Painless Mesenteric Cyst in an Adult: A Case ReportSubhash Chandra Mandal1 Kunal Bikram Deo11BP Koirala Institute of Health Sciences, Dharan, Nepal

Long-term, individual-level studies can provide valuable insights into the effects of climate and landscape change on the ecology and population dynamics of wild animals. However, many such studies lack environmental data collected at sufficient spatial and temporal scales to determine how populations respond to changing conditions. In these cases, the retrospective use of satellite-derived data can provide a way to recover past environmental information. Here, we used 27 years of data from an insectivorous passerine in southeastern Australia, the superb fairy-wren Malurus cyaneus, to assess how climate variation influences vegetation productivity and, indirectly, superb fairy-wren life history traits through potential changes in trophic interactions. Specifically, we combined long-term individual-level monitoring of superb fairy-wrens and local weather records with Landsat satellite imagery, from which we derived measures of vegetation productivity using the Normalised Difference Vegetation Index (NDVI) as a proxy for food availability through arthropod abundance. We found a complex set of associations between NDVI and different components of weather, when considering both concurrent and lagged effects. Our analyses of the causes of seasonal variation in superb fairy-wren life history traits demonstrated that NDVI was associated with: (i) temporal variation in breeding success, with years with high spring and summer NDVI values having relatively high average breeding success; and (ii) spatial variation in adult mortality in autumn and winter, with superb fairy-wren territories with low autumn–winter NDVI values having higher average mortality rates. Notably, autumn–winter NDVI values were found to have remained relatively consistent over time, and therefore cannot explain recently observed increases in adult autumn–winter mortality. Our study illustrates the potential of using long-term Landsat satellite imagery to investigate whether associations between animal life history traits and climate are mediated by vegetation productivity and to what extent temporal trends are influenced by climate change.

Background: Meige syndrome induced by antipsychotics causes significant functional impairment. This case report describes a pediatric patient with treatment-resistant schizophrenia complicated by Myge syndrome. Case Presentation: A 12-years-old boy with schizophrenia developed blepharospasm and facial twitching around the mouth during treatment with multiple antipsychotic medications. Given the diagnosis of treatment-resistant schizophrenia

Intraspecific variation is the collective genotypic and phenotypic variability among individuals and populations of a species. Its documentation across taxa is considered essential for understanding ecological-evolutionary processes and biodiversity consequences in Anthropocene environments. The systematic assessment of intraspecific variation is, however, a complex task. Here, we present a conceptual approach for holistic surveying of intraspecific variation. We illustrate its feasibility through application in chimpanzees, a taxon with high anthropological significance for understanding hominid diversification and conservation importance as flagship and umbrella species. By establishing a large-scale, highly collaborative and well-structured network of research sites, standardized genomic, microbiome, mycobiome, physiological, dietary, demographic, behavioral and ecological data could be collected across many populations. Studies unprecedented in scale, complexity, and disciplinary integration allow addressing long-standing questions and complex topics which previously could not be studied with existing approaches restricted in extent and scale. Adopting similar approaches for other taxa exhibiting high intraspecific variation, including other primates, corvids, parrots or cetaceans will advance holistic species understanding. Such work will reveal generalizable patterns and improve understanding of contexts shaping ecological-evolutionary processes underlying the emergence of intraspecific variation, facilitating inclusion of intraspecific variation into conservation strategies and revealing consequences of losing intraspecific variation in Anthropocene environments.

One-hour Manual Intrathoracic Gauze Packing as Damage Control for Massive Hemothorax in a Peri-arrest Patient During Prolonged Interfacility Transfer: A Case ReportSayumi Tanaka1,2, Yuko Okishio2, Sadao Kawasaki1, Kentaro Ueda2, Takafumi Yonemitsu2, Kyohei Miyamoto2, Natsuyo Shinohara2, Masaou Tanaka1, Naoaki Shibata2, Tsuyoshi Nakashima2, Kosei Kunitatsu2, Nozomu Shima2, and Shigeaki Inoue21Department of Emergency Medicine, National Hospital Organization Minami Wakayama Medical Center, Wakayama, Japan.2Department of Emergency and Critical Care Medicine, Wakayama Medical University, Wakayama, Japan.

Pediatric Giant Lipoblastoma: A Case Report and Literature Review

Summary: Thoracic vertebral malformations occur frequently in small animals; however, they are uncommon in horses and usually appear as incidental findings on radiographs or at necropsy. Very few affected horses show clinical signs and typically these are observed at a young age. The previously reported cases of clinically apparent hemivertebrae in the thoracic spine of horses describe animals less than 28 months old. This case report describes the clinical, diagnostic and post-mortem findings in a 14-year-old gelding with a thoracic hemivertebra and insidious onset of ataxia. In addition to being the first reported clinically apparent case of a thoracic hemivertebra in an adult horse, this case illustrates the difficulty of diagnosing thoracic vertebral malformations in mature horses. Computed tomography of the thoracic spine can yield a reliable post-mortem diagnosis.

In a tropical montane catchment of the Colombian Andes (Abanico del Quindío), we analysed a seven-year (2018–2025) monthly record of precipitation isotopes (δ 2H and deuterium excess, d-excess) using a novel combination of Seasonal–Trend decomposition (STL) and generalized additive models (GAMs). This approach separates intra-annual and interannual variability and quantifies their climatic drivers. Results reveal a pronounced seasonal δ 2H cycle (~80–100‰ amplitude) driven by a strong amount effect: rainy months yield depleted δ 2H, whereas drier periods see enriched values. δ 2H and d-excess co-vary seasonally, but their interannual responses diverge under ENSO influences: δ 2H is enriched during El Niño conditions (positive MEI.v2) and more depleted in La Niña, whereas d-excess shows the opposite pattern, rising during La Niña (consistent with enhanced continental moisture recycling) and dropping in El Niño. After 2019, coincident with a prolonged “triple-dip” La Niña, the seasonal δ 2H peak shifted ~1 month earlier and its amplitude dampened (~20% reduction), reflecting modified rainfall seasonality. GAM results further indicate that precipitation amount and Atlantic SST anomalies (TNA index) significantly predict δ 2H variability (p < 0.001), while ENSO (MEI.v2) adds no independent explanatory power after controlling for these factors. For d-excess, the GAM yields significant positive effects of TNA and precipitation and a negative effect of MEI.v2. The best-fit model explains 86% of δ 2H variance and 62% of d-excess variance, underscoring the strength of this integrated STL–GAM approach for unravelling multi-scale climate controls on precipitation isotopes in tropical mountains.

This work addresses an inverse source problem for a coupled reaction–diffusion system that models the interaction between biochemical oxygen demand (BOD) and dissolved oxygen deficit (DO) in water-quality monitoring. The objective is to reconstruct an unknown pollution source acting in the (BOD) equation from partial observations of the (DO) deficit, a difficult task due to the indirect coupling between the source and the observations. We propose a non-iterative reconstruction strategy based on topological sensitivity analysis. The method evaluates the first-order variation of a quadratic misfit functional induced by the nucleation of an infinitesimal source inclusion, thereby yielding an explicit topological gradient whose negative values indicate likely source locations. We establish well-posedness of the forward coupled system, prove an identifiability result for the admissible class of sources under exact data, and derive the associated topological sensitivity formula. Numerical experiments with noisy boundary data illustrate accurate localization and robustness with respect to moderate modelling uncertainties.

A document by Ayushma Acharya. Click on the document to view its contents.

IntroductionEctopic ACTH secretion accounts for approximately 10–20% of cases of ACTH-dependent Cushing’s syndrome and is most commonly associated with pulmonary neuroendocrine tumours and small-cell lung carcinoma (1). Gastrointestinal sources are rare and frequently under-recognised, particularly in cases without classical phenotypic features of hypercortisolism (1,3).Mortality in untreated ectopic ACTH syndrome is largely driven by severe metabolic complications, thromboembolism, and infectious sequelae secondary to profound hypercortisolism (2). Early recognition is therefore essential.In acute and general medical settings, electrolyte disturbances in oncology patients are commonly attributed to gastrointestinal losses, chemotherapy-related effects, or poor oral intake. Failure to recognise hormonally mediated causes may result in repeated admissions, delayed diagnosis, and increased morbidity. This case illustrates how ectopic ACTH secretion may present primarily as severe metabolic instability rather than overt Cushingoid phenotype.

A document by Jianmiao Ge. Click on the document to view its contents.

Drought tolerance in crops often involves trade-offs between water conservation, growth and reproduction. Understanding how water-saving strategies are implemented at physiological and metabolic levels remains critical for improving crop performance under water-limited conditions. Here, we characterize a wheat TILLING mutant, WS1, which exhibits enhanced survival under drought stress. WS1 showed reduced stomatal conductance and transpiration rates, accompanied by increased carbon isotope discrimination, indicating improved water-use efficiency. Despite these traits, WS1 displayed weak stomatal responses to exogenous abscisic acid, suggesting that its water-saving behaviour is not primarily driven by canonical ABA signalling. Metabolomic analyses revealed substantial accumulation of proline and alterations in nitrogen and carbon metabolism, consistent with a survival-oriented metabolic state under water limitation. Phosphoproteomic profiling further identified distinct phosphorylation patterns associated with energy-related signalling components, including proteins linked to SnRK1-mediated pathways. These molecular features were not interpreted as causal drivers but rather as indicators of an altered energy-sensing and metabolic state supporting drought survival. Notably, WS1 exhibited reduced fertility, highlighting an intrinsic trade-off between survival and reproductive investment. Together, our results demonstrate that WS1 adopts a water-saving drought survival strategy characterized by coordinated physiological and metabolic reprogramming. This study provides an integrated framework for understanding survival-oriented drought responses in wheat and offers a basis for future genetic dissection of water-use strategies in crops.

Anomalous Single Coronary Ostium from the Right Sinus of Valsalva Complicated by Severe Triple-Vessel Atherosclerosis

Wild bees and wasps are vital to ecosystems, yet large-scale monitoring of individual insects as well as their habitats and behaviors requires expert knowledge and is very labour-intensive. Recent advances in computer vision offer both methodological solutions and practical applications for these tasks. This review systematically surveys state-of-the-art literature (2020-2025) on computer-vision-based monitoring of wild bees and wasps. We compare the primary monitoring tasks, such as individual detection and classification, habitat observation, and assessment of insect behavior, and analyze how specific computer vision techniques contribute to each. By examining the datasets used in the reviewed studies, we further categorize dataset types and collection strategies to inform future image acquisition. In addition, we draw insights from widely used public resources (e.g., iNaturalist, Observation) regarding their strengths and limitations for this domain. We then examine how hardware and software are integrated in these studies, and review released repositories, existing applications, and the design of more complex, multifunctional monitoring stations. These analyses provide guidance for benchmarking and future deployment with existing datasets and monitoring tools. We eventually propose the design of building more comprehensive and efficient automatic monitoring systems for wild bees and wasps.

1 INTRODUCTIONThe global demographic shift toward aging has elevated physiological reserve depletion and multisystem vulnerability to core challenges in modern medicine [1], epitomized by frailty and multimorbidity—conditions that drastically amplify susceptibility to physiological stressors. This vulnerability was starkly underscored by COVID-19’s disproportionate impact on older adults [2, 7]. While short-term outcomes in this population are well-documented, granular longitudinal data tracing the clinical trajectory from acute infection to death among the oldest old, particularly centenarians, remain critically scarce.This report addresses this gap by presenting a 35-month progression of a 105-year-old man from post-COVID-19 survival to multisystem failure. We conceptualize his decline as a “health collapse spiral,” contextualizing it within the established model of stressor-induced decompensation in frailty [5, 8]. This case offers a rare longitudinal visualization of systemic physiological reserve depletion at the extreme limits of human age.

Gestational Polyphenol Levels and Risk of Atopic and Respiratory Outcomes in Early-Life: Insights from The LiNA StudyTo the editor,Maternal diet during pregnancy may potentially influence immune development and subsequent atopic risk in children1. Dietary antioxidant and anti-inflammatory compounds, such as polyphenols, have been associated with a reduced risk of allergies and respiratory diseases2. However, most available evidence on their health effects comes from self-reported food-frequency questionnaires, which are intrinsically susceptible to recall and reporting biases3. Thus, there is a need for objective biomarkers of polyphenol internal exposure during gestation. Here, we investigated the link between maternal polyphenol markers in late pregnancy, individually and as mixtures, with the lifetime prevalence of atopic dermatitis (AD), food sensitization, wheezing, and bronchitis in 3-year-olds (Figure-1A and Figure-S1 ), and assessed whether the children’s Th2 blood cytokines (Table-S1 ) may mediate their association with AD.Our study included 581 mother-child pairs of the prospective birth-cohort LiNA (n=622 at baseline)4 with semiquantitative LC-HRMS-based measurements of 46 food markers in gestational urine samples5 (Table-S2 ). To capture consistent patterns of internal exposure and reduce sparse-data bias, only polyphenol markers with a detection rate >70% (n=14) were selected for analysis (Table-S3 ). Some polyphenols were strongly positively correlated, e.g., isosakuranetin and homoeriodictyol (r =0.97) or negatively correlated, e.g., naringenin and enterolactone (r =-0.83) (Figure-S2B ). All statistical models were fitted using the annotated LC-HRMS signal intensities categorized into tertiles (Ts) and adjusted for environmental and lifestyle variables to control for potential confounding (details in Supporting Information).In the 3-year follow-up subcohort (n=478, Figure-1B ), adjusted logistic regression models showed that children whose mothers ranked the upper tertile (T3) of the flavonoids isosakuranetin (aOR=0.45, 95% CI: 0.22-0.88), norwogonin-glucuronide (aOR=0.42, 95% CI: 0.20-0.84), and pinocembrin (aOR=0.41, 95% CI: 0.20-0.81) had lower odds of AD compared with those in the lowest tertile (T1, used as reference). The upper tertiles of enterolactone and hippuric acid, two microbiota-derived compounds, were also associated with reduced odds of wheezing (aOR=0.50, 95% CI: 0.31-0.80) and bronchitis (aOR=0.60, 95% CI: 0.37-0.95) (Figure-1B ). Next, we examined whether mixtures of major polyphenol groups detected in pregnancy may be associated with health outcomes at age 3. In the quantile g-computation analyses, a one-tertile increase in the mixture of flavonoids was associated with reduced odds of AD (aOR=0.50, 95% CI: 0.27-0.92; p =0.027), with pinocembrin and norwogonin-glucuronide having the largest weights (33% and 23%) in the overall estimate (Figure-2A ). Among microbiota-derived compounds, hippuric acid and enterolactone contributed equally (weights: 44%) to the mixture model linked with lower wheezing risk (aOR=0.68, 95% CI: 0.48-0.96; p =0.029) (Figure-S3 ).Lastly, we performed mediation analyses to assess whether the children’s Th2 cytokine profile (n=268) was consistent with the observed inverse relationship between isosakuranetin, norwogonin-glucuronide, and pinocembrin and AD. The indirect association via IL-5 was statistically significant (-0.022, 95% CI: -0.055, -0.001, p =0.042), whereas the direct association in the outcome model reached only borderline significance (-0.101, 95% CI: -0.201, 0.009, p =0.079) (Figure 2B ). This trend aligns with in vitro andin vivo studies on certain phytochemicals’ capacity to modulate Th2-signaling, involving IL-5 and NF-κB pathways6.Altogether, we identified five polyphenol markers (isosakuranetin, norwogonin-glucuronide, pinocembrin, enterolactone, and hippuric acid) whose relative levels were associated with lower risk of selected childhood outcomes in the LiNA cohort and provided exploratory evidence consistent with IL-5-related immunomodulation in AD. Nonetheless, several limitations must be acknowledged: detection of metabolites in a single urine sample with semiquantification, a relatively small subcohort with blood cytokines, potential parental misreporting, lack of microbiome data, and generalizability limited to Central European populations. Our findings are hypothesis-generating and require replication in larger cohorts with quantitative metabolomics analysis of repeated exposure assessment. This study underscores a gap in approaches that integrate prenatal maternal diet, gut microbiome function, and immune programming to strengthen causal inference.

Background: Unexpected news in Fetal Medicine (FM) includes suspected fetal anomalies, uncertain ultrasound findings, or risks that may alter pregnancy management or outcomes. How such news is communicated can have lasting emotional and decisional consequences, particularly for women with pre-existing mental health conditions (MHCs). Objective: To explore communication practices used by FM healthcare professionals (HCPs) when delivering unexpected news to pregnant women with MHCs. Design: Qualitative co-production study Setting: Three FM services in East London, UK Population: Pregnant women with pre-existing MHC attending FM consultations, their accompanying significant others, and FM HCP. Methods: Twenty-one real-life FM consultations were audio- and/or video-recorded. Recordings were analysed collaboratively by academic researchers and public contributors with lived experience using applied conversation analysis. Main outcome measures: Observable communication practices and their interactional consequences within consultations. Results: Communication practices that supported understanding and emotional containment included clear and inclusive opening practices, explanation of ongoing activities, use of accessible language, acknowledgement of emotional cues, allowing time for processing, and involvement of significant others. Practices associated with noticeable uncertainty or distress included rushed encounters, unexplained silences or questions, technical language without clarification, vague reassurance, missed emotional cues, and exclusion of companions. Conclusions: This co-produced analysis identifies communication practices that shape how unexpected news is experienced in FM consultations. The findings can inform training and service development to support clearer, more empathetic, and more inclusive communication, particularly for women with MHCs.