bluuebunny/crossref_metadata_2025 huggingface dataset:
Double umbilical artery converging into a single umbilical artery: A case report
Authors: Yang Chunfang , Yang Xiaolu , Qiu Lihua , Liu Zhihui
Published: October 2024

Rationale:

The normal structure and Doppler parameters of the umbilical cord are closely related to many diseases, including fetal infection, chromosomal abnormalities, hypoxia, and growth and development restrictions. We report a case of bilateral umbilical artery confluence resulting in the formation of a single umbilical artery in the free segment of the fetal umbilical cord, diagnosed at 24 weeks and 4 days gestation. The fetus was born prematurely after premature membrane rupture at 31 weeks and 3 days gestation. The Toxoplasma, Others, Rubellavirus, Cytomegalovirus, Herpesvirus test showed positive results for Toxoplasma gondii, rubella virus, and herpes simplex virus IgG antibodies.

Patient concerns:

A 36-year-old woman had vaginal discharge for > 1 hour at 31 weeks + 3 days gestation and came to our obstetrics department for treatment.

Diagnosis:

The pregnant woman sought treatment due to premature membrane rupture and vaginal discharge for > 1 hour. The vaginal discharge was caused by Escherichia coli. After cesarean section, the Toxoplasma, Others, Rubellavirus, Cytomegalovirus, Herpesvirus test revealed positive results for the following: T gondii, rubella virus, and herpes simplex virus IgG antibodies. The patient underwent 2 ultrasound examinations and was diagnosed with umbilical artery malformation (the free segment of the umbilical cord on the fetal side converged into a single umbilical artery), which may have been related to fetal infection.

Interventions:

The patient received anti-inflammatory and fetal lung maturation treatment for 2 days before undergoing a cesarean section.

Outcomes:

The mother and newborn received anti-inflammatory, symptomatic, and supportive treatment and were discharged after 1 week of improvement. After 1 month, 6 months, and 1 year of follow-up after birth, the growth and development of the infant (height and weight) were significantly lower than those of her peers, and her responses to sound and light were slightly delayed.

Lessons:

Umbilical artery malformation is extremely rare and may be related to intrauterine parasitic and viral infections. Ultrasound has the advantages of being noninvasive and cost-effective and can be used to dynamically observe umbilical artery structure. An abnormal change in umbilical artery structure found during ultrasound examination can indicate intrauterine infection risk, which provides clinical guidance for further examination of pregnant women, early diagnosis, timely targeted treatment, and fetal prognosis improvement.
Relationship Between HSV-1 Serostatus and HSV-2 IgG Confirmation Results using an Inhibition Assay
Authors: Shates Tessa M. , Realegeno Susan , Prince Harry E. , Marlowe Elizabeth M.
Published: October 2024

Background: Approximately 2% of HerpeSelect Herpes Simples Virus type 2 (HSV-2) IgG enzyme immunoassay (screen assay) sera positive samples do not confirm using an HSV-2 IgG inhibition assay. Of these, roughly 1.33% are confirmed negative and a small proportion (0.2%) are indeterminate due to inhibition observed with HSV-1 and HSV-2 lysate. The objective of this study was to assess the relationship between HSV-1 IgG serostatus and HSV-2 IgG confirmation results using the HSV-2 IgG inhibition assay.

Methods: This study included consecutive HSV-2 IgG screen-positive specimens regardless of index value. Specimens were also tested for HSV-1 IgG. The HSV-2 IgG confirmation results from the inhibition assay were evaluated to assess the relationship between inhibition results and HSV-1 serostatus.

Results: Of the 21,006 positive HSV-2 IgG specimens, 13,237 (63%) were also positive for HSV-1 IgG. The proportion of HSV-1 IgG-positive samples among inhibition-indeterminate samples (33/40, 83%) was higher than among inhibition-negative (167/279, 60%) and inhibition-positive (13,041/20,691, 63%) samples. Among HSV-1 IgG-positive samples, the median HSV-1 IgG index was also significantly higher for the inhibition-indeterminate group (median = 48.8) than for the inhibition-negative (median = 30.7) and inhibition-positive groups (median = 31.2) (P = 0.00013 and P = 3.1e-05, respectively).

Conclusion: These findings suggest that HSV-2 IgG inhibition-indeterminate, but not inhibition-negative, results are associated with higher index values of HSV-1 IgG. Further studies are needed to understand other factors associated with inhibition-indeterminate results.
Use of the superficial circumflex iliac artery perforator flap for urethra and/or shaft reconstruction in gender diverse persons: 10-year single center experience
Authors: De Gelder Anouk , Young-Afat Danny , Claes Karel , Morrison Shane , Lumen Nikolaas , Spinoit Anne-Françoise , Waterschoot Mieke , D’Arpa Salvatore , Monstrey Stan , Buncamper Marlon
Published: October 2024

BACKGROUND:

Although the free radial forearm flap (FRFF) is the gold standard for phalloplasty, the conspicuous donor-site scar, need for microsurgery and the tendency for the phallus to deflate over time makes both patients and surgeons look for alternatives. We describe our long-term experience with the pedicled superficial circumflex iliac artery (SCIP) flap for urethral and/or penile shaft reconstruction. This flap can be applied for similar indications as FRFF-phalloplasty, but with primary closure of the donor site(s) and without microsurgery.

METHODS:

We retrospectively reviewed surgical outcomes of all patients who underwent urethra and/or shaft reconstruction using SCIP-flaps as part of phalloplasty for gender-affirming surgery in our center between 2012 and 2022.

RESULTS:

Over a 10-year period, 55 SCIP-flaps were performed as part of phalloplasty. This included 47 unilateral SCIP-flaps, of which 10 were used for shaft reconstructions and 37 for urethra reconstructions. Primary closure was achieved in 100% of patients. No failures were observed for shaft reconstructions.

For urethra reconstructions, 8 SCIP-urethras (14%) failed completely, and 3 SCIP-flaps were converted to free flaps. In total, 82% of patients with a SCIP-urethra reconstruction were able to stand while voiding.

Eight bilateral SCIP-flaps were performed for one-stage shaft and urethra creation, of which 3 patients (38%) experienced urethral fistulas and/or strictures.

CONCLUSIONS:

This study shows that the SCIP-flap is a technically feasible and safe pedicled alternative for urethral and penile shaft reconstruction in gender diverse individuals, with similar urethral complication rates compared to FRFF and ALT-phalloplasty, however, with potentially lower shaft sensation.
Methods for Human Reliability Analysis in Dentistry
Authors: Bijelic Bojan , Grozdanovic Dragutin , Grozdanovic Miroljub , Jovanovic Evica
Published: October 2024

Human error (HE) is one of the main causes of accidents in different organizations and industries. Dentistry is a medical branch with a high risk of error since it involves complex manual tasks that must be performed with a high degree of accuracy. To understand the various aspects of HE in dentistry, which is crucial for developing strategies to mitigate its impact on patients’ safety, it is necessary to perform a human reliability analysis (HRA). However, there is scarce data on the use of HRA in dentistry. In this paper, we give a brief description of the main phases of HRA with an emphasis on HRA methods that could be used in dentistry. Since HRA methods have been designed for diverse industrial applications, we discuss their possible application in dentistry. Among the discussed methods, the Systematic Human Error Reduction and Prediction Approach (SHERPA) and the Human Error Assessment and Reduction Technique were identified as the best candidates for performing HRA in dentistry. This is of great importance since understanding and addressing HEs is crucial for improving patient safety and the overall quality of dental care.
Eustachian Tube Dysfunction After LeFort 1 Osteotomy Orthognathic Surgery
Authors: Lindemann Cameron B. , Bastemeyer Avori K. , McGann Ethan , Mondragon Claudia , Eliason Michael
Published: October 2024

The authors present a 24-year-old male with a history of class III occlusal deformity who underwent a maxillary advancement with LeFort I osteotomies. Eighteen months after surgery, he was diagnosed with bothersome Eustachian tube dysfunction (ETD). Anatomical shifts secondary to the LeFort osteotomies required for maxillary advancement result in vector changes of muscles that regulate the function of the Eustachian tube. This realignment of muscles is suspected to be a major contributing factor in causing this patient’s new onset Eustachian tube dysfunction. This article represents a pilot project as data are collected for a retrospective and, ultimately, prospective studies on this topic.
Early life adversity has sex-dependent effects on survival across the lifespan in rhesus macaques
Authors: Patterson Sam K. , Andonov Ella , Arre Alyssa M. , Martínez Melween I. , Negron-Del Valle Josué E. , Petersen Rachel M. , Phillips Daniel , Rahman Ahaylee , Ruiz-Lambides Angelina , Villanueva Isabella , Lea Amanda J. , Snyder-Mackler Noah , Brent Lauren J.N. , Higham James P.
Published: October 2024

Exposure to early life adversity is linked to detrimental fitness outcomes across taxa. Owing to the challenges of collecting longitudinal data, direct evidence for long-term fitness effects of early life adversity from long-lived species remains relatively scarce. Here, we test the effects of early life adversity on male and female longevity in a free-ranging population of rhesus macaques (
Macaca mulatta
) on Cayo Santiago, Puerto Rico. We leveraged six decades of data to quantify the relative importance of 10 forms of early life adversity for 6599 macaques. Individuals that experienced more early life adversity died earlier than those that experienced less adversity. Mortality risk was highest during early life, defined as birth to 4 years old, but heightened mortality risk was also present in macaques that survived to adulthood. Females and males were affected differently by some forms of adversity, and these differences might be driven by varying energetic demands and dispersal patterns. Our results show that the fitness consequences of early life adversity are not uniform across individuals but vary as a function of the type of adversity, timing and social context, and thus contribute to our limited but growing understanding of the evolution of early life sensitivities.

This article is part of the discussion meeting issue ‘Understanding age and society using natural populations’
Population age structure shapes selection on social behaviour in a long-lived insect
Authors: Cook Phoebe A. , Costello Robin A. , Brodie III Edmund D. , Formica Vincent
Published: October 2024

Social traits are expected to experience highly context-dependent selection, but we know little about the contextual factors that shape selection on social behaviours. We hypothesized that the fitness consequences of social interactions will depend on the age of social partners, and therefore that population age structure will shape evolutionary pressures on sociality. Here, we investigate the consequences of age variation at multiple levels of social organization for both individual fitness and sexual selection on social network traits. We experimentally manipulated the age composition of populations of the forked fungus beetle
Bolitotherus cornutus
, creating 12 replicate populations with either young or old age structures. We found that fitness is associated with variance in age at three different levels of organization: the individual, interacting social partners, and the population. Older individuals have higher reproductive success, males pay a fitness cost when they interact with old males and females achieve lower fitness in older populations. In addition to influencing fitness, population age structure also altered the selection acting on social network position in females. Female sociality is under positive selection only in old populations. Our results highlight age structure as an understudied demographic variable shaping the landscape of selection on social behaviour.

This article is part of the discussion meeting issue ‘Understanding age and society using natural populations’.
The life history of harvester ant colonies
Authors: Gordon Deborah M.
Published: October 2024

A long-term study of a population of desert seed-eating ant colonies of the red harvester ant,
Pogonomyrmex barbatus
, in New Mexico, USA, shows that a colony can live for 20–30 years—the lifespan of its founding queen. A colony’s collective behaviour shifts in the course of its life history. These changes, generated by social interactions within the colony, adjust the behaviour of the colony as it grows older and larger, in response to its environment and neighbouring colonies. A worker lives only a year and performs different tasks as it ages, in response to interactions with other workers and the local surroundings. A colony’s behaviour changes—becoming more stable and consistent—as the colony grows older, with more ants to participate in social interactions. A neighbourhood of colonies, often of similar age, grows old together. Colonies differ in how they regulate foraging behaviour collectively to manage water loss. These differences influence how foragers of neighbouring colonies partition foraging area. In a harsh but stable environment, the gradual behavioural shifts over a colony’s lifespan allow it to adjust to slow changes in the composition of its neighbourhood and in environmental conditions.

This article is part of the discussion meeting issue ‘Understanding age and society using natural populations’
Divergent age-related changes in parasite infection occur independently of behaviour and demography in a wild ungulate
Authors: Albery Gregory F. , Hasik Adam Z. , Morris Sean , Morris Alison , Kenyon Fiona , McBean David , Pemberton Josephine M. , Nussey Daniel H. , Firth Josh A.
Published: October 2024

As animals age, they exhibit a suite of phenotypic changes, often including reductions in movement and social behaviour (‘behavioural ageing’). By altering an individual’s exposure to parasites, behavioural ageing may influence infection status trajectories over the lifespan. However, these processes could be confounded by age-related changes in other phenotypic traits, or by selective disappearance of certain individuals owing to parasite-induced mortality. Here, we uncover contrasting age-related patterns of infection across three helminth parasites in wild adult female red deer (
Cervus elaphus
). Counts of strongyle nematodes (order: Strongylida) increased with age, while counts of liver fluke (
Fasciola hepatica
) and tissue worm (
Elaphostrongylus cervi
) decreased, and lungworm (
Dictyocaulus
) counts did not change. These relationships could not be explained by socio-spatial behaviours, spatial structuring, or selective disappearance, suggesting behavioural ageing is unlikely to be responsible for driving age trends. Instead, social connectedness and strongyle infection were positively correlated, such that direct age–infection trends were directly contrasted with the effects implied by previously documented behavioural ageing. This suggests that behavioural ageing may reduce parasite exposure, potentially countering other age-related changes. These findings demonstrate that different parasites can show contrasting age trajectories depending on diverse intrinsic and extrinsic factors, and that behaviour’s role in these processes is likely to be complex and multidirectional.

This article is part of the discussion meeting issue ‘Understanding age and society using natural populations’.
Peribacillus simplex and Klebsiella pneumoniae Responsible for Pyonephrosis with Secondary Psoas Abscess: A Case Report
Authors: Malihy Zakaria , Abassor Tilila , Ben lahlou Yassine , Benaissa Elmostafa , Chadli Mariama
Published: October 2024

Bacterial urinary tract infections (UTIs) are common, ranging from benign cystitis to complicated pyelonephritis, which can lead to severe complications such as pyonephrosis and sepsis. Pyonephrosis, characterized by the presence of pus in the renal cavities, often requires urgent urological intervention. We report a unique case of pyonephrosis with a psoas abscess caused by Klebsiella pneumoniae (K. pneumoniae) and Peribacillus simplex (P. simplex) in a 64-year-old diabetic female patient. This is the first case of pyonephrosis caused by P. simplex. The patient presented with acute right lumbar pain, fever, and altered consciousness. Imaging revealed severe right hydronephrosis, pyonephrosis, and a perirenal phlegmon infiltrating the psoas with abscesses. Surgical drainage and nephrectomy were performed. Microbiological and proteomic analysis identified K. pneumoniae and P. simplex.This case highlights the importance of considering environmental bacteria like P. simplex in severe infections and ensuring rigorous protocols to avoid contamination. Successful management of pyonephrosis relies on prompt surgical drainage and appropriate antibiotic therapy based on culture results.
Dengue epidemic alert thresholds, a tool for surveillance and epidemic detection
Authors: Thayer Maile B. , DrPH Melissa Marzan-Rodriguez , Aponte Jomil Torres , DrPH Aidsa Rivera , Rodriguez Dania M. , Madewell Zachary J. , Rysava Kristyna , Paz-Bailey Gabriela , Adams Laura E. , Johansson Michael A.
Published: October 2024

Abstract

Epidemic detection enables swift public health responses. Dengue viruses pose a significant public health challenge in Puerto Rico, where they are endemic and cause intermittent epidemics. A weekly intercept-only negative binomial regression model was fitted using historical data from January 1986 to June 2024. Thresholds were defined using three percentiles (60%, 75%, and 90%). The 75th percentile threshold aligned best with historical epidemic classifications. This model provides a robust method for defining thresholds, accounting for skewed data, utilizing all historical data, and improving upon traditional methods like endemic channels. In March 2024, the Puerto Rico Department of Health declared a public health emergency due to an unseasonably early surge in cases that exceeded the epidemic alert threshold in February. This real-time application highlights the value of these thresholds to support dengue epidemic detection and public health response. Integrating thresholds with other tools and strategies can enhance epidemic preparedness and management.

One-sentence summary line

Epidemic alert thresholds can correctly detect and classify epidemics and enable timely public health response.
Climate change, weather, and geography shape seed mass variation and decline across western North America
Authors: Lenzo Leah J. , Forister Matthew L. , Olwell Peggy , Leger Elizabeth A.
Published: October 2024

Seeds are an essential reproductive strategy for most plants, and seed mass is predicted to respond to environmental factors, but we do not know if climate change-related size changes observed in other organisms will also be reflected in seed mass. We investigated the temporal, geographic, and environmental patterns that influence seed mass across 2,800 species of native plants from over 13,000 populations across the western US using information from two decades of collections from a national program, Seeds of Success. Most species exhibited low variation in seed mass, though some varied by up to 220% over their occupied area. Measures of climate change influenced seed mass in over 40% of species, which could be evidence of adaptation to new optimal values or maladaptive responses. Species with the most variation in seed mass were those collected across sites with a wide range of minimum temperatures, from more northern latitudes, and across a wide range of dates, and seeds were generally larger in areas where it was wetter and warmer. Seed mass declined for over half (55%) of species, and declined overall by an average of 0.012 mg each year, though there were many species-specific differences, including 17% of species increasing appreciably in mass. Relationships between seed mass and environmental variables varied widely in strength, identity, and direction among species, including those that often co-occur. These results support the need to continue native seed collections for conservation and restoration, as plant reproductive strategies may be shifting with changing climates.
Accelerated pseudogenization in ancient endosymbionts of giant scale insects
Authors: Choi Jinyeong , Palanichamy Pradeep , Tanaka Hirotaka , Kondo Takumasa , Gruwell Matthew E. , Husnik Filip
Published: October 2024

Symbiotic microorganisms are subject to a complex interplay of environmental and population-genetic pressures that drive their gene loss. Despite the widely held perception that ancient symbionts have stable genomes, even tiny genomes experience ongoing pseudogenization. Whether these tiny genomes also experience bursts of rapid gene loss is, however, less understood. Giant scale insects (Monophlebidae) feed on plant sap and rely on the symbiotic bacteriumWalczuchellawhich provides them with essential nutrients. When compared to other ancient symbionts with similar genome sizes such asKarelsulcia, Walczuchella’s genome was previously reported as unusually pseudogene-rich (10 % of coding sequences). However, this result was based on only one genome assembly raising questions about the assembly quality or a recent ecological shift such as co-symbiont acquisition driving the gene loss. Here, we generated six complete genomes ofWalczuchellafrom three genera of giant scales, each with distinct co-symbiotic partners. We show that all the genomes are highly degraded and particularly genes related to the cellular envelope and energy metabolism seem to be ongoing pseudogenization. Apart from general mechanisms driving genome reduction such as the long-term intracellular lifestyle with transmission bottlenecks, we hypothesize that a more profound loss of DNA replication and repair genes together with recent co-obligate symbiont acquisitions likely contribute to the accelerated degradation ofWalczuchellagenomes. Our results highlight that even ancient symbionts with small genomes can experience significant bursts of gene loss when stochastic processes erase a gene that accelerates gene loss or when the selection pressure changes such as after cosymbiont acquisition.
Improving the monitoring of the invasive Blue Crab (Callinectes sapidus): combining environmental DNA and citizen observations
Authors: Delrieu-Trottin Erwan , Bianic Mathieu , Miaud Claude , Garcia Manon , Arnal Veronique , Hocde Regis , Cochet Christophe , Barre Nathalie , Cornil Laetitia , Manel Stephanie
Published: October 2024

1. Early detection is a crucial tool for identifying and managing the spread of invasive species. 2. In this study, we validated a probe-based quantitative polymerase chain reaction (qPCR) assay for the detection of the invasive Blue Crab, Callinectes sapidus, in the Mediterranean Sea, using 22 initial eDNA environmental samples (eDNA) collected from three coastal lagoons. 3. A subsequent large-scale eDNA sampling campaign (61 samples in 31 sites), conducted in collaboration with local stakeholders, was carried out to map the distribution of Callinectes sapidus along the Occitanie coastline (Western Mediterranean, France). 4. Using eDNA probe-based qPCR, Callinectes sapidus was detected in 32 out the 61 samples (52%), confirming its presence in 24 out of 31 sites surveyed, including the 13 lagoons where its occurrence had already been reported, as well as two additional lagoons and at sea where no prior records existed. 5. Our results demonstrate the utility of eDNA probe-based qPCR for effective monitoring the invasive Blue Crab. The integration of eDNA analysis with citizen science observations enhances the monitoring framework, facilitating early detection and contributing to improved management strategies from a prevention perspective.
Estimating historical disease burden and the impact of vaccination by influenza type and subtype in the United States, 2016-2020
Authors: Morris Sinead E. , Mathis Sarabeth M. , Chung Jessie R. , Flannery Brendan , O’Halloran Alissa , Cummings Charisse N. , Garg Shikha , Lu Peng-Jun , Santibanez Tammy A. , Reed Carrie , Biggerstaff Matthew , Iuliano A. Danielle
Published: October 2024

Seasonal influenza causes substantial morbidity and mortality in the United States. The U.S. Centers for Disease Control and Prevention (CDC) uses a compartmental framework to estimate the annual disease burden and burden prevented by vaccination for all influenza types and subtypes combined. However, these estimates do not capture underlying shifts in disease burden caused by different circulating influenza virus types or subtypes. We demonstrate an extension of the current framework to estimate disease burden and burden prevented by vaccination for influenza A virus subtypes A(H1N1) and A(H3N2), and influenza type B viruses. We applied this method to data from the 2016/17 to 2019/20 seasons that include age- and virus-specific hospitalizations and vaccine effectiveness estimates, and age-specific vaccination coverage estimates. We estimated the number of symptomatic illnesses, medically-attended illnesses, hospitalizations, and deaths caused by each virus, and the corresponding number prevented by vaccination. Disease burden and vaccine-prevented burden varied substantially by season, age, and virus type or subtype. The greatest disease burden was estimated in 2017/18, whereas 2019/20 had the greatest burden prevented by vaccination. Influenza A viruses contributed most to disease burden in all seasons. Vaccination against influenza B viruses prevented the largest percentage of hospitalizations among children and adults <65 years, whereas vaccination against A(H1N1) prevented the largest percentage of hospitalizations among adults ≥65 years. Overall, our results highlight complex variability in influenza disease burden by season, age, and virus type and subtype. These findings can be used to improve understanding of the factors impacting influenza disease burden each season and to enhance communications of the value of influenza vaccination.

Highlights

Estimates of disease burden and vaccine-prevented burden inform influenza guidance.

Contributions to burden from each virus type and subtype vary by season and age.

A(H3N2) caused the greatest total disease burden from the 2016/17 to 2019/20 seasons.

Children <18 years experienced greater influenza B burden compared with other ages.

Vaccination against A(H1N1) and B prevented the greatest percentage of severe disease.
Using General Practice Patient Survey data to explore prevalence and patient uncertainty about Long Covid
Authors: Woodrow Mirembe , Ziauddeen Nida , Smith Dianna , Alwan Nisreen A
Published: October 2024

Background

The high global burden of Long Covid (LC) has significant implications for population wellbeing, healthcare, social care and national economies.

Aim

To explore associations between patient sociodemographic and health characteristics with two outcomes: reporting having LC and expressing uncertainty about having LC, as described by general practice (GP) survey respondents.

Design and setting

Analysis of GP Patient Survey (England), a random sample of 759,149 patients aged 16yrs+ registered with a GP in England (2023).

Method

Multivariable logistic regression modelling comparing those with and without LC, and those who were unsure in relation to patient characteristics.

Results

4.8% of respondents reported having LC, and 9.1% were unsure. Significant adjusted associations indicating higher risk of LC included age (highest odds 35-54yrs), sex (females), ethnicity (White Gypsy/Irish Traveller, mixed/multiple ethnic groups), sexual orientation (gay/lesbian or bisexual), living in a deprived area, being a carer or a parent and having a long-term condition (LTC). Those aged ≤25yrs, males, non-binary, heterosexual, not parents or carers, from other white, Indian, Bangladeshi, Chinese, Black or Arab backgrounds, former and current smokers, and with no defined LTC were more likely to be unsure about having LC compared to answering ‘yes’.

Conclusion

There is an unequal distribution of LC in England, with the condition being more prevalent in minoritised and disadvantaged groups. There are also high levels of uncertainty about having LC. Improved awareness is needed amongst the general population and healthcare professionals to ensure those most vulnerable in society are identified and provided with care and support.
Population-based Normative Reference for Retinal Microvascular Atlas
Authors: Yusufu Mayinuer , Vingrys Algis J. , Shang Xianwen , Zhang Lei , Shi Danli , Congdon Nathan , He Mingguang
Published: October 2024

Objective

To establish the normative range of a comprehensive set of retinal vascular measurements to better understand their value as biomarkers for assessing ocular and systemic health.

Methods

This cross-sectional study used data from the UK Biobank. Retina-based Microvascular Health Assessment System (RMHAS) software was used to extract retinal vascular measurements, including Calibre, Complexity, Density, Branching Angle, and Tortuosity, differentiating between arteries and veins, and between the macula and retinal periphery. In addition, we explored relationships between those measurements and health metrics, including age, systolic blood pressure (SBP), body mass index, glycated hemoglobin, and intraocular pressure.

Results

Among 10,151 healthy participants, we reported a normative range for 114 retinal vascular measurements, stratified by sex and age. The mean values of Central Retinal Artery Equivalent (CRAE) and Central Retinal Vein Equivalent (CRVE) were 152 (standard deviation=14.9) μm and 233 (21.5) μm respectively. The mean value of Fractal Dimension (FD) was 1.77 (0.032), with arterial FD 1.53 (0.039) and venular FD 1.56 (0.025). Age and SBP showed the strongest associations with most retinal parameters among health metrics. CRAE, CRVE, Density, and Complexity decreased with increasing age and SBP. Changes in arterial measurements with age and SBP were generally greater than for venous measurements. Generalized Additive Models further revealed that observed associations were mainly linear.

Conclusions

By establishing population normative data for a comprehensive set of retinal vascular measurements, our study enables quantifiable approaches to better understand retinal vascular changes.
Towards an extended classification of noise-distortion preferences by modeling longitudinal dynamics of listening choices
Authors: Angonese Giulia , Buhl Mareike , Gößwein Jonathan A. , Kollmeier Birger , Hildebrandt Andrea
Published: October 2024

Individuals have different preferences for setting hearing aid (HA) algorithms that reduce ambient noise but introduce signal distortions. “Noise haters” prefer greater noise reduction, even at the expense of signal quality. “Distortion haters” accept higher noise levels to avoid signal distortion. These preferences were assumed to be stable over time, and individuals were classified solely on the basis of these stable, trait scores. However, the question remains as to how stable individual listening preferences are and whether day-to-day state-related variability needs to be considered as a further criterion for classification. We designed a mobile task to measure noise-distortion preferences over two weeks in an ecological momentary assessment study withN= 185 (106 f,Mage= 63.1,SDage= 6.5) unaided individuals with subjective hearing difficulties. Latent State-Trait Autoregressive (LST-AR) modeling was used to evaluate stability and dynamics of individual listening preferences. The analysis revealed a significant amount of state-related variance. The model has been extended to a mixture LST-AR model for data-driven classification, taking into account trait and state components of listening preferences. In addition to successful identification of noise haters, distortion haters and a third intermediate class based on longitudinal, outside of the lab data, we further differentiated individuals with different degrees of variability in listening preferences. It follows that individualisation of HA fitting could be improved by assessing individual preferences along the noise-distortion trade-off, and the day-to-day variability of these preferences needs to be taken into account for some individuals more than others.
Predicting Depressive and Anxiety Symptoms Among Lebanese and Syrian adults in a Suburb of Beirut during the Concurrent Crises: A Population-Based Study
Authors: Shamas Hazar , Ragi Marie-Elizabeth , Abi Zeid Berthe , DeJong Jocelyn , McCall Stephen J. ,   with the CAEP Study Group
Published: October 2024

Background

People living in low socioeconomic conditions are more prone to depression and anxiety. This study aimed to develop and internally validate prediction models for depressive and anxiety symptoms in Lebanese adults and Syrian refugees residing in a suburb of Beirut, Lebanon.

Methods

This was a population-based study among COVID-19 vulnerable adults in low socioeconomic neighborhoods in Sin-El-Fil, Lebanon. Data were collected through a telephone survey between June and October 2022. The outcomes depressive and anxiety symptoms were investigated for Lebanese and Syrian populations. Depressive and anxiety symptoms were defined as having a PHQ-9 and GAD-7 score of 10 or more respectively. Outcomes’ predictors were identified through LASSO regression, discrimination and model calibrations were assessed using area under curve (AUC) and C-Slope.

Results

Of 2,045 participants, 1,322 were Lebanese, 664 were Syrian, and 59 were from other nationalities. Among Lebanese and Syrian populations, 25.3% and 43.9% had depressive symptoms, respectively. Additional predictors for depressive symptoms were not attending school, not feeling safe at all at home, and not having someone to count on in times of difficulty. Not having legal residency documentation for Syrian adults was a context-specific predictor for depressive symptoms. These predictors were similar to that of anxiety symptoms. Both Lebanese and Syrian models had good discriminations and excellent calibrations.

Conclusion

This study highlights the main predictors of poor mental health were financial, health, and social indicators for both Lebanese and Syrian adults during the concurrent crisis in Lebanon. Findings emphasise social protection and financial support are required in populations with low socioeconomic status.

Research in context

What is already known on this topic

The prevalence of depression and anxiety has increased globally. Vulnerable populations, such as refugees and populations of low socioeconomic status, are more prone to depression and anxiety.

What this study adds

This study included Lebanese and Syrian adults residing in low socioeconomic status areas of Sin-El-Fil, Lebanon. This is a population-based comparison of the predictors to poor mental health in Lebanon between refugees and Lebanese. The study highlights the need to meet financial, physical, and social needs of individuals to address mental health.

How this study might affect research, practice, or policy

The findings of this study highlight the need to reduce financial stress, address physical pain and social isolation, and advocate for Syrian residency documentation to reduce the occurrence of anxiety and depressive symptoms in people living in low socioeconomic conditions.
Linking dynamic connectivity states to cognitive decline and anatomical changes in Alzheimer's disease
Authors: Tessadori Jacopo , Boscolo Galazzo Ilaria , Storti Silvia F , Pini Lorenzo , Brusini Lorenza , Cruciani Federica , Sona Diego , Menegaz Gloria , Murino Vittorio
Published: October 2024

Alterations in brain connectivity provide early indications of neurodegenerative diseases like Alzheimer's disease (AD). Here, we present a novel framework that integrates a Hidden Markov Model (HMM) within the architecture of a convolutional neural network (CNN) to analyze dynamic functional connectivity (dFC) in resting-state functional magnetic resonance imaging (rs-fMRI). Our unsupervised approach captures recurring connectivity states in a large cohort of subjects spanning the Alzheimer's disease continuum, including healthy controls, individuals with mild cognitive impairment (MCI), and patients with clinically diagnosed AD. The framework successfully identified distinct brain states associated with different clinical stages of AD, demonstrating a progressive reduction in functional flexibility as disease severity increased. Specifically, we observed that patients with AD spend more time in brain states dominated by unimodal sensory networks, while healthy controls exhibited more transitions to polymodal, cognitively demanding states. Importantly, the fraction of time spent in each state correlated with cognitive performance and anatomical atrophy in key regions, providing new insights into the disease's progression. Our findings suggest that the disruption of dynamic connectivity patterns in AD follows a two-stage model: early compensatory hyperconnectivity is followed by a decline in connectivity organization. This framework offers a powerful tool for early diagnosis and monitoring of AD progression and may have broader applications in studying other neurodegenerative conditions.
“People here live in denial”: A qualitative study of the pervasive impact of stigma on asthma diagnosis and care in Kenya and Sudan
Authors: Ahmed Rana , Mulupi Stephen , Taegtmeyer Miriam , Ardrey Jane , Devereux Graham , Chinouya Martha , Osman Rashid , Hussein ElHafiz , Modawey Sundos , Eltahir Hoyam , Kinyua Caroline , Meme Helen , Shayo Elizabeth H , El Sony Asma , Tolhurst Rachel
Published: October 2024

Epidemiological studies show a global increase in asthma, straining healthcare systems in low- and middle-income countries. There are multiple barriers to accessing diagnosis and treatment in Sub-Saharan African countries like Kenya and Sudan such as healthcare infrastructure, diagnostic tools, healthcare workers’ capacities, and cost. Asthma can be well controlled using safe and cost-effective treatments such as inhalers. Stigma related to asthma negatively impacts treatment-seeking and adherence in higher-income settings, with limited information about such impacts in Sub-Saharan Africa.

We conducted qualitative interviews and Focus Group Discussions in Kenya and Sudan to explore health systems aspects of diagnosis and management of chronic respiratory diseases. Participants included patients, primary care healthcare workers, hospitals, and community actors. Data were analysed through a framework approach; our initial analysis showed that asthma stigma was prevalent in both countries. Further analysis was done through Health, Stigma, and Discrimination Framework by Stangl.

Negative perceptions about the aetiology and prognosis of asthma contribute to stigma. Anticipated, internalized stigma, and enacted stigma affects individuals with asthma, encouraging them to hide their symptoms and resist diagnosis. This contribute to delayed healthcare seeking and treatment uptake, impacting both individuals with asthma and health professionals. Overall, stigma exacerbates challenges in communicating diagnosis, managing the illness, and maintaining psychosocial health and well-being for those with asthma.

Poor asthma control can exacerbate fear and stigma. Improving asthma control has the potential to reduce fear and positively influence community norms. The rollout of inhalers and spacers for asthma treatment should be accompanied by deliberate stigma reduction strategies and awareness raising at all levels of the system.
Managing uncertainty and complexity during a public health emergency: Understanding the immediate and ongoing effects of the COVID-19 epidemic on a global Neglected Tropical Disease program
Authors: Sutherland E. , Stelmach R. , Warren N. , Jackson J. , Allen B. , Mwingira U. , Brady M. , Ngondi J. , Hernandez L. , Dahal G. , Kabona G. , Telfort M. , Oydediran F. , Seife F. , Sitoe H. , Baker M.
Published: October 2024

When COVID-19 emerged as a global pandemic, the World Health Organization (WHO) recommended a pause in the delivery of neglected tropical disease preventative chemotherapy and surveillance. The Act to End NTDs | East program (Act | East) worked with country neglected tropical disease (NTD) programs to develop, support, and implement guidelines that allowed NTD service delivery and surveillance to resume. This paper examines those adaptations that Act | East made as a program to support numerous countries, over a discrete time period, to resume NTD program operations. This paper also examined how the pause and the resumption of service delivery with new guidelines and standard operating procedures in place affected program operations. Specifically, we examine delays in scheduled mass drug administration and disease surveys, coverage achieved by resumed mass drug administration campaigns, and the impact that COVID-19 had on planning and budgeting. We review which adaptations have been retained in a post-COVID-19 landscape, and which may inform NTD and other global health programs, to better respond in future public health emergencies.
An optimal network that promotes the spread of an advantageous variant in an SIR epidemic
Authors: Lopez Samuel , Komarova Natalia L.
Published: October 2024

In the course of epidemics, the pathogen may mutate to acquire a higher fitness. At the same time, such a mutant is automatically at a disadvantage because the resident virus has a head start in accessing the pool of susceptible individuals. We considered a class of tunable small-world networks, where a parameter,p(the rewiring probability), characterizes the prevalence of non-local connections, and we asked, whether the underlying network can influence the fate of a mutant virus. Under an SIR model, we considered two measures of mutant success: the expected height of the peak of mutant infected individuals, and the total number of recovered from mutant individuals at the end of the epidemic. Using these measures, we have found the existence of an optimal (for an advantageous mutant virus) rewiring probability that promotes a larger infected maximum and a larger total recovered population corresponding to the advantageous pathogen strain. This optimal rewiring probability decreases as mean degree and the infectivity of the wild type are increased, and it increases with the mutant advantage. The non-monotonic behavior of the advantageous mutant as a function of rewiring probability may shed light into some of the complex patterns in the size of mutant peaks experienced by different countries during the COVID19 pandemic.
Double haploid development in drug-typeCannabis sativaL. through microspore indirectde-novoplant regeneration
Authors: Tonolo Francesco
Published: October 2024

Double haploid technology (DH) is an essential tool in plant breeding, enabling the rapid production of homozygous lines. However,Cannabis sativaL. has been categorized as recalcitrant to DH induction. In this study, we evaluated the potential to generate DHC. sativaplants via anther culture and indirectde-novoorganogenesis. We examined a THCA-dominant cultivar with a callus induction success of 29.48%. Mixoploidy in the callus indicated spontaneous genome doubling. This is the first report documenting the successful induction of DHC. sativaplants throughde-novoindirect organogenesis. These findings have profound implications for theC. sativabreeding sector by potentially improving efficiency of genome editing and hybrid development in this economically significant species.
Resolving the “Ontogeny Problem” in Vertebrate Paleontology
Authors: Napoli James G.
Published: October 2024

Ontogenetic change is a major source of phenotypic variation among members of a species and is often of greater magnitude than the anatomical differences that distinguish closely related species. Ontogeny has therefore become a problematic confounding variable in vertebrate paleontology, especially in study systems distant from extant crown clades, rendering taxonomic hypothesis testing (a fundamental process in evolutionary biology) rife with difficulty. Paleontologists have adopted quantitative methods to compensate for the perception that juvenile specimens lack diagnostic apomorphies seen in their adult conspecifics. Here, I critically evaluate these methods and the assumptions that guide their interpretation using a µCT dataset comprising growth series of American and Chinese alligator. I find that several widespread assumptions are scientifically unjustifiable, and that two popular methods – geometric morphometrics and cladistic analysis of ontogeny – have unacceptably high rates of type II error and present numerous procedural difficulties. However, I also identify a suite of ontogenetically invariant characters that differentiate the living species ofAlligatorthroughout ontogeny. These characters overwhelmingly correspond to anatomical systems that develop prior to (and play a signaling role in) the development of the cranial skeleton itself, suggesting that their ontogenetic invariance is a consequence of the widely conserved vertebrate developmental program. These observations suggest that the architecture of the cranium is fixed early in embryonic development, and that ontogenetic remodeling does not alter the topological relationships of the cranial bones or the soft tissue structures they house. I propose a general model for future taxonomic hypothesis tests in the fossil record, in which the hypothesis that two specimens different ontogenetic stages of a single species can be falsified by the discovery of character differences that cannot be attributed plausibly to ontogenetic variation.
Epigenetic responses inBorrelia-infected Ixodesscapularisticks: Over-expression of euchromatic histone lysine methyltransferase 2 and no change in DNA methylation
Authors: MacIntosh Grace Hadley , Nuyens Alexandra C. , Vickery Jessica L. , Berthold Anne , Lloyd Vett K.
Published: October 2024

Borrelia burgdorferi, a tick-vectored spirochete bacteria best known for causing Lyme disease, has been found to induce physiological and behavioural changes in its tick vector that can increase tick fitness and its ability to transmit the bacteria. The mechanism by which this bacterium modulates these changes remains unknown. Epigenetics plays a central role in transducing external and internal microbiome environmental influences to the organism, so we investigated DNA methylation and the expression of a key histone modification enzyme inBorrelia-infected and uninfectedIxodes scapularisticks. DNA methylation of the pericentromeric tandem repeats family,Ixodes scapularisRepeats (ISR) were assessed by methylated-DNA immunoprecipitation (MeDIP) followed by qPCR of the ISR regions. DNA methylation of the ISR sequences was found. The different repeats had different levels of DNA methylation, however, these levels were not significantly affected by the presence or absence ofB. burgdorferi. The epigenetic regulatoreuchromatic histone lysine methyltransferase 2(EHMT2) is recognized as having a key role in modulating the organismal stress response to infections. To assessEHMT2transcription inBorrelia-infected and uninfected ticks, real-time reverse transcriptase PCR was performed. Uninfected ticks had over 800X lowerEHMT2expression than infected ticks. This study is among the first to identify a gene that may be involved in producing epigenetic differences in ticks depending on infection status and lays the groundwork for future epigenetic studies ofI. scapularisin response toB. burgdorferias well as other pathogens that these ticks transmit.