Background Patients with cancer are at increased risk of atrial fibrillation (AF) while cancer is also associated with increased risk of thromboembolism as well as bleeding. Direct oral anticoagulants (DOACs) have emerged as an alternative to warfarin for AF to reduce thromboembolic events, however, the studies on these anticoagulation strategies in cancer patients are limited. Objective We aimed to conduct a systematic review and meta-analysis to compare the efficacy and safety of DOACs vs warfarin in cancer patients. Methods 13 studies were included in the meta-analysis comparing DOAC treatment to warfarin for AF in cancer patients. Outcomes studied were all-cause mortality, cardiovascular death, acute myocardial infarction (AMI), bleeding and thromboembolic events. Mantel-Haenszel method was used to calculate pooled log odds-ratio (OR) for binary outcomes and Hedges’ g using inverse-variance method for continuous outcomes. We used random effects model with 95% confidence interval (CI) for statistical significance. Results DOACs as compared to warfarin in cancer patients with AF were associated with decreased odds of all-cause mortality (OR 0.67, 95% CI 0.48-0.94, I 2=96%, p=0.019), cardiovascular deaths (OR 0.62, 95% CI 0.49-0.79, I 2= 0%, p<0.001), AMI (OR 0.66, 95% CI 0.49-0.89, I 2= 0%, p<0.01), combined ischemic stroke and systemic embolic events.

Lycopene has known antioxidant, anti-inflammatory, anti-proliferative, and neuroprotective effects. This is the first study to evaluate the potential protective role of lycopene against hepatic encephalopathy. An experimental hepatic encephalopathy model was established by intraperitoneal administration of thioacetamide to rats. A total of 24 rats were randomized into four groups: healthy group, control group, low-dose (50 mg/kg) lycopene group, and high-dose (100 mg/kg) lycopene group. The locomotor activity test was measured on the first day of the study to determine baseline measurements and again at the end of the study to determine changes. Blood samples were collected, and liver, brain, and lungs were removed and weighed. Except for stereotypic movements (p>0.05), all other final locomotor activity tests were statistically significant (p<0.05). There was no statistical significance in IL-4 and IL-1RA analysis results (p>0.05), but IL-6, IL-10 and IL-1ꞵ analysis results were significant between control and healthy and high-dose lycopene groups (p<0.05). AST, ALT, total bilirubin, direct bilirubin and ammonia parameters were significantly lower in the low-dose lycopene group compared to the control and high-dose lycopene groups (p<0.05). Lycopene administration had hepatoprotective and neuroprotective efficacy against HE, supported both in locomotor activity tests and at biochemical tests.

Aims: This study aimed to examine the relationship between resilience and hope levels of healthcare workers who have experienced the COVID-19 pandemic, the effects of resilience and gender on individual performance, the effects of hope levels on individual performance, and determined whether hope mediated the effect of resilience on individual performance. Design: This was a descriptive cross-sectional study Methods: The Psychological resilience, hopes, and individual performance of health workers affiliated with the Istanbul Provincial Health Directorate were obtained from online questionnaires completed by participants between April 2021 and August 2021. A hierarchical regression analysis, mediation analysis, and moderation analysis were performed on 412 healthcare workers to test the hypotheses. Results: There was a significant relationship between resilience and hope levels among healthcare professionals. In addition, healthcare professionals’ psychological resilience and hope levels significantly affected their performance. The indirect effect of healthcare professionals’ psychological resilience levels on their individual performance through hope was not significant. Conclusion: The findings show that employees with high hope and resilience are more likely to recover from stressful situations and display better individual performance. Impact: This study offers both a practical and theoretical perspective on the effects of hope and resilience on employee performance, as psychological capital that can help all health managers and employees, especially during crisis periods such as the COVID-19 pandemic. The hope and resilience of the employees who use their personal resources as a buffer to cope with the difficult work routine of the employees also increase; thus, difficult work means more resources in the management and, as a result, improves performance. Patient or Public Contribution: No patient or public contribution.

Challenges in Cardiac Implantable Electronic Device Surveillance: Insights from Real-World DataGeorge S. Prousi, MD and Pamela K. Mason, MDUniversity of VirginiaCorresponding author:Pamela K. Mason, MDBox 800158Charlottesville, VA 22908434-924-2465Fax: 434-982-1998Pkm5f@virginia.eduDisclosures:Mason- Consulting and honoraria for Medtronic and Boston ScientificProusi- NoneCardiac implantable electronic devices (CIEDs), including permanent pacemakers (PPMs), implantable cardioverter-defibrillators (ICDs) and cardiac resynchronization therapy (CRT) devices have improved patient outcomes for a variety of cardiovascular conditions.1,2 There is an upward trend in the utilization of CIEDs due to multiple variables including an aging population with increased comorbidities and expanded indications.3 CIED technology has rapidly evolved and device components must undergo rigorous evaluation to ensure safety and efficacy. Despite pre-market testing and post-market surveillance, historically, there has been an underestimation of device and lead failures.4 It is well known that transvenous leads are the “weak link” in most CIED systems, and efforts to reduce CIED malfunctions must address this issue.To improve the reliability of transvenous leads, design and manufacturing has included a focus on insulation integrity. Optim™, a co-polymer of silicone and polyurethane is a form of insulation incorporated into the Abbott Tendril™ STS 2088TC (Tendril 2088) leads. It was developed with an aim to reduce the risk of lead abrasion. There have been several studies suggesting an accelerated degradation of materials and lead failure for leads using Optim™, and particularly the Tendril 2088 lead.5-7 However, most of the clinical studies are single-center and observational.In this edition of the Journal of Cardiovascular Electrophysiology, Ahmed et al. used an analytic real-world data model to compare the Tendril 2088 lead to pacing leads manufactured by competitors. This model uses patient device tracking, the Abbott device registration database, and the Medicare-fee-for-service database, and it has been validated previously.8 Probablistic linking was used to link the patients who were implanted with Tendril 2088 leads from the Abbott registry to the Medicare database. The authors then compared the rates of Tendril 2088 mechanical lead malfunction resulting in lead-related surgical intervention to competitors’ pacing leads. The numbers are substantial, with 89,629 Tendril 2088 leads identified compared to 433,481 competitive manufacturer leads. The groups were demographically similar, and the follow-up period was a minimum of two years. This real-world data analysis revealed no significant difference in surgical intervention-free survival rates between the two groups.The findings of this study present a contrast from other studies that suggested that there may be an increased risk of Tendril 2088 lead failures as compared to competitors’ pacing leads. The authors outline potential reasons for this variance, which include sample size, possible bias within the populations, and how “lead failure” is defined. This study had a rigorous definition of failure which needed surgical intervention but may not completely reflect all failure presentations and the effect on patient outcomes. This serves as a reminder of the challenges in product evaluation and surveillance.The authors have offered important insights into the Abbott Tendril 2088 lead, although evaluation of the Tendril 2088 lead and the Optim™ insulation will be ongoing.7 They also should also be congratulated for showing the added value of a real-world data model in post-market product monitoring. With these models, sample sizes can more accurately and expeditiously identify occurrences of device related malfunction and capture a wider range of patient demographics.Device manufacturers and the electrophysiology community are continually developing ways to analyze and follow products for safety and reliability. It is clear that the traditional methods of pre-market studies and post-market registries are inadequate to identify product deficiencies. This is particularly true for more uncommon issues or ones that only occur in specific populations or circumstances. Manufacturers are adding simulation modeling data to their product evaluation to enhance the reliability of their data.9 The addition of real-world data is another substantial advancement.It is important to note that many CIED manufacturers are making efforts to move away from traditional stylet-driven transvenous leads.10 This is a simple acknowledgement that these leads are still the “weak link” in most device systems despite sophisticated engineering and aggressive surveillance. Lumen-less transvenous leads are available which are thought to be more durable. For ICDs, subcutaneous and extravascular leads are both lumen-less and do not use the vasculature. Finally, leadless pacemakers avoid the issue all together.Regardless of these advances, millions of patients have transvenous CIED systems in place and these systems will continue to be the major mode of providing CIED therapies into the near future. We need robust mechanisms to follow all CIED products and real-world data models will play a role. Though there will be further question about the reliability of Tendril 2088 leads, there should be no dispute over the united pursuit for early identification of device related malfunctions and the use of large-scale data to achieve the best possible outcomes for our patients.Kusumoto FM, Schoenfeld MH, Barrett C, et al. 2018 ACC/AHA/HRS guideline on the evaluation and management of patients with bradycardia and cardiac conduction delay: Executive summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines, and the Heart Rhythm Society. Heart Rhythm. 2019;16:e227-e279.Al-Khatib SM, Stevenson WG, Ackerman MJ, et al. 2017 AHA/ACC/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. J Am Coll Cardiol. 2018;72:e91-e220.Greenspon AJ, Patel JD, Lau E, et al. . Trends in permanent pacemaker implantation in the United States from 1993 to 2009: increasing complexity of patients and procedures. J Am Coll Cardiol. 2012;60:1540-5.Roberts H, Matheson K, Sapp J, et al. Prevalence and management of electrical lead abnormalities in cardiac implantable electronic device leads. Heart Rhythm O2. 2023;4:417-426.Segan L, Samuel R, Lim M, et al. Incidence of Premature Lead Failure in 2088 TendrilTM Pacing Leads: A Single Centre Experience. Heart Lung Circ. 2021;30:986-9956.Shah AD, Hirsh DS, Langberg JJ. User-reported abrasion-related lead failure is more common with durata compared to other implantable cardiac defibrillator leads. Heart Rhythm. 2015;12:2376-80.El-Chami MF. The saga of tendril leads continues: Should we continue to bury our heads in the sand? J Cardiovasc Electrophysiol. 2021;32:1122-1123.Braghieri L, Ahmed A, Curtis AB, et al. Evaluating cardiac lead safety using observational, real-world data: EP PASSION proof-of-concept study. Heart Rhythm. 2024;S1547-5271(24)02819-4.Crossley, George H.Sanders, Prashanthan et al. Safety, efficacy, and reliability evaluation of a novel small-diameter defibrillation lead: Global LEADR pivotal trial results 2024;S1547-5271(24)02395-6.Wiles BM, Roberts PR. Lead or be led: an update on leadless cardiac devices for general physicians. Clin Med (Lond). 2017;17:33-36.

Heatwaves associated with climate change threaten biodiversity by disrupting behaviours like parental care. While parental care may buffer populations from adverse environments, studies show mixed results, possibly due to heat stress affecting different care components. We investigated how heat stress impacts parental care and offspring performance in the burying beetle Nicrophorus nepalensis under control and heat stress conditions. We examined pre-hatching and post-hatching care by reciprocally exchanging carcasses across both conditions. Heatwaves affecting only one care period did not alter reproduction, but when both were stressed, reproductive success declined. Females exhibited higher energy expenditure during provisioning, evidenced by greater body mass loss. Notably, heat stress had long-lasting effects on offspring via carcass preparation, resulting in smaller adult size and higher mortality. These results highlight the complexity of environmental stressors on parental care, suggesting that different care components may evolve independently, while underscoring the limits of care under prolonged heat stress.

ABSTRACT: Background: Frailty is a multidimensional condition with syndromes relating to falls, immobility, incontinence, impaired memory and medication side-effects. With increasing numbers of frailty, particularly in rural areas, healthcare systems are being challenged globally. Moreover, frailty may be more common in rural communities as a consequence of transportation issues, limited access to healthcare services and health promotion activities. Advanced Nurse Practitioners are ideally placed to undertake comprehensive geriatric assessments and identify frailly syndromes. Aims: Explore the function of the advanced Nurse Practitioner in managing people living with frailty in rural areas, considering public health agendas and evidence-based practice. Design: Discussion paper Key learnings: Frailty is linked to poorer health outcomes, an excessive use of health resources and decreased quality of life. Incorporating Advanced Nurse Practitioners into integrated models of care and health improvement strategies, can improve patient outcomes. Conclusion: Using advanced clinical and decision-making skills, Advanced Nurse practitioners deliver evidence-based care to improve patient safety and health outcomes. Creating partnerships to enhance the provision of healthcare, they are focused on frailty prevention, detection and providing support to develop co-produced management plans to address individual needs. The Advanced Nurse Practitioner has the ability to practice autonomously within an expanded scope of clinical practice, making them the ideal professional to support people living with frailty in rural areas. Impact for Nursing: When thinking about future strategies for advanced practice, it is important to acknowledge the lack of regulation, inadequate title protection, role variability, and different educational requirements. Organisations need to consider the enablers and barriers of Advanced Nurse Practitioners fulfilling their duties. Advanced Nurse practitioners are guided by public health agendas to improve the population health of those in rural areas. ABSTRACT WORD COUNT: 278

Note: Cobalt nanowires technology in the approximate dimensions of 1 to 100 nm, where only one phenomenon of its kind offers descriptive applications, is in the capacity of matter.Cobalt nanowires exhibit electromagnetic absorbing behavior at medium temperature, and when the magnetic field is applied perpendicular to the nanowires, these nanoelectronic devices have a larger coercive field compared to when the electromagnetic field is parallel to the nanowires. Cobalt wires are formed. Nanotechnology encompasses science, engineering and non-scale technology, imaging, measurement, design and manipulation of materials at this length scale. Due to nanotechnology, the speed of computers has increased compared to the past and the value of calculations has decreased. In the immersion method, the nanowires  have enough time to transfer from the particles of the nanowires to the holes; The step of forming uniform nanoparticles is done slowly and finally uniform nanowires are formed. Structural investigation with FESEM  in the immersion method of uniform nanowires in all pores and in a wide area in the particles of nanowires. The simple answer to this question is any particle less than 100 nanometers.  But as  the scale of 1-100 nm determines the size range of a nanoparticle.  In order to prevent particle contact, a cluster of atoms may be removed below 1 nm, but the electron movement in nanoparticles has to particles <1 nm.  Because particles are three-dimensional.

Note: Electrically conductive graphene nanostrips  in the structure of multi-layer and single-layer nanotubes  show signs of ballistic transport  . Although the electrical conductivity of graphene  obtained by electrochemical methods is not as good as that of perfect graphene,  it is still  a suitable  option for the production of electrically conductive  graphene nanoribbons .SWCNTs inside the carbon nanotubes are mixed with graphene conductive fillers  to obtain  conductive materials  that are light in weight and have a minimum electrical resistance of less than 105 m/Ω. These  graphene nanoribbons show a non-linear   increase  in the amount of electrical conductivity that this increase is a function of the amount of the reinforcing phase. At a certain value  of the nanoparticle, which is known as the permeability threshold, the nanoparticle  has the ability to form a network structure. This causes a sudden increase  in electrical conductivity of  graphene nanoribbons  inside CNTs carbon nanotubes.

Paroxysmal migraine associated with Vancomycin administration: a case report, a review of pharmacovigilance databases for similar cases and possible mechanisms

Objective This study aimed to assess alterations in right ventricular (RV) function following percutaneous coronary intervention (PCI) in patients with non–acute coronary syndrome angina utilizing three-dimensional speckle tracking echocardiography (3D-STE). Methods A prospective study was conducted involving 136 patients diagnosed with non–acute coronary syndrome angina undergoing PCI, constituting the study group, alongside 110 age and gender-matched healthy volunteers serving as the control group. Echocardiographic evaluations, including both conventional and three-dimensional assessments, were performed on all study participants at 1 week, 6 months, and 12 months post-PCI. Parameters such as tricuspid annular plane systolic excursion (TAPSE) were derived from conventional echocardiography, while tricuspid lateral annular systolic velocity (S’) was measured via tissue Doppler imaging. Three-dimensional speckle tracking echocardiography (3D-STE) was utilized to quantify metrics including right ventricular fractional area change (RVFAC), right ventricular free wall longitudinal strain (RVFWLS), right ventricular global longitudinal strain (RVGLS), right ventricular stroke volume (RVSV), and right ventricular ejection fraction (RVEF). Results TAPSE, S’, RVFAC, RVFWLS, RVGLS, RVSV and RVEF exhibited significant increases from 1 week to 6 months post-PCI ( P < 0.05). However, from 6 to 12 months post-PCI, RVFAC, RVGLS, RVSV and RVEF demonstrated no notable changes ( P > 0.05). Meanwhile, TAPSE, S’, and RVFWLS sustained significant elevations: TAPSE (19.63±3.253% to 22.603±2.885%, P < 0.001); S’ (10.57±2.643 cm/s to 12.61±2.189 cm/s, P < 0.001); RVFWLS (18.64±2.745% to 19.926±3.291%, P = 0.002).By the 12-month mark post-PCI, S’, RVFAC, RVFWLS, RVGLS and RVEF were notably lower compared to those in the healthy control group: S’ (12.61±2.189 cm/s vs. 13.20±1.946 cm/s, P < 0.001), RVFAC (48.469±2.402% vs. 49.20±3.222%, P < 0.001), RVFWLS (19.926±3.291% vs. 22.10±1.994%, P < 0.001), RVEF (49.191±5.801% vs. 50.15±4.844%, P < 0.001). Conclusion Following PCI, right ventricular systolic function in patients with non–acute coronary syndrome angina improves significantly over time. However, even at the 12-month post-PCI mark, the right ventricular systolic function remains inferior to that of the control group. Notably, 3D-STE emerges as a non-invasive method for quantifying right ventricular systolic function post-PCI in non–acute coronary syndrome angina patients.

Spontaneous remission of EoETo the Editor,Eosinophilic esophagitis (EoE) is a chronic inflammation of the esophagus, mediated by Th2 immunity, triggered primarily by dietary allergens (1). It affects children and adults (1). The disease burden imposes a negative impact on patients’ quality of life (2).The incidence and prevalence of EoE vary across North America and Europe and have increased over time (3,4). Studies focusing on endoscopic outcomes have reported progression of significant fibrostenoses in most patients with over a decade of untreated EoE (4). Thus far, there are no reports that EoE can spontaneously remit at the tissue level over time.Here, we report spontaneous remission of EoE in 4 patients who are followed at our hospital (Tables 1, 2). All patients are identified via routine clinical care, no consent is required.In case #1, dairy was the sole trigger for his EoE diagnosed at age 8 yo, he tolerated baked dairy at 11-4/12 yo but failed unbaked dairy trial at 11-9/12 yo. His EoE was non-PPI-responsive but responsive to swallowed budesonide. He used swallowed budesonide parodically during vacations when food avoidance was not feasible. He re-trialed unbaked dairy at 17 yo (9 years post EoE diagnosis), with daily consumption of unbaked dairy for 3 months, without any symptoms. Repeat EGD with biopsies showed remission of his EoE.In case #2, his EoE was diagnosed at 12 yo, and responded to 4 food elimination diet (dairy, soy, wheat and peanut). Sequential addition of soy and peanut, followed by wheat, then baked dairy did not provoke any symptoms or tissue eosinophilia. At age of 18 yo, 6 years post diagnosis, he had a trial of unbaked dairy for 3 months with regular consumption (more than 5 days per week) without any symptoms, repeat EGD with biopsies showed remission of EoE. He received subcutaneous immunotherapy for environmental allergies.In case #3, dairy was the sole trigger for his EoE, diagnosed at 13 yo, but he was unable to comply with the dairy avoidance. His EoE was non-PPI responsive. He was treated with swallowed budesonide, biopsy-proven effective, for 4 years and continued eating dairy. He self-stopped taking swallowed budesonide at 17 yo and continued eating a regular diet including dairy, without any symptoms. Repeat EGD with biopsies showed remission of EoE.In case #4, she presented with gagging, choking and coughing with eating and drinking at 6 months old. Her EoE was diagnosed at 1.4 yo after an ER visit and hospitalization from a significant choking episode. Her EoE was non-PPI responsive, but responsive to elemental diet. Subsequent diet trials with repeat EGDs have identified her EoE triggers being corn, pea and egg. She was symptoms free and had clean EGD biopsies with elimination diet for 6 years. Due to issues of developmental delay and slow weight gain, her parents decided to stop diet elimination and let her to eat a regular diet. She was asymptomatic and gaining weight. Repeat EGD with biopsies revealed remission of EoE.Here, we present evidence of spontaneous EoE remission in 4 of our patients, identified through our routine clinical care. Our results raised the possibility of spontaneous remission of EoE. Interestingly, all 4 patients were in remission previously with either diet elimination or swallowed steroid treatment for variable amount of time before their final remission without any treatment. It is possible that immune responses have changed during the period when their EoEs were in remission with treatment, these changes have led to the final treatment-free remission. Questions remain about the durability of the treatment-free remission. Large scale prospective study is needed to further evaluate the possibility of spontaneous EoE remission.References:Muir A, and Falk GW. Eosinophilic esophagitis: a review. JAMA 2021;326(13):1310-1318.Mukkada V, Falk GW, Eichinger CS, King D, Todorova L, Shaheen NJ. Health-related quality of life and costs associated with eosinophilic esophagitis: a systematic review. Clin Gastroenterol Hepatol 2018;16(4):495-503.e8Shaheen NJ, Mukkada V, Eichinger CS, et al. Natural history of eosinophilic esophagitis: a systemic review of epidemiology and disease course. Dis Esophagus 2018;31(8):1-14.Dellon ES, and Hirano I. Epidemiology and natural history of eosinophilic esophagitis. Gastroenterology 2018;154(2):319-332.Qian Yuan, MD, PhDFood Allergy CenterMassachusetts General HospitalHarvard Medical SchoolBoston, MA, 02114, USAFunding:NoneConflict of interest:NoneWord count of the text:598Table 1. Clinical features of the 4 EoE patients

IntroductionChronic pain, defined as pain persisting for more than 3 months, affects a significant portion of the adult population in the United Kingdom (UK), with estimates ranging from one-third to one-half of adults experiencing it (Cohen, Vase, and Hooten 2021; Fayaz et al. 2016). Low back pain (LBP) is the leading cause of years of healthy life lost due to disability (YLD) globally and in the UK, affecting both sexes across all age groups (Institute for Health Metrics Evaluation 2024). Approximately 619 million people worldwide experience LBP annually, with females disproportionately affected at a rate of 9,300 cases per 100,000, compared to 5,520 per 100,000 for males (Ferreira et al. 2023). Similarly, neck pain is also a major contributor to YLD, ranked 15th globally and 11th in the UK, affecting an estimated 203 million people per year globally (Institute for Health Metrics Evaluation 2024; Kazeminasab et al. 2022; Wu et al. 2024), with 2,890 cases per 100,000 females versus 2,000 per 100,000 males (Wu et al. 2024). Given these significant differences in how musculoskeletal conditions, like neck and back pain, affect males and females, understanding the biological and social factors contributing to this disparity is crucial. This understanding is necessary to develop tailored, sex- and gender-considered management strategies that improve healthcare (International Association for the Study of Pain 2024; Zheng et al. 2022). For clarity, sex refers to biological characteristics that define individuals as male or female (Walker and Cook 1998), such as chromosomal makeup, hormone levels, genetic factors, and anatomical structure, whilst gender refers to socially constructed roles and identities (Walker and Cook 1998; International Association for the Study of Pain 2024). Biological sex differences include variations in skeletal structure, hormone regulations, and reproductive anatomy, all of which can influence health and pain experience (Goymann, Brumm, and Kappeler 2023). For example, males have broader shoulders and narrower pelvises, while females have wider pelvises to facilitate childbirth, alongside other distinct skeletal and hormonal variations (Weiss 2024; Huang et al. 2012). In forensic settings, sex is typically determined by the morphology of the pelvis or skull, as well as long bone measurements, with the pelvis being a key indicator due to its distinct differences between males and females (Spradley 2016). Male and female hormones also affect the development of the skeletal system, as bone growth and development are partly controlled by hormones such as testosterone and oestrogen (Baustian, Crandall, and Martin 2015). Intersex individuals, who possess biological characteristics that do not fit typical definitions of male or female, are often excluded from these binary categories, and their specific needs must also be considered in clinical guidelines (International Association for the Study of Pain 2024; Rosenwohl-Mack et al. 2020). Despite the importance of accounting for sex diversity, much of current research and healthcare practice continues to overlook these nuances (Biz et al. 2024). Current healthcare frameworks often fail to sufficiently consider the unique needs of gender-diverse populations, including intersex individuals, leading to significant disparities in healthcare (Biz et al. 2024). Sex-based biological differences may influence the development and experience of pain (International Association for the Study of Pain 2024). For instance, skeletal differences such as a wider pelvis in females can alter biomechanics and posture, potentially affecting how stress and strain are distributed across the spine (Sizer and James 2014; Grechenig et al. 2021). Additionally, hormonal fluctuations, particularly oestrogen and progesterone, which vary throughout the menstrual cycle and life stages, like pregnancy and menopause, may impact pain perception and sensitivity (Tommaso 2011; Chen et al. 2024; McCarthy and Raval 2020). Thus, these sex-based factors can result in differences in how neck and back pain develop and are experienced by females. The need to consider sex-specific differences is further supported by initiatives like the UK’s National Health Service (NHS)“Universal Personalised Care”, which advocates for individualised care based on patient’s preferences, needs, and values (NHS England 2019). However, it remains unclear to what extent sex-specific factors are considered within this personalised approach when managing chronic conditions, such as neck and back pain. The recent publication of the Women’s Health Strategy for England (Department of Health & Social Care 2022) recognises the need to address health inequalities, and highlights the need for healthcare systems to move away from a "male as default" approach (Department of Health & Social Care 2022). Historically, healthcare research, training, and education have often focused on males, leading to gaps in knowledge about how conditions like chronic musculoskeletal pain affect females differently (International Association for the Study of Pain 2024; Barlek et al. 2022; Zucker and Prendergast 2020). This male-centric bias could result in less effective treatment and management of these conditions in females. The Women’s Health Strategy aims to provide better information, education, and resources to ensure that healthcare professionals are equipped to deliver sex-sensitive, person-centred care (Department of Health & Social Care 2022). This highlights the urgent need to assess current clinical guidance to determine whether they adequately consider sex-specific factors in the management of general health conditions, like neck and back pain. This study undertakes a documentary analysis of UK-based Clinical Practice Guidelines (CPGs) and Clinical Guidance Documents (CGDs) for chronic neck and back pain, aiming to identify whether female-specific factors are included, examine the focus of these factors, and pinpoint gaps that need to be addressed to improve the management of neck and back pain for female patients specifically.

Lysine lactylation of (Kla), a newly recognized post-translational modification of proteins, is prevalent in various diseases and is increasingly attracting interest. The multifaceted roles of Kla are being revealed, demonstrating a complex ‘double-edged sword’ effect in different disorders, which is influenced by site-specific modifications and other factors. Recent studies have underscored the therapeutic potential of Kla in the treatment of a range of disorders. This review examines the current status of research on drugs and other compounds that may affect the role of Kla in disease. It also considers alternative approaches to therapy. The differential effects of Kla and its inhibitors in disease models are assessed, and therapeutic strategies that harness Kla as a treatment mechanism are suggested. Furthermore, the review explores the therapeutic promise of Kla targets in managing disorders, providing a scientific basis and a roadmap for subsequent research and drug development.

Ants occupy a great variety of habitats, perform essential ecological roles, and interact with a wide variety of other organisms. However, the interaction between ants and molluscs is a lesser-explored relationship that can be categorized into a) ant predation on molluscs, b) shell collection as hoarding behaviour, c) the use of shells for nesting, and d) myrmecophilic relationships. This study reports new data about these interactions from accidental field observations, a quantitative analysis of the snail shells found in 16 Messor ant nest cleanings, and a qualitative analysis of 51 additional nests of different species. We found 1127 snail shells from 20 species, most of them belonging to juveniles of the Geomitridae and Helicidae families. Notably, Granopupa granum was the only species found alive in the collected material. Furthermore, in our qualitative assessment, we found 86.8% of the analysed nests with shell remains in the nest cleanings of ten ant species. Additional observations revealed ants transporting both empty shells and live snails to the nest, some living snail species around the nest entries, and additional interactions between snails and ants. Our results may support cases of a) predation of snails of certain species by ants, as many shells were found with perforations compatible with ant attacks and we have recorded direct predation, b) the collection of empty shells to gather the body remains of snails as a trophic resource, and c) the potential existence of more myrmecophilous snail species than currently known, capable of living in ant nests without being attacked, like Cecilioides acicula, Ferrussacia folliculum, or G. granum. Although more studies are necessary to understand the intriguing relationship between ants and snails, the study of ant nest wastes can also become a valuable tool for detecting rare native micromollusc, as well as invasive, non-native and aquatic species.

This article develops a duality principle applicable to a originally non-convex primal variational formulation. More specifically, we develop applications to a full complex Ginzburg-Landau system in superconductivity, including a magnetic field and respective magnetic potential. The results are obtained through basic tools of functional analysis, calculus of variations, duality and optimization theory in infinite dimensional spaces. It is worth emphasizing we have obtained a convex dual variational formulation which may be applied to a large class of similar models in the calculus of variations. Finally, in the last sections, we present a procedure for improving the convexity conditions of an originally non-convex primal formulation which is also applied to a Ginzburg-Landau type equation.

A Guide to creating and Coloring an Orbital Prosthesis in a Sequential MannerSamira Naybandi Atashi1, Azam Mostafavi21.Department of Prosthodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Po. Code: 14399-55991, Iran2. Department of Prosthodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Po. Code: 14399-55991, IranCorresponding author:Azam Mostafavi,Department of Prosthodontics, School of Dentistry, Tehran University of Medical Sciences, Tehranas-mostafavi@sina.tums.ac.ir

In this study, we analyzed the BK polyomavirus (BKPyV) genome derived from three rodent cell lines established from tumors that were experimentally induced by injecting BKPyV into newborn rodents. Three cell lines (Vn-324, In-1024, and Vn1919) were recently deposited in the JCRB Cell Bank. Vn-324 was established from a hamster choroid plexus papilloma induced by injecting purified BKPyV Gardner strain wild-type 501 ( wt-501) into new born hamster. This cell line was reported to be negative for the large T-antigen using indirect immunofluorescence. In this study, we examined the large T-antigen expression using the reverse-transcriptase-polymerase chain reaction (RT-PCR). Vn1919 was established from a mouse ependymoma induced by the injection of purified plaque morphology mutant 522 ( pm-522) into newborn BALB/c mice. In-1024 cells were established from hamster insulinoma, however, there have been no reports on the establishment of this cell line. The non-coding control region (NCCR) of BKPyV derived from Vn-324 genomic DNA and wt-501 had the same structure, whereas the NCCR of BKPyV derived Vn1919 genomic DNA and pm-522 had the same structure. BKPyV derived from In-1024 genomic DNA had a large deletion in the viral proteins 1, 2 and 3 (VP1, VP2, and VP3) coding region. Additionally, the structure of the NCCR had a different pattern from that of mutant variants pm-522 and wt-501. Our findings suggest that the hamster insulinoma, from which the In-1024 cell line was established, was induced by injecting a virus stock containing a proliferation-defective mutant variant that was expanded in human embryonic kidney cells.

This research explores the performance of existing classification models with remote-sensing satellite images of Bangladesh's roads. The models were analyzed under normal conditions, in addition, tried to break down the images in various methods. The goal is to find out the type of data that facilitates these models to give the best results and develop monitoring system. It is also investigated, what other things in the images, besides the roads, affect the models' performance. Datasets were created specifically focused on road classification and segmentation and tried various deep-learning models for this purpose. This research helps identify the best data types for improving classification accuracy and highlights what elements in the images can impair the models' functionality. In the end, we componentized the trained models utilizing web technologies and created automation systems for road quality measurement.

Species Distribution Models (SDMs) are commonly used statistical tools in conservation biology, global change assessment, and reserve prioritization. Correlative SDMs relate species occurrences to environmental conditions, and it is common to model heterogeneity in the data with coarse-scale spatial and temporal predictors. However, this approach neglects the fine-scale environmental conditions experienced by most organisms. Further, most SDMs use occurrence data from short-term studies but make long-term predictions of future conditions. We compare four modeling frameworks that varied the temporal extent (short-term [1 year] versus long-term [10 years]) and resolution of environmental data (fine versus coarse). We expected that long-term data and finer temporal resolution of environmental variables would provide more accurate model predictions because they integrate variability in population sizes under varying microclimatic conditions. We built SDMs for 37 bird species in the H. J. Andrews Experimental Forest, Cascade Range, Oregon (USA). We used a 10-year (2010-2019) time series of annual observations during breeding season across 184 sites as response variables and gridded maps of hourly below forest canopy microclimate temperatures and LiDAR-derived vegetation variables as predictors. We evaluated the interannual transferability of long- versus short-term models and fine versus coarse-resolution temperature models; we also tested whether species’ functional traits affected the performance of models. Temporally dynamic (long-term) models with higher-resolution microclimate data outperformed static and short-term approaches in terms of performance (AUC difference ~ 0.10, TSS difference ~ 0.12). Model performance and similarity between spatial predictions were higher for dynamic rather than static models, especially for migratory species. Models for small bird species performed better as temporal resolution increased, whereas for long-lived species with larger body sizes, dynamic approaches performed similarly to static models. We advocate for increased use of fine-scale, long-term data in SDMs to boost the performance and reliability of future predictions under global change.

With an increasing focus on both performance and efficiency, UAV control systems have made great progress. In this work, we extend a previous LPV-MPC technique by including a more simplified control system for UAVs. The proposed control method removes the requirement for a velocity controller by concentrating on improving MPC performance using Particle Swarm Optimization (PSO) of the weight matrices. This system uses PSO to balance control effort with trajectory ac-curacy and simplifies the control architecture, hence improving UAV control efficiency. It is especially appropriate for situations where simplicity and energy economy are absolutely important.

Objective:The aim of the present study was to determine the relationship between night eating symptoms(NES) and body mass index(BMI) in preclinical medical students and to examine the potential mediating role of impulsivity, depressive symptoms and sleep-related factors in this relationship. Method:The study included 408 preclinical medical students. All participants were asked to complete the sociodemographic information form, Night Eating Questionnaire(NEQ), Pittsburgh Sleep Quality Index(PSQI), Barratt Impulsiveness Scale-11(BIS-11), and Patient Health Questionnaire Depressive Symptom Scale(PHQ-9). Results:The mean age of the participants was 19.94±1.50 years; 235(57.6%) of the participants were female. A significant positive correlation was identified between the NEQ score and BMI of the participants(r=0.146;p=0.004). A moderate but significant correlation was observed between the NEQ score and BIS-11(r=0.328), PHQ-9(r=0.446) and PSQI scores(r=0.503) of the participants. Sleep quality was found to mediate the relationship between NES and BMI(β=-0.066, S.E.=0.020, 95% CI[-0.080, -2.814]) while impulsivity and depressive symptoms did not(p>0.05). Examination of the relationship between sleep quality sub-dimensions and NEQ indicated that PGQI-2(sleep latency) played a mediating role(β=-0.051, S.E.=0.014, 95% CI[-0.057,-0.005]), while the other sub-dimensions did not. Discussion:The findings of our study support the existence of a relationship between NES and BMI. Among the potential mediators in this relationship, a mediating role of sleep quality rather than depressive symptoms and impulsivity, was identified. Sleep latency, a component related to sleep quality, was found to have an effect on BMI. Future studies are needed to investigate the effectiveness of interventions aimed at improving sleep hygiene in order to control weight gain in NES patients.

Response to: “Advocating for Change: Lifting Mesh Suspension in SUI Surgery Based on Established Literature and Long-Term TVT Study Results”Corresponding author: Berit Rein Solhaug (Gynecologist, PhD student) Department of Obstetrics and Gynecology, St. Olavs Hospital, Trondheim, Norway Department of Clinical and Molecular Medicine, Norwegian University of Technology and Science, Trondheim, Norway berit.r.solhaug@ntnu.noRune Svenningsen (Gynecologist, Professor II) Department of Obstetrics and Gynecology, Oslo University Hospital,Oslo, NorwayInstitute of Clinical Medicine, University of Oslorune.svenningsen@medisin.uio.no   Maria Oyasaeter Nyhus (Gynecologist, PhD) Department of Obstetrics and Gynecology, St. Olavs Hospital, Trondheim, Norway Department of Clinical and Molecular Medicine, Norwegian University of Technology and Science, Trondheim, Norway maria.o.nyhus@ntnu.no   Ingrid Volloyhaug (Gynecologist, Professor II) Department of Obstetrics and Gynecology, St. Olavs Hospital, Trondheim, Norway Department of Clinical and Molecular Medicine, Norwegian University of Technology and Science, Trondheim, Norway ingrid.volloyhaug@ntnu.no

Despite it is well documented that house dust mite (HDM) can cause tissue damage and activate innate immune cells, its potential to promote gastrointestinal sensitization and allergenicity to food proteins has been relatively unexplored. This study aimed to determine the immunostimulant properties of HDM in the development of allergy to egg white (EW) when administered in a murine model of oral sensitization without exogenous adjuvant. The effect of its proteolytically inactivated form (iHDM) was also investigated to evaluate the contribution of protease activity to its potential adjuvant effect. HDM and iHDM stimulated allergy to unrelated egg allergens through the oral route as evidenced by signs of mast cell degranulation in the intestinal tract following challenge with the EW, although only iHDM induced detectable concentrations of serum EW-specific IgE and IgG1 antibodies. Although HDM affected the expression of genes encoding tight junction proteins and Th2-inducing alarmins in the intestine to a greater extent than iHDM, the presence of active proteinases was not a requirement for its adjuvant activity, since iHDM preferentially promoted Th2 responses in intestinal lymphoid tissues. These results suggest that the ingestion of environmental dust may favour food allergy initiation and highlight the complex and context-dependent nature of the adjuvant activity of HDM.

Abstract Objectives: Women experiencing reduced fetal movements (RFM) have an increased risk of adverse pregnancy outcome (APO). Single-population studies may introduce bias and limiting generalisability. This study aimed to identify factors most strongly associated with APO, including stillbirth, fetal growth restriction (FGR), and admission to neonatal intensive care unit in women with RFM. Design and settings: Individual-level data from multiple sites in Manchester and Leicester were synthesised and analysed. Population or Sample: 1,175 women between 28 +0 and 41 +0 weeks’ gestation with singleton pregnancies. Methods: Factors associated with APO were assessed by two-stage individual participant data meta-analysis (IPD-MA). Main Results: 7.7% of RFM pregnancies ended in APO, with the most common complication being FGR (birthweight ≤3 rd centile) in 4.6%. Maternal past medical history (adjusted Odds Ratio, aOR = 2.28, 95% CI 1.08-4.83) and smoking status (aOR = 2.52, 95% CI 1.20-5.29) were most strongly associated with APO. Estimated fetal weight (EFW) percentile (aOR = 0.97, 95% CI 0.96-0.99) and maternal age (aOR = 1.05, 95% CI 1.01-1.09) were also significant risk factors, though high heterogeneity between studies in EFW percentile was observed (I 2 = 76.84%, Tau 2 = 0.0004, Q-statistic p-value = 0.0007). Conclusions: IPD-MA allowed amalgamation of patient-level data across studies, and more accurate and reliable associations were found by accounting for heterogeneity. Further work is required to investigate the model’s generalisability across diverse populations and settings. Funding: This study received no specific funding. Keywords: Individual Participant Data Meta-Analysis; Adverse pregnancy outcome; Stillbirth; Fetal Growth Restriction; Perinatal mortality; Decreased Fetal Movement