Plants have a wide range of adaptive and protective mechanisms to cope with dehydration. Central in these processes are the Late Embryogenesis Abundant (LEA) proteins, whose levels notably increase in response to dehydration during seed development and vegetative tissues. Understanding the function of LEA proteins is essential for gaining insights into plant development and their adaptive responses to environmental stress. This study focuses on group 6 LEA proteins (LEA6) from Arabidopsis thaliana: AtLEA6-2.1, AtLEA6-2.2, and AtLEA6-2.3. Phylogenetic analysis reveals that LEA6 family emerged with seed plants, pointing to a unique role in seed viability. Functional characterization using T-DNA insertion mutants demonstrated that AtLEA6-2.1, but not AtLEA6-2.2, is essential for tolerance to high-osmolarity and salinity during germination and post-germination growth. AtLEA6-2.1 deficiency also altered root architecture under salinity, increasing primary root length while reducing lateral root number and length, suggesting a role in root development not described before for a LEA protein. Furthermore, AtLEA6-2.1 is critical for seed longevity, as mutants lacking this protein showed reduced germination after natural and accelerated aging. These mutants exhibited increased glass-former fragility, indicating that AtLEA6-2.1 deficiency reduces cellular viscosity, which we found correlates with reduced longevity. Our investigation extends to protective protein assays under dehydration, revealing that the acidic nature of this protein family requires specific conditions for its in vitro protective activity. Overall, this study underscores the essential role of AtLEA6-2.1 in the plant response to low-water availability, seed longevity, and glassy state properties, making it a potential target for enhancing plant resilience to environmental challenges.

Tropical tree species vary in photosynthetic temperature sensitivity, with species from warmer habitats or those acclimated to higher temperatures typically displaying higher thermal optima for net CO2 assimilation (Topt, Anet). Sustaining photosynthesis at elevated temperatures likely requires increased allocation of resources (ATP, NADPH, nitrogen, carbon) toward heat stress management, particularly PSII repair. However, under extreme heat, repair demands may exceed available resources, potentially limiting acclimation. It is unclear whether higher Topt, Anet reflects inherently greater PSII heat stability.We studied 11 tropical tree species across a topographic (hilltop, slope, valley) and thermal gradient (summer peaks: 46.1, 40.1, 31.8 °C, respectively) in India’s Central Western Ghats forest, measuring photosynthetic temperature responses and PSII thermal tolerance (T5, the temperature causing 5% PSII efficiency decline) at peak summer. We found an inverse correlation between T5 and Topt, Anet (p = 0.005): lower Topt, Anet was associated with higher PSII heat stability (higher T5), and vice versa. This could suggest a trade-off between investing resources to achieve higher Topt, Anet and maintaining PSII heat stability. ·      Species may struggle to simultaneously acclimate to elevated temperatures and remain resilient to extreme heat events. These findings have implications for understanding tropical forest tree responses to climate warming.

Predicting the structure of ligands bound to proteins is a foundational problem in modern biotechnology and drug discovery, yet little is known about how to combine the predictions of protein-ligand structure (poses) produced by the latest deep learning methods to identify the best poses and how to accurately estimate the binding affinity between a protein target and a list of ligand candidates. Further, a blind benchmarking and assessment of protein-ligand structure and binding affinity prediction is necessary to ensure it generalizes well to new settings. Towards this end, we introduce MULTICOM_ligand, a deep learning-based protein-ligand structure and binding affinity prediction ensemble featuring structural consensus ranking for unsupervised pose ranking and a new deep generative flow matching model for joint structure and binding affinity prediction. Notably, MULTICOM_ligand ranked among the top-5 ligand prediction methods in both protein-ligand structure prediction and binding affinity prediction in the 16th Critical Assessment of Techniques for Structure Prediction (CASP16), demonstrating its efficacy and utility for real-world drug discovery efforts. The source code for MULTICOM_ligand is freely available on GitHub.

Species distribution models (SDMs) are valuable tools for assessing species’ responses to environmental factors and identifying areas suitable for their survival. The careful selection of input variables is critical, as their interactions, and correlations with other environmental factors can affect model performance. This study evaluates the influence of climate and soil variables on SDMs’ performance for 5,033 Australian plant species, selected to represent the largest phylogenetic diversity of native terrestrial vascular flora. Using an ensemble of correlative models, we assessed the predictive performance of climate and soil variables, individually and in combination, across four distinct ecoregions: Desert (n = 640 species), Mediterranean (n = 1,246), Temperate (n = 1,936), and Tropical (n = 1,211). Our results demonstrate that on a continental scale, climate variables have a greater influence on plant distributions than soil variables. Although incorporating soil and climate variables enhanced model performance in some ecoregions, our results indicate that relying solely on small-scale variables such as soil may increase the likelihood of overfitting. In soil-only models, Clay content (CLY), Nitrogen Total Organic (NTO), and Soil Organic Carbon (SOC) were important across modelled species, with their relevance varying by ecoregion. Our findings have significant implications for understanding the interplay between climate, soil, and plant distribution within diverse ecoregions. By highlighting the crucial role of climate in large-scale models, this study serves as a foundation for developing more accurate predictions of plant distributions, ultimately improving model accuracy for biodiversity assessments.

\receivedDD MMMM YYYY \acceptedDD MMMM YYYYArticle title:

Durian, or Durio zibethinus, is an exotic fruit with high economic value in Southeast Asia. This study aims to determine the genetic variants based on the chloroplast genome between species and cultivars in the Durio genus and design the molecular marker based on microsatellite resources. The research was conducted by collecting the data of 8 chloroplast genomes followed by the genome structure and organization analysis, variants analysis, phylogenetic relationship analysis, and possibly, primer designing. Overall, the results showed that regions with high Pi values for the nucleotide diversity analysis were the regions in ycf1, psbZ-rps14, accD, and rpl33-rps18. Although the nucleotide diversity analysis had shown various hotspots from the current data of complete chloroplast genomes of the Durio genus, the accD region showed to have a high Pi value between species but failed to distinguish between variants of the same species. Furthermore, 13 primer SSR regions were selected from 135 SSRs, and the corresponding primer pairs were designed for amplification. Durio zibethinus cv. Ri6 has a close relationship to other Durio zibethinus cultivars but has high genetic divergence from other Durio genus species. The Durio genus had a close relationship to Reevesia genus according to the phylogenetic tree of Malvaceae family. The cp genomes are stated to be a useful tool in studying the phylogenetic relationship. In conclusion, the cp genomes are a useful tool and could be further utilized for molecular markers designing, the evolution history of the Durio genus.

Objective: We aimed to compare central blood pressure, central pulse pressure, and parameters like augmentation index (Aix) and pulse wave velocity (PWV), which are used to evaluate arterial stiffness using an oscillometric method called arteriography, among hypertensive patients with and without concomitant ascending aortic aneurysms. Methods: A total of 83 patients were included in this study, including 44 consecutive patients with hypertension (HT) diagnosed and ascending aortic (AA) diamater 40 mm or more detected by 2D transthoracic echocardiography (TTE), and 39 controls with HT diagnosed and normal AA diameter. Results: E/e’ ratio was found to be significantly higher in the aneurysm group (9,05±2,24 vs 7,75±1,94, p<0.05). The difference between peripheral and central systolic blood pressures was found to be significantly lower in the aneurysm group compared to the control group (9,3±4,5 vs 11,8±4,1, p<0.05, respectively). Among the examined arterial stiffness parameters, Aix values were significantly higher in the aneurysm group (27±8,7 vs 22,7±9,6, p<0.05), while PWV did not show a statistically significant difference between the groups (8,85±1,85 vs 8,59±1,19, p>0.05, respectively). Conclusion: Our study suggests that the use of the osilometric arteriograph device is a simple, cost-effective, and reliable method for assessing increased aortic stiffness in patients coexistence HT and AA aneurysm. We also mention an interesting point about the potential relationship between the development of AA aneurysm and elevated aortic stiffness in hypertensive patients.

In an era defined by elusive post-truth conditions, illusions and trickery saturate public discourse—circulating with breathtaking speed, overshadowing sustained reflection, and igniting cultural divides. Drawing on select posthuman perspectives and Marshall McLuhan’s figure/ground analysis, this article explores how illusions become events in which truths are simultaneously asserted, obscured, and transformed. Rather than dismiss illusions as mere deception or lapse in rationality, I consider them emergent phenomena co-produced by humans, machines, and intangible intensities—fueling a new “shock-shrug” cycle of ephemeral attention. As cynicism or confusion easily follow, an ethic of re/truthing offers an alternative mode of inquiry: one that refuses naive faith in universal truths while pursuing genealogical mappings of illusions to retain possibilities for critical engagement. I examine these dynamics through concepts such as ephemeral intensities, comedic appropriation, and the overshadowing of ecological crises. Ultimately, illusions require genealogical approaches to memory, shifting our educational engagements beyond linear corrections toward collaborative sense-making across human and nonhuman entanglements.

We present sufficient conditions to obtain a generalized ( φ,𝔇) –pullback attractor for evolution processes on time–dependent phase spaces, where φ is a given decay function and 𝔇 is a given universe. We deal specifically with the case in which φ has either exponential or polynomial decay, the universe is the one of uniformly bounded families, and apply the abstract results to a non–autonomous wave equation with time–dependent propagation velocity.

Lignin valorization has attracted significant attention in recent years due to its abundance and potential as a renewable organic carbon resource to produce value-added chemicals and fuel additives. Catalytic upgrading of lignin faces challenges due to its complex structure and an active catalyst with selective surface properties is needed to break the stable C–O and C–C interunit linkages. In this work, a series of multifunctional Ru/NbOPO4/TiO2 catalysts with varying surface acidic properties are developed and explored upon hydrogenolysis of lignin model compound eugenol. Textural and surface acid-base properties of the prepared materials are studied by N2-physisorption, NH3-TPD, XRD, SEM-EDS, Raman spectra, FT-IR, and TEM. Catalytic results reveal synergistic role of acid and metal sites upon catalyst performance, whereupon high yields of hydrocarbons (86.9–100 wt.%) are obtained with selective cleavage of the methoxy and hydroxy groups under milder conditions. Further study identifies the reaction mechanism and determines a rate law and partial reaction orders. This research advances the understanding of catalyst design for upgrading of the lignin or lignin monomers into value added chemicals, and on the other hand, contributes to sustainable development by maximizing biomass usage and providing environmentally friendly alternatives in renewable energy.

The unit commitment and economic dispatch problems are crucial aspect of power system operation and management. Economic dispatch (ED) involves the optimal allocation of power generation from multiple sources to meet the electrical demands at minimal costs, while unit commitment (UC) entails deciding which generating unit should be online (committed) and which should be offline over a specific time horizon to meet forecasted electricity demand. These problems are considered difficult optimization problems due to the number/type of variable and constraints present. This paper presents a literature survey of classical optimization techniques applied to the UC and ED problems. Comparative numerical results for some standard benchmark problems showcase the performance differences among these methods. Future research directions are identified and discussed, paving the way for solutions with better accuracy, computational efficiency and, ease of implementation.

Power flow and state estimation are fundamental processes in the operation and planning of power systems. The power flow model integrates network, load, and generation data to calculate voltages, line flows, and system losses across different buses, relying on the resolution of nodal power balance equations. Concurrently, state estimation plays a pivotal role by reconciling actual measurements with modeled values, determining the most probable state of the system. This paper explores power flow and state estimation challenges in power systems engineering, presenting numerical results for an AC power flow problem and two state estimation problems in DC and AC networks. The Newton power flow algorithm is adeptly employed to address the intricacies of the first power flow problem, showcasing its effectiveness in handling the complexities of contemporary power systems. Furthermore, the paper sheds light on the state estimation problems, employing the weighted least squares method to enhance accuracy and reliability. The challenges encountered and solutions proposed provide valuable insights into the intricacies of these critical processes.

Proteins dynamically exhibit fluctuating conformations, primarily driven by variations in their main chain dihedral angles phi (ϕ) and psi (ψ). In general, these conformational ensembles are such that the overall three-dimensional structure of proteins remains invariant. The conservation of three-dimensional structure thus imposes limits on variations in individual residues’ ϕ and ψ, and moreover, compensatory mechanisms exist when one of these dihedral angles undergoes a significant change. This study attempts to quantify conformational variability in protein structures by analysing dihedral angle fluctuations across diverse protein families using Shannon entropy. We assessed 26 protein families, whose structures have been determined by X-ray crystallography, NMR spectroscopy, and for one structure on which molecular dynamics simulations have been carried out. Additionally, we included a family of protein structures predicted using AlphaFold and compared the results with those of experimentally determined structures. Our findings reveal consistent Shannon entropy values across most protein families with slight variability, suggesting a natural limit to dihedral angle fluctuations that balance structural integrity and flexibility. Significant local correlations in dihedral angle adjustments reveal sophisticated compensatory mechanisms essential for maintaining overall structural integrity. These insights enhance our understanding of the delicate balance between protein stability and flexibility and have significant implications for protein engineering, drug design, and the broader study of protein dynamics.

The JAK/STAT (Janus Kinase/Signal Transducer and Activator of Transcription) pathway plays a pivotal role in signaling for a diverse range of cytokines and growth factors in mammals, controlling various cellular processes. Within the STAT family, the STAT5B protein is implicated in a spectrum of hematopoietic diseases. Dysregulation of STAT5B phosphorylation is associated with numerous conditions, including clonal hematopoietic stem cell disorders like Myeloproliferative Neoplasms (MPNs). Understanding the intricate phosphorylation mechanisms of STAT5B is crucial for deciphering the pathogenesis of diseases linked to JAK-STAT pathway dysregulation. This study delves into the impact of phosphorylation on STAT5B conformational changes, employing over 400 ns explicit molecular dynamics (MD) simulations and comprehensive computational analyses, including the machine-learning-based bound ion coordination detector, HIT2. The results indicate that phosphorylation induces a redistribution of electrostatic charges and alters hydrogen bond formations in antiparallel structures. Moreover, phosphorylated parallel STAT5B dimers exhibit significantly negative surface changes and dense electric field lines, augmenting interactions within the STAT5B dimers. These discoveries shed light on the molecular mechanisms governing STAT5B and present potential therapeutic targets for hematopoietic diseases involving aberrant STAT5B activation.

Generative Artificial Intelligence (AI) is one most recent digital technologies and generative AI tools such as ChatGPT have the potential to transform higher education. However, the implementation strategy of generative AI technology in higher education remains unclear due to limited data about student experience in the use of generative AI tools. The aim of this study is to evaluate student engagement and students’ opinions on engineering education after the use of ChatGPT as a supportive tool using a survey. The first four questions in the survey aimed to identify the demographics and how the students used the generative AI tools to support their learning. The remaining questions aimed to evaluate whether the students agreed on the benefits of using generative AI tools to enhance their learning using a six-level Likert scale. The correlations between the questions aim to evaluate student demographics and how students use generative AI, and the questions aim to evaluate whether the students agree on the benefits of using generative AI tools to enhance their learning were analysed using the Chi-square test of independence. Students’ opinions about the benefits of using generative AI tools to enhance their learning were evaluated using Multinomial test and the frequencies in the categories of the Likert scale were compared to each other using pairwise Binomial test. Analyses of the responses indicated a positive impact of generative AI technology in engineering education. Therefore, strategies may be developed to implement generative AI technology in engineering education to support student learning in the future.

The Japanese Archipelago harbors unique beech flora (Fagus L.; Fagaceae), with a sympatric distribution of two endemic species, F. crenata and F. japonica, upon which a diverse array of 34 types of leaf galls induced by gall midges (Diptera: Cecidomyiidae) have been documented. The inducers of most of these galls remain undescribed, and their phylogenetic relationships with known taxa are still poorly understood. In this study, we collected 29 types of leaf galls from the two Japanese Fagus species, including 6 previously unreported types, and sequenced the cytochrome c oxidase subunit I mitochondrial gene of the inducers to infer maximum-likelihood and Bayesian time-calibrated phylogenies. Our phylogenetic analyses revealed that the Fagus-hosting guild forms a monophyletic clade within the tribe Dasineurini, with F. crenata-hosting taxa occupying a basal position within the lineage. These taxa are closely related to the genera Hartigiola and Mikiola and have likely undergone adaptive radiation on the leaves of F. crenata and F. japonica in the ecologically segregated Japanese Archipelago since the Miocene period, accompanied by multiple host shifts between the two Fagus species and location shifts within their leaves.

Lilium pseudonanum, a cryptic species endemic to highly restricted habitats within the eastern Himalayas, has been identified and taxonomically distinguished from the morphologically similar L. nanum Klotzsch. Genetic analyses utilizing nuclear and chloroplast datasets have conclusively established L. pseudonanum as a separate species, revealing no close phylogenetic relationship to L. nanum, despite their historical treatment as conspecific. Morphological principal component analysis (PCA) indicated no pronounced differences between the two species, apart from notably larger basal leaf blades in L. pseudonanum, underscoring its cryptic nature. Furthermore, these species display ecological niche divergence; L. pseudonanum occupies habitats characterized by higher summer precipitation and prolonged snow accumulation during winter, providing increased moisture availability relative to the drier habitats of L. nanum. Environmental niche modeling (ENM) predicts that the potential range of L. nanum may shift due to global warming, potentially driving upward migration to higher elevations or latitudes. This movement could result in overlapping habitats with L. pseudonanum, raising critical concerns about habitat loss and the risk of genetic introgression. Such genetic mixing may compromise the taxonomic distinctiveness and ecological stability of L. pseudonanum. Given its extremely restricted geographic range and small population size, L. pseudonanum is designated as ”Critically Endangered” (CR). Consequently, urgent actions to verify its taxonomic status and implement comprehensive conservation measures are vital for its survival.

Background Race and sex disparities in catheter ablation (CA) utilization for atrial fibrillation (AF) have been documented. Less is known about race and sex differences in comorbidity burden and quality of care outcomes after CA. Objectives We sought to characterize race and sex differences in patient and procedural characteristics and their impact on prolonged length of stay (LOS) after CA for AF. Methods A retrospective cohort of patients that received CA for AF between 2018-2024 was developed from our single center NCDR registry. The analysis was restricted to Non-Hispanic White (NHW) and Non-Hispanic Black (NHB) patients due to small sample sizes for other groups. The association between race, sex, and prolonged LOS was evaluated using a multivariate stepwise regression model. A sensitivity analysis was performed with the composite outcome of complications given its sparsity. Causal mediation analysis was performed to assess whether race differences in prolonged LOS were mediated by complications. Results Between 2018-2024, 3,345 patients were included in the cohort. NHB patients were younger and more likely to have Medicaid insurance, higher BMI, higher comorbidity burden, history of atrial flutter, prolonged LOS, and complications after ablation. They were less likely to have prior CA. Female patients were older, less likely to have private insurance and prior CA, and more likely to have paroxysmal AF, transient ischemic attack, and chronic lung disease. NHB race [aOR 1.90 (95% CI 1.24-2.88), p=0.003] and a composite outcome of procedural complications [aOR 156 (95% CI 72.5-377), p<0.001] were independently associated with prolonged LOS. The higher odds of prolonged LOS for NHB patients was not mediated by a higher level of complications in this group. Conclusion Prolonged LOS was more frequent among NHB patients undergoing CA. The higher odds of prolonged LOS among NHB patients was not mediated by a higher incidence of complications, suggesting that other factors like comorbidity burden and social determinants of health (SDOH) are more significant contributors. Policies focused on improving comorbidity management and addressing sociocultural disparities may reduce prolonged hospitalizations after CA for AF.

Déjà vu All Over Again: Pacing the Left Bundle Branch Area with Defibrillator LeadsVardhmaan Jain, MD1 and Michael S. Lloyd, MD FHRS11 Section of Cardiac Electrophysiology, Department of Medicine, Emory University School of Medicine, Atlanta, GACorresponding author:Michael Lloyd1364 Clifton Rd NE suite F424Atlanta, GA 30322Mlloyd2@emory.edu@Mlloyd_emoryFunding: noneKeywords: Left bundle branch area pacing (LBBAP), ICD, defibrillator, conduction system pacingDisclosures: VJ: none; ML: research and consulting, Boston Scientific, Medtronic, AbbottLawrence “Yogi” Berra was noted for his simplistic malapropisms that were occasionally profound – earning him the moniker Yogi , after the yoga masters who were reputed for giving wise advice. Excluding one temporary study and case reports, this editorial addresses the third of a similar group of published small series examining implantation of standard active fixation defibrillator leads left bundle branch area pacing (LBBAP) position (see manuscript Table 5).1,2On the surface, this may invoke a sense of déjà vu, but there is a simplistic elegance in the concept of using a single lead to accomplishboth defibrillation and physiologic pacing that warrants repeat examination.In this issue of Journal of Cardiovascular Electrophysiology, Ghosh et al. present their account of patients undergoing LBBAP with the Abbott Medical DurataTM lead (Sylmar, CA).3Twelve patients who had an indication for either cardiac resynchronization therapy (7) or defibrillator (5) and underwent implantation of a 7-F DurataTM DF-4 implantable cardioverter-defibrillator (ICD) stylet-driven lead positioned deep into the interventricular septum. They used a non-deflectable dual curve 9 Fr preformed sheath to angulate this lead for septal penetration. A meticulous combination of electro-anatomical mapping, fluoroscopy, contrast and slack adjustment was used to achieve optimal lead positioning which resulted in LBBAP in unipolar configurations with adequate sensing/pacing in 9 out of 12 patients. In one patient, they were able to achieve adequate LBBA-ICD pacing but poor sensing, whereas two patients were met with failure to penetrate the septum. In 7 out of 9 patients with a successful LBBAP-ICD, they were able to demonstrate successful defibrillation of induced VF. At 5-month follow-up, all successful implants had stable electrical parameters with an increase in median left ventricular ejection fraction from 30 (28.5-35.5)% to 35 (30-36.5)%.The implantation method was not easy, with a median procedure time of 140 minutes, fluoroscopy time of 22.5 minutes, and about 3.5 attempts per patient. Two patients experienced trans-septal perforation and 1 experienced lead micro-dislodgment.This series is the third of its kind, but many uncertainties still exist with this technique. To be clear, Abbott Medical has not formally tested the Durata lead with this type of angulation and flexion and thus advises this practice is off label. Stylet-driven leads have been shown to be associated with increased risk of lead-related complications in the long term, and the number of components that could fail on an extendable/retractable helical defibrillator lead far surpasses a fixed helical lumen-less lead.4 The challenges associated with the extraction of a bulky defibrillator lead embedded deep within the septum remain largely uncharted. As such, extractions could be hindered by an elevated risk of septal perforation, intramyocardial hematoma formation, and ventricular septal defect.The authors observed that the more proximal positioning of the implanted LBBAP-ICD lead within the septum resulted in significant redundancy of the defibrillation coil extending into the right atrium. While they demonstrated adequate defibrillation of induced ventricular fibrillation with this anatomical configuration, the long-term implications remain uncertain. Specifically, concerns arise regarding the potential for progressive tricuspid regurgitation due to interference with the valve apparatus, as well as the possibility of adverse effects on defibrillation thresholds over time. Additionally, the thickened coiled segment of the defibrillator lead posed challenges during implantation, as it was difficult to maneuver through currently available sheaths. Achieving optimal septal positioning required steep angulations, which could introduce a heightened risk of lead fracture over prolonged use.Finally, it should be remembered that cathodal capture of the tip electrode in LBBAP leads results in the QRS complexes we desire- with high-frequency onset and right bundle branch delay morphologies. But for defibrillators in this construct, only bipolar pacing is allowed. In a typical septum, using the interelectrode distances of the lead under study, anodal capture of the RV septum by the ring should be therule rather than the exception at nominal programmed outputs (e.g. , 3V at 0.4ms) if the lead is sufficiently embedded. Capture of the superficial RV septum may not matter if the LV endocardium is depolarized via the Purkinje system, but this hasn’t been proven, and one can be assured these bipolar paced QRSs are not the poster child LBBAP morphologies we are used to seeing. The authors in this series report anodal capture in a minority, but like other series of its kind, granular 12 lead data and rigid criteria for anodal capture are not included. Further, the reduction in QRS duration for those with successful LBBAP in this study was not significantly lower than baseline.Coincidentally, we were asked to provide editorial comment a few months ago on another case series of this type, and, yes, there was a bit of déjà vu when reviewing this account. This does not discount the fact that important and promising breakthroughs are usually heralded by numerous small series, which eventually spark larger, more formal trials, which at this point are sorely needed. Perhaps a greater need lies in the rigorous preclinical testing and design of defibrillator leads and tools specifically intended for placement deep within the septum – an area which subjects leads to forces and geometries entirely different than more traditional implant locations. Ghosh and colleagues should be congratulated on adding to the small but mounting evidence that LBBAP is feasible with a DF4 ICD lead. As the authors note, dedicated non-improvised tools, and continued published clinical experience may better inform us if this practice will be the technique of the future for patients in need of both a defibrillator and ventricular pacing.

\receivedDD MMMM YYYY \acceptedDD MMMM YYYY

High altitude pulmonary edema (HAPE) is a common, potentially life threatening condition seen in health care facilities at elevations above 2500 m. Forty-four thousand people live between 2430 to 3352 meters in Summit, Lake and Park Counties, Colorado. In contrast to the populations in the mountains of Nepal, Ethiopia and the Andes, few families have lived at elevation for more than a generation. In addition, there were 18.4 million tourists coming to the central Rockies Mountain region (2022). Residents may be acclimatized, but not adapted. Visitors are likely neither acclimatized nor adapted. This results in altitude related medical conditions, some needing treatment. The author reviewed 248 medical records of children aged 18 years and under presenting to the St. Anthony Summit Medical Center at 2800 m with the diagnosis of hypoxia, pneumonia, acute altitude sickness (AMS), pulmonary edema or respiratory distress. After excluding duplicates and other diagnoses, 64 cases were determined to be HAPE. The most prominent characteristics of HAPE cases were rapid onset of symptoms at altitude with marked hypoxia that improved within hours on high flow oxygen. Pneumonia cases at altitude rarely exhibit hypoxia and are more toxic with a longer duration of cough. This is the largest contemporary primary case analysis defining the presentation and characteristics of HAPE cases in children in the US. The objective of this study was to find factors supporting the diagnosis of HAPE to increase provider confidence and avoid unnecessary treatment. Suggested management and further research needed are discussed.

Background Human parvovirus B19 (B19V) is responsible of a wide clinical spectrum ranging from asymptomatic infection, through mild disease, up to life threatening one. Outbreaks are registered every three to four years and a recent international alert for a new outbreak has been released. Here is reported the experience of B19 virus circulation in a 600-bed tertiary care pediatric hospital in Rome, from 2018 to 2024. Methods This retrospective study involved a total of 9,695 blood samples (about 8,500 patients), 11 amniotic fluids (11 pregnant women) and 2,483 sera (about 2,000 patients), processed in the Virology Unit of Bambino Gesù Children’s Hospital in Rome for B19V direct and indirect detection. Results and Conclusions The 9.6% of blood samples investigated for B19V DNA resulted positive. The annual positivity rate ranged from 0.8% in 2023, to 9.8% in 2018 and 32.8% in 2024; the same epidemiology resulted from the analysis of the Immunoglobulins M and G anti-B19V. Focusing on the last year, 314 patients resulted positive for B19V DNA detection: 204/314 (65%) had a primary infection, 150/204 (73.5%) were hospitalized and 17/150 (11.3%) needed Intensive Care Unit (ICU) for cardiovascular, central nervous and gastrointestinal pathologies. Two patients died for myocarditis. Four amniotic fluids resulted positive. B19V typing of a subset of samples revealed the presence of only genotype 1A and a low intra-genotypic diversity between strains from severe and mild disease. In conclusion, in 2024 was observed a significant increase of B19V circulation with serious effects on clinical outcome and consequent hospitalization.

Chronic rhinosinusitis (CRS) is a complex, multifactorial inflammatory disease of the nasal mucosa and paranasal sinuses, in which disruption of the integrity of the mucosal barrier initiates an inflammatory cascade. It results, among other things, in the formation of polyps, increased secretion and impaired sense of smell. The aim of the study was to investigate the effect of biological treatment with mepolizumab or dupilumab on the cytological examination of the nasal mucosa in CRSwNP patients. The study included 23 patients who underwent cytological examinations at least 3 times during 6 months of treatment. 21 patients were treated for 9 months. Samples were evaluated at 400x magnification and expressed as the mean of 50 high-power microscopic fields (HPF) that had been assessed. Ciliated cells, goblet cells, plasma cells, neutrophils, eosinophils and mast cells were counted. All patients had their sense of smell tested every 3 months using a visual analogue scale (VAS). During biological treatment of CRSwNP patients with mepolizumab and dupilumab, cytological examinations revealed an increase in the number of ciliated cells, a decrease in the number of eosinophils correlated with an improvement in the sense of smell on the VAS scale.

Access to omega-3 long-chain polyunsaturated fatty acids (n-3 LC-PUFA), and the physical and social complexity of habitat have been proposed to influence brain development and cognitive ability. We aimed to investigate how juvenile brown trout mitigate dietary n-3 LC-PUFA deprivation in complex habitats, typical of natal streams, by testing the effects of n-3 LC-PUFA deficiency in diet and habitat complexity on somatic growth, cognitive performance, encephalisation, and n-3 LC-PUFA biosynthesis and nutrient routing capacity. Brown trout were raised from egg for seven months post-hatch on either a high (8.91%) or low (1.79%) n-3 LC-PUFA diet; for the final three months, trout were further divided into complex (heavily ornamented tanks with small, changing, populations) or simple habitats (bare tanks with many, constant, inhabitants). Cognitive abilities including recognition, memory and inference were tested by comparing the times required to establish stable hierarchical relationships in agonistic dyadic trials featuring naïve trout and trials in which one of the trout had previously observed the other. Gas chromatography and compound-specific stable hydrogen isotope analysis revealed increased biosynthesis and routing of n-3 LC-PUFA to the brain among trout on n-3 LC-PUFA-deficient diets. Fed ad libitum, trout did not sacrifice somatic growth to fuel biosynthesis and routing of n-3 LC-PUFA, but dietary deficiency in n‑3 LC-PUFA did lead to smaller brains, and smaller brains were associated with lower cognitive performance. Complex habitats gave rise to trout showing better cognitive performance, and were associated with lower somatic growth, but habitat complexity played only minor roles in encephalisation and the n-3 LC-PUFA composition of brain lipids. We conclude that brown trout can only partially compensate for the paucity of dietary n-3 LC-PUFA, and we suggest that cognitive divergences may play a role in the diversification of life-history variants among brown trout in the wild.