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POEMS Syndrome is a constellation of findings including Polyneuropathy, Organomegaly, Endocrinopathy, Monoclonal plasma cell disorder, and Skin changes. Calciphylaxis, a microangiopathy involving vascular calcification and thrombotic occlusions, occurs rarely in POEMS. We present a case of prominent calciphylaxis that antedated the diagnosis of POEMS. The patient presented with extensive ecchymoses progressing to necrotic lesions in the setting of acute renal injury. Previously, she had chronic slowly progressive polyneuropathy, splenomegaly, hypothyroidism, amenorrhea, and ascites. Calciphylaxis was diagnosed on skin biopsy, and POEMS was diagnosed based upon clinical findings plus a bone marrow biopsy showing 15% lambda chain restricted plasma cells. Treatment for the calciphylaxis was supportive with fluids, tissue debridement, wound vacuum devices and antibiotics for secondary infection. Myeloma was treated with bortezomib and steroids. All aspects of the patient's manifestations improved. We conclude that calciphylaxis can be a prominent feature of POEMS and can appear prior to recognition of the full-blown syndrome., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Through a series of empirical studies involving native speakers of English, German, and Chinese, this paper reveals that the predicate "true" is inherently ambiguous in the empirical domain. Truth statements such as "It is true that Tom is at the party" seem to be ambivalent between two readings. On the first reading, the statement means "Reality is such that Tom is at the party." On the second reading, the statement means "According to what X believes, Tom is at the party." While there appear to exist some cross-cultural differences in the interpretation of the statements, the overall findings robustly indicate that "true" has multiple meanings in the realm of empirical matters., (© The Author(s) 2024.)

This paper discusses the idea of community data that was introduced in the Non-Personal Data framework in India. Our interest is to engage with existing commentaries on the definitional challenges around who is a community, how it is constituted, who it represents, as well as propose a framework to be able to explore how to address concerns of access to justice. In our attempt to offer a model to operationalise community data, we argue that such community data justice includes three crucial aspects, that is, the identification of belonging with a community, the capacity to participate within a community, and finally opportunity to exit the community. Consequently, justice in terms of access to, and use of community data inherently includes an analysis of the individual's standing in the community., Competing Interests: Competing InterestsNot applicable., (© The Author(s) 2024.)

Cancer provokes systemic diseases through three possible mechanisms: 1) Distal metastasis in multiple tissues and organs, which directly causes functional damage and impairment of involved organs; 2) Paraneoplastic syndrome (PNS) that affects multiple organ systems, including the endocrine, gastrointestinal, hematologic, neurologic, dermatologic, and ophthalmologic systems; and 3) Cancer cachexia (CCA) or self-wasting syndrome characterized by anorexia, progressive bodyweight loss, adipose atrophy, and muscle atrophy. While cancer metastasis has received considerable attention for comprehensive research, PNS and CCA remain relatively overlooked. At the time of this writing, effective treatments of PNS and CCA in human cancer patients are lacking. This review focuses on discussing mechanistic insights into PNA and CCA and current advances in development of new possible therapeutic interventions., Competing Interests: Competing interestsAuthor Yihai Cao is a member of the Editorial Board for Holistic Integrative Oncology. The paper was handled by the other Editor and has undergone rigorous peer review process. Author Yihai Cao was not involved in the journal's peer review of or decisions related to, this manuscript., (© The Author(s) 2024.)

Background: There are established sex-specific differences in heart failure with reduced ejection fraction (HFrEF) outcomes. Randomized clinical trials (RCTs) based on cardiovascular outcome benefits, typically either reduced cardiovascular mortality or hospitalization for heart failure (HHF), influence current guidelines for therapy., Objectives: The authors evaluate the representation of women in HFrEF RCTs that observed reduced all-cause or cardiovascular mortality or HHF., Methods: We queried Cumulative Index to Nursing and Allied Health Literature, Excerpta Medica dataBASE, Medical Literature Analysis and Retrieval System Online, and PubMed for HFrEF RCTs that reported a statistically significant benefit of intervention resulting in improved mortality or HHF published from 1980 to 2021. We estimated representation using the participation-to-prevalence ratio (PPR). A PPR of 0.8 to 1.2 was considered representative., Results: The final analysis included 33 RCTs. Women represented only 23.2% of all enrolled participants (n = 24,366/104,972), ranging from 11.4% to 40.1% per trial. Overall PPR was 0.58, with per-trial PPR estimates ranging from 0.29 to 1.00. Only 5 trials (15.2%) had a PPR of women representative of the disease population. Representation did not change significantly over time. The proportion of women in North American trials was significantly greater than trials conducted in Europe ( P = 0.03). The proportion of women was greater in industry trials compared to government-funded trials ( P = 0.05)., Conclusions: Women are underrepresented in HFrEF RCTs that have demonstrated mortality or HHF benefits and influence current guidelines. Representation is key to further delineation of sex-specific differences in major trial results. Sustained efforts are warranted to ensure equitable and appropriate inclusion of women in HFrEF trials., Competing Interests: All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Animal models utilizing predator odor stress are important in understanding implications for post-traumatic stress disorder. 2,5-dihydro-2,4,5-trimethylthiazoline (TMT) has been used to measure stress reactive behaviors during TMT exposure, indicative of stress coping behaviors. In addition, long-term consequences of stress including contextual-induced stress memory, anxiety-like and hyperarousal behaviors, and subsequent increases in alcohol self-administration can also be examined after TMT exposure. In this article, we describe the TMT exposure protocol used in our lab and how we measure different stress-reactive behaviors that rats engage in during the TMT exposure. Rats are placed in Plexiglass chambers that contain white bedding on the bottom of the chamber and a metal basket in the top right corner containing a filter paper that 10 µl of TMT is pipetted onto. During the 10 min exposure, rats can move around the chamber freely. Exposures are recorded by a video camera for later analysis. During TMT exposure, rats engage in a variety of stress-reactive behaviors, including digging and immobility behavior. These are two distinctly different types of stress-induced behavioral coping strategies to measure individual differences in stress responsivity. To examine individual differences, we group rats into TMT-subgroups based on time spent engaging in digging or immobility behavior. We calculate a digging/immobility ratio score in which we divide the total time spent digging by the total time spent immobile. A cut-off strategy is used such that rats with a criterion ratio score <1.0 are classified as TMT-1 (i.e., low digging/high immobility; greater passive coping) and rats with a ratio score >1.0 are classified as TMT-2 (i.e., high digging/low immobility; greater active coping). Here, we provide a detailed description of the TMT exposure protocol and step-by-step process in evaluation of stress-reactive behaviors. © 2024 Wiley Periodicals LLC. Basic Protocol 1: Predator odor stressor exposure using TMT Basic Protocol 2: Description of stress-reactive behaviors during TMT exposure and formation of TMT-subgroups., (© 2024 Wiley Periodicals LLC.)

Inference of source levels for ambient ocean sound from local wind at the sea surface requires an assumption about the nature of the sound source. Depending upon the assumptions made about the nature of the sound source, whether monopole or dipole distributions, the estimated source levels from different research groups are different by several decibels over the frequency band 10-350 Hz. This paper revisits the research issues of source level of local wind-generated sound and shows that the differences in estimated source levels can be understood through a simple analysis of the source assumptions., (© 2024 Author(s). All article content, except where otherwise noted, is licensed under a Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).)

This paper shows that a highly simplified model of speech production based on the optimization of articulatory effort versus intelligibility can account for some observed articulatory consequences of signal-to-noise ratio. Simulations of static vowels in the presence of various background noise levels show that the model predicts articulatory and acoustic modifications of the type observed in Lombard speech. These features were obtained only when the constraint applied to articulatory effort decreases as the level of background noise increases. These results support the hypothesis that Lombard speech is listener oriented and speakers adapt their articulation in noisy environments., (© 2024 Author(s). All article content, except where otherwise noted, is licensed under a Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).)