears may be using non‐hunting zones within mine lands as refugia from hunting and are using anthropogenic food sources available at refuse sites on mine lands, which may increase regional black bear populations in areas with high mining activity.

Abstract Background In most regions and ecosystems, soils are the largest terrestrial carbon pool. Their potential vulnerability to climate and land use change, management, and other drivers, along with soils’ ability to mitigate climate change through carbon sequestration, makes them important to carbon balance and management. To date, most studies of soil carbon management have been based at either large or site-specific scales, resulting in either broad generalizations or narrow conclusions, respectively. Advancing the science and practice of soil carbon management requires scientific progress at intermediate scales. Here, we conducted the fifth in a series of ecoregional assessments of the effects of land use change and forest management on soil carbon stocks, this time addressing the Northeast U.S. We used synthesis approaches including (1) meta-analysis of published literature, (2) soil survey and (3) national forest inventory databases to examine overall effects and underlying drivers of deforestation, reforestation, and forest harvesting on soil carbon stocks. The three complementary data sources allowed us to quantify direction, magnitude, and uncertainty in trends. Results Our meta-analysis findings revealed regionally consistent declines in soil carbon stocks due to deforestation, whether for agriculture or urban development. Conversely, reforestation led to significant increases in soil C stocks, with variation based on specific geographic factors. Forest harvesting showed no significant effect on soil carbon stocks, regardless of place-based or practice-specific factors. Observational soil survey and national forest inventory data generally supported meta-analytic harvest trends, and provided broader context by revealing the factors that act as baseline controls on soil carbon stocks in this ecoregion of carbon-dense soils. These factors include a range of soil physical, parent material, and topographic controls, with land use and climate factors also playing a role. Conclusions Forest harvesting has limited potential to alter forest soil C stocks in either direction, in contrast to the significant changes driven by land use shifts. These findings underscore the importance of understanding soil C changes at intermediate scales, and the need for an all-lands approach to managing soil carbon for climate change mitigation in the Northeast U.S.

Abstract The amphibian skin microbiome is an important component of anti-pathogen defense, but the impact of environmental change on the link between microbiome composition and host stress remains unclear. In this study, we used radiotelemetry and host translocation to track microbiome composition and function, pathogen infection, and host stress over time across natural movement paths for the forest-associated treefrog, Boana faber. We found a negative correlation between cortisol levels and putative microbiome function for frogs translocated to forest fragments, indicating strong integration of host stress response and anti-pathogen potential of the microbiome. Additionally, we observed a capacity for resilience (resistance to structural change and functional loss) in the amphibian skin microbiome, with maintenance of putative pathogen-inhibitory function despite major temporal shifts in microbiome composition. Although microbiome community composition did not return to baseline during the study period, the rate of microbiome change indicated that forest fragmentation had more pronounced effects on microbiome composition than translocation alone. Our findings reveal associations between stress hormones and host microbiome defenses, with implications for resilience of amphibians and their associated microbes facing accelerated tropical deforestation.

Isotopic and nuclear techniques are indispensable in many fields, including health, industry, food, and agriculture. The techniques discussed, collectively known as fallout radionuclide, fingerprint, and isotope hydrology, are currently being employed to characterize and assess phenomena that could potentially degrade soil and water resources. Given the intricate nature of erosion and sedimentation processes in landscapes and water reservoirs, conducting a comprehensive characterization and evaluation of these phenomena is imperative. A traditional literature review was conducted to obtain the most thorough understanding of both the current state of the art and the subject matter regarding the conception of these techniques’ application and the manner of their use (use combined/integrated or use isolated in search of particular results on a single type of degradation, whether soil or water). There is no evidence that an integrative methodology employing these isotopic and nuclear techniques has previously been utilized (as evidenced by 109 current publications), thereby impeding the analysis of the potential sequential occurrence of soil and water degradation. The findings substantiate the hypothesis that isotopic and nuclear techniques can be integrated sequentially through a synergistic convergence. This represents an emerging methodology for addressing the complex needs of the landscape’s soil and water degradation process.

ABSTRACT The Serra da Bodoquena National Park is an important protected area that promotes the conservation of a threatened ecosystem, the Dry Forest. It comprises two major fragments of predominantly Seasonally Dry Forest vegetation. The two fragments are under different protection schemes because they are considered different biomes. The southern fragment is considered part of the Atlantic Forest biome, and is thus protected by the Atlantic Forest Law, while the northern one is considered part of the Cerrado biome and is protected by the Native Vegetation Protection Law of Brazil (2012). This difference affects management and threatens the conservation of the National Park. The Native Vegetation Protection Law is more permissive, thus increasing the conflicts between the park and surroundings in the northern fragment. We used floristic composition to provide a more accurate definition for the two fragments with regard to their phytogeographical domain. Our results identified high floristic similarity between the fragments, indicating the same vegetation type for both. Among the 202 plant species identified in this study, 76% belong to the Atlantic Forest biome. This relatively high proportion indicates that the predominant vegetation and species composition of the National Park is typical of the Atlantic Forest. The occurrence of fragments of the Atlantic Forest, with a representative number of species of its flora outside the area of application of the law of the Atlantic Forest, defined by Decree No. 6.660 / 2008, indicates the need to elaborate or adapt the law to protect these fragments.

As doenças cardiovasculares lideram a causa de mortalidade no mundo. O eletrocardiograma é uma das formas de obter o diagnóstico relacionado a doenças cardíacas. O exame consiste no registro da atividade elétrica do músculo cardíaco por meio de eletrodos posicionados nos braços, pernas e tórax do indivíduo. Neste trabalho estudamos o modelo de McSharry, que é capaz de reproduzir os sinais característicos do eletrocardiograma usando três equações diferenciais acopladas. Adicionando ao modelo um ruído e um termo senoidal, verificamos que essas modificações permitem alterar a característica do sinal de eletrocardiograma. Mostramos que é possível gerar sinais semelhantes àqueles que caracterizam anomalias no sistema cardiovascular. Utilizamos exames reais reportados pela Sociedade de Cardiologia do Estado do Rio de Janeiro para comparar com os resultados das simulações.

Background: Smith-Lemli-Opitz syndrome (SLOS) is an inherited disorder of cholesterol biosynthesis associated with congenital malformations, growth delay, intellectual disability and behavior problems. SLOS is caused by bi-allelic mutations in DHCR7, which lead to reduced activity of 7-dehydrocholesterol reductase that catalyzes the last step in cholesterol biosynthesis. Symptoms of SLOS are thought to be due to cholesterol deficiency and accumulation of its precursor 7-dehydrocholesterol (7-DHC) and 8-dehydrocholesterol (8-DHC), and toxic oxysterols. Therapy for SLOS often includes dietary cholesterol supplementation, but lipids are poorly absorbed from the diet, possibly due to impaired bile acid synthesis. We hypothesized that bile acid supplementation with cholic acid would improve dietary cholesterol absorption and raise plasma cholesterol levels. Methods: Twelve SLOS subjects (10 M, 2F, ages 2–27 years) who had plasma cholesterol ≤125 mg/dL were treated with cholic acid (10 mg/kg/day) divided twice daily for 2 months. Plasma cholesterol, 7-DHC and 8-DHC were measured by GC–MS. Oxysterols were measured by ultra-high-performance LC-MS/MS. Data were analyzed using paired t-tests. Results: At baseline, plasma cholesterol was 75 ± 24 mg/dL (mean ± SD; range 43–125, n = 12). After 2 months on cholic acid, mean plasma cholesterol increased to 97 ± 29 mg/dL (p = 0.011). Eleven of 12 subjects showed an increase in plasma cholesterol that varied from 3.8% to 85.7% (mean 38.7 ± 23.3%). 7-Hydroxycholesterol decreased by 20.6% on average (p = 0.013) but no significant changes were seen in 7-DHC or 8-DHC. Mean body weight tended to increase (3.6% p = 0.069). Subjects tolerated cholic acid well and experienced no drug-related adverse events. Conclusions: In this pilot study, cholic acid supplementation was well tolerated and safe and resulted in an increase in plasma cholesterol in most SLOS subjects. Further controlled longitudinal studies are needed to look for the sustainability of the biochemical effect and possible clinical benefits.

Funding Updated [...]

Abstract Lymphoid organs are unusual multicellular tissues: they are densely packed, but the lymphocytes trafficking through them are actively moving. We hypothesize that the intriguing ability of lymphocytes to avoid jamming and clogging is in part attributable to the dynamic shape changes that cells undergo when they move. In this work, we test this hypothesis by investigating an idealized system, namely, the flow of self-propelled, oscillating particles passing through a narrow constriction in two dimensions (2D), using numerical simulations. We found that deformation allows particles with these properties to flow through a narrow constriction in conditions when non-deformable particles would not be able to do so. Such a flowing state requires the amplitude and frequency of oscillations to exceed threshold values. Moreover, a resonance leading to the maximum flow rate was found when the oscillation frequency matched the natural frequency of the particle related to its elastic stiffness. To our knowledge, this phenomenon has not been described previously. Our findings could have important implications for understanding and controlling flow in a variety of systems in addition to lymphoid organs, such as granular flows subjected to vibration.

Objectives To determine the community’s perception on the magnitude of Xeroderma pigmentosum (XP) disease and healthcare-seeking practices in Micheweni, Pemba in response to the public widespread information on the increased burden of the disease.Design Mixed-methods cross-sectional study.Setting Micheweni district, Pemba.Participants 211 male and female adults in the household survey, three caretakers/parents of patients with XP in the case study, 20 key community leaders/influential people and health workers in in-depth interviews and 50 community members and other leaders in six focus groups.Results This study has revealed that XP disease exists in few families of which some of them have more than one child affected. The record review showed that there were a total of 17 patients who were diagnosed with the disease for the past 3 years, however only 10 were alive during the time of the survey. Findings from the community members revealed that several patients were believed to have XP disease and perceived causes include inheritance, food types, beliefs and other sociocultural practices. Stigma and discrimination were reported by caretakers and religious leaders. However, some cases believed to be XP were identified as other skin conditions when clinical examination was performed by the team of our researchers. There is a great confusion about XP and other skin diseases.Conclusion The study has shown that XP affects only few families, hence termed as concentrated rather than a generalised disease. Due to the rareness of the disease, majority of people in the district are unaware of the disease, hence confusing it with other skin conditions. There is a need for the government in collaboration with other stakeholders to provide educational programme to community members about the disease to address the misconception about the magnitude of the disease.

Purpose: To assess the future publication rates of abstracts presented at AANA annual meetings between 2015 and 2019. Methods: Abstracts presented at the 2015-2019 AANA annual meetings were identified. The PubMed and Google Scholar databases were searched for a corresponding manuscript for each abstract using the name of the first author, abstract title, and keywords. A level of evidence and anatomic category were assigned to each abstract. For each corresponding manuscript identified, the authors, journal of publication, journal impact factor (IF), time to publication, and number of citations were recorded. Results: Overall, 70.5% of abstracts presented at the 2015-2019 AANA annual meetings (275 of 390) went on to future publication, with 63.6% (248 of 390) achieving publication within 3 years. The median time to publication from presentation was 12.8 months. Arthroscopy (29.8%) was the most frequent journal of publication. The average IF of publishing journals was 4.92 ± 3.41, with 61.8% of manuscripts (170 of 275) published in journals with an IF of at least 4.00. Published manuscripts received an average of 36.30 ± 47.6 citations per manuscript. A stronger level of evidence was associated with an increased likelihood of future publication (P = .008). Conclusions: Pre-publication literature presented at the AANA annual meetings has continued to be associated with a strong likelihood of future publication in Arthroscopy and Arthroscopy, Sports Medicine, and Rehabilitation, as well as other respected peer-reviewed journals. Clinical Relevance: Exposure to pre-publication literature may have an impact on clinical management. It is important to understand the quality of research presented in abstracts from AANA annual meetings. Knowing how many abstracts are ultimately published in peer-reviewed journals provides an indicator of the quality and reliability of the research.

Background: The emergence of genetic variants of SARS-CoV-2 was associated with changing epidemiological characteristics throughout coronavirus disease 2019 (COVID-19) pandemic in population-based studies. Individual-level data on the clinical characteristics of infection with different SARS-CoV-2 variants in African countries is less well documented. Objectives: To describe the evolving clinical differences observed with the various SARS-CoV-2 variants of concern and compare the Omicron-driven wave in infections to the previous Delta-driven wave. Method: We performed a retrospective observational cohort study among patients admitted to a South African referral hospital with COVID-19 pneumonia. Patients were stratified by epidemiological wave period, and in a subset, the variants associated with each wave were confirmed by genomic sequencing. Outcomes were analysed by Cox proportional hazard models. Results: We included 1689 patients were included, representing infection waves driven predominantly by ancestral, Beta, Delta and Omicron BA1/BA2 BA4/BA5 variants. Crude 28-day mortality was 25.8% (34/133) in the Omicron wave period versus 37.1% (138/374) in the Delta wave period (hazard ratio [HR] 0.68 [95% CI 0.47–1.00] p = 0.049); this effect persisted after adjustment for age, gender, HIV status and presence of cardiovascular disease (adjusted HR [aHR] 0.43 [95% CI 0.28–0.67] p 0.001). Hospital-wide SARS-CoV-2 admissions and deaths were highest during the Delta wave period, with a decoupling of SARS-CoV-2 deaths and overall deaths thereafter. Conclusion: There was lower in-hospital mortality during Omicron-driven waves compared with the prior Delta wave, despite patients admitted during the Omicron wave being at higher risk. Contribution: This study summarises clinical characteristics associated with SARS-CoV-2 variants during the COVID-19 pandemic at a South African tertiary hospital, demonstrating a waning impact of COVID-19 on healthcare services over time despite epidemic waves driven by new variants. Findings suggest the absence of increasing virulence from later variants and protection from population and individual-level immunity.

Las leguminosas al crecer asociadas a otras especies son capaces de incrementar el valor nutritivo total de las no fijadoras de Nitrógeno (N) y aumentar su productividad. El objetivo fue evaluar la fijación biológica de N de Adesmia bicolor (Leguminosae) creciendo consociada con Festuca arundinacea (Gramineae) a lo largo de su ciclo de vida. El ensayo se realizó en la Universidad Nacional de Río Cuarto. Se evaluaron cuatro tratamientos: A1:F0 (Control I: A. bicolor, cultivo puro), A1:F1 (A. bicolor y F. arundinacea en proporciones similares), A3:F1 (A. bicolor y F. arundinacea en proporciones 3 a 1) y A0:F1 (Control II: F. arundinacea, cultivo puro). Durante las fases de crecimiento se seleccionaron tres áreas de superficie de 0,25 m2 por tratamiento, se determinó producción de biomasa seca total, número de nódulos y contenido de N. En A. bicolor se observó una mayor producción de biomasa seca total en el cultivo puro A1:F0 con respecto a los consociados en todas las fases de crecimiento. En F. arundinacea se notó una mayor producción de biomasa seca total en el cultivo puro A0:F1 en etapa vegetativa y de fructificación, mientras que en etapa de floración fue mayor en los tratamientos consociados. El contenido de N en las dos especies fue más elevado en la parte aérea que subterránea. Los valores más altos de N se presentaron en el tratamiento A3:F1. En A. bicolor la mayor producción de nódulos fue, en todos los tratamientos, en etapa vegetativa. Se concluye que A. bicolor es efectiva para fijar N tanto en cultivo puro como consociada. Teniendo en cuenta los valores de biomasa de F. arundinacea y el contenido de N en ambas especies se observaron resultados prometedores en los tratamientos consociados, por lo cual se sugiere continuar con estudios que permitan comprender el comportamiento de esta asociación.

Abstract Background Each spring and fall billions of songbirds depart on nocturnal migrations across the globe. Theory suggests that songbirds should depart on migration shortly after sunset to maximize their potential for nightly flight duration or to time departure with the emergence of celestial cues needed for orientation and navigation. Although captive studies have found that songbirds depart during a narrow window of time after sunset, observational studies have found that wild birds depart later and more asynchronously relative to sunset than predicted. Methods We used coded radio tags and automated radio-telemetry to estimate the time that nearly 400 individuals from nine songbird species departed their breeding or wintering grounds across North America. We also assessed whether each species was most likely beginning long-distance migratory flights at departure or instead first making non-migratory regional flights. We then explored variation in nocturnal departure time by post-departure movement type, species, age, sex, and season. Results We found that 90% of individuals from species that were likely initiating long-distance migratory flights departed within 69 min of civil dusk, regardless of species, season, age, or sex. By contrast, species that likely first made non-migratory regional movements away from the migratory destination departed later and more asynchronously throughout the night. Regardless of post-departure movement type, 98% of individuals departed after civil dusk but otherwise showed no preference in relation to twilight phase. Conclusions Although the presence of celestial orientation cues at civil dusk may set a starting point for departure each night, the fact that species likely beginning long-distance migration departed earlier and more synchronously relative to civil dusk than those first making non-migratory regional movements is consistent with the hypothesis that departing promptly after civil dusk functions to maximize the potential for nightly flight duration and distance. By studying the onset of migration, our study provides baseline information about departure decisions that may enhance our understanding of departure timing throughout migration.

Abstract Background Weather can have both delayed and immediate impacts on animal populations, and species have evolved behavioral adaptions to respond to weather conditions. Weather has long been hypothesized to affect the timing and intensity of avian migration, and radar studies have demonstrated strong correlations between weather and broad-scale migration patterns. How weather affects individual decisions about the initiation of migratory flights, particularly at the beginning of migration, remains uncertain. Methods Here, we combine automated radio telemetry data from four species of songbirds collected at five breeding and wintering sites in North America with hourly weather data from a global weather model. We use these data to determine how wind profit, atmospheric pressure, precipitation, and cloud cover affect probability of departure from breeding and wintering sites. Results We found that the probability of departure was related to changes in atmospheric pressure, almost completely regardless of species, season, or location. Individuals were more likely to depart on nights when atmospheric pressure had been rising over the past 24 h, which is predictive of fair weather over the next several days. By contrast, wind profit, precipitation, and cloud cover were each only informative predictors of departure probability in a single species. Conclusions Our results suggest that individual birds actively use weather information to inform decision-making regarding the initiation of departure from the breeding and wintering grounds. We propose that birds likely choose which date to depart on migration in a hierarchical fashion with weather not influencing decision-making until after the departure window has already been narrowed down by other ultimate and proximate factors.

Abstract Background Children with medical complexity (CMC) often rely upon the use of multiple medications to sustain quality of life and control substantial symptom burden. Pediatric polypharmacy (≥ 5 concurrent medications) is prevalent and increases the risk of medication-related problems (MRPs). Although MRPs are associated with pediatric morbidity and healthcare utilization, polypharmacy is infrequently assessed during routine clinical care for CMC. The aim of this randomized controlled trial is to determine if a structured pharmacist-led Pediatric Medication Therapy Management (pMTM) intervention reduces MRP counts, as well as the secondary outcomes of symptom burden and acute healthcare utilization. Methods This is a hybrid type 2 randomized controlled trial assessing the effectiveness of pMTM compared to usual care in a large, patient-centered medical home for CMC. Eligible patients include all children ages 2–18 years old, with ≥ 1 complex chronic condition, and with ≥ 5 active medications, as well as their English-speaking primary caregivers. Child participants and their primary parental caregivers will be randomized to pMTM or usual care before a non-acute primary care visit and followed for 90 days. Using generalized linear models, the overall effectiveness of the intervention will be evaluated using total MRP counts at 90 days following pMTM intervention or usual care visit. Following attrition, a total of 296 CMC will contribute measurements at 90 days, which provides > 90% power to detect a clinically significant 1.0 reduction in total MRPs with an alpha level of 0.05. Secondary outcomes include Parent-Reported Outcomes of Symptoms (PRO-Sx) symptom burden scores and acute healthcare visit counts. Program replication costs will be assessed using time-driven activity-based scoring. Discussion This pMTM trial aims to test hypotheses that a patient-centered medication optimization intervention delivered by pediatric pharmacists will result in lower MRP counts, stable or improved symptom burdens, and fewer cumulative acute healthcare encounters at 90 days following pMTM compared to usual care. The results of this trial will be used to quantify medication-related outcomes, safety, and value for a high-utilization group of CMC, and outcomes may elucidate the role of integrated pharmacist services as a key component of outpatient complex care programs for this priority pediatric population. Trial Registration This trial was prospectively registered at clinicaltrials.gov (NCT05761847) on Feb 25, 2023.

On November 7th and 8th, 2022, The National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health (NIH), The Coalition for Epidemic Preparedness Innovation (CEPI), The Bill & Melinda Gates Foundation (BMGF), The Biomedical Advanced Research and Development Authority (BARDA), and the Wellcome Trust hosted a virtual workshop entitled “Mucosal Vaccines for SARS-CoV-2: Scientific Gaps and Opportunities.” During the workshop, researchers and vaccine developers from around the world discussed the potential of mucosal vaccines to block SARS-CoV-2 transmission and reviewed the status of SARS-CoV-2 mucosal vaccine research. Here, we summarize key challenges and opportunities in basic, translational, and clinical research that were highlighted during the meeting. We also provide recommendations to advance the field and accelerate the development of mucosal vaccines for SARS-CoV-2.

Abstract Eggshell morphology is a valuable indicator of the local conditions within the nests of modern crocodilians and birds. In contrast to these latter, the anatomical structure of the eggshells of most crocodilian species is practically unknown. Here, we provide the first characterization of crocodilian eggshells, using x-ray micro-CT scans. We studied eggshells of Caiman latirostris and Caiman yacare from various developmental stages that coincide with the beginning of embryonic ossification. The new 3D renderings revealed complex ornamentation, unique among crocodilians, and amphora-shaped pore canals, some of which converge in single pore openings. We also documented a high density of pore canals with a gas diffusion capacity 45 times higher than the average predicted for modern avian eggshells. The external ornamentation and the thickness of the compact layer of the eggshells (i.e. excluding ornamentation) showed ontogenetic and interspecific differences that could be related to nesting materials and nesting areas selected by each species. The shell features described here evidence a greater structural complexity than previously recognized in phylogenetically close, sympatric crocodilian species. Further comprehensive morphological analyses on other modern and fossil crocodilian eggshells using micro-CT technology will shed new light on the evolution of reproductive strategies in this intriguing archosaur clade.

Although the personality correlates of dispositional interpersonal forgiveness (forgiveness of others) have been well characterized, those of dispositional self-forgiveness are less well understood. Moreover, when the personality correlates are examined for both types of forgiveness, the comparison has been based on participants’ self-report ratings on questionnaires. The current study sought to address these gaps in the literature by adopting a scenario-based approach, which has been used less frequently, especially in self-forgiveness research. A total of 160 participants read six fictional scenarios, each describing a severe transgression, from the perspective of the transgressor (self-forgiveness, n = 78) or the victim (interpersonal forgiveness, n = 82) of the transgression, and then responded to several items assessing different facets of forgiveness (avoidance, revenge, and benevolence). Participants’ personality (Big Five) and explanatory style were also assessed. Consistent with prior literature, agreeableness and neuroticism generally predicted different facets of interpersonal forgiveness. These two personality traits also predicted facets of self-forgiveness, but, additionally, conscientiousness and one’s tendency to internalize failure (the personal component of explanatory style) uniquely predicted self-forgiveness, especially avoidance motivations. These results point to both similarities and differences in the personality correlates of interpersonal and self-forgiveness. As a secondary, more exploratory aim, the current study compared the results from our scenario-based assessment of forgiveness to those based on a commonly used questionnaire, the Other and Self subscales of the Heartland Forgiveness Scale (HFS). As expected, the Other subscale of the HFS were associated with levels of interpersonal forgiveness assessed with our transgression scenarios, but, surprisingly, the HFS Self subscale was more strongly related to interpersonal than self-forgivess assessed with scenarios. Moreover, the Self subscale was not associated with levels of self-forgiveness assessed with transgression scenarios, except for avoidance motivations. These results suggest that scenario-based and questionnaire-based methods may capture different facts of forgiveness and cannot be used interchangeably, especially for the assessment of self-forgiveness. More generally, the current study illustrates the importance of conducting direct within-study comparisons of interpersonal and self-forgiveness as well as of different assessment methods to better understand the similarities and differences between the two types of forgiveness.

Spin qubits in Si/SiGe quantum dots suffer from variability in the valley splitting which will hinder device scalability. Here, by using 3D atomic characterization, the authors explain this variability by random Si and Ge atomic fluctuations and propose a strategy to statistically enhance the valley splitting

Here we describe a publicly available dataset titled “Simultaneous EEG and fMRI signals during sleep from humans” on the OpenNeuro platform. To investigate spontaneous brain activity across distinct brain states, electroencephalography (EEG) and functional magnetic resonance imaging (fMRI) were simultaneously acquired from 33 healthy participants (age: 22.1±3.2 years; male/female: 17/16) during the resting state and sleep. The dataset consisted of two resting-state scanning sessions and several sleep sessions for each participant. In addition, sleep staging of the EEG data was performed by a Registered Polysomnographic Technologist and provided along with the EEG and fMRI data. This dataset provides an opportunity to examine spontaneous brain activity using multimodal neuroimaging signals.

The relations between Bell nonlocality and Kochen–Specker contextuality have been subject of research from many different perspectives in the last decades. Recently, some interesting results on these relations have been explored in the so-called generalized Bell scenarios, that is, scenarios where Bell spatial separation (or agency independence) coexist with (at least one of the) parties’ ability to perform compatible measurements at each round of the experiment. When this party has an n -cycle compatiblity setup, it was first claimed that Bell nonlocality could not be concomitantly observed with contextuality at this party’s local experiment. However, by a more natural reading of the definition of locality, it turns out that both Bell nonlocality and local contextuality can, in fact, be jointly present. In spite of it, in this work we prove that in the simplest of those scenarios there cannot be arbitrary amounts of both of these two resources together. That is, in these cases we show that the violation of any Bell inequality limits the possible violations of any local noncontextuality inequality. We also explore this trade-off relation using quantifiers of nonlocality and contextuality, discussing how such a relation can be understood in terms of a ‘global’ notion of contextuality, and we study possible extensions of this result to other scenarios.

Spiral waves are spatial-temporal patterns that can emerge in different systems as heart tissues, chemical oscillators, ecological networks and the brain. These waves have been identified in the neocortex of turtles, rats, and humans, particularly during sleep-like states. Although their functions in cognitive activities remain until now poorly understood, these patterns are related to cortical activity modulation and contribute to cortical processing. In this work, ,we construct a neuronal network layer based on the spatial distribution of pyramidal neurons. Our main goal is to investigate how local connectivity and coupling strength are associated with the emergence of spiral waves. Therefore, we propose a trustworthy method capable of detecting different wave patterns, based on local and global phase order parameters. As a result, we find that the range of connection radius ( R ) plays a crucial role in the appearance of spiral waves. For R

At least 20,000 plant species produce latex, a capacity that appears to have evolved independently on numerous occasions. With a few exceptions, latex is stored under pressure in specialized cells known as laticifers and is exuded upon injury, leading to the assumption that it has a role in securing the plant after mechanical injury. In addition, a defensive effect against insect herbivores and fungal infections has been well established. Latex also appears to have effects on viruses, and laticifers are a hostile environment for virus colonization. Only one example of successful colonization has been reported: papaya meleira virus (PMeV) and papaya meleira virus 2 (PMeV2) in Carica papaya. In this review, a summary of studies that support both the pro- and anti-viral effects of plant latex compounds is provided. The latex components represent a promising natural source for the discovery of new pro- and anti-viral molecules in the fields of agriculture and medicine.

Abstract Background The effectiveness of alteplase for ischemic stroke treatment is limited, partly due to the occurrence of intracranial and extracranial hemorrhage. Mutant pro-urokinase (m-proUK) does not deplete fibrinogen and lyses fibrin only after induction with alteplase. Therefore, this treatment has the potential to be safer and more efficacious than treatment with alteplase alone. The aim of this study is to assess the safety and efficacy of thrombolytic treatment consisting of a small bolus alteplase followed by m-proUK compared with standard thrombolytic treatment with alteplase in patients presenting with ischemic stroke. Methods DUMAS is a multicenter, phase II trial with a prospective randomized open-label blinded end-point (PROBE) design, and an adaptive design for dose optimization. Patients with ischemic stroke, who meet the criteria for treatment with intravenous (IV) alteplase can be included. Patients eligible for endovascular thrombectomy are excluded. Patients are randomly assigned (1:1) to receive a bolus of IV alteplase (5mg) followed by a continuous IV infusion of m-proUK (40 mg/h during 60 min) or usual care with alteplase (0.9 mg/kg). Depending on the results of interim analyses, the dose of m-proUK may be revised to a lower dose (30 mg/h during 60 min) or a higher dose (50 mg/h during 60 min). We aim to include 200 patients with a final diagnosis of ischemic stroke. The primary outcome is any post-intervention intracranial hemorrhage (ICH) on neuroimaging at 24 h according to the Heidelberg Bleeding Classification, analyzed with binary logistic regression. Efficacy outcomes include stroke severity measured with the National Institutes of Health Stroke Scale (NIHSS) at 24 h and 5–7 days, score on the modified Rankin scale (mRS) assessed at 30 days, change (pre-treatment vs. post-treatment) in abnormal perfusion volume, and blood biomarkers of thrombolysis at 24 h. Secondary safety endpoints include symptomatic intracranial hemorrhage, death, and major extracranial hemorrhage. This trial will use a deferred consent procedure. Discussion When dual thrombolytic therapy with a small bolus alteplase and m-proUK shows the anticipated effect on the outcome, this will lead to a 13% absolute reduction in the occurrence of ICH in patients with ischemic stroke. Trial registration NL7409 (November 26, 2018)/NCT04256473 (February 5, 2020)

Abstract Titanosaurs were successful herbivorous dinosaurs widely distributed in all continents during the Cretaceous, with the major diversity in South America. The success of titanosaurs was probably due to several physiological and ecological factors, in addition to a series of morphological traits they achieved during their evolutionary history. However, the generalist nesting behaviour using different palaeoenvironments and strategies was key to accomplish that success. Titanosaur nesting sites have been found extensively around the world, with notable records in Spain, France, Romania, India, and, especially, Argentina. Here, we describe the first titanosaur nesting site from the Late Cretaceous of Brazil that represents the most boreal nesting site for South America. Several egg-clutches, partially preserved, isolated eggs and many eggshell fragments were discovered in an Inceptisol palaeosol profile of the mining Lafarge Quarry, at the Ponte Alta District (Uberaba Municipality, Minas Gerais State), corresponding to the Serra da Galga Formation (Bauru Group, Bauru Basin). Although classical mechanical preparation and CT scans have not revealed embryonic remains in ovo, the eggs and eggshell features match those eggs containing titanosaurian embryos found worldwide. The morphology of the egg-clutches and observations of the sedimentary characteristics bolster the hypothesis that these sauropods were burrow-nester dinosaurs, as was already suggested for the group based on other nesting sites. The egg-clutches distributed in two levels along the Lafarge outcrops, together with the geopalaeontological data collected, provide clear evidence for the first colonial nesting and breeding area of titanosaur dinosaurs in Brazil.

Abstract Cost-efficient library generation by early barcoding has been central in propelling single-cell RNA sequencing. Here, we optimize and validate prime-seq, an early barcoding bulk RNA-seq method. We show that it performs equivalently to TruSeq, a standard bulk RNA-seq method, but is fourfold more cost-efficient due to almost 50-fold cheaper library costs. We also validate a direct RNA isolation step, show that intronic reads are derived from RNA, and compare cost-efficiencies of available protocols. We conclude that prime-seq is currently one of the best options to set up an early barcoding bulk RNA-seq protocol from which many labs would profit.

Healthy brains display a wide range of firing patterns, from synchronized oscillations during slow-wave sleep to desynchronized firing during movement. These physiological activities coexist with periods of pathological hyperactivity in the epileptic brain, where neurons can fire in synchronized bursts. Most cortical neurons are pyramidal regular spiking (RS) cells with frequency adaptation and do not exhibit bursts in current-clamp experiments (in vitro). In this work, we investigate the transition mechanism of spike-to-burst patterns due to slow potassium and calcium currents, considering a conductance-based model of a cortical RS cell. The joint influence of potassium and calcium ion channels on high synchronous patterns is investigated for different synaptic couplings (gsyn) and external current inputs (I). Our results suggest that slow potassium currents play an important role in the emergence of high-synchronous activities, as well as in the spike-to-burst firing pattern transitions. This transition is related to the bistable dynamics of the neuronal network, where physiological asynchronous states coexist with pathological burst synchronization. The hysteresis curve of the coefficient of variation of the inter-spike interval demonstrates that a burst can be initiated by firing states with neuronal synchronization. Furthermore, we notice that high-threshold (IL) and low-threshold (IT) ion channels play a role in increasing and decreasing the parameter conditions (gsyn and I) in which bistable dynamics occur, respectively. For high values of IL conductance, a synchronous burst appears when neurons are weakly coupled and receive more external input. On the other hand, when the conductance IT increases, higher coupling and lower I are necessary to produce burst synchronization. In light of our results, we suggest that channel subtype-specific pharmacological interactions can be useful to induce transitions from pathological high bursting states to healthy states.

Infection with SARS-COV-2 can result in self-limited upper airway infection or progress to a more systemic inflammatory condition including pneumonic COVID-19. Here the authors utilise a multi-omics approach to interrogate the immune response of patients with self-limiting upper respiratory SARS-CoV-2 infection and reveal a temporal immune trajectory they associate with viral containment and restriction from pneumonic progressive disease.

Facioscapulohumeral dystrophy is an autosomal dominant disorder that results in progressive muscle weakness. Patients most commonly present with facial and periscapular muscle weakness, which progresses to involve their upper and lower extremities as well as truncal muscles. We present a patient with facioscapulohumeral dystrophy who underwent staged bilateral total hip arthroplasties but developed late prosthetic joint infection. This case also reports the management of periprosthetic joint infection after total hip arthroplasties through explant and placement of an articulating spacer as well as both neuraxial and general anesthetic management for this uncommon neuromuscular disorder.

Abstract Atom probes generate three‐dimensional atomic‐scale tomographies of material volumes corresponding to the size of modern‐day solid‐state devices. Here, the capabilities of atom probe tomography are evaluated to analyze buried interfaces in semiconductor heterostructures relevant for electronic and quantum devices. Employing brute‐force search, the current dominant reconstruction protocol to generate tomographic three‐dimensional images from Atom Probe data is advanced to its limits. Using Si/SiGe heterostructure for qubits as a model system, the authors show that it is possible to extract interface properties like roughness and width that agree with transmission electron microscopy observations on the sub‐nanometer scale in an automated and highly reproducible manner. The demonstrated approach is a versatile method for atomic‐scale characterization of buried interfaces in semiconductor heterostructures.

Abstract Background and aim Non‐small cell lung cancer (NSCLC) continues to claim millions of lives worldwide. Although its poor prognosis is largely attributed to the lack of adequate and precise detection technologies, cancer cells’ suppression of the immune system adds on to the difficulty of identifying abnormal NSCLC tumors in their early stages. Therefore, cancer immunotherapy, which activates the immune system and helps it fight tumors, has recently become the most sought‐after technique, especially in the advanced stages of NSCLC, where surgery or chemotherapy may or may not bring about the desired survival benefits in patients. Methods This review focuses on the various immunotherapeutic interventions and their efficacy in advanced NSCLC clinical trials. Monoclonal antibodies like anti‐PD‐1/PD‐L1 agents and anti‐CTLA‐4 antibodies, cancer vaccines, oncolytic viruses and adoptive T cell therapy have been discussed in brief. Furthermore, the effects of gender, age, and race on the efficacy of immune checkpoint inhibitors and suggest plausible future approaches in the realm of immuno‐oncology. Results Immunotherapy is used alone or in combination either with other immunological agents or with chemotherapy. However, the efficacy of these strategies depends extensively on various demographic variables, as some patients respond perfectly well to immunotherapy, while others do not benefit at all or experience disease progression. By targeting a “hallmark” of cancer (immune evasion), immunotherapy has transformed NSCLC management, though several barriers prevent its complete effectiveness. Conclusions All these immunological strategies should be interpreted in the current setting of synergistic treatment, in which these agents can be combined with chemotherapy, radiotherapy, and, or surgery following patient and tumor characteristics to proportionate the best‐individualized treatment and achieve superior results. To better pursue this goal, further investigations on cost‐effectiveness and sex‐gender, race, and age differences in immunotherapy are needed.

The disassembly of microtubules can generate force and drive intracellular motility. During mitosis, for example, chromosomes remain persistently attached via kinetochores to the tips of disassembling microtubules, which pull the sister chromatids apart. According to the conformational wave hypothesis, such force generation requires that protofilaments curl outward from the disassembling tips to exert pulling force directly on kinetochores. Rigorously testing this idea will require modifying the mechanical and energetic properties of curling protofilaments, but no way to do so has yet been described. Here, by direct measurement of working strokes generated in vitro by curling protofilaments, we show that their mechanical energy output can be increased by adding magnesium, and that yeast microtubules generate larger and more energetic working strokes than bovine microtubules. Both the magnesium and species-dependent increases in work output can be explained by lengthening the protofilament curls, without any change in their bending stiffness or intrinsic curvature. These observations demonstrate how work output from curling protofilaments can be tuned and suggest evolutionary conservation of the amount of curvature strain energy stored in the microtubule lattice.

Resting-state functional magnetic resonance imaging (rsfMRI) allows the study of functional brain connectivity based on spatially structured variations in neuronal activity. Proper evaluation of connectivity requires removal of non-neural contributions to the fMRI signal, in particular hemodynamic changes associated with autonomic variability. Regression analysis based on autonomic indicator signals has been used for this purpose, but may be inadequate if neuronal and autonomic activities covary. To investigate this potential co-variation, we performed rsfMRI experiments while concurrently acquiring electroencephalography (EEG) and autonomic indicator signals, including heart rate, respiratory depth, and peripheral vascular tone. We identified a recurrent and systematic spatiotemporal pattern of fMRI (named as fMRI cascade), which features brief signal reductions in salience and default-mode networks and the thalamus, followed by a biphasic global change with a sensory-motor dominance. This fMRI cascade, which was mostly observed during eyes-closed condition, was accompanied by large EEG and autonomic changes indicative of arousal modulations. Importantly, the removal of the fMRI cascade dynamics from rsfMRI diminished its correlations with various signals. These results suggest that the rsfMRI correlations with various physiological and neural signals are not independent but arise, at least partly, from the fMRI cascades and associated neural and physiological changes at arousal modulations.

Kdm6a is an X-chromosome-linked H3K27me2/3 demethylase that promotes chromatin accessibility and gene transcription and is critical for tissue/cell-specific differentiation. Previous results showed higher Kdm6a levels in XX than in XY hypothalamic neurons and a female-specific requirement for Kdm6a in mediating increased axogenesis before brain masculinization. Here, we explored the sex-specific role of Kdm6a in the specification of neuronal subtypes in the developing hypothalamus. Hypothalamic neuronal cultures were established from sex-segregated E14 mouse embryos and transfected with siRNAs to knockdown Kdm6a expression (Kdm6a-KD). We evaluated the effect of Kdm6a-KD on Ngn3 expression, a bHLH transcription factor regulating neuronal sub-specification in hypothalamus. Kdm6a-KD decreased Ngn3 expression in females but not in males, abolishing basal sex differences. Then, we analyzed Kdm6a-KD effect on Ascl1, Pomc, Npy, Sf1, Gad1, and Th expression by RT-qPCR. While Kdm6a-KD downregulated Ascl1 in both sexes equally, we found sex-specific effects for Pomc, Npy, and Th. Pomc and Th expressed higher in female than in male neurons, and Kdm6a-KD reduced their levels only in females, while Npy expressed higher in male than in female neurons, and Kdm6a-KD upregulated its expression only in females. Identical results were found by immunofluorescence for Pomc and Npy neuropeptides. Finally, using ChIP-qPCR, we found higher H3K27me3 levels at Ngn3, Pomc, and Npy promoters in male neurons, in line with Kdm6a higher expression and demethylase activity in females. At all three promoters, Kdm6a-KD induced an enrichment of H3K27me3 only in females. These results indicate that Kdm6a plays a sex-specific role in controlling the expression of transcription factors and neuropeptides critical for the differentiation of hypothalamic neuronal populations regulating food intake and energy homeostasis.

The Brazilian housing program, Minha Casa, Minha Vida (MCMV) (My House, My Life), was launched in 2009 to address the housing deficit issue, with the goal of distributing contracted housing units throughout the Brazilian territory. However, the program faces criticisms regarding the distribution of these units. Thus, this paper aims to analyze the distribution heterogeneity of these contracted housing units (CHUs). Two analytical approaches were employed: temporal and spatial (states). To achieve this objective, inferential methods such as Ordinary Least Squares (OLS), Spatial Autoregressive Model (SAR), and panel data regressions were employed. The findings indicate that, from a temporal perspective, there is a positive relationship between the urban housing deficit (UHD) and CHUs. However, the relationship is negative from a spatial perspective, characterizing such heterogeneity among the states. In addition, bordering regions are subject to mutual spatial influences in terms of contracted units, thereby reinforcing this heterogeneity over time.

Breast cancer (BC) is the most common cancer in women, with metastatic BC being responsible for the highest number of deaths. A frequent site for BC metastasis is the brain. Brain metastasis derived from BC involves the cooperation of multiple genetic, epigenetic, angiogenic, and tumor–stroma interactions. Most of these interactions provide a unique opportunity for development of new therapeutic targets. Potentially targetable signaling pathways are Notch, Wnt, and the epidermal growth factor receptors signaling pathways, all of which are linked to driving BC brain metastasis (BCBM). However, a major challenge in treating brain metastasis remains the blood–brain barrier (BBB). This barrier restricts the access of unwanted molecules, cells, and targeted therapies to the brain parenchyma. Moreover, current therapies to treat brain metastases, such as stereotactic radiosurgery and whole-brain radiotherapy, have limited efficacy. Promising new drugs like phosphatase and kinase modulators, as well as BBB disruptors and immunotherapeutic strategies, have shown the potential to ease the disease in preclinical studies, but remain limited by multiple resistance mechanisms. This review summarizes some of the current understanding of the mechanisms involved in BC brain metastasis and highlights current challenges as well as opportunities in strategic designs of potentially successful future therapies.

Spruce budworm, Choristoneura fumiferana Clemens, is an ecologically significant defoliator of spruce and balsam fir in North America. Optimization of semiochemical-mediated control is needed to improve the existing integrated pest management systems such as mating disruption and population estimation. This study used single sensillum recordings (SSR) to identify the responses of olfactory receptor neurons (ORNs) in the antennal sensilla of adult male and female C. fumiferana to host plant volatiles, and female sex pheromones. There have been few SSR studies done on spruce budworm, and to our knowledge, the present study represents the first attempt to examine the responses of ORNs from antennal sensilla in response to a range of host and conspecific stimuli. A total of 86 sensilla were characterized and sorted into 15 possible sensillum categories based on odor responses. We observed that specialist sensilla responding to few ligands were more abundant in both male and female than sensilla exhibiting more generalized odorant responses. (E/Z)-11-tetradecenal elicited responses from ORNs from any sensilla which were sensitive to pheromones in both males and females. Female C. fumiferana ORNs were able to detect and physiologically respond to female-produced sex pheromones with the same degree of sensitivity as their male counterparts. Together, these data improve our knowledge of mechanisms by which adult budworms respond to pheromone and host plant volatiles and provide insights that may be complementary to existing integrated pest management (IPM) strategies based on the chemical ecology of spruce budworm.

Plasmodium vivax is the most geographically widespread cause of human malaria and is responsible for the majority of cases outside of the African continent. While great progress has been made towards eliminating human malaria, drug resistant parasite strains pose a threat towards continued progress. Resistance has arisen to multiple antimalarials in P. vivax, including to chloroquine, which is currently the first line therapy for P. vivax in most regions. Despite its importance, an understanding of the molecular mechanisms of drug resistance in this species remains elusive, in large part due to the complex biology of P. vivax and the lack of in vitro culture. In this review, we will cover the extent and challenges of measuring clinical and in vitro drug resistance in P. vivax. We will consider the roles of candidate drug resistance genes. We will highlight the development of molecular approaches for studying P. vivax biology that provide the opportunity to validate the role of putative drug resistance mutations as well as identify novel mechanisms of drug resistance in this understudied parasite. Validated molecular determinants and markers of drug resistance are essential for the rapid and cost-effective monitoring of drug resistance in P. vivax, and will be useful for optimizing drug regimens and for informing drug policy in control and elimination settings.

Abstract Purpose Colorectal cancer (CRC) diagnosis is associated with high mortality in the United States and thus warrants the study of novel treatment approaches. Vascular changes are well observed in cancers and evidence indicates that antihypertensive (AH) medications may interfere with both tumor vasculature and in recruiting immune cells to the tumor microenvironment based on preclinical models. Extant literature also shows that AH medications are correlated with improved survival in some forms of cancer. Thus, this study sought to explore the impact of AH therapies on CRC outcomes. Patients and Methods This study was a non‐interventional, retrospective analysis of patients aged 65 years and older with CRC diagnosed from January 1, 2007 to December 31st, 2012 in the Surveillance, Epidemiology, and End‐Results (SEER)‐Medicare database. The association between AH drug utilization on AJCC stage I–III CRC mortality rates in patients who underwent treatment for cancer was examined using Cox proportional hazards models. Results The study cohort consisted of 13,982 patients diagnosed with CRC. Adjusted Cox proportional hazards regression showed that among these patients, the use of AH drug was associated with decreased cancer‐specific mortality (HR: 0.79, 95% CI: 0.75–0.83). Specifically, ACE inhibitors (hazard ratio [HR]: 0.84, 95% CI: 0.80–0.87), beta‐blockers (HR: 0.87, 95% CI: 0.84–0.91), and thiazide diuretics (HR: 0.83, 95% CI: 0.80–0.87) were found to be associated with decreased mortality. An association was also found between adherence to AH therapy and decreased cancer‐specific mortality (HR: 0.94, 95% CI: 0.90–0.98). Conclusion Further research needs to be performed, but AH medications may present a promising, low‐cost pathway to supporting CRC treatment for stage I–III cancers.

Abstract The current COVID-19 pandemic has already claimed more than 3.7 million victims and it will cause more deaths in the coming months. Tools that track the number and locations of cases are critical for surveillance and help in making policy decisions for controlling the outbreak. However, the current surveillance web-based dashboards run on proprietary platforms, which are often expensive and require specific computational knowledge. We developed a user-friendly web tool, named OUTBREAK, that facilitates epidemic surveillance by showing in an animated graph the timeline and geolocations of cases of an outbreak. It permits even non-specialist users to input data most conveniently and track outbreaks in real-time. We applied our tool to visualize the SARS 2003, MERS, and COVID19 epidemics, and provided them as examples on the website. Through the zoom feature, it is also possible to visualize cases at city and even neighborhood levels. We made the tool freely available at https://outbreak.sysbio.tools/ . OUTBREAK has the potential to guide and help health authorities to intervene and minimize the effects of outbreaks.

The temporal dynamics of forest canopy structure are influenced by disturbances that alter vegetation quantity and distribution. While canopy structural indicators such as leaf area index (LAI), canopy cover, and canopy height have been widely studied in the context of disturbance, the post-disturbance temporal dynamics of structural complexity, which summarizes the heterogeneity of vegetation arrangement, are poorly understood. With the goal of advancing conceptual and empirical understanding of the temporal dynamics of structural complexity following disturbance, we synthesized results from three large-scale disturbance manipulation experiments at the University of Michigan Biological Station (UMBS): the 4-year Forest Resilience Threshold Experiment (FoRTE) manipulating levels of disturbance severity; the decade-long Forest Accelerated Succession Experiment (FASET), in which all early successional tree species were stem-girdled within 39 ha in the same landscape; and forest chronosequences established following clear-cut harvesting. We found that the temporal dynamics of canopy structure following disturbance were dependent upon three factors: (1) the source and severity of disturbance; (2) the spatial and temporal scales of analysis; and (3) the measure of structure assessed. Unlike vegetation area index and canopy cover, which initially decreased in response to disturbance, structural complexity measures such as canopy and top rugosity did not consistently respond to moderate levels of disturbance severity. Over multi-decadal timescales, structural complexity increased to a maximum, regardless of whether fire occurred at the time of stand establishment, but intervening low-to-moderate severity disturbance in regrown century-old forests altered trajectories of canopy rugosity. We conclude that structural complexity indicators display a more nuanced temporal and directional response to disturbance than conventional leaf area and cover indexes. Predicting what disturbance conditions modify trajectories of structural complexity remains critical to disturbance characterization and the inference of ecosystem functioning.

Abstract Chemotherapy resistance is the main impediment in the treatment of acute myeloid leukaemia (AML). Despite rapid advances, the various mechanisms inducing resistance development remain to be defined in detail. Here we report that loss-of-function mutations (LOF) in the histone methyltransferase EZH2 have the potential to confer resistance against the chemotherapeutic agent cytarabine. We identify seven distinct EZH2 mutations leading to loss of H3K27 trimethylation via multiple mechanisms. Analysis of matched diagnosis and relapse samples reveal a heterogenous regulation of EZH2 and a loss of EZH2 in 50% of patients. We confirm that loss of EZH2 induces resistance against cytarabine in the cell lines HEK293T and K562 as well as in a patient-derived xenograft model. Proteomics and transcriptomics analysis reveal that resistance is conferred by upregulation of multiple direct and indirect EZH2 target genes that are involved in apoptosis evasion, augmentation of proliferation and alteration of transmembrane transporter function. Our data indicate that loss of EZH2 results in upregulation of its target genes, providing the cell with a selective growth advantage, which mediates chemotherapy resistance.

Abstract Comparing the molecular and cellular properties among primates is crucial to better understand human evolution and biology. However, it is difficult or ethically impossible to collect matched tissues from many primates, especially during development. An alternative is to model different cell types and their development using induced pluripotent stem cells (iPSCs). These can be generated from many tissue sources, but non-invasive sampling would decisively broaden the spectrum of non-human primates that can be investigated. Here, we report the generation of primate iPSCs from urine samples. We first validate and optimize the procedure using human urine samples and show that suspension- Sendai Virus transduction of reprogramming factors into urinary cells efficiently generates integration-free iPSCs, which maintain their pluripotency under feeder-free culture conditions. We demonstrate that this method is also applicable to gorilla and orangutan urinary cells isolated from a non-sterile zoo floor. We characterize the urinary cells, iPSCs and derived neural progenitor cells using karyotyping, immunohistochemistry, differentiation assays and RNA-sequencing. We show that the urine-derived human iPSCs are indistinguishable from well characterized PBMC-derived human iPSCs and that the gorilla and orangutan iPSCs are well comparable to the human iPSCs. In summary, this study introduces a novel and efficient approach to non-invasively generate iPSCs from primate urine. This will extend the zoo of species available for a comparative approach to molecular and cellular phenotypes.

Abstract Background Precise detection of Plasmodium infections in community surveys is essential for effective malaria control. Microscopy and rapid diagnostic tests (RDTs) are the major techniques used to identify malaria infections in the field-based surveys. Although microscopy is still considered as the gold standard, RDTs are increasingly becoming versatile due to their rapid and adequate performance characteristics. Methods A malaria prevalence cross-sectional survey was carried out in north-western Tanzania in 2016, aimed at appraising the performance of high sensitivity Plasmodium falciparum (HSPf) tests compared to SD Bioline Pf and microscopy in detecting P. falciparum infections. A total of 397 individuals aged five years and above were tested for P. falciparum infections. The sensitivity, specificity, positive, and negative predictive values (PPV and NPV) of microscopy, Pf RDT and HSPf RDT was determined using PCR as the gold standard method. Results The prevalence of P. falciparum infections determined by microscopy, SD Bioline Pf, HSPf and PCR was 21.9, 27.7, 33.3 and 43.2%, respectively. The new HSPf RDT had significantly higher sensitivity (98.2%) and specificity (91.6%) compared to the routinely used SD Bioline Pf RDT(P

Abstract The zoonotic enterohemorrhagic Escherichia coli (EHEC) O157: H7 bacterium causes diarrhea, hemorrhagic colitis, and hemolytic uremic syndrome (HUS) in humans. Cattle are primary reservoirs and EHEC O157: H7; the bacteria predominately inhabit the colon and recto-anal junctions (RAJ). The early innate immune reactions in the infected gut are critical in the pathogenesis of EHEC O157: H7. In this study, calves orally inoculated with EHEC O157: H7 showed infiltration of neutrophils in the lamina propria of ileum and RAJ at 7 and 14 days post-infection. Infected calves had altered mucin layer and mast cell populations across small and large intestines. There were differential transcription expressions of key bovine β defensins, tracheal antimicrobial peptide (TAP) in the ileum, and lingual antimicrobial peptide (LAP) in RAJ. The main Gram-negative bacterial/LPS signaling Toll-Like receptor 4 (TLR4) was downregulated in RAJ. Intestinal infection with EHEC O157: H7 impacted the gut bacterial communities and influenced the relative abundance of Negativibacillus and Erysipelotrichaceae in mucosa-associated bacteria in the rectum. Thus, innate immunity in the gut of calves showed unique characteristics during infection with EHEC O157: H7, which occurred in the absence of major clinical manifestations but denoted an active immunological niche.

ABSTRACT Objectives: Currently, not much is known about the interactions between voice and growth hormone (GH). We have described large kindred with isolated GH deficiency (IGHD) due to a GHRH receptor mutation, resulting in severe short stature and high-pitched voice. These IGHD individuals have little interest in GH treatment, as they consider themselves “short long-lived people”, rather than patients. Interestingly, they report normal general quality of life, but they rate their Voice-Related Quality of Life (V-RQOL) as low. Here, we assessed the social and auditory-perceptual impacts of artistic-intervention voice therapy with semioccluded vocal tract exercises (SOVTE) and choral singing, on their voices. Material and methods: Seventeen GH-naïve adult IGHD individuals were enrolled in a single-arm interventional pre-post study with 13 weekly sessions of choir singing over 90 days. Outcome measures were V-RQOL scores, self-assessment of voice, and auditory-perceptual analysis (GRBAS scale, G: grade of the severity of dysphonia; R: roughness; B: breathiness; A: asthenia; and S: strain). Results: Marked improvements in total (p = 0.0001), physical (p = 0.0002), and socioemotional (p = 0.0001) V-RQOL scores and in self-assessment of voice (p = 0.004) were found. The general grades of vocal deviation (p = 0.0001), roughness (p = 0.0001), breathiness (p = 0.0001) and strain (p = 0.0001) exhibited accentuated reductions. Conclusions: Voice therapy with semioccluded vocal tract exercises and choral training improved social impact and perceptual voice assessments in IGHD subjects and markedly improved their voice-related quality of life. This is particularly important in a setting where GH replacement therapy is not widely accepted.