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Sterile inflammation after myocardial infarction is classically credited to myeloid cells interacting with dead cell debris in the infarct zone1,2. Here we show that cardiomyocytes are the dominant initiators of a previously undescribed type I interferon response in the infarct borderzone. Using spatial transcriptomics analysis in mice and humans, we find that myocardial infarction induces colonies of interferon-induced cells (IFNICs) expressing interferon-stimulated genes decorating the borderzone, where cardiomyocytes experience mechanical stress, nuclear rupture and escape of chromosomal DNA. Cardiomyocyte-selective deletion of Irf3 abrogated IFNIC colonies, whereas mice lacking Irf3 in fibroblasts, macrophages, neutrophils or endothelial cells, Ccr2-deficient mice or plasmacytoid-dendritic-cell-depleted mice did not. Interferons blunted the protective matricellular programs and contractile function of borderzone fibroblasts, and increased vulnerability to pathological remodelling. In mice that died after myocardial infarction, IFNIC colonies were immediately adjacent to sites of ventricular rupture, while mice lacking IFNICs were protected from rupture and exhibited improved survival3. Together, these results reveal a pathological borderzone niche characterized by a cardiomyocyte-initiated innate immune response. We suggest that selective inhibition of IRF3 activation in non-immune cells could limit ischaemic cardiomyopathy while avoiding broad immunosuppression.Cardiomyocytes are the dominant initiators of a type I interferon response in the infarct borderzone. [ABSTRACT FROM AUTHOR]

During the past four decades, ultrasound has become popular as an imaging modality applied to the musculoskeletal (MSK) system, particularly outside the USA, due to its low cost, accessibility, and lack of ionizing radiation. A basic requirement in performing these examinations is to have a core group of radiologists and ultrasound technologists with expertise in MSK ultrasound. The extent to which ultrasound will be part of the imaging offered by a particular radiology practice or in an academic institution will vary according to expertise, availability, and reimbursements. A brief discussion of the technical capabilities of the current generation of ultrasound scanners will be followed by a description of some of the more prevalent MSK ultrasound imaging applications. The extent to which training to perform these exams within and outside of Radiology plays a role is discussed. Applications that are unique to ultrasound, such as dynamic evaluation of musculoskeletal anatomy and some, US-guided interventions are an important part of MSK imaging. Ultrasound is increasingly important in the assessment of superficial structures, such as tendons, small joints, and peripheral nerves. These applications help to establish the place of ultrasound as an important part of the Radiologists approach to MSK imaging. Outside of radiology, for a variety of clinical subspecialties, ultrasound already plays an integral role in MSK imaging. [ABSTRACT FROM AUTHOR]

Purpose: The original aim of the study was to determine, in a double-blind 3-arm crossover human trial (n = 7), the effect of supplemental levels of iron (25 mg) and zinc (30 mg) on β-carotene (synthetic) bioavailability (10 h postprandial). However, despite the high dose of supplemental β-carotene (15 mg) consumed with the high fat (18 g), dairy-based breakfast test meal, there was a negligible postprandial response in plasma and triglyceride rich fraction β-carotene concentrations. We then systematically investigated the possible reasons for this low bioavailability of β-carotene. Methods: We determined (1) if the supplemental β-carotene could be micellised and absorbed by epithelial cells, using a Caco-2 cell model, (2) if the fat from the test meal was sufficiently bioavailable to facilitate β-carotene bioavailability, (3) the extent to which the β-carotene could have been metabolised and converted to retinoic acid/retinol and (4) the effect of the test meal matrix on the β-carotene bioaccessibility (in vitro digestion) and Caco-2 cellular uptake. Results: We found that (1) The supplemental β-carotene could be micellised and absorbed by epithelial cells, (2) the postprandial plasma triacylglycerol response was substantial (approximately 75–100 mg dL−1 over 10 h), indicating sufficient lipid bioavailability to ensure β-carotene absorption, (3) the high fat content of the meal (approximately 18 g) could have resulted in increased β-carotene metabolism, (4) β-carotene bioaccessibility from the dairy-based test meal was sixfold lower (p < 0.05) than when digested with olive oil. Conclusion: The low β-carotene bioavailability is probably due to a combination of the metabolism of β-carotene to retinol by BCMO1 and interactions of β-carotene with the food matrix, decreasing the bioaccessibility. Trail registration: The human trail was retrospectively registered (ClinicalTrail.gov ID: NCT05840848). [ABSTRACT FROM AUTHOR]

Background: Referral of patients with heart failure (HF) who are at high mortality risk for specialist evaluation is recommended. Yet, most tools for identifying such patients are difficult to implement in electronic health record (EHR) systems. Objective: To assess the performance and ease of implementation of Machine learning Assessment of RisK and EaRly mortality in Heart Failure (MARKER-HF), a machine-learning model that uses structured data that is readily available in the EHR, and compare it with two commonly used risk scores: the Seattle Heart Failure Model (SHFM) and Meta‐Analysis Global Group in Chronic (MAGGIC) Heart Failure Risk Score. Design: Retrospective, cohort study. Participants: Data from 6764 adults with HF were abstracted from EHRs at a large integrated health system from 1/1/10 to 12/31/19. Main measures: One-year survival from time of first cardiology or primary care visit was estimated using MARKER-HF, SHFM, and MAGGIC. Discrimination was measured by the area under the receiver operating curve (AUC). Calibration was assessed graphically. Key results: Compared to MARKER-HF, both SHFM and MAGGIC required a considerably larger amount of data engineering and imputation to generate risk score estimates. MARKER-HF, SHFM, and MAGGIC exhibited similar discriminations with AUCs of 0.70 (0.69–0.73), 0.71 (0.69–0.72), and 0.71 (95% CI 0.70–0.73), respectively. All three scores showed good calibration across the full risk spectrum. Conclusions: These findings suggest that MARKER-HF, which uses readily available clinical and lab measurements in the EHR and required less imputation and data engineering than SHFM and MAGGIC, is an easier tool to identify high-risk patients in ambulatory clinics who could benefit from referral to a HF specialist. [ABSTRACT FROM AUTHOR]

Background: The effectiveness of prophylactic pancreatic duct stenting (PPDS) in preventing post-ampullectomy pancreatitis (PAP) at the time of endoscopic ampullectomy (EA) has been reported, however, results are conflicting. We conducted a systematic review and meta-analysis looking at the use of PPDS in reducing PAP as well as overall post-ampullectomy complications. Methods: Multiple databases were searched through May 2023 for studies reporting on EA. Meta-analysis was performed to determine pooled proportions and relative risk (RR) with 95% confidence intervals (CI) of PAP, with and without PPDS. Pooled rates of adverse events including perforation, delayed bleeding, cholangitis, and procedure related mortality were assessed. Random effects model was used for our meta-analysis and heterogeneity was assessed using the I2 statistics. Results: Thirty-four studies (14 case series, 18 cohort studies and 2 randomized controlled trials) with 1868 patients were included. The overall pooled rate of PAP was 12.3% (CI 10.3–14.5). We found no statistically significant difference in rates of PAP among patients with PPDS, 11.9% (CI 8.9–15.7) and without PPDS, 16.6% (CI 13.4–20.4), RR 0.8 (CI 0.51–1.28), p = 0.4. In terms of severe PAP, we found no difference between the two groups. The overall pooled rates of successful en-bloc and piecemeal resection were 74.8% (CI 67.3–81.1) and 25.1% (CI 19–32.4). Additionally, pooled rates of ampullary stenosis, post procedural bleeding, perforation, cholangitis, and procedure related mortality were 3.6%, 11.1%, 4.2%, 3.5%, and 1.3%, respectively. Conclusions: Our analysis shows that PPDS at the time of EA does not offer a significant protective effect against PAP. While the incidence of PAP was higher among the no PPDS group, it is plausible that this is more likely due to variation among studies in terms of lesion size, length/size of pancreatic stent used and etiology of ampullary lesions. Future well-designed randomized controlled trials are needed to validate our findings. [ABSTRACT FROM AUTHOR]

Copyright of Notfall & Rettungsmedizin is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background and Objectives: Achalasia has several treatment modalities. We aim to compare the efficacy and safety of laparoscopic Heller myotomy (LHM) with those of pneumatic dilatation (PD) in adult patients suffering from achalasia. Methods: We searched Cochrane CENTRAL, PubMed, Web of Science, SCOPUS and Embase for related clinical trials about patients suffering from achalasia. The quality appraisal and assessment of risk of bias were conducted with GRADE and Cochrane's risk of bias tool, respectively. Homogeneous and heterogeneous data was analyzed under fixed and random-effects models, respectively. Results: The pooled analysis of 10 studies showed that PD was associated with a higher rate of remission at three months, one year, three years and five years (RR = 1.25 [1.09, 1.42] (p = 0.001); RR = 1.13 [1.05, 1.20] (p = 0.0004); RR = 1.48 [1.19, 1.82] (p = 0.0003); RR = 1.49 [1.18, 1.89] (p = 0.001)), respectively. LHM was associated with lower number of cases suffering from adverse events, dysphagia and relapses (RR = 0.50 [0.25, 0.98] (p = 0.04); RR = 0.33 [0.16, 0.71] (p = 0.004); RR = 0.38 [0.15, 0.97] (p = 0.04)), respectively. There is no significant difference between both groups regarding the lower esophageal pressure, perforations, remission rate at two years, Eckardt score after one year and reflux. Conclusion: PD had higher remission rates than LHM at three months, one year and three years, but not at two years or five years. More research is needed to determine whether PD has a significant advantage over LHM in terms of long-term remission rates. [ABSTRACT FROM AUTHOR]

The use of digital technology has the potential to support students' understanding in the mathematics classroom with the teacher playing a vital role. However, teaching with digital technology is not trivial, especially for teachers who are new to this. In this paper, we present an analysis of the enactment of a function lesson of a Sri Lankan mathematics teacher who used digital technology for the first time in her teaching. We combined the instrumental orchestration and ROG (resources, orientations and goals) frameworks into a conceptual framework to analyse her teaching. In particular, we used instrumental orchestration to identify how the teacher orchestrated the resources in her technology-rich classroom. This was combined with ROG theory to understand the reasons underpinning the decisions involved in moving from one orchestration to another. We demonstrate that this teacher showed diverse orchestrations and use the ROG framework to present these in the sequences in which they were used, formed into chains of orchestrations linked by goals. We propose that her didactical performance is a function of orchestration types over in-the-moment decision-making. [ABSTRACT FROM AUTHOR]

We have proposed that galaxy formation is catalyzed by the collision of infalling and outstreaming particles from leaky, horizonless astrophysical black holes, most likely gravastars, and based on this gave a model for the disk galaxy scale length. In this paper we modify our original scale length formula by including an activation probability P for a collision to lead to nucleation of star formation. The revised formula extrapolates from early universe JWST data to late time data to within a factor of five, and suggests that galaxy dimensions should systematically get smaller as the observed redshift z increases. We also show that particles recycling through gravastars can lead to a reduction in the temperature of the surrounding gas, through a "heat pump" refrigeration effect. This can trigger galaxy formation through enhanced star formation in the vicinity of the gravastar. [ABSTRACT FROM AUTHOR]

The pathophysiology of posttraumatic stress disorder (PTSD) is associated with the activation of the innate immune system, including cytokines like interleukin 6 (IL-6). However, the role of IL-6 in the etiology and treatment of PTSD still remains elusive. We conducted a prospective controlled trial to investigate the development of IL-6 during psychosomatic treatment in individuals with PTSD in comparison with individuals without PTSD. We assessed IL-6 mRNA expression before and after 2 months of psychosomatic treatment in individuals with and without PTSD. Severities of PTSD and depressive symptoms were assessed in parallel. Linear mixed regression was applied for statistical analysis, including the factors diagnosis PTSD and pre–post treatment after subgrouping for intake of anti-inflammatory drugs. The development of IL-6 mRNA expression during treatment was affected by the use of anti-inflammatory drugs. In the subgroup without intake of anti-inflammatory drugs, no significant statistical treatment effect in individuals with and without PTSD emerged. In the subgroup of individuals taking anti-inflammatory drugs, a significant interaction effect of the factors pre–post treatment and diagnosis PTSD was observed. Whereas IL-6 mRNA expression in individuals without PTSD decreased according to amelioration of symptoms, IL-6 mRNA expression in individuals with PTSD increased significantly during treatment, in opposite direction to symptom severity. Anti-inflammatory drugs might affect IL-6 mRNA expression in individuals with PTSD in a paradoxical way. This study offers a further piece of evidence that IL-6 could be involved in the pathophysiology of PTSD and PTSD-specific immunologic molecular mechanisms. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to evaluate evolution of ultra-processed food intake and recurrent weight gain in patients who underwent Roux-en-Y gastric bypass. Materials and Methods: This study is an observational longitudinal study that evaluated patients who underwent metabolic and bariatric surgery at four time points: before surgery and at 3, 12, and 60 months after surgery. Anthropometric and dietary intake data were collected through two 24-h dietary recalls. All foods consumed were classified according to degree of processing. Recurrent weight gain was considered the difference between current weight and nadir weight. Results: The sample consisted of 58 patients with a mean age of 38.7 ± 8.9 years and 68% female. After 60 months, mean excess weight loss and recurrent weight gain were 73.6 ± 27.2% and 22.5 ± 17.4%. Calorie and macronutrient intake decreased significantly between the pre-surgery period, and 3 and 12 months post-surgery; however, there was no significant difference after 60 months. In relation to food groups or macronutrients, no difference was observed between the pre-surgery period and 60 months post-surgery. The contribution of unprocessed or minimally processed foods to calorie intake gradually decreased after 3 months post-surgery. Conclusion: The profile of dietary intake after 60 months of metabolic and bariatric surgery tends to approach that of the pre-surgery period. The contribution of unprocessed and minimally processed foods to calorie intake decreased after 60 months, while ultra-processed food contribution increased. [ABSTRACT FROM AUTHOR]

Background: Percutaneous coronary intervention (PCI) is standard of care in patients with acute coronary syndrome (ACS) suitable for interventional revascularization. Intracoronary imaging by optical coherence tomography (OCT) expanded treatment approaches adding diagnostic information and contributing to stent optimization. Objectives: This meta-analysis aimed to assess the effects of OCT-guided vs. angiography-guided PCI in treatment of ACS. Methods: A structured literature search was performed. All controlled trials evaluating OCT-guided vs. angiography-guided PCI in patients with ACS were eligible. The primary end point was major adverse cardiac events (MACE). Results: Eight studies enrolling 2612 patients with ACS were eligible. 1263 patients underwent OCT-guided and 1,349 patients angiography-guided PCI. OCT guidance was associated with a 30% lower likelihood of MACE (OR 0.70, 95% CI 0.53–0.93, p = 0.01, I2 = 1%). OCT-guided PCI was also associated with significantly decreased cardiac mortality (OR 0.49, 95% CI 0.25–0.96, p = 0.04, I2 = 0%). There was no detectable difference in all-cause mortality (OR 1.08, 95% CI 0.51–2.31, p = 0.83, I2 = 0). Patients in OCT-guided group less frequently required target lesion revascularization (OR 0.26, 95% CI 0.07–0.95, p = 0.04, I2 = 0%). Analysis of myocardial infarction did not result in significant treatment differences. In subgroup or sensitivity analysis the observed advantages of OCT-guided PCI were not replicable. Conclusion: The evidence suggests that PCI guidance with OCT in ACS decreases MACE, cardiac death and target lesion revascularization compared to angiography. On individual study level, in subgroup or sensitivity analyses these advantages were not thoroughly replicable. [ABSTRACT FROM AUTHOR]

Background: Few studies have evaluated the post-endoscopic adverse events in patients with neutropenia and thrombocytopenia. Current guidelines do not provide clear direction on this topic. Aim: We explore the pooled rates of safety and adverse effects of endoscopic interventions in thrombocytopenia and neutropenia patients via a systematic review & meta-analysis. Methods: Databases, including Medline, Scopus, and Embase, were searched (in May 2023) using specific terms for studies evaluating the clinical outcomes of endoscopy in patients with thrombocytopenia and neutropenia. Standard meta-analysis methods were employed using the random-effects model. I2% heterogeneity was used to assess the heterogeneity. Results: Six studies and four studies evaluated endoscopic outcomes in patients with thrombocytopenia and neutropenia respectively with mean age was 56 years. The pooled rate of total post-biopsy bleeding and total post-polypectomy bleeding among patients with thrombocytopenia was 4% (95% CI 1–11), I2 = 84%, and 12% (95% CI 3–36) I2 = 43%. The total rate of post procedure-related bleeding in thrombocytopenia was 5% (95% CI 1–14) I2 = 95%. The pooled rate of post-endoscopic infection (fever from any cause, bacteremia) in neutropenia was 10% (95% CI 3–28%) I2 = 96%. On sub analysis, the pooled rate of bacteremia and 30 days all-cause mortality in neutropenia was 4% (95% CI 3–5%) I2 = 0% and 13% (95% CI 4–34%) I2 = 95% respectively. Conclusion: Our data supports the notion that endoscopic procedures are safe for neutropenic, thrombocytopenic patients with suitable indications and reasonable functional status and have an acceptable risk/benefit ratio. [ABSTRACT FROM AUTHOR]

Pollinators face many stressors, including reduced floral diversity. A low-diversity diet can impair organisms’ ability to cope with additional stressors, such as pathogens, by altering the gut microbiome and/or immune function, but these effects are understudied for most pollinators. We investigated the impact of pollen diet diversity on two ecologically and economically important generalist pollinators, the social bumble bee (Bombus impatiens) and the solitary alfalfa leafcutter bee (Megachile rotundata). We experimentally tested the effect of one-, two-, or three-species pollen diets on gut bacterial communities in both species, and the melanization immune response in B. impatiens. Pollen diets included dandelion (Taraxacum officinale), staghorn sumac (Rhus typhina), and hawthorn (Crataegus sp.) alone, each pair-wise combination, or a mix of all three species. We fed bees their diet for 7 days and then dissected out guts and sequenced 16S rRNA gene amplicons to characterize gut bacterial communities. To assess melanization in B. impatiens, we inserted microfilament implants into the bee abdomen and measured melanin deposition on the implant. We found that pollen diet did not influence gut bacterial communities in M. rotundata. In B. impatiens, pollen diet composition, but not diversity, affected gut bacterial richness in older, but not newly-emerged bees. Pollen diet did not affect the melanization response in B. impatiens. Our results suggest that even a monofloral, low-quality pollen diet such as dandelion can support diverse gut bacterial communities in captive-reared adults of these bee species. These findings shed light on the effects of reduced diet diversity on bee health. [ABSTRACT FROM AUTHOR]

Lewy body (LB) diseases, characterized by the aggregation of misfolded α-synuclein proteins, exhibit notable clinical heterogeneity. This may be due to variations in accumulation patterns of LB neuropathology. Here we apply a data-driven disease progression model to regional neuropathological LB density scores from 814 brain donors with Lewy pathology. We describe three inferred trajectories of LB pathology that are characterized by differing clinicopathological presentation and longitudinal antemortem clinical progression. Most donors (81.9%) show earliest pathology in the olfactory bulb, followed by accumulation in either limbic (60.8%) or brainstem (21.1%) regions. The remaining donors (18.1%) initially exhibit abnormalities in brainstem regions. Early limbic pathology is associated with Alzheimer's disease-associated characteristics while early brainstem pathology is associated with progressive motor impairment and substantial LB pathology outside of the brain. Our data provides evidence for heterogeneity in the temporal spread of LB pathology, possibly explaining some of the clinical disparities observed in Lewy body disease. Lewy body diseases exhibit notable clinical and pathological heterogeneity. Here, the authors found three distinct trajectories of Lewy body pathology that are associated with different clinicopathological characteristics. [ABSTRACT FROM AUTHOR]

The introduction of AlphaFold 21 has spurred a revolution in modelling the structure of proteins and their interactions, enabling a huge range of applications in protein modelling and design2–6. Here we describe our AlphaFold 3 model with a substantially updated diffusion-based architecture that is capable of predicting the joint structure of complexes including proteins, nucleic acids, small molecules, ions and modified residues. The new AlphaFold model demonstrates substantially improved accuracy over many previous specialized tools: far greater accuracy for protein–ligand interactions compared with state-of-the-art docking tools, much higher accuracy for protein–nucleic acid interactions compared with nucleic-acid-specific predictors and substantially higher antibody–antigen prediction accuracy compared with AlphaFold-Multimer v.2.37,8. Together, these results show that high-accuracy modelling across biomolecular space is possible within a single unified deep-learning framework.AlphaFold 3 has a substantially updated architecture that is capable of predicting the joint structure of complexes including proteins, nucleic acids, small molecules, ions and modified residues with greatly improved accuracy over many previous specialized tools. [ABSTRACT FROM AUTHOR]

Inquiry includes a broad spectrum of approaches, depending on students' responsibility over the process and the extent of the teacher's guidance. While numerous studies have examined students' achievements and engagement across different types of inquiry-based environments, analyses of teachers' guidance during the process are lacking. Therefore, our overarching goal was to examine the interplay between characteristics of the inquiry-based environment and teacher's just-in-time support. Specifically, we examined the learning processes and achievements of middle-school students as they collaboratively engaged in either a structured or a guided inquiry-based task and were supported by their teacher. Structuring scaffolds were designed to support the structured inquiry task, while problematizing scaffolds were designed to support the guided inquiry task. Post-test scores indicated a similar significant increase in students' scientific understanding for both research conditions, despite significant differences in students' engagement in metacognitive processes during their scientific trials. Students from the guided inquiry group engaged in longer discussions and made more references to metacognitive processes, in comparison to students from the structured inquiry group. A low to moderate correlation between students' engagement in metacognitive processes and test-scores was identified. The teacher's regulation of students' discourse in the structured inquiry group was significantly greater than in the guided inquiry group, though the nature of regulation was similar. We propose that the teacher's regulation of students' metacognitive discourse outweighed the differences between students' learning processes in the two learning environments, resulting in similar achievements in the two conditions albeit differences in metacognitive engagement. Implications are discussed. [ABSTRACT FROM AUTHOR]

Background: The ideal time frame between gonadotropin-releasing hormone (GnRH) agonist (GnRHa) trigger administration and oocyte retrieval in GnRH antagonist cycles has not been well studied. Our goal was to evaluate the effect of this time interval on oocyte yield and oocyte maturation rate in GnRH antagonist cycles designated for non-medical ("planned") oocyte cryopreservation. Methods: We conducted a retrospective cohort study including patients who underwent elective fertility preservation, using the GnRH antagonist protocol and exclusively triggered by GnRH-agonist. We focused on the effect of the trigger-to-retrieval time interval on oocyte yield and maturation rate, while also incorporating age, body mass index (BMI), anti-Müllerian hormone (AMH) levels, basal Follicle-Stimulating Hormone (FSH) levels, as well as the type and dosage of gonadotropin FSH medication. Results: 438 cycles were included. Trigger-to-retrieval time interval ranged from 32.03 to 39.92 h. The mean oocyte yield showed no statistically significant difference when comparing retrievals < 36 h (n = 240, 11.86 ± 8.6) to those triggered at ≥ 36 h (n = 198, 12.24 ± 7.73) (P = 0.6). Upon dividing the cohort into four-time quartiles, no significant differences in the number of retrieved oocytes were observed (P = 0.54). Multivariate regression analysis failed to reveal any significant associations between the interval and the aforementioned variables. Conclusions: The GnRHa trigger to oocyte retrieval interval range in our cohort did not significantly affect oocyte yield and maturation rate. [ABSTRACT FROM AUTHOR]

This study investigated the interruption-recovery pattern of air pollutants (O3, PM2.5 and PM10) during and after the COVID-19 pandemic in Southern Brazil using machine learning models. The results showed that 2020 was an atypical year for air pollution levels due to restriction measures. However, we also found that 2021 was not a definitive year for the assessed air pollutants in the region but rather a transitional year. It was only in 2022 that the pollutant levels returned to usual levels in the region. In this sense, our findings suggest that the levels observed in 2022 can be considered the "new normal" for air pollutants in the region. Furthermore, we found that O3 levels decreased significantly and were sustained and further decreased in 2022, while PM2.5 and PM10 levels showed a reversed but similar trend with a slight increase in concentrations from 2020 to 2021 and again from 2021 to 2022. Overall, this study provides valuable insights into the impacts of COVID-19 on air pollution levels and highlights the need for continued efforts to improve air quality in the region. [ABSTRACT FROM AUTHOR]

Introduction: Pancreatic duct stents (PDS) are widely used for the prevention of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis. However, there is a paucity of data regarding the adverse events associated with PDS placement. This study aims to investigate the reported adverse events and device failures related to PDS, utilizing the Manufacturer and User Facility Device Experience (MAUDE) database maintained by the U.S. Food and Drug Administration (FDA). Methods: Post-marketing surveillance data from January 2013 to December 8, 2023, were extracted from the FDA's MAUDE database to analyze the reports pertaining to the use of commonly used PDS. The primary outcomes of interest were device issues and patient-related adverse events. Statistical analysis was performed using Microsoft Excel 2010, with the calculation of pooled numbers and percentages for each device and patient adverse event. Results: A total of 579 device issues and 194 patient-related adverse events were identified. Device issues were primarily attributed to stent deformation (n = 72; 12.4%), followed by migration of the device into the pancreatic duct or expulsion out of the duct (n = 60; 10.4%), and stent fracture/breakage (n = 55; 9.4%). Among the patient-reported adverse events, inflammation was the most common (n = 26; 13.4%), followed by reports of stents becoming embedded in tissue (n = 21; 10.8%) and stent occlusion/obstruction (n = 16; 8.2%). The most prevalent device failures associated with Advanix stents were material deformation, with perforation (n = 3, 30%) being the most frequently reported adverse event. Concerning Geenen stents, migration or expulsion of the device (n = 34, 16.9%) constituted the most common device-related adverse events, while inflammation (n = 20, 16.7%) was the most frequently reported patient-related issue. For Zimmon stents, migration or expulsion of the device (n = 22, 8.8%) were the most frequently reported device-related problems, whereas perforation (n = 7, 10.9%) and bleeding (n = 7, 10.9%) were the most frequent patient-related adverse events. Conclusion: Our findings highlight important device and patient adverse events that endoscopists and referring providers should be aware of before considering pancreatic stent placement. [ABSTRACT FROM AUTHOR]

Ethylenediaminetetraacetic acid (EDTA), a classically used chelating agent of decalcification, maintains good morphological details, but its slow decalcification limits its wider applications. Many procedures have been reported to accelerate EDTA-based decalcification, involving temperature, concentration, sonication, agitation, vacuum, microwave, or combination. However, these procedures, concentrating on purely tissue-outside physical factors to increase the chemical diffusion, do not enable EDTA to exert its full capacity due to tissue intrinsic chemical resistances around the diffusion passage. The resistances, such as tissue inner lipids and electric charges, impede the penetration of EDTA. We hypothesized that delipidation and shielding electric charges would accelerate EDTA-based penetration and the subsequent decalcification. The hypothesis was verified by the observation of speedy penetration of EDTA with additives of detergents and hypertonic saline, testing on tissue-mimicking gels of collagen and adult mouse bones. Using a 26% EDTA mixture with the additives at 45°C, a conventional 7-day decalcification of adult mouse ankle joints could be completed within 24 h while the tissue morphological structure, antigenicity, enzymes, and DNA were well preserved, and mRNA better retained compared to using 15% EDTA at room temperature. The addition of hypertonic saline and detergents to EDTA decalcification is a simple, rapid, and inexpensive method that doesn't disrupt the current histological workflow. This method is equally or even more effective than the currently most used decalcification methods in preserving the morphological details of tissues. It can be highly beneficial for the related community. [ABSTRACT FROM AUTHOR]

Agriculture-based industries generate huge amounts of byproducts/wastes every year, which are not exploited or disposed efficiently posing an environmental problem with implications to human and animal health. Finding strategies to increase the recycling of agro-industrial byproducts/wastes (AIBWs) is a primary objective of the current study. A thorough examination of AIBWs in conjunction with experimental research is proposed to facilitate sorting for various agro-industrial applications and consequently increasing byproduct/waste utilization. Accordingly, two sustainable, locally available sources of AIBWs, namely, wheat bran (WB) and garlic straw and peels (GSP) were studied in detail including content and composition of proteins, phytohormones and nutritional elements, as well as the effect of AIBW extracts on plant and microbial growth. Hundreds of proteins were recovered from AIBW mainly from WBs, including chaperons, metabolite and protein modifying enzymes, and antimicrobial proteins. In-gel assays showed that WB and GSP possess high protease and nuclease activities. Conspicuously, phytohormone analysis of AIBWs revealed the presence of high levels of strigolactones, stimulants of seed germination of root parasitic weeds, as well as indole acetic acid (IAA) and abscisic acid (ABA). Garlic straw extract strongly inhibited germination of the weed Amaranthus palmeri but not of Abutilon theophrasti and all examined AIBWs significantly affected post-germination growth. Bacterial growth was strongly inhibited by garlic straw, but enhanced by WBs, which can be used at least partly as a bacterial growth medium. Thus, an in-depth examination of AIBW characteristics will enable appropriate sorting for diverse agro-industrial applications, which will increase their utilization and consequently their economic value. [ABSTRACT FROM AUTHOR]

Measurements of inclusive charged-particle jet production in pp and p-Pb collisions at center-of-mass energy per nucleon-nucleon collision s NN = 5.02 TeV and the corresponding nuclear modification factor R pPb ch jet are presented, using data collected with the ALICE detector at the LHC. Jets are reconstructed in the central rapidity region |ηjet| < 0.5 from charged particles using the anti-kT algorithm with resolution parameters R = 0.2, 0.3, and 0.4. The pT-differential inclusive production cross section of charged-particle jets, as well as the corresponding cross section ratios, are reported for pp and p-Pb collisions in the transverse momentum range 10 < p T , jet ch < 140 GeV/c and 10 < p T , jet ch < 160 GeV/c, respectively, together with the nuclear modification factor R pPb ch jet in the range 10 < p T , jet ch < 140 GeV/c. The analysis extends the pT range of the previously-reported charged-particle jet measurements by the ALICE Collaboration. The nuclear modification factor is found to be consistent with one and independent of the jet resolution parameter with the improved precision of this study, indicating that the possible influence of cold nuclear matter effects on the production cross section of charged-particle jets in p-Pb collisions at s NN = 5.02 TeV is smaller than the current precision. The obtained results are in agreement with other minimum bias jet measurements available for RHIC and LHC energies, and are well reproduced by the NLO perturbative QCD Powheg calculations with parton shower provided by Pythia8 as well as by Jetscape simulations. [ABSTRACT FROM AUTHOR]

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Purpose of Review: The goal of this paper was to highlight the degree to which sleep, behavioral health, and leader involvement were interrelated using data from militaries in five English-speaking countries: Australia, Canada, New Zealand, the UK, and the United States. Recent Findings: Many service members reported sleeping fewer than the recommended 7 h/night: 34.9%, 67.2%, and 77.2% of respondents from New Zealand, Canada, and the United States, respectively. Countries reporting shorter sleep duration also reported fewer insomnia-related difficulties, likely reflecting higher sleep pressure from chronic sleep loss. Across all countries, sleep problems were positively correlated with behavioral health symptoms. Importantly, leader promotion of healthy sleep was positively correlated with more sleep and negatively correlated with sleep problems and behavioral health symptoms. Summary: Insufficient sleep in the military is ubiquitous, with serious implications for the behavioral health and functioning of service members. Leaders should attend to these risks and examine ways to promote healthy sleep in service members. [ABSTRACT FROM AUTHOR]

Salt marshes are capable of mitigating metal pollution in coastal environments, yet the efficacy of this remediation is contingent upon various environmental factors and the plant species involved. This study investigates the influence of different anthropogenic activities, including industrial, urban, recreational (in an insular area), and dredging operations, on the bioaccumulation of eight metals (As, Cd, Cr, Cu, Hg, Ni, Pb, and Zn) within Spartina alterniflora Loisel. in the Patos Lagoon estuary, Brazil. The research aims to assess the pattern of metal bioaccumulation and distribution within the plant's leaves, stems, and roots while also examining metal presence in the sediment. Our main findings reveal that S. alterniflora exhibited elevated metal levels in its plant structure directly related with the metal concentrations in the surrounding sediment, which, in turn, is related to the different anthropogenic activities. The industrial area presented the highest metal levels in sediment and plant sections, followed by dredging, insular, and urban areas. This same pattern was mirrored for the bioconcetration factors (BCF), with the BCFs consistently indicating active metal bioaccumulation across all areas and for most of the metals. This provides evidence of the metal bioaccumulation pattern in S. alterniflora, with elevated BCFs in areas affected by activities with a higher degree of impact. Translocation factors (TF) showed varying metal mobility patterns within the plant's below-ground and above-ground sections across the different areas, with only Hg exhibiting consistent translocation across all study areas. Zn was the primary metal contributor in all plant sections, followed by Pb and Cu. It is worth noting that Pb is a non-essential metal for this plant, highlighting the relationship between elevated Pb contributions in the plant sections and the bioaccumulation of this metal within the plant's structure. Overall, this study emphasizes the bioaccumulation capacity of S. alterniflora and elucidate the intrinsic connection between different anthropogenic activities and their impact on the resultant availability and bioaccumulation of metals by this salt marsh plant. [ABSTRACT FROM AUTHOR]

Research on context effects shows that the composition of choice sets and choice framing strongly influences consumer decision-making. Researchers have identified various context effect types and provide insight into their antecedents, consequences, and mechanisms of action. However, the research on context effects is spread across several fields, making it difficult to grasp the entire scope. Reviews focusing on specific effect types can facilitate rigorous research and publication practices, but they focus primarily on prominent context effects, neglecting others. Furthermore, those reviews do not provide insight into the structure of scholarly networks that result from research collaborations and shape, generate, distribute, and preserve the intellectual knowledge of the context effect domain. Addressing these issues, we present a large-scale bibliometric analysis of the field, that helps navigate the context effect landscape, highlights its themes, and identifies knowledge gaps. An interactive web application also allows for our analyses to be customized and extended. [ABSTRACT FROM AUTHOR]

Reproduction in flowering plants depends to a large degree on interactions with competitors, mutualists, and antagonists, but may also depend on the context within which interaction partners exist. Herbivory can reduce plant attractiveness to pollinators, but since many flowering plant species are visited by the same pollinators, the effects of herbivory on pollinator behavior may have consequences for undamaged neighboring plant species. We assessed how herbivory to a dominant plant species affects pollination services to neighboring flowering species in a community in which we simulated herbivory to milkweeds (Asclepias syriaca) by removing foliar tissue and applying jasmonic acid exogenously. We measured the quality of pollination services to undamaged neighboring plants by assessing the proportion of heterospecific pollen deposited on stigmas of four undamaged neighboring plant species, and measured seed production in one of these species. Our results indicate that simulated herbivory to a dominant plant species may have community-wide effects on pollination services. Simulated herbivory to milkweed increased the proportion of heterospecific pollen deposited on two neighboring plant species (Vicia cracca and Clinopodium vulgare), reduced it for one species (Lysimachia quadrifolia) and resulted in no change for another (Galium palustre). Additionally, simulated herbivory to milkweed resulted in a non-significant trend for lower seed production per fruit in V. cracca. These results support the hypothesis that herbivory on one flowering plant species can impact pollinator services for other flowering species at the patch level. These effects highlight the interconnectedness and interdependence of flowering plant species in plant-pollinator communities. [ABSTRACT FROM AUTHOR]

This document is a correction notice for an article titled "The thymocyte-specific RNA-binding protein Arpp21 provides TCR repertoire diversity by binding to the 3'-UTR and promoting Rag1 mRNA expression" published in Nature Communications. The correction addresses errors in Figure 6 of the original article, where panel labels were misplaced, causing mismatches between the panels and the legend. The errors have been corrected in both the PDF and HTML versions of the article. The authors of the article are listed at the end of the correction notice. [Extracted from the article]

In 2011, a leading investigative television program in Israel launched a series of short documentaries entitled "Four Minutes," each dedicated to an Israeli political leader. This paper focuses on three of these documentaries, dedicated to then-president Shimon Peres; then-Knesset member Tzipi Livni, who 2 years earlier had won the elections but failed to form a government, and Rabbi Ovadia Yosef, the founder of the Ultra-Orthodox Sephardi "Shas" party. Our goal is to outline the means by which these films construct and deliver their condensed messages, and to explore how, despite the rigid constraints of the format, they create a cohesive and complex portrait of these political figures and their strategic agendas. We analyze how the films' multimodal language is used to reflect the messages promoted by each of the figures as well as by the filmmakers themselves. [ABSTRACT FROM AUTHOR]

The regulation of thymocyte development by RNA-binding proteins (RBPs) is largely unexplored. We identify 642 RBPs in the thymus and focus on Arpp21, which shows selective and dynamic expression in early thymocytes. Arpp21 is downregulated in response to T cell receptor (TCR) and Ca2+ signals. Downregulation requires Stim1/Stim2 and CaMK4 expression and involves Arpp21 protein phosphorylation, polyubiquitination and proteasomal degradation. Arpp21 directly binds RNA through its R3H domain, with a preference for uridine-rich motifs, promoting the expression of target mRNAs. Analysis of the Arpp21–bound transcriptome reveals strong interactions with the Rag1 3′-UTR. Arpp21–deficient thymocytes show reduced Rag1 expression, delayed TCR rearrangement and a less diverse TCR repertoire. This phenotype is recapitulated in Rag1 3′-UTR mutant mice harboring a deletion of the Arpp21 response region. These findings show how thymocyte-specific Arpp21 promotes Rag1 expression to enable TCR repertoire diversity until signals from the TCR terminate Arpp21 and Rag1 activities.Regulation of thymocyte development by RNA-binding proteins is not fully characterized. Here the authors show the RBP ARPP21 interacting with the Rag1 3’-UTR to promote Rag1 expression, TCR rearrangement and an increased diversity of the TCR repertoire and that ARPP21 is down regulated by TCR stimulation. [ABSTRACT FROM AUTHOR]

Microtubules (MTs) are key components of the eukaryotic cytoskeleton and are essential for intracellular organization, organelle trafficking and mitosis. MT tasks depend on binding and interactions with MT-associated proteins (MAPs). MT-associated protein 7 (MAP7) has the unusual ability of both MT binding and activating kinesin-1-mediated cargo transport along MTs. Additionally, the protein is reported to stabilize MTs with its 112 amino-acid long MT-binding domain (MTBD). Here we investigate the structural basis of the interaction of MAP7 MTBD with the MT lattice. Using a combination of solid and solution-state nuclear magnetic resonance (NMR) spectroscopy with electron microscopy, fluorescence anisotropy and isothermal titration calorimetry, we shed light on the binding mode of MAP7 to MTs at an atomic level. Our results show that a combination of interactions between MAP7 and MT lattice extending beyond a single tubulin dimer and including tubulin C-terminal tails contribute to formation of the MAP7-MT complex. Integrated structural data show that the MAP7 microtubule binding domain stabilizes the microtubule lattice through binding along protofilaments. Both strong and weak interactions between MAP7 and the lattice extend beyond a single tubulin dimer and include the tubulin C-terminal tails. [ABSTRACT FROM AUTHOR]

Pronator syndrome is a median nerve entrapment neuropathy that can be difficult to diagnose due to its variable presentation and objective findings. Neurolymphomatosis is an uncommon disease in which malignant lymphocytes infiltrate central or peripheral nerve endoneurium and is often missed for prolonged periods prior to diagnosis. We present a rare case of pronator syndrome and anterior interosseous nerve palsy due to neurolymphomatosis that was occult on initial MRI in spite of the presence of a median nerve mass discovered intra-operatively during neurolysis. This case demonstrates the value of ultrasound for the examination of peripheral nerve pathology and illustrates its utility as an adjunct to MRI, in part due to the ability to screen a large region. [ABSTRACT FROM AUTHOR]

We study the problem of the decay of initial data in the form of a unit step for the Bogoyavlensky lattices. In contrast to the Gurevich–Pitaevskii problem of the decay of initial discontinuity for the KdV equation, it turns out to be exactly solvable, since the dynamics is linearizable due to termination on the half-line. The answer is written in terms of generalized hypergeometric functions, which serve as exponential generating functions for generalized Catalan numbers. This can be proved by the fact that the generalized Hankel determinants for these numbers are equal to 1, which is a well-known result in combinatorics. Another method is based on a nonautonomous symmetry reduction consistent with the dynamics. It reduces the lattice equation to a finite-dimensional system and makes it possible to solve the problem for a more general finite-parameter family of initial data. DOI 10.1134/S106192084010011 [ABSTRACT FROM AUTHOR]

Introduction: Non-dissociative carpal instability (CIND) may lead to severe functional impairment. Destabilisation of the scapho-trapezial-trapezoidal (STT) ligament complex seems to result in a CIND. Materials and methods: In one group with eight cadaver arms, distal scaphoid pole was resected with the adjacent ligaments. In the other eight cadavers, hemitrapeziectomy was performed followed by total trapeziectomy. CT scans were performed in different wrist positions, and the changed positions of the scaphoid, lunate and capitate were measured in comparison to non-operated wrists. Results: Mainly in clenched fist position, dissociation between proximal and distal row can be determined after total trapeziectomy and resection of distal scaphoid pole. Capitate rotates dorsally up to 24°, the scaphoid up to 17° and the lunate up to 7° compared to the non-operated wrists. Resection of the distal scaphoid pole results in dorsal rotation of capitate and scaphoid of about 14° and the lunate 8°. Relative scapholunate and capitolunate angle increased significantly after total trapeziectomy, especially in clenched fist position. After scaphoid pole resection, significant SL and CL angles changes could be seen in almost every wrist position. Conclusion: Destabilisation of the STT ligament complex by total trapeziectomy or distal scaphoid pole resection results in dissociation of the proximal and distal carpal row without instability within the proximal or distal row, corresponding to a CIND. Level of evidence: III. [ABSTRACT FROM AUTHOR]

Robinson and Rogers (J Psychopathol Behav Assess 40(3):376–385, 2018) introduced an ADHD Dissimulation (Ds-ADHD) Scale for the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) that has not yet been clinically validated. The current study examined its utility among a sample of U.S. Veterans. The sample (n = 236) was separately divided according to Performance and Symptom Validity Tests. The relationships between the Ds-ADHD scale and other standard measures were also examined. The Ds-ADHD scale effectively classified cases according to both performance and symptom validity statuses, but the sensitivity was lower than was previously observed. While there was poor discrimination according to performance validity status, there was acceptable discrimination according to symptom validity status. The Ds-ADHD scale identified group status over and above the traditional MMPI-2-RF validity scales. Ds-ADHD scores from participants who produced credible performance were not significantly correlated with performance on a sustained attention test. Results provided limited support for the use of Ds-ADHD scale during neuropsychological evaluations in which there is a question about a potential adult ADHD diagnosis. [ABSTRACT FROM AUTHOR]

Intestinal microbiome dysbiosis is a known risk factor for recurrent kidney stone disease (KSD) with prior data suggesting a role for dysfunctional metabolic pathways other than those directly utilizing oxalate. To identify alternative mechanisms, the current study analyzed differences in the metabolic potential of intestinal microbiomes of patients (n = 17) and live-in controls (n = 17) and determined their relevance to increased risk for KSD using shotgun metagenomic sequencing. We found no differences in the abundance of genes associated with known oxalate degradation pathways, supporting the notion that dysfunction in other metabolic pathways plays a role in KSD. Further analysis showed decreased abundance of key enzymes involved in butyrate biosynthesis in patient intestinal microbiomes. Furthermore, de novo construction of microbial genomes showed that the majority of genes significantly enriched in non-stone formers are affiliated with Faecalibacterium prausnitzii, a major butyrate producer. Specifically pertaining to butyrate metabolism, the majority of abundant genes mapped back to F. prausnitzii, Alistipes spp., and Akkermansia muciniphila. No differences were observed in ascorbate or glyoxylate metabolic pathways. Collectively, these data suggest that impaired bacterial-associated butyrate metabolism may be an oxalate-independent mechanism that contributes to an increased risk for recurrent KSD. This indicates that the role of the intestinal microbiome in recurrent KSD is multi-factorial, which is representative of the highly intertwined metabolic nature of this complex environment. Future bacteria-based treatments must not be restricted to targeting only oxalate metabolism. [ABSTRACT FROM AUTHOR]

Medical digital twins are computational models of human biology relevant to a given medical condition, which are tailored to an individual patient, thereby predicting the course of disease and individualized treatments, an important goal of personalized medicine. The immune system, which has a central role in many diseases, is highly heterogeneous between individuals, and thus poses a major challenge for this technology. In February 2023, an international group of experts convened for two days to discuss these challenges related to immune digital twins. The group consisted of clinicians, immunologists, biologists, and mathematical modelers, representative of the interdisciplinary nature of medical digital twin development. A video recording of the entire event is available. This paper presents a synopsis of the discussions, brief descriptions of ongoing digital twin projects at different stages of progress. It also proposes a 5-year action plan for further developing this technology. The main recommendations are to identify and pursue a small number of promising use cases, to develop stimulation-specific assays of immune function in a clinical setting, and to develop a database of existing computational immune models, as well as advanced modeling technology and infrastructure. [ABSTRACT FROM AUTHOR]

The digitization of aircraft cockpits places high demands on the colour vision of pilots. The present study investigates colour vision changes upon acute exposure to hypobaric hypoxia. The digital Waggoner Computerized Color Vision Test and the Waggoner D-15 were performed by 54 healthy volunteers in a decompression chamber. Respective altitude levels were sea level, 10,000 or 15,000 ft for exposure periods of 15 and 60 min, respectively. As for 60 min of exposure a significant decrease in colour perception was found between subjects at 15,000 ft as compared to the control group as well as between subjects at 15,000 ft as compared to subjects at 10,000 ft. No significant difference was found in the comparison within the 15,000 ft groups across time points pre-, peri-, and post-exposure. Thus, pilots appear to experience only minor colour vision impairment up to an exposure altitude of 15,000 ft over 60 min of exposure. [ABSTRACT FROM AUTHOR]

This statement outlines a review of the literature and current practice concerning the prevalence, clinical significance, diagnosis and management of dyspnoea in critically ill, mechanically ventilated adult patients. It covers the definition, pathophysiology, epidemiology, short- and middle-term impact, detection and quantification, and prevention and treatment of dyspnoea. It represents a collaboration of the European Respiratory Society (ERS) and the European Society of Intensive Care Medicine (ESICM). Dyspnoea ranks among the most distressing experiences that human beings can endure. Approximately 40% of patients undergoing invasive mechanical ventilation in the intensive care unit (ICU) report dyspnoea, with an average intensity of 45 mm on a visual analogue scale from 0 to 100 mm. Although it shares many similarities with pain, dyspnoea can be far worse than pain in that it summons a primal fear response. As such, it merits universal and specific consideration. Dyspnoea must be identified, prevented and relieved in every patient. In the ICU, mechanically ventilated patients are at high risk of experiencing breathing difficulties because of their physiological status and, in some instances, because of mechanical ventilation itself. At the same time, mechanically ventilated patients have barriers to signalling their distress. Addressing this major clinical challenge mandates teaching and training, and involves ICU caregivers and patients. This is even more important because, as opposed to pain which has become a universal healthcare concern, very little attention has been paid to the identification and management of respiratory suffering in mechanically ventilated ICU patients. [ABSTRACT FROM AUTHOR]

Although substantial progress has been made in the pathophysiology and management of the post-thrombotic syndrome (PTS), several aspects still need clarification. Among them, the incidence and severity of PTS in the real world, the risk factors for its development, the value of patient's self-evaluation, and the ability to identify patients at risk for severe PTS. Eligible participants (n = 1107) with proximal deep-vein thrombosis (DVT) from the global GARFIELD-VTE registry underwent conventional physician's evaluation for PTS 36 months after diagnosis of their DVT using the Villalta score. In addition, 856 patients completed a Villalta questionnaire at 24 months. Variable selection was performed using stepwise algorithm, and predictors of severe PTS were incorporated into a multivariable risk model. The optimistic adjusted c-index was calculated using bootstrapping techniques. Over 36-months, 27.8% of patients developed incident PTS (mild in 18.7%, moderate in 5.7%, severe in 3.4%). Patients with incident PTS were older, had a lower prevalence of transient risk factors of DVT and a higher prevalence of persistent risk factors of DVT. Self-assessment of overall PTS at 24 months showed an agreement of 63.4% with respect to physician's evaluations at 36 months. The severe PTS multivariable model provided an optimistic adjusted c-index of 0.68 (95% CI 0.59–0.77). Approximately a quarter of DVT patients experienced PTS over 36 months after VTE diagnosis. Patient's self-assessment after 24 months provided added value for estimating incident PTS over 36 months. Multivariable risk analysis allowed good discrimination for severe PTS. [ABSTRACT FROM AUTHOR]