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Comprehensive investigation of matrix metalloproteinases in skin cutaneous melanoma: diagnostic, prognostic, and therapeutic insights

Development and validation of an interpretable machine learning model for predicting left atrial thrombus or spontaneous echo contrast in non-valvular atrial fibrillation patients

Purpose Left atrial thrombus or spontaneous echo contrast (LAT/SEC) are widely recognized as significant contributors to cardiogenic embolism in non-valvular atrial fibrillation (NVAF). This study aimed to construct and validate an interpretable predictive model of LAT/SEC risk in NVAF patients using machine learning (ML) methods. Methods Electronic medical records (EMR) data of consecutive NVAF patients scheduled for catheter ablation at the First Hospital of Jilin University from October 1, 2022, to February 1, 2024, were analyzed. A retrospective study of 1,222 NVAF patients was conducted. Nine ML algorithms combined with demographic, clinical, and laboratory data were applied to develop prediction models for LAT/SEC in NVAF patients. Feature selection was performed using the least absolute shrinkage and selection operator (LASSO) and multivariate logistic regression. Multiple ML classification models were integrated to identify the optimal model, and Shapley Additive exPlanations (SHAP) interpretation was utilized for personalized risk assessment. Diagnostic performances of the optimal model and the CHA2DS2-VASc scoring system for predicting LAT/SEC risk in NVAF were compared. Results Among 1,078 patients included, the incidence of LAT/SEC was 10.02%. Six independent predictors, including age, non-paroxysmal AF, diabetes, ischemic stroke or thromboembolism (IS/TE), hyperuricemia, and left atrial diameter (LAD), were identified as the most valuable features. The logistic classification model exhibited the best performance with an area under the receiver operating characteristic curve (AUC) of 0.850, accuracy of 0.812, sensitivity of 0.818, and specificity of 0.780 in the test set. SHAP analysis revealed the contribution of explanatory variables to the model and their relationship with LAT/SEC occurrence. The logistic regression model significantly outperformed the CHA2DS2-VASc scoring system, with AUCs of 0.831 and 0.650, respectively (Z = 7.175, P < 0.001). Conclusions ML proves to be a reliable tool for predicting LAT/SEC risk in NVAF patients. The constructed logistic regression model, along with SHAP interpretation, may serve as a clinically useful tool for identifying high-risk NVAF patients. This enables targeted diagnostic evaluations and the development of personalized treatment strategies based on the findings.

Implication of tumor morphology and MRI characteristics on the accuracy of automated versus human segmentation of GBM areas

Cosmic carnage: planetary rubble spotted at a dying star

Attributes and factors associated with long covid in patients hospitalized for acute COVID-19: A retrospective cohort study

Background It is now recognized that many patients have persistent symptoms after recovery from acute COVID-19 infection, an infection caused by the coronavirus SARS-CoV-2. This constellation of symptoms known as ‘Long COVID’ may manifest with a wide range of physical and cognitive/psychological symptoms. Few data are available on the prevalence, attributes, and factors associated with Long COVID in Africa. Method This was a retrospective review of patients’ electronic medical records from Hallelujah General Hospital (one of the first private hospitals to treat COVID-19 patients). The hospital’s database was searched for patients hospitalized for acute COVID-19 infection from March 2020 to December 2022. Two hundred and forty-seven participants who underwent follow-up beginning four weeks after symptom onset were assessed for Long COVID. Admission and follow-up data were collected using Kobo Toolbox and exported into SPSS 27 for analysis. The relationship between the independent and dependent variables was explored through binary logistic regression. Results One hundred seventy-eight (72.1%) participants had at least one persisting symptom 4 weeks post-symptom onset, at a median follow-up time of 35 (IQR 32–40) days. The most frequently reported symptoms were fatigue (41.7%), shortness of breath (31.2%), cough (27.1%), and sleep disturbances (15%). Duration of symptoms more than 7 days before admission [aOR = 1.97; CI95% = 1.04 to 3.75; P = 0.038] and length of stay more than 10 days in the hospital [aOR = 2.62; CI95% = 1.20 to 5.72; P = 0.016] were found to be significantly associated with Long COVID. Conclusion There is a high prevalence of Long COVID among patients hospitalized for acute COVID-19. Those who had a longer duration of symptoms before admission and a longer stay in the hospital appear to have a higher risk.

Physiopathological effects of entrance versus distal spread-out Bragg peak on mouse spinal cord neurons

Proximity ferroelectricity in wurtzite heterostructures

Experienced cognitive load in the emergency department. A prospective study

Background and importance The emergency department (ED) is a hectic place, where many critically ill patients are treated. For residents working in the ED, this environment may be demanding. Objectives The aim of this study was to investigate the [1] cognitive load experienced by residents working in the ED, and [2] differences in cognitive load during the day. Methods In this multicentre, prospective study in three EDs in the Netherlands, the experienced cognitive load was graded by residents on three scales, agreed upon during Delphi meetings: the complexity (low-high: 1–3), mental effort (low-high: 1–9) and comfortability scale (low-high: 0–100%). We applied the scores per decision, 1-hour and 2-hour intervals, patient and shift. Main results We observed 14 residents and analysed 74 1-hour and 45 2-hour intervals, 79 patients, 24 shifts and 592 separate decisions. The experienced cognitive load per decision was low. In contrast, the cognitive load was higher per 2-hour interval (mental effort: median 4.0 (IQR 4.0) and comfortability 80% (IQR 20)) and per shift (mental effort: median 5.5 (IQR 4.0) and comfortability 80% (IQR 20). Complexity was low for all measurements. Mental effort rose from 17h onwards higher values, whereas a decrease in comfortability was seen from 21h onwards. Conclusion From 17h onwards, residents working in the ED experienced rather high mental effort and reported feeling not optimally comfortable when making decisions. The mental effort was highest between 21-23h. This was found when cognitive load was measured per 2-hour interval and per shift, but not per decision. This study may provide an insights to optimise cognitive load by reorganisation of the ED.

Construction of cuproptosis-related genes risk model predicts the prognosis of Uterine Corpus Endometrial Carcinoma

Calcium phosphate formation and deposition in ischemic neurons

Ischemic stroke causes acute brain calcium phosphate (CaP) deposition, a process involving primarily the injured neurons. Whereas the adverse impact of CaP deposition on the brain structure and function has been recognized, the underlying mechanisms remain poorly understood. This investigation demonstrated that the neuron-expressed, plasma membrane-associated Ca2+-binding proteins annexin (Anx) A2, AnxA5, AnxA6, and AnxA7 contributed to neuronal CaP deposition in the mouse model of ischemic stroke. These Anxs were released from the degraded plasma membrane of the ischemic neurons and were able to form Anx/CaP complexes, a nanostructure capable of binding to the β actin filaments via Anx–actin interaction to cause neuronal CaP deposition prior to brain infarction. Anx administration to the healthy mouse brain caused brain CaP deposition and infarction. Monomeric β actin was able to block competitively Anx binding to β actin filaments and prevent ischemic stroke- and Anx administration-induced brain CaP deposition and infarction. Administration of siRNAs specific to the four Anx mRNAs alleviated brain CaP deposition and infarction. These observations support the role of Anxs in CaP formation and deposition in ischemic neurons.

Identification of Legionella by MALDI Biotyper through three preparation methods and an in-house library comparing phylogenetic and hierarchical cluster results

Physicists describe exotic ‘paraparticles’ that defy categorization

Prevalence, predisposing factors, and turnover intention related to low back pain among health workers in Accra, Ghana

Background Globally, low back pain (LBP) is responsible for disability among 60.1 million people. Health workers face a higher likelihood of being exposed to LBP compared to employees in the construction and manufacturing sectors. Data on LBP among hospital workers in Ghana are however limited. This study examined the prevalence, predisposing factors and turnover intention related to LBP among health workers in the Greater Accra region of Ghana. Methods A multi-centred facility-based cross-sectional study was conducted in the Greater Accra region from January 30 –May 31, 2023. A multi-stage sampling technique was adopted, and the study participants were selected through proportion-to-size simple random sampling. STATA 15 software was used for analysis. Logistic regression analysis was used to determine the factors associated with LBP at a p < 0.05. Results A survey was conducted among 607 health workers in 10 public and private hospitals. The prevalence of LBP was 81.6% [95% CI: (78.2%-84.6%)]. Advanced age [AOR = 1.07 (1.00, 1.16)], working for more than 5 days in a week [AOR = 8.14 (2.65, 25.02)], working overtime [AOR = 2.00 (1.16, 3.46)], rarely involved in transferring patients [AOR = 3.22 (1.08, 9.60)], most of the time involved in transferring patients [AOR = 6.95 (2.07, 23.26)], awkward posture during work [(AOR = 2.36 (1.31, 4.25)], perceived understaffing [(AOR = 1.84 (95% CI = 1.04–3.27)], sleep duration ≥ 8 [AOR = 0.54 (0.31, 0.97)] and sitting intermittently at work [AOR = 0.31 (0.12, 0.80)] were factors significantly associated with LBP. A substantial number, 123 (24.9%), occasionally had intention of leaving their jobs. Conclusion The study revealed a high proportion of low back pain (LBP), and turnover intention attributed to LBP. Moreover, organizational and occupational factors were found to be significantly associated with LBP. These findings underscore the importance of targeted interventions aimed at reducing the burden of LBP within these specific areas.

Dynamics of SARS-CoV-2 infection over two epidemic waves in Manaus, Brazil: A serological study of seven thousand blood donors

Background Most longitudinal studies of COVID-19 incidence have used unlinked samples. The city of Manaus, Brazil, has a blood donation program which allows sample linkage, and was struck by two large COVID-19 epidemic waves between mid-2020 and early 2021. Methods We estimated the changing force of infection, i.e. incidence in susceptible individuals. Seroconversion was inferred by a mixture model for serial values from the Abbott Architect SARS-CoV-2 nucleocapsid (N) IgG assay. We estimated the number of suspected COVID-19 hospitalizations arising from each infection over calendar time. Results Whole blood donations between April 2020 and March 2021 were included from 6734 people, 2747 with two or more donations. The inferred criterion for seroconversion, and thus an incident infection, was a 6.07 fold increase in N IgG reactivity. The overall force of infection was 1.19 per person year (95% confidence interval 1.14–1.24) during the two main waves. The estimated number of suspected hospitalizations per infection, was approximately 4.1 times higher in the second wave than in the first. Conclusions Serial values from this assay can be used to infer seroconversion over time, and in Manaus show a higher number of suspected COVID-19 hospitalizations per infection in the second wave relative to the first.

From tiny to immense: Geological spotlight on the Alexander Mosaic (National Archaeological Museum of Naples, Italy) using non-invasive in situ analyses

A key challenge in the art and archaeological field is the instrumental analysis of objects and materials while preserving their integrity. In this study, the world-renowned artwork Alexander Mosaic (The Issus Battle, collection of the National Archaeological Museum of Naples, IT), the most iconic representation of the face of the Macedonian king Alexander the Great coming from a Pompeii domus, was thoroughly analyzed with mobile and non-invasive methods, within a great project of restoration started in 2020. Representative areas of the Mosaic, overall consisting of ca. two million of tesserae, was studied by in situ videomicroscopy, infrared thermography (IRT), multispectral imaging, portable X-ray fluorescence (pXRF), Fourier transform infrared (FTIR) and Raman spectroscopy. Ten tesserae colors were discriminated, and hypotheses on their geological provenances are proposed. Plasters, mineral components and other substances of old protective materials were characterized. The information obtained with this approach paved the way to knowledgeable restoration.

Ongoing measles outbreak in Romania: Clinical investigation and molecular epidemiology performed on whole genome sequences

Aim Romania is currently facing a prolonged measles outbreak. The aim of the study was to analyse the circulating human measles virus (HMV) strains by combining whole genome sequencing (WGS) with phylogenetic analysis, with a focus on the haemagglutinin gene. Methods We conducted an observational study in the first five months of 2024, in which 168 patients diagnosed with measles were randomly included. We have evaluated the clinical and epidemiological differences between children and adults. Screening for samples to be sequenced was performed with a commercial kit (PrimerDesign). WGS was done on Illumina MiSeq platform and phylogenetic analysis was performed with ML FastTree. Results No significant epidemiological and clinical differences between patients in the two age groups were identified. WGS was successfully performed for a number of 124 HMV strains. Genotype analysis indicated all the sequences as D8, except one that was B3. Phylogenetic analysis identified two well supported clusters, suggestive for at least two local transmission networks in Romania. One large transmission network (n = 108) consisted of sequences both from adults and children. Only one sequence from outside Romania (reported in Russia in 2023) clustered within this group. Another small transmission cluster was identified (14 sequences of which 11 from patients infected in the spring of 2024 and three in 2022). A few differences between the two co-circulating viral variants/clusters were observed. The median duration of hospitalisation was 2 days longer for patients in smaller cluster compared to those in the larger one (p = 0.019). Furthermore, these two clusters presented different mutation profiles in the hemagglutinin (HA) and neuraminidase (N) genes with implications for molecular surveillance. Conclusion The current measles epidemic in Romania is driven mainly by two D8 genotype variants with different mutation profiles and slightly different severity of the disease, highlighting the usefulness of sustained molecular surveillance.

Correction: Association between nutritional level, menstrual-related symptoms, and mental health in female medical students

Are men’s gender equality beliefs associated with self-reported intimate partner violence perpetration? A state-level analysis of California men

Objectives To assess the association between gender equality beliefs and self-reported intimate partner violence (IPV) perpetration among California men. Methods We analyzed men’s data (N = 3609) from three waves (2021, 2022, and 2023) of cross-sectional data from a statewide sample of California adults. We assessed gender equality beliefs using a three-item measure adapted from the World Values Survey, with higher scores representing more gender unequal beliefs (e.g., ‘On a whole, men make better political leaders than women’). We assessed IPV perpetration in the last year by asking a) whether men committed any form of violence in the last year (physical violence, use or threat of violence with a weapon, sexual violence) and b) among those who reported committing violence, who they committed violence against. Those reporting violence against “a spouse or romantic partner” were categorized as perpetrating past-year IPV. Analyses were weighted to yield population estimates. Crude and adjusted logistic regression models evaluated the association between gender equality beliefs and past-year IPV perpetration. Results Almost 2% of men–equivalent to more than 280,000 men in California—reported IPV perpetration in the past year [1.9% (95%CI = 1.4–2.5)], and every one-point increase in their gender equality belief scale score [indicative of less gender equitable beliefs] was associated with 2.1 times greater odds of perpetrating past-year IPV (AOR: 2.14, 95%CI 1.61–2.86). Conclusions Findings support prior research indicating that patriarchal beliefs reinforce men’s violence against women in relationships and signal a need for violence prevention efforts focused on boys and men to that can include normative belief shifts related to women’s capacities.

Partially unraveling mechanistic underpinning and weight loss effects of time-restricted eating across diverse adult populations: A systematic review and meta-analyses of prospective studies

Time-restricted eating (TRE) is a promising and cost-effective dietary approach for weight management. This study aimed to evaluate the effects of TRE on weight loss in three adult populations using pre- and post-intervention analyses while also investigating its underlying mechanism. A systematic search was conducted across four databases (PubMed, Web of Science, Scopus, and the CENTRAL) up until January 28, 2024, specifically focusing on prospective studies that examined the efficacy of TRE in achieving weight loss. A random effects model was employed to conduct meta-analyses, while heterogeneity was assessed using the I2 statistic (PROSPERO: CRD42023439317). The study encompassed 36 selected studies involving 44 effect sizes and 914 participants. The effectiveness of the TRE was found to vary across health conditions, with modest weight loss observed in healthy individuals (pooled effect size -1.04 Kg, 95% CI: -1.42 to -0.65) and more significant weight reduction seen in participants with chronic diseases (pooled effect size -3.33 Kg, 95% CI: -5.05 to -1.62) and overweight/obesity (pooled effect size -4.21 Kg, 95% CI: -5.23 to -3.10). The observed decrease in body weight could be partially attributed to factors influencing energy balance, as evidenced by the significantly lower mean calorie intake at the end of the intervention (1694.71 kcal/day, 95% CI: 1498.57–1890.85) compared to the baseline intake (2000.64 kcal/day, 95% CI: 1830–2172.98), despite the absence of intentional efforts to restrict energy intake by the participants. These findings support the efficacy of this lifestyle intervention for weight loss maintenance and guide the development of its clinical guidelines.

Trait and plasticity evolution under competition and mutualism in evolving pairwise yeast communities

Although we have a good understanding of how phenotypic plasticity evolves in response to abiotic environments, we know comparatively less about responses to biotic interactions. We experimentally tested how competition and mutualism affected trait and plasticity evolution of pairwise communities of genetically modified brewer’s yeast. We quantified evolutionary changes in growth rate, resource use efficiency (RUE), and their plasticity in strains evolving alone, with a competitor, and with a mutualist. Compared to their ancestors, strains evolving alone had lower RUE and RUE plasticity. There was also an evolutionary tradeoff between changes in growth rate and RUE in strains evolving alone, suggesting selection for increased growth rate at the cost of efficiency. Strains evolving with a competitive partner had higher growth rates, slightly lower RUE, and a stronger tradeoff between growth rate and efficiency. In contrast, mutualism had opposite effects on trait evolution. Strains evolving with a mutualist had slightly lower growth rates, higher RUE, and a weak evolutionary tradeoff between growth rate and RUE. Despite their different effects on trait evolution, competition and mutualism had little effect on plasticity evolution for either trait, suggesting that abiotic factors could be more important than biotic factors in generating selection for plasticity.