Search

The Hodgkin lymphoma International Study for Individual Care (HoLISTIC) Consortium's A-HIPI model, developed in 2022 for advanced-stage classical Hodgkin lymphoma (cHL), predicts survival within 5 years amongst newly diagnosed patients. This study validates its performance in the Brazilian Hodgkin lymphoma registry. By 2022, the Brazilian HL registry included 1357 cHL patients, with a median 5-year follow-up. Probabilities for 5-year progression-free survival (PFS) and overall survival (OS) were calculated using A-HIPI-model equations. Discrimination (Harrell C-statistic/Uno C-statistic) and calibration measures assessed external validation and calibration. Lab values beyond the allowed range were excluded, mirroring the initial A-HIPI analysis. A total of 694 advanced-stage cHL patients met the original inclusion criteria (age 18-65 years, Stage IIB-IV). Median age was 31 years; 46.3% were females. Stage distribution was IIB (33.1%), III (27.4%), IV (39.5%). Bulky disease in 32.6%. Five-year PFS and OS were 68.4% and 86.0%, respectively. Harrell C-statistics were 0.60 for PFS and 0.69 for OS, and Uno C-statistics were 0.63 for PFS and 0.72 for OS. Calibration plots demonstrated well-calibrated predictions with calibration slopes of 0.91 and 1.03 for 5-year OS and PFS, respectively. Despite differing patient, clinical characteristics, and socioeconomic factors, the baseline prediction tool performed well in the Brazilian cohort, demonstrating adequate discrimination and calibration. This supports its reliability in diverse settings., (© 2024 British Society for Haematology and John Wiley & Sons Ltd.)

Insects pose significant challenges in cotton‐producing regions. Here, they describe a high‐throughput CRISPR/Cas9‐mediated large‐scale mutagenesis library targeting endogenous insect‐resistance‐related genes in cotton. This library targeted 502 previously identified genes using 968 sgRNAs, generated ≈2000 T0 plants and achieved 97.29% genome editing with efficient heredity, reaching upto 84.78%. Several potential resistance‐related mutants (10% of 200 lines) their identified that may contribute to cotton‐insect molecular interaction. Among these, they selected 139 and 144 lines showing decreased resistance to pest infestation and targeting major latex‐like protein 423 (GhMLP423) for in‐depth study. Overexpression of GhMLP423 enhanced insect resistance by activating the plant systemic acquired resistance (SAR) of salicylic acid (SA) and pathogenesis‐related (PR) genes. This activation is induced by an elevation of cytosolic calcium [Ca2+]cyt flux eliciting reactive oxygen species (ROS), which their demoted in GhMLP423 knockout (CR) plants. Protein‐protein interaction assays revealed that GhMLP423 interacted with a human epidermal growth factor receptor substrate15 (EPS15) protein at the cell membrane. Together, they regulated the systemically propagating waves of Ca2+ and ROS, which in turn induced SAR. Collectively, this large‐scale mutagenesis library provides an efficient strategy for functional genomics research of polyploid plant species and serves as a solid platform for genetic engineering of insect resistance. [ABSTRACT FROM AUTHOR]

A family of transition metal complexes of meso‐aryl‐2‐aza‐21‐carbaporphyrin (N‐confused porphyrin, NCP) derivatives acting as ortho‐metallating ligands for ruthenium(II), rhodium(III), and iridium(III) is synthesized and characterized by XRD, spectroscopic, and electrochemical methods. The chirality of these systems is shown by the separation of the enantiomers and analyzed by circular dichroism and DFT. A preliminary catalytic study indicates the activity of the iridium(III) ortho‐metallated complexes in the N‐heterocyclization of primary amines with diols. [ABSTRACT FROM AUTHOR]

Subjective well‐being has been attracting a considerable amount of attention. Urban planning is expected to play a significant role in improving subjective well‐being. This study focuses on neighborhood environmental cognition as a new intervention target of urban planning and aims to clarify its association with subjective well‐being. We conducted surveys using the element‐recall method to assess neighborhood environmental cognition and the Subjective Well‐being Inventory. Data were collected from 104 respondents over 50 years old living in suburban area of Nara Prefecture, Japan. The results revealed the following: The ability to recall many or diverse elements is positively correlated with subjective well‐being. However, the spatial distribution of the recalled elements was not correlated with subjective well‐being. The components of subjective well‐being, positive affect and negative affect, have different relationships with neighborhood environmental cognition. Further, sex affects the association between negative affect and neighborhood environmental cognition. The ability to recall the elements that are not meant for daily visits is positively correlated with subjective well‐being. These findings suggest that, in addition to making cities walkable, creating places that are easy to be recognized and recalled by residents is also important. [ABSTRACT FROM AUTHOR]

Severe cutaneous adverse reactions to drugs (SCARs) are rare but life-threatening delayed allergies. While they primarily affect the skin, they can also affect internal organs. Accordingly, they present with diverse clinical symptoms that vary not only between SCARs subtypes but also among patients. Despite the availability of topical and systemic treatments, these only address the symptoms and not the cause. To develop more effective therapies, it is necessary to elucidate the complexity of the pathophysiology of SCARs in relation to their severity. In line with the new type IV hypersensitivity reactions nomenclature proposed by the European Academy of Allergy and Clinical Immunology (EAACI), this review highlights the current insights into the intricate immune mechanisms engaged, the interplay between the culprit drug and genetic predisposition in drug presentation mechanisms, but also how external factors, such as viruses, are implicated in SCARs. Their relevance to the development of targeted medicine is also discussed., (© 2024 The Author(s). Allergy published by European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd.)

Snow avalanches are thought to influence large wood dynamics within mountain streams, but studies that explicitly quantify their impact are minimal. In three headwater catchments of the Frying Pan River, Colorado, USA, we found that wood loads in stream reaches intersected by avalanche pathways ranged from 220 to 8,500 m3/ha and were significantly greater than in non‐avalanched reaches. Inter‐catchment differences in the number of avalanche occurrences were not reflected in control reach wood loads, suggesting that elevated loads may be restricted to the general vicinity of the avalanche pathway. However, the sizable wood volumes in avalanche reaches generated notable geomorphic impacts, indicating that avalanches can create hotspots of in‐stream geomorphic complexity and influence the overall habitat mosaic of the stream ecosystem. Loads in avalanche reaches were moreover significantly greater than literature values for similar streams and recruitment processes, emphasizing the importance of snow avalanches as a wood recruitment mechanism. Plain Language Summary: Snow avalanches are thought to contribute downed, dead wood to mountain streams, but the volume and mobility of supplied wood is unknown. Because downed wood is important for many stream processes (such as habitat creation and sediment storage), an increased understanding of the importance of avalanches for wood supply has notable implications for management of mountain watersheds and their ecosystems. Here we study several streams within the Frying Pan River Basin in Colorado, USA, where avalanche paths commonly intersect the streams that flow along steep mountain valley bottoms. We find that the volume of wood within the length of stream intersected by snow avalanches that occurred in Winter 2019 is substantially greater than the wood volumes outside those reaches. We additionally discover that in‐stream wood volumes within the avalanche areas in this study are significantly greater than values reported by other studies for similar streams and recruitment processes. Overall, our work further emphasizes that avalanches are important suppliers of wood to mountain streams and calls for future studies to continue to expand understanding of how snow avalanches impact mountain stream ecosystems. Key Points: In‐stream wood loads supplied by avalanches are on the order of 102–103 m3/ha within avalanche‐impacted reachesAvalanche‐derived wood may have low mobility but generate hotspots of geomorphic complexityLoads in avalanche reaches are significantly larger than literature values for comparable streams and recruitment mechanisms [ABSTRACT FROM AUTHOR]

Background: Tumor‐induced osteomalacia (TIO) belongs to a rare disease of the paraneoplastic syndrome. Phosphate uric mesenchymal tumor (PMT) is the most common cause of TIO, while the possibility of other tumors cannot be excluded. Case presentation: We present a case of a 36‐year‐old female patient with systemic skeletal abnormalities. The woman complained of low back pain with mild motor dysfunction for 2 years. Laboratory examination showed abnormalities in markers of bone metabolism, parathyroid hormone (PTH), vitamin D and serum phosphorus. Pooled imaging examination indicated extension abnormalities in the skeletal system and a single lesion in the right femoral head. The lesion of the right femoral was imaging with somatostatin receptor‐positive, which was highly suggestive of a single neuroendocrine tumor. CT guided right femoral tumorectomy and bone grafting were performed when medical treatment failed. Postoperative pathological diagnosis was phosphate urinary mesenchymal tumor secreting fibroblast growth factor 23 (FGF23), which accorded with pre‐operative expectations. The postoperative symptoms were effectively relieved, and indicators returned to normal. Conclusion: The tumors causing TIO exhibited significant heterogeneity in terms of tissue origin, pathological characteristics and biological behavior, but the unique common characteristic is the secretion of FGF23. With significant progress in diagnosis and treatment, the clinical follow‐up of most TIO patients shows a good prognosis, but the prognosis of those with malignant tumors is relatively poor. [ABSTRACT FROM AUTHOR]

Background: In humans, lung congestion scores are predictive of recurrence of acute congestive heart failure (CHF) and are superior to cardiac biomarkers in predicting survival. Objectives: The primary aim of this retrospective study was to determine if a modified lung congestion score (LCS) in dogs diagnosed with acute CHF because of myxomatous mitral valve disease was associated with time until recurrence or death. Animals: Complete medical records were available for a total of 94 dogs between 2010 and 2019, but only 35 dogs fulfilled the criteria for inclusion. Methods: This retrospective study used descriptive statistics to describe the cumulative and corrected LCS. Correlations were used to examine the association of the corrected LCS and time until recurrence or death, selected echocardiographic variables, and timing of furosemide administration. Results: The mean LCS was 8.4 (SD 3.3) and corrected LCS was 0.48 (SD 0.19). The pattern was predominantly symmetric (40% of dogs) and focal (caudal) but more commonly right‐sided when asymmetric (40% vs 20%). The median number of days after initial diagnosis of acute CHF to readmission and death was 150 days (range 4‐572), and 266 days (range 5‐965), respectively. No significant association between the dog's corrected LCS and number of days until readmission (r =.173, P =.42) nor survival (r =.109, P =.56) was found. There was a negative significant correlation (r = −.71, P <.001) between the time interval of furosemide administration and corrected LCS. [ABSTRACT FROM AUTHOR]

An obituary for professor emeritus Gunnar Harling is presented.

Venous thromboembolism (VTE) is often associated with malignant diseases and notably contributes to morbidity and mortality in patients with cancer. Cancer‐associated thrombosis (CAT) brings additional costs to health expenditures and has a negative impact on oncological outcomes. Either the recurrence rate of VTE or bleeding complications are also higher in patients with cancer. Prophylactic anticoagulation has been recommended in peri‐surgical periods, inpatient settings, and high‐risk ambulatory patients. Although various risk stratification scores are used, none are ideal for identifying patients who can benefit from anticoagulant prophylaxis. New risk scoring systems or biomarkers are needed to identify patients who are more likely to benefit from prophylaxis with low bleeding risk. The questions about the patients who will be given prophylaxis and those who develop thromboembolism, with which drug, and how long they will be treated are still not fully answered. Anticoagulation is the cornerstone of the treatment, but management of CAT remains complex. Low molecular weight heparins and direct oral anticoagulants are effective and safe options for the treatment of CAT. Recognizing adverse effects, drug–drug interactions, and accompanying conditions that cause dose adjustment is crucial. Prevention and treatment of VTE in patients with cancer require a multidisciplinary and patient‐based approach. Plain Language Summary: Cancer‐associated thrombosis is a significant cause of mortality and morbidity in patients with cancer.Chemotherapy, surgery, and/or use of central venous access remarkably increase the risk of thrombosis.Prophylactic anticoagulation should be considered not only in inpatient follow‐up and during peri‐surgical period but also ambulatory patients with a high risk of thrombosis.Many parameters, such as drug–drug interactions, primary side of cancer, and comorbidities of patients should be considered when selecting anticoagulant drugs.More accurate risk stratification scores or biomarkers are still an unmet need. Cancer‐associated thrombosis is a serious and common complication of cancer. This study offers important insights into the management of cancer‐associated thrombosis and the potential drug–drug interactions that can arise when using antithrombotic and antineoplastic agents. [ABSTRACT FROM AUTHOR]

Aims: Cardiac decompensation in aortic stenosis (AS) involves extra‐valvular cardiac damage and progressive fluid overload (FO). FO can be objectively quantified using bioimpedance spectroscopy. We aimed to assess the prognostic value of FO beyond established damage markers to guide risk stratification. Methods and results: Consecutive patients with severe AS scheduled for transcatheter aortic valve implantation (TAVI) underwent prospective risk assessment with bioimpedance spectroscopy (BIS) and echocardiography. FO by BIS was defined as ≥1.0 L (0.0 L = euvolaemia). The extent of cardiac damage was assessed by echocardiography according to an established staging classification. Right‐sided cardiac damage (rCD) was defined as pulmonary vasculature/tricuspid/right ventricular damage. Hospitalization for heart failure (HHF) and/or death served as primary endpoint. In total, 880 patients (81 ± 7 years, 47% female) undergoing TAVI were included and 360 (41%) had FO. Clinical examination in patients with FO was unremarkable for congestion signs in >50%. A quarter had FO but no rCD (FO+/rCD−). FO+/rCD+ had the highest damage markers, including N‐terminal pro‐B‐type natriuretic peptide (NT‐proBNP) levels. After 2.4 ± 1.0 years of follow‐up, 236 patients (27%) had reached the primary endpoint (29 HHF, 194 deaths, 13 both). Quantitatively, every 1.0 L increase in bioimpedance was associated with a 13% increase in event hazard (adjusted hazard ratio 1.13, 95% confidence interval 1.06–1.22, p < 0.001). FO provided incremental prognostic value to traditional risk markers (NT‐proBNP, EuroSCORE II, damage on echocardiography). Stratification according to FO and rCD yielded worse outcomes for FO+/rCD+ and FO+/rCD−, but not FO−/rCD+, compared to FO−/rCD−. Conclusion: Quantitative FO in patients with severe AS improves risk prediction of worse post‐interventional outcomes compared to traditional risk assessment. [ABSTRACT FROM AUTHOR]

Background: Ex vivo lung perfusion (EVLP) is a method for the evaluation and reconditioning of high‐risk donor lungs to increase the pool of potential donor lungs. Methods: We reviewed all consecutive patients who received lung transplants from May 2012 to May 2017 with follow‐up until July 2021. EVLP was used in lungs initially rejected due to inadequate oxygenation but without other contraindications. Lungs with improved oxygenation levels above the threshold were transplanted. The primary endpoint was the time to graft failure, which was defined as the time from surgery to death or re‐transplantation, whichever occurred first. The secondary outcome was freedom from chronic lung allograft dysfunction. Results: A total of 157 patients underwent transplantation during the study period. Thirty‐nine patients received EVLP‐treated donor lungs. Restricted mean graft survival time up to 7 years is 5.14 years for non‐EVLP and 4.19 for EVLP, the difference being −0.95 (confidence interval [CI]—1.93 to 0.04, p =.059). The hazard ratio is 1.66 (CI 1.00–2.75, p =.046). Chronic lung allograft dysfunction was the highest contributor to mortality in both groups. There were significant differences in freedom from chronic lung allograft dysfunction at 12 and 24 months of follow‐up (p =.005 and p =.030, respectively). Subgroup analyses revealed that the first patients who received EVLP in 2012–2013 had a substantially worse 5‐year graft survival than those who received EVLP more recently in 2016–2017 (14.3% vs. 60.0%). For the latter, the 5‐year graft survival was observed to be remarkably close to the non‐EVLP group (60.8%). Conclusion: Long‐term survival was significantly lower, and lung function was poorer among recipients in the EVLP group than in the non‐EVLP group. However, the outcome of patients who received EVLP‐treated lungs was observed to improve steadily after the first 2 years after EVLP was introduced in Denmark. [ABSTRACT FROM AUTHOR]

Bambusoideae is a taxon of mass‐flowering monocarpic perennials with a long life cycle. Forest ecosystems are affected by Bambusoideae seeding and death events in various ways, including an increased abundance of Apodemus spp. The utilization and preference of dwarf bamboo seeds over tree seeds by field mice remain elusive. Therefore, we aimed to determine whether field mice prefer dwarf bamboo to tree seeds. We examined one dwarf bamboo species (Sasa borealis) against four tree species with varying acorn/fruit traits (Castanea crenata, Quercus crispula, Fagus crenata, and Lindera triloba). The seeds were placed in a container in a forest among dead S. borealis culms, with an automatic camera monitoring the setup. The examined seeds were mainly foraged by two field mouse species, Apodemus speciosus and Apodemus argenteus, with preference in the following order: C. crenata, L. triloba, S. borealis, F. crenata, and Q. crispula. Our findings indicated that during S. borealis mast seeding years, predation pressure on F. crenata and Q. crispula seeds could be considerably reduced. This suggests that mast seeding might disrupt the normal pattern of survival, and seed dispersal patterns, potentially altering the forest vegetation composition. [ABSTRACT FROM AUTHOR]

Objective: This study was undertaken to develop a multimodal machine learning (ML) approach for predicting incident depression in adults with epilepsy. Methods: We randomly selected 200 patients from the Calgary Comprehensive Epilepsy Program registry and linked their registry‐based clinical data to their first‐available clinical electroencephalogram (EEG) and magnetic resonance imaging (MRI) study. We excluded patients with a clinical or Neurological Disorders Depression Inventory for Epilepsy (NDDI‐E)‐based diagnosis of major depression at baseline. The NDDI‐E was used to detect incident depression over a median of 2.4 years of follow‐up (interquartile range [IQR] = 1.5–3.3 years). A ReliefF algorithm was applied to clinical as well as quantitative EEG and MRI parameters for feature selection. Six ML algorithms were trained and tested using stratified threefold cross‐validation. Multiple metrics were used to assess model performances. Results: Of 200 patients, 150 had EEG and MRI data of sufficient quality for ML, of whom 59 were excluded due to prevalent depression. Therefore, 91 patients (41 women) were included, with a median age of 29 (IQR = 22–44) years. A total of 42 features were selected by ReliefF, none of which was a quantitative MRI or EEG variable. All models had a sensitivity > 80%, and five of six had an F1 score ≥.72. A multilayer perceptron model had the highest F1 score (median =.74, IQR =.71–.78) and sensitivity (84.3%). Median area under the receiver operating characteristic curve and normalized Matthews correlation coefficient were.70 (IQR =.64–.78) and.57 (IQR =.50–.65), respectively. Significance: Multimodal ML using baseline features can predict incident depression in this population. Our pilot models demonstrated high accuracy for depression prediction. However, overall performance and calibration can be improved. This model has promise for identifying those at risk for incident depression during follow‐up, although efforts to refine it in larger populations along with external validation are required. [ABSTRACT FROM AUTHOR]

A 37-year-old man with Crohn's disease (CD) and a history of abdominal surgery was diagnosed with anal canal cancer. Robot-assisted laparoscopic abdominoperineal resection was performed and the patient was discharged without any postoperative complications. Recently, minimally invasive surgery for CD patients has grown in popularity. However, there have been few studies of robotic surgery for CD patients with anal canal cancer. To the best of our knowledge, we present the first report of a patient with CD-associated anal canal cancer who underwent robot-assisted laparoscopic abdominoperineal resection. [ABSTRACT FROM AUTHOR]

Background: Genetic testing can identify cancer risk early, enabling prevention and early detection. We describe use of risk management interventions following genetic testing in the Cancer Health Assessment Reaching Many (CHARM) study. CHARM assessed risk and provided genetic testing to low income, low literacy, and other underserved populations that historically face barriers to accessing cancer genetic services. Methods: CHARM was implemented in Kaiser Permanente Northwest (KPNW) and Denver Health (DH) between 2018 and 2020. We identified post‐testing screening (mammography, breast MRI, colonoscopy) and surgical (mastectomy, oophorectomy) procedures using electronic health records. We examined utilization in participants who did and did not receive actionable risk management recommendations from study genetic counselors following national guidelines. Results: CHARM participants were followed for an average of 15.4 months (range: 0.4–27.8 months) after results disclosure. Less than 2% (11/680) received actionable risk management recommendations (i.e., could be completed in the initial years following testing) based on their test result. Among those who received actionable recommendations, risk management utilization was moderate (54.5%, 6/11 completed any procedure) and varied by procedure (mammogram: 0/3; MRI: 2/4; colonoscopy: 4/5; mastectomy: 1/5; oophorectomy: 0/3). Cancer screening and surgery procedures were rare in participants without actionable recommendations. Conclusion: Though the number of participants who received actionable risk management recommendations was small, our results suggest that implementing CHARM's risk assessment and testing model increased access to evidence‐based genetic services and provided opportunities for patients to engage in recommended preventive care, without encouraging risk management overuse. [ABSTRACT FROM AUTHOR]

Conjugate addition of ethanol and subsequent oxidation with [bis (trifluoroacetoxy)iodo]benzene (PIFA) allowed for the inner ethoxylation of 3‐oxo‐N‐confused tetraphenylporphyrin (ONCP). First oxidation of ONCP with PIFA followed by treatment with ethanol gave two more N‐confused phlorins derivatives 5 and 6. [ABSTRACT FROM AUTHOR]

1,3‐butadiene is widely used as a raw material in the synthesis of rubber and automobile tires. In this study, machine learning models were utilized to predict the performance of catalysts in the oxidative dehydrogenation of n‐butane to 1,3‐butadiene., The datasets consisted of 304 data points generated from experiments conducted in a fixed‐bed reactor in the temperature range of 400– 500 °C and O2/C4 molar feed ratio of 1–4 mol/mol, using metal oxides of Nickel (Ni), Iron (Fe), Cobalt (Co), Bismuth (Bi), Molybdenum (Mo), Manganese (Mn) and Tungsten (W) supported on gamma alumina catalysts. Repeated 10‐fold cross‐validation was used, with 70 % of the datasets randomly selected for training and optimizing the models, whereas the remaining 30 % were used for testing the models. Among the various models examined, support vector machine with radial basis function (SVMR) model had the best coefficient of determination (R2) performance for the n‐butane conversion (training set: 98.3 % vs. test set: 88.3 %) and 1,3‐butadiene selectivity (training set: 94.0 % vs. test set: 88.6 %). In addition, the models had the lowest training and test mean absolute errors (MAE) and root mean square errors (RMSE). This study highlights the notable role of machine learning algorithms in enhancing the prediction of n‐butane oxidative dehydrogenation catalyst performance, thus promoting the development of more effective catalyst designs that exhibit high activity and selectivity, contributing positively to the field of heterogeneous catalysis. Notably, a user‐friendly application incorporating the developed machine learning models was developed, providing an invaluable tool for the real‐time on‐site prediction of catalyst performance in the oxidative dehydrogenation of n‐butane to 1,3‐butadiene. This application is a significant advancement, facilitating swift and accurate catalyst performance prediction, fostering more efficient catalyst design, streamlining, and revolutionizing the rubber and automobile tire synthesis industries. [ABSTRACT FROM AUTHOR]

Organic molecules with fluoroalkylene scaffolds, especially a tetrafluoroethylene (CF2CF2) moiety, in their molecular structures exhibit unique biological activities, or can be applied to functional materials such as liquid crystals and light‐emitting materials. Although several methods for the syntheses of CF2CF2‐containing organic molecules have been reported to date, they have been limited to methods using explosives and fluorinating agents. Therefore, there is an urgent need to develop simple and efficient approaches to synthesize CF2CF2‐containing organic molecules from readily available fluorinated substrates using carbon‐carbon bond formation reactions. This personal account summarizes the simple and efficient transformation of functional groups at both ends of 4‐bromo‐3,3,4,4‐tetrafluorobut‐1‐ene and discusses its synthetic applications to biologically active fluorinated sugars and functional materials, such as liquid crystals and light‐emitting molecules. [ABSTRACT FROM AUTHOR]

The growth rates of freshwater fish are known to change among populations under different habitat conditions. The Amur three‐lips (Opsariichthys uncirostris uncirostris), a cyprinid predator, is an endemic subspecies in the Lake Biwa–Yodogawa River system and Lake Mikata in western Japan but has also been unintentionally introduced into nonindigenous regions. Non‐native populations are known to have downsized owing to their adaptation to small habitats; however, only two habitats with substantially different sizes have been assessed previously. Therefore, in this study, native and non‐native Amur three‐lips populations were assessed, and their growth rates associated with population type (i.e., native/non‐native), habitat size, and sample period (i.e., in the 1960s or after the 2000s) were analyzed statistically. According to a literature search, seven previous studies reported the growth of this species and included mean length‐at‐age data (measured as body length with estimated age using otolith reading). They included three cases from the largest native habitat, Lake Biwa from different sample periods. The result of the multivariate analysis indicated that the growth rate of Amur three‐lips was higher in native populations than in non‐native populations and increased as habitat size increased. In addition, a model selection approach indicated that population type was a more influential covariate than habitat size. These findings suggest that Amur three‐lips exhibit "home‐field advantage" in terms of growth rate, that is, native populations grow larger than non‐native populations. Future studies conducted on a larger geographic scale will provide further insights into the adaptation of Amur three‐lips under various habitat conditions. [ABSTRACT FROM AUTHOR]

Background: Men who have sex with men (MSM) are at high risk for oral human papillomavirus (HPV infection). There are no specific screening guidelines to facilitate the identification of people at risk for oral HPV infection. We aimed to estimate the prevalence of oral high‐risk HPV and create a risk score to identify MSM at higher risk for prevalent oral HPV. Methods: We collected baseline data from a clinical trial from a subsample of 500 MSM attending sexually transmitted disease treatment clinics; they provided an oral gargle sample for high‐risk HPV detection. We calculated oral high‐risk HPV prevalence and 95% confidence intervals (CIs), used a logistic regression model to identify factors associated with high‐risk HPV infection, and created a risk score. Results: The prevalence of any oral high‐risk HPV among MSM was 11.1% (95% CI: 8.6–14.2), with a higher prevalence observed among men living with HIV (14.8%). Factors independently associated with oral high‐risk HPV were age ≥40 years (OR = 2.71, 95% CI: 1.28–5.73 compared to <40 years), being HIV‐positive with CD4 count 200–499 (OR = 2.76, 95% CI: 1.34–5.65 compared to HIV‐negative), and recent recreational use of vasodilators (poppers/sildenafil) (OR = 2.02, 95% CI: 1.02–2.97). The risk score had good discriminatory power (AUC = 0.70, 95% CI: 0.63–0.77). Conclusions: MSM have specific predictors for prevalent oral high‐risk HPV, and a risk score could be used by clinicians to target men with vaccine recommendations and counseling, and identify those who could benefit from primary interventions given the available resources, or for referral to dental services for follow‐up when available. [ABSTRACT FROM AUTHOR]

Background: Administration of vancomycin as a continuous infusion has been associated with reduced nephrotoxicity. Given limited published experience with continuous infusion vancomycin in outpatient parenteral antimicrobial therapy (OPAT) programs, we reviewed outcomes from our center. Methods: This was a retrospective, single‐center study of adult patients receiving vancomycin OPAT as continuous or intermittent infusion for an intended treatment duration of at least 7 days. The primary outcome was time to nephrotoxicity with continuous versus intermittent infusion vancomycin while on OPAT; additional outcomes included time to any vancomycin‐associated adverse event, time to 60‐day death or readmission, and time to 60‐day emergency department encounter. Proportional hazards modeling was used to identify variables independently associated with outcomes, as well as assess the strength of association of continuous infusion with each outcome. Results: Four‐hundred ninety‐two patients were included: 118 treated with continuous and 374 with intermittent vancomycin infusion. Continuous infusion was not associated with lower rates of nephrotoxicity compared to intermittent infusion (adjusted hazard ratio (aHR) 0.72, 95% CI: 0.35–1.50). There were no advantages of continuous over intermittent infusion in the rates of any adverse event (aHR 0.93, 95% CI: 0.56–1.53), 60‐day death or readmission (aHR 1.04, 95% CI: 0.68–1.61), or 60‐day emergency department encounter (aHR 1.17, 95% CI: 0.68–1.99). Vancomycin area under the concentration‐time curve (AUC) at discharge was the only modifiable factor identified that was independently associated with patient safety outcomes. Conclusion: There was no appreciable benefit of continuous infusion vancomycin on outpatient safety outcomes. AUC‐centered dosing approaches warrant further investigation as strategies to improve vancomycin safety in OPAT programs. [ABSTRACT FROM AUTHOR]

Information regarding the food habits of tropical cervids is limited. We studied the food habits of rusa deer (Rusa timorensis), a tropical cervid in the Pangandaran Nature Reserve, West Java, Indonesia. The faecal composition of the rusa deer collected over a year was analysed using microscopy of plant fragments. The results showed marked seasonal changes: in the rainy season, the rusa deer mainly fed on Cynodon dactylon, a lawn‐like grass, which accounted for approximately 50% of the faecal composition. During the dry season, C. dactylon in the faeces decreased to approximately 20%, while the composition of fruits increased, suggesting that food conditions for the deer were better in this season. This pattern differs from that of temperate cervids which can feed on abundant plant leaves during summer but are forced to consume low‐quality foods such as bark and dead leaves during winter. [ABSTRACT FROM AUTHOR]

Background: Obesity (body mass index [BMI] ≥30 kg/m2) is an important epidemiological risk factor for developing acute myeloid leukemia (AML). Therefore, the authors studied the association of obesity with clinical and genetic phenotype and its impact on outcome in adults with AML. Methods: The authors analyzed BMI in 1088 adults who were receiving intensive remission induction and consolidation therapy in two prospective, randomized therapeutic clinical trials of the Eastern Cooperative Oncology Group‐American College of Radiology Imaging Network: E1900 (ClinicalTrials.gov identifier NCT00049517; patients younger than 60 years) and E3999 (ClinicalTrials.gov identifier NCT00046930; patients aged 60 years or older). Results: Obesity was prevalent at diagnosis (33%) and, compared with nonobesity, was associated with intermediate‐risk cytogenetics group (p =.008), poorer performance status (p =.01), and a trend toward older age (p =.06). Obesity was not associated with somatic mutations among a selected 18‐gene panel that was tested in a subset of younger patients. Obesity was not associated with clinical outcome (including complete remission, early death, or overall survival), and the authors did not identify any patient subgroup that had inferior outcomes based on BMI. Obese patients were significantly more likely to receive <90% of the intended daunorubicin dose despite protocol specification, particularly in the E1900 high‐dose (90 mg/m2) daunorubicin arm (p =.002); however, this did not correlate with inferior overall survival on multivariate analysis (hazard ratio, 1.39; 95% confidence interval, 0.90–2.13; p =.14). Conclusions: Obesity is associated with unique clinical and disease‐related phenotypic features in AML and may influence physician treatment decisions regarding daunorubicin dosing. However, the current study demonstrates that obesity is not a factor in survival, and strict adherence to body surface area‐based dosing is not necessary because dose adjustments do not affect outcomes. Obesity is prevalent in adults with acute myeloid leukemia, and these patients are more likely to have intermediate‐risk cytogenetics and worse performance status; however, obesity does not affect clinical outcomes, including complete remission, early death, or overall survival. Dose modifications of daunorubicin (dose reductions and dose capping) in obese patients does not affect clinical outcomes; therefore, strict adherence to the full dose based on body surface area is not required for intensive therapy in adults with acute myeloid leukemia. [ABSTRACT FROM AUTHOR]

Objectives: Heart failure exacerbations are a common cause of hospitalizations with a high readmission rate. There are few validated predictors of readmission after treatment for acute decompensated heart failure (ADHF). Lung ultrasound (LUS) is sensitive and specific in the assessment of pulmonary congestion; however, it is not frequently utilized to assess for congestion before discharge. This study assessed the association between number of B‐lines, on LUS, at patient discharge and risk of 30‐day readmission in patients hospitalized for acute decompensated heart failure (ADHF). Methods: This was a single‐center prospective study of adults admitted to a quaternary care center with a diagnosis of ADHF. At the time of discharge, the patient received an 8‐zone LUS exam to evaluate for the presence of B‐lines. A zone was considered positive if ≥3 B‐lines was present. We assessed the risk of 30‐day readmission associated with the number of lung zones positive for B‐lines using a log‐binomial regression model. Results: Based on data from 200 patients, the risk of 30‐day readmission in patients with 2–3 positive lung zones was 1.25 times higher (95% CI: 1.08–1.45), and in patients with 4–8 positive lung zones was 1.50 times higher (95% CI: 1.23–1.82, compared with patients with 0–1 positive zones, after adjusting for discharge blood urea nitrogen, creatinine, and hemoglobin. Conclusion: Among patients admitted with ADHF, the presence of B‐lines at discharge was associated with a significantly increased risk of 30‐day readmission, with greater number of lung zones positive for B‐lines corresponding to higher risk. [ABSTRACT FROM AUTHOR]

For multicenter randomized trials or multilevel observational studies, the Cox regression model has long been the primary approach to study the effects of covariates on time‐to‐event outcomes. A critical assumption of the Cox model is the proportionality of the hazard functions for modeled covariates, violations of which can result in ambiguous interpretations of the hazard ratio estimates. To address this issue, the restricted mean survival time (RMST), defined as the mean survival time up to a fixed time in a target population, has been recommended as a model‐free target parameter. In this article, we generalize the RMST regression model to clustered data by directly modeling the RMST as a continuous function of restriction times with covariates while properly accounting for within‐cluster correlations to achieve valid inference. The proposed method estimates regression coefficients via weighted generalized estimating equations, coupled with a cluster‐robust sandwich variance estimator to achieve asymptotically valid inference with a sufficient number of clusters. In small‐sample scenarios where a limited number of clusters are available, however, the proposed sandwich variance estimator can exhibit negative bias in capturing the variability of regression coefficient estimates. To overcome this limitation, we further propose and examine bias‐corrected sandwich variance estimators to reduce the negative bias of the cluster‐robust sandwich variance estimator. We study the finite‐sample operating characteristics of proposed methods through simulations and reanalyze two multicenter randomized trials. [ABSTRACT FROM AUTHOR]

With big data becoming widely available in healthcare, machine learning algorithms such as random forest (RF) that ignores time‐to‐event information and random survival forest (RSF) that handles right‐censored data are used for individual risk prediction alternatively to the Cox proportional hazards (Cox‐PH) model. We aimed to systematically compare RF and RSF with Cox‐PH. RSF with three split criteria [log‐rank (RSF‐LR), log‐rank score (RSF‐LRS), maximally selected rank statistics (RSF‐MSR)]; RF, Cox‐PH, and Cox‐PH with splines (Cox‐S) were evaluated through a simulation study based on real data. One hundred eighty scenarios were investigated assuming different associations between the predictors and the outcome (linear/linear and interactions/nonlinear/nonlinear and interactions), training sample sizes (500/1000/5000), censoring rates (50%/75%/93%), hazard functions (increasing/decreasing/constant), and number of predictors (seven, 15 including noise variables). Methods' performance was evaluated with time‐dependent area under curve and integrated Brier score. In all scenarios, RF had the worst performance. In scenarios with a low number of events (⩽70), Cox‐PH was at least noninferior to RSF, whereas under linearity assumption it outperformed RSF. Under the presence of interactions, RSF performed better than Cox‐PH as the number of events increased whereas Cox‐S reached at least similar performance with RSF under nonlinear effects. RSF‐LRS performed slightly worse than RSF‐LR and RSF‐MSR when including noise variables and interaction effects. When applied to real data, models incorporating survival time performed better. Although RSF algorithms are a promising alternative to conventional Cox‐PH as data complexity increases, they require a higher number of events for training. In time‐to‐event analysis, algorithms that consider survival time should be used. [ABSTRACT FROM AUTHOR]

We use the five landscape ecology metrics of aggregation index, percentage of like adjacencies, interspersion and juxtaposition index, patch density, and Shannon's evenness index to assess spatial heterogeneity at 15 floodplains in the continental United States. Assessments are based on floodplain classes and patches delineated remotely using topography and vegetation. Floodplain reaches examined here represent diverse drainage areas, flow regimes, valley geometries, channel planforms, and biomes. We selected sites with minimal direct human alteration. Our objectives are to quantify floodplain spatial heterogeneity; evaluate whether statistically significant patterns are present; and interpret the statistical analyses with respect to the influence of lateral channel mobility and valley‐floor space available. We develop a conceptual model of the influences on lateral mobility and space available, and then test specific hypotheses derived from this conceptual model. These natural floodplains have a median aggregation index of 58.8%, median percentage of like adjacencies of 58.5%, median interspersion and juxtaposition index of 74.9%, median density of 1,241 patches/ha, and median Shannon's evenness index of 0.934 (n = 15). In other words, natural floodplains have moderate aggregation of classes, high evenness and intermixing of classes, and a wide range of patch densities. Drainage area, the ratio of floodplain/channel width, elevation, precipitation, total sinuosity, large wood volume, planform, and flow regime emerge as important variables to floodplain heterogeneity. These results highlight the influence of biotic‐abiotic interactions in shaping floodplain heterogeneity across diverse river corridors. Plain Language Summary: As river channels move across their valley floors, they create diverse topography including natural levees, cutoff meanders, secondary channels, and floodplain wetlands. These features increase the spatial variability of the floodplain. Many studies indicate that this variability strongly influences habitat abundance and diversity, storage of flood waters and excess nitrate or phosphate, and other floodplain functions. However, no one has systematically measured floodplain variability across multiple rivers and different geographic regions. We measured the variability of natural floodplains at 15 sites in the continental United States using metrics developed by landscape ecologists. We find that natural floodplains have distinctive variability signatures that relate to drainage area, the size of the floodplain, and other characteristics. Key Points: Natural floodplains have moderate aggregation of classes, high evenness and intermixing of classes, and a wide range of patch densitiesFloodplain heterogeneity reflects space available on the valley floor and lateral channel mobility [ABSTRACT FROM AUTHOR]

Age is an essential trait for understanding the ecology and management of wildlife. A conventional method of estimating age in wild animals is counting annuli formed in the cementum of teeth. This method has been used in bears despite some disadvantages, such as high invasiveness and the requirement for experienced observers. In this study, we established a novel age estimation method based on DNA methylation levels using blood collected from 49 brown bears of known ages living in both captivity and the wild. We performed bisulfite pyrosequencing and obtained methylation levels at 39 cytosine‐phosphate‐guanine (CpG) sites adjacent to 12 genes. The methylation levels of CpGs adjacent to four genes showed a significant correlation with age. The best model was based on DNA methylation levels at just four CpG sites adjacent to a single gene, SLC12A5, and it had high accuracy with a mean absolute error of 1.3 years and median absolute error of 1.0 year after leave‐one‐out cross‐validation. This model represents the first epigenetic method of age estimation in brown bears, which provides benefits over tooth‐based methods, including high accuracy, less invasiveness, and a simple procedure. Our model has the potential for application to other bear species, which will greatly improve ecological research, conservation, and management. [ABSTRACT FROM AUTHOR]

The reproductive characteristics of understory bamboo and the effects of dieback on overstory tree seedlings through temporal changes in the environment at the forest floor have only been examined in a few bamboo species, due to the unpredictable occurrence of flowering events and long intervals between them but provide valuable information on tree regeneration and succession in a forest with dense dwarf bamboo cover.We investigated environmental conditions and assessed seedlings (< 30‐cm tall) of the dwarf bamboo Sasa borealis and overstory tree species at 44–50 measurement points during 2016–2021, which included a S. borealis mass flowering event in 2017. We also conducted seed germination tests to determine germination rates and patterns in S. borealis. Environmental factors affecting seedling recruitment of S. borealis and of overstory trees were analysed using spatiotemporal generalized linear mixed models in the Bayesian framework.We observed gradual temporal changes in the environment, including increasing canopy openness and decreasing maximum height of dead S. borealis culms. The seeds germinated slowly and the emergence of current‐year S. borealis seedlings peaked in spring–summer in 2019. The tree seedling density after 2019 increased significantly compared to that before the dieback. The model results suggest that tree seedling establishment was enhanced by increased light availability.Continuous field observation beginning before S. borealis dieback revealed gradually enhanced tree recruitment in response to slow decay of the remaining dead culms and slow recovery of S. borealis. The seedling regeneration pattern of understory bamboo partly contributes to a prolonged opportunity for overstory tree regeneration. [ABSTRACT FROM AUTHOR]

Serologic biomarker to predict clinical outcome is needed for immune checkpoint inhibitors (ICIs). We evaluated soluble intercellular adhesion molecules‐1 (sICAM‐1) as a predictor of response to ICIs treatment. Ninety‐five patients with cancer treated with ICI were studied. The serum sICAM‐1 levels of baseline, post two cycle therapy and end of therapy (EOT) were measured by enzyme‐linked immunoassay. We randomly assigned the patients into the primary cohort (n = 47) and validation cohort (n = 48). Serum sICAM‐1 post two cycle (277.7 ± 181.6 ng/mL) and EOT (403.9 ± 218.9 ng/mL) were significantly elevated compared to baseline (244.8 ± 153.8 ng/mL, p = 0.008 and p = 0.004, respectively). Early changes of sICAM‐1 (ΔsICAM‐1), deemed as sICAM‐1 after two cycles minus baseline, were assessed. Following ICI treatments, responders had significantly lower ΔsICAM‐1 compared with nonresponders in the primary cohort (p = 0.040) and the validation cohort (p = 0.026). High ΔsICAM‐1 was strongly associated with inferior progression‐free survival (PFS; (primary cohort: p = 0.001 and validation cohort: p = 0.002) and overall survival (OS; (primary cohort: p < 0.001 and validation cohort: p = 0.007). The ΔsICAM‐1 remained independently associated with worse PFS and OS in the primary cohort and the validation cohort. Subgroup analysis indicated patients whose sICAM‐1 significantly elevated had shorter PFS and OS in both anti‐PD‐1 and anti‐PD‐L1 treatment groups. Early change of serum sICAM‐1 could be used to monitor and predict clinical benefit of ICI therapy in patients with solid cancer. [ABSTRACT FROM AUTHOR]

A bidirectional rocking isolation bearing system (Bi‐RIBS) is proposed to provide seismic protection for bridge structures. By using the 3‐D rocking motion of the Bi‐RIBS, this system acts as a mechanical fuse to limit the maximum force transmitted to the bridge piers and as a restoring component to control an excessive girder response. Possible applications in bridge structures were discussed. A simple analytical model was established to characterize the dynamics of an example bridge featuring such a Bi‐RIBS. A series of dynamic analyses were performed by using the proposed model to investigate the effects of several factors on controlling the seismic responses of the bridge, for example, the design parameters of Bi‐RIBS including inclined angle and size, the damping property at the support interface, and the mass ratio. The peak ground accelerations of the bidirectional ground motion record were scaled to various levels to evaluate the maximum performance indices of the bridge structure and the response control effectiveness of the Bi‐RIBS compared to the uncontrolled counterparts. The simulation results demonstrated that the proposed Bi‐RIBS could effectively control the maximum pier displacement while keeping the bearing from overturning if suitable parameters were selected. In particular, the control effectiveness on the maximum pier response becomes more significant as the seismic intensity increases, due to its distinctive negative stiffness property. [ABSTRACT FROM AUTHOR]

A shared decision on the most appropriate agent for the treatment of cancer-associated thrombosis should consider the following factors, which should be reassessed as patients continue along their cancer care pathway: risk of bleeding; tumour site; suitability of oral medications; potential for drug-drug interactions; and patient preference and values regarding choice of drug. Continuing anticoagulation beyond 6 months in patients with cancer-associated venous thromboembolism and active cancer is recommended., (© 2024 British Society for Haematology and John Wiley & Sons Ltd.)