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Perineural anesthesia of the tibial nerve can be performed ultrasound-guided or blindly, with the latter still being commonly used in equine practice due to practical constraints, despite its lower accuracy and hence, common failure to achieve desensitization. This may be associated with anatomical variations or inadequate landmarks for injection. To examine the course of the tibial nerve, document potential anatomical variations, and determine optimal landmarks for perineural injection, dissection was conducted along the medial aspect of the tibia in 10 paired cadaver hindlimbs. No anatomical variations of the tibial nerve were observed. Mean tibial nerve thickness was 6 ± 1 mm. The junction with the plantar nerves was located at a maximum of 85 mm and the junction with the medial cutaneous branch was at a maximum of 150 mm proximal to the proximal aspect of the calcaneal tubercle. The mean distance of the tibial nerve to the cranial border of the superficial digital flexor was 11 ± 6 mm. In conclusion, problems with perineural anesthesia of the tibial nerve cannot simply be attributed to anatomical variations. The thickness of the nerve and the amount of perineural tissue may present specific challenges for achieving adequate desensitization. Our results support the generally recommended site for tibial nerve perineural injection at 100 mm proximal to the calcaneal tubercle and 11 mm cranial to the superficial digital flexor.

Detailed information on forest tree species is crucial to inform management and policy and support environmental and ecological research. Sentinel-2 imagery is useful for obtaining spatially explicit and frequent information on forest tree species due to its suitable spatial, spectral, and temporal resolutions. However, classification workflows often do not generalise well to time periods that are not seen by the model during the calibration phase. This study investigates the temporal transferability of dominant tree species classification. To this end, the Random Forest, Support Vector Machine, and Multilayer Perceptron algorithms were used to classify five tree species in Flanders (Belgium) with regularly spaced Sentinel-2 time series from 2018 to 2022. Cross-year single-year input scenarios were compared with same-year single-year input scenarios to quantify the temporal transferability of the five evaluated years. This resulted in a decrease in overall accuracy between 2.30 and 14.92 percentage points depending on the algorithm and evaluated year. Moreover, our results indicate that the cross-year classification performance could be improved by using multi-year training data, reducing the drop in overall accuracy. In some cases, gains in overall accuracy were even observed. This study highlights the importance of including interannual spectral variability during the training stage of tree species classification models to improve their ability to generalise in time.

Extramammary Paget disease (EMPD) is an uncommon adenocarcinoma of apocrine gland-rich areas, presenting significant diagnostic challenges due to its nonspecific clinical appearance and frequent misidentification as benign, inflammatory skin conditions. Traditional diagnostic methods such as biopsy are invasive and uncomfortable, often required repeatedly due to high recurrence rates. Dermoscopy and non-invasive imaging techniques have been used but provide limited diagnostic accuracy due to their constraints in depth penetration and resolution. Recent advancements in imaging technologies, such as line-field confocal optical coherence tomography (LC-OCT), show promise in enhancing diagnostic precision while minimizing invasive procedures. LC-OCT merges high-resolution imaging with deep penetration capabilities, capturing detailed horizontal and vertical skin images akin to histopathology. This study evaluated the diagnostic performance of LC-OCT in detecting EMPD and its recurrence in 17 clinically suspicious anogenital regions, belonging to six patients. Data were collected prospectively at the patient’s bedside by an LC-OCT expert with poor training for EMPD, and, then, reviewed retrospectively by an independent LC-OCT expert with adequate training for EMPD and no concerns about time. The prospective examination yielded 64.7% accuracy (11 true results out of 17 total cases), 71.4% sensitivity (10 true positives out of 14 actual positives), and 33.3% specificity (1 true negative out of 3 actual negatives). The retrospective analysis achieved 94.1% accuracy (16 true results out of 17 total cases), 100% sensitivity (14 true positives out of 14 actual positives), and 66.7% specificity (2 true positives out of 3 actual positives), with the only false positive case being a difficult-to-diagnose concomitant presentation of a lichen sclerosus et atrophicus. Despite the need for specialized training, our results suggest that LC-OCT represents a valuable tool for accurately identifying EMPD and improving its management by reducing unnecessary biopsies. Further studies are needed to standardize its clinical application.

El Instituto Nacional de Salud, ha llevado a cabo por primera vez el proceso de identificación de Prioridades Nacionales de Investigación en Salud Bucal a cargo de la Subdirección de Investigación y Laboratorios de Enfermedades No Transmisibles del Centro Nacional de Salud Pública con la asesoría técnica de la Dirección de Investigación e Innovación en Salud y en coordinación con la Dirección Ejecutiva de Salud Bucal de la Dirección General de Intervenciones Estratégicas en Salud Pública del Ministerio de Salud mediante metodología participativa de tres actores claves: investigadores/especialistas, expertos y decisores. El objetivo de este artículo es describir el proceso seguido para la identificación de estas prioridades, el cual comprendió cinco fases: i) identificación de objetivos estratégicos del MINSA, ii) identificación de necesidades de investigación en salud bucal, iii) revisión por expertos y valoración de las necesidades según criterios, iv) priorización (valoración de la lista de prioridades según calificación) y v) presentación de las prioridades. Como resultado se obtuvieron las 12 prioridades que posteriormente fueron aprobadas por Resolución Ministerial N.° 262-2022/MINSA, con un periodo de vigencia 2022–2026. Además, se brindaron recomendaciones para futuros procesos.

Abstract Introduction Sustained-release intraocular implants provide a therapeutic option for open-angle glaucoma (OAG) and ocular hypertension (OHT) patients who are non-compliant with eyedrops. Currently, there are no published patient-reported outcome (PRO) measures that assess treatment satisfaction with intraocular implants. To address this gap, a new PRO instrument, the Allergan Satisfaction with Treatment Experience Questionnaire (ASTEQ), has been developed in accordance with Food and Drug Administration guidance. Methods Qualitative research interviews were conducted among patients with OAG/OHT who had received three intraocular injections of a sustained-release bimatoprost (10 or 15 µg) implant within the clinical trial setting. A preliminary conceptual framework capturing treatment satisfaction concepts in glaucoma, as identified from the literature, was used to develop a semi-structured interview guide. A concept elicitation (CE) interview to identify aspects of the glaucoma treatment experience pertinent to intraocular implants provided content for a draft instrument. A cognitive debriefing (CD) interview to test the instrument’s interpretability, relevance, and validity informed its subsequent refinement. Interview analysis followed a grounded theory approach to identify data patterns and relationships. Results CE interviews (n = 19) indicated that participants’ main considerations in rating satisfaction with implant treatment were physical comfort during preparation for the implant and implant administration, anxiety about the procedure, frequency of implant administration, possible side effects, convenience and accessibility of the implant, relationship with the clinician, and lifestyle fit. Draft ASTEQ revision based on CD interviews (n = 20) and readability tests yielded a nine-item ASTEQ instrument comprising satisfaction with overall implant experience and frequency of administration, occurrence/bother of immediate and long-term side effects, worry about implant administration and possible risks/side effects, and physical discomfort during preparation for the implant and implant administration. Conclusion The ASTEQ instrument has demonstrated content validity in patients with OAG/OHT treated with a sustained-release bimatoprost implant. Further research is necessary to evaluate its psychometric properties.

In Canada, the demands of female immigrant adolescents in terms of sexual health are largely unmet and have grown significantly in recent years. According to studies, racialized immigrant adolescents are less likely than non-immigrant adolescents to be knowledgeable about sexual and reproductive health and to use resources for sex education and related services. This difference seems to be related to socio-cultural and religious practices in Pakistani immigrant adolescents. This paper intends to explain the viewpoints of female adolescents of first- or second-generation Pakistani descent who reside in Canada with regard to their development of sexuality and psychological well-being. Moreover, this paper also describes how female adolescents perceive the necessity to support their sexuality as they go through the adolescent stage. Individual interviews and timelines were created using qualitative interpretative descriptive design. We included 21 female adolescents of first- or second-generation Pakistani ethnicity using a purposive sample. Data analysis was performed using a thematic analysis. The findings indicate that immigrant adolescent girls received conflicting messages about sexuality from their parents which impacted their psychological well-being. Additionally, survey participants noted that prejudice, exclusion from sex education classes, and a lack of sexual health information contributed to social isolation, health care avoidance, and poor mental health outcomes like melancholy and anxiety among adolescent girls. The absence of sexuality-related communication with parents and the scarcity of medical professionals who can relate to and address the needs and realities of immigrants may have an impact on the participants’ experiences. Female immigrant girls also spoke up on the need for open, honest, and stigma-free conversations as well as for the need to end the taboo around the subject of sexuality. This study used principles from both intersectionality and postmodern feminist theories to increase our understanding of the interplay between the experiences of developing sexuality and overall well-being in female immigrant adolescents of Pakistani descent. It is crucial to involve, listen to, and incorporate female adolescents’ voices when planning and implementing interventions to support healthy sexuality among immigrant adolescents.

Abstract Background For centuries, morphology has been the most commonly selected trait in horses. A 3D video recording enabled us to obtain the coordinates of 43 anatomical landmarks of 2089 jumping horses. Generalized Procrustes analysis provided centered and scaled coordinates that were independent of volume, i.e., centroid size. Genetic analysis of these coordinates (mixed model; 17,994 horses in the pedigree) allowed us to estimate a variance–covariance matrix. New phenotypes were then defined: the “summarized shapes”. They were obtained by linear combinations of Procrustes coordinates with, as coefficients, the eigenvectors of the genetic variance–covariance matrix. These new phenotypes were used in genome-wide association analyses (GWAS) and multitrait genetic analysis that included judges’ scores and competition results of the horses. Results We defined ten shapes that represented 86% of the variance, with heritabilities ranging from 0.14 to 0.42. Only one of the shapes was found to be genetically correlated with competition success (rg = − 0.12, standard error = 0.07). Positive and negative genetic correlations between judges’ scores and shapes were found. This means that the breeding objective defined by judges involves improvement of anatomical parts of the body that are negatively correlated with each other. Known single nucleotide polymorphisms (SNPs) on chromosomes 1 and 3 for height at withers were significant for centroid size but not for any of the shapes. As these SNPs were not associated with the shape that distinguished rectangular horses from square horses (with height at withers greater than body length), we hypothesize that these SNPs play a role in the overall development of horses, i.e. in height, width, and length but not in height at withers when standardized to unit centroid size. Several other SNPs were found significant for other shapes. Conclusions The main application of 3D morphometric analysis is the ability to define the estimated breeding value (EBV) of a sire based on the shape of its potential progeny, which is easier for breeders to visualize in a single synthetic image than a full description based on linear profiling. However, the acceptance of these new phenotypes by breeders and the complex nature of summarized shapes may be challenging. Due to the low genetic correlations of the summarized shapes with jumping performance, the methodology did not allow indirect performance selection criteria to be defined.

Abstract This study investigates the effects of including patients’ clinical information on the performance of deep learning (DL) classifiers for disease location in chest X-ray images. Although current classifiers achieve high performance using chest X-ray images alone, consultations with practicing radiologists indicate that clinical data is highly informative and essential for interpreting medical images and making proper diagnoses. In this work, we propose a novel architecture consisting of two fusion methods that enable the model to simultaneously process patients’ clinical data (structured data) and chest X-rays (image data). Since these data modalities are in different dimensional spaces, we propose a spatial arrangement strategy, spatialization, to facilitate the multimodal learning process in a Mask R-CNN model. We performed an extensive experimental evaluation using MIMIC-Eye, a dataset comprising different modalities: MIMIC-CXR (chest X-ray images), MIMIC IV-ED (patients’ clinical data), and REFLACX (annotations of disease locations in chest X-rays). Results show that incorporating patients’ clinical data in a DL model together with the proposed fusion methods improves the disease localization in chest X-rays by 12% in terms of Average Precision compared to a standard Mask R-CNN using chest X-rays alone. Further ablation studies also emphasize the importance of multimodal DL architectures and the incorporation of patients’ clinical data in disease localization. In the interest of fostering scientific reproducibility, the architecture proposed within this investigation has been made publicly accessible( https://github.com/ChihchengHsieh/multimodal-abnormalities-detection ).

Abstract Pulmonary arterial hypertension is a rare but life-threatening and clinically heterogeneous disease. The diagnostic schedule of this disorder is complex, and no specific indicator of the arterial etiology has been explored. In this study, untargeted plasma metabolomics was applied to evaluate the metabolic fingerprints of pulmonary arterial hypertension patients. Plasma samples were prepared using a new approach, which applies proteinase K during the sample preparation procedure to increase the metabolite coverage. The metabolic fingerprints were determined via LC–MS and subsequently analyzed with the use of both uni- and multivariate statistics. A total of 21 metabolites were discovered to be significantly altered in pulmonary arterial hypertensive patients. The metabolites were mainly related to the phospholipid metabolic pathways. In this study, decreases were found in the phosphatidylcholines (PCs) [PC(32:0), PC(40:7), PC(42:7)], phosphatidylethanolamine PE(18:0/18:2), lysophosphatidylethanolamines (LPEs) [LPE(22:6), LPE(18:2), LPE(18:0), LPE(20:4), LPE(20:1), LPE(20:0)], lysophosphatidylcholine LPC(20:4) and lysophosphatidylserine LPS(19:0), as well as increase of sphingomyelin SM(36:2), in the plasma samples of pulmonary arterial hypertensive patients in comparison to the control group. Besides their function as components of the biological membranes, these metabolites are also involved in the intracellular signaling pathways that are related to cell proliferation and apoptosis. The results obtained during this study confirm the potential of (untargeted) metabolomics to identify the molecular characteristics of the pathophysiology of pulmonary arterial hypertension. The clinical relevance of this study constitutes the selection of a metabolic panel that can potentially detect and properly diagnose the disease.

Abstract Background Early diagnosis of Gaucher disease (GD) allows for disease-specific treatment before significant symptoms arise, preventing/delaying onset of complications. Yet, many endure years-long diagnostic odysseys. We report the development of a machine learning algorithm to identify patients with GD from electronic health records. Methods We utilized Optum’s de-identified Integrated Claims-Clinical dataset (2007–2019) for feature engineering and algorithm training/testing, based on clinical characteristics of GD. Two algorithms were selected: one based on age of feature occurrence (age-based), and one based on occurrence of features (prevalence-based). Performance was compared with an adaptation of the available clinical diagnostic algorithm for identifying patients with diagnosed GD. Undiagnosed patients highly-ranked by the algorithms were compared with diagnosed GD patients. Results Splenomegaly was the most important predictor for diagnosed GD with both algorithms, followed by geographical location (northeast USA), thrombocytopenia, osteonecrosis, bone density disorders, and bone pain. Overall, 1204 and 2862 patients, respectively, would need to be assessed with the age- and prevalence-based algorithms, compared with 20,743 with the clinical diagnostic algorithm, to identify 28 patients with diagnosed GD in the integrated dataset. Undiagnosed patients highly-ranked by the algorithms had similar clinical manifestations as diagnosed GD patients. Conclusions The age-based algorithm identified younger patients, while the prevalence-based identified patients with advanced clinical manifestations. Their combined use better captures GD heterogeneity. The two algorithms were about 10–20-fold more efficient at identifying GD patients than the clinical diagnostic algorithm. Application of these algorithms could shorten diagnostic delay by identifying undiagnosed GD patients.

OBJECTIVES: The etiology of testicular germ cell tumors (TGCT) is suspected to be related to prenatal environmental risk factors. Some solvents have potential endocrine disrupting or carcinogenic properties and may disrupt male genital development in utero. The aim of this study was to examine the association between parental occupational exposure to solvents and TGCT risk among their offspring. METHODS: A French nationwide case–control study, TESTIS included 454 TGCT cases and 670 controls frequency-matched on region and 5-year age strata. Participants were interviewed via telephone and provided information on parental occupations at birth. Job-exposure matrices (JEM) developed in the French Matgéné program were used to assign exposure to five petroleum-based solvents, five solvents or groups of oxygenated solvents, and five chlorinated solvents. Odds ratios (OR) for TGCT and 95% confidence intervals (CI) were estimated using conditional logistic regression, adjusting for TGCT risk factors. RESULTS: Occupational exposure to at least one solvent during the year of their son’s birth was 41% among fathers and 21% among mothers. Paternal exposure to at least one solvent showed OR 0.89 (95% CI 0.68–1.15). Exposure to perchloroethylene (OR 1.41, 95% CI 0.55–3.61), methylene chloride (OR 1.13, 95% CI 0.54–2.34) and diesel/kerosene/fuel oil (OR 1.17, 95% CI 0.80–1.73) disclosed OR >1 but with low precision. Our results suggest a possible modest increase in non-seminoma risk for sons whose fathers were highly exposed to trichloroethylene (OR 1.44, 95% CI 0.79–2.63). Maternal exposure to at least one solvent showed OR 0.90 (95% CI 0.65–1.24). When stratifying by birth year, men born in the 1970s experienced an increased TGCT risk following maternal exposure to fuels and petroleum-based solvents (OR 2.74, 95% CI 1.11–6.76). CONCLUSION: Overall, no solid association was found between parental occupational exposure to solvents and TGCT risk. The association found with maternal occupational exposure to fuels and petroleum solvents among older men needs further investigation.

Abstract Among evolutionary trends shaping phenotypic diversity over macroevolutionary scales, CREA (CRaniofacial Evolutionary Allometry) describes a tendency, among closely related species, for the smaller-sized of the group to have proportionally shorter rostra and larger braincases. Here, we used a phylogenetically broad cranial dataset, 3D geometric morphometrics, and phylogenetic comparative methods to assess the validity and strength of CREA in extinct and living felids. To test for the influence of biomechanical constraints, we quantified the impact of relative canine height on cranial shape evolution. Our results provided support to CREA at the family level. Yet, whereas felines support the rule, big cats, like Pantherinae and Machairodontinae, conform weakly if not at all with CREA predictions. Our findings suggest that Machairodontinae constitute one of the first well-supported exceptions to this biological rule currently known, probably in response to the biomechanical demands and developmental changes linked with their peculiar rostral adaptations. Our results suggest that the acquisition of extreme features concerning biomechanics, evo-devo constraints, and/or ecology is likely to be associated with peculiar patterns of morphological evolution, determining potential exceptions to common biological rules, for instance, by inducing variations in common patterns of evolutionary integration due to heterochronic changes under ratchet-like evolution.

Abstract Background The management and care of older patients with multiple health problems is demanding and complex. Interprofessional and intraprofessional collaboration has the potential to improve both the efficiency and the quality of care for these patients. However, it has proven difficult to demonstrate the efficacy of this approach in terms of objective patient-related outcomes. Recently, a care model with interprofessional and intraprofessional care was started, the Intensive Collaboration Ward (ICW). This ward combines interprofessional care and intraprofessional care for older patients with multiple health problems. The aim of this study was to evaluate the effects of ICW care in older patients with multiple health problems. Methods This retrospective cohort study evaluated the effects on patients outcomes. This was done by comparing patients of the new model, the ICW (ICW group), to a historical cohort of comparable patients who would have been eligible for the ICW (control group). Outcomes were medical consultations, allied health professional consultations, radiological procedures, waiting time for radiological procedures, change in primary treating specialty, length of hospital stay, readmission rate, and mortality rate. Linear and logistic regression analyses were performed, adjusted for baseline differences. Results The ICW group required significantly fewer medical consultations than the control group. Calls to specialists from the emergency room decreased significantly, but there was no change in in-person consultations on the ER. 51% of control patients had ≥ 1 in-hospital consultation compared to 21% of ICW patients (p

Abstract A renewed interest in the use of psychedelics for treating obsessive compulsive disorder (OCD) has emerged in the last 20 years. But pre-clinical and clinical evidence remain scarce, and little is known about the factor determining the magnitude and persistence of the therapeutic effect. We therefore designed a retrospective online survey to explore, in the general population using psychoactive drugs, their impact on OCD symptoms. We also assessed the attitude of the participants towards the substance in term of frequency of intakes. In a sample of 174 participants, classic psychedelics were reported as the only substances effective at reducing OCD symptoms. In classic psychedelics users, symptoms reduction was associated with the intensity of acute effects, itself correlated to the dose. Reports on the persistence of the therapeutic effect varied from weeks to months, but we could not find any predicting factor. Finally, the occurrence and frequency of subsequent intakes, which seemed to be limited in our sample, were predicted by the magnitude and persistence of the therapeutic effect, respectively. Our observations support the hypothesis of classic psychedelics efficacy in reducing OCD symptoms but a careful evaluation of the persistence of this effect is still needed.

Abstract Background Breast cancer is the most frequently diagnosed cancer and the leading cause of cancer death in women. Approximately 50% of breast cancers are discovered at an early stage in patients for whom conservative surgery is indicated. Intraoperative localization of non-palpable breast lesions is generally accomplished using a hook wire to mark the area of concern under ultrasound or stereotactic localization. But this technique has several drawbacks (painful, stressful…). We propose the use of a wire-free breast lesion system using miniature radiofrequency identification (RFID) tags. This technique could improve patient comfort and surgical comfort for surgeons. We therefore propose a study to assess the interest of introducing the RFID localization technique at the Jean PERRIN comprehensive cancer center. Methods This is a single-center prospective trial designed to assess the interest in introducing the RFID localization technique at the Jean Perrin center. It aims to show the superiority of the RFID technique in terms of patient tolerance compared to the gold-standard (hook wire). A sequential inclusion in time will be performed: 20 inclusions in the gold-standard group, then 20 patients in the RFID group before repeating the inclusion scheme. Any patient requiring preoperative localization will receive a senology consultation. The RFID tag will be placed during this consultation. The hook wire localization will be done the day before the surgery. Patients will fill out a Hospital Anxiety and Depression scale (HAD) questionnaire at the time of inclusion. They will then fill out a satisfaction questionnaire in 2 steps: during the placement of the device (RFID tag or hook wire) or during the postoperative consultation at 1 month. Radiologists and surgeons will fill out a questionnaire to evaluate the localization technique, respectively after the localization and surgery procedures. Discussion The RFID study is the first study in France which specifically assesses the interest of the RFID localization in terms of patients comfort. Patient comfort is one of the key elements to take into consideration when managing patients in oncology and new technologies such as RFID tags could improve it. Trial registration ClinicalTrials.gov ID; NCT04750889 registered on February 11, 2021.

In this theoretical paper, we delineate two fundamental paradigms in how scholars conceptualize the nature of machines in human-machine communication (HMC). In addition to the well-known Media Equation paradigm, we distinguish the Media Evocation paradigm. The Media Equation paradigm entails that people respond to machines as if they are humans, whereas the Media Evocation paradigm conceptualizes machines as objects that can evoke reflections about ontological categories. For each paradigm, we present the main propositions, research methodologies, and current challenges. We conclude with theoretical implications on how to integrate the two paradigms, and with a call for mixed-method research that includes innovative data analyses and that takes ontological classifications into account when explaining social responses to machines.

Abstract Background Encephalopathy can occur from a non-fatal toxic drug event (overdose) which results in a partial or complete loss of oxygen to the brain, or due to long-term substance use issues. It can be categorized as a non-traumatic acquired brain injury or toxic encephalopathy. In the context of the drug toxicity crisis in British Columbia (BC), Canada, measuring the co-occurrence of encephalopathy and drug toxicity is challenging due to lack of standardized screening. We aimed to estimate the prevalence of encephalopathy among people who experienced a toxic drug event and examine the association between toxic drug events and encephalopathy. Methods Using a 20% random sample of BC residents from administrative health data, we conducted a cross-sectional analysis. Toxic drug events were identified using the BC Provincial Overdose Cohort definition and encephalopathy was identified using ICD codes from hospitalization, emergency department, and primary care records between January 1st 2015 and December 31st 2019. Unadjusted and adjusted log-binomial regression models were employed to estimate the risk of encephalopathy among people who had a toxic drug event compared to people who did not experience a toxic drug event. Results Among people with encephalopathy, 14.6% (n = 54) had one or more drug toxicity events between 2015 and 2019. After adjusting for sex, age, and mental illness, people who experienced drug toxicity were 15.3 times (95% CI = 11.3, 20.7) more likely to have encephalopathy compared to people who did not experience a drug toxicity event. People who were 40 years and older, male, and had a mental illness were at increased risk of encephalopathy. Conclusions There is a need for collaboration between community members, health care providers, and key stakeholders to develop a standardized approach to define, screen, and detect neurocognitive injury related to drug toxicity.

Objective: This study was aimed at analyzing and disseminating the fossil wood collection data stored in the thin slide sections of the paleobotany collection of the Department of Paleontology and Stratigraphy of the Institute of Geosciences of a university in Southern Brazil. Thin sheets of petrified wood are described. Research data used in geosciences specifically seek to develop a model for the use of this type of sheet in paleobotany, enabling visualization of its representativeness in studies published over 40 years to obtain the anatomical characteristics of fossil woods and define their systematic affinities as a specific typology of research data in geosciences. Methods: The methodology involved interviewing a paleobotanical specialist and using different techniques applied in metric studies to map scientific production. Thus, a dataset of (20) thin slide sections of petrified fossil wood used in “Stressing environmental conditions in the “petrified forest” from the Mata Sequence in the Triassic context of the Paraná Basin,” a paper published by the Journal of South American Earth Sciences (DOI:10.1016/j.jsames.2023.104415), was used. Depending on the methodology, these thin petrified wood sheets can reveal paleoclimatic signatures based on the anatomical characteristics of the fossil wood. In addition to this case study, which represents a collection of more than (2.000) thousand blades of fossil wood and approximately 40 years of research, the paleobotanical collection of the department is reused in methodology classes. The collection comprises a database created by research physicists that provides information on anatomical features, systematic affinities, paleoclimatic conditions, and paleoenvironmental insights. Potential for reuse: The reuse, registration, storage, identification, and preservation of thin slide sections as a type of research data used in paleobotany aims to improve the methodology associated with the organization of the physical database of the institution. The research data and blades of fossil wood are being digitized, and soon will be available under the CC BY 4.0 license in the ZENODO repository, according to the sample described here in this data paper (DOI Mendeley:10.17632/b8phfcsync.1). Furthermore, the data can be reused in optical and electronic scanning microscopy software.

Not available.

This paper reports the synthesis of borosilicate bioactive glasses nanoparticles containing ions of interest (calcium, strontium or silver ions) for the purpose of bone tissue regeneration using a modified Stöber method and their shaping by robocasting to produce macroporous grid-like architectures with controlled interconnected porosity. Main focus is on the design of a paste formulation, the optimization of the robocasting process to produce 3D scaffolds and ion release from the sintered scaffold in solution. Pastes were developed (40 vol% powder loading), characterized, and extruded layer-by-layer to form three-dimensional scaffolds with a grid-like macrostructure (400 μm diameter of the rods). After drying under controlled atmosphere, scaffolds were sintered. The sintering study revealed that the addition of silver reduced the densification point of the borosilicate glass. After immersion in a buffer solution, ionic release (Si, B and Sr) of the sintered scaffold was evaluated, and compared with the synthetized powder. The shaping process did not affect Sr dissolution. This controllable ion-release behavior of the scaffolds are promising for their therapeutic application.

Introduction: The plant-based alkaloid muscimol is a potent agonist of inhibitory GABAA-neurotransmitter receptors. GABAA receptors are a heterogeneous family of pentameric complexes, with 5 out of 19 subunits assembling around the central anion pore. Muscimol is considered to bind to all receptor subtypes at the orthosteric drug binding site at the β+/α− interface. Recently, we observed that the antipsychotic drugs clozapine (CLZ), loxapine (LOX) and chlorpromazine (CPZ) although exerting functional inhibition on multiple GABAA receptor subtypes showed diverging results in displacing 3H-muscimol. While a complete displacement could be observed in hippocampal membranes by bicuculline (BIC), and no displacement with CPZ, the compounds CLZ and LOX competed partially. Non-sigmoidal, complex dose response curves were indicative of multiple sites. In the current study we now aimed to investigate more extensively this heterogeneity of bicuculline sensitive muscimol sites in rat brain.Methods: We tested membranes from four different brain regions (hippocampus, cerebellum, thalamus and striatum) and selected recombinantly expressed subunit combinations with displacement assays. 3H-muscimol displacement was tested with BIC, LOX, CLZ and CPZ. In silico ligand structural analysis and computational docking was performed.Results: We observed a unique pharmacology of each tested compound in the studied brain regions. Combining two of the tested ligands suggests that in striatum all CLZ sites are contained in the pool of LOX sites, while the CPZ sites may in part be non-overlapping with LOX sites. Experiments on recombinantly expressed receptors indicate, that BIC can displace 3H-muscimol from all tested receptors, while LOX and CLZ display different and variable competition indicative of multiple sites. Molecular docking produced structural correlates of the observed diversity of muscimol sites on the basis of bicuculline bound experimental structures.Discussion: These findings indicate that 3H-muscimol binding sites in rat brain are heterogeneous, with different populations of receptors, which are CPZ, LOX or CLZ sensitive or insensitive. These binding sites show a varying distribution in different rat brain regions. Molecular docking suggests that the so-called loop F region of α subunits drives the observed differences.

Animal models have been commonly used in immunotherapy research to study the cell response to external agents and to assess the effectiveness and safety of new therapies. Over the past few decades, immunocompromised (also called immunodeficient) mice allowed researchers to grow human tumor cells without the impact of the host’s immune system. However, while this model is very valuable to understand the tumor biology and to understand the underlying mechanism of immunotherapy, the results may not always directly translate to humans. The tumor microenvironment has significant implications for tumor engraftment, growth, invasion, etc., and the immune system plays a critical role in shaping the tumor microenvironment. Human immunocompetent mice, also named humanized mice, are engineered mice that possess functional human immune cells. This in vivo model can be used to effectively study the effect of the human immune system to a human implanted tumor. Moreover, this can effectively mimic the response to treatment. This section is an overview of the current understanding of the different humanized mice that could be utilized to mimic the tumor microenvironment in chordoma.

Compositional NOx changes caused by energetic electron precipitation (EEP) at a specific altitude and those co-dependent on vertical transport are referred to as the EEP direct and indirect effect, respectively. The direct effect of EEP at lower mesospheric and upper stratospheric altitudes is linked to the high-energy tail of EEP (≳ 300 keV). The relative importance of this direct effect on NOx, ozone, and atmospheric dynamics remains unresolved due to inadequate particle measurements and scarcity of polar mesospheric NOx observations. An accurate parameterization of the high-energy tail of EEP is, therefore, crucial. This study utilizes EEP flux data from MEPED aboard the POES/Metop satellites from 2004–2014. Data from both hemispheres (55–70° N/S) are combined in daily flux estimates. 164 peaks above the 90th percentile of the ≳ 30 keV flux are identified. These peaks are categorized into absolute E1 and E3 events representing weak and strong ≳ 300 keV responses, respectively. A subset of absolute E1 and E3 events with similar ≳ 30 keV responses is termed overlapping events. Additionally, relative E1 and E3 events are determined by the relative strength of the ≳ 300 keV response, scaled by the initial ≳ 30 keV flux. A comparison between E1 and E3 events aims to identify solar wind and geomagnetic conditions leading to high-energy EEP responses and to gain insight into the conditions that generate a high-energy tail, independent of the initial ≳ 30 keV flux level. Superposed epoch analysis of mesospheric NO density from SOFIE confirms an observable direct impact on lower mesospheric chemistry associated with the absolute E3 events. A probability assessment based on absolute events identifies specific thresholds in the solar wind-magnetosphere coupling function (epsilon) and the geomagnetic indices Kp*10 and Dst, capable of determining the occurrence or exclusion of absolute E1 and E3 events. Elevated solar wind speeds persisting in the recovery phase of a deep Dst trough appear characteristic of overlapping and relative E3 events. This study provides insight into which parameters are important for accurately modeling the high-energy tail of EEP.

Surface-canopy forming kelps (Macrocystis pyrifera and Nereocystis luetkeana) can be monitored along the Northeast Pacific coast using remote sensing. These kelp canopies can be submerged by tides and currents, making it difficult to accurately determine their extent with remote sensing techniques. Further, both species have morphologically distinct canopies, each made up of structures with differing buoyancies, and it is not well understood whether the differing buoyancies between these species’ canopies affects their detectability with remote sensing technologies. Here, we collected in situ above-water spectral signatures for the surface-canopies of Nereocystis and Macrocystis, providing the first direct hyperspectral comparison between the structures that make up the canopies of these species. Additionally, we compare the strength of their red-edge and near-infrared band signals, as well as the normalized difference red-edge (NDRE) and normalized difference vegetation index (NDVI) values. At the bed level, we compare detection of kelp canopy extent using both NDRE and NDVI classified unoccupied aerial vehicle imagery. We also characterized how changing tides and currents submerge the canopies of both species, providing insights that will allow remote sensors to more accurately determine the extent of kelp canopy in remote sensing imagery. Observations of canopy structures paired with in situ hyperspectral data and simulated multispectral data showed that more buoyant kelp structures had higher reflectance in the near-infrared wavelengths, but even slightly submerged canopy structures had a higher reflectance in the red-edge rather than the near-infrared. The higher red-edge signal was also evident at the bed level in the UAV imagery, resulting in 18.0% more canopy classified with NDRE than with NDVI. The area of detected canopy extent decreased by an average of 22.5% per meter of tidal increase at low current speeds (

Abstract With the technological advances made to expand space exploration, astronauts will spend extended amounts of time in space before returning to Earth. This situation of unloading and reloading influences human physiology, and readaptation to full weight‐bearing may significantly impact astronauts' health. On Earth, similar situations can be observed in patients who are bedridden or suffer from sport‐related injuries. However, our knowledge of male physiology far exceeds our knowledge of female's, which creates an important gap that needs to be addressed to understand the sex‐based differences regarding musculoskeletal adaptation to unloading and reloading, necessary to preserve health of both sexes. Using a ground‐based model of total unloading for 14 days and reloading at full weight‐bearing for 7 days rats, we aimed to compare the musculoskeletal adaptations between males and females. Our results reveal the existence of significant differences. Indeed, males experienced bone loss both during the unloading and the reloading period while females did not. During simulated microgravity, males and females showed comparable muscle deconditioning with a significant decline in rear paw grip strength. However, after 7 days of recovery, muscle strength improved. Additionally, sex‐based differences in myofiber size existing at baseline are significantly reduced or eliminated following unloading and recovery.

Purpose: Table grapes are exported in refrigerated (reefer) containers owing to their temperature sensitivity. Previous studies have found that insufficient airflow around pallets of fruit cause hotspots in reefer containers, which could negatively affect fruit quality. This study compared the efficacy of two technologies fitted inside reefer containers to improve airflow for table grape shipments. Method: Ambient and pulp temperature sensors were inserted in two shipments of three containers each; each shipment had one container fitted with airflow Technology 1, one fitted with airflow Technology 2, and a control container. Sensors were placed in cartons in the top, middle and bottom layers of six pallets per container to obtain the ambient and pulp temperature profiles of table grapes along the export cold chain from the cold store in South Africa until the destination distribution centre in the Netherlands. Descriptive statistics and two-way ANOVA tests were used to analyse the datasets. Findings: The largest number of temperature breaks and the longest temperature breaks were recorded in the control containers. Overall, the containers fitted with airflow technologies fared better than the control containers. The containers fitted with Technology 2 performed marginally better than those fitted with Technology 1. However, the sample size of this study was too small to draw definitive conclusions. Further research with larger sample sizes is required for more definitive results. Originality: This article identifies areas along the table grape export cold chain where temperature deviations occur more frequently and links the temperature deviations to product quality. It also ascertains which airflow technologies can help to limit the deterioration of product quality and cut financial losses.

Human metapneumovirus (HMPV) is an important cause of acute lower respiratory infection in children and adults worldwide. There are four genetic subgroups of HMPV and both neutralizing antibodies and T cells contribute to protection. However, little is known about mechanisms of pathogenesis and most published work is based on a few extensively passaged, laboratory-adapted strains of HMPV. In this study, we isolated and characterized a panel of low passage HMPV clinical isolates representing all four genetic subgroups. The clinical isolates exhibited lower levels of in vitro replication compared to a lab-adapted strain. We compared disease phenotypes using a well-established mouse model. Several virulent isolates caused severe weight loss, lung pathology, airway dysfunction, and fatal disease in mice, which was confirmed in three inbred mouse strains. Disease severity did not correlate with lung viral titer, as virulent strains exhibited restricted replication in the lower airway. Virulent HMPV isolates were associated with markedly increased proinflammatory cytokine production and neutrophil influx; however, depletion of neutrophils or genetic ablation of inflammasome components did not reverse disease. Virulent clinical isolates induced markedly increased type I and type III interferon (IFN) secretion in vitro and in vivo. STAT1/2-deficient mice lacking both type I and type III IFN signaling showed reduced disease severity and increased lung viral replication. Inhibition of type I IFN signaling using a blocking antibody or genetic ablation of the type I IFN receptor reduced pathology with minimal effect on viral replication. Conversely, blockade of type III IFN signaling with a neutralizing antibody or genetic ablation of the IFN-lambda receptor had no effect on pathogenesis but restored viral replication. Collectively, these results demonstrate distinct roles for type I and type III IFN in HMPV pathogenesis and immunity.

BackgroundWe aimed to compare patient characteristics, MRSA sequence types, and biofilm production of MRSA strains that did and did not cause a foreign body infection in patients with MRSA bloodstream infections (BSI)MethodsAll adult patients with MRSA BSI hospitalized in two hospitals were identified by clinical microbiology laboratory surveillance. Only patients who had at least one implanted foreign body during the episode of BSI were included.ResultsIn July 2018 - March 2022, of 423 patients identified with MRSA BSI, 118 (28%) had ≥1 foreign body. Among them, 51 (43%) had one or more foreign body infections. In multivariable analysis, factors associated with foreign body infection were history of MRSA infection in the last year (OR=4.7 [1.4-15.5], p=0.012) community-associated BSI (OR=68.1 [4.2-1114.3], p=0.003); surgical site infection as source of infection (OR=11.8 [2-70.4], p=0.007); presence of more than one foreign body (OR=3.4 [1.1-10.7], p=0.033); interval between foreign body implantation and infection

In forensic medicine, estimating human skeletal remains' post-mortem interval (PMI) can be challenging. Following death, bones undergo a series of chemical and physical transformations due to their interactions with the surrounding environment. Post-mortem changes have been assessed using various methods, but estimating the PMI of skeletal remains could still be improved. We propose a new methodology with handheld hyperspectral imaging (HSI) system based on the first results from 104 human skeletal remains with PMIs ranging between 1 day and 2000 years. To differentiate between forensic and archaeological bone material, the Convolutional Neural Network analyzed 65.000 distinct diagnostic spectra: the classification accuracy was 0.58, 0.62, 0.73, 0.81, and 0.98 for PMIs of 0 week–2 weeks, 2 weeks–6 months, 6 months–1 year, 1 year–10 years, and >100 years, respectively. In conclusion, HSI can be used in forensic medicine to distinguish bone materials >100 years old from those

IntroductionIn situ carbon sequestration in forests is important in the context of climate change mitigation, and setting aside managed forests has been proposed as an option for increased carbon sequestration. Comparing set-aside and managed forests may provide insights and rules of thumb on the potential for additional in situ carbon sequestration in set-aside forest.MethodsIn an observational study, we compared re-inventory data from the network of set-aside forest reserves in Flanders, which have been unmanaged for 17–66 years (2 surveys with a 10 years interval), with re-inventory data from the regional forest inventory, representing the overall forest area in Flanders (2 surveys with a 15 years interval).ResultsThe aboveground carbon pools and sequestration rates were higher in the set-aside forests compared to the average forest in Flanders. In the average Flemish forest, the aboveground carbon pool increased from 64.7 to 85.1 tC ha−1, over a period of 15 years. In the set-aside forests, the mean pool was higher at the first measurement and further increased from 84.8 to 102.4 tC ha−1, over a period of 10 years. The mean aboveground annual carbon sequestration rate was 1.3 tC ha−1 year−1 in the average forest in Flanders and 1.8 tC ha−1 year−1 in the set-aside forests. The stocks and fluxes depended on the soil conditions and were higher in set-aside forests on silt and sandy silt sites compared to wet and sand sites. The set-aside forests on dry sites showed additionality in in situ aboveground carbon sequestration. We saw no indication of approaching a culmination point in the first decades following set-aside: plots with high carbon pools did not show lower carbon sequestration. In conclusion, set-aside forests can combine high carbon pools with high sequestration rates on suitable sites. Under the current management policy, we expect Flemish forests—regular and set-aside—to further increase their carbon pools in the coming decades.

Introduction. Les parents atteints d’un trouble de santé mentale (TM) présentent des besoins particuliers pour lesquels les services de santé et les services sociaux actuels ne sont souvent pas adaptés. L’ergothérapeute est bien outillé pour évaluer et intervenir sur les compétences parentales et sur la sécurité et le bien-être du système familial. Toutefois, le rôle de l’ergothérapeute en soutien à la parentalité auprès d’adultes ayant un TM demeure méconnu. Objectif. Recenser l’étendue des connaissances quant aux pratiques actuelles et celles à développer chez l’ergothérapeute en soutien à la parentalité d’adultes atteints d’un TM. Méthodologie. Une revue de la portée utilisant la méthodologie décrite par Arksey et O’Malley (2005) et Levac et al. (2010) a été conduite utilisant les bases de données Embase, Medline, CINAHL et PsycInfo, ainsi que la littérature grise (Google Scholar, GreyLit, Opengrey et GreySource Index). L’ensemble des données fut soumis à une analyse narrative descriptive-analytique s’appuyant sur le Modèle canadien du processus de pratique (MCPP). Résultats. Des 1785 articles scientifiques et documents repérés, 9 articles provenant des bases de données et 23 documents issus de la littérature grise ont rempli les critères d’inclusion et d’exclusion. Les résultats s’organisent en trois principaux thèmes qui sont les suivantes : les pratiques actuelles des ergothérapeutes, l’efficacité des interventions mises en place et les pratiques ergothérapiques à développer ou à renforcer auprès des parents atteints d’un TM et les leviers pour leur développement ou leur amélioration. Les résultats illustrent l’importance de préconiser une approche préventive et centrée sur la famille, d’assurer une collaboration entre les différentes parties prenantes, de développer des interventions accessibles et adaptées à la clientèle et de soutenir le développement des compétences des ergothérapeutes. Le rôle d’agent de changement pour les ergothérapeutes revêt une importance particulière. Conclusion. Les ergothérapeutes doivent continuer à déployer, à documenter et à évaluer leurs pratiques liées à la parentalité, vu leur apport considérable au mieux-être de la famille. Le développement et le renforcement des pratiques doivent aussi s’appuyer sur la recherche visant les défis d’ordre contextuel ainsi que sur la formation initiale et continue. _____________________________ Occupational therapy in parenting support for people living with a mental health disorder: current practice and potential developments Introduction. Parents with a mental health disorder (MHD) present special needs for which current health and social services are often not adapted. The occupational therapist is well equipped to assess and intervene on parenting skills and on the safety and well-being of the family system. However, the role of the occupational therapist in supporting parenthood with adults with MHD remains unknown. Objective. To identify the extent of knowledge regarding current practices and those to be developed by occupational therapists to support the parenting of adults with MHD. Methodology. A scoping review using the methodology described by Arksey and O'Malley (2005) and Levac et al. (2010) was conducted using the Embase, Medline, CINAHL and PsycInfo databases, as well as grey literature (Google Scholar, GreyLit, Opengrey and GreySource Index). All data was subjected to a descriptive-analytical narrative analysis based on the Canadian practice process framework (CPPF). Results. Of the 1785 scientific articles and documents retrieved, 9 articles from the databases, and 23 documents from the gray literature met the inclusion and exclusion criteria. The results were organized into three main themes which are the current practices of occupational therapists, the effectiveness of the interventions, and the occupational therapy practices to be developed, and the levers for their development or improvement. The results illustrate the importance of advocating a preventive and family-centered approach, of ensuring collaboration between the various stakeholders, of developing interventions that are accessible and adapted to the clientele, and of supporting the development of the skills of occupational therapists. The role of change agent for occupational therapists is essential. Conclusion. Occupational therapists must continue to deploy, document, and evaluate their practices related to parenting, given their considerable contribution to the well-being of the family. The development and strengthening of practices must also be based on research targeting contextual challenges as well as on initial and ongoing training.

Bicuspid aortic valve (BAV), the most common congenital heart defect, is a major cause of aortic valve disease requiring valve interventions and thoracic aortic aneurysms predisposing to acute aortic dissections. The spectrum of BAV ranges from early onset valve and aortic complications (EBAV) to sporadic late onset disease. Rare genomic copy number variants (CNVs) have previously been implicated in the development of BAV and thoracic aortic aneurysms. We determined the frequency and gene content of rare CNVs in EBAV probands (n = 272) using genome-wide SNP microarray analysis and three complementary CNV detection algorithms (cnvPartition, PennCNV, and QuantiSNP). Unselected control genotypes from the Database of Genotypes and Phenotypes were analyzed using identical methods. We filtered the data to select large genic CNVs that were detected by multiple algorithms. Findings were replicated in a BAV cohort with late onset sporadic disease (n = 5040). We identified 3 large and rare (< 1,1000 in controls) CNVs in EBAV probands. The burden of CNVs intersecting with genes known to cause BAV when mutated was increased in case-control analysis. CNVs intersecting with GATA4 and DSCAM were enriched in cases, recurrent in other datasets, and segregated with disease in families. In total, we identified potentially pathogenic CNVs in 9% of EBAV cases, implicating alterations of candidate genes at these loci in the pathogenesis of BAV.

Aneurysmal subarachnoid hemorrhage (aSAH) can be prevented by early detection and treatment of intracranial aneurysms in high-risk individuals. We investigated whether individuals at high risk of aSAH in the general population can be identified by developing an aSAH prediction model with electronic health records (EHR) data. To assess the aSAH model's relative performance, we additionally developed prediction models for acute ischemic stroke (AIS) and intracerebral hemorrhage (ICH) and compared the discriminative performance of the models. We included individuals aged ≥35 years without history of stroke from a Dutch routine care database (years 2007-2020) and defined outcomes aSAH, AIS and ICH using International Classification of Diseases (ICD) codes. Potential predictors included sociodemographic data, diagnoses, medications, and blood measurements. We cross-validated a Cox proportional hazards model with an elastic net penalty on derivation cohorts and reported the c-statistic and 10-year calibration on validation cohorts. We examined 1,040,855 individuals (mean age 54.6 years, 50.9% women) for a total of 10,173,170 person-years (median 11 years). 17,465 stroke events occurred during follow-up: 723 aSAH, 14,659 AIS, and 2,083 ICH. The aSAH model's c-statistic was 0.61 (95%CI 0.57-0.65), which was lower than the c-statistic of the AIS (0.77, 95%CI 0.77-0.78) and ICH models (0.77, 95%CI 0.75-0.78). All models were well-calibrated. The aSAH model identified 19 predictors, of which the 10 strongest included age, female sex, population density, socioeconomic status, oral contraceptive use, gastroenterological complaints, obstructive airway medication, epilepsy, childbirth complications, and smoking. Discriminative performance of the aSAH prediction model was moderate, while it was good for the AIS and ICH models. We conclude that it is currently not feasible to accurately identify individuals at increased risk for aSAH using EHR data.

IntroductionSmall fiber neuropathy (SFN) is a common cause of neuropathic pain in peripheral neuropathies. Good accessibility of diagnostics and treatment is necessary for an accurate diagnosis and treatment of SFN. Evidence is lacking on the quality performance of the diagnostic SFN service in the Netherlands. Our aim was to determine the patient satisfaction and -accessibility of the diagnostic SFN service, and to identify areas for improvement.MethodsIn a single-center, prospective, survey-based cohort study, 100 visiting patients were asked to fill in the SFN patient satisfaction questionnaire (SFN-PSQ), with 10 domains and 51 items. Cut-off point for improvement was defined as ≥ 25% dissatisfaction on an item. A chi-square test and linear regression analyses was used for significant differences and associations of patient satisfaction.ResultsFrom November 2020 to May 2021, 98 patients with SFN-related complaints filled in the online SFN-PSQ within 20 minutes. In 84% of the patients SFN was confirmed, average age was 55.1 (52.5-57.8) years and 67% was female. High satisfaction was seen in the domains 'Waiting List Period', Chest X-ray', 'Consultation with the Doctor or Nurse Practitioner (NP)', 'Separate Consultation with the Doctor or NP about Psychological Symptoms', and 'General' of the SFN service. Overall average patient satisfaction score was 8.7 (IQR 8-10) on a 1-to-10 rating scale. Main area for improvement was shortening the 8-week period for receiving the results of the diagnostic testing (p < 0.05). General health status was statistically significant associated with patient satisfaction (p < 0.05).ConclusionA good reflection of the high patient satisfaction and -accessibility of the SFN-service is shown, with important points for improvement. These results could help hospitals widely to optimize the logistic and diagnostic pathway of SFN analysis, benchmarking patient satisfaction results among the hospitals, and to improve the quality of care of comparable SFN services.

Background and aims Hypertension is a leading risk factor for cardiovascular disease. Electronic health records (EHRs) are routinely collected throughout a person’s care, recording all aspects of health status, including current and past conditions, prescriptions and test results. EHRs can be used for epidemiological research. However, there are nuances in the way conditions are recorded using clinical coding; it is important to understand the methods which have been applied to define exposures, covariates and outcomes to enable interpretation of study findings. This study aimed to identify codelists used to define hypertension in studies that use EHRs and generate recommended codelists to support reproducibility and consistency.Eligibility criteria Studies included populations with hypertension defined within an EHR between January 2010 and August 2023 and were systematically identified using MEDLINE and Embase. A summary of the most frequently used sources and codes is described. Due to an absence of Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT) codelists in the literature, a recommended SNOMED CT codelist was developed to aid consistency and standardisation of hypertension research using EHRs.Findings 375 manuscripts met the study criteria and were eligible for inclusion, and 112 (29.9%) reported codelists. The International Classification of Diseases (ICD) was the most frequently used clinical terminology, 59 manuscripts provided ICD 9 codelists (53%) and 58 included ICD 10 codelists (52%). Informed by commonly used ICD and Read codes, usage recommendations were made. We derived SNOMED CT codelists informed by National Institute for Health and Care Excellence guidelines for hypertension management. It is recommended that these codelists be used to identify hypertension in EHRs using SNOMED CT codes.Conclusions Less than one-third of hypertension studies using EHRs included their codelists. Transparent methodology for codelist creation is essential for replication and will aid interpretation of study findings. We created SNOMED CT codelists to support and standardise hypertension definitions in EHR studies.

Liver retransplantation (reLT) yields poorer outcomes than primary liver transplantation, necessitating careful patient selection to avoid futile reLT. We conducted a retrospective analysis to assess reLT outcomes and identify associated risk factors. All adult patients who underwent a first reLT at the Medical University of Innsbruck from 2000 to 2021 (N = 111) were included. Graft- and patient survival were assessed via Kaplan-Meier plots and log-rank tests. Uni- and multivariate analyses were performed to identify independent predictors of graft loss. Five-year graft- and patient survival rates were 64.9% and 67.6%, respectively. The balance of risk (BAR) score was found to correlate with and be predictive of graft loss and patient death. The BAR score also predicted sepsis (AUC 0.676) and major complications (AUC 0.720). Multivariate Cox regression analysis identified sepsis [HR 5.179 (95% CI 2.575–10.417), p < 0.001] as the most significant independent risk factor for graft loss. At a cutoff of 18 points, the 5 year graft survival rate fell below 50%. The BAR score, a simple and easy to use score available at the time of organ acceptance, predicts and stratifies clinically relevant outcomes following reLT and may aid in clinical decision-making.

Abstract Biological invasions represent one of the major threats to biodiversity conservation, especially in island ecosystems. Field‐based assessments of the invasion degree are required for managing and monitoring invaded habitats but there is no unifying measure available in the literature. Here, we developed a standardised method for quantifying invasion degree based on four metrics: alien and native species cover, alien species richness, the occurrence frequency of alien species and invasion level, and demonstrated its use in two contrasted habitats of Reunion Island. This rapid survey quantified relative abundance and diversity of alien plant species among three vegetation strata (herbaceous, shrub and tree) in a systematic sampling. In lowland tropical forest, it took 40 person days to survey 150 ha (344 plots), and 52 person days in subalpine vegetation to survey 125 ha (304 plots). Our results showed that the herbaceous stratum was the most invaded in terms of invasion level; more than 45% in lowland tropical forest and almost 55% in subalpine vegetation. Based on cluster analysis and kriging, we mapped three different levels of invasion highlighting potential invasion fronts. We found that it was important to differentiate invasion degree per vegetation strata as mean alien cover was significantly different between strata at each site. This method is suitable for the majority of protected areas where fine‐scale assessment is required to characterise the spatial pattern of plant invasions, monitor invasive species and identify invasion foci to control or populations of emerging species to eradicate.

To identify markers of oocyte competence, we compared the biochemical characteristics of fluid and cells from follicles containing oocytes with different capacities to form an embryo. Follicles (5-6 mm) were dissected, and follicular fluid (FF), granulosa cells (GC), cumulus cells (CC) from immature and mature cumulus-oocyte-complexes (COC) were individually collected. The oocytes were matured, fertilized, and cultured individually until day 8 (D8) of development. On D8, the samples were grouped according to embryo production into those that gave rise to blastocysts (EMB) and those that did not reach the blastocyst stage (NEMB). In CCs from immature and mature COCs and GCs, expression of CASP3, SERPINE2, VCAN, LUM, FSHR, EGFR, PGR, and GHR genes was quantified. Cell-free DNA (cfDNA), progesterone, and estradiol concentrations in the FF were determined. Data were analyzed by Mann-Whitney U test (GraphPad Prism 9). GHR was highly expressed in immature CCs from the EMB group, whereas CASP3 was highly expressed in mature CCs from the NEMB group (P

We present the current state of the art in micro-transfer printing for heterogeneously integrated silicon photonic integrated circuits. The versatility of the technology is highlighted, as is the way ahead to make this technology a key enabler for next-generation photonic systems-on-chip.

Introduction Uterine adenomyosis is a benign gynaecological disease that causes physical and psychological problems, impacting on relationships. It is poorly understood and consequently may be diagnosed late. This protocol describes the process of conducting a systematic scoping review to retrieve and describe literature examining the daily experience and impact of living with uterine adenomyosis. It will explore the journey to diagnosis (and perceptions of what this process is like); identify the main concepts currently used in the literature and highlight gaps in knowledge for future research in relevant populations.Methods and analysis Using the Joanna Briggs Institute methodology, the population–concept–context approach is used to form clear review questions. A three-phase search strategy will locate published and unpublished evidence from multiple sources. All articles reporting on the personal experiences of women diagnosed with uterine adenomyosis will be considered. Findings from qualitative, quantitative and mixed-method study designs from all settings will be included, not limited by geography but restricted to English. Documents will be screened by the primary researcher, supported by university supervisors. Search outputs will be presented using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 flow diagram. No formal quality appraisal will be conducted. Review findings will be descriptively collated and reported consistent with the Scoping Review Extension of the PRISMA checklist. Patient and public involvement engagement reflected a positive response for the project that this protocol supports.Ethics and dissemination As primary data will not be collected, formal ethical approval is not required. Prepared as part of a professional doctorate thesis, the findings of this study will be disseminated via peer-reviewed publications, conference presentations, support groups and social media networks.

BackgroundTesticular germ cell tumors (TGCT) are the most frequent cancer in young men in developed countries. Parental occupational exposures during early-life periods are suspected to increase TGCT risk. The objective was to estimate the association between parental occupations at birth and adult TGCT.MethodsA case–control study was conducted, including 454 TGCT cases aged 18–45 from 20 French university hospitals, matched to 670 controls based on region and year of birth. Data collected from participants included parental jobs at birth coded according to the International Standard Classification of Occupation—1968 and the French nomenclature of activities—1999. Odds ratios (OR) for TGCT and 95% confidence intervals (CI) were estimated using conditional logistic regression, adjusting for TGCT risk factors.ResultsPaternal jobs at birth as service workers (OR = 1.98, CI 1.18–3.30), protective service workers (OR = 2.40, CI 1.20–4.81), transport equipment operators (OR = 1.96, CI 1.14–3.37), specialized farmers (OR = 2.66, CI 1.03–6.90), and maternal jobs as secondary education teachers (OR = 2.27, CI 1.09–4.76) or in secondary education (OR = 2.35, CI 1.13–4.88) were significantly associated with adult TGCT. The risk of seminoma was increased for the above-mentioned paternal jobs and that of non-seminomas for public administration and defence; compulsory social security (OR = 1.99, CI 1.09–3.65); general, economic, and social administration (OR = 3.21, CI 1.23–8.39) for fathers; and secondary education teacher (OR = 4.67, CI 1.87–11.67) and secondary education (OR = 3.50, CI 1.36–9.01) for mothers.ConclusionSome paternal jobs, such as service workers, transport equipment operators, or specialized farmers, and maternal jobs in secondary education seem to be associated with an increased risk of TGCT with specific features depending on the histological type. These data allow hypotheses to be put forward for further studies as to the involvement of occupational exposures in the risk of developing TGCT, such as exposure to pesticides, solvents, or heavy metals.

BackgroundHealth benefits have been reported with art activities. Heart rate is a biomarker of health state. The aim of this randomized controlled trial (RCT) was to compare the changes in heart rate over a 3 month-period in older adults participating in art-based activities at the Montreal Museum of Fine Arts (MMFA, Quebec, Canada) and in their control counterparts.Methods/designParticipants (mean age 71.0 ± 5.1; 84.9% female) were a subset of older community dwellers recruited in a RCT in two parallel groups (n = 28 in the intervention group and n = 25 in the control group) who had their heart rate recorded. They attended weekly participatory MMFA-based art activities over a 3-month period. Heart rate was collected via the smart watch Fitbit Alta HR at baseline (M0) and at 3 months (M3). The outcomes were mean heart rate per hour for the full day, including active and inactive hours.ResultsHeart rate for full day (p = 0.018) and active hours (p = 0.028) were slower in the intervention group compared to the control group. Decrease in mean heart rate for full day between M0 and M3 in the intervention group was higher than in the control group (p = 0.030). The linear regression showed that MMFA-based art activities decreased full day heart rate (Coefficient of regression Beta = −6.2 with p = 0.010).ConclusionMMFA-based art activities significantly decreased full day heart rate, suggesting a health benefit in older community dwellers who participated in the RCT.Clinical trial registration: NCT03679715.

IntroductionCardiometabolic diseases (CMD) are the leading cause of death in high-income countries and are largely attributable to modifiable risk factors. Population health management (PHM) can effectively identify patient subgroups at high risk of CMD and address missed opportunities for preventive disease management. Guided by the Reach, Efficacy, Adoption, Implementation and Maintenance (RE-AIM) framework, this scoping review of PHM interventions targeting patients in primary care at increased risk of CMD aims to describe the reported aspects for successful implementation.MethodsA comprehensive search was conducted across 14 databases to identify papers published between 2000 and 2023, using Arksey and O’Malley’s framework for conducting scoping reviews. The RE-AIM framework was used to assess the implementation, documentation, and the population health impact score of the PHM interventions.ResultsA total of 26 out of 1,100 studies were included, representing 21 unique PHM interventions. This review found insufficient reporting of most RE-AIM components. The RE-AIM evaluation showed that the included interventions could potentially reach a large audience and achieve their intended goals, but information on adoption and maintenance was often lacking. A population health impact score was calculated for six interventions ranging from 28 to 62%.DiscussionThis review showed the promise of PHM interventions that could reaching a substantial number of participants and reducing CMD risk factors. However, to better assess the generalizability and scalability of these interventions there is a need for an improved assessment of adoption, implementation processes, and sustainability.

Purpose: PARP-inhibitors have potent radiosensitizing properties in pre-clinical models. To identify the maximum tolerated dose (MTD) of the PARP-inhibitor Olaparib in combination with radiotherapy in patients with head and neck cancer, a single institutional phase-I dose escalation trial was initiated. Patients and methods: The starting dose of Olaparib was 25 mg BID, combined with radiotherapy (70 Gy in 35 fractions). The MTD was defined as the highest dose-level at which not more than 20 % of patients experience dose-limiting toxicities (DLT) or as the highest reached dose in the absence of DLT’s. Results: One week Olaparib‐only treatment (25 mg QD) was administered to all patients prior to the start of radiotherapy. In dose-level I, Olaparib (25 mg BID) was combined with accelerated radiotherapy (70 Gy in 6 weeks). Because of DLT’s in 3 of the 4 treated patients (acute tracheotomy 5 and 7 months and osteoradionecrosis 7 months after treatment), the Olaparib dose was de-escalated to 25 mg QD, and combined with conventional radiotherapy (70 Gy in 7 weeks) (dose-level II). There were no DLT’s observed in 5 patients treated within dose-level II. After a median follow-up of 60 months, the 4-year LRC and OS rates were 77.8 % and 88.9 %, respectively. Conclusion: Olaparib 25 mg QD combined with conventionally fractionated radiotherapy was well tolerated and identified as the MTD while severe DLT’s were observed when Olaparib 25 mg BID was combined with accelerated radiation. This combination might be further explored in future Olaparib dose escalation studies in patients with locally-advanced HNSCC unfit for cisplatin-based chemoradiotherapy.

Previous research has demonstrated that lead (Pb2+, for the remainder of the paper referred to as Pb) and other heavy metals are present in table eggs from backyard birds. While the source of Pb exposure is unknown, exposure to the environment via the foraging behavior of backyard poultry is likely a significant factor. A longitudinal cohort study was conducted to better understand how oral Pb consumption correlates with Pb concentration in table eggs and other physiological compartments (i.e. bone, blood, and liver). In order of absolute mean concentration, Pb was most present in bone (226.24 ppb experimental vs. 31.00 ppb control), blood (14.47 ppb experimental vs 0.27 ppb control), liver (11.24 ppb experimental vs 0.75 ppb control), and egg (1.17 ppb experimental vs 0.06 ppb control). The low concentration of Pb in table eggs implies that Pb preferentially accumulates in other tissues aside from the egg. While this study showed that eggs have the lowest overall tropism for Pb, the presence of Pb in other tissues demonstrates a public health risk when chickens are orally exposed to Pb via oral consumption.

(1) Background: Dysregulation in serotonergic and noradrenergic systems may be implicated in the neurobiophysiological mechanisms underlying pain-related cognitive impairment in chronic whiplash-associated disorders (CWAD). This study aimed to unravel the role of serotonergic and noradrenergic descending pathways in cognitive functioning at rest and in response to exercise in people with CWAD. (2) Methods: 25 people with CWAD were included in this double-blind, randomized, controlled crossover study. Endogenous descending serotonergic and noradrenergic inhibitory mechanisms were modulated by using a single dose of a selective serotonin reuptake inhibitor (Citalopram) or a selective norepinephrine reuptake inhibitor (Atomoxetine). Cognitive performance was studied at rest and in response to exercise (1) without medication intake; (2) after intake of Citalopram; and (3) after intake of Atomoxetine. (3) Results: After Atomoxetine intake, selective attention improved compared with the no medication day (p < 0.05). In contrast, a single dose of Citalopram had no significant effect on cognitive functioning at rest. When performing pairwise comparisons, improvements in selective attention were found after exercise for the no medication condition (p < 0.05). In contrast, after intake of Citalopram or Atomoxetine, selective and sustained attention worsened after exercise. (4) Conclusions: A single dose of Atomoxetine improved selective attention only in one Stroop condition, and a single dose of Citalopram had no effect on cognitive functioning at rest in people with CWAD. Only without medication intake did selective attention improve in response to exercise, whereas both centrally acting medications worsened cognitive performance in response to a submaximal aerobic exercise bout in people with CWAD.

Abstract Background Formal education surrounding abortion care during pre-clinical years of medical school is limited and will likely decrease with the overturning of Roe v. Wade. This study describes and evaluates the impact of an original abortion didactic session implemented during the pre-clinical years of medical school. Methods We implemented a didactic session at the University of California Irvine outlining abortion epidemiology, pregnancy options counseling, standard abortion care, and the current legislative landscape surrounding abortion. The preclinical session also included an interactive, small group case-based discussion. Pre-session and post-session surveys were obtained to evaluate changes in participants’ knowledge and attitudes and to collect feedback for future sessions. Results 92 matched pre- and post-session surveys were completed and analyzed (response rate 77%). The majority of the respondents identified themselves as more “pro-choice” compared to “pro-life” on the pre-session survey. Results reflected significantly increased comfort discussing abortion care and significantly increased knowledge about abortion prevalence and techniques after the session. Qualitative feedback was overwhelmingly positive and reflected participants’ appreciation for the focus on the medical aspects of abortion care as opposed to an ethical discussion. Conclusions Abortion education targeted to preclinical medical students can be implemented effectively by a medical student cohort with institutional support.