Browse Articles

Author Correction: B-cell-specific checkpoint molecules that regulate anti-tumour immunity

The balance evaluation systems test (BESTest), mini-BESTest and brief-BESTest as clinical tools to assess balance control across different populations: A reliability generalization meta-analysis

Background The Balance Evaluation Systems Test (BESTest) and two abbreviated versions, Mini-BESTest and Brief-BESTest are used to assess functioning of balance control systems. Its reliability across different populations remains to be determined. Objective The present study followed reliability generalization procedures to estimate an average internal consistency and inter and intra-rater reliability for the BESTest, Mini-BESTest and Brief-BEStest. In this study, the heterogeneity of reliability coefficients in each instrument is evaluated. If heterogeneity is significant, a moderator analysis is performed to identify the characteristic which explains such variability. Methods A search of the PubMed, Embase, PsycINFO, Web of Science, Scopus and CINAHL databases was carried out to February 10th 2024. Two reviewers independently selected empirical studies published in English or Spanish that applied the BESTest, Mini-BESTest and/or Brief-BESTest and reported any reliability coefficient and/or internal consistency with data at hand. Results Sixty-four studies reported any reliability estimate BESTest, Mini-BESTest and/or Brief-BESTest scores (N. = 5225 participants). Mean Cronbach alpha for the Mini-BESTest and Brief-BESTest (total score = 0.92) indicating no variability in estimated internal consistency. Likewise, no variability was obtained for inter-rater and intra-rater mean agreement of the BESTest (ICC = 0.97; 0.94), Mini-BESTest (ICC = 0.95; 0.94) and Brief-BESTest (ICC = 0.96; 0.95). Mean scores, standard deviation of scores, mean age, gender, population type, mean history of the disorder, disease, raters´ experience, number of raters, rater formation, continent of study and design type presented statistically significant relationships with ICC and/or Cronbach´s alpha for BESTest and the two abbreviated versions. Conclusions The mean intraclass correlations and Cronbach alpha obtained for BESTest, Mini-BESTest and Brief-BESTest exhibited an excellent inter and intra-rater reliability and internal consistency. The average reliability obtained three scales adequate to be applied for screening balance problems in different populations. Some continuous and categorical moderator variables increase reliability and internal consistency of these scales.

Medical School Grading — Is “Good Enough” Good Enough?

Take Nature’s poll: How will Trump’s policies affect US science?

Effects of the Family Nurse Partnership on all eligible mothers: a data linkage cohort study in England

Background An intensive programme of home visiting, the Family Nurse Partnership (FNP), is received by around one in four first-time adolescent mothers in selected areas in England. During home visits, nurses support mothers to make choices about healthy pregnancies, improving child development, and fulfilling their own aspirations and ambitions. Evidence is needed of the wider effects of the FNP, including for mothers not enrolled in the programme (who might experience unintended effects). We evaluated child and maternal outcomes for all eligible mothers giving birth before, during, and after the period in which FNP was active in local areas. Methods We created a linked cohort of 237,185 eligible mothers, aged 13-19, who gave birth between April 2010 and March 2019, and who had a first antenatal booking appointment (or a date of 28 completed weeks of gestation, if missing) when FNP was active in their area. We used administrative hospital data to identify unplanned maternal/child hospitalisations up to 2 years after birth for children born and mothers delivering before, during and after FNP was active. Generalised linear models were used to adjust for background regional time trends, maternal characteristics, and clustering of outcomes within residential areas. Results We found no evidence of differences in unplanned hospital admissions for children born during the FNP period (36.9% versus 36.0%, relative risk [RR] 1.01; 95% CI 0.99-1.02), or after FNP was active (37.1%, RR 1.0; 95% CI 0.95-1.06), compared with those born before FNP was active. There was no evidence of differences in child admissions for maltreatment/injury-related diagnoses or for maternal admissions for adversity-related diagnoses. Conclusion Child and maternal outcomes were similar before, during and after FNP active periods, suggesting that the FNP did not have a wider impact on outcomes in all eligible mothers, including those not participating in the FNP.

Left Atrial Appendage Closure after Ablation for Atrial Fibrillation

Potential of saccharomyces cerevisiae fermentation-derived postbiotic technology in mitigating multiple drug-resistant Salmonella enterica serovars in an in vitro broiler cecal model

Diamond V Original XPC® is a Saccharomyces cerevisiae fermentation-derived postbiotic technology (SCFP) designed to interact synergistically with the animal to provide health benefits by enhancing immune function, supporting digestive integrity and absorption, and maintaining gastrointestinal (GIT) microbial balance in the host. The current study investigated the effects of 1.25% SCFP on multidrug-resistant (MDR) Salmonella serovars: S. Typhimurium (ATCC 14028), S. Enteritidis, S. Infantis, S. Heidelberg, S. Typhimurium DT104, and S. Reading, and shifts in cecal microbiota populations. Using an anaerobic in vitro poultry cecal model, cecal contents were inoculated with ~ 108 colony forming units (CFU) of MDR Salmonella serovars and incubated for 24 h at 37°C anaerobically. The treatments included: control group consisting of 0.2 g of crushed poultry feed, and a treatment group 0.25 g of feed +  1.25% inclusion of Original XPC® (SCFP). The SCFP significantly reduced five of the six serovars: S. Typhimurium ATCC, S. Enteritidis, S. Infantis, S. Heidelberg, and S. Reading (P <  0.05). Time significantly impacted S. Typhimurium DT104 reduction (P <  0.001). The most significant decrease was observed for S. Enteritidis (3.9 log10 CFU/mL), followed by S. Heidelberg (3.8 log10 CFU/mL), S. Infantis (3.4 log10 CFU/mL), S. Typhimurium ATCC (3 log10 CFU/mL), and S. Reading (1.8 log10 CFU/mL) compared to controls that averaged approximately 1 log10 CFU/mL reduction. Microbiota analysis at 24 h involved genomic DNA extraction, amplification using custom dual-indexed primers, and sequencing on the Illumina MiSeq platform. Sequencing data were analyzed using QIIME2-2021.11. S. Infantis and S. Heidelberg inoculated samples were the only groups that significantly enhanced microbial richness and evenness with SCFP addition at 24 h (P <  0.05). Pairwise comparisons revealed that samples inoculated with S. Reading and S. Typhimurium DT104 exhibited a minor change in microbial composition with SCFP, compared to other serovars that demonstrated increased microbial diversity with SCFP. Additionally, S. Infantis and S. Heidelberg inoculated samples exhibited phylogenetic diversity and microbial abundance with SCFP compared to controls at 24 h (P <  0.05). Lachnospiraceae CHKCI001 was significantly more abundant in SCFP-treated samples compared to controls (ANCOM, P <  0.05), suggesting SCFP impact on cecal fermenters and production of fermentation end products that may impact the ecosystem and inhibit pathogen growth. Although various serovars may exhibit somewhat different responses, SCFP effectively mitigated multiple MDR serovars of Salmonella under in vitro incubation conditions.

NEJM at AHA — Left Atrial Appendage Closure after Ablation for Atrial Fibrillation

Exclusive: Trump White House directs NIH to study ‘regret’ after transgender people transition

Strengths, weaknesses, opportunities and threats of mobile applications in undergraduate nursing: a scoping review protocol

Aim To describe the protocol for a scoping review on the main strengths, weaknesses, opportunities and threats of mobile applications in undergraduate nursing. Background Some studies have shown that mobile applications have been objects of increasing interest in nursing education. Although these technologies offer potential benefits to the educational process, their implementation and use are not always without challenges and implications. In this sense, the SWOT analysis will be used to summarize the strengths, weaknesses, opportunities and threats of those technologies. Design Scoping review protocol, conducted in accordance with JBI guidelines. Method This is a protocol for a scoping review to be carried out following the JBI guidelines, in three phases and in the following data sources: Nursing Database, Latin American and Caribbean Literature in Health Sciences, Medical Literature Analysis and Retrieval System Online, Scopus, Web of Science and ScienceDirect, later, Google Scholar and, finally, in the references of the primarily collected studies. The inclusion criteria are studies that addressed the topic of mobile applications in Nursing teaching, available in full, free of charge and without time or language cut-off. The exclusion criteria are studies that did not address the topic, opinion articles, letters to the editor and editorials. The results will be presented through tables and a SWOT chart, with the study variables. Expected Results The results will cover the characterization of the sample studies, followed by a SWOT chart containing the main strengths, weaknesses, opportunities and threats of mobile applications in undergraduate nursing. Conclusion The SWOT analysis will identify strengths and weaknesses, promote self-knowledge and strategies for mobile applications in undergraduate nursing. It can also assist in decision-making, communication with partners and publication, improving scientific research.

Alteplase for Posterior Circulation Ischemic Stroke at 4.5 to 24 Hours

The conserved HIV-1 spacer peptide 2 triggers matrix lattice maturation

Abstract The virus particles of human immunodeficiency virus type 1 (HIV-1) are released in an immature, non-infectious form. Proteolytic cleavage of the main structural polyprotein Gag into functional domains induces rearrangement into mature, infectious virions. In immature virus particles, the Gag membrane-binding domain, MA, forms a hexameric protein lattice that undergoes structural transition, following cleavage, into a distinct, mature MA lattice 1 . The mechanism of MA lattice maturation is unknown. Here we show that released spacer peptide 2 (SP2), a conserved peptide of unknown function situated about 300 residues downstream of MA, binds MA to induce structural maturation. By high-resolution in-virus structure determination of MA, we show that MA does not bind lipid into a side pocket as previously thought 1 , but instead binds SP2 as an integral part of the protein–protein interfaces that stabilize the mature lattice. Analysis of Gag cleavage site mutants showed that SP2 release is required for MA maturation, and we demonstrate that SP2 is sufficient to induce maturation of purified MA on lipid monolayers in vitro. SP2-triggered MA maturation correlated with faster fusion of virus with target cells. Our results reveal a new, unexpected interaction between two HIV-1 components, provide a high-resolution structure of mature MA, establish the trigger of MA structural maturation and assign function to the SP2 peptide.

Telemedicine interventions for improving antibiotic stewardship and prescribing: A systematic review

The global antibiotic resistance crisis necessitates optimized stewardship programs, with telemedicine emerging as a promising delivery strategy. This systematic review evaluated the effectiveness of telemedicine interventions in improving antibiotic stewardship across clinical settings. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we systematically searched seven databases from January 2010 to July 2024. Two independent reviewers assessed studies using Risk of Bias in Non-randomized Studies (ROBINS-I) and Cochrane Risk of Bias 2.0 tools, with evidence certainty evaluated using Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Twenty-one studies met inclusion criteria (10 observational, 8 quasi-experimental, 2 Randomized Controlled Trials [RCTs], 1 mixed-methods), predominantly from the United States (57.0%, n = 12). Among studies reporting antibiotic use outcomes (52.4%, n = 11), 90.9% demonstrated significant reductions ranging from 5.3% to 62.7%, with the highest-quality evidence showing a 28% reduction (95% Confidence Interval [CI]: 22-34%). Guideline adherence studies (57.1%, n = 12) showed acceptance rates of 67.7% to 98%, with comparable effectiveness between telemedicine and in-person consultation (79.1% vs 80.4%, p = 0.36). Prescribing rate outcomes (38.1%, n = 8) revealed setting-dependent variations: inpatient implementations demonstrated significant reductions (Relative Risk [RR] 0.68; 95% CI: 0.63-0.75), while outpatient findings showed mixed results. Quality assessment revealed predominantly low risk of bias [ROB] (66.7%, n = 14). These findings suggest that telemedicine effectively improves antibiotic stewardship compared to traditional care models, particularly in hospital settings, while outpatient applications demonstrated variable effectiveness. This review was registered with the International Prospective Register of Systematic Reviews (PROSPERO: CRD42023454663).

NEJM Outbreaks Update — H5N1: A View from the States

A novel use of Stereo Baited Remote Underwater Video and Drop-Down Video for biodiversity and marine landscape mapping and prediction

To make the best-informed decisions on managing marine resources whilst also restoring biodiversity, the creation and analysis of benthic maps is highly valuable. This study focuses on benthic mapping to study patch - and landscape - level processes affecting epifauna and demersal species using Stereo Baited Remote Underwater Video (SBRUV) and Drop-Down Video (DDV) surveys. Surveys were conducted within the South Arran Marine Protected Area between 2013–2019 and yielded 554 SBRUV data points and 333 DDV data points. These data were processed to determine proportional coverage of substrata and kriged to produce benthic maps. From this it was possible to estimate the patch scale of substrata to gain a more detailed understanding of the marine landscape, composition structure, and epibenthic biodiversity. The resulting validated maps allowed the number of substrata patches and patch characteristics such as area and perimeter-to-area ratio to be calculated to support management and understanding of the value of this seascapes for benthic and demersal biodiversity. Our approach allowed for the identification of areas of higher biodiversity that may assist during mapping of Marine Protected Areas’ (MPA) vulnerable features. These methods should provide better information about site condition and ecosystem service provision than existing methods.

Twice-Yearly Lenacapavir for HIV Prevention in Men and Gender-Diverse Persons

Mendelian randomization study showed no causality between metformin treatment and polycystic ovary syndrome

Background Despite previous clinical studies providing some evidence of an association between metformin treatment and polycystic ovary syndrome(PCOS), these findings remain controversial. To investigate whether the association reflect causality, a two-sample Mendelian randomization (MR) method was conducted. Methods Data from genome-wide association studies were analyzed, with the exposure factor being metformin and the outcome variable being PCOS. The inverse variance weighted(IVW) was used as the primary method for MR analysis. In addition, MR–Egger, weighted median, heterogeneity tests, and sensitivity analyses were performed. Results The initial and validation MR analyses indicated that genetically predicted metformin treatment had no effects on PCOS. Sensitivity analyses provided additional confirmation of the reliability of the MR results. Conclusions Our two-sample MR analysis did not find genetic evidence supporting a significant association between metformin treatment and PCOS.

The Genetic Architecture of Congenital Diarrhea and Enteropathy

Machine learning for automated electrical penetration graph analysis of aphid feeding behavior: Accelerating research on insect-plant interactions

The electrical penetration graph (EPG) is a well-known technique that provides insights into the feeding behavior of insects with piercing-sucking mouthparts, mostly hemipterans. Since its inception in the 1960s, EPG has become indispensable in studying plant-insect interactions, revealing critical information about host plant selection, plant resistance, virus transmission, and responses to environmental factors. By integrating the plant and insect into an electrical circuit, EPG allows researchers to identify specific feeding behaviors based on their distinctive waveform patterns. However, the traditional manual analysis of EPG waveform data is time-consuming and labor-intensive, limiting research throughput. This study presents a novel Machine Learning (ML) approach to automate the annotation of EPG signals. We rigorously evaluated six diverse ML models, including neural networks, tree-based models, and logistic regression, using an extensive dataset from multiple aphid feeding experiments. Our results demonstrate that a Residual Network (ResNet) architecture achieved the highest overall waveform classification accuracy of 96.8% and highest segmentation overlap rate of 84.4%, highlighting the potential of ML for accurate and efficient EPG analysis. This automated approach promises to accelerate research in this field significantly and broaden insights into insect-plant interactions, showcasing the power of computational techniques for insect biological research. The source code for all experiments conducted within this study is publicly available at https://github.com/HySonLab/ML4Insects.

Working at Cross-PURPOSEs to Ending HIV