Methodological Considerations in Evaluating Recombinant Zoster Vaccine Effectiveness in COPD PatientsDear Editor,We read with great interest the article by Tsai et al. addressing the effectiveness of recombinant zoster vaccine (RZV) in chronic obstructive pulmonary disease (COPD) patients[1]. This study highlights the significantly lower risk of herpes zoster among vaccinated COPD patients (HR, 0.62; 95% CI, 0.51–0.75) and importantly draws attention to the concerningly low vaccination rate (<0.5%) in this high-risk population. While these findings provide valuable evidence supporting RZV vaccination in COPD patients, several methodological considerations warrant discussion to strengthen future research in this area.First, there appears to be a discrepancy regarding the study population selection. While the limitations section suggests the inclusion of predominantly U.S. patients, the flow chart indicates data incorporation from five countries. This inconsistency is critical as zoster vaccine implementation and availability varied substantially across countries[2]. For instance, different countries introduced RZV at varying times following its initial U.S. approval in 2017. Additionally, countries have different histories with the live-attenuated zoster vaccine (ZVL); some countries primarily used ZVL, while others transitioned to or directly implemented RZV as their preferred choice[2]. Recent methodological analyses have demonstrated how differential timing of vaccine availability across regions creates systematic selection bias in vaccine effectiveness studies[3]. The composition of vaccinated and unvaccinated groups becomes intrinsically linked to geographical location and timing of vaccine introduction, potentially confounding the effectiveness estimates[3]. In this study, countries with later RZV implementation would contribute proportionally more patients to the unvaccinated group during their pre-implementation period, while early-adopting countries like the U.S. would contribute more to the vaccinated group. A clear breakdown of the temporal and geographical distribution of both vaccinated and unvaccinated groups, along with country-specific vaccination policies, would help assess the impact of this systematic bias.Second, while propensity score matching was employed, several important confounders were not addressed. The study could have benefited from an active comparator design, such as using influenza vaccine recipients as the reference group. This approach would help control for unmeasured confounding factors related to healthcare access and health-seeking behavior, which are known to affect the validity of observational studies[4]. Additionally, important clinical variables such as COPD exacerbation frequency and healthcare utilization patterns were not included in the matching process.Finally, since COPD severity and medication use could potentially influence vaccine effectiveness, we suggest performing stratification analyses. Previous research has demonstrated that COPD patients have varying risks of herpes zoster depending on disease severity and medication regimens, particularly corticosteroid use[5]. Separating analyses based on GOLD stages and medication use patterns would provide more nuanced insights into vaccine effectiveness across different patient subgroups and help identify those who might benefit most from vaccination.These methodological refinements would strengthen the evidence base for RZV use in COPD patients and better inform clinical decision-making. We commend the authors for addressing this important clinical question and hope these suggestions contribute to future research in this area.Bor-Yun Wang, MD1; James Cheng-Chung Wei, MD, PhD1,2*1 Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan2 Division of Allergy, Immunology and Rheumatology, Chung Shan Medical University Hospital, Taichung, Taiwan*Corresponding author: James Cheng-Chung Wei, MD, PhD Division of Allergy, Immunology and Rheumatology Chung Shan Medical University Hospital No. 110, Sec. 1, Jianguo N. Rd., South District Taichung City 402, Taiwan. Email: jccwei@gmail.com ORCID: 0000-0002-1235-0679

Background: In HPV-primary screening, sample quality significantly influences test accuracy. Unlike cytology-based screening, no consensus guidelines exist for sample quality assessment in HPV testing. This study aims to evaluate the impact of sample cellularity on HPV testing. Methods: A total of 37,592 liquid-based cytology (LBC) samples from women undergoing screening (aged 30-64, mean 47.8±9 years) were analyzed using Cobas®4800 HPV Test (Roche). Sample adequacy was assessed by the assay’s β-globin internal control and by an independent quantitative cellularity assessment (OncoPredict HPV, Hiantis). HPV positivity rates (PR) were stratified according to β-globin Ct values. Results: Overall HPV-PR was 7.7%. PR reached 9.7% in samples with β-globin ≤ 28Ct, decreasing markedly to 1.4% for β-globin > 34 Ct (p < 0.001). Quantitative analysis showed that Cobas®4800 β-globin Ct = 34 corresponds to approximately 1,5x10^3 nucleated cells/rxn. A subset of 195 HPV-negative samples with β-globin Ct ≥34 was evaluated by LBC: 19% had inadequate cellularity according to LBC guidelines, 8% ≥ ASC-US and 73% NILMs, of which 65% showed cellular atrophy. Conclusion: These findings emphasize the importance of assessing cellularity in HPV-screening in order to avoid potentially false-negative results due to inadequate samples. Future research should focus on establishing standardized cellularity thresholds to improve screening accuracy.

Title:A Case of Squamous Cell Carcinoma Arising from an Intraductal Papilloma of the BreastAuthors:Kanako Nishiyama, Department of Breast Surgery, Matsuyama Red Cross Hospital, Bunkyo-cho, Matsuyama-city, Ehime, JapanKumiko Okujima, Department of Breast Surgery, Matsuyama Red Cross Hospital, Bunkyo-cho, Matsuyama-city, Ehime, JapanCorresponding Author:Kanako Nishiyama, Department of Breast Surgery, Matsuyama Red Cross Hospital, Bunkyo-cho, Matsuyama-city, Ehime, JapanEmail: ryosukemama130@gmail.comPhone:81-89-924-1111Key Clinical MessageThis rare case highlights invasive squamous cell carcinoma arising from an intraductal papilloma, emphasizing early detection and aggressive re-biopsy for accurate diagnosis and effective treatment.Abstract:We present a rare case of squamous cell carcinoma arising from an intraductal papilloma in a 60-year-old female. Histopathology revealed an invasive squamous carcinoma with p63 positivity, coexisting with a benign papilloma. Following partial mastectomy and adjuvant therapy, the patient remained disease-free for 4 years and 8 months, highlighting the importance of early detection.Keywords:Breast cancer, squamous cell carcinoma, intraductal papilloma, squamous differentiationFigures and Tables:Figures: 3, Tables: 0IntroductionIntraductal papilloma (IDP) is a benign breast tumor arising from the mammary duct epithelium, with an incidence of 2-3%.1Diagnosis typically involves imaging followed by histological confirmation to rule out malignancy. IDPs are known to undergo metaplastic changes (apocrine, squamous, and sebaceous) as a reactive process.2 Squamous metaplasia in papilloma is rare, usually benign, and typically presents as a small focus in all cases. In extreme cases, papillomas can undergo complete squamous metaplasia and transform into squamous cell carcinoma (SqCC) in situ.3,4 Here, we report a rare case of a patient with an IDP who underwent complete squamous metaplasia and malignant transformation.Case History / ExaminationA 60-year-old female with a medical history of chronic hepatitis C and no significant family history was referred to our department four years earlier following an abnormal breast cancer screening result. Imaging revealed benign findings in the right breast, which remained stable without notable changes during follow-up. However, routine follow-up revealed a newly developed mass in the left breast. Mammography identified a focal asymmetrical density (FAD) in the upper outer quadrant of the left breast. Breast ultrasonography further showed a well-defined, smooth, hypoechoic mass measuring 9.2 × 8.8 × 6.0 mm (Figure 1A). A core needle biopsy was performed, and the lesion was diagnosed as benign IDP.Six months later, follow-up ultrasonography revealed an increase in tumor size to approximately 11.2 mm (Figure 1B). Another six months later, the lesion further enlarged to 13 mm (Figure 1C), prompting a repeat vacuum-assisted biopsy. Histopathological examination revealed the coexistence of benign IDP and invasive carcinoma with squamous differentiation. Immunohistochemical analysis showed that the tumor was negative for the estrogen receptor (ER), progesterone receptor (PgR), and HER2, confirming the diagnosis of triple-negative breast cancer (TNBC).Differential DiagnosisContrast-enhanced MRI demonstrated a 1.1-cm mass in the upper outer quadrant of the left breast, showing heterogeneous internal fast-washout enhancement and surrounding regional non-mass enhancement. Based on these findings, we considered primary breast cancer, particularly invasive ductal carcinoma arising from ductal carcinoma in situ (DCIS), or IDP with squamous metaplasia for the differential diagnosis. Re-biopsy and histopathology confirmed invasive SqCC arising from pre-existing IDP.Conclusion and ResultsBased on these findings, the patient was diagnosed with left breast cancer, cT1N0M0, Stage I. Surgical management involved a partial mastectomy with sentinel lymph node biopsy. No lymph node metastasis was detected, and axillary dissection was omitted. Histopathological examination after surgery confirmed invasive SqCC with a maximum invasion diameter of 10 mm coexisting with areas of benign IDP (Figure 2). Immunohistochemical analysis demonstrated p63 positivity in the tumor cells (Figure 3), consistent with squamous differentiation. Notably, the lesion exhibited biphasic characteristics comprising areas of benign IDP and atypical squamous epithelial cells infiltrating the stroma, with no evidence of glandular carcinoma components. Based on these findings, the tumor was diagnosed as SqCC arising from pre-existing IDP.The patient underwent adjuvant chemotherapy and radiotherapy. At 4 years and 8 months postoperatively, there was no evidence of recurrence and the patient remained disease-free.DiscussionPrimary SqCC of the breast is a rare malignancy, accounting for less than 0.1% of all invasive breast cancers.5,6 It is thought to arise from the squamous metaplasia of ductal carcinoma cells or the mammary ductal epithelium. Breast SqCC tumors are generally larger than conventional breast cancer histological subtypes, with an average size exceeding 5 cm. Breast SqCC typically occurs in elderly patients and is associated with a low incidence of lymph node metastases but carries a risk of distant metastases.5,6 These tumors lack estrogen and progesterone receptors and are known to exhibit resistance to conventional breast cancer chemotherapy regimens.7 Importantly, the diagnosis of breast SqCC requires the exclusion of other primary sites of SqCC within the body. Although treatment often follows standard breast cancer protocols, including mastectomy and lymph node dissection, the prognosis remains unclear and no definitive treatment guidelines for breast SqCC have been established.7Although SqCC is typically identified as an advanced invasive carcinoma, non-invasive SqCC of the breast is an extremely rare entity characterized by the presence of pure squamous cells without glandular differentiation.4 In contrast, DCIS is defined by the presence of malignant epithelial cells confined within the ducts, without invasion beyond the basement membrane. DCIS exhibits various structural patterns, including solid, cribriform, micropapillary, and mixed types.8 In situ squamous cell carcinoma is exceptionally rare, with only a few reported cases in the literature.4,9,10 Histologically, these cases exhibit distinctive features such as keratinized squamous cells, intercellular bridges, and keratin pearl formation. Immunohistochemical analyses typically demonstrate positivity for markers associated with squamous differentiation, including p63, p40, and cytokeratin. Reports of in situ SqCC, including the present case, suggest that squamous differentiation may occur during the early stages of breast cancer development.Squamous metaplasia of the breast is an exceptionally rare pathology that can closely resemble malignant lesions on imaging and fine needle aspiration biopsy.11 Chronic inflammation, particularly in response to foreign materials such as silicone implants, has been identified as a potential causative factor and may play a pivotal role in the development of squamous metaplasia.12 This phenomenon has been observed in various breast lesions, including IDP and fibroadenoma, and often raises a strong suspicion of malignancy. To minimize unnecessary surgical intervention, intraoperative frozen section analysis has been demonstrated as a critical tool for distinguishing benign from malignant lesions.11 However, in cases where a biopsy confirms the presence of a benign IDP but findings such as tumor growth or irregular margins raise concerns for malignancy, prompt re-biopsy should be performed to achieve an accurate diagnosis. This approach ensured appropriate management and reduced the risk of overtreatment.In the present case, SqCC in situ was identified during the follow-up of IDP, suggesting that squamous differentiation may represent an early event in the development of breast cancer. However, similar cases are exceedingly rare, highlighting the need for further case collection and analyses to elucidate the underlying mechanisms and clinical significance of this phenomenon.References1. Tarallo V, Canepari E, Bortolotto C. Intraductal papilloma of the breast: A case report. J Ultrasound . 2012;15(2):99-101. doi: 10.1016/j.jus.2012.03.002.2. Hoda SA, Koerner FC, Brogi E, Rosen PP. Rosen’s Breast Pathology. Philadelphia: Wolters Kluwer; 2021.3. Mayorga MR, Hutchinson G. Squamous cell carcinoma in situ of the breast with the configuration of an intraductal papilloma.Cureus . 2023;15(11):e49382. doi: 10.7759/cureus.49382.4. Arafah M, Ginter PS, Taylor DC, Hoda SA. Squamous Cell Carcinoma In Situ of the Breast: Report of a Case. Breast J. 2016;22(5):573-577. doi: 10.1111/tbj.12631.5. Anne N, Sulger E, Pallapothu R. Primary squamous cell carcinoma of the breast: a case report and review of the literature. J Surg Case Rep. 2019;2019(6):rjz182. doi: 10.1093/jscr/rjz1826. Badge SA, Gangane NM, Shivkumar VB, Sharma SM. Primary squamous cell carcinoma of the breast. Int J Appl Basic Med Res . 2014;4(1):53-55. doi: 10.4103/2229-516X.125697.7. Siegelmann-Danieli N, Murphy TJ, Meschter SC, Stein ME, Prichard J. Primary pure squamous cell carcinoma of the breast. Clin Breast Cancer . 2005;6(3):270-272. doi: 10.3816/CBC.2005.n.030.8. Scripcaru G, Zardawi IM. Mammary ductal carcinoma in situ: a fresh look at architectural patterns. Int J Surg Oncol . 2012:Article ID 979521.9. Lu J, Zhang T, Wang L, Li X. Pure squamous cell carcinoma in situ of the breast with neither myoepithelial nor luminal differentiation: A case report. Asian J Surg . 2023;46(10):4659-4661. doi: 10.1016/j.asjsur.2023.05.069.10. Hayes MM, Peterse JL, Yavuz E, Vischer GH, Eusebi V. Squamous cell carcinoma in situ of the breast: a light microscopic and immunohistochemical study of a previously undescribed lesion. Am J Surg Pathol . 2007;31(9):1414-1419. doi: 10.1097/PAS.0b013e31803d15dd.11. Mascolo M, Mignogna C, De Cecio R, Bonuso C, Accurso A. Squamous metaplasia of the breast simulating a malignant neoplasm: a case.Eur J Cancer Care (Engl) . 2009;18(6):650-652. doi: 10.1111/j.1365-2354.2008.00929.x.12. Alikhan MB, Nassar A, Mansoor I. Squamous metaplasia on the breast implant capsule. Int J Surg Pathol . 2010;18(6):570-574. doi: 10.1177/1066896908329587.ImagesFigure1. Serial ultrasound images of the left breast mass.(A) Initial presentation: The lesion was identified and diagnosed as an IDP via needle biopsy. (B) Six months later: A slight increase in size was observed. (C) One year later: The lesion demonstrated further enlargement with irregular margins, raising suspicion of malignancy.Figure2. Low-power view of the left breast tumor.Hematoxylin and eosin staining revealed SqCC components (outlined in red) intermingled with areas of benign IDP. In some regions, SqCC infiltrated beyond the ductal structures.Figure3. High-power view (×100) of the left breast tumor.(A) Hematoxylin and eosin staining highlights the juxtaposition of IDP (left) and SqCC components (right). (B) Immunohistochemical staining for p63 demonstrates positivity in the SqCC component.Patient Consent StatementWritten informed consent was obtained from the patient for the publication of this case report and any accompanying images.AcknowledgementsThe authors thank Dr. Yosuke Mizuno, a pathologist, for her contributions to this paper.Author ContributionsKanako Nishiyama: Conceptualization; data curation; investigation; writing –originaldraft; writing –review and editing.Kumiko Okujima: Writing –review and editing.Conflict of Interest statementThe authors declare that there are no conflicts of interest regarding the publication of this article.

A document by Xavier Pardell Peña. Click on the document to view its contents.

Background: Non-ischemic cardiomyopathies can be primary (p-NICM) which involves mainly the heart muscle or caused by systemic disease with heart muscle involvement as it is seen in systemic infiltrative diseases (i-NICM). There is limited data on the safety and in-hospital outcomes of ventricular tachycardia (VT) ablation in i-NICM. Methods: We identified patients who underwent VT ablation between 2018-2021 using the National Inpatient Sample Database. i-NICM include amyloidosis, hemochromatosis, or sarcoidosis. In-hospital complications include mortality, acute kidney injury (AKI), acute heart failure (AHF), bleeding, vasopressor use, blood transfusion and cardiac tamponade. Multivariate logistic regression analyses were performed. Results: There were 7,420 VT ablations, 7,235 had P-NICM and 185 had i-NICM. A multivariable analysis did not reveal any difference in mortality (adjusted odds ratio [aOR]: 0.81; 95% confidence interval 0.32-1.98; p=0.62), AHF aOR: 0.88 (0.41-1.81; p=0.69, AKI aOR:1.17 (0.83-1.65); p=0.36, blood transfusion aOR: 0.63 (0.25-1.59); p=0.33, vasopressor aOR: 0.86( 0.51-1.49); p=0.61 or pericardial effusion/ tamponade aOR: 1.16 (0.67-2.1); p=0.58 Figure Conclusion: Patients with i-NICM had similar in-hospital complications compared to P-NICM further supporting the safety of VT ablation in managing recurrent VT in patients with i-NICM.

Rainfall forecast is generally defined as the prediction of precipitation or severe convective weather in a specific region over a short time interval, recognized as playing an extremely important role in daily meteorological disaster prevention. Traditional precipitation forecasting methods, which primarily rely on numerical weather prediction, have limited the capability to utilize the latest information for short-term precipitation nowcast. A novel deep learning model based on the RFAt- UNet3+ is proposed for precipitation nowcasting, which is composed of the attention and receptive field modules additionally. An accurate precipitation forecast is accomplished by employing a data-driven neural network approach.

The most used semiconductor in the DSSC photoanode is titanium dioxide nanoparticles (TiO₂ NPs), which are usually synthesized using chemical or physical processes. The main problem with these processes is that they are less environmentally friendly and may impose problems on the environment. Therefore, there is a need to synthesize TiO₂ NPs in an eco-friendly way via a green method. In this study, gambier leaves extract is used as environmentally friendly medium in the green synthesis of TiO₂ NPs. The active chemicals and functional groups of the plant extracts are examined using liquid chromatography-mass spectroscopy (LCMS) and infrared spectroscopy (FTIR). The obtained TiO₂ NPs are characterized using ultraviolet spectroscopy (UV-DRS), X-ray diffraction (XRD), and scanning electron microscopy equipped with energy dispersive X-ray spectroscopy (SEM/EDS), Raman spectroscopy, and high-resolution transmission electron microscopy equipped selected area diffraction (HRTEM/SAED). The results from the green syntheses are further used as a semiconductor in DSSC device. The highest efficiency of 4.40% is obtained from the TiO₂ NPs synthesized using gambier leaves extract containing 50% acetylacetone, higher than that of commercial TiO₂ NPs (2.83%). These findings provide insight for future sustainability and the possibility to open new door for more environmentally friendly green synthesis of nanomaterials.

Understanding population response to disturbance is critical to both ecological theory and wildlife conservation. The current framework for quantifying demographic resilience assumes that resilience is static. Yet, survival and fecundity, two key components of demography, change over time. Here, we assessed how incorporating time affects the estimates of demographic resilience of two spotted hyena (Crocuta crocuta) populations with 55 years of combined longitudinal data. We developed an approach based on mark-recapture data, matrix population models and transient analyses to calculate five resilience metrics. We found strong evidence that incorporating time improves the assessment of inertia (long-term population response) and maximum attenuation (greatest reduction in population size). Resilience estimates were also highly sensitive to population structure, the proportion of individuals in different life states. Considering variation over time in assessing demographic resilience will make resilience estimates more accurate, thereby extending their utility for both ecological theory and conservation.

The SARS-CoV-2 virus, which caused the COVID-19 pandemic, has produced a variety of clinical symptoms, with anosmia (loss of smell) emerging as a notable one. This narrative review aims to explore the incidence and severity of anosmia in COVID-19 patients compared to other respiratory infections. We analyze existing literature to highlight the pathophysiological mechanisms underlying olfactory dysfunction in COVID-19, its prevalence among different patient populations, and the implications for diagnosis and management. The review also discusses the potential long-term effects of anosmia on quality of life and the importance of olfactory training and therapeutic interventions. In order to improve patient outcomes, this paper advocates for the inclusion of anosmia in screening methods and additional research by summarizing current knowledge and highlighting the need for increased awareness of this important clinical characteristic of COVID-19.

IntroductionFrom fortified borders to decorative garden walls, fences form ubiquitous widespread networks that sprawl across the global terrestrial landscape. Fences and walls are one of the oldest tools used by people to manage other people and wildlife, e.g., by marking territorial boundaries, separating livestock from wild animals, or monitoring the movement of people through border controls. There is no reliable measure of extent of the global fence network, however it is estimated to be at least 10 times that of the global road network (Jakes et al. 2018), which is currently more than 64 million km (Dulac 2013), and expected to reach 90 million km by 2050 (Laurance et al. 2014). Despite the enormous extent of the fence network, fences are rarely subjected to Environmental Impact Assessments, and the ecological impacts of fencing are severely underestimated and understudied (Jakes et al. 2018, McInturff et al. 2020, Buton et al. 2024). The main purposes of a fence – to fragment, isolate and/or reduce interactions – often align with negative ecological impacts, while meeting the goals to protect livestock, prevent access of invasive species, and control the spread of diseases (Terborgh et al. 2001, Woodroffe et al. 2014, Jakes et al. 2018, Mysterud and Rolandsen 2019, McInturff et al. 2020). Fences and walls are erected through all landscapes, including those that are ecologically important and protected. One example that has received a lot of media and political attention, is the recently constructed border fence between Poland and Belarus which cuts through Białowieża Forest, the best preserved lowland temperate forest in Europe and transboundary World Heritage Site (Jaroszewicz et al. 2021). Such barriers have the goal to hinder the flow of people, and consequently also block the movement of wildlife and challenge landscape connectivity (Olson and van der Ree 2015, Linnell et al. 2016), which can trigger a cascade of direct and indirect ecological impacts (e.g. Nowak et al, submitted). Border fences are also used to control the spread of diseases, such as African Swine Fever (ASF). With the aim to reduce the movement of infected wild boar, and contain ASF, fences have been built along numerous country borders in Europe, e.g., the 70-km long ASF fence at the German-Danish border which runs directly through Natura 2000 areas (Eilenberg and Harrisson 2023, Klein et al. 2024). Similar border fences to control ASF exist at the German-Polish border, and are planned to be installed at the Norwegian-Swedish border. The fragmentation effect of border fences is clear and apparent, however the impacts caused by fences that are for example, along roads and railways, denote property borders, or enclose protected areas are often underestimated. Without proper research of the downstream or indirect impacts to non-target species and the functioning of ecosystems, negative impacts of fences will continue to be overlooked and unaccounted for. This special issue provides a collection of articles in which authors present different perspectives on fences and how we, as humans, use fences to communicate with the natural world and manage wildlife. Finally, the issue provides guidelines to improve fence design and implementation, and discusses research steps to move forward in the field.

Species with shared geographic history may co-evolve, with interactions leading to niche differentiation and improved resource capture. Thus, plant communities assembled from sympatric sources (shared geographic origins) are predicted to be more productive and invasion resistant than those from allopatric sources (different origins), even with identical species composition. We compared performance among communities of four species from 15 locations, assembled from allopatric or sympatric sources. Unexpectedly, allopatric-sourced communities had 29-35% more inflorescences, 19% higher survival, 19% longer growing season, 26-53% greater size, and 108% lower invader biomass than sympatric-sources. Sympatric populations showed trait convergence consistent with strong environmental selection, with trait variation higher in allopatric communities. Variation was associated with higher productivity and invasion resistance, suggesting an advantage of allopatric sources for community reassembly when environmental filters are strong. These findings challenge assumptions about the advantages of shared origins and have implications for understanding competition, community assembly, and ecosystem restoration.

This current study investigates the impacts of Joule dissipation, a chemical reaction parameter, on magnetohydrodynamic flow in the boundary layer of an incompressible fluid on Axisymmetric flow through a radially extending surface. The governing system of partial differential equations is changed to dimensionless temperature and concentration differential equations by similarities of transition within the boundary layer. A solution is numerically obtained with the help of the fourth-order Runge-Kutta integration and Shooting techniques. Graphical analysis examines how physical characteristics affect temperature, concentration, and velocity profiles. Further, Nusselt, skin friction, and Sherwood coefficients are calculated for important parameters and presented in the table.

Pregnancy-related venous thromboembolism risk perception and prevention in risk-averse times – significant change required; a commentaryMagee LA1 , Arya R2, Boag C3, Buxton L4, Coleman MA5, Jivraj F6, Scott R7, Sheen K8, Silverio SA1,9, von Dadelszen P1

Coloration and patterning have been implicated in lineage diversification across various taxa, as color traits are heavily influenced by sexual and natural selection. Investigating the biochemical and genomic foundations of these traits therefore provides deeper insights into the interplay between genetics, ecology, and social interactions in shaping the diversity of life. In this study, we assessed the pigment chemistries and genomic underpinnings of carotenoid color variation in naturally hybridizing Dinopium flamebacks. We employed reflectance spectrometric analysis to quantify species-specific plumage coloration, High-Performance Liquid Chromatography (HPLC) to elucidate the feather carotenoids of flamebacks across the hybrid zone, and Genome-Wide Association Study (GWAS) using next-generation sequencing data to uncover the genetic factors underlying carotenoid color variation in flamebacks. Our analysis revealed that the red mantle feathers of D. psarodes primarily contain astaxanthin, with small amounts of other 4-keto-carotenoids. In contrast, the yellow mantle feathers of D. benghalense predominantly contained lutein and 3’-dehydro-lutein, alongside minor amounts of zeaxanthin, β-cryptoxanthin, and canary-xanthophylls A and B. Hybrids with an intermediate, orange, coloration deposited all of these pigments in their mantle feathers, with notably higher concentrations of carotenoids with ε-end rings. The GWAS analysis identified the CYP2J2 gene, which plays a role in carotenoid ketolation, as co-varying with color. This gene exhibited significant allele variation and evidence of multiple copies across species. These findings contribute to the growing knowledge on avian carotenoid metabolism and highlight how genomic architecture can influence phenotypic diversity.

This paper investigates the critical role of psychology in the context of digital payment cybercrimes, focusing on the exploitation of human behavior by cybercriminals. With the rising popularity of digital payment methods, the ease and efficiency they offer have revolutionized financial transactions. However, this advancement has also attracted cybercriminals who capitalize on human vulnerabilities to achieve financial gains. This study uncovers the interplay between psychology and digital payment cybercrimes through an examination of evolving cyber threats, relevant psychological theories, analysis of cybercriminal tactics, and a survey-based approach that explores participants' experiences, reactions to suspicious messages, emotional triggers, familiarity with cybercriminal techniques, and patterns in digital payment app updates. The survey outcomes offer insights into the psychological dimensions of these cybercrimes, shedding light on factors that render individuals susceptible to digital fraud. Furthermore, the survey findings provide compelling evidence that supports and aligns with the theories and principles discussed in the literature.

Contemporary work environments require humans to process audiovisual information displays whilst moving around the world. The attentional demands associated with using devices such as in-ear headphones and head-mounted displays may be significantly influenced by varying locomotor demands, yet this relationship remains poorly understood. This study investigates the interplay of information presentation modality, movement state, and cognitive task difficulty. In a virtual reality laboratory, 22 participants performed a cued task-switch paradigm with two difficulty levels while standing, walking, or walking with perturbations on a treadmill. We used a questionnaire, behavioral and mobile EEG data to investigate cognitive-motor interference. We find that locomotion interfered with cognitive task performance, and that the presentation modality of task-switch notification modified the nature of this interference. While auditory cue presentation resulted in faster responses under low cognitive load conditions, visual information presentation was less impaired by higher cognitive and locomotor demands. A detailed analysis of the EEG response to cues addressed these differences in terms of multi-modal attentional mechanisms. Hence, wearable information presentation should be tailored to the specific needs, particularly for cognitively demanding information in mobile work settings.

We present a novel method utilizing in-situ video data of fish locomotion to calculate thrust. This methodology was applied to several large elasmobranch species, which are typically challenging to measure. Using motion tracking software, we analyzed video footage of both wild and captive sharks to track their position and speed. In order to estimate the total force output, we used the tail/body motion in respect to the surrounding medium assuming equilibrium conditions. The force output for each shark was converted into scaled thrust, enabling comparisons independent of size. This scaled thrust was then analyzed across swimming modes and caudal fin morphology, serving as a proxy for each species’ behavioral ecology. Through PCA analysis we demonstrate the coupling between morphological traits and hydrodynamic forces. The ratio of the upper to lower lobe of the caudal fin (CLAR) emerged as a strong predictor of scaled thrust, accounting for over 80% of observed variation. These morphological traits, a proxy for behavioral ecology, appear to be the most suitable predictor of hydrodynamic forces given the quantitative nature of the variable compared to the categorical classifications of swimming mode. Our findings indicate that coastal pelagic species exhibited similar but significantly lower scaled thrust values than benthic species, suggesting that benthic species may be less efficient, expending more energy to remain aloft or compensate for drag relative to generating forward motion. Our findings demonstrate how morphological traits have evolved to optimize energy expenditure based on behavioral ecology, highlighting a tradeoff between benthic and coastal pelagic species. We propose that the unique ecological niches of these species drive behavioral changes that result in morphological adaptations to optimize performance. Given the relatedness between morphology/behavioral ecology and swim mode, selected pressure overtime could also explain the ecological need of different swim modes.

Unemployment remains a major challenge in many developing countries in the world, including Kenya. It is worthy noting that, youths unemployment rate is high and mismatch of skills in the job market is phenomenal. This paper develops a deterministic mathematical model to assess the role of post-secondary education on the unemployment problem in Kenya. We perform a thorough quantitative and qualitative analysis of the model. We compute the unemployment reproduction R u , prove that the model has a unique unemployment free equilibrium (UFE) when R u < 1 and admits a unique unemployment endemic equilibrium (UEE) whenever R u > 1 . The unique UFE and UEE are both locally and globally asymptotically stable whenever R u < 1 and R u > 1 respectively. Further, we validate the model by fitting it to real data of unemployed persons in Kenya in the year 1991−2023 as reported by the International Labour Organization (ILO). Numerical results indicate that, an increased individual’s skills match to the job market demands, significantly decreases the number of unemployed persons and increases the number of employed individuals. Moreover, it is demonstrated that, increasing the rate of employment to the unemployed persons reduces the problem of unemployment substantially. This can be achieved by setting up more sectors for job opportunities.

Malaria remains one of the most significant global health challenges, particularly in tropical and subtropical regions, with sub-Saharan Africa bearing the highest burden. Advances in malaria control, including insecticide-treated nets (ITNs), indoor residual spraying, and artemisinin-based combination therapies (ACTs), have reduced malaria cases and deaths. However, the emergence and spread of antimalarial drug resistance, especially to artemisinin, present a growing threat to malaria control and elimination efforts. Resistance to ACTs, characterized by delayed parasite clearance due to kelch13 mutations, is most prevalent in Southeast Asia and is beginning to emerge in Africa. This systematic literature review examines the global impact of drug resistance on malaria transmission, treatment efficacy, and control strategies. Findings reveal that drug resistance undermines treatment effectiveness, increases transmission potential, and imposes significant operational and economic challenges. Resistance hotspots in Southeast Asia, sub-Saharan Africa, and South Asia are expanding, driven by human migration and inadequate surveillance systems. The review highlights the need for strengthened molecular surveillance, the development of triple ACT therapies, and region-specific interventions to address resistance patterns. Without coordinated global efforts, drug resistance will continue to undermine progress toward malaria elimination, exacerbating the disease’s global burden. This review underscores the urgent need for innovative treatment strategies, improved surveillance systems, and international collaboration to contain the spread of drug-resistant malaria and ensure the sustainability of malaria control programs worldwide.

Despite the several studies conducted on lipid levels among people living with HIV/AIDS on combination antiretroviral therapy (cART), drawing causal conclusions from these studies regarding the lipid profiles of individuals living with HIV/AIDS remains challenging.We analyzed the lipid profile pattern among PLWHA on cART. The study was a cross-sectional analysis at Cape Coast Teaching Hospital’s HIV/AIDS clinic. This study spanned the periods of December 2016 to May 2017 among 272 PLWHA. Data on socio-demographic characteristics, clinical history, and Cluster of differentiation (CD4) count were collected. Enzymatic-linked colorimetric methods carried out lipid analyses and a multiple logistic regression model was used to assess factors associated with dyslipidemia among cART-positive and naïve PLWHA. cART positive PLWHA had a significant increase in hypercholesterinemia [157(85.8%), p < 0.0001)], LDL-C [ 153 (84.1%), p < 0.0001)] and Non-HDL-C [167 (91.8%), p < 0.0001) than cART naive PLWHA. Being female [(adjusted odds ratio, AOR=3.10; 95% confidence interval, CI= (1.31-7.32), p < 0.05)] and duration of therapy (> 24 months) [(AOR=3.29; 95% CI = (1.05-10.30), p < 0.05)] were factors that contributed to dyslipidemia among cART-positive PLWHA. Besides, CD4 + count (>500mm 3) contributed to high LDL-C among cART positive PLWHA [(AOR=1.96; 95% CI = (1.20-19.30), p < 0.05)]. Our findings suggest that lipid metabolism abnormalities (dyslipidemia) are common in cART-positive PLWHA. Thus, there is a need for the country’s HIV/AIDS program to establish laboratory surveillance of lipids for both cART-positive PLWHA with special attention.

Background: Hemophagocytic lymphohistiocytosis (HLH) is a potentially fatal condition. Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) overlaps with HLH. Human-herpesvirus 6 (HHV6) is a common childhood infection that rarely causes neurological complications. HHV6-related HLH/DRESS has only been described in case reports . Procedure: From all admissions to Children’s Minnesota with positive HHV6 the records of a subgroup and additional patients from Israel formed a cohort of patients with HHV6-rlated HLH using HLH-2004 criteria. Results: Of 50 consecutive HHV-6 patients, five (10%) developed HLH/DRESS and with two from other centers a cohort of seven is described (six with HLH and one with DRESS). Four had concurrent viruses as possible pathogenic factors. All had thrombocytopenia, elevated soluble IL2 receptor (CD25), and fever; 6/7 had elevated ferritin, and all 5 evaluated had bone marrow hemophagocytosis. Most (6/7) had CNS involvement, all had liver abnormalities, and most had coagulopathy. One patient with Kabuki syndrome was on gammaglobulin replacement therapy, whereas none of the other patients had immune deficiency. One patient had a heterozygous pathogenic variant of TNFSF13B, with no immunodeficiency. Four required etoposide and dexamethasone therapy, while three were also treated with ganciclovir/valganciclovir. The outcome was excellent (median follow-up almost 6 years) with no neurologic sequelae, recurrent HLH, or need for hematopoietic stem cell transplantation. Conclusions: The high incidence of HHV6-related HLH in admitted patients indicates a strong need for vigilance regarding this condition. HHV6-related HLH has a high rate of CNS manifestations, but the outcome in this group of patients was excellent.

Given scarce data on childhood cancer outcomes in Colombia and discrepancies among hospital-based, population-based, and government registries, we implemented VIGICANCER, a childhood cancer clinical outcomes surveillance system to collect, analyze, and disseminate valid, reliable, and timely data. VIGICANCER has expanded to ten Colombian cities, achieving inclusion of 55-60% of children nationwide. VIGICANCER yields key, exhaustive, and actionable population-based information, guides multilevel interventions, and informs public policy while providing timely feedback to participating institutions. VIGICANCER’s systematic results have positioned our childhood cancer surveillance system as a successful model in Latin America, reproducible in other low–and middle-income countries with similar contexts.

Background:To investigate the clinical effects of the treatment of mid-superior rectal cancer with the natural orifice specimen extraction surgery (NOSES) guided by the concept of enhanced recovery after surgery (ERAS). Method: The clinical data of 80 patients with rectal cancer who met the inclusion criteria in Shaoyang’s Central Hospital from January 2018 to December 2020 were retrospectively analyzed. Results: All 80 patients underwent NOSES surgery and were managed with the ERAS concept during the perioperative period.Intraoperative conditions of 80 patients: The average operative time was (158.2±18.5)min; The average intraoperative bleeding was (26.0±14.5)ml; The average number of lymph nodes detected was (14.4±4.1). Postoperative complications related to 80 patients occurred: Postoperatively, two patients developed anastomotic leakage; One patient developed abdominal infection; One patient developed pulmonary infection; One patient developed postoperative intestinal obstruction; Three patients developed urinary retention. Postoperative recovery in 80 patients: The mean pain NRS score was (2.8±0.7); The firstly postoperative bedtime was (1.5±0.6)days; The average postoperative time to exhaustion was (2.0±0.5)days; And the average postoperative feeding time was (2.0±0.5)days. Postoperative psychological status of 80 patients: The postoperative psychological status of all 80 patients was excellent without depression and other adverse emotions. Conclusion: NOSES radical surgery for rectal cancer under the guidance of the ERAS concept further optimized the effect of minimally invasive, cosmetic, functional, and individualized treatment of laparoscopic rectal cancer surgery, and the combination of NOSES radical surgery for rectal cancer with ERAS concept has more tremendous advantages and is worth promoting and carrying out with good application prospects.

Objective:To investigate the relationship between preoperative NLR values, CEA, and other clinical and pathological indicators and potential lymph node metastasis in patients with cN0 stage (diagnosed by preoperative imaging) colorectal cancer, and to construct a clinical prediction model. Methods:The medical records of 430 patients with stage cN0 colorectal cancer who underwent radical surgical resection from January 2022 to June 2024 at Shaoyang Hospital affiliated to Nanhua University were retrospectively analyzed, and they were classified into lymph node metastasis group and no-lymph node metastasis group according to postoperative pathological diagnosis, and the relationship between clinical and pathological indexes, such as NLR, CEA, etc., and lymph node metastasis status was compared. Multifactorial logistic regression analysis was used to screen the independent risk factors of lymph node metastasis in patients with stage cN0 colorectal cancer, and the probability model of lymph node metastasis by logistic regression was constructed. The Nomogram of preoperative related risk factors for lymph node metastasis was further drawn by R language. Results: Multifactorial logistic regression analysis yielded that preoperative NLR, CEA, CA-199, preoperative T stage, and vascular invasion were the independent influencing factors of lymph node metastasis in patients with cN0 stage colorectal cancer (P<0.05); the sensitivity of single detection of CEA and NLR was: 73.20% and 72.00%; the specificity of single detection of CEA and NLR was, 68.70%; the sensitivity and specificity of combined detection were: 82.20%, 76.90%. By comparison, the AUC of NLR and CEA single test was 0.755 and 0.818, and the AUC of CEA+CEA combined test was 0.857. The risk nomogram prediction model of preoperative related indexes was constructed, and its area under the curve was 0.870. Conclusion:1. high preoperative NLR and CEA levels are independent influences on potential lymph node metastasis in patients with stage cN0 colorectal cancer;2. the efficacy of combined NLR and CEA detection was significantly higher than that of single detection;3. the clinical prediction model of lymph node metastasis constructed by preoperative related indexes had moderate differentiation and good consistency.