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We discuss the properties of the non-Hermitian 𝒫𝒯-symmetric two–scalar fields model. We investigate stability areas of this system and properties of vortices that emerge in the system of two interacting scalar fields. The phase diagram of the model contains stable and unstable regions depending on 𝒫𝒯-symmetry breaking, which intercross the regions of U(1)-symmetric and U(1)-broken phases in a nontrivial way. At non-zero quartic couplings, the non-Hermitian model possesses classical vortex solutions in the 𝒫𝒯-symmetric regions. We also consider a close Hermitian analog of the theory and compare the results with the non-Hermitian model.

Jonas Hoffmann,1,* Burkhard Haastert,2,* Manuela Brüne,1 Matthias Kaltheuner,3 Alexander Begun,1 Nadja Chernyak,4 Andrea Icks1,4,5 1Institute of Health Services Research and Health Economics, German Diabetes Center, Düsseldorf, Germany; 2mediStatistica, Neuenrade, Germany; 3Specialized Diabetes Practice Leverkusen, Leverkusen, Germany; 4Faculty of Medicine, Centre for Health and Society, Institute of Health Services Research and Health Economics, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany; 5German Center for Diabetes Research, Ingolstädter Neuherberg, Germany *These authors contributed equally to this work Aims: Patients with diabetes are probably often unaware of their comorbidities. We estimated agreement between self-reported comorbidities and administrative data. Methods: In a random sample of 464 diabetes patients, data from a questionnaire asking about the presence of 14 comorbidities closely related to diabetes were individually linked with statutory health insurance data. Results: Specificities were >97%, except cardiac insufficiency (94.5%), eye diseases (93.8%), peripheral arterial disease (92.6%), hypertension (90.9%), and peripheral neuropathy (85.8%). Sensitivities were 90% (hypertension, myocardial infarction, and eye disease), and six were below 70%. Six negative predictive values were >90%, and two

In species with internal fertilization, sperm, and seminal fluid are transferred from male to female during mating. While both sperm and seminal fluid contain various types of molecules, including RNA, the role of most of these molecules in the coordination of fertilization or in other possible functions is poorly understood. In Drosophila, exosomes from the accessory gland, which produces seminal fluid, are transferred to females, but their potential cargoes have not been described. Moreover, while the RNA composition of sperm has been described in several mammalian species, little work on this problem has occurred in Drosophila. Here we use single nucleotide polymorphism differences between males and females from a set of highly inbred lines of D. melanogaster, and transcriptome data from the female reproductive tract, sperm, testis, and accessory gland, to investigate the potential origin, male vs female, RNA molecules isolated from 3 female reproductive tract organs, the seminal receptacle and spermatheca, which store sperm, and the parovaria, which does not. We find that mated females carry male-derived transcripts from many genes, including those that are markers of the accessory gland and known seminal fluid proteins. Our observations also support the idea that intact sperm transcripts can be isolated from the female sperm storage organs.

Most eukaryotic genes have been vertically transmitted to the present from distant ancestors. However, variable gene number across species indicates that gene gain and loss also occurs. While new genes typically originate as products of duplications and rearrangements of preexisting genes, putative de novo genes-genes born out of ancestrally nongenic sequence-have been identified. Previous studies of de novo genes in Drosophila have provided evidence that expression in male reproductive tissues is common. However, no studies have focused on female reproductive tissues. Here we begin addressing this gap in the literature by analyzing the transcriptomes of 3 female reproductive tract organs (spermatheca, seminal receptacle, and parovaria) in 3 species-our focal species, Drosophila melanogaster-and 2 closely related species, Drosophila simulans and Drosophila yakuba, with the goal of identifying putative D. melanogaster-specific de novo genes expressed in these tissues. We discovered several candidate genes, located in sequence annotated as intergenic. Consistent with the literature, these genes tend to be short, single exon, and lowly expressed. We also find evidence that some of these genes are expressed in other D. melanogaster tissues and both sexes. The relatively small number of intergenic candidate genes discovered here is similar to that observed in the accessory gland, but substantially fewer than that observed in the testis.

Transcriptome analysis of several animal clades suggests that male reproductive tract gene expression evolves quickly. However, the factors influencing the abundance and distribution of within-species variation, the ultimate source of interspecific divergence, are poorly known. Drosophila melanogaster, an ancestrally African species that has recently spread throughout the world and colonized the Americas in the last roughly 100 years, exhibits phenotypic and genetic latitudinal clines on multiple continents, consistent with a role for spatially varying selection in shaping its biology. Nevertheless, geographic expression variation in the Americas is poorly described, as is its relationship to African expression variation. Here, we investigate these issues through the analysis of two male reproductive tissue transcriptomes [testis and accessory gland (AG)] in samples from Maine (USA), Panama, and Zambia. We find dramatic differences between these tissues in differential expression between Maine and Panama, with the accessory glands exhibiting abundant expression differentiation and the testis exhibiting very little. Latitudinal expression differentiation appears to be influenced by the selection of Panama expression phenotypes. While the testis shows little latitudinal expression differentiation, it exhibits much greater differentiation than the accessory gland in Zambia vs American population comparisons. Expression differentiation for both tissues is non-randomly distributed across the genome on a chromosome arm scale. Interspecific expression divergence between D. melanogaster and D. simulans is discordant with rates of differentiation between D. melanogaster populations. Strongly heterogeneous expression differentiation across tissues and timescales suggests a complex evolutionary process involving major temporal changes in the way selection influences expression evolution in these organs.

Background Errors associated with failures in filing, actioning and communicating blood test results can lead to delayed and missed diagnoses and patient harm. This study aimed to audit how blood tests in primary care are filed, actioned and communicated in primary care, to identify areas for patient safety improvements.Methods UK primary care clinicians were recruited through the Primary Care Academic CollaboraTive (PACT). PACT members audited 50 recent sets of blood tests from their practice and retrospectively extracted data on blood test result coding, actioning and communication. PACT members received a practice report, showing their own results, benchmarked against other participating practices.Results PACT members from 57 general practices across all four UK nations collected data on 2572 patients who had blood tests in April 2021. In 89.9% (n=2311) they agreed with the initial clinician’s actioning of blood tests; 10.1% disagreed, either partially (7.1%) or fully (3.0%).In 44% of patients (n=1132) an action (eg, ‘make an appointment’) was specified by the filing clinician. This action was carried out in 89.7% (n=1015/1132) of cases; in 6.8% (n=77) the action was not carried out, in 3.5% (n=40) it was unclear. In the 117 cases where the test result had not been actioned 38% (n=45) were felt to be at low risk of harm, 1.7% (n=2) were at high risk of harm, 0.85% (n=1) came to harm.Overall, in 47% (n=1210) of patients there was no evidence in the electronic health records that results had been communicated. Out of 1176 patients with one or more abnormal results there was no evidence of test communication in 30.6% (n=360). There were large variations between practices in rates of actioning and communicating tests.Conclusion This research demonstrates variation in the way blood test results are actioned and communicated, with important patient safety implications.

Abstract Searching for genes contributing to longevity is a typical task in association analysis. A number of methods can be used for finding this association -- from the simplest method based on the technique of contingency tables to more complex algorithms involving demographic data, which allow us to estimate the genotype-specific hazard functions. The independence of individuals is the common assumption in all these methods. At the same time, data on related individuals such as twins are often used in genetic studies. This paper proposes an extension of the relative risk model to encompass twin data. We estimate the power and also discuss what happens if we treat the twin data using the univariate model.

In animals with internal fertilization, males transfer gametes and seminal fluid during copulation, both of which are required for successful reproduction. In Drosophila and other insects, seminal fluid is produced in the paired accessory gland (AG), the ejaculatory duct, and the ejaculatory bulb. The D. melanogaster AG has emerged as an important model system for this component of male reproductive biology. Seminal fluid proteins produced in the Drosophila AG are required for proper storage and use of sperm by the females, and are also critical for establishing and maintaining a suite of short- and long-term postcopulatory female physiological responses that promote reproductive success. The Drosophila AG is composed of two main cell types. The majority of AG cells, which are referred to as main cells, are responsible for production of many seminal fluid proteins. A minority of cells, about 4%, are referred to as secondary cells. These cells, which are restricted to the distal tip of the D. melanogaster AG, may play an especially important role in the maintenance of the long-term female post-mating response. Many studies of Drosophila AG evolution have suggested that the proteins produced in the gland evolve quickly, as does the transcriptome. Here, we investigate the evolution of secondary cell number and position in the AG in a collection of eight species spanning the entire history of the Drosophila genus. We document a heretofore underappreciated rapid evolutionary rate for both number and position of these specialized AG cells, raising several questions about the developmental, functional, and evolutionary significance of this variation.

We discuss the gauge field theory approach to protein structure study, which allows a natural way to introduce collective degrees of freedom and nonlinear topological structures. Local symmetry of proteins and its breaking in the medium is considered, what allows to derive Abelian Higgs model of protein backbone, correct folding of which is defined by gauge symmetry breaking due hydrophobic forces. Within this model structure of protein backbone is defined by superposition of one-dimensional topological solitons (kinks), what allows to reproduce the three-dimensional structure of the protein backbone with precision up to 1A and to predict its dynamics.

Building upon literature that considers social network influences on health attitudes and behaviors among youth experiencing homelessness, this study assessed associations regarding social norms of pregnancy, perceived by youth experiencing homelessness (ages 13-25; N = 304) as endorsed by their network members, and youths' pregnancy attitudes. Multivariate results revealed that youth who perceived their street peers as more objecting to (versus encouraging of) them becoming involved in a pregnancy were 51% less likely to endorse pro-pregnancy attitudes (OR = 0.49, p < 0.01). Youth who perceived their serious partners as more objecting to their pregnancy involvement were 74% less likely to endorse pro-pregnancy attitudes (OR = 0.26, p < 0.01). Results suggest utility in exploring peer-based and dyadic approaches to prevention efforts with this group.

Abstract Background and Aim Pouchitis is a common complication after restorative ileal pouch–anal anastomosis following proctocolectomy for ulcerative colitis. Antibiotic‐dependent or antibiotic‐refractory chronic pouchitis (CP), which is a common cause of pouch failure affecting 15–20% of patients, is challenging to treat. The efficacy of second‐line immunomodulator and biologic therapy remains poorly defined. We present a pooled analysis of real‐world efficacy data from peer‐reviewed full‐text manuscripts, focusing on immunomodulator and biologic therapies in CP. Methods Embase and PubMed databases were searched for full‐text articles describing the treatment of CP. We performed a systematic review and pooled analysis of published studies to assess the efficacy of immunomodulators, including thiopurines and methotrexate, and biologics including antitumor necrosis factor, anti‐integrin, and interleukin‐12/23 antagonists. Clinical and endoscopic response and remission rates were combined for pooled analyses. Rates of treatment discontinuation and safety were also assessed. Results Pooled analysis comprised 20 full‐text articles (485 patients). Overall clinical response rate was 46% (95% CI: 35–59%) and clinical remission rate was 35% (95% CI: 21–52%). Overall endoscopic response and remission rates were 41% (95% CI: 18–68%) and 15% (95% CI: 5–39%), respectively. Individual agents' safety profile was reassuring, with vedolizumab being the most favorable. Conclusion The real‐world efficacy data of immunomodulators in the treatment of CP is insufficient. Vedolizumab and ustekinumab appeared effective and safe for CP, whereas anti‐TNFs showed higher rates of adverse events. The high heterogeneity within the studies is attributed to the real‐world study design, obfuscating drug efficacy comparisons across the studies. Further studies are required to define the comparative effectiveness of available treatments of CP.

Conclusion: EBD is a highly effective and safe procedure in both de novo and anastomotic strictures < 4 cm that can prevent or delay the need for surgical treatment.

Many traits responsible for male reproduction evolve quickly, including gene expression phenotypes in germline and somatic male reproductive tissues. Rapid male evolution in polyandrous species is thought to be driven by competition among males for fertilizations and conflicts between male and female fitness interests that manifest in postcopulatory phenotypes. In Drosophila, seminal fluid proteins secreted by three major cell types of the male accessory gland and ejaculatory duct are required for female sperm storage and use, and influence female postcopulatory traits. Recent work has shown that these cell types have overlapping but distinct effects on female postcopulatory biology, yet relatively little is known about their evolutionary properties. Here, we use single-nucleus RNA-Seq of the accessory gland and ejaculatory duct from Drosophila melanogaster and two closely related species to comprehensively describe the cell diversity of these tissues and their transcriptome evolution for the first time. We find that seminal fluid transcripts are strongly partitioned across the major cell types, and expression of many other genes additionally defines each cell type. We also report previously undocumented diversity in main cells. Transcriptome divergence was found to be heterogeneous across cell types and lineages, revealing a complex evolutionary process. Furthermore, protein adaptation varied across cell types, with potential consequences for our understanding of selection on male postcopulatory traits.

Abstract Fossil apes from the eastern Mediterranean are central to the debate on African ape and human (hominine) origins. Current research places them either as hominines, as hominins (humans and our fossil relatives) or as stem hominids, no more closely related to hominines than to pongines (orangutans and their fossil relatives). Here we show, based on our analysis of a newly identified genus, Anadoluvius, from the 8.7 Ma site of Çorakyerler in central Anatolia, that Mediterranean fossil apes are diverse, and are part of the first known radiation of early members of the hominines. The members of this radiation are currently only identified in Europe and Anatolia; generally accepted hominins are only found in Africa from the late Miocene until the Pleistocene. Hominines may have originated in Eurasia during the late Miocene, or they may have dispersed into Eurasia from an unknown African ancestor. The diversity of hominines in Eurasia suggests an in situ origin but does not exclude a dispersal hypothesis.

Early work on de novo gene discovery in Drosophila was consistent with the idea that many such genes have male-biased patterns of expression, including a large number expressed in the testis. However, there has been little formal analysis of variation in the abundance and properties of de novo genes expressed in different tissues. Here, we investigate the population biology of recently evolved de novo genes expressed in the Drosophila melanogaster accessory gland, a somatic male tissue that plays an important role in male and female fertility and the post mating response of females, using the same collection of inbred lines used previously to identify testis-expressed de novo genes, thus allowing for direct cross tissue comparisons of these genes in two tissues of male reproduction. Using RNA-seq data, we identify candidate de novo genes located in annotated intergenic and intronic sequence and determine the properties of these genes including chromosomal location, expression, abundance, and coding capacity. Generally, we find major differences between the tissues in terms of gene abundance and expression, though other properties such as transcript length and chromosomal distribution are more similar. We also explore differences between regulatory mechanisms of de novo genes in the two tissues and how such differences may interact with selection to produce differences in D. melanogaster de novo genes expressed in the two tissues.

Background: Patient reported outcomes (PROs) are important measures in acquired heart disease but have not been well defined in Adult Congenital Heart Disease (ACHD). Our aim was to explore the discriminatory capacity of PRO survey tools in Fontan circulatory failure (FCF). Methods: Consecutive adults were enrolled from our ambulatory clinics. Inclusion criteria were age ≥18 years, a Fontan circulation or a hemodynamically insignificant shunt lesion, and sufficient cognitive/language abilities to complete PROs. A comprehensive package of PRO measures, designed to assess perceived health-related quality of life (HRQOL) was administered (including the Kansas City Cardiomyopathy Questionnaire [KCCQ-12], EuroQol-5-dimension [EQ5D], Short Form Health Status Survey [SF-12], self-reported New York Heart Association [NYHA] Functional Class, and Specific Activity Scale [SAS]). Results: We compared 54 Fontan patients (35 ± 10 years) to 25 simple shunt lesion patients (34 ± 11 years). The KCCQ-12 score was lower in Fontan versus shunt lesion patients (87 [IQR 79, 95] versus 100 [IQR 97, 100], p-value < 0.001). The FCF subgroup was associated with lower KCCQ-12 scores as compared with the non-FCF subgroup (82 [IQR 56, 89] versus 93 [IQR 81, 98], p-value = 0.002). Although the KCCQ-12 had the best discriminatory capacity for determination of FCF of all PRO tools studied (c-statistic 0.75 [CI 0.62, 0.88]), superior FCF discrimination was achieved when the KCCQ-12 was combined with all PRO tools (c-statistic 0.82 [CI 0.71, 0.93]). Conclusions: The KCCQ-12 questionnaire demonstrated good discriminatory capacity for the identification of FCF, which was further improved through the addition of complementary PRO tools. Further research will establish the value of PRO tools to guide management strategies in ACHD.

Bacteria associated with marine invertebrate play a fundamental role in the biology, ecology, development and evolution of their hosts. Although many studies have been focused on the microbial populations of benthic and pelagic habitats, little is known about bacteria colonizing tube-dwelling polychaete. In this context, the current study provided the first characterization of the Melinna palmata Grube, 1870 microbiome based on Illumina sequencing of 16S rRNA gene of the polychaete tissue and proximate sediments collected from the Black Sea, Romania, along a 24.2 m – 45.4 m depth-gradient. The diversity, taxonomic composition and deduced functional profile of the tissue and sediments associated bacterial communities were compared and analyzed in relation with the environmental parameters. This polychaete harbored a distinct bacterial assemblage as compared to their sediments and independent on the depth of their habitat, including 8 phyla in tissues dominated by Proteobacteria, and 12 phyla in sediments majorly represented by Actinobacteriota, respectively. At order level, Synechococcales, Rhodobacterales and Actinomarinales were highly represented in the M. palmata microbiome, while Microtrichales, Anaerolineales and Caldilineales were mostly found in sediments. A significant correlation was observed between Cyanobacteria taxa and the dissolved oxygen concentrations in shallow waters impacted by the Danube inputs. Meanwhile, this phylum showed a positive correlation with Planctomycetota colonizing the invertebrate tissues, and a negative one with Actinobacteriota and Chloroflexi found in sediments. The deduced functional profile of these bacterial assemblages suggested the prevalence of the amino acid and carbohydrate metabolism for both analyzed matrices. This pioneering report on the M. palmata microbiome highlighted the environment contribution to bacterial species enrichment of the polychaete, and provided a glimpse on the putative role of microbial communities associated with this marine organism.

Reproductive justice is an intersectional social movement, theory, and praxis well aligned with social work's mission and values. Yet, advancing reproductive justice-the right to have children, to not have children, to parent with safety and dignity, and to sexual and bodily autonomy-has not been a signature area of scholarship and practice for the field. This article argues that it is critical for social work to advance reproductive justice to truly achieve the grand challenge of closing the health gap. The article starts by discussing the history and tenets of reproductive justice and how it overlaps with social work ethics. The authors then highlight some of the ways by which social workers have been disruptors of and complicit in the oppression of individuals, families, and communities with regard to their reproductive rights and outcomes. The article concludes with a call to action and recommendations for social work to foreground reproductive justice in research, practice, and education efforts by centering marginalized voices while reimagining the field's pursuit of health equity.

Developmental plasticity influences the size of adult tissues in insects. Tissues can have unique responses to environmental perturbation during development; however, the prevalence of within species evolution of tissue-specific developmental plasticity remains unclear. To address this, we studied the effects of temperature and nutrition on wing and femur size in D. melanogaster populations from a temperate and tropical region. Wings were more sensitive to temperature, while wings and femurs were equally responsive to nutrition in both populations and sexes. The temperate population was larger under all conditions, except for femurs of starved females. In line with this, we observed greater femur size plasticity in response to starvation in temperate females, leading to differences in sexual dimorphism between populations such that the slope of the reaction norm of sexual dimorphism in the tropical population was double that of the temperate population. Lastly, we observed a significant trend for steeper slopes of reaction norms in temperate than in tropical females, but not in males. These findings highlight that plasticity divergence between populations can evolve heterogeneously across sexes and tissues and that nutritional plasticity can alter sexual dimorphism in D. melanogaster.