Browse Articles

Prediction of therapeutic dropout in patients with addictions: Development and validation of the Predictors of Dropout from Addiction Treatment (PDAT) scale

Background Withdrawal from addiction treatment is a frequent but difficult-to-predict contingency. We clarify and contextualize the concept of dropouts in addiction treatment, as well as the external and internal elements that most frequently lead to such dropouts. The main instruments used to measure dropout are summarized, after which a new tool, Predictors of Dropout from Addiction Treatment (PDAT) scale, is presented. The PDAT consists of four factors: 1) Motivation: desire to recover and to actively engage in current treatment; 2) Craving: longing for the use of substances and/or the substance addiction environment; 3) Problem awareness: level of insight, or degree of knowledge, and ability to objectify the problem and the disease, with the renunciations and limitations that this entails; and 4) Dysphoria: dyade inner restlessness – moodiness, i.e., emotional disturbance and depressive anticipation that precedes treatment withdrawal. Methods The sample consisted of 243 addicted subjects in residential treatment, ranging in age from 18 to 63 years (average = 38.43, standard deviation = 10.95), who completed an initial 26-item PDAT questionnaire. The factor structure of the PDAT was determined by factor analysis. Mixed effects logistic regressions and receiver operating characteristics curve (ROC) analyses were applied to assess the predictive validity of the PDAT. Results: The 13-item PDAT showed adequate reliability and convergent and discriminant validity, with both the general scale and each of its factors having predictive validity 7 and 15 days after administration. Conclusion The scale is a useful instrument with proven clinical efficacy and brevity of application. In addition, its four factors are useful for targeting interventions based on the unbalanced factors.

Behavioral and physiological insights into cross-stage interactions in the desert locust

Abstract Gregarious desert locusts produce stage-specific pheromones that facilitate cohesive behavior in juveniles and synchronize maturation and mating in sexually mature adults. During locust outbreaks, merging populations result in cross-stage interactions, yet their impact on locust biology remains poorly understood. This study tested the hypothesis that cross-stage interactions influence juvenile cohesion and physiological traits. Using behavioral assays and gas chromatography-mass spectrometry, we examined short- and long-term interactions between juvenile and adult desert locusts. In short-term (24 h) cage assays, the presence of adults did not significantly affect grouping behavior in gregarious 3rd instar nymphs, as measured by the mean distance between individuals. Likewise, overall, juvenile pheromone emissions, based on previously identified nymphal components, showed no significant differences regardless of adult presence. Cross-stage interactions also had no measurable effect on the development time of 3rd instar nymphs. In contrast, long-term assays showed that 1st instar nymphs grouped with adults matured faster and grew heavier than older nymphal instars and fledglings, and, as mature males, released higher levels of phenylacetonitrile (PAN). Additionally, adult females emerging from these interactions oviposited earlier and laid more eggs than those not exposed to adults as juveniles. These findings indicate that cross-stage interactions impact development uniquely across different gregarious locust stages. Additionally, they offer important insights into desert locust behavior and chemical ecology, which could aid in developing more effective management strategies.

Correction: Relationship between physical function and sarcopenia in the older adults from Amazonas: A cross-sectional study

Production and characterization of anti-bacterial metabolite(s) from Egyptian archaeological sites

Abstract Antimicrobial agents produced by Xenorhabdus spp. may hold the answer to novel antimicrobial agents. Antibacterial activity of some bacterial strains isolated from different Egyptian archaeological sites was evaluated. The most potent organism that reported high antibacterial activity was identified as Xenorhabdus nematophila. The produced bioactive compound was identified as xenortide using LC–MS and NMR studies. Optimization of xenortide’s production was assessed using a central composite statistical design. The most effective fermentation factors were identified as carbon, nitrogen source concentrations and pH levels. Nano-xenortide was synthesized using the ball milling method, followed by its characterization and evaluation for its anticipated antibacterial and anticancer properties. Statistical analysis of the findings indicated that the produced nano-xenortide exhibited superior antibacterial efficacy. Furthermore, the assessment of its cytotoxicity revealed that nano-xenortide is a promising, safe candidate that can be used as an antibacterial and anti-colorectal-carcinoma agent.

A nonlinear polycrystalline ice elastoplastic contact model and its application

With the gradual warming of the global climate, the possibility and risk of large-scale sliding and collapse disasters of glaciers, large ice sheets, and thicker ice sheets have increased. Using the discrete element numerical method to analyze glacier stability is of great importance for polar disaster prediction. A contact model, which can accurately reflect the mechanical properties of polycrystalline ice, is key to conducting a discrete element numerical simulation of glacier stability. Based on the results of conventional triaxial compression tests on polycrystalline ice, we proposed an elastoplastic contact model. A custom contact model subroutine (dynamic link library [DLL]) for the two-dimensional particle flow code (PFC2D) was generated using C++. A self-defined contact model subroutine (DLL) was used to simulate the biaxial shear of the flexible film at different temperatures. The numerical simulation results were in good agreement with the experimental results. The proposed contact model accurately reflected the deformation characteristics of polycrystalline ice. Finally, a discrete element numerical simulation of glacier ice collapse was conducted. An elastoplastic contact model of polycrystalline ice was established to provide a numerical basis for glacier stability analysis and multi-field coupling research.

Author Correction: A constellation of mud volcanoes originated from a buried Arctic mega-slide, Southwestern Barents Sea

Circular insights for rhythmic health: A Bayesian approach with stochastic diffusion for characterizing human physiological rhythms with applications to arrhythmia detection

Accurate detection of arrhythmic patterns in physiological signals—particularly electrocardiogram (ECG)—is vital for early diagnosis and intervention. Traditional amplitude-based models often fail to capture disruptions in the underlying phase dynamics. In this study, we propose a novel Bayesian framework based on circular stochastic differential equations (SDEs) to model the temporal evolution of cardiac phase as a diffusion process on the circle. Using the MIT-BIH arrhythmia dataset, and also based on extensive simulation of ECG signals with phase anomalies, we validate the proposed methodology and compare our method against two standard approaches: a linear autoregressive (AR) model and a Fourier-based spectral method. Quantitative evaluation demonstrates that depending on the assumption, our method capable of achieving superior accuracy while better balancing sensitivity and specificity in detecting subtle phase anomalies, particularly those undetectable by conventional amplitude-based tools. Unlike existing techniques, our framework is naturally suited for circular data and offers short-term probabilistic prediction. The proposed approach provides a statistically coherent and interpretable framework for modeling rhythmic biomedical signals, laying a foundation for future extensions to multimodal or hierarchical physiological models.

Synthesis, characterization and cytotoxic evaluation of metal complexes derived from new N′-(2-cyanoacetyl)isonicotinohydrazide

Abstract The novel ligand (H2L), N’-(2-cyanoacetyl)isonicotinohydrazide, has been synthesized via reacting the isonicotinic hydrazide with 1-cyanoacetyl-3,5-dimethylpyrazole. The keto-form of the free ligand has been evoked from its spectral data. Based on elemental analyses and mass spectra, the ligand formed 1:1 (M: L) metal complexes with the acetate salts of Cu(II), Co(II), Ni(II) and Zn(II). The complexes’ spectral analyses revealed that the ligand behaved as a mononegative bidentate via the hydrazonyl N1 and deprotonated enolized acetyl oxygen. Moreover, the DFT quantum chemical calculations revealed that the ligand had higher HOMO and lower LUMO energies than metal complexes, implying an electron donating character. Furthermore, the in vitro anticancer activity against HepG2 and HCT-116 cell lines displayed that the ligand was more potent than doxorubicin against both cell lines, although the metal complexes displayed lower efficacy.

The relationship between the Geriatric Nutritional Risk Index and all-cause mortality in patients with peripheral artery disease

Background Peripheral artery disease (PAD) is a common atherosclerotic condition that leads to limb dysfunction and increases mortality risk. Malnutrition is closely related to the long-term mortality of PAD patients. Therefore, studying the relationship between the Geriatric Nutritional Risk Index (GNRI) and long-term mortality in patients with PAD is crucial for identifying high-risk populations and developing targeted interventions. Methods Data were sourced from the National Health and Nutrition Examination Survey (NHANES) conducted between 1999–2004, including 532 PAD patients. Kaplan-Meier survival analysis and multivariate Cox regression models assessed the relationship between GNRI and all-cause mortality in PAD patients. Subgroup analyses were conducted to explore differences based on demographic and disease backgrounds. Results During the follow-up period, a total of 415 all-cause deaths were recorded. The Kaplan-Meier survival curve showed significant differences in mortality rates between the different GNRI quartile groups. Multivariate Cox regression analysis showed a significant negative correlation between GNRI and the long-term mortality risk of PAD patients (HR: 0.950, 95%CI: 0.918, 0.983). Compared to the first GNRI quartile, PAD patients in the third (HR: 0.569, 95%CI: 0.357, 0.909) and fourth (HR: 0.396, 95%CI: 0.208, 0.751) quartiles had a significantly reduced risk of long-term mortality. Restrictive cubic spline analysis showed a significant linear negative correlation between GNRI and all-cause mortality in PAD patients. The subgroup analysis results showed that the negative correlation between GNRI and all-cause mortality in PAD patients was significant in all subgroups except for the female subgroup, subgroup with ABI > 0.7, subgroup without smoking history, and subgroup without hypertension. Conclusion There is a significant negative association between GNRI and all-cause mortality in PAD patients, suggesting that malnutrition may be a key factor affecting the prognosis of PAD patients. Early identification and intervention for malnutrition could reduce long-term mortality risks. Future research should further explore the role of nutritional interventions in the management of PAD and validate the findings of this study.

Hesperidin exacerbates the therapeutic potency of cisplatin against hepatocytotoxicity of Ehrlich ascites carcinoma in mice

Abstract The present research was set out to delineate the protective and therapeutic potency of hesperidin (Hesp) versus cisplatin (Cis) against the deleterious consequences of Ehrlich ascites carcinoma (EAC) on the liver and the prospective mitigative effect of Hesp against Cis-mediated hepatotoxic side-effects. A total of 70 female mice were randomly assigned into control, Hesp, EAC, Hesp-protected, Hesp-treated, Cis-treated, and Cis + Hesp-treated groups. Mice inoculated with EAC cells exhibited significant reductions in the serum total protein and albumin levels, along with significant elevations of the serum aminotransferases, lactate dehydrogenase, amylase, and lipase activities, and alpha-fetoprotein level. A significant increment in malondialdehyde level concomitantly with significant declines in reduced glutathione concentration and catalase activity were also observed in the liver of EAC-bearing mice. Additionally, marked hepatic pathological changes as well as a strong Ki-67 expression and a weak caspase-3 expression in the neoplastic cells infiltrating hepatocytes were observed. In contrast, the administration of Hesp and/or Cis to the EAC-bearing mice reversed, to varying degrees, the cytotoxic effects of EAC. Besides, Hesp minimized the harmful hepatic chemotherapeutic side-effects of Cis. Overall, Hesp could be a promising phytochemical against EAC-induced cytotoxicity with its potential to improve the antitumor efficacy of chemotherapeutic drugs and minimize their hepatic adverse side-effects.

The effect of camel milk on house dust mite allergen induced asthma model in BALB/C mice

Camel milk has demonstrated robust immunomodulatory and anti-inflammatory properties in various clinical and experimental studies. However, no previous studies have characterized the cellular immunological effects of camel milk in the context of allergic asthma. Therefore, the present work aimed to evaluate the protective effects of camel milk in house dust mite induced asthma in mice, which emulate human pulmonary inflammation. Female BALB/c mice aged 8- to 10-week-old were intranasally sensitized with vehicle or HDM in 2.5 µl (5 µg) per nostril, 5 days a week for 3 weeks. On day 22, mice received an HDM challenge by a large volume but low dose into the lung (5 µg in 50µl) using intranasal inoculation. Using oral gavage technique, CM/HDM group mice received 0.5 ml of camel milk or vehicle five times a week, starting a day prior to sensitization. On day 23 following HDM challenge, mice were exposed to serial challenges with 10, 20, 40 and 100 mg/ml aerosolized methacholine to measure lung dynamics. Furthermore, BALF and whole lung samples were harvested to examine pulmonary inflammation. Camel milk effectively inhibited both HDM-induced infiltration of eosinophils and AHR. In addition to this, camel milk downregulates the number of pulmonary Th2 and Th17 cells and suppressed CCL17 expression in whole lung homogenates. Furthermore, camel milk reduced HDM-induced IL-4 and IL-13 expression following in vitro restimulation of pulmonary T cell subsets. Additionally, camel milk suppressed total concentrations of IL-5 and IL-13 in the lung. These results corroborate the asthma-preventive potential of camel milk and highlight the significance of diminished local concentrations of Th2- associated cytokines. In the present study, the observed downregulation of asthma progression by camel milk suggests its potential health benefits; however, further experimental and controlled clinical trials are needed before it can be considered a supplementary approach for allergic asthma management.

Circular RNA circIGF1R controls cardiac fibroblast proliferation through regulation of carbohydrate metabolism

Abstract Excessive fibroblast proliferation and metabolic reprogramming are hallmarks of pathological cardiac remodeling, contributing significantly to impaired cardiac function. This study investigates the role of circular RNAs (circRNAs) in fibroblast metabolic reprogramming, an unexplored area with potential therapeutic implications. Through deep circRNA sequencing of cardiac tissue from heart failure (HF) patients and healthy individuals, we identified circIGF1R (hsa_circ_0005035), which exhibited dysregulation specifically in isolated cardiac fibroblasts derived from failing hearts. Silencing circIGF1R in patient-derived human cardiac fibroblasts (HCFs) led to accelerated proliferation, enhanced glycolytic activity, altered glucose trafficking, and increased glucose import. Conversely, administering recombinant circIGF1R inhibited the accelerated proliferation and enhanced glycolytic activity observed in HCFs from HF patients. Mechanistically, RNA pulldown assays and in silico analyses identified AZGP1 as a potential interaction partner facilitating the glycolysis-inhibitory and anti-proliferative functions of circIGF1R. Our findings identify circIGF1R as a pivotal regulator of fibroblast proliferation via metabolic reprogramming, particularly by glycolysis inhibition. Overexpression of circIGF1R demonstrated significant anti-fibrotic effects in cardiac fibroblasts derived from heart failure patients. These results underscore the therapeutic potential of circIGF1R in attenuating cardiac fibrosis by directly targeting fibroblast metabolism in the context of pathological cardiac remodeling.

Association between N-terminal pro-brain natriuretic peptide levels and outcomes of ischemic stroke: A systematic review and meta-analysis

Background N-terminal pro-brain natriuretic peptide (NT-proBNP) was identified as an important biomarker of cardiovascular disease, in ischemic stroke. This study intends to assess the association of NT-proBNP levels with clinical outcomes of patients ischemic stroke patients. Methods A comprehensive search of MEDLINE, Web of Science, ScienceDirect, and Cochrane CENTRAL electronic databases was done for papers published till April 2024 and reporting on the levels of NT-proBNP in patients with ischemic stroke. Outcomes of interest included mortality (all-cause and cardiovascular) and neurological, and functional outcomes. A random-effects meta-analysis model was used, and final estimates were reported as pooled odds ratio (OR) with 95% confidence interval (CI). Results Elevated NT-proBNP levels were significantly linked to increased all-cause (pooled OR = 2.322, 95% CI: 1.718 to 2.925) and cardiovascular mortality (pooled OR = 1.797, 95% CI: 1.161 to 2.433). Higher NT-proBNP levels were also related to poorer functional outcomes (pooled OR = 1.129, 95% CI: 1.041 to 1.217). Patients with higher NT-proBNP levels had somewhat worse neurological outcomes (pooled OR = 1.317, 95% CI: 0.859 to 1.774). Considerable heterogeneity was detected across the studies (I² > 40% in most analyses). Conclusion NT-proBNP levels may serve as a robust predictor of mortality and offer potential utility in predicting functional recovery in ischemic stroke patients. The integration of NT-proBNP measurement into clinical settings may be beneficial for risk stratification and management of stroke survivors.

Calprotectin in the risk stratification of patients with acute dyspnoea in the emergency department

Abstract Acute dyspnoea is one of the most common presenting symptoms in the emergency department (ED) and has a variety of underlying causes. Calprotectin is a neutrophil activation marker associated with adverse outcomes in acute cardiovascular and infectious diseases. However, the usefulness of calprotectin in the risk stratification of patients with acute dyspnoea is unknown. The objectives were to, in unselected patients presenting to the ED with acute dyspnoea, investigate the association between (1) calprotectin and 90-day mortality, (2) calprotectin and 90-mortality in subgroups of patients with cardiovascular disease or pneumonia, and (3) calprotectin and illness severity. Single-centre observational cohort study from a university hospital in southern Sweden. A total of 1186 patients from the original Acute Dyspnoea Study, were included. Patients were followed for discharge diagnosis and mortality. Calprotectin concentration was measured in plasma samples collected at the ED. Mean age was 72 years and 56% were women. During follow-up, 143 patients died. In multivariate Cox regression for 90-day mortality, calprotectin in the highest quartile (> 0.96 mg/L) compared to the lowest quartile (< 0.27 mg/L) was associated with a hazard ratio of 2.71 (95% confidence interval 1.39–5.26, p < 0.01). The association with mortality remained significant in the subgroup of patients with acute cardiovascular disease (N = 205, p < 0.01). There was no statistically significant difference in median calprotectin values between survivors and non-survivors with pneumonia (1.62 vs. 1.31, p = 0.155). Multivariate linear regression showed a strong positive correlation between calprotectin and illness severity (respiratory rate ≥ 29 or oxygen saturation ≤ 90%, p < 0.001). In conclusion, calprotectin was associated with 90-day mortality and correlated strongly with illness severity. This indicates that measurement of calprotectin at admission could improve clinical risk stratification of the acute dyspnoeic ED patient. Clinical trial number: Not applicable.

Development of a highly specific enzyme-linked immunosorbent assay for detection of antibodies to Duck Tembusu virus using subviral particles

Duck Tembusu virus (DTMUV) belongs to the family Flaviviridae and genus Orthoflavivirus. It causes disease in ducks, affecting the nervous system and significantly reducing egg production. The first outbreak of DTMUV in Thailand was reported in 2013, with widespread cases across various regions. However, serological diagnosis of DTMUV is challenging due to antibody cross-reactivity with other flaviviruses. To address this issue, we developed an ELISA based on subviral particles. The cassette encoding the membrane precursor and envelope genes of DTMUV (strain KPS54A61) were cloned into a pCAGGS vector with an OSF-tag and transfected into HEK-293T cells to generate subviral particles. The subviral particles were detected in the supernatant of the transfected cell via immunoblotting using anti-DTMUV E protein and anti-Strep-tag antibodies, which revealed a protein band of approximately 59 kDa. An electron microscopy confirmed the presence of particles approximately 35 nm in diameter. To optimize the SP-based ELISA, checkerboard titration identified the optimal antigen concentration as 70 µg/mL and the optimal serum dilution as 1:100,000. A cut-off value was established for the assay, and testing 300 duck serum samples using the SP-based ELISA identified 41 positive samples (14%) and 259 negative samples (86%). The SP-based ELISA exhibited 100% sensitivity and specificity, achieving a perfect agreement score of 1.0 in comparison with the serum neutralization test. Additionally, specificity testing using antibodies specific to Japanese Encephalitis virus (JEV) revealed no cross-reactivity in the ELISA test. Therefore, the developed SP-based ELISA is highly effective for screening and monitoring DTMUV outbreaks in duck farms, significantly reducing the risk of viral spread and enabling the timely implementation of disease control measures.

Tyrosine kinase inhibitors were well-tolerated among patients with different etiologies of advanced HCC with lower survival in non-viral patients

Abstract We studied the characteristics and survival of patients with sorafenib-treated HCC and impact of underlying etiology on outcomes. This retrospective multicenter study recruited patients with sorafenib-treated advanced HCC (12/2016 to 4/2023) till death or the study end (2/2024). Time to progression (TTP) and overall survival (OS) were recorded. We evaluated; Clinico-laboratory and imaging predictors of OS, The impact of underlying etiology on tumor variables, outcomes and tolerance for sorafenib > 6 months. This study included 706 patients. Median duration of Sorafenib therapy was 240.00 (90.00–360.00) days. Median OS was 314.00(146.00–601.00) days. Median TTP was 180.00(90.00–330.00) days. COX regression revealed that the independent factors of mortality were baseline AST, Tumor size, hepatic vein thrombosis (HVT), development of jaundice and shifting to Regorafenib. Advanced HCCs were more common on top of non-cirrhotic non-viral and HBV-related liver disease. Adverse events, TTP and tumor response didn’t differ with the underlying etiology. Median OS was lower in non-viral-related HCC than HCV-related HCC (218.00 versus 326.50 days, P-value = 0.048). Patients who continued sorafenib > 6 months had lower AFP, HVT, adverse effects and better tumor response after 3 months. OS is lower in non-viral Sorafenib-treated HCC compared with viral-related HCC and Sorafenib was well-tolerated among different HCC etiologies.

Diazotrophic growth of free-living Rhizobium etli: Community-like metabolic modeling of growing and non-growing nitrogen-fixing cells

Rhizobium etli, a nitrogen-fixing bacterium, grows both in symbiosis (with plants) and in free-living state. While most metabolic models focus on its symbiotic form, this study refined the existing iOR363 model to account for free-living growth. By addition of a biomass formation reaction followed by model curation growth was simulated using various N-sources (NH₃, NO₂, and NO₃). At fixed succinate uptake rate (4.16 mmol/gDWC/h), ammonia yielded the highest growth rate of 0.259 h ⁻ ¹. To represent free-living N-fixing R. etli, a novel two-member community-like model, consisting of both growing and differentiated non-growing N-fixing cells with ammonia exchange, was developed. The XFBA approach, based on community Flux Balance Analysis (cFBA), was formulated to maintain fixed abundances rather than assuming equal growth rates. With a non-growing:growing abundance ratio of 1:9 in community, N-fixation resulted in lower growth rate of 0.1933 h ⁻ ¹ due to the high energy demand of N₂ assimilation compared to ammonia. Sensitivity analysis revealed that increased abundance of N-fixing cells from 5 to 30% led to decreases of 10% in N2-fixation and 25% in growth rate of growing member. Furthermore, Principal Component Analysis identified oxidative phosphorylation, TCA cycle, and glycolysis as key pathways differentiating flux distributions across N-sources. At high uptake of oxygen, causing nitrogenase inactivity, cytochrome bd oxidase was activated to scavenge oxygen, though at the cost of lower growth rate (by 12% per mmol increase in O2 uptake/gDWC/h). This study provided a platform to obtain insights to free-living state of R. etli which may have applications for other diazotrophs.

The arousal paradox in critical task performance in automated driving during sleep inertia using a quasi experimental approach

Abstract Sleep inertia is the post-awakening transitional state of lowered arousal, characterized by increased low-frequency activity in the electroencephalogram (EEG) and impaired cognition. While some theories consider arousal holistically, recent research questions whether these findings apply to situations requiring immediate critical action post-awakening, such as for pilots, emergency responders, or future drivers of automated vehicles. This study compared self-reported, cortical, and physiological arousal in such a scenario. Twenty-four participants completed four drives in a driving simulator. In three drives, participants were instructed to sleep for 20, 40, and 60 min during automated driving before being prompted to resume control. The sleep stage prior to the takeover request served as a quasi-experimental independent variable. Regression analyses showed that cortical arousal was low following awakenings from N2 or N3, indicated by increased delta, theta, and alpha activity. However, beta activity and heart rate also increased, suggesting elevated physiological arousal. Significant positive correlations were found between delta activity, heart rate and self-reported sleepiness. This “arousal paradox” is not in line with the idea of arousal as a holistic concept. We hypothesize that the heightened physiological response under sleep inertia may be attributed to stress in demanding situations under sleep inertia. We conclude that forced awakenings from N2 or N3 should be avoided. If someone is nevertheless awakened from N2 or N3, they should be given sufficient time between awakening and taking over duties for arousal to normalize.

Diurnal pattern of respiration in corals and algae and its implications for gross primary production quantification

Mitochondrial respiration (R) and gross photosynthesis (GP) are crucial components of the energy and carbon budgets of photosynthesizing organisms in coral reefs. This study investigates the diurnal and seasonal patterns of R in common reef algae and corals, examining the relationship between R and photosynthesis. Additionally, it evaluates discrepancies between daily R and GP calculations based on diurnal variations versus constant nighttime R, latter being the more traditional approach. We collected three coral species (Montastrea cavernosa, Porites astreoides, and Diploria strigosa) and three algal species (Caulerpa verticillata, Ceramium nitens, and Laurencia obtusa) from a Bermuda reef in fall (October) and measured their metabolic rates in a controlled outdoor mesocosm environment. Diurnal patterns of photosynthesis were measured under natural sunlight, and respiration was measured at different times by covering the incubations with a black sheet. Measurements were repeated with re-collected corals in spring (April) and summer (July). Our findings reveal pronounced diurnal patterns in R for both corals and algae, with peak R in the afternoon, lagging behind peak GP by 1–3 hours. Seasonal analysis showed the highest R in summer and the lowest in fall, correlating with temperature and light intensity variations. The study indicates that traditional models, assuming constant nighttime R throughout the day, underestimate daily R and GP rates by an average of 14% and 13%, respectively, and by 23% and 18% at a maximum. These results highlight the need to incorporate the dynamic nature of respiration into our understanding of energy and carbon fluxes in reef organisms. As metabolic energy availability is crucial for organism resilience, improved estimates of R and GP are essential for predicting organism survival in a changing environment.

AI-supported versus manual microscopy of Kato-Katz smears for diagnosis of soil-transmitted helminth infections in a primary healthcare setting

Abstract Soil-transmitted helminths primarily comprise Ascaris lumbricoides, Trichuris trichiura, and hookworms, infecting more than 600 million people globally, particularly in underserved communities. Manual microscopy of Kato-Katz thick smears is a widely used diagnostic method in monitoring and control programs, but is time-consuming, requires on-site experts and has low sensitivity, especially for light intensity infections. In this study, portable whole-slide scanners and deep learning-based artificial intelligence (AI) were deployed in a primary healthcare setting in Kenya. Stool samples (n = 965) were collected from school children and Kato-Katz thick smears were digitized for AI-based detection. Light-intensity infections accounted for 96.7% of cases. Three diagnostic methods - manual microscopy, autonomous AI and human expert-verified AI - were compared to a composite reference standard, which combined expert-verified helminth eggs in physical and digital smears. Sensitivity for A. lumbricoides, T. trichiura and hookworms was 50.0%, 31.2%, and 77.8% for manual microscopy; 50.0%, 84.4%, and 87.4% for the autonomous AI; and 100%, 93.8%, and 92.2% for expert-verified AI in smears suitable for analysis (n = 704). Specificity exceeded 97% across all methods. The expert-verified AI had higher sensitivity than the other methods while maintaining high specificity for the detection of soil-transmitted helminths in Kato-Katz thick smears, especially in light-intensity infections.