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BackgroundPreventative self-care can reduce dental disease that disproportionately burdens vulnerable populations. Personalized digital oral self-care behavioral interventions offer a promising solution. However, the success of these digital interventions depends on toothbrushing data collection e-platforms attuned to the needs and preferences of vulnerable communities. ObjectiveThe aim of this study is to assess the usability and feasibility of the Remote Oral Behaviors Assessment System (ROBAS), which has been adapted to address the unique requirements of socioeconomically disadvantaged minority individuals. MethodsA cohort of 53 community-clinic participants, including 31 (58%) Latino and 22 (42%) Black individuals with no prior experience using electric toothbrushes, were recruited to use ROBAS, with planned assessments at baseline, 2 months, and 4 months. Beyond evaluating ROBAS’s technical performance, extensive feedback was gathered to gauge users’ experiences, viewpoints, and overall contentment. The System Usability Scale (SUS) served as a primary metric for assessing user satisfaction and acceptability. ResultsROBAS exhibited largely reliable and consistent data-gathering capabilities. SUS scores (mean 75.6, SD 14.5) reflected participant contentment within a range of values for other commonly used digital devices and technologies. Among participants who answered questions about willingness to pay for ROBAS, 97% (30/31) indicated that they were willing to pay for ROBAS either as a one-time payment or as a subscription-based service. Additionally, 87.5% of participants expressed that they would endorse it to acquaintances. Most participants expressed no reservations about privacy; among those who expressed privacy concerns (n=20, 50%), the concerns included exposure of information (n=18, 45%), monitoring of brushing habits (n=12, 30%), and collection of information (n=14, 35%), although these concerns did not significantly correlate with specific participant traits. In qualitative terms, users valued ROBAS's ability to monitor brushing habits but called for refinements, especially in Wi-Fi and application connectivity. Recommendations for system improvements encompassed enhanced app functionality, individualized coaching, more comprehensive brushing data, and the addition of flossing activity tracking. ConclusionsThe research highlights ROBAS's promise as a digital platform for unobtrusively tracking daily oral self-care activities in marginalized communities. The system proved to be both feasible, as evidenced by its stable and accurate data capture of brushing behaviors, and user-friendly, as reflected by strong SUS scores and positive user feedback. Influential factors for its uptake included ease of learning and operation, and the feedback provided.

Abstract Introduction Treatments for atopic dermatitis (AD) often fail to achieve lasting disease control. In the CrisADe CONTROL phase III study (ClinicalTrials.gov: NCT04040192), participants aged ≥ 3 months with mild to moderate AD treated with once-daily (QD) crisaborole, following initial treatment success with crisaborole twice daily (BID), had longer periods of flare-free maintenance, a higher number of flare-free days, and a lower number of flares compared with those who received vehicle. The study was an exploratory analysis of data on the maintenance of response per Investigator’s Static Global Assessment (ISGA; ISGA score of 0 [clear] or 1 [almost clear]) during the CrisADe CONTROL study through week 52. Methods Exploratory endpoints were the time to ISGA response during the open-label run-in period, and the maintenance of ISGA response and the severity and duration of flares during the double-blind maintenance period. Outcomes were stratified by age (participants aged 3 months to

Abstract Background Protection against SARS-CoV-2 is mediated by humoral and T cell responses. Pakistan faced relatively low morbidity and mortality from COVID-19 through the pandemic. To examine the role of prior immunity in the population, we studied IgG antibody response levels, virus neutralizing activity and T cell reactivity to Spike protein in a healthy control group (HG) as compared with COVID-19 cases and individuals from the pre-pandemic period (PP). Methods HG and COVID-19 participants were recruited between October 2020 and May 2021. Pre-pandemic sera was collected before 2018. IgG antibodies against Spike and its Receptor Binding Domain (RBD) were determined by ELISA. Virus neutralization activity was determined using a PCR-based micro-neutralization assay. T cell – IFN-γ activation was assessed by ELISpot. Results Overall, the magnitude of anti-Spike IgG antibody levels as well as seropositivity was greatest in COVID-19 cases (90%) as compared with HG (39.8%) and PP (12.2%). During the study period, Pakistan experienced three COVID-19 waves. We observed that IgG seropositivity to Spike in HG increased from 10.3 to 83.5% during the study, whilst seropositivity to RBD increased from 7.5 to 33.3%. IgG antibodies to Spike and RBD were correlated positively in all three study groups. Virus neutralizing activity was identified in sera of COVID-19, HG and PP. Spike reactive T cells were present in COVID-19, HG and PP groups. Individuals with reactive T cells included those with and without IgG antibodies to Spike. Conclusions Antibody and T cell responses to Spike protein in individuals from the pre-pandemic period suggest prior immunity against SARS-CoV-2, most likely from cross-reactive responses. The rising seroprevalence observed in healthy individuals through the pandemic without known COVID-19 may be due to the activation of adaptive immunity from cross-reactive memory B and T cells. This may explain the more favourable COVID-19 outcomes observed in this population.

Abstract Introduction and objectives The NICE guidelines for acute ureteric colic recommend diagnostic imaging, definitive management and definitive care within 24 and 48 h of symptoms and 4 weeks of temporisation, respectively. However, the NHS reality is fraught with long waiting times to definitive treatment, further compounded by a progressively increasing stone burden, paucity of on‐site lithotripters and a decrease in non‐cancer elective theatre sessions during the COVID‐19 pandemic. By the time patients attended the elective surgeries, their reference images (RIs) were often significantly out of date. Scant direction exists on what interval between imaging and surgery invalidates the usefulness of the RIs in providing surgical guidance. This study aimed to evaluate the role of imaging–surgery intervals (ISIs) on upper tract stone negative surgery outcomes and derive a cut‐off ISI warranting updated images, with a view to improving efficiency and patient safety. Materials and methods Upper tract stone surgeries were retrospectively assessed. Each renal unit was considered independently in bilateral stones. Cases were grouped into renal/pelvic (referred to as ‘RENAL’) and URETERIC stones. Data retrieved included the ISI, intra‐operative disparity (IOD) between stone‐related features on RIs and the surgical findings. Receiver operating curves (ROCs) were used to determine ISI cut‐offs more predictive of IODs. Results Four hundred and twenty‐seven surgeries on 174 (40.7%) RENAL and 253 (59.3%) URETERIC stones were appraised. No stones were found intraoperatively in 52 (12.1%) patients. Longer ISIs were associated with IODs, especially with URETERIC stones (p = 0.011, CI95 0.63; 4.84). The derived ROC ISI cut‐offs beyond which IODs, including negative surgeries, were more likely were 9 weeks for URETERIC (AUC: 63%, CI95 0.56; 0.70) and 19 weeks (AUC: 58.6%, CI95 0.50; 0.68) for RENAL stones, respectively. Conclusion There is a need to update reference imaging done more than 9 or 19 weeks before surgery for URETERIC and RENAL stones, respectively.

Abstract Background and Aims COVID‐19 vaccinations have reduced morbidity and mortality from the disease. Antibodies against severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) have been associated with immune protection. Seroprevalence studies revealed high immunoglobulin G (IgG) antibody levels to SARS‐CoV‐2 in the Pakistani population before vaccinations. We investigated the effect of BBIBP‐CorV vaccination on circulating IgG antibodies and interferon (IFN)‐γ from T cells measured in a cohort of healthy individuals, with respect to age, gender, and history of COVID‐19. Methods The study was conducted between April and October 2021. BBIBP‐CorV vaccinated participants were followed up to 24 weeks. Antibodies to SARS‐CoV‐2 Spike protein and its receptor‐binding domain (RBD) were measured. IFNγ secreted by whole blood stimulation of Spike protein and extended genome antigens was determined. Results Study participants with a history of prior COVID‐19 displayed a higher magnitude of IgG antibodies to Spike and RBD. IgG seropositivity was greater in those with prior COVID‐19, aged 50 years or younger and in females. At 24 weeks after vaccination, 37.4% of participants showed IFN‐γ responses to SARS‐CoV‐2 antigens. T cell IFN‐γ release was higher in those with prior COVID‐19 and those aged 50 years or less. Highest IFN‐γ release was observed to extended genome antigens in individuals both with and without prior COVID‐19. Conclusion We found that IgG seropositivity to both Spike and RBD was affected by prior COVID‐19, age and gender. Importantly, seropositive responses persisted up to 24 weeks after vaccination. Persistence of vaccine induced IgG antibodies may be linked to the high seroprevalence observed earlier in unvaccinated individuals. Increased T cell reactivity to Spike and extended genome antigens reflects cellular activation induced by BBIBP‐CorV. COVID‐19 vaccination may have longer lasting immune responses in populations with a higher seroprevalence. These data inform on vaccination booster policies for high‐risk groups.

Scleractinian corals, considered key reef ecosystem engineers, have suffered irreparable damage over the last decades, with causes widely attributed directly and indirectly to increased human pressure on coral communities. Stony coral tissue loss disease (SCTLD), first detected in Florida in 2014, by early 2023 had spread to 26 jurisdictions in the wider Caribbean, causing severe effects on coral reefs. In January 2020, monitoring efforts to detect SCTLD began on the island of Roatan in Honduras. The disease was first reported in Flowers Bay, Roatan, in September 2020. Since then, dedicated collaborative efforts have been made to assess the severity of the disease, mitigate its effects, and raise coral reef conservation awareness. To track the progression of the outbreak, presence-absence data were collected using the rover diver methodology. With at least 28 species affected, SCTLD has spread across the Bay Islands over a period of 13 months. Roatan and Utila have been the most impacted islands, with the disease encircling them rapidly at a rate of approximately 155 m/day. The spread of SCTLD was overall rapid, but geographical patterns were detected in Roatan, where it showed faster progression on the windward side than on the leeward side. Further research is required to explore whether these disparities are related to marine traffic, water quality, currents, or a combination of multiple factors. Our findings shed new knowledge on the spread of SCTLD in Honduras, which can provide insights for other Caribbean nations whose economies are also dependent on the health of their coral reefs.

Abstract In the absence of nationwide mass testing for an emerging health crisis, alternative approaches could provide necessary information efficiently to aid policy makers and health bodies when dealing with a pandemic. The following work presents a methodology by which Twitter data surrounding the first wave of the COVID-19 pandemic in the UK is harvested and analysed using two main approaches. The first is an investigation into localized outbreak predictions by developing a prototype early-warning system using the distribution of total tweet volume. The temporal lag between the rises in the number of COVID-19 related tweets and officially reported deaths by Public Health England (PHE) is observed to be 6–27 days for various UK cities which matches the temporal lag values found in the literature. To better understand the topics of discussion and attitudes of people surrounding the pandemic, the second approach is an in-depth behavioural analysis assessing the public opinion and response to government policies such as the introduction of face-coverings. Using topic modelling, nine distinct topics are identified within the corpus of COVID-19 tweets, of which the themes ranged from retail to government bodies. Sentiment analysis on a subset of mask related tweets revealed sentiment spikes corresponding to major news and announcements. A Named Entity Recognition (NER) algorithm is trained and applied in a semi-supervised manner to recognise tweets containing location keywords within the unlabelled corpus and achieved a precision of 81.6%. Overall, these approaches allowed extraction of temporal trends relating to PHE case numbers, popular locations in relation to the use of face-coverings, and attitudes towards face-coverings, vaccines and the national ‘Test and Trace’ scheme.

Flor yeasts are Saccharomyces cerevisiae strains noted by their ability to create a type of biofilm in the air-liquid interface of some wines, known as 'flor' or 'velum', for which certain proteins play an essential role. Following a proteomic study of a flor yeast strain, we deleted the CCW14 (covalently linked cell wall protein) and YGP1 (yeast glycoprotein) genes--codifying for two cell surface glycoproteins--in a haploid flor yeast strain and we reported that both influence the weight of the biofilm as well as cell adherence (CCW14). [ABSTRACT FROM AUTHOR]

Stony Coral Tissue Loss Disease (SCTLD) has affected Caribbean coral reef colonies since it was first detected in Florida in 2014. Its rapid spread and virulent nature are a major concern to coastal nations in the Caribbean Sea. Belize and Honduras have approached their management and strategies in somewhat different ways, but with the same goal of evaluating and controlling the spread and reducing mortality rates of their coral colonies. They both used amoxicillin trihydrate powder with Coral Ointment Base2B which proved effective in halting the spread of the disease and lowered mortality rates in treated corals. In addition to treatment, both countries have continued to monitor the extent of the disease, entering the data into the collaborative disease tracker platform on AGRRA.org. Between October 2020 and November 2021, a total of 14,495 corals from 29 species were assessed at sites in Belize and Honduras that were affected by SCTLD. The overall prevalence (all coral species) of SCTLD at these sites was 14%. Three species (Meandrina meandrites, Dendrogyra clyindrus and Dichocoenia stokesi) were in the top affected species in both countries, with 42%, 38% and 32% SCTLD prevalence, respectively. The sharing of information allowed Belize and Honduras to be relatively prepared for the onset of SCTLD in their waters through a series of monitoring and intervention actions. Although the treatment has proved to be somewhat effective, it is time and labor intensive. Reducing other well-known anthropogenic including sewage and dredging, is key to supporting coral reef health and resiliency.

The molecular and evolutionary processes underlying fungal domestication remain largely unknown despite the importance of fungi to bioindustry and for comparative adaptation genomics in eukaryotes. Wine fermentation and biological ageing are performed by strains of S. cerevisiae with, respectively, pelagic fermentative growth on glucose and biofilm aerobic growth utilizing ethanol. Here, we use environmental samples of wine and flor yeasts to investigate the genomic basis of yeast adaptation to contrasted anthropogenic environments. Phylogenetic inference and population structure analysis based on single nucleotide polymorphisms revealed a group of flor yeasts separated from wine yeasts. A combination of methods revealed several highly differentiated regions between wine and flor yeasts, and analyses using codon-substitution models for detecting molecular adaptation identified sites under positive selection in the high-affinity transporter gene ZRT1. The cross-population composite likelihood ratio revealed selective sweeps at three regions, including in the hexose transporter gene HXT7, the yapsin gene YPS6 and the membrane protein coding gene MTS27. Our analyses also revealed that the biological ageing environment has led to the accumulation of numerous mutations in proteins from several networks, including Flo11 regulation and divalent metal transport. Together, our findings suggest that the tuning of FLO11 expression and zinc transport networks are a distinctive feature of the genetic changes underlying the domestication of flor yeasts. Our study highlights the multiplicity of genomic changes underlying yeast adaptation to man-made habitats and reveals that flor/wine yeast lineage can serve as a useful model for studying the genomics of adaptive divergence. [ABSTRACT FROM AUTHOR]

IntroductionAn estimated 1.5 million cases were reported in Pakistan until 23 March, 2022. However, SARS-CoV-2 PCR testing capacity has been limited and the incidence of COVID-19 infections is unknown. Volunteer healthy blood donors can be a control population for assessment of SARS-CoV-2 exposure in the population. We determined COVID-19 seroprevalence during the second pandemic wave in Karachi in donors without known infections or symptoms in 4 weeks prior to enrollment.Materials and methodsWe enrolled 558 healthy blood donors at the Aga Khan University Hospital between December 2020 and February 2021. ABO blood groups were determined. Serum IgG reactivity were measured to spike and receptor binding domain (RBD) proteins.ResultsStudy subjects were predominantly males (99.1%) with a mean age of 29.0±7.4 years. Blood groups were represented by; B (35.8%), O (33.3%), A (23.8%) and AB (7%). Positive IgG responses to spike were detected in 53.4% (95% CI, 49.3-37.5) of blood donors. Positive IgG antibodies to RBD were present in 16.7% (95% CI; 13.6-19.8) of individuals. No significant difference was found between the frequency of IgG antibodies to spike or RBD across age groups. Frequencies of IgG to Spike and RBD antibodies between December 2020 and February 2021 were found to be similar. Seropositivity to either antigen between individuals of different blood groups did not differ. Notably, 31.2% of individuals with IgG antibodies to spike also had IgG antibodies to RBD. Amongst donors who had previously confirmed COVID-19 and were seropositive to spike, 40% had IgG to RBD.ConclusionsOur study provides insights into the seroprevalence of antibodies to COVID-19 in a healthy cohort in Karachi. The differential dynamics of IgG to spike and RBD likely represent both exposure to SARS-CoV-2 and associate with protective immunity in the population.

Multisystem inflammatory syndrome in children (MIS-C) is a hyperinflammatory complication of SARS-Cov2 infection. While early reports insinuated less severe infections in pediatric populations, MIS-C is becoming a more recognized clinical manifestation. Cardiac involvement is common, although severe cases requiring extracorporeal membrane oxygenation (ECMO) remain infrequent.

Dear Editor, Sepsis, a potentially fatal outcome, carries an extremely high risk of mortality. Coagulation abnormalities are often considered in association with sepsis. Changes that are significant clinically in terms of signs, symptoms or lab parameters affect up to 70% of septic patients of which 35% meet the criteria for disseminated intravascular coagulation [1]. Septic patients may develop thromboembolic sequela due to coagulopathies, and certain microvascular clots may not be clinically apparent but contribute to multiorgan dysfunction [2]. The risk of requiring intensive care and mortality increases with the severity of sepsis-induced coagulopathy (SIC). Lyon PG et al. reported in their study that hospital-based mortality doubled in patients with SIC from 25.4% in patients without SIC to 56.1% with severe SIC. Moreover, the length of ICU stays increased with the severity of SIC [3]. Despite recent advances in the management of sepsis that have resulted in an increase in the rate of survival, the coagulopathies caused by sepsis have received less attention. In order to prevent an increase in SIC-related mortality, we must address a number of issues, including patient delays in seeking care and hospital delays in acquiring proper health care services. As observed in our clinical practice the delay in treating patients with suitable antibiotics to treat the underlying infection is one of the most common issues noticed. In addition, there is no gold standard investigation for measuring coagulopathy. To monitor anticoagulant therapy, traditional coagulation testing designed as plasma-based tests are insufficient [4]. Sepsis-induced coagulopathy has shown high prevalence but is the least understood clinical issue in critical diseases and actions should be taken to reduce mortality from SIC. It is critical to manage SIC quickly and effectively, as any delay in therapy can increase the chances of negative outcomes [5]. In patients with sepsis who develop thrombocytopenia, the existence of SIC should be thoroughly investigated. The use of specific scoring frameworks, such as thrombocytopenia, delayed prothrombin time, and organ failure as measured by the Sequential Organ Failure Assessment score, should be used to determine the existence of coagulopathy in sepsis. Moreover, there are numerous different conditions that clinically mimic SIC. For instance, in clinical practice, it is frequently confused for heparininduced thrombocytopenia, especially when it occurs in conjunction with organ dysfunction. Given that coagulopathy in sepsis is a dynamic process with multiple manifestations, work should be done to develop an exact, precise, and ideal method to detect this dynamic alteration in sepsis so that patients are not delayed in receiving treatment. Furthermore, proper SIC management guidelines should be defined and implemented globally [6]