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Racial disparities in urine drug screening among seizure patients in the emergency department

Background The potential for racial disparity using urine drug screening (UDS) in patients with seizures is sparsely reported. This study aims to determine racial and ethnic disparities when ordering UDS in patients with suspected seizures in the emergency department (ED). Methods In this retrospective study, we identified patients over the age of 18 with suspected seizures who presented to the ED at the University of Kansas Medical Center between October 2017 and October 2020. Data encompassed demographic, clinical, electrographic, and UDS information from the electronic medical records (EMR). Data were compared between Black and White patients, as well as between Hispanic and non-Hispanic patients. We used the Chi-square test to assess differences in UDS testing based on patient race and ethnicity. Results A total of 2945 patients were identified. Among these, 1750 (59%) were White and 821 (28%) were Black patients. Of these patients, 612 (20.8%) underwent UDS in the ED. Black patients had UDS performed more frequently compared to White patients (p = 0.046). Additionally, the positivity rate for UDS was higher among Black patients than White patients (p = 0.019). UDS testing did not differ by ethnicity (p = 0.164). Amphetamine positivity was higher among White patients; however, the positivity rates of other drugs did not differ by race and ethnicity. Black patients were more often admitted to the neurology intensive care unit. No differences in discharge rates or EEG testing were noted across race or ethnicity. Conclusion Increased UDS testing was seen in Black patients compared to White patients in our single-institution cohort, warranting further research into the underlying causes of this disparity.

Dysregulated RNA splicing impairs regeneration in alcohol-associated liver disease

Time-restricted feeding leads to sex- and organ-specific responses in the murine digestive system

Food intake is a key regulator of the digestive system function; however, little is known about organ- and sex-specific differences in food-driven regulation. We placed male and female C57Bl/6 mice on time-restricted feeding (TRF), limiting access to food to an 8-hour window. Food was added either at dark (ZT12) or light (ZT0) onset for 14 days. Afterwards, the feeding period was delayed by 4 hours for half the mice, and the respective TRF regime continued for another 14 days. TRF from ZT12 to ZT20 led to the highest weight gain in females and the lowest in males, while improving intestinal transepithelial resistance (TEER) in both sexes. However, it also diminished food-anticipatory gene expression of several hepatic genes, particularly in female mice. Shifting food access to ZT16 increased weight gain and reduced fasting glucose levels in male mice, while also inducing strong food-driven gene expression changes in hepatic and duodenal tissues in both sexes. Feeding during the early lights-on phase (ZT0-ZT8) caused only minor physiological changes. However, it led to an overall downregulation of hepatic and an upregulation of duodenal and gastric gene expression and blunted the food-anticipatory expression response in both sexes. Delaying feeding until ZT4 was highly detrimental, reducing TEER and further disrupting gene expression in the stomach and liver in both sexes. In contrast, at least partial restoration of food-driven gene expression was seen in the duodenum, particularly in males. These findings highlight the strong sex- and organ-specific effects of food intake time on physiological and gene expression responses. Notably, we observed a lack of alignment in gene-expression responses between the gut and liver, underscoring tissue-specific sensitivity to feeding cues.

The negligible role of carbon offsetting in corporate climate strategies

Abstract Carbon credits feature prominently in corporate climate strategies and have sparked public debate about their potential to delay companies’ internal decarbonisation. While industry reports claim that credit purchasers decarbonise faster, rigorous evidence is missing. Here, we provide an in-depth analysis of 89 multinational companies’ historical emission reductions and climate target ambitions. Based on self-reported environmental data and more than 400 sustainability reports, we find no significant difference between the climate strategies of companies that purchased credits and those that did not. Voluntary offsetting is not a central part of most companies’ climate strategies, and many pass credit costs directly onto their customers. While the companies within our sample retired one-fourth of all carbon credits in 2022, the top five offsetters’ expenditures on voluntary emission offsetting are, on average, only 1 percent relative to their capital expenditures. For most companies, carbon credits are, therefore, unlikely to crowd out internal decarbonisation measures. Yet, we document that for large-scale offsetters in the airline industry, carbon credit purchases competed with financing internal decarbonisation measures.

Nursing students’ self-efficacy in lifestyle counselling: Associations with learning methods

Several non-communicable diseases are strongly linked to lifestyle factors, making preventive measures essential. One effective approach is lifestyle counselling, which has demonstrated promising results in the prevention, treatment, and management of these diseases. However, despite its potential, patients often do not receive lifestyle counselling to the extent required. The existing literature indicates that one contributing factor is low self-efficacy in lifestyle counselling among nurses. This study aimed to explore nursing students’ self-efficacy in lifestyle counselling and its association with self-assessed learning methods. Nursing students (n = 310) completed a questionnaire that had a cross-sectional study design at a university in southern Sweden. The self-efficacy in lifestyle counselling scale (SELC20 + 20) was used to measure self-efficacy in lifestyle counselling, and additional questions about learning methods were included to assess Bandura’s sources of self-efficacy. Multiple linear regression was used to explore the relationship between self-efficacy in lifestyle counselling and self-assessed learning methods. The mean total knowledge score was significantly higher than that of the mean total ability score. The learning methods that were significantly associated with self-efficacy in knowledge of lifestyle counselling after adjustment for age and sex, were: own search for knowledge, theoretical knowledge through education, receiving feedback on counselling, personal experiences, observed lifestyle counselling, and experience in lifestyle counselling (R2 = 0.30). Learning methods that were significantly associated with self-efficacy in lifestyle counselling ability, after adjusting for age and sex, were: own search for knowledge, personal experiences, theoretical knowledge through education, and receiving feedback on counselling (R2 = 0.33). The results indicated that mastery experiences, vicarious experiences, and social persuasion were significantly associated with knowledge of lifestyle counselling, while mastery experiences and social persuasion were significantly associated with lifestyle counselling ability. Further research is needed to deepen our understanding of how self-efficacy in lifestyle counselling develops among nursing students.

A neuronal correlate for time interval estimation in the crow’s telencephalon

Abstract Interval timing, the ability to perceive and estimate durations between events, is essential for many animal behaviors. In mammals, it is linked to specific cortical and sub-cortical brain regions, but its neural basis in birds remains unclear. We trained two male carrion crows on a time estimation task using visual stimuli, cueing them to wait for a minimum duration of 1500 ms, 3000 ms, or 6000 ms before responding to receive a reward. During the task, we recorded activity from single neurons in the nidopallium caudolaterale (NCL), the avian executive telencephalon. Many neurons showed tuning to specific durations, suggesting that time intervals are encoded as abstract magnitudes along an ordered scale. Population-level decoding revealed that NCL activity predicted the crows’ intended wait time, independent of the sensory properties of the cues. These findings show that abstract time estimation can emerge from neural architectures different from the mammalian neocortex.

Investigating the role of AI explanations in lay individuals’ comprehension of radiology reports: A metacognition lens

While there has been extensive research on techniques for explainable artificial intelligence (XAI) to enhance AI recommendations, the metacognitive processes in interacting with AI explanations remain underexplored. This study examines how AI explanations impact human decision-making by leveraging cognitive mechanisms that evaluate the accuracy of AI recommendations. We conducted a large-scale experiment (N = 4,302) on Amazon Mechanical Turk (AMT), where participants classified radiology reports as normal or abnormal. Participants were randomly assigned to three groups: a) no AI input (control group), b) AI prediction only, and c) AI prediction with explanation. Our results indicate that AI explanations enhanced task performance. Our results indicate that explanations are more effective when AI prediction confidence is high or users’ self-confidence is low. We conclude by discussing the implications of our findings.

The maximum Tc of conventional superconductors at ambient pressure

Abstract The theoretical maximum critical temperature (T c) for conventional superconductors at ambient pressure remains a fundamental question in condensed matter physics. Through analysis of electron-phonon calculations for over 20,000 metals, we critically examine this question. We find that while hydride metals can exhibit maximum phonon frequencies of more than 5000 K, the crucial logarithmic average frequency $${\omega }_{\log }$$ ω log rarely exceeds 1800 K. Our data reveals an inherent trade-off between $${\omega }_{\log }$$ ω log and the electron-phonon coupling constant λ, suggesting that the optimal Eliashberg function that maximizes T c is unphysical. Based on our calculations, we identify Li2AgH6 and its sibling Li2AuH6 as theoretical materials that likely approach the practical limit for conventional superconductivity at ambient pressure. Analysis of thermodynamic stability indicates that compounds with higher predicted T c values are increasingly unstable, making their synthesis challenging. While fundamental physical laws do not strictly limit T c to low-temperatures, our analysis suggests that achieving room-temperature conventional superconductivity at ambient pressure is extremely unlikely.

Charity coverage and decreased COVID-19 mortality among uninsured patients in Texas: A retrospective cohort study

Purpose Decreased access to care and social drivers of health have been implicated in COVID-19 disparities. The objective of this study was to test the association between county-funded charity coverage (CFCC) and mortality among uninsured patients hospitalized with COVID-19 in a highly uninsured county. Methods This retrospective cohort study compared electronic health record (EHR) data among uninsured patients hospitalized with COVID-19 in a high-volume safety-net health system in Dallas County, Texas between June 2020 and December 2021. Uninsured patients included CFCC recipients and self-pay patients. We compared mortality over 180 days of follow-up using Cox proportional hazards models, adjusting for gender, age, race/ethnicity, and co-morbidities. Additional outcomes included 90-day mortality, need for mechanical ventilation, and intubation within 24 hours of presentation. Results Among 2,047 patients, 47.0% received CFCC and 53.0% were self-pay. Overall, CFCC patients were older, more likely Hispanic, and had more diagnosed co-morbidities. CFCC patients had decreased adjusted mortality compared to self-pay (aHR 0.61, 95% CI [0.45 to 0.82], p < 0.01), with an absolute risk reduction of 3.3% and a number needed to treat (NNT) with CFCC of 30.4 (95% CI 21.4–66.6). CFCC was associated with lower 90-day mortality compared to self-pay (OR = 0.64, 95% CI [0.45–0.92], p = 0.01), despite similar need for ventilation. Intubation within 24 hours of presentation was lower for CFCC compared to self-pay (OR = 0.46, 95% CI [0.22–0.93], p = 0.03). Conclusions CFCC was associated with decreased mortality among the uninsured hospitalized with COVID-19. The NNT for CFCC to prevent 1 death among uninsured patients was similar to that for standard medications to treat COVID-19. These findings support expanding coverage to improve COVID-19 outcomes.

Constructing synthetic nuclear architectures via transcriptional condensates in a DNA protonucleus

Abstract Nuclear biomolecular condensates are essential sub-compartments within the cell nucleus and play key roles in transcription and RNA processing. Bottom-up construction of nuclear architectures in synthetic settings is non-trivial but vital for understanding the mechanisms of condensates in real cellular systems. Here, we present a facile and versatile synthetic DNA protonucleus (PN) platform that facilitates localized transcription of branched RNA motifs with kissing loops (KLs) for subsequent condensation into complex condensate architectures. We identify salinity, monomer feeding, and KL-PN interactions as key parameters to control co-transcriptional condensation of these KLs into diverse artificial nuclear patterns, including single and multiple condensates, interface condensates, and biphasic condensates. Over time, KL transcripts co-condense with the PN matrix, with the final architecture determined by their interactions, which can be precisely modulated using a short DNA invader strand that outcompetes these interactions. Our findings deepen the understanding of RNA condensation in nuclear environments and provide strategies for designing functional nucleus-mimetic systems with precise architectural control.

Deep feature engineering for accurate sperm morphology classification using CBAM-enhanced ResNet50

Background and objective: Male fertility assessment through sperm morphology analysis remains a critical component of reproductive health evaluation, as abnormal sperm morphology is strongly correlated with reduced fertility rates and poor assisted reproductive technology outcomes. Traditional manual analysis performed by embryologists is time-intensive, subjective, and prone to significant inter-observer variability, with studies reporting up to 40% disagreement between expert evaluators. This research presents a novel deep learning framework combining Convolutional Block Attention Module (CBAM) with ResNet50 architecture and advanced deep feature engineering (DFE) techniques for automated, objective sperm morphology classification. Materials and methods: We propose a hybrid architecture integrating ResNet50 backbone with CBAM attention mechanisms, enhanced by a comprehensive deep feature engineering pipeline. The framework incorporates multiple feature extraction layers (CBAM, GAP, GMP, pre-final) combined with 10 distinct feature selection methods including Principal Component Analysis (PCA), Chi-square test, Random Forest importance, variance thresholding, and their intersections. Classification is performed using Support Vector Machines with RBF/Linear kernels and k-Nearest Neighbors algorithms. The model was rigorously evaluated on two benchmark datasets: SMIDS (3000 images, 3-class) and HuSHeM (216 images, 4-class) using 5-fold cross-validation. Results: The proposed framework achieved exceptional performance with test accuracies of 96.08 ± 1.2% on SMIDS dataset and 96.77 ± 0.8% on HuSHeM dataset using deep feature engineering, representing significant improvements of 8.08% and 10.41% respectively over baseline CNN performance. McNemar’s test confirmed statistical significance (χ2=24.31,p<0.001). The best configuration (GAP + PCA + SVM RBF) demonstrated superior performance compared to existing state-of-the-art approaches, including recent Vision Transformer and ensemble methods. Conclusions and clinical impact: This research demonstrates the effectiveness of attention-based deep learning combined with sophisticated feature engineering for sperm morphology analysis. The proposed framework achieves state-of-the-art performance while providing clinically interpretable results through Grad-CAM attention visualization. Clinical implications include: (1) standardized, objective fertility assessment reducing diagnostic variability, (2) significant time savings for embryologists (from 30–45 minutes to <1 minute per sample), (3) improved reproducibility across laboratories, and (4) potential for real-time analysis during assisted reproductive procedures, ultimately enhancing patient care and treatment outcomes in reproductive medicine.

Proximity labeling of axonemal protein CFAP91 identifies EFCAB5 that regulates sperm motility

Abstract Radial spokes (RSs) are conserved multimolecular structures attached to the axonemal microtubule doublets and are essential for the motility control of both cilia and sperm flagella. CFAP91, an RS3 protein, is implicated in human male infertility, yet its molecular function remains poorly understood. Here, we demonstrate that Cfap91 knockout (KO) mice exhibit impaired sperm flagellum formation and male infertility. Using a transgenic rescue model expressing FLAG- and BioID2-tagged CFAP91, we reveal that CFAP91 immunoprecipitates with RS3 proteins CFAP251 and LRRC23, whose localization is disrupted in Cfap91 KO sperm flagella. In addition, proximity labeling in mature spermatozoa identifies EFCAB5 as a sperm-specific CFAP91-proximal component. We show that Efcab5 KO males exhibit reduced sperm motility and fertility. Our findings establish CFAP91 as an essential scaffolder of RS3 assembly and EFCAB5 as a sperm-specialized movement regulator, advancing understanding of axonemal specialization in mammalian spermatozoa and its relevance to male infertility.

A protocol to develop a Quality Assessment Tool for Realist Synthesis (QUATRES)

A realist synthesis or review is a theory-driven, realist-informed interpretive approach to synthesizing secondary data, informing evidence-based practice, and explaining social phenomena. Realist syntheses use flexible and iterative methods to achieve this goal, including drawing on stakeholders’ knowledge. Thus, realist syntheses require robust planning to be conducted and reported. Similarly, owing to their complex and iterative nature, they also need assessment guidelines so that knowledge practitioners and policymakers can appraise the value of the evidence they produce. While some current tools guide the conduct and reporting of realist syntheses, little comprehensive guidance exists on effectively assessing the quality of realist syntheses. To this end, we aim to develop a Quality Assessment Tool for Realist Synthesis (QUATRES) to encourage the transparent reporting of the review methods, the explicit assessment of the quality of reviews and the reliability of their findings. To achieve this, we will employ a multi-method study design consisting of three work packages: an audit of peer-reviewed articles to identify strengths and weaknesses in a sample of papers reporting realist syntheses, a methodological review of realist synthesis methodology guidance to identify quality markers, and a Delphi consensus to refine and validate quality markers.

Author Correction: Lnc-mg is a long non-coding RNA that promotes myogenesis

Identification of potential inflammation markers for outgrowth of cow’s milk allergy

Immunoglobulin E (IgE)-mediated cow’s milk allergy (CMA) is an immune-mediated reaction to cow’s milk (CM). Non-IgE-mediated CMA resolves in most children in the first years of life, whereas IgE-mediated CMA outgrowth is often later or not at all. The exact mechanisms underlying resolution of IgE-mediated CMA are not fully understood. We aim to gain insight in the immunological mechanisms underlying resolution of IgE-mediated CMA by analyzing unique saliva samples of allergic infants using the Olink ® Target 96 Inflammation panel. Twenty-four children who outgrew their CMA after 12 months were compared to 15 with persistent CMA. Persistent CMA was accompanied by an increase in interleukin-15 receptor subunit alpha in the first 6 months, followed by a decrease, hinting towards an initial increased T cell response. At the same time caspase-8 was increased and interleukin-7 was decreased in persistent CMA. For CMA resolution, we found elevated levels of delta and notch-like epidermal growth factor-related receptor. Furthermore, adenosine deaminase (ADA) increased significantly between 0 and 12 months in resolved CMA, but not in persistent CMA. KEGG pathway analysis suggests mainly the TNF signaling pathway to be important in the resolution of CM allergy. Our findings show that Olink ® Target 96 Inflammation panel analysis of saliva samples can reveal potential immunological markers and mechanisms involved in CMA resolution.

Integrated single-cell atlas of human atherosclerotic plaques

Abstract Atherosclerosis, a major cause of cardiovascular diseases, is characterized by the buildup of lipids and chronic inflammation in the arteries, leading to plaque formation and potential rupture. Despite recent advances in single-cell transcriptomics (scRNA-seq), the underlying immune mechanisms and transformations in structural cells driving plaque progression remain incompletely defined. Existing datasets often lack comprehensive coverage and consistent annotations, limiting the utility of downstream analyses. Here, we present an integrated single-cell atlas of human atherosclerotic plaques, covering roughly 250k high-quality annotated cells. We achieve robust cell type annotations validated by expert consensus and surface protein measurements. Using this atlas, we introduce distinct markers for plaque neutrophils, identify a proangiogenic endothelial cell cluster enriched in advanced lesions, and specialized macrophage subsets. We also establish that fibromyocytes are exclusive to vascular tissue. This comprehensive atlas enables accurate automatic cell type annotation of new datasets, improves experimental design by guiding sample size and detection power, and supports the deconvolution of bulk RNA-seq data. An interactive WebUI makes these resources widely accessible.

RETRACTED: Shocked quartz at the Younger Dryas onset (12.8 ka) supports cosmic airbursts/impacts contributing to North American megafaunal extinctions and collapse of the Clovis technocomplex

Shocked quartz grains are an accepted indicator of crater-forming cosmic impact events, which also typically produce amorphous silica along the fractures. Furthermore, previous research has shown that shocked quartz can form when nuclear detonations, asteroids, and comets produce near-surface or “touch-down” airbursts. When cosmic airbursts detonate with enough energy and at sufficiently low altitude, the resultant relatively small, high-velocity fragments may strike Earth’s surface with high enough pressures to generate thermal and mechanical shock that can fracture quartz grains and introduce molten silica into the fractures. Here, we report the discovery of shocked quartz grains in a layer dating to the Younger Dryas (YD) onset (12.8 ka) in three classic archaeological sequences in the Southwestern United States: Murray Springs, Arizona; Blackwater Draw, New Mexico; and Arlington Canyon, California. These sites were foundational in demonstrating that the extinction or observed population bottlenecks of many megafaunal species and the coeval collapse/reorganization of the Clovis technocomplex in North America co-occurred at or near the YD onset. Using a comprehensive suite of 10 analytical techniques, including electron microscopy (TEM, SEM, CL, and EBSD), we have identified grains with glass-filled fractures similar to shocked grains associated with nuclear explosions and 27 accepted impact craters of different ages (e.g., Meteor Crater, 50 ka; Chesapeake Bay, 35 Ma; Chicxulub, 66 Ma; Manicouagan, 214 Ma) and produced in 11 laboratory shock experiments. In addition, we used hydrocode modeling to explore the temperatures, pressures, and shockwave velocities associated with the airburst of a 100-m fragment of a comet and conclude that they are sufficient to produce shocked quartz. These shocked grains co-occur with previously reported peak concentrations in platinum, meltglass, soot, and nanodiamonds, along with microspherules, similar to those found in ~28 microspherule layers that are accepted as evidence for cosmic impact events, even in the absence of a known crater. The discovery of apparently thermally-altered shocked quartz grains at these three key archaeological sites supports a cosmic impact as a major contributing factor in the megafaunal extinctions and the collapse of the Clovis technocomplex at the YD onset.

BMAL1-TRIM28 represses transposable elements independently of CLOCK in pluripotent cells

Over-time changes in the prevalence of metabolic syndrome and its components among elderly population in Iran from 2016 to 2021; A nation-wide study

Background The prevalence of Metabolic Syndrome (MetS) increases with aging, significantly contributing to the rising burden of non-communicable diseases (NCDs). This study aimed to investigate over-time changes in the prevalence of MetS and its components among the elderly population of Iran. Methods We analyzed data from the 2016 and 2021 national STEPwise approach to non-communicable disease risk factor Surveillance (STEPS) for participants aged ≥65 who completed all three survey steps (questionnaire-based assessments, physical measurements, and laboratory tests) with no missing data on MetS components. According to the STEPS protocol, individuals with severe mental disorders, physical limitations that prevented measurements, or inability to provide laboratory samples were excluded. Using survey analysis techniques and weights, we ensured the findings are nationally representative. MetS was defined using the following criteria: National Cholesterol Education Program Adult Treatment Panel III (NCEP ATPIII), International Diabetes Federation (IDF), American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI), and Joint Interim Statement (JIS). Regional IDF (RIDF) and regional JIS (RJIS) were defined by ethnicity-specific values of waist circumference. Results This study included 4,000 elderly participants in 2016 and 3,849 in 2021, with a mean age of 74 and 72 years, respectively. Approximately 50% were female in both years, and the proportion of urban residents increased from 67% in 2016 to 75% in 2021. The national prevalence of MetS among the elderly increased significantly from 46.11%−66.38% in 2016 to 54.15%−73.98% in 2021 across different criteria, with an annual percent change of 2.19%−3.26%. Prevalence was higher in females and urban populations, while males showed a greater increase. High blood pressure, low high-density lipoprotein cholesterol, and central obesity were the most common components of MetS, while elevated triglycerides and high fasting plasma glucose showed the largest increases over time. Conclusions The escalating prevalence of MetS in the elderly is a matter of increasing concern, underscoring the need for targeted policy interventions aimed at promoting healthy aging, empowering the elderly, and advocating for lifestyle modifications.

Monatomic glass formation through competing order balance