Browse Articles
Discover research articles across all indexed journals
Cost-effectiveness analysis of a postoperative 48-hour care bundle for high-risk patients undergoing abdominal surgery
Background Enhancing surgical care pathways, including scaling-up care after surgery, seeks to deliver better patient-centered care and improve outcomes. However, the value associated with these pathways need to be investigated. Methods We analyzed the potential increase in efficiency of a new care pathway, a postoperative 48-hour care bundle designed to enhance care for high-risk patients undergoing major abdominal surgery, based on micro-costing and cost-effectiveness analyses. Data from a prospective cohort of patients who underwent a high-risk surgical bundle were compared with those who received the standard care regimen. The bundle included standardized risk communication using the ex-care model, implementing a high-risk patient discharge checklist from the recovery room to the ward, ensuring prompt nursing admission to the ward, increasing the frequency of vital sign monitoring in the surgical ward, conducting troponin measurements, and providing rapid access to medical support when needed. Costs were calculated individually throughout the postoperative period until discharge following the time-driven activity-based costing method. One-year survival rates were evaluated using Kaplan-Meier survival curves. A cost-effectiveness analysis was conducted in terms of life-year gain (LYG) and incremental cost-effectiveness ratio (ICER). Results Data from 130 and 188 patients in the bundled and non-bundled groups, respectively, were evaluated. The mean cost per patient of the high-risk surgical bundle was US$2114.63 while for the conventional care group it was US$1447.86. The Kaplan-Meier curve for one-year mortality showed that the groups differed significantly (p = 0.002). According to the model, the new care strategy incremented 0.12 life-year gained at an incremental cost of $150.12. The projected incremental cost-effectiveness ratio for one year of life was $1217.66. Conclusion Our results suggest that implementing a high-risk surgical bundle can enhance healthcare delivery efficiency, making it a valuable and cost-effective strategy for high-level testing to create a more sustainable healthcare system.
Upper eyelid contour measurement in an Asian population using Bézier curve analysis
Purpose To define and quantify the upper eyelid contour of normal Asian adults using a software program utilizing Bézier curves. Methods Eighty eyes of 80 healthy Korean subjects were included in this study. The Bézier curve tool of Image J software was used to extract the upper eyelid contours. The x and y coordinate values of the four points of the Bézier curve were analyzed using graphical analysis software in Matlab. Various parameters were measured automatically using a custom-written software algorithm. Results The Bézier curves showed an excellent level of inter-rater reliability (intraclass correlation coefficient of 0.97 for absolute agreement, two-way random effects model, 95% CI 0.94 to 0.98). The Bézier curve for Asians was drawn from the medial palpebral commissure to the lateral canthus. The eye width was 24.8±1.8 mm in women and 25.3±2.0 mm in men. The contour peak was located at 1.7±1.0 mm temporally from the pupil center in women and 1.5±1.3 mm in men, and the height was 4.7±0.7 mm in women and 3.8±0.9 mm in men. The palpebral fissure obliquity (angle of the line connecting the medial canthal end to the lateral canthal end) was 9.98±3.07° in women and 7.52±2.89° in men. Conclusion The upper eyelid contour was measured simply and efficiently using a Bézier curves function. The main features of Asian upper eyelid contour are that the inner part of the medial canthus is covered by the eyelids, and the lateral endpoint is located higher than the medial endpoint.
Validity of the process and outcome specific measure in women with abnormal Papanicolaou screening test
Introduction Women receiving abnormal Papanicolaou (Pap) findings often face psychosocial burden. This study aimed to evaluate the validity and reliability of the Process and Outcome Specific Measure (POSM) in women with abnormal Pap screening test in Serbia. Methods A cross-sectional study was conducted with 238 consecutive women attending cervical cancer screening. Exploratory factor analysis was used to determine the structure of the POSM, and Cronbach’s alpha coefficient to assess internal consistency. Results The factor analysis revealed two factors that explained 47.8% of variance: the first – Worry factor (4 items loaded onto the factor represented questions about worries), and the second – Information-Support factor (3 items loaded onto the factor represented questions about feeling informed well enough and being satisfied with support from others). The Cronbach’s alpha coefficients for the Worry factor and the Information-Support factor were 0.572 and 0.428, respectively. Conclusion The Serbian version of the POSM could be a useful tool for assessing worry and information-support in women with abnormal Pap smear results.
Improved MPC for trajectory planning of self-driving cars
To tackle the challenges associated with lane changes in diverse driving environments, this study introduces an Improved Model Predictive Control (IMPC) approach that integrates vehicle state and driving context to execute maneuvers effectively. Initially, a simplified model is established, incorporating vehicle position, velocity, and driving conditions. Subsequently, a Sigmoid function is utilized to restrict vehicle movements, while Finite State Machine (FSM) decision-making selects appropriate maneuvers in real time according to changing driving conditions. In addition, a discrete Simplified Dual Neural Network (SDNN) is utilized to efficiently solve Quadratic Programming (QP) problems, overcoming the slow-solving issue of traditional MPC and ensuring rapid acquisition of longitudinal and lateral accelerations for lane changes, braking, and overtaking maneuvers. Finally, the results from hardware-in-the-loop (HIL) simulation validation indicate that IMPC can efficiently address collision avoidance with surrounding dynamic vehicles across three distinct driving scenarios.
Genetic evidence for a fall-spawning group of Gulf sturgeon (Acipenser oxyrinchus desotoi) in the Apalachicola River, Florida, USA
The Gulf sturgeon ( Acipenser oxyrinchus desotoi ) is a large, long-lived, anadromous fish inhabiting the northern Gulf of Mexico. This charismatic fish was hunted to near extinction in the early 1900s. In 1991 the subspecies was listed as threatened under the Endangered Species Act. Recovery continues to be challenged by threats such as habitat destruction, fisheries bycatch, and climate change. There are seven known natal rivers. Historically, each river was thought to contain a single, spring-spawning group. Recent studies have discovered several rivers (Suwannee, Choctawhatchee) contain a second, fall-spawning group. This study utilizes genetic techniques to investigate the proposed existence of a fall-spawning group in the Apalachicola River, Florida. Juvenile Gulf sturgeon were sampled between May and July, from 2013 to 2022. Four adults were also captured on the spawning grounds during October of 2022. Samples were genotyped for thirteen microsatellite loci to assess genetic population structure within the Apalachicola River. Analyses detected two distinct genetic groups (F ST = 0.085). Dates of capture, length frequency distributions of juveniles, and genetic assignment of spawning adults allowed us to characterize these as separate spring- and fall-spawning groups. While approximately 90% of juveniles collected were assigned to the spring, only slight differences in genetic diversity were detected between groups. The temperature window for spawning was found to be three weeks shorter on average in the fall than the spring, highlighting the need for additional research into differing environmental or anthropogenic influences on these populations. The discovery of a fall-spawning group of Gulf sturgeon in the Apalachicola River improves our understanding of the representation, redundancy, and resiliency of the species and provides critical information for improved management of this river system.
Plebeia catamarcensis and Tetragonisca fiebrigi (Hymenoptera, Apidae) propolis promotes longevity and anti-Alzheimer effects in Caenorhabditis elegans
Alzheimer’s disease is a neurodegenerative condition associated with oxidative stress, affecting millions of people worldwide, with expected increases due to the aging population. The development of efficient therapies is still challenging. Propolis, with its antioxidant properties, shows potential in controlling the oxidative stress associated with the disease. The present study aimed to determine the chemical composition of ethanolic extract from propolis produced by Plebeia catamarcensis (EEP-Pc) and Tetragonisca fiebrigi (EEP-Tf), as well as their in vitro and in vivo antioxidant effects, lifespan influence and induced paralysis in Caenorhabditis elegans, mutant model for Alzheimer’s disease. The chemical profile of EEP-Pc and EEP-Tf was characterized through GC-MS and HPLC, identifying phenolic compounds and terpenes. In vitro antioxidant activity was observed using the DPPH• free radicals scavenging method and protection against proteins and DNA oxidation. In vivo, P. catamarcensis and T. fiebrigi propolis extracts showed no reproductive or locomotor toxicity and promoted resistance to oxidative stress in nematodes exposed to the oxidative agent Juglone. Both propolis extracts increased longevity and reduced the signs of paralysis caused by the accumulation of β-amyloid peptides, a marker for Alzheimer’s disease. Together, these data show that propolis from stingless bees P. catamarcensis and T. fiebrigi exhibits promising antioxidant activities against oxidative stress, indicating pharmacological potential with the capacity to reduce symptoms of Alzheimer’s disease.
The benefits and dangers of anthropomorphic conversational agents
A growing body of research suggests that the recent generation of large language model (LLMs) excel, and in many cases outpace humans, at writing persuasively and empathetically, at inferring user traits from text, and at mimicking human-like conversation believably and effectively—without possessing any true empathy or social understanding. We refer to these systems as “anthropomorphic conversational agents” to aptly conceptualize the ability of LLM-based systems to mimic human communication so convincingly that they become increasingly indistinguishable from human interlocutors. This ability challenges the many efforts that caution against “anthropomorphizing” LLMs, attaching human-like qualities to nonhuman entities. When the systems themselves exhibit human-like qualities, calls to resist anthropomorphism will increasingly fall flat. While the AI industry directs much effort into improving the reasoning abilities of LLMs—with mixed results—the progress in communicative abilities remains underappreciated. In this perspective, we aim to raise awareness for both the benefits and dangers of anthropomorphic agents. We ask: should we lean into the human-like abilities, or should we aim to dehumanize LLM-based systems, given concerns over anthropomorphic seduction? When users cannot tell the difference between human interlocutors and AI systems, threats emerge of deception, manipulation, and disinformation at scale. We suggest that we must engage with anthropomorphic agents across design and development, deployment and use, and regulation and policy-making. We outline in detail implications and associated research questions.
A universally applicable definition for domestication
The process of domestication is commonly perceived as a human achievement, and domestic species are typically assumed to be those under human control. Domestic species have emerged from a greater diversity of interactions than this perspective allows, and none of the many definitions proposed for domestication can readily, reliably, and consistently distinguish domestic and nondomestic populations. Here, we propose that the process of domestication should instead be defined solely as evolution of a nonhuman population in response to an anthropogenic niche and that a domestic population is one that cannot sustain itself outside of an anthropogenic niche. As a result, this definition does not require comparisons with a presumed and largely unobservable ancestor. Instead, it focuses on the observable relationship between a nonhuman population and humans. It also avoids making assumptions about how domestication happens, thus enabling an exploration of the mechanisms underlying the process of adaptation to an anthropogenic niche. By applying this definition to plants, animals, and microbes, we illustrate its utility for investigating the evolution of the relationship between humans and other species and for anticipating which species are likely to survive in an increasingly human-influenced world. Domestication is simply an evolutionary process resulting from the interaction between two species, one of which is human. As we work to protect Earth’s biodiversity, this definition allows us to understand why, in response to the conditions human societies create, some species survive and thrive, while others struggle and go extinct.
Author Correction: Akt1 and dCIZ1 promote cell survival from apoptotic caspase activation during regeneration and oncogenic overgrowth
Dynamic mechanical modulation of chiroptical structures via linearly assembled plasmonic nanoparticles on birefringent polymer films
Observation of ferromagnetic phase in the second moiré band of twisted MoTe2
TIM3-blockade synergizes with IL2 in alleviating intra-tumoral CD8+T cell exhaustion
The geometric-electronic coupled design of diatomic catalyst towards oxygen reduction reaction
Biogenesis of DNA-carrying extracellular vesicles by the dominant human gut methanogenic archaeon
Abstract Extracellular vesicles (EVs) play many important roles in cells from all domains of life. Here, we characterize EVs produced by Methanobrevibacter smithii , the dominant methanogenic archaeon in the human gut, which contains a peptidoglycan cell wall. We show that M. smithii EVs are enriched in histones and diverse DNA repair proteins. Consistently, the EVs carry DNA and are strongly enriched in extrachromosomal circular DNA (eccDNA) molecules, which originate from excision of a 2.9-kb chromosomal fragment, and a proviral genome. The eccDNA encodes enzymes implicated in biosynthesis of cofactor F 420 and coenzyme M, two elements critical for methanogenesis. Furthermore, several of the most abundant EV proteins are implicated in methanogenesis. Cryo-electron tomography suggests that EVs are formed by budding from the cell membrane and are trapped under the peptidoglycan layer prior to liberation through disruptions in the cell wall. Our results reveal parallels with EV biogenesis in bacteria and suggest that M. smithii EVs have potential impact on methane production in the gut.
H3.3 deposition counteracts the replication-dependent enrichment of H3.1 at chromocenters in embryonic stem cells
Abstract Chromocenters in mouse cells are membrane-less nuclear compartments representing typical heterochromatin stably maintained during cell cycle. We explore how histone H3 variants, replicative H3.1/2 or replacement H3.3, mark these domains during the cell cycle in mouse embryonic stem cells, neuronal precursor cells as well as immortalized 3T3 cells. We find a strong and distinct H3.1 enrichment at chromocenters, with variation in mouse embryonic stem cells. Mechanistically, this H3.1 selective enrichment depends on the DNA Synthesis Coupled deposition pathway operating in S phase challenged when we target H3.3 deposition through the DNA Synthesis Independent deposition pathway mediated by HIRA. Altering the H3.1/H3.3 dynamics at chromocenters in mouse embryonic stem cells affects nuclear morphology and cell division. Here, we reveal opposing mechanisms for H3.1 and H3.3 deposition with different enforcement according to cell cycle and potency which determine their ratio at chromocenters and are critical for genome stability and cell survival.
Space-time optical diffraction from synthetic motion
Abstract The interaction of light with objects and media moving at relativistic and superluminal speeds enables unconventional phenomena such as Fresnel drag, Hawking radiation, and light amplification. Synthetic motion, facilitated by modulated internal degrees of freedom, enables the study of relativistic phenomena unrestricted by the speed of light. In this study, we investigate synthetically moving apertures created by high-contrast reflectivity modulations, which are generated by ultrafast laser pulses on a subwavelength thin film of indium tin oxide. The space-time diffraction of a weaker probe beam reveals a complex, non-separable spatio-temporal transformation, where changes in the frequency of the wave are correlated to changes in its momentum. By using schemes of continuous or discrete modulation we demonstrate tunable frequency-momentum diffraction patterns with gradients that depend upon the relative velocity between the modulation and the probe wave. The diffraction patterns are matched by operator-based theory and the gradients are analytically predicted using a super-relativistic Doppler model, where the modulation is described as a superluminally moving scattering particle. Our experiments open a path towards mimicking relativistic mechanics and developing complex and programmable spatio-temporal transformations of light.
Prime editor with rational design and AI-driven optimization for reverse editing window and enhanced fidelity
Abstract Prime editing (PE) is a precise tool for introducing genetic mutations in eukaryotes. Extending the efficient editing scope and mitigating undesired byproducts are possible. We introduce reverse PE (rPE), a SpCas9-directed variant that enabled DNA editing at the 3′ direction of HNH-mediated nick site. The rPE leveraging nCas9-D10A and rPE gRNA targeting the 5′ direction of HNH-mediated nick site inscribes genetic alterations, achieving a reverse editing window and potentially high fidelity. HNH and reverse transcriptase engineered using protein language models in conjunction with La facilitate circular erPEmax and erPE7max, achieving editing efficiency up to 44.41% without nick gRNA or positive selection. Furthermore, our findings underscore the capability of rPE in inserting functionally enhanced variant (PIK3CD E527G) for cell therapy. By expanding the editing scope and enhancing genomic manipulability, rPE represents a meaningful advancement in prime editing, improving its utility for research and therapeutic applications.
Reaction-induced dynamic evolution of PtIn/SiO2 catalyst for propane dehydrogenation
Proteomic and metabolomic profiling of extracellular vesicles produced by human gut archaea
Abstract Gastrointestinal bacteria interact with the host and each other through various mechanisms, including the production of extracellular vesicles (EVs). However, the composition and potential roles of EVs released by gut archaea are poorly understood. Here, we study EVs produced by four strains of human gut-derived methanogenic archaea: Methanobrevibacter smithii ALI, M. smithii GRAZ-2, M. intestini , and Methanosphaera stadtmanae . The size (~130 nm) and morphology of these EVs are comparable to those of bacterial EVs. Proteomic and metabolomic analyses reveal that the archaeal EVs are enriched in putative adhesins or adhesin-like proteins, free glutamic and aspartic acid, and choline glycerophosphate. The archaeal EVs are taken up by macrophages in vitro and elicit species-specific responses in immune and epithelial cell lines, including production of chemokines such as CXCL9, CXCL11, and CX3CL1. The EVs produced by M. intestini strongly induce pro-inflammatory cytokine IL-8 in epithelial cells. Future work should examine whether archaeal EVs play roles in the interactions of archaea with other gut microbes and with the host.