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Abstract Molecules that can reversibly switch between electronic states under an external stimulus are of interest to numerous applications. Complexes of open shell metal ions with redox active ligands undergo valence tautomerism, resulting in magnetic, colour and structural switching, relevant to data storage and actuators. However, the precise structural changes occurring during valence tautomerism in the solid state are unclear due to the lack of atomic-resolution characterization. Here, variable temperature and high-pressure single crystal X-ray diffraction is used to characterize valence tautomerism in two isostructural cobalt complexes, [Co(bis(6-methyl-2-pyridylmethyl) amine)(3,5-di-tert-butyl-1,2-dioxolene)]+ and [Co(tris(6-methyl-2-pyridylmethyl)amine)(3,5-di-tert-butyl-1,2-dioxolene)]+ to atomic resolution. The less sterically hindered dimethylated complex exhibits two-step thermally-induced interconversion between the high-spin CoII-seminquinonate and low-spin CoIII-catecholate forms (valence tautomerism) at 155 and 95 K due to the presence of two symmetry-independent complexes. In contrast, the more sterically hindered trimethylated complex does not display thermal valence tautomerism. Both complexes exhibit unique behaviour under high pressure. The dimethylated species undergoes gradual, one-step valence tautomerism in both symmetry-independent complexes concurrently between 0.43 GPa and 1.30 GPa. In the trimethylated species, pressure is sufficient to overcome steric hindrance, leading to one-step valence tautomerism between 2.60 GPa and 3.10 GPa, demonstrating pressure-triggered valence tautomerism in a thermally inactive complex. This study is among the few investigations using in situ high-pressure single crystal X-ray diffraction to achieve atomic-level structural characterization of valence tautomerism, aiding the development of robust structure-property relationships in these types of complexes.

Abstract The International Mouse Phenotyping Consortium (IMPC) systematically produces and phenotypes mouse lines with presumptive null mutations to provide insight into gene function. The IMPC now uses the programmable RNA-guided nuclease Cas9 for its increased capacity and flexibility to efficiently generate null alleles in the C57BL/6N strain. In addition to being a valuable novel and accessible research resource, the production of 3313 knockout mouse lines using comparable protocols provides a rich dataset to analyze experimental and biological variables affecting in vivo gene engineering with Cas9. Mouse line production has two critical steps – generation of founders with the desired allele and germline transmission (GLT) of that allele from founders to offspring. A systematic evaluation of the variables impacting success rates identified gene essentiality as the primary factor influencing successful production of null alleles. Collectively, our findings provide best practice recommendations for using Cas9 to generate alleles in mouse essential genes, many of which are orthologs of genes linked to human disease.

Magnetic resonance imaging (MRI) is known for its accurate soft tissue delineation of tumors and normal tissues. This development has significantly impacted the imaging and treatment of cancers. Radiomics is the process of extracting high-dimensional features from medical images. Several studies have shown that these extracted features may be used to build machine-learning models for the prediction of treatment outcomes of cancer patients. Various feature selection techniques and machine models interrogate the relevant radiomics features for predicting cancer treatment outcomes. This study aims to provide an overview of MRI radiomics features used in predicting clinical treatment outcomes with machine learning techniques. The review includes examples from different disease sites. It will also discuss the impact of magnetic field strength, sample size, and other characteristics on outcome prediction performance.

Acute pancreatitis (AP) is an inflammatory condition, characterized by elevated levels of amylase and lipase, with manifestation of acute abdominal pain and acute with high mortality and morbidity rates. The most common causes of AP other than gallbladder stones and alcohol include hypercalcemia, infections, hypercalcemia, and drugs. One such drug associated with AP is azathioprine. Azathioprine for dermatologic lesions are used as steroid sparing immunomodulatory agents. Here in, we report such an unusual case of azathioprine induced acute pancreatitis.

Abstract Background Anorexia nervosa is a serious and potentially lethal psychiatric disorder. Furthermore, there is significant evidence that some individuals develop a very long-standing form of the illness that requires a variety of different treatment interventions over time. Objective The primary goal of this paper was to provide a review of treatment strategies for severe and enduring anorexia nervosa (SE-AN) with the particular focus on treatments involving hospital care. Additionally, we wish to highlight a contemporary approach to such care and provide qualitative reactions to this model from both staff and patients. Methods A selective and strategic review of the treatment literature for SE-AN was conducted for the current paper. Emphasis was placed on clinical or scientific papers related to hospital-based care. Additionally, staff who work on a specific inpatient eating disorder unit with a substantial treatment program for SE-AN, along with a number of SE-AN patients were surveyed regarding their experiences working on, or receiving treatment on the unit. Importantly, the staff of this unit created a specific treatment protocol for individuals receiving hospital care. The results of the highlight both advantages and challenges of a hospital-based protocol oriented toward emphasizing quality of life, medical stability, and a health-promoting meal plan. Discussion While there is general inconsistency with the type of treatment that is best suited to individuals with SE-AN, this is particularly true for higher levels of care that rely on inpatient hospital units or residential treatment settings. This is a highly significant clinical topic in need of further clinical and scientific examination.

Abstract Decisions about the treatment of eating disorders do not occur in a socio-political vacuum. They are shaped by power relations that produce categories of risk and determine who is worthy of care. This impacts who gets access to care and recognition of rights in mental health services. Globally, there are calls for more human rights-based approaches in mental health services to reduce coercion, improve collaborative decision making and enhance community care. Treating individuals with longstanding, Severe and Enduring Eating Disorders (SEED) or Severe and Enduring Anorexia Nervosa (SE-AN) can be particularly problematic when it involves highly controversial issues such as treatment withdrawal and end-of-life decisions and, where legally permissible, medically assisted dying. In this article, we argue that the socio-political context in which clinical decision making occurs must be accounted for in these ethical considerations. This encompasses considerations of how power and resources are distributed, who controls these decisions, who benefits and who is harmed by these decisions, who is excluded from services, and who is marginalised in decision making processes. The article also presents tools for critically reflective practice and collaborative decision-making that can support clinicians in considering power factors in their practice and assisting individuals with longstanding eating disorders, SEED and SE-AN to attain their rights in mental health services.

Vegetables and cereals, besides health benefits, are of significant socio-economic importance in Ghana, because, the whole production process provides employment for both rural and urban dwellers. Unfortunately, the high prevalence of pests (weeds inclusive) and disease complexes, associated with them, inflict significant economic damage on field and storage, if not properly managed. This review purposed to document challenges from pesticide use and suggest perspective recommendations for mitigation. Information was sourced from published journal articles, technical and annual reports (Research Extension Farmer Linkage Committee (RELC), Environmental Protection Agency (EPA, Ghana), and Institutions), the authors’ observations and personal communication with farmers, agricultural extension agents and other experts. The review analysis indicated over 80% of farmers use pesticides, particularly on high-value cash vegetable and cereal crops; and also to alleviate human labour constraints. Challenges such as pesticide resistance, increasing incidence of existing pests and diseases, or the manifestation of new pests and diseases due to climate change or continuous cropping among others were evident, prompting shifts to increased pesticide use for management and also for desired profit. Highlights on concerns for the insatiable quest for pests and disease control by chemical means, consequently increased reports on dangers of continuous pesticide use on human and public health, the environment and the economy. This research revealed that a minimal understanding of the use and application of pesticides contributed to the non-intended effects on health and the environment. Hopefully, the identified gaps and recommendations if properly addressed by policy would significantly enhance quality production systems for global trade and protect local consumers. State the contribution of this study to scholarship.

Abstract Strength, ductility, and failure properties of metals are tailored by plastic deformation routes. Predicting these properties requires modeling of the structural dynamics and stress evolution taking place on several length scales. Progress has been hampered by a lack of representative 3D experimental data at industrially relevant degrees of deformation. We present an X-ray imaging based 3D mapping of an aluminum polycrystal deformed to the ultimate tensile strength (32% elongation). The extensive dataset reveals significant intra-grain stress variations (36 MPa) up to at least half of the inter-grain variations (76 MPa), which are dominated by grain orientation effects. Local intra-grain stress concentrations are candidates for damage nucleation. Such data are important for models of structure-property relations and damage.

Abstract Resistance to pod shattering is a key domestication-related trait selected for seed production in many crops. Here, we show that the transition from shattering in wild soybeans to shattering resistance in cultivated soybeans resulted from selection of mutations within the coding sequences of two nearby genes - Sh1 and Pdh1. Sh1 encodes a C2H2-like zinc finger transcription factor that promotes shattering by repressing SHAT1-5 expression, thereby reducing the secondary wall thickness of fiber cap cells in the abscission layers of pod sutures, while Pdh1 encodes a dirigent protein that orchestrates asymmetric lignin distribution in inner sclerenchyma, creating torsion in pod walls that facilitates shattering. Integration analyses of quantitative trait locus mapping, genome-wide association studies, and allele distribution in representative soybean germplasm suggest that these two genes are primary modulators underlying this domestication trait. Our study thus provides comprehensive understanding regarding the genetic, molecular, and cellular bases of shattering resistance in soybeans.

Abstract Background Many people with opioid use disorder who stand to benefit from buprenorphine treatment are unwilling to initiate it due to experience with or fear of both spontaneous and buprenorphine-precipitated opioid withdrawal (BPOW). An effective means of minimizing withdrawal symptoms would reduce patient apprehensiveness, lowering the barrier to buprenorphine initiation. Ketamine, approved by the FDA as a dissociative anesthetic, completely resolved BPOW in case reports when infused at a sub-anesthetic dose range in which dissociative symptoms are common. However, most patients attempt buprenorphine initiation in the outpatient setting where altered mental status is undesirable. We explored the potential of short-term use of ketamine, self-administered sublingually at a lower, sub-dissociative dose to assist ambulatory patients undergoing transition to buprenorphine from fentanyl and methadone. Methods Patients prescribed ketamine were either (1) seeking transition to buprenorphine from illicit fentanyl and highly apprehensive of BPOW or (2) undergoing transition to buprenorphine from illicit fentanyl or methadone and experiencing BPOW. We prescribed 4–8 doses of sublingual ketamine 16 mg (each dose bioequivalent to 3–6% of an anesthetic dose), monitored patients daily or near-daily, and adjusted buprenorphine and ketamine dosing based on patient response and prescriber experience. Results Over a period of 14 months, 37 patients were prescribed ketamine. Buprenorphine initiation was completed by 16 patients, representing 43% of the 37 patients prescribed ketamine, and 67% of the 24 who reported trying it. Of the last 12 patients who completed buprenorphine initiation, 11 (92%) achieved 30-day retention in treatment. Most of the patients who tried ketamine reported reduction or elimination of spontaneous opioid withdrawal symptoms. Some patients reported avoidance of severe BPOW when used prophylactically or as treatment of established BPOW. We developed a ketamine protocol that allowed four of the last patients to complete buprenorphine initiation over four days reporting only mild withdrawal symptoms. Two patients described cognitive changes from ketamine at a dose that exceeded the effective dose range for the other patients. Conclusions Ketamine at a sub-dissociative dose allowed completion of buprenorphine initiation in the outpatient setting in the majority of patients who reported trying it. Further research is warranted to confirm these results and develop reliable protocols for a range of treatment settings.

Aim: Human epidermal growth factor receptor-2 (HER2) is a well-established prognostic and predictive biomarker. It is an FDA-approved therapeutic target for HER2 positive breast, gastroesophageal, and more recently, lung and colon cancers. It is an emerging biomarker in biliary tract, bladder, cervical, endometrial, ovarian, and pancreatic cancers. The emergence of new indications warrants further characterization of HER2 expression in diverse cancer populations. This study investigated HER2 expression in solid tumour samples and the feasibility of obtaining these results. Methods: Prospective consent was obtained at a Canadian tertiary academic cancer center from adult oncology patients who were referred for molecular genetic testing of malignant tissue samples. Standard HER2-targeted malignancies were considered breast and gastroesophageal, and were excluded from this study. Between July 2020 and November 2023, 499 samples of solid tumors underwent immunohistochemistry (IHC) HER2 staining. A median turnaround time (TAT) of 14 days would be considered feasible for clinical decision making. Results: The mean age (± SD) of participants was 67 ± 12.5 years, with 270 (54%) male and 229 (46%) female. HER2 protein expression was measured in 42 unique cancer types. IHC levels of 0, 1+, 2+, and 3+ were reported and were 43%, 12%, 35%, and 10% of all analyzable samples respectively (tissue inadequate in 3% of samples). The median TAT for HER2 expression results from time of request to result in release was 18 (interquartile range, 11 to 30) days. Conclusions: HER2 protein expression varies widely between different cancer types. TAT for HER2 IHC results was a median of 18 days, which is close to our feasibility cut-off.

Abstract Objective To report initial results from the Amyotrophic Lateral Sclerosis (ALS) Identified genetic testing (GT) program on characteristics of individuals tested and frequency of reported disease‐causing variants. Methods ALS Identified used the Invitae Amyotrophic Lateral Sclerosis panel (Invitae, San Francisco, CA, USA) to assay 22 ALS‐associated genes. Sponsored by Biogen (Cambridge, MA, USA), the program was launched in June 2021 and was available at no charge to individuals ≥18 years in the United States and Puerto Rico with an ALS diagnosis or a known family history of ALS. Deidentified data were available to Biogen. Results As of 26 October 2023, 998 healthcare professionals ordered the panel at 681 unique care sites. Of 8054 individuals examined, 7483 (92.9%) were reported to have a clinical diagnosis of ALS, while 571 (7.1%) were asymptomatic relatives. Of the individuals with a clinical ALS diagnosis, 57.7% were male (n = 4319) and 42.3% female (n = 3164). Mean (SD) age at diagnosis is 62 (13) years. Out of the 7483 clinically diagnosed individuals, 1810 (24.2%) showed genetic variations in ALS‐associated genes. Among these, 865 individuals (47.8%) carried pathogenic variants, and 44 (2.4%) had likely pathogenic variants, totaling 12.1% of the clinically diagnosed population. Interpretation Since 2021 there has been robust uptake and sustained use of the ALS Identified program, one of the largest samples of people with ALS to date across the United States, demonstrating the interest and need for genetic ALS testing.

Abstract Life expectancy in sub-Saharan Africa (SSA) has increased owing to economic growth and improvements in medical care. An increased representation of older people among orthopaedic trauma victims is a significant consequence of population ageing, as shown in previous studies, including few in SSA. This retrospective review in Nigeria aims to corroborate previous studies and highlight the emergence of geriatric orthopaedic trauma (GOT) as a public health concern in SSA. Among 241 orthopaedic trauma in-patients aged ≥ 60, the mortality rate was 3.7%. They made up 21.2% of adult orthopaedic trauma admissions. The incidence of GOT increased steadily over the five-year study period with a spike during COVID-19 lockdown. Males constituted 51%. Mean age was 72.5 years (range, 60–105 years). Mean distance to the hospital was 35.8 km and 50.6% lived farther than 10 km. The main causes of injury were falls (50.6%) and traffic crashes (48.1%). Fractures were the predominant (91.7%) injuries. Univariate analyses revealed significant differences along age and gender stratifications. Longer distance to the hospital significantly delayed presentation. The study supports previous studies and shows that GOT is evolving as a public health concern in SSA. The 2030 Sustainable Development agenda is apt to stem the trend.

Abstract Background Cardiometabolic diseases are a major global health concern. This study aims to identify areas for targeted interventions and investigate the impact of socioeconomic status and lifestyle as a potential mediator in the context of the US. Methods Our study analyzed data from the Health Information National Trends Survey 5, a nationwide survey by the National Cancer Institute. Using standardized scales and questions, we examined cardiometabolic disease outcomes, lifestyle factors, and socioeconomic status of non-institutionalized civilians aged 18 + in the US. We analyzed the data using structural equation modelling. Results Our findings show that socioeconomic status and lifestyle significantly predict cardiometabolic disease outcomes. However, our analysis did not support lifestyle as the primary mediating factor in the association between socioeconomic status and cardiometabolic diseases, suggesting that other factors may significantly influence this relationship. Conclusions Cardiometabolic diseases require lifestyle and structural interventions addressing socioeconomic factors. Policymakers must consider multifaceted factors to prevent, detect, and manage these diseases effectively and equitably.

Abstract Multidrug efflux pumps have been found to play a crucial role in drug resistance in bacteria and eukaryotes. In this study, we investigated the presence of functional multidrug and toxic compound extrusion (MATE) efflux pumps, inferred from whole genome sequencing, in the halophilic archaeon Halorubrum amylolyticum CSM52 using Hoechst 33342 dye accumulation and antimicrobial sensitivity tests in the presence and absence of efflux pump inhibitors (EPIs). The whole genome sequence of H. amylolyticum CSM52 contained two putative MATE-type efflux pump genes, which may contribute to the inherent resistance to conventional antimicrobial agents reported in archaea. Antimicrobial susceptibility of the wild-type H. amylolyticum CSM52 testing revealed a lack of sensitivity to a wide range of antimicrobials, including glycopeptides, aminoglycosides, macrolides, fluoroquinolones, tetracycline, and chloramphenicol. However, the presence of EPIs, such as thioridazine, fluoxetine, and chlorpromazine, significantly increased the susceptibility of H. amylolyticum CSM52 to a number of these antimicrobials, indicating the potential involvement of efflux pumps in the observed resistance. A molecular modelling study with EPIs and substrate antimicrobials provided important insights into the molecular interactions with the putative transporter. It suggests that the occupancy of the transporter channel by EPIs has the potential to impact the efflux of antimicrobials. Phylogenetic analysis of the amino acid sequences of both MATE pumps showed low similarity with bacterial representatives, suggesting the presence of novel and distinct MATE efflux pumps in archaea. Our findings provide the first experimental evidence of active antibiotic efflux mechanisms in archaea and their potential roles in antimicrobial resistance, broadening our understanding of mechanisms of archaeal antimicrobial resistance, an overlooked aspect of AMR research.

Abstract Background Ghana is a malaria-endemic country with the entire population at risk. The Northern region of the country recorded the highest malaria case fatality rate (CFR) for two consecutive years: 1.11% in 2013 and 1.07% in 2014. Even though the National Malaria Elimination Programme (NMEP) has achieved a reduction in malaria mortality, the existence of high case fatality in the Northern region was alarming. This study, therefore, aimed to determine the factors associated with malaria mortality in the northern region of Ghana to institute control measures. Methods An unmatched case control study was conducted from July 2015 to August 2015. The study population consisted of patients admitted to health facilities for severe malaria in the Northern region of Ghana. A case was defined as a patient diagnosed with severe malaria at an eligible health facility who died as a result of malaria. A control was a patient diagnosed with severe malaria admitted to an eligible health facility who did not die. Health facilities that recorded CFRs of 1.0% and above were randomly sampled for this study, after which, 10 cases and 20 controls were recruited from each health facility. Information on cases and controls was then abstracted from hospital records using an electronically deployed abstraction tool. Continuous variables were expressed as means and medians, and categorical variables as frequencies and proportions. Multivariable logistic regression was used to assess the strength of the association between malaria mortality and factors predictive of malaria mortality. A p-value of

Research on the origin of life investigates the transition from abiotic chemistry to the emergence of biology, with the ‘RNA world hypothesis’ as the leading theory. RNA’s dual role in storage and catalysis suggests its importance in this narrative. The discovery of natural ribozymes emphasizes RNA’s catalytic capabilities in prebiotic environments, supporting the plausibility of an RNA world and prompting exploration of precellular evolution. Collective autocatalytic sets (CASs) mark a crucial milestone in this transition, fostering complexity through autocatalysis. While modern biology emphasizes sequence-specific polymerases, remnants of CASs persist in primary metabolism highlighting their significance. Autocatalysis, driven by CASs, promotes complexity through mutually interdependent catalytic sets. Yet, the transition from ribonucleotides to complex RNA oligomers remains puzzling. Questions persist about the genesis of the first self-replicating RNA molecule, RNA’s stability in prebiotic conditions, and the shift to complex molecular reproduction. This review delves into diverse facets of the RNA world’s emergence, addressing critical bottlenecks and scientific advances. Integrating insights from simulation and in vitro evolution research, we illuminate the multistep biogenesis of catalytic RNA from the abiotic world. Through this exploration, we aim to elucidate the journey from the primordial soup to the dawn of life, emphasizing the interplay between chemistry and biology in understanding life’s origins.

Abstract Amyotrophic lateral sclerosis (ALS) is a debilitating neurodegenerative condition leading to progressive muscle weakness, atrophy, and ultimately death. Traditional ALS clinical evaluations often depend on subjective metrics, making accurate disease detection and monitoring disease trajectory challenging. To address these limitations, we developed the nQiALS toolkit, a machine learning-powered system that leverages smartphone typing dynamics to detect and track motor impairment in people with ALS. The study included 63 ALS patients and 30 age- and sex-matched healthy controls. We introduce the three core components of this toolkit: the nQiALS-Detection, which differentiated ALS from healthy typing patterns with an AUC of 0.89; the nQiALS-Progression, which separated slow and fast progression at specific thresholds with AUCs ranging between 0.65 and 0.8; and the nQiALS-Fine Motor, which identified subtle progression in fine motor dysfunction, suggesting earlier prediction than the state-of-the-art assessment. Together, these tools represent an innovative approach to ALS assessment, offering a complementary, objective metric to traditional clinical methods and which may reshape our understanding and monitoring of ALS progression.

Abstract Background Trigeminal trophic syndrome is a rare cranial and facial condition caused by damage to the central or peripheral branches of the trigeminal nerve. This syndrome consists of a triad of anesthesia, paresthesia, and crescent-shaped facial ulcer involving the ala nasi and sometimes extending to the upper lip. Although previous screening for human immunodeficiency virus in some patients with trigeminal trophic syndrome was negative, we present a unique case of trigeminal trophic syndrome who tested positive for human immunodeficiency virus with eye complications. Case presentation We present a rare case of trigeminal trophic syndrome in a 44-year-old Black African woman who tested positive for human immunodeficiency virus. She presented with a 6-week history of progressive, persistent, and painless left sided facial and scalp ulcerations that started as small skin erosion. Diagnosis of trigeminal trophic syndrome was made on clinical grounds based on the triad of anesthesia, paresthesia, and unilateral crescent-shaped ulcer in the trigeminal dermatome and her past medical history. The ulcer healed completely after counseling and pharmacological therapy, but she later developed left periorbital cellulitis and left upper eyelid full-thickness defect. Conclusion This is by far the first documented case of trigeminal trophic syndrome with a positive human immunodeficiency virus test. Testing for human immunodeficiency virus in patients with trigeminal trophic syndrome is necessary as this can help improve clinical management and treatment outcomes. Seeking the services of specialists remotely in resource constraint settings is beneficial for managing complications associated with trigeminal trophic syndrome.

Abstract Background Retained surgical items (RSI) are preventable events that pose a significant risk to patient safety. Current strategies for preventing RSIs rely heavily on manual instrument counting methods, which are prone to human error. This study evaluates the feasibility and performance of a deep learning-based computer vision model for automated surgical tool detection and counting. Methods A novel dataset of 1,004 images containing 13,213 surgical tools across 11 categories was developed. The dataset was split into training, validation, and test sets at a 60:20:20 ratio. An artificial intelligence (AI) model was trained on the dataset, and the model’s performance was evaluated using standard object detection metrics, including precision and recall. To simulate a real-world surgical setting, model performance was also evaluated in a dynamic surgical video of instruments being moved in real-time. Results The model demonstrated high precision (98.5%) and recall (99.9%) in distinguishing surgical tools from the background. It also exhibited excellent performance in differentiating between various surgical tools, with precision ranging from 94.0 to 100% and recall ranging from 97.1 to 100% across 11 tool categories. The model maintained strong performance on a subset of test images containing overlapping tools (precision range: 89.6–100%, and recall range 97.2–98.2%). In a real-time surgical video analysis, the model maintained a correct surgical tool count in all non-transition frames, with a median inference speed of 40.4 frames per second (interquartile range: 4.9). Conclusion This study demonstrates that using a deep learning-based computer vision model for automated surgical tool detection and counting is feasible. The model’s high precision and real-time inference capabilities highlight its potential to serve as an AI safeguard to potentially improve patient safety and reduce manual burden on surgical staff. Further validation in clinical settings is warranted.

Abstract Herbivorous insects alter biogeochemical cycling within forests, but the magnitude of these impacts, their global variation, and drivers of this variation remain poorly understood. To address this knowledge gap and help improve biogeochemical models, we established a global network of 74 plots within 40 mature, undisturbed broadleaved forests. We analyzed freshly senesced and green leaves for carbon, nitrogen, phosphorus and silica concentrations, foliar production and herbivory, and stand-level nutrient fluxes. We show more nutrient release by insect herbivores at non-outbreak levels in tropical forests than temperate and boreal forests, that these fluxes increase strongly with mean annual temperature, and that they exceed atmospheric deposition inputs in some localities. Thus, background levels of insect herbivory are sufficiently large to both alter ecosystem element cycling and influence terrestrial carbon cycling. Further, climate can affect interactions between natural populations of plants and herbivores with important consequences for global biogeochemical cycles across broadleaved forests.

Abstract Objective The objective of this study is to investigate the prevalence of diabetes in a clinical population of primarily Indigenous women in Guatemala. Results In a retrospective chart review of a clinical program serving 13,643 primarily Indigenous women in Guatemala, crude diabetes prevalence was 8.3% (95% Confidence Interval [CI]: 7.8 to 8.7) and age-adjusted diabetes prevalence was 7.9% (95% CI: 7.3 to 8.5). Among those with diabetes, 37.9% (95% CI: 35.1 to 40.8) of women were undiagnosed. Diabetes prevalence rose significantly with increasing age and was significantly higher among women with obesity (risk ratio: 1.4 [95% CI: 1.1 to 1.8]) and among women least likely to be in poverty (risk ratio: 2.0 [95% CI: 1.5 to 2.6]). Diabetes prevalence was significantly lower among Indigenous women (risk ratio: 0.7 [95% CI: 0.6 to 0.9]) and among women who spoke Mayan languages rather than Spanish (risk ratio: 0.7 [95% CI: 0.6 to 0.9]). There was no significant difference in diabetes prevalence between women who lived in rural settings and women who lived in urban settings.

Abstract The biomedical research community addresses reproducibility challenges in animal studies through standardized nomenclature, improved experimental design, transparent reporting, data sharing, and centralized repositories. The ARRIVE guidelines outline documentation standards for laboratory animals in experiments, but genetic information is often incomplete. To remedy this, we propose the Laboratory Animal Genetic Reporting (LAG-R) framework. LAG-R aims to document animals’ genetic makeup in scientific publications, providing essential details for replication and appropriate model use. While verifying complete genetic compositions may be impractical, better reporting and validation efforts enhance reliability of research. LAG-R standardization will bolster reproducibility, peer review, and overall scientific rigor.

In recognition of the critical role of residency programs in narrowing healthcare inequalities, Global Health scholarships were introduced at Mbarara University of Science and Technology (MUST) in 2011. Since then, at least 154 postgraduate students in priority programs have benefited. We conducted an online cross-sectional survey to examine how the scholarships and beneficiaries have impacted MUST and the community. Fifty (50) beneficiaries, representing 32.5%, responded, of whom 36 (72%) were alumni. Most respondents were males (n = 30; 60%) pursing Master of Medicine (n = 29; 58%) or Master of Nursing Science (n = 20; 40%) programs. The scholarship schemes included First Mile (n = 29; 58%), Kayanja (n = 12; 24%), Paiko (n = 5; 10%) and Seed (n = 4; 8%). The majority of the scholarships supported both tuition and research fees (n = 41; 82%), the rest being partial. Career advancement was undertaken by eight (16%) of the scholars in the form of fellowships (n = 3; 6%), other masters (n = 3; 6%) and PhDs (n = 3; 6%), with some students having attained a combination of these. All scholars belonged to at least one health professional association. Over 88% (n = 32) of the alumni and 28% (n = 4) of the students were employed. The majority of those employed were in the public sector (n = 24; 66.7%), mainly the health sector (n = 18; 50%), academia (n = 14; 38.9) or both (n = 4; 11.1%). There was a high impact on health care provision, undergraduate training and research carried out by the scholars both during training and post-graduation. High levels of career satisfaction, scholarship impact and academic program relevance were reported. The findings provide insights on how low-fund specialty scholarships can have a far-reaching impact on local training, health care and research in low- and middle-income countries.

Background: Homelessness is a global challenge affecting both high-income and lower-income countries. While survival is a priority, when assessing rehousing programs, thriving should be a goal. There is, however, a lack of clarity around the concept of thriving in existing literature, as for example it is used interchangeably across a number of professions. Aim: This paper provides an in-depth concept analysis of thriving, with a specific focus on thriving post-homelessness. Method: Walker and Avant’s (2011) concept analysis method was utilized. Results: As a result of this concept analysis, eight defining attributes were identified, including bio-psycho-social-spiritual improvement, adaptive coping styles, a sense of accomplishment, satisfaction across multiple life domains, functional well-being, improving or achieving a high level of performance, finding meaning in life or life activities, and having the necessities of daily living. It was found that thriving is a multidimensional process with subjective and objective components as well as an outcome, which all contribute to an individual's well-being and satisfaction. As a consequence of thriving, one feels more secure and confident and an enhanced sense of belonging. Conclusion: This concept analysis includes an updated definition of an individual's thriving post-homelessness in order to allow for comprehensive measurement in the context of housing research, including a positive assessment of one's life situation across multiple domains, as well as access to basic necessities such as shelter, food, and clothing. Future research can utilize the results of this concept analysis to explore thriving within the context of housing, especially to establish a well-structured housing program for persons exiting homelessness.

Abstract Background Passively collected smartphone sensor data provide an opportunity to study physical activity and mobility unobtrusively over long periods of time and may enable disease monitoring in people with amyotrophic lateral sclerosis (PALS). Methods We enrolled 63 PALS who used Beiwe mobile application that collected their smartphone accelerometer and GPS data and administered the self‐entry ALS Functional Rating Scale‐Revised (ALSFRS‐RSE) survey. We identified individual steps from accelerometer data and used the Activity Index to summarize activity at the minute level. Walking, Activity Index, and GPS outcomes were then aggregated into day‐level measures. We used linear mixed effect models (LMMs) to estimate baseline and monthly change for ALSFRS‐RSE scores (total score, subscores Q1–3, Q4–6, Q7–9, Q10–12) and smartphone sensor data measures, as well as the associations between them. Findings The analytic sample (N = 45) was 64.4% male with a mean age of 60.1 years. The mean observation period was 292.3 days. The ALSFRS‐RSE total score baseline mean was 35.8 and had a monthly rate of decline of −0.48 (p‐value

Abstract Background The Community-based Health Planning and Services (CHPS) initiative plays a key role in delivering maternal and child health nutrition services in Ghana. This study explored bottle necks hindering the delivery of maternal and child nutrition services at CHPS zones and searched for strategies to address them from the perspective of community health officers in rural Northern Ghana. Methods An exploratory qualitative cross-sectional study design using key informant interviews involving the municipal nutrition officer and Community Health Officers (CHOs) from eleven CHPS zones was carried out in April 2019. Manual data analysis was done using the framework analysis approach in qualitative data analysis for applied policy research. Results This study identified challenges of maternal and child nutrition services in the Jirapa municipality to be municipal health directorate and CHPS zone based in nature. Municipal health directorate based challenges were inadequate logistics/medicines; lack of staff training; lack of supervision/monitoring; and inadequate financial support/motivation/incentives. CHPS zone based challenges were lack of planning activities by staff; inadequate home visits; lack of commitment by staff; and lack of community meetings/engagements. Proposed strategies to address municipal health directorate based challenges included adequate provision of logistics/medicines; frequent training of staff in maternal and child nutrition related issues; frequent supervision/monitoring activities from the municipal health directorate; and providing financial support/motivation/incentives at the CHPS zones. Proposed strategies to address CHPS zone based challenges were planning of activities; improved home visits; increased commitment towards delivering maternal and child nutrition services; and frequent community meetings/engagements. Conclusion In order to improve maternal and child nutrition services at CHPS zones, there is the need to address certain systemic challenges at both the municipal or district health directorate and CHPS zones levels of the primary health care system. It is recommended that, the Municipal Health Directorate; the Municipal Health Management Team; the Municipal Assembly and all relevant stakeholders involved in improving maternal and child nutrition services at the community level, actively engage CHOs to help address the systemic challenges.

Abstract Conservation agriculture (CA) is a set of principles thought to be able to enhance crop productivity while minimizing impacts on the environment. The evidence base for CA can be challenging to synthesize because it encompasses many different practices and social and agroecological outcomes. To facilitate synthesis of CA evidence we have created a dataset organizing 218 response variables from five common categories of CA: cover crops, tillage management, pest management, nutrient management, and crop diversification. These data cover the Midwestern United States (U.S.) from 1980–2020. The dataset is also summarized and visualized on the AgEvidence website, which enables users to interactively explore, filter, and download data. We hope this dataset will help a wide variety of stakeholders, including researchers, policy makers, advocacy groups, and growers access the evidence needed to make informed and impactful decisions about how to produce food with less negative environmental impact.

Abstract Extracellular vesicles have emerged as important mediators of cell-to-cell communication in the pathophysiology of fibrotic diseases. One such disease is Peyronie’s disease (PD), a fibrotic disorder of the penis caused by uncontrolled transformation of resident fibroblasts to alpha-smooth muscle actin positive myofibroblasts. These cells produce large amounts of extracellular matrix, leading to formation of a plaque in the penile tunica albuginea (TA), causing pain, penile curvature, and erectile dysfunction. We have used primary fibroblasts derived from the TA of PD patients to explore the role of transforming growth factor beta 1 (TGF-β1), a key signalling factor in this process. TGF-β1 treatment elicited a range of responses from the myofibroblasts: (i) they secreted extracellular vesicles (EVs) that were more numerous and differed in size and shape from those secreted by fibroblasts, (ii) these EVs prevented TGF-β1-induced transformation of fibroblasts in a manner that was dependent on vesicle uptake and (iii) they prevented phosphorylation of Erk1/2, a critical component in modulating fibrogenic phenotypic responses, but did not affect TGF-β1-induced Smad-signalling. We posit that this effect could be linked to enrichment of TSG-6 in myofibroblast-derived EVs. The ability of myofibroblast-derived vesicles to prevent further myofibroblast transformation may establish them as part of an anti-fibrotic negative feedback loop, with potential to be exploited for future therapeutic approaches.

Abstract Maize demand in Sub-Saharan Africa is expected to increase 2.3 times during the next 30 years driven by demographic and dietary changes. Over the past two decades, the area cropped with maize has expanded by 17 million hectares in the region, with limited yield increase. Following this trend could potentially result in further maize cropland expansion and the need for imports to satisfy domestic demand. Here, we use data collected from 14,773 smallholder fields in the region to identify agronomic practices that can improve farm yield gains. We find that agronomic practices related to cultivar selection, and nutrient, pest, and crop management can double on-farm yields and provide an additional 82 million tons of maize within current cropped area. Research and development investments should be oriented towards agricultural practices with proven capacity to raise maize yields in the region.

Radiation treatment of cancers like prostate or cervix cancer requires considering nearby bone structures like vertebrae. In this work, we present and validate a novel automated method for the 3D segmentation of individual lumbar and thoracic vertebra in computed tomography (CT) scans. It is based on a single, low-complexity convolutional neural network (CNN) architecture which works well even if little application-specific training data are available. It is based on volume patch-based processing, enabling the handling of arbitrary scan sizes. For each patch, it performs segmentation and an estimation of up to three vertebrae center locations in one step, which enables utilizing an advanced post-processing scheme to achieve high segmentation accuracy, as required for clinical use. Overall, 1763 vertebrae were used for the performance assessment. On 26 CT scans acquired for standard radiation treatment planning, a Dice coefficient of 0.921 ± 0.047 (mean ± standard deviation) and a signed distance error of 0.271 ± 0.748 mm was achieved. On the large-sized publicly available VerSe2020 data set with 129 CT scans depicting lumbar and thoracic vertebrae, the overall Dice coefficient was 0.940 ± 0.065 and the signed distance error was 0.109 ± 0.301 mm. A comparison to other methods that have been validated on VerSe data showed that our approach achieved a better overall segmentation performance.

Abstract Background Definitive local therapy with stereotactic ablative radiation therapy (SABR) for ultracentral lung lesions is associated with a high risk of toxicity, including treatment related death. Stereotactic MR-guided adaptive radiation therapy (SMART) can overcome many of the challenges associated with SABR treatment of ultracentral lesions. Methods We retrospectively identified 14 consecutive patients who received SMART to ultracentral lung lesions from 10/2019 to 01/2021. Patients had a median distance from the proximal bronchial tree (PBT) of 0.38 cm. Tumors were most often lung primary (64.3%) and HILUS group A (85.7%). A structure-specific rigid registration approach was used for cumulative dose analysis. Kaplan-Meier log-rank analysis was used for clinical outcome data and the Wilcoxon Signed Rank test was used for dosimetric data. Results Here we show that SMART dosimetric improvements in favor of delivered plans over predicted non-adapted plans for PBT, with improvements in proximal bronchial tree DMax of 5.7 Gy (p = 0.002) and gross tumor 100% prescription coverage of 7.3% (p = 0.002). The mean estimated follow-up is 17.2 months and 2-year local control and local failure free survival rates are 92.9% and 85.7%, respectively. There are no grade ≥ 3 toxicities. Conclusions SMART has dosimetric advantages and excellent clinical outcomes for ultracentral lung tumors. Daily plan adaptation reliably improves target coverage while simultaneously reducing doses to the proximal airways. These results further characterize the therapeutic window improvements for SMART. Structure-specific rigid dose accumulation dosimetric analysis provides insights that elucidate the dosimetric advantages of SMART more so than per fractional analysis alone.

Abstract Current approaches to diagnosing male infertility inadequately assess the complexity of the male gamete. Beyond the paternal haploid genome, spermatozoa also deliver coding and non-coding RNAs to the oocyte. While sperm-borne RNAs have demonstrated potential involvement in embryo development, the underlying mechanisms remain unclear. In this study, 47 sperm samples from normozoospermic males undergoing fertility treatment using donor oocytes were sequenced and analyzed to evaluate associations between sperm RNA elements (exon-sized sequences) and blastocyst progression. A total of 366 RNA elements (REs) were significantly associated with blastocyst rate (padj

Background: The annual meetings hosted by the American Shoulder and Elbow Surgeons (ASES) present the latest prepublication literature in shoulder and elbow surgery, facilitating early dissemination of novel findings that impact clinical decision-making. Evaluating the publication rate of presented abstracts at ASES conferences becomes crucial in assessing the quality of research showcased, as these presentations often precede the peer-review process. Methods: The ASES conference programs from 2015-2019 were reviewed to identify presented abstracts. For each abstract, the title, author(s), conference year, and meeting type (open vs. closed) were recorded. The names of the author(s) of each abstract were searched in the PubMed and Google Scholar databases to determine if there was an associated published manuscript. For each identified manuscript, the title, author(s), date of publication, publishing journal, impact factor of the publishing journal, level of evidence, and number of citations were recorded. Results: A total of 316 abstracts were presented as podium lectures at ASES open and closed meetings between 2015 and 2019. Within 3 years of presentation, 240 (75.9%) of the presented abstracts resulted in publication. There was an increase in the proportion of abstracts resulting in publication within 3 years of the presentation from 2015-2019 (R = 0.8733, P = .053). Overall, the proportion of presented abstracts that went on to publication in peer-reviewed journals also increased (R = 0.8907, P = .043). Manuscripts of abstracts presented at open meetings had a shorter time to publication (8.78 vs. 11.82 months; P = .0160) and were cited more often (40.89 vs. 30.11, P = .0099) than those presented at closed meetings. Conclusion: There has been an increase in the publication rate of abstracts presented at ASES annual meetings in the study period. Published manuscripts of abstracts presented at ASES open conferences were published faster, and were cited more often, than closed conferences. ASES conferences allow for the presentation of high-quality prepublication literature in shoulder and elbow surgery.

We report a cluster of serogroup B invasive meningococcal disease identified via genomic surveillance in older adults in England and describe the public health responses. Genomic surveillance is critical for supporting public health investigations and detecting the growing threat of serogroup B Neisseria meningitidis infections in older adults.

The study was conducted to evaluate the nitrogen utilization efficiency (NUE) of open-pollinated maize cultivars under low nitrogen soil conditions. It took place at the Lower Niger River Basin Development Authority in Ilorin, Nigeria, during the 2019 and 2020 cropping seasons. The nitrogen treatments (0, 45, and 90 kg N ha⁻1) were assigned as the main plots, while the genotypes were designated as sub-plots in a split-plot design. The NUE of open-pollinated varieties (OPVs) and Topcrosses significantly increased with the application of 45 kg of nitrogen per hectare compared to 0 kg. Similarly, the maize grain yield for both OPVs and Topcrosses ranged from 1.40 to 3.57 t ha⁻1 and from 1.07 to 2.64 t ha⁻1 across the two years with the application of 45 kg of nitrogen per hectare compared to 0 kg. With the exception of days to 50 % silking, all other traits tested exhibited a significant correlation with grain yield. A gene pool for tolerance to low nitrogen may have been present in the cultivars Dmr-Esr Y Cif 2 and Acr 95 Tze Comp 4C3, which combined well with other cultivars to produce high grain yield and NUE. Topcrosses, including Ev Dt-Y 2000 Str C0 × Tze-W Dt Str C4, Dmr-Esr Y Cif 2 × Acr 95 Tze Comp 4C3, Ak 95 Dmr-Esrw × Tzb Rel D4 CO-W, Dmr-Esr Y Cif 2 × Tze-W Dt Str C4, and Br 9922 Dmr Sr × Ev Dt-Y 2000 Str C0, also demonstrated strong potential for maize grain yield and NUE. This suggests that these crosses could serve as promising candidates for developing low nitrogen tolerance in maize for low nitrogen soil environments. A positive relationship between fertilizer levels, NUE, and grain yield indicates that proper nitrogen fertilizer management can enhance both NUE and the grain yield of maize genotypes. Genetic analysis revealed that both phenotypic coefficient of variation (PCV) and environmental variance (δ2p) were higher than genotypic coefficient of variation (GCV) and genetic variance (δ2g), suggesting that environmental influences were more significant than genetic factors for the tested traits. Consequently, improving these traits may be achieved by manipulating environmental conditions.

Introduction The purpose of this study was to describe how hip fractures differentially affect male and female patients regarding fracture pattern, hospital course, and postoperative course. Materials and Methods This retrospective case series was performed in a metropolitan healthcare system involving 2996 hip fracture patients >59 years old who underwent surgical management (eg, intramedullary nail, hemiarthroplasty, percutaneous pinning, etc.). Male patients were matched to female patients using 1:2 nearest neighbor matching on the basis of age and Charlson Comorbidity Index. Outcomes of interest included AO/OTA fracture classification, 30- and 90-day readmission, and 30-day and 1-year mortality rates. Results The cohort was predominantly female (64.5%). Female patients were more likely to sustain a type 31A fracture compared to males ( P = .016). The average CCI was higher for males vs females (3.0 ± 2.5 vs 2.6 ± 2.3, P < .001). Males were more likely to be readmitted at 30 ( P < .001) and 90 ( P = .015) days after discharge. The 30-day mortality was higher for males vs females (6.6% vs 4.5%, P = .015). Approximately 19.9% of male patients vs 15.1% of females died within a year of surgery ( P < .001). The average time to surgery was longer for males vs females (23.8 ± 18.8 vs 22.5 ± 21.9 h, P = .048). Males were more likely to die within a year if they underwent surgery >24 h after admission ( P = .029). Discussion Hip fractures have different implications for male and female patients. With age, the incidence of IT fractures increased in females, while it decreased in males. On average, males with hip fractures are sicker than females, which likely contributes to the longer time to surgery as well as increased readmission and mortality rates seen in males. Conclusions Male and female hip fracture patients are not similar in baseline health status, fracture pattern, or postoperative morbidity and mortality. Orthogeriatricians and other providers that care for this patient population should be aware of these differences when implementing treatment strategies to optimize the recovery of their patients, and while educating patients and their families about postoperative expectations.

ObjectiveThis study explores the health information needs of individuals with autism spectrum disorder (ASD) and their caregivers in the post-COVID-19 era by analyzing discussions from Reddit, a popular social media platform.MethodsUtilizing a mixed-method approach that integrates qualitative content analysis with quantitative sentiment analysis, we analyzed user-generated content from the “r/autism” subreddit to identify recurring themes and sentiments.ResultsThe qualitative analysis uncovered key themes, including symptoms, diagnostic challenges, caregiver experiences, treatment options, and stigma, reflecting the diverse concerns within the ASD community. The quantitative sentiment analysis revealed a predominance of positive sentiment across discussions, although significant instances of neutral and negative sentiments were also present, indicating varied experiences and perspectives among community members. Among the machine learning models used for sentiment classification, the Bi-directional Long Short-Term Memory (Bi-LSTM) model achieved the highest performance, demonstrating a validation accuracy of 95.74%.ConclusionsThe findings highlight the need for improved digital platforms and community resources to address the specific health information needs of the ASD community, particularly in enhancing access to reliable information and fostering supportive environments. These insights can guide future interventions and policies aimed at improving the well-being of autistic persons and their caregivers.

Purpose: To investigate the impact of smartphone viewing distance and angle on reaction times. Design: A prospective, self-controlled, single-center study. Methods: Participants engaged in a driving simulation facing a large screen with a simulated brake pedal. They were tasked to stop the simulation once recognizing the deceleration of upcoming traffic. Tests were conducted without distraction and with a standardized distraction simulating texting while driving (TWD). Smartphone positions varied at distances of 30 cm and 60 cm, and at angles parallel to and 30° below the road plane. Reaction times were measured from the onset of simulated closure to detection. Stopping distances were extrapolated using data from the National Highway Traffic Safety Administration. Results: Ninety-four participants were included with a mean age of 24 ± 2.7 years. The control reaction time was 11.5 ± 4.1 s. Reaction times significantly decreased with smartphone placement at a closer distance of 30 cm parallel (17.0 ± 3.3 s) vs 60 cm parallel (15.4 ± 3.8 s), P

Background: Left ventricular assist devices (LVADs) may induce electromagnetic interference (EMI) affecting implanted cardiac devices, including more novel subcutaneous implantable cardiac defibrillators (S-ICDs). Methods: In this case series, the authors retrospectively reviewed courses of 6 patients with S-ICDs who underwent LVAD implantation at a single center. Results: Of the 6 patients reviewed, 4 experienced inappropriate ICD shocks, of which 3 resulted from EMI. Five of the 6 patients ultimately had S-ICD therapies disabled. Conclusions: Due to EMI resulting in inappropriate shocks and improved tolerability of malignant arrhythmias, deactivation or removal of S-ICDs should be considered in patients undergoing LVAD implantation.

The mapping of soils in Africa is at least a century old. We currently have access to various maps depicting mapping units locally and for the continent. In the past two decades, there has been a growing interest in alternatives for generating soil maps through digital soil mapping (DSM) techniques. There are, however, numerous challenges pertaining to the implementation of DSM in Africa, such as the unavailability of appropriate covariates, age and positional error in the measurements, low sampling density, and spatial clustering of the soil data used to fit and validate the models. This review aims to investigate the current state of DSM in Africa, identify challenges specific to implementing DSM in Africa and the ways it has been solved in the literature. We found that nearly half of African countries had an existing digital soil map covering either a local or national area, and that most studies were performed at a local extent. Soil carbon was the most common property under study, whereas soil hydraulic variables were seldom reported. Nearly all studies performed mapping for the topsoil up to 30 cm and calculated validation statistics using existing datasets but without collecting a post-mapping probability sample. Few studies (i.e., 11%) reported an estimate of map uncertainty. Half of the studies had in mind a downstream application (e.g., soil fertility assessment) in the map generation. We further correlated the area of study and sampling density and found a strong negative relationship. About 30% of the studies relied on legacy soil datasets and had a lack of sufficient spatial coverage of their area of study. From this review, we highlight some research opportunities and suggest improvements in the current methodologies. Future research should focus on capacity building in DSM, new data collection, and legacy data rescue. New initiatives, that should be initiated and led from within the continent, could support the long-term monitoring of soils and updating of soil information systems while ensuring their contextualised usability. This pairs with better delivery of existing DSM studies to stakeholders and the generation of a value-added proposition to governmental institutions.

This study focused on the current and future drivers of land-use change and its impact on the Amanzule wetland. It suggests policy implications for reviewing and strengthening existing policies for sustainable land use. This study employed remote sensing and GIS techniques, including participatory rural appraisal techniques. The administration of questionnaires and focus group discussions were conducted in the Ellembelle and Jomoro municipalities, where the Amanzule wetland provides economic and social services. The results showed increased land use over the last 32 years driven by various drivers, including food crop production, rubber plantations, oil and gas establishments, and infrastructure development. The study further revealed that these drivers could influence land-use change in 18 years (2018–2036). Urbanisation, cropland, rubber plantations, and shrubland will drive land-use change in the study area between 2036 and 2054. The Amanzule wetland area is expected to decrease from 272.34 ha in 2018 to 210.60 ha by 2036. The wetland area is expected to further decrease from 210.60 ha in 2036 to 174.33 ha by 2054. Other land use classes, such as mangrove and swamp forests, are also expected to decrease within the same period. The study recommends advocating for a wetland policy, enforcing the Land Use and Spatial Planning Act 925 and the Petroleum Exploration and Production Act 919 for sustainable development.

Tropical forests play a significant role in climate change by sequestering atmospheric carbon dioxide. However, deforestation and forest degradation adversely affect these forests’ carbon stocks. Reports indicate that anthropogenic activities have led to forest degradation and deforestation in Boabeng Fiema Monkey Sanctuary (BFMS) and Kogyae Strict Nature Reserve (KSNR). This study assessed the effects of these activities on the carbon stocks of BFMS and KSNR. Using satellite imagery, field measurements and allometric models, carbon stocks of the study area were assessed from 1992 to 2023. The assessment revealed significant losses attributed to anthropogenic activities, such as hunting, farming and charcoal burning. BFMS experienced a total loss of 40,236 Mg C, while KSNR lost 272,109 Mg C. The closed forests had the highest carbon stock amongst the different vegetation types, with soil representing the most significant carbon pool in the protected areas, revealing the influence of vegetation structure on carbon sequestration and the need for soil conservation. The substantial carbon sequestration potential observed in the different vegetation types of the study area indicates that the Forest-Savannah Transition Zone is a prospective area for climate change mitigation aligning with the Sustainable Development Goals (Goals 13 and 15) and the National Climate Change Policy of Ghana. These findings provide valuable insights for carbon trading and biodiversity conservation, emphasizing the potential of nature-based solutions in addressing global climate challenges.

We report the case of a 48-year-old female with a history of tubal ligation who presented to her PCP with altered mental status and back pain. Inpatient workup revealed multiple myeloma, and treatment with bortezomib and dexamethasone was initiated. Due to teratogenicity on lenalidomide, a pre-treatment urine pregnancy test was performed and returned positive. She denied sexual activity and had no history of germ cell tumor. While urine hCG remained low positive for three tests, her serum hCG remained normal (

The DNA damage response (DDR) is a fundamental readout for evaluating efficacy of cancer therapeutics, many of which target DNA associated processes. Current techniques to evaluate DDR rely on immunostaining for phosphorylated histone H2AX (γH2AX), which is an indicator of DNA double-strand breaks. While γH2AX immunostaining can provide a snapshot of DDR in fixed cell and tissue samples, this method is technically cumbersome due to temporal monitoring of DDR requiring timepoint replicates, extensive assay development efforts for 3D cell culture samples such as organoids, and time-consuming protocols for γH2AX immunostaining and its evaluation. The goal of this current study is to reduce overall burden on assay duration and development in non-small cell lung cancer (NSCLC) organoids by leveraging label-free multiphoton imaging. In this study, simultaneous label-free autofluorescence multiharmonic (SLAM) microscopy was used to provide rich intracellular information based on endogenous contrasts. SLAM microscopy enables imaging of live samples eliminating the need to generate sacrificial sample replicates and has improved image acquisition in 3D space over conventional confocal microscopy. Predictive modeling between label-free SLAM microscopy and γH2AX immunostained images confirmed strong correlation between SLAM image features and γH2AX signal. Across multiple DNA targeting chemotherapeutics and multiple patient-derived NSCLC organoid lines, the optical redox ratio and third harmonic generation channels were used to robustly predict DDR. Imaging via SLAM microscopy can be used to more rapidly predict DDR in live 3D NSCLC organoids with minimal sample handling and without labeling.

Developing countries, including Ghana, face challenges ensuring access to clean and reliable cooking fuels and technologies. Traditional biomass sources mainly used in most developing countries for cooking contribute to deforestation and indoor air pollution, necessitating a shift towards environmentally friendly alternatives. The study's primary objective is to evaluate the economic viability of using solar PV-based green hydrogen as a sustainable fuel for cooking in Ghana. The study adopted well-established equations to investigate the economic performance of the proposed system. The findings revealed that the levelized cost of hydrogen using the discounted cash flow approach is about 89 %, 155 %, and 190 % more than electricity, liquefied petroleum gas (LPG), and charcoal. This implies that using the hydrogen produced for cooking fuel is not cost-competitive compared to LPG, charcoal, and electricity. However, with sufficient capital subsidies to lower the upfront costs, the analysis suggests solar PV-based hydrogen could become an attractive alternative cooking fuel. In addition, switching from firewood to solar PV-based hydrogen for cooking yields the highest carbon dioxide (CO2) emissions savings across the cities analysed. Likewise, replacing charcoal with hydrogen also offers substantial CO2 emissions savings, though lower than switching from firewood. Correspondingly, switching from LPG to hydrogen produces lower CO2 emissions savings than firewood and charcoal. The study findings could contribute to the growing body of knowledge on sustainable energy solutions, offering practical insights for policymakers, researchers, and industry stakeholders seeking to promote clean cooking adoption in developing economies.

The study investigated the impact of partial pulp removal (PPR) and fermentation duration (FD) on drying behavior, quality attributes and flavor profile of cocoa beans. The research explored the use of PPR (ranging from 0 % to 100 %) at various FDs (0–6 days) as potential pulp pre-conditioning technique to enhance the drying time, pH, titratable acidity (TTA), fermentation quality (FQ), fermentation index (FI), and flavor attributes of fermented and sun-dried Ghanaian cocoa beans. The results revealed a significant reduction in drying time from 144 to 4.3 h for the 6 days fermented beans subjected to 0–100 % PPR treatment. Nib pH levels increased from 5.28 to 5.74, while the nib TTA values decreased from 0.083 to 0.013 meq NaOH/100g for PPR treatment ratios of 0 %–100 % PPR, respectively. The FQ and FI values peaked at 98.7 % and 1.19 for the 50 % PPR treatment before decreasing to 58.3 % and 0.098, respectively, at 100 % PPR. Sensory evaluation revealed improved overall flavor quality scores with increasing PPR, reaching a maximum of 44.8 at 50 % PPR before reducing to 34.0 at 100 % PPR. Principal component analysis clustered samples according to the PPR treatment ratio, fermentation duration, and quality parameters measured. Optimal conditions for enhanced nib acidification, fermentation quality, and flavor attributes were identified at 50 % PPR and 6-days fermentation using the response surface methodology. Overall, the study demonstrates the potential of PPR as a pulp pre-conditioning technique to improve drying time and enhance the quality of cocoa beans.

Objectives Stereotactic body radiotherapy (SBRT) is widely used for localized prostate cancer and implementation of MR-guided radiotherapy has the advantage of tighter margins and improved sparing of organs at risk. Here we evaluate outcomes and time required to treat using non-adaptive MR-guided SBRT (MRgSBRT) for localized prostate cancer at our institution. Methods From 9/2019 to 11/2021 we conducted a retrospective review of 80 consecutive patients who were treated with MRgSBRT to the prostate. Patients included low (LR) (5%), favorable intermediate (FIR) (40%), unfavorable intermediate (UIR) (49%), and high risk (HR) (6%). Short-term androgen deprivation therapy was used in 32% of patients. Target volumes included prostate gland and proximal seminal vesicles with an isotropic 3 mm margin. Treatment was prescribed to 36.25 Gy in 5 fractions every other day with urethral sparing. Hydrogel spacer was used in 18% of patients. Time on the linac was recorded as beam on time (BOT) plus total treatment time (TTT) including gating. Analyzed outcomes included PSA response and patient reported outcomes scored by the American Urological Association (AUA) questionnaire and toxicity per CTCAE v5. General linear regression model was used to analyze factors affecting PSA and AUA in longitudinal follow up, and chi-square test was used to assess factors affecting toxicity. Results Median follow up was 19.3 months (3.8 – 36.6). Median BOT was 4.6 min (2.6 – 7.2) with a median TTT of 11 min (7.6 – 15.8). Pre-treatment vs post-RT median PSA was 6.36 (2.20 – 19.6) vs 0.85 (0.19 – 3.6), respectively ( P < 0.001). PSA decrease differed significantly when patients were stratified by risk category, favoring LR/FIR vs UIF/HR group ( P = 0.019). Four (5%) patients experienced a biochemical failure (BCF), with a median time to BCF of 20.4 months (7.9 – 34.5). Median biochemical failure free survival (BCFFS) was not reached, with 2-yr and 4-yr BCFFS of 97.1% and 72.1%, respectively. Patients with LR/FIR disease had 100% 2-yr and 4-yr BCFFS, whereas patients with UIF/HR had 95% and 41% 2-yr and 4-yr BCFFS ( P = 0.05). Mean pre-treatment AUA was 7.3 (1 - 25) vs 11.3 (1 - 26) at first follow-up; however, AUA normalized to baseline over time. Urethral Dmax ≥35 Gy trended to lower AUA score at all follow-ups ( P = 0.07). Forty-one (51%) patients reported grade 1-2 genitourinary toxicities at the 1 month follow up. Grade 3 toxicity (proctitis) was noted in 1 patient. There was no decrease in any grade rectal toxicity with use of hydrogel spacer (3 vs 6, P = 0.2). No grade ≥4 toxicities was observed. Conclusions MRgSBRT has the potential for treatment adaptation but this comes at the cost of increased resource utilization. Our experience with non-adaptive MRgSBRT of the prostate highlights its short treatment times as well as efficacy with good PSA control and low toxicity profile.