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Abstract Introduction This study explored the behaviours of people living with HIV in Singapore and Hong Kong in terms of achieving and maintaining their physical and psychological wellbeing in relation to HIV, to identify the challenges and support needed in HIV care. Methods This qualitative study involved 90‐minute interviews among Singapore and Hong Kong people living with HIV aged ≥18 years to explore health‐related quality of life perceptions and gaps in patient empowerment in HIV care during February–May 2022. The COM‐B (C: Capability; O: Opportunity; M: Motivation; B: Behaviour) framework was used during data analysis to identify behaviour facilitators and barriers for people living with HIV to achieve and maintain their wellbeing. Detailed accounts of respondents’ experience of living with and managing HIV, that is what worked well, unmet needs and perceived significance of wellbeing indicators, were analysed qualitatively via a combination of inductive content and deductive frameworks. Results A total of 30 and 28 respondents were recruited from Singapore (SG) and Hong Kong (HK), respectively. Most respondents were aged 20−49 years (SG: 83.3%; HK: 64.3%), males (SG: 96.7%; HK: 92.9%), men who have sex with men (SG: 93.3%; HK: 71.4%), had university or higher education (SG: 73.3%; HK: 50.0%) and were fully employed (SG: 73.3%; HK: 57.1%). In both Singapore and Hong Kong, physical health was considered a key focus of overall wellbeing, albeit attention to long‐term health associated with cardiovascular and renal health was less salient. The impact of symptoms, side effects of treatment, mood and sleep were among the top wellbeing indicators of importance. Respondents felt that insufficient information was provided by physicians, citing consultation time and resource constraints impeding further expression of concerns to their physicians during consultation. Respondents prioritized functional wellness and delegated psychosocial health to supportive care professionals, patient groups, families and/or friends. Conclusions There is a need in Singapore and Hong Kong to empower people living with HIV to establish better communications with their physicians and be more involved in their treatment journey and equally prioritize their psychosocial wellbeing.

Abstract Expression levels of microRNAs (miRNAs) in single cells are low and conventional miRNA detection methods require amplification that can be complex, time-consuming, costly and may bias results. Single cell microfluidic platforms have been developed; however, current approaches are unable to absolutely quantify single miRNA molecules expressed in single cells. Herein, we present an amplification-free sandwich hybridisation assay to detect single miRNA molecules in single cells using a microfluidic platform that optically traps and lyses individual cells. Absolute quantification of miR-21 and miR-34a molecules was achieved at a single cell level in human cell lines and validated using real-time qPCR. The sensitivity of the assay was demonstrated by quantifying single miRNA molecules in nasal epithelial cells and CD3+ T-cells, as well as nasal fluid collected non-invasively from healthy individuals. This platform requires ~50 cells or ~30 µL biofluid and can be extended for other miRNA targets therefore it could monitor miRNA levels in disease progression or clinical studies.

The consequences of the delivery of futile or potentially ineffective medical care and interventions are devastating on the healthcare system, our patients and their families, and healthcare providers. In emergency situations in particular, determining if escalating invasive interventions will benefit a frail and/or severely critically ill patient can be exceedingly difficult. In this review, our objective is to define the problem of potentially ineffective care within the specialty of acute care surgery and describe strategies for improving the care of our patients in these difficult situations.

Abstract Background The aim of this study was to develop and psychometrically evaluate a parent-rated parenting assessment scale including positive and negative dimensions of parenting. Factorial validity, reliability, measurement invariance, latent mean differences and construct validity of the Assessment Scale of Positive and Negative Parenting Behavior (FPNE) were tested in a pooled sample of five studies of 1,879 school-aged children (6.00 to 12.11 years). Methods Exploratory factor analysis (EFA) was performed on a first randomized split-half sample, and confirmatory factor analysis (CFA) and exploratory structural equation modeling (ESEM) were conducted in the second half of the sample. Measurement invariance tests were conducted to assess factor structure equivalence across gender and age. Results The EFA results supported a two-factor structure and the CFA results revealed a model with two correlated factors (Positive Parenting, Negative Parenting), which included 23 items and showed acceptable model fit and good psychometric properties. ESEM did not yield a model with significantly better model fit. Internal consistencies were acceptable. Adequate concurrent validity was demonstrated by low to moderate correlations between the FPNE and similar constructs. The factor structure was invariant (configural, metric, scalar) across different age groups and gender. Tests of latent mean differences revealed that older children scored significantly higher on negative parenting than younger children, while boys showed lower levels of positive parenting and higher levels of negative parenting compared to girls. All effect sizes were small. Conclusions The results suggest that the FPNE is a reliable and valid instrument for the assessment of parenting.

X-ray computed tomography (XRT) has gradually established its position as a non-destructive and, therefore, reproducible three-dimensional (3D) investigation technique, allowing for material- and geometry-independent applications. In the context of this study, XRT provides an enhanced understanding of thermal-induced microstructural changes in an andalusite-based refractory, which are not apparent from the limited two-dimensionality of conventional optical investigation techniques. By subjecting an andalusite-based sample to an XRT scan after temperature treatments of T = 110 °C, 800 °C, 1000 °C, 1200 °C and 1400 °C, the XRT technique in this study introduced a novel perspective on the sintering process of andalusite refractory materials. The XRT investigation focused on the thermal-induced defect and crack evolution of the castable as a function of temperature. In addition to general sintering phenomena, this includes the formation of a capillary network filled with silica-rich glass phases (SiO2) due to the mullitization of andalusite. The results of the XRT analysis indicate the existence of glass bridges within these structures.

Purpose – Large class sizes are becoming the norm in higher education against concerns of dropping learning qualities. To maintain the standard of learning and add value, one of the common strategies is for the course convenor to proactively monitor student engagement with learning activities against their assessment outcomes and intervene timely. Learning analytics has been increasingly adopted to provide these insights into student engagement and their performance. This case study explores how learning analytics can be used to meet the convenor’s requirements and help reduce administrative workload in a large health science class at the University of New South Wales. Design/methodology/approach – This case-based study adopts an “action learning research approach” in assessing ways of using learning analytics for reducing workload in the educator’s own context and critically reflecting on experiences for improvements. This approach emphasises reflexive methodology, where the educator constantly assesses the context, implements an intervention and reflects on the process for in-time adjustments, improvements and future development. Findings – The results highlighted ease for the teacher towards the early “flagging” of students who may not be active within the learning management system or who have performed poorly on assessment tasks. Coupled with the ability to send emails to the “flagged” students, this has led to a more personal approach while reducing the number of steps normally required. An unanticipated outcome was the potential for additional time saving through improving the scaffolding mechanisms if the learning analytics were customisable for individual courses. Originality/value – The results provide further benefits for learning analytics to assist the educator in a growing blended learning environment. They also reveal the potential for learning analytics to be an effective adjunct towards promoting personal learning design.

Introduction The autonomic nervous system (ANS) relies on two essential feedback loops: respiratory sinus arrythmia (RSA) and arterial baroreflex which are both regulated by a complex interplay of sympathetic and parasympathetic activations. The amplitude of RSA is modified by the respiratory frequency, i.e. an increase in respiratory frequency leads to a progressive decline in RSA as vagal effectors become less able to follow variations at higher frequencies. On the contrary, a reduction in the respiratory frequency can increase RSA. Slow Paced Breathing (SPB) is usually associated with deep changes in thoracic volume which increases the parasympathetic tone, and which has numerous expected beneficial effects on health. However, some studies report little or no effects. The goal of this study was to test a personalized SPB training vs. placebo to help disentangle the effects of SPB from those solely linked to breathing awareness or distraction. Methods Twenty-four young healthy volunteers participated in this study. They performed a four-week protocol of personalized SPB exercises (SPB group, n = 12) or control condition (spontaneous breathing, CON group, n = 12). Before and after the interventional period, they performed baroreflex sensitivity (BRS) and heart rate variability (HRV) assessments in our laboratory (labPRE and labPOST). During these four weeks, they performed three times per week an orthostatic test (OT) at home immediately before (hPRE) and after (hPOST) a SPB or CON exercise. The OT consisted of five minutes supine (sup) immediately followed by five minutes standing (stand). Personalized SPB was determined as the breathing frequency that elicited the greatest possible RSA, i.e., the best synchronization between breathing and heart rate. The HRV assessments included measures of heart rate (HR), root mean square of the successive differences (RMSSD), power spectrum in the low- and high-frequency bands (LF and HF). Results HFsup increased only in the SPB group (1062±686 vs 1469±905 ms2) from labPRE to labPOST. In addition, both RMSSDsup (54±29 vs. 62±19 ms) and HFsup (1369±1211 vs. 1469±905 ms2) were greater in the SPB group than the control group in labPOST. BRS increased only in the SPB group from labPRE to labPOST (12.8±3.2 vs. 15.2±2.8 ms/mmHg). LFsup decreased from hPRE to hPOST and this decrease was greater in SPB than CON. RMSSDstand increased in both groups from hPRE to hPOST and this increase was greater in CON than SPB. LFstand decreased from hPRE to hPOST. This decrease was greater by the end than at the beginning of the intervention and greater in SPB than CON. HFstand increased from hPRE to hPOST, and this increase was greater in SPB than CON. Discussion/Conclusion Four weeks of SPB training led to a larger increase in parasympathetic modulations to the heart in SPB than CON, indicating that such prolonged intervention has beneficial effects on health. These specific benefits were generally significant from week 4 onward. Further studies are required to better explore the underlying mechanisms.

Chronic pain is a prevalent and debilitating condition whose neural mechanisms are incompletely understood. An imbalance of cerebral excitation and inhibition (E/I), particularly in the medial prefrontal cortex (mPFC), is believed to represent a crucial mechanism in the development and maintenance of chronic pain. Thus, identifying a non-invasive, scalable marker of E/I could provide valuable insights into the neural mechanisms of chronic pain and aid in developing clinically useful biomarkers. Recently, the aperiodic component of the electroencephalography (EEG) power spectrum has been proposed to represent a non-invasive proxy for E/I. We, therefore, assessed the aperiodic component in the mPFC of resting-state EEG recordings in 149 people with chronic pain and 115 healthy participants. We found robust evidence against differences in the aperiodic component in the mPFC between people with chronic pain and healthy participants, and no correlation between the aperiodic component and pain intensity. These findings were consistent across different subtypes of chronic pain and were similarly found in a whole-brain analysis. Their robustness was supported by preregistration and multiverse analyses across many different methodological choices. Together, our results suggest that the EEG aperiodic component does not differentiate between people with chronic pain and healthy individuals. These findings and the rigorous methodological approach can guide future studies investigating non-invasive, scalable markers of cerebral dysfunction in people with chronic pain and beyond.

This study aimed to determine whether the farm-level use of a Saccharomyces cerevisiae-based postbiotic was associated with Salmonella prevalence and concentration, serotype diversity, and antimicrobial resistance in the subiliac lymph nodes (LN) of cull dairy cows. In collaboration with two commercial processing plants in the Southwestern (SW) and Northeastern (NE) regions of the U.S., cull dairy cattle lots processed in the same week from dairy farms that fed or not the postbiotic were sampled. Up to 20 LN were collected from dairy cattle from each supplier farm at least once every season. Samples were analyzed for Salmonella by culture and quantitative PCR methods, and isolates were subjected to serotype identification and antimicrobial susceptibility testing. Although a numerically lower prevalence was observed, the preharvest administration of the postbiotic was not significantly associated with Salmonella prevalence in cull dairy cattle. However, Salmonella prevalence significantly varied by region; the SW region showed a higher prevalence than the NE region. Whereas dominant Salmonella serotypes included Montevideo, Mbandaka, Muenster, Cerro, Meleagridis, and Anatum, the probability of isolating a dominant serotype did not significantly vary by feed additive status (FAS) or region, but varied by season. Up to 34 isolates (out of 391) exhibited resistance to each antimicrobial, with the highest number of isolates exhibiting resistance to streptomycin and ciprofloxacin; however, this did not significantly vary by FAS, season, or region. The precise reasons for the lack of effectiveness of the postbiotic in reducing Salmonella burden are unknown; however, varied administration durations of the postbiotic due to culling at different lactation cycle stages or during dry periods may have hindered its impact, especially if dairy cows were culled early. Other factors may include dietary components, farm management practices, and external environmental influences.

In vitro models based on permanent fish liver cell lines have proven to be versatile tools for examining chemical biotransformation and toxicity. However, their in vivo relevance remains uncertain due to their potentially de-differentiated phenotype. Here, we investigate whether a 3D cell culture environment can restore hepatocyte-like properties of the Rainbow trout liver cell line RTL-W1. Utilizing ultralow attachment (ULA) microwell plates, we achieved controlled sizing and extended culture (3 weeks) of spheroidal aggregate cultures (spheroids). RTL-W1 cells within the spheroids remained viable and metabolically active, as confirmed by the CellTiter-Glo 3D assay. Transmission electron microscopy revealed that spheroids exhibit tissue-like arrangements, such as interdigitations, cell-cell junctions, and endo- or exocytic activity at the cell-cell interface. They also displayed ultrastructural characteristics typical of metabolically active cells/hepatocytes, including abundant endoplasmic reticulum (ER), Golgi apparatus, and mitochondria. RT-qPCR analysis showed upregulation of genes involved in xenobiotic and endogenous (lipid) metabolism in 3D cultures over time. Notably, for several genes, especially cyp1a, expression levels were significantly higher in spheroids than in monolayers cultured for the same duration. This was corroborated at the enzyme level by increased Cyp1a-dependent catalytic activity (EROD). Interestingly, increased Cyp1a expression did not lead to heightened susceptibility to benzo[a]pyrene toxicity, which requires bioactivation. However, RTL-W1 3D and 2D cell cultures exhibited differential susceptibility to toxicity from other model chemicals, such as the surfactant SDS and the metal copper (Cu). These findings support the hypothesis that RTL-W1 cells can re-differentiate to a hepatocyte-like phenotype when cultured in a 3D configuration and may exhibit distinct biological responses upon exposure to xenobiotics. Overall, this study advances our understanding of the potential of cell line-derived 3D in vitro models for research and providing more physiologically relevant data for regulatory contexts.

O gênero Dipteryx Schreb. (Papilionoideae) conhecido principalmente como cumaru, compreende espécies de árvores economicamente importantes que têm chamado a atenção de vários países. O objetivo deste estudo foi avaliar a morfologia polínica das espécies do gênero Dipteryx ocorrentes no Brasil visando corroborar com a classificação e circunscrição das espécies do gênero. O material polínico das espécies foi retirado de exsicatas depositadas no herbário do Instituto Nacional de Pesquisas da Amazônia (INPA). Os grãos de pólen foram tratados por meio de acetólise, mensurados, descritos quanto ao tamanho, âmbito, forma e ornamentação e posteriormente, fotomicrografados. Constatou-se que os grãos de pólen são mônades, tamanho variando de médios à grandes, isopolares, com forma suboblata a prolata-esferoidal, âmbito subtriangular a triangular, 3-colporados, exina microrreticulada a reticulada. As espécies de Dipteryx apresentaram grãos de pólen com pequenas variações morfológicas, especialmente quanto à ornamentação da exina. Assim, a morfologia polínica do gênero, poderá subsidiar futuros trabalhos nas diversas áreas da Palinologia.

Legal judgment prediction (LJP) presents a formidable challenge in artificial intelligence, demanding intricate comprehension of legal texts, nuanced interpretation of statutes, and complex reasoning over multifaceted case elements. While recent advancements in natural language processing have shown promise, existing approaches often struggle to capture the sophisticated interplay between facts, legal principles, and precedents that characterize legal decision-making. This paper introduces LegalReasoner, a novel multi-stage framework that leverages large language models (LLMs) and integrates domain-specific knowledge for enhanced legal judgment prediction. Our approach encompasses four key stages: 1) legal knowledge infusion, where we pre-train an LLM on a vast corpus of legal literature using contrastive learning techniques; 2) case-law retrieval, employing a graph neural network to identify relevant precedents and statutes; 3) multi-hop reasoning, utilizing a transformer-based architecture with a hierarchical attention mechanism to navigate complex legal arguments; and 4) judgment synthesis, where we employ a generative adversarial network to produce coherent and legally sound judgments. We evaluate LegalReasoner on two diverse datasets: the European Court of Human Rights (ECHR) cases and the Chinese AI and Law Challenge (CAIL2018). Our framework demonstrates substantial improvements over state-of-the-art baselines, achieving an average accuracy increase of 7.8% across all datasets. Furthermore, we conduct extensive ablation studies and interpretability analyses to elucidate the contributions of each component and provide insights into the model’s decision-making process. Our work not only advances the field of automated legal reasoning but also offers a transparent and explainable system that could serve as a valuable tool for legal professionals. By bridging the gap between AI and legal expertise, LegalReasoner paves the way for more efficient, consistent, and fair legal decision-making processes.

Rationale & Objective: Autosomal dominant polycystic kidney disease (ADPKD) affects health-related quality of life (HRQoL) including pain, discomfort, fatigue, emotional distress, and impaired mobility. Stakeholders prioritized kidney cyst-related pain as an important core outcome domain in clinical trials, leading to the development of disease-specific assessment tools. Study Design: The ADPKD Registry is hosted online with multiple disease-specific patient-reported outcomes modules to characterize the patient experience in the United States. Setting & Participants: The ADPKD Registry allows consented participants access to a Core Questionnaire that includes demographics, comorbid conditions, current symptoms, and kidney function. Participants complete subsequent modules on a 3-month schedule, including 2 validated HRQoL tools, the ADPKD-Pain and Discomfort Scale (ADPKD-PDS), the ADPKD Impact Scale (ADPKD-IS) and a Healthcare Access and Utilization module. Exposures: Patient-reported latest estimated glomerular filtration rate or creatinine used to calculate stage of chronic kidney disease. Outcomes: Health-related quality of life, measured using validated ADPKD-specific tools; access to polycystic kidney disease-specific health care. Analytical Approach: For the 2 HRQoL tools, scores were calculated for physical, emotional, and fatigue domains; pain severity; and pain interference (based on the licensed user manuals). Associations to health care access were also assessed. Results: By July 2022, 1,086 individuals with ADPKD completed at least 1 of the HRQoL modules, and 319 completed 4 over a year. Participants were an average age of 53. In total, 71% were women, and 91% were White, with all chronic kidney disease (CKD) stages represented. In total, 2.5% reported being treated with dialysis, and 23% had a kidney transplant. CKD stage 4/5 participants reported the most dull kidney pain, whereas sharp kidney pain was evenly distributed across early CKD stages. Dull kidney pain had an impact on sleep regardless of CKD stage. There was a strong positive correlation between the ADPKD-PDS and ADPKD-IS. Patients with a neutral or positive HRQoL were less likely to have been denied access to imaging or other care. Limitations: Currently, all the information collected is patient reported without health record validation of clinical variables. Conclusions: Use of the HRQoL tools in the ADPKD Registry provided a broad cross-sectional assessment in the United States and provided granular information on the burden of pain across the CKD spectrum in ADPKD. The ADPKD Registry allowed assessment of ADPKD impact in a community that experiences decline in health and kidney function over decades. Plain-Language Summary: The Autosomal Dominant Polycystic Kidney Disease Registry is a longitudinal, patient-powered research tool created with the goal to better understand the impacts of ADPKD on affected individuals in the United States. Here, we analyze pain and other health-related quality of life outcomes in 1,086 individuals using validated tools and comment on the utility of these tools for future use in clinical trials and observational studies. We found that sharp pain, dull pain, fullness discomfort, and other related impacts affected individuals across the disease spectrum, although some participants reported more dull pain in later stages (CKD stages 4 and 5). Future analysis of these trends over time will be valuable in understanding how to assess and address the burden of pain in autosomal dominant polycystic kidney disease.

Abstract Background The long-term repercussions that war can have on both war generations and post-war generations lack in the literature. It is imperative to understand the psychological consequences of the Lebanese Civil War that took place from 1975 to 1990, on the offspring of those who took part in it. Accordingly, the objective of this study was to assess the association between paternal/veterans PTSD and adult offspring’s emotional regulation strategies and alexithymia levels, 30 years after the end of war. Method A cross-sectional study was carried out between September 2020 and September 2021 on a sample of 75 fathers of Lebanese former veterans and paramilitary veterans and their adult offspring. For the veterans and paramilitary veterans’ population, the PTSD Checklist was used to assess post-traumatic stress disorder, and the Combat Exposure Scale (CES) was used to measure the level of combat exposure. For the offspring population, the Emotional Regulation Questionnaire (ERQ) was used to assess emotional regulation strategies and the Toronto Alexithymia Scale (TAS) was used to measure the levels of alexithymia. Results Paternal PTSD (Beta = 10.19) was associated with higher levels of alexithymia in the offspring population. Regarding emotional regulation strategies, results showed that paternal PTSD (Beta = -3.24) was significantly associated with a decrease in the cognitive reappraisal score in the offspring. Also, paternal PTSD (Beta = 4.57) was significantly associated with an increase in expressive suppression score. Additionally, an older father’s age (Beta = 1.11) was significantly associated with an increased alexithymia score in the offspring. Moreover, results showed that paternal combat injuries (Beta = -4.24) were significantly associated with a decrease in the alexithymia score in the offspring population and an increase in the expressive suppression score (Beta = 3.28). Conclusion This study shows that fathers’ traumatic experience of war influences emotion regulation and alexithymia levels in their offspring. Longitudinal studies taking into account the age of the offspring at the time of onset of fathers’ symptoms may provide us with additional information to understand the influence of paternal PTSD on the emotional functioning of offspring during different phases of emotional development.

Introduction: The Medical Surveillance Scheme (MSS) was introduced in 1976 to regulate sexually transmitted infections (STIs) and govern sex workers in Singapore. While this scheme promotes access to health resources such as testing and treatment, only a small number of migrant sex workers (MSWs) are selected for the scheme. Undocumented MSWs who occupy the largest proportion of sex industry have been forced to face increasing exclusion and precarity. This paper aims to examine how they are invisibilized in the public health system and the social barriers and risks they are thus exposed to. Method: We draw on a qualitative study involving focus group discussions (FGDs) and semi-structured in-depth interviews (IDIs) in Singapore. Interviews explored themes including sex work experiences, personal migrant history, sexual health, occupational hazards, community support system, and recommendations for policymakers. Data were analyzed through inductive thematic analysis. Results: Overall, we conducted four FGDs (n=14), of which peer interviewers (n=3) were identified and trained to lead interviews alongside a researcher. IDIs (n=53) were conducted among sex workers (n=67) stratified by migrant status, types of work venues and geographical characteristics. First, interviewees described how MSWs are categorized, regulated and excluded from the public health system of Singapore through the MSS state apparatus. Such workers must undergo mandatory STI testing and are constituted as a key population characterized by danger and impurity. Moreover, many MSWs do not qualify to join the MSS due to the disciplinary controls around race, nationality, gender. Thus, they remain undocumented, where public health services are not accessible. Second, interviewees described how the exclusion from the MSS regulations exacerbates the fragility experienced in their everyday life which is entwined with social barriers and risks, including (1) more difficulties in living arrangements, language, and employment choices; and (2) occupational hazards including sexual illness, sexual violence, manipulation, state violence and social stigmatization. Conclusion: Given the limits of MSS and the social barriers and risks that it engenders for undocumented migrant sex workers, more work must be done to bridge inequities to healthcare access, and to create safe spaces where all sex workers can access support systems without fear. [ABSTRACT FROM AUTHOR]

COVID-19 laboratory diagnosis primarily relies on molecular tests, highly sensitive during early infection stages with high viral loads. As the disease progresses, sensitivity decreases, requiring antibody detection. Since the beginning of the pandemic, serological tests have been developed and made available in Brazil, but their diagnostic performance varies. This study evaluated the IBMP ELISA IgA/IgM/IgG COVID-19 kit performance in detecting SARS-CoV-2 antibodies. A total of 90 samples, including 64 from COVID-19 patients and 26 pre-pandemic donors, were assessed based on time post symptom onset (0–7, 8–14, and 15–21 days). The kit showed 61% sensitivity, 100% specificity, and 72% accuracy overall. Sensitivity varied with time, being 25%, 57%, and 96% for 0–7, 8–14, and 15–21 days, respectively. Similar variations were noted in other commercial tests. The Gold ELISA COVID-19 (IgG/IgM) had sensitivities of 31%, 71%, and 100%, while the Anti-SARS-CoV-2 NCP ELISA (IgG) and Anti-SARS-CoV-2 NCP ELISA (IgM) showed varying sensitivities. The IBMP ELISA kit displayed high diagnostic capability, especially as the disease progressed, complementing COVID-19 diagnosis. Reproducibility assessment revealed minimal systematic and analytical errors. In conclusion, the IBMP ELISA IgA/IgM/IgG COVID-19 kit is a robust tool for detecting anti-SARS-CoV-2 antibodies, increasing in efficacy over the disease course, and minimizing false negatives in RT-PCR COVID-19 diagnosis.

Purpose: The specialty of Laboratory Genetics and Genomics (LGG) was created in 2017 in an effort to reflect the increasing convergence in technologies and approaches between clinical molecular genetics and clinical cytogenetics. However, there has not yet been any formal evaluation of the merging of these disciplines and the challenges faced by Program Directors (PDs) tasked with ensuring the successful training of laboratory geneticists under the new model. Methods: An electronic multi-question Qualtrics survey was created and was sent to the PD for each of the Accreditation Council for Graduate Medical Education–accredited LGG fellowship programs at the time. The data were collected, and the responses were aggregated for each question. Results: All of the responding PDs had started training at least 1 LGG fellow. PDs noted challenges with funding, staff shortages, molecular/cytogenetics content integration, limited total training time, increased remote work, increased sendout testing, and a lack of prior cytogenetics knowledge among incoming fellows. Conclusion: This survey attempted to assess the challenges that LGG PDs have been facing in offering and integrating clinical molecular genetics and clinical cytogenetics fellowship training. Common challenges between programs were noted, and a set of 6 concluding comments are provided to facilitate future discussion.

Domoic acid-producing blooms of the diatom genus Pseudo-nitzschia are pervasive in coastal environments globally. Domoic acid, a neurotoxin, accumulates via trophic transfer into marine food webs and is often associated with mass marine mammal mortality and stranding events. In Southern California, California sea lions (Zalophus californianus) are an indicator species for food web impacts of domoic acid because they are abundant secondary consumers, sensitive to domoic acid intoxication, and are actively monitored by stranding networks. However, domoic acid exposure may occur a distance from where a sea lion ultimately strands. This spatiotemporal variation complicates coupling domoic acid observations in water to strandings. Therefore, we sought to quantify whether monitoring data from four pier sites across the region, covering nearly 700 km of coastline from 2015-2019, could be used to predict adult and subadult sea lion strandings along the 68 km Orange County coastline surveyed by the Pacific Marine Mammal Center. We found that increased sea lion strandings were often observed just prior to an increase in particulate domoic acid at the piers, confirming that clusters of subadult and adult sea lion strandings with clinical signs of domoic acid intoxication serve as indicators of bloom events. In addition, domoic acid concentrations at Stearns Wharf, nearly 200 km from stranding locations, best predicted increased total sea lion strandings, and strandings of sea lions with domoic acid intoxication symptoms. Particulate domoic acid concentrations greater than 0.05 μg/L at Stearns Wharf were linked to stranding probabilities in Orange County ranging from 2.2% to 55% per week, and concentrations of 0.25 μg/L resulted in weekly stranding probabilities ranging from 16% to 81% depending on the stranding scenario modeled.

Abstract The causative agent of white mold, Sclerotinia sclerotiorum, is capable of infecting over 600 plant species and is responsible for significant crop losses across the globe. Control is currently dependent on broad-spectrum chemical agents that can negatively impact the agroecological environment, presenting a need to develop alternative control measures. In this study, we developed transgenic Arabidopsis thaliana (AT1703) expressing hairpin (hp)RNA to silence S. sclerotiorum ABHYDROLASE-3 and slow infection through host induced gene silencing (HIGS). Leaf infection assays show reduced S. sclerotiorum lesion size, fungal load, and ABHYDROLASE-3 transcript abundance in AT1703 compared to wild-type Col-0. To better understand how HIGS influences host–pathogen interactions, we performed global RNA sequencing on AT1703 and wild-type Col-0 directly at the site of S. sclerotiorum infection. RNA sequencing data reveals enrichment of the salicylic acid (SA)-mediated systemic acquired resistance (SAR) pathway, as well as transcription factors predicted to regulate plant immunity. Using RT-qPCR, we identified predicted interacting partners of ABHYDROLASE-3 in the polyamine synthesis pathway of S. sclerotiorum that demonstrate co-reduction with ABHYDROLASE-3 transcript levels during infection. Together, these results demonstrate the utility of HIGS technology in slowing S. sclerotiorum infection and provide insight into the role of ABHYDROLASE-3 in the A. thaliana–S. sclerotiorum pathosystem.

Histological evidence of pancreatitis is commonly found in necropsy studies in cats. A clinical diagnosis of pancreatitis is challenging due to nonspecific clinical signs, a lack of diagnostic lipase cutoffs, and frequent presence of multiple diseases. It is still unknown how often pancreatitis alone is found in sick cats and how often clinicopathological evidence of pancreatitis in sick cats does not lead to a clinical diagnosis of pancreatitis. Our aims were to evaluate the extent of comorbidities in cats with suspected pancreatitis, evaluate how often sick cats with hyperlipasemia are diagnosed only with non-pancreatic diseases, and compare their clinical findings. Medical records of 563 client-owned hospitalized cats with available lipase activity measurement (LIPC Roche) > 30 U/L (RI, 6–26) were searched and medical diagnoses recorded and grouped by organ system. Clinicopathological findings were compared between cats with pancreatitis alone (PA), pancreatitis with concurrent disease (PD), and no suspected pancreatitis (NP). We found that PA was present in 33 (6%) cats, 159 cats (28%) were in the PD group, and 371 cats (66%) had no suspected pancreatitis (NP). Clinical, laboratory, and ultrasonographic findings did not differ between PA and PD cats. Lipase activities did not differ between the three groups. The most common disease categories in PD and NP cats were gastrointestinal, hepatobiliary, renal/urinary, and endocrine, and renal/urinary, gastrointestinal, cardiac, and musculoskeletal, respectively. We conclude that cats are rarely hospitalized because of suspected pancreatitis alone, and PA cats did not differ clinically from PD cats. Hyperlipasemia in sick cats without a diagnosis of pancreatitis may be due to a reactive pancreatopathy or preexisting chronic pancreatitis.