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The microtopography of tidal freshwater forested wetlands (TFFWs) impacts biogeochemical processes affecting the carbon and nitrogen dynamics, ecological parameters, and habitat diversity. However, it is challenging to quantify low-relief microtopographic features that might only vary by a few tens of centimeters. We assess the high-resolution fine-scale microtopographic features of a TFFW with terrestrial LiDAR and aerial LiDAR to test a method appropriate to quantify microtopography in low-relief forested wetlands. Our method uses a combination of water-level and elevation thresholding (WALET) to delineate hollows in terrestrial and aerial LiDAR data. Close-range remote sensing technologies can be used for microtopography in forested regions. However, the aerial and terrestrial LiDAR technologies have not been used to analyze or compare microtopographic features in TFFW ecosystems. Therefore, the objectives of this study were (1) to characterize and assess the microtopography of low-relief tidal freshwater forested wetlands and (2) to identify optimal elevation thresholds for widely available aerial LiDAR data to characterize low-relief microtopography. Our results suggest that the WALET method can correctly characterize the microtopography in this area of low-relief topography. The microtopography characterization method described here provides a basis for advanced applications and scaling mechanistic models.

Abstract At some moment in our lives, we are probably faced with the following question: How likely is it that you would recommend [company X] to a friend or colleague?. This question is related to the Net Promoter Score (NPS), a simple measure used by several companies as indicator of customer loyalty. Even though it is a well-known measure in the business world, studies that address the statistical properties or the sample size determination problem related to this measure are still scarce. We adopt a Bayesian approach to provide point and interval estimators for the NPS and discuss the determination of the sample size. Computational tools were implemented to use this methodology in practice. An illustrative example with data from financial services is also presented.

In ecology, foraging requires animals to expend energy in order to obtain resources. The cost of foraging can be reduced through kleptoparasitism, the theft of a resource that another individual has expended effort to acquire. Thus, kleptoparasitism is one of the most significant feeding techniques in ecology. The phenomenon of kleptoparasitism has garnered significant attention from scholars due to its substantial impact on the food chain. However, the proportionate amount of mathematical modelling to facilitate the analysis has made limited progress in the literature. This circumstance motivated us to develop mathematical models that could explain the population dynamics of the prey-predator food chain. This study explores a scenario with two predators and one prey, where one predator is a kleptoparasite and the other is a host. The energy depletion caused by the predator's counterattack subsequent to kleptoparasitism, notwithstanding the nonlethal nature of this antagonism, is an additional component incorporated into this model. It has been suggested that biologically viable equilibria must meet certain parametric conditions in order to exist and to be stable both locally and globally. This article delves deeply into the occurrences of various one-parametric bifurcations, such as saddle-node bifurcation, transcritical bifurcation, and Hopf bifurcation, as well as two-parametric bifurcations, such as Bautin bifurcation. A subcritical Hopf bifurcation happens when the growth rate of the first predator is relatively low, while a supercritical Hopf bifurcation occurs when the growth rate of the first predator is quite large, allowing for the coexistence of all three species. Numerical simulations have been conducted to validate our theoretical findings.

Abstract Myocardial infarction (MI) is the most prevalent non‐communicable disease worldwide. Nanotheranostics have made significant progress in the biomedical field, presenting an avenue to overcome the limitations of conventional approaches towards MI, in which personalized interventions have enhanced nanotherapeutic efficacy. The pharmacokinetics and pharmacodynamics of nanoscale materials have been modified through alteration of their physical and chemical properties such as structure, size, and surface, thereby improving target sensitivity and specificity. This revolutionary technology has also been accomplished through precision therapeutics in MI. In this review, we discuss advanced nanoparticle designs utilized in the diagnosis and treatment of MI that could be applied to deliver personalized treatment and improve patient outcomes.

Swallowing impairment is a highly prevalent and clinically significant problem affecting people and dogs. There are myriad causes of swallowing impairment of which gastroesophageal reflux is the most common in both species. Similarities in anatomy and physiology between humans and canines results in analogous swallowing disorders including cricopharyngeus muscle achalasia, esophageal achalasia, hiatal herniation, and gastroesophageal reflux with secondary esophagitis and esophageal dysmotility. Accordingly, the diagnostic approach to human and canine patients with swallowing impairment is similar. Diagnostic procedures such as swallowing fluoroscopy, high-resolution manometry, pH/impedance monitoring, and endolumenal functional luminal imaging probe can be performed in both species; however, nasofacial conformation, increased esophageal length, and the difficulty of completing several of these procedures in awake dogs are inherent challenges that need to be considered. Human patients can convey their symptoms and respond to verbal cues, whereas veterinarians must rely on clinical histories narrated by pet owners followed by comprehensive physical examination and observation of the animal eating different food consistencies and drinking water. Dogs may also be unwilling to drink or eat in the hospital setting and may be resistant to physical restraint during diagnostic procedures. Despite the species differences and diagnostic challenges, dogs are a natural animal model for many oropharyngeal and esophageal disorders affecting people, which presents a tremendous opportunity for shared learnings. This manuscript reviews the comparative aspects of esophageal anatomy and physiology between humans and canines, summarizes the diagnostic assessment of swallowing impairment in both species, and discusses future considerations for collaborative medicine and translational research.

Atherosclerosis continues to be a leading cause of morbidity and mortality globally. The precise evaluation of the extent of an atherosclerotic plaque is essential for forecasting its likelihood of causing health concerns and tracking treatment outcomes. When compared to conventional methods used, nanoparticles offer clear benefits and excellent development opportunities for the detection and characterisation of susceptible atherosclerotic plaques. In this review, we analyse the recent advancements of nanoparticles as theranostics in the management of atherosclerosis, with an emphasis on applications in drug delivery. Furthermore, the main issues that must be resolved in order to advance clinical utility and future developments of NP research are discussed. It is anticipated that medical NPs will develop into complex and advanced next-generation nanobotics that can carry out a variety of functions in the bloodstream.

Bacterial meningitis is a catastrophic nervous system disorder with high mortality and wide range of morbidities. Some of the meningitis-causing bacteria occupy cholesterol dependent cytolysins (CDCs) to increase their pathogenicity and arrange immune-evasion strategy. Studies have observed that the relationship between CDCs and pathogenicity in these meningitides is complex and involves interactions between CDC, blood-brain barrier (BBB), glial cells and neurons. In BBB, these CDCs acts on capillary endothelium, tight junction (TJ) proteins and neurovascular unit (NVU). CDCs also observed to elicit intriguing effects on brain inflammation which involves microglia and astrocyte activations, along with neuronal damage as the end-point of pathological pathways in bacterial meningitis. As some studies mentioned potential advantage of CDC-targeted therapeutic mechanisms to combat CNS infections, it might be a fruitful avenue to deepen our understanding of CDC as a candidate for adjuvant therapy to combat bacterial meningitis.

Abstract In advanced Renal Cell Carcinoma (aRCC), systemic therapy is the mainstay of treatment, with no or little role for surgery in these patients. Tyrosine kinase inhibitors (TKIs) and immune-oncological (IOs) therapies, either alone or in combination, are recommended in these patients depending on patient and tumour factors. The sequencing of therapies is critical in RCC because the choice of subsequent line therapy is heavily dependent on the response and duration of the previous treatment. There are additional barriers to RCC treatment in India. Immunotherapy is the cornerstone of treatment in ccRCC, but it is prohibitively expensive and not always reimbursed, effectively putting it out of reach for the vast majority of eligible patients in India. Furthermore, in advanced RCC (particularly the clear cell variety), Indian oncologists consider the disease burden of the patients, which is particularly dependent on the quantum of the disease load, clinical symptoms, and performance status of the patient, before deciding on treatment. There are no India-specific guidelines for clear cell RCC (ccRCC) treatment or the positioning and sequencing of molecules in the management of advanced ccRCC that take these country-specific issues into account. The current consensus article provides expert recommendations and treatment algorithms based on existing clinical evidence, which will be useful to specialists managing advanced ccRCC.

Abstract Background Precise prognostication is the key to optimum and effective treatment planning for early-stage hormone receptor (HR) positive, HER2/neu negative breast cancer patients. Differences in the breast cancer incidence and tumor anatomical features at diagnosis, pharmacogenomics data between Western and Indian women along with the vast diversity in the economic status and differences in insurance policies of these regions; suggest recommendations put forward for Western women might not be applicable to Indian/Asian women. Opinions from oncologists through a voting survey on various prognostic factors/tools to be considered for planning adjuvant therapy are consolidated in this report for the benefit of oncologists of the sub-continent, SAARC and Asia’s LMIC (low and middle-income countries). Methods A three-phase DELPHI survey was conducted to collect opinions on prognostic factors considered for planning adjuvant therapy in early-stage HR+/HER2/neu negative breast cancer patients. A panel of 25 oncologists with expertise in breast cancer participated in the survey conducted in 2021. The experts provided opinions as ‘agree’ or disagree’ or ‘not sure’ in phases-1 and 2 which were conducted virtually; in the final phase-3, all the panel experts met in person and concluded the survey. Results Opinions on 41 statements related to prognostic factors/tools and their implications in planning adjuvant endocrine/chemotherapy were collected. All the statements were supported by the latest data from the clinical trials (prospective/retrospective). The statements with opinions of consensus less than 66% were disseminated in phase-2, and later in phase-3 with supporting literature. In phase-3, all the opinions from panelists were consolidated and guidelines were framed. Conclusions This consensus guideline will assist oncologists of India, SAARC and LMIC countries in informed clinical decision-making on adjuvant treatment in early HR+/HER2/neu negative breast cancer patients.

Coronavirus disease 2019 (COVID-19) has caused respiratory system diseases and affected people’s access to healthcare services for diseases other than COVID-19. After the COVID-19 pandemic, changes occurred in the number and content of pathology laboratory samples, related to measures such as reducing the number of outpatient clinics in hospitals, postponing elective surgery, and restricting cancer screening. All samples sent to the pathology laboratory between 2019 and 2020 were included in our study. Biopsy, cytology, histochemical, and immunohistochemical staining and biopsies for malignant cases were evaluated. Changes in sample number and content caused by the pandemic were examined. The number of biopsies was 24 312 in 2019 and 13 208 in 2020. On comparison, a decrease was observed in all parameters. The largest (78.5%) and smallest (11.02%) decreases were observed in examinations of the incoming preparations for consultation (214–46) and Trucut needle biopsies (726–646), respectively. Cases such as appendectomies that require urgent intervention and malignancies that require further examination and diagnosis are the least affected. However, whether the decrease in cancer screening will affect the early diagnosis and treatment of malignancies and create a public health problem in the future remains to be established.

ABSTRACTHuman aging is characterized by gut microbiome alteration and differential loss of gut commensal species associated with the onset of frailty. The administration of cultured commensal strains to replenish lost taxa could potentially promote healthy aging. To investigate the interaction of whole microbiomes and administered strains, we transplanted gut microbiota from a frail or healthy elderly subject into germ-free mice. We supplemented the frail-donor recipient group with a defined consortium of taxa (the “S7”) that we identified by analyzing healthy aging subjects in our previous studies and whose abundance correlated with health-promoting dietary intervention. Inoculation with a frail or a healthy donor microbiome resulted in differential microbiota compositions in murine recipients 5 weeks post-transplantation. Fecal acetate levels were significantly higher in healthy donor recipient mice than in frail donor recipient mice after 4 weeks. However, the frailty-related phenotype was not replicated in recipient mice with single-dose microbiota transplantation from a healthy and a frail donor. Five S7 species colonized successfully in germ-free mice, with a relatively high abundance of Barnesiella intestinihominis and Eubacterium rectale. The engraftment of five S7 species in germ-free mice increased fecal acetate levels and reduced colon permeability and plasma TNF-ɑ concentration. Supplementation with the S7 in frail-microbiota recipient mice did not increase alpha-diversity but significantly increased the abundance of Barnesiella intestinihominis. S7 supplementation showed the potential for improving spatial reference memory in frail-microbiota recipient mice. Collectively, these data highlight the challenge of elderly microbiota engraftment in the germ-free mouse model but show promise for modulating the gut microbiome of frail elderly subjects by administering an artificial gut microbe consortium associated with healthy aging.

ABSTRACTAlthough many recent studies have examined associations between the gut microbiome and COVID-19 disease severity in individual patient cohorts, questions remain on the robustness across international cohorts of the biomarkers they reported. Here, we performed a meta-analysis of eight shotgun metagenomic studies of COVID-19 patients (comprising 1,023 stool samples) and 23 > 16S rRNA gene amplicon sequencing (16S) cohorts (2,415 total stool samples). We found that disease severity (as defined by the WHO clinical progression scale) was associated with taxonomic and functional microbiome differences. This alteration in gut microbiome configuration peaks at days 7–30 post diagnosis, after which the gut microbiome returns to a configuration that becomes more similar to that of healthy controls over time. Furthermore, we identified a core set of species that were consistently associated with disease severity across shotgun metagenomic and 16S cohorts, and whose abundance can accurately predict disease severity category of SARS-CoV-2 infected subjects, with Actinomyces oris abundance predicting population-level mortality rate of COVID-19. Additionally, we used relational diet-microbiome databases constructed from cohort studies to predict microbiota-targeted diet patterns that would modulate gut microbiota composition toward that of healthy controls. Finally, we demonstrated the association of disease severity with the composition of intestinal archaeal, fungal, viral, and parasitic communities. Collectively, this study has identified robust COVID-19 microbiome biomarkers, established accurate predictive models as a basis for clinical prognostic tests for disease severity, and proposed biomarker-targeted diets for managing COVID-19 infection.

Adequate zinc nutrition is important for child growth, neurodevelopment, immune function, and normal pregnancy outcomes. Seventeen percent of the global population is estimated to be at risk for inadequate zinc intake. However, zinc is not included in the fortification standards of several low- and middle-income countries with mandatory fortification programs, despite data suggesting a zinc deficiency public health problem. To guide policy decisions, we investigated the factors enabling and impeding the inclusion of zinc as a fortificant by conducting in-depth interviews with 17 key informants from 10 countries. Findings revealed the decision to include zinc was influenced by guidance from international development partners and enabled by the assessment of zinc deficiency, mandatory regional food fortification standards which included zinc, the World Health Organization (WHO) guidelines for zinc fortification, and the low cost of zinc compound commonly used. Barriers included the absence of zinc from regional fortification standards, limited available data on the efficacy and effectiveness of zinc fortification, and the absence of national objectives related to the prevention of zinc deficiency. To promote zinc fortification there is a need to put the prevention of zinc deficiency higher on the international nutrition agenda and to promote large-scale food fortification as a key deficiency mitigation strategy.

Abstract Background Serum folate is considered a biomarker of chronic enteropathy (CE) in dogs, but few studies have examined associations with markers of CE. Hypothesis/Objectives To evaluate serum folate concentrations in dogs with and without CE and associations with sample hemolysis and selected markers of CE. We hypothesized that hypofolatemia would be more common in dogs with CE and associated with hypocobalaminemia, higher CIBDAI, and hypoalbuminemia. Animals Six hundred seventy‐three dogs with available serum folate measurements performed at an academic veterinary hospital between January 2016 and December 2019. Methods Medical records were retrospectively reviewed to categorize cases as CE or non‐CE and record clinical details and laboratory markers. Relationships between serum folate, cobalamin, and CE variables were assessed using chi‐square, Kruskal‐Wallis, or Spearman's correlation tests. Results Of the 673 dogs, 99 CE were compared to 95 non‐CE. In the overall cohort, serum folate concentration did not correlate with sample hemolysis (P = .75). In the CE subset, serum folate and cobalamin concentrations were positively associated (rho = 0.34, FDR = 0.02). However, serum folate concentrations (median [25th, 75th percentiles]) were higher (CE: 12.1 (8.9, 16.1), non‐CE: 10.4 (7.2, 15.5); P = .04) and cobalamin concentrations were lower (CE: 343 (240, 597), non‐CE: 550 (329, 749); P = .001) in the CE vs non‐CE group. Serum folate was not associated with markers of CE, but serum cobalamin was associated with albumin (P = .04) and cholesterol (P = .03). Conclusions and Clinical Importance Hypofolatemia is an inferior biomarker of CE compared to hypocobalaminemia.