Search Results (133)

Background/Objectives: Conventional blood collection can be challenging in a non-clinical or home-based setting. In response, vacuum-assisted lancing devices for capillary blood collection (typically from the upper arm) have gained popularity to broaden access to diagnostic testing. However, these devices are often costly relative to the reimbursement rate for common laboratory testing panels. This study describes the design and evaluation of Comfort Draw™, a simplified and economical vacuum-assisted capillary blood collection device. Methods: Comfort Draw™ was evaluated by 12 participants in a preliminary study and by 42 participants in a follow-up study. Metrics assessed included the following: vacuum pressure of the device, skin temperature generated by the Comfort Draw prep warmer, blood collection volume, and analytical accuracy (for 19 common serum-based analytes). Results: Acceptable blood volume (>400 µL) and serum volume (>100 µL) were collected by Comfort Draw in 85.5% and 95.1% of cases, respectively. Seventeen of the nineteen analytes examined were within CLIA acceptance limits compared to matched venous samples. Self-reported pain scores associated with Comfort Draw collection averaged 0.39 on a scale from 0 to 10. Conclusions: In this preliminary clinical study, Comfort Draw was found to be a valid and relatively painless method for collecting capillary blood specimens. The device’s simple design and lower cost could enable broader applications compared to more complex alternative capillary blood collection devices. Full article

There is growing interest in the use of herbicide for the silvicultural practice of tree thinning (i.e., chemical thinning or e-thinning) in New Zealand. Potential benefits of this approach include improved stability of the standing crop in high winds, and safer and lower-cost operations, particularly in steep or remote terrain. As uptake grows, tools for monitoring treatment effectiveness, particularly during the early stages of stress, will become increasingly important. This study evaluated the use of UAV-based multispectral and hyperspectral imagery to detect early herbicide-induced stress in a nine-year-old radiata pine (Pinus radiata D. Don) plantation, based on temporal changes in crown spectral signatures following treatment with metsulfuron-methyl. A staggered-treatment design was used, in which herbicide was applied to a subset of trees in six blocks over several weeks. This staggered design allowed a single UAV acquisition to capture imagery of trees at varying stages of herbicide response, with treated trees ranging from 13 to 47 days after treatment (DAT). Visual canopy assessments were carried out to validate the onset of visible symptoms. Spectral changes either preceded or coincided with the development of significant visible canopy symptoms, which started at 25 DAT. Classification models developed using narrow band hyperspectral indices (NBHI) allowed robust discrimination of treated and non-treated trees as early as 13 DAT (F1 score = 0.73), with stronger results observed at 18 DAT (F1 score = 0.78). Models that used multispectral indices were able to classify treatments with a similar accuracy from 18 DAT (F1 score = 0.78). Across both sensors, pigment-sensitive indices, particularly variants of the Photochemical Reflectance Index, consistently featured among the top predictors at all time points. These findings address a key knowledge gap by demonstrating practical, remote sensing-based solutions for monitoring and characterising herbicide-induced stress in field-grown radiata pine. The 13-to-18 DAT early detection window provides an operational baseline and a target for future research seeking to refine UAV-based detection of chemical thinning. Full article

Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory disease predominantly of the small airways and parenchyma. COPD lungs exhibit an influx of circulating innate immune cells, which, when isolated, display impaired functions, including imbalanced protease secretion. In addition to immune cells, the extracellular matrix (ECM) plays a crucial role in COPD pathology. Remodeling of the ECM can generate ECM fragments, which can be released into circulation and subsequently induce pro-inflammatory responses. COPD is a heterogeneous disease, and serological biomarkers can be used to sub-categorize COPD patients for targeted treatments and optimal recruitment in clinical trials. This study evaluated fragments of calprotectin, collagen type VI, and versican, generated by neutrophil elastase and matrix metalloproteinases (MMP-) 2 and 12, respectively, as potential biomarkers of COPD disease, severity, and endotypes. Lower plasma levels of a neoepitope marker of calprotectin, indicative of activated neutrophils (nordicCPa9-HNETM), were detected in COPD donors compared to controls. CPa9-HNE was associated with milder disease, higher degree of air-trapping, and higher serum levels of MMP-2. Deposition of CPa9-HNE levels in lung tissue revealed no differences between groups. Taken together, CPa9-HNE was found to be a potential marker of mild COPD, but further studies are warranted to validate our findings. Full article

Machupo virus (MACV), a member of the Arenaviridae family and causative agent of Bolivian hemorrhagic fever, results in lethality rates of 25–35% in humans. Mice lacking the signal transducer and activator of transcription 1 (STAT-1^−/−) have previously been shown to succumb to MACV infection within 7–8 days via the intraperitoneal route. Despite these reports, we observed partial lethality in STAT-1^−/− mice following challenge with wild-type MACV. Serial sampling studies to evaluate the temporal progression of infection and pathologic changes after challenge revealed a two-phase disease course. The first phase was characterized by viral load and pathological lesions in the spleen, liver, and kidney followed by a second, lethal phase, defined by high viral titers and inflammation in the brain and spinal cord resulting in neurological manifestations and subsequent mortality. Tissue adaptation in the brains of challenged STAT-1^−/− mice resulted in a fully lethal model in STAT-1^−/− mice (mouse-adapted; maMACV). A similar two-phase disease course was observed following maMACV challenge, but more rapid dissemination of the virus to the brain and overall pathology in this region was observed. The outcome of these studies is a lethal small rodent model of MACV that recapitulates many aspects of human disease. Full article

This retrospective review examines whether there is a difference in all-cause mortality in patients who required surgical intervention for neovascular glaucoma (NVG, N = 186) versus primary open-angle glaucoma (POAG, N = 190). Cox proportional hazard models compared mortality across three models: unadjusted, age-adjusted (Model 1), and age-, hypertension-, and diabetes-adjusted (Model 2). In all models, NVG patients who required glaucoma surgery had a higher all-cause mortality rate compared to those with POAG who underwent similar procedures: unadjusted (HR 2.22, (1.59, 3.10), p < 0.0001), Model 1 (HR 2.99, 95% CI (2.12, 4.22), p < 0.0001), and Model 2 (HR 1.88, 95% CI (1.27, 2.80), p < 0.0018). In Model 1, those with NVG due to PDR had a higher all-cause mortality rate after glaucoma surgery than those with NVG secondary to CRVO (HR 2.00, 95% CI (1.19, 3.45), p < 0.0095). Patients treated with CPC had higher all-cause mortality rates than those treated with tube shunt in all models: unadjusted (HR 1.82, 95% CI (1.33, 2.47), p < 0.0001), Model 1 (HR 1.91, 95% CI (1.40, 2.61), p < 0.0001), and Model 2 (HR 1.50, 95% CI (1.04, 2.16), p < 0.03). We observed a higher all-cause mortality rate among patients with NVG requiring glaucoma surgery compared to those with POAG requiring similar surgeries, which could suggest that NVG patients requiring glaucoma surgery had more compromised systemic health. Full article

Background: Prehabilitation is increasingly being used in patients undergoing multimodality treatment for oesophagogastric cancer (OGC). Most studies to date have been small, single-centre trials. This collaborative study sought to assess the overall impact of prehabilitation on patient outcomes following OGC surgery. Methods: Data came from four prospective prehabilitation trials conducted in the UK or Ireland in patients undergoing multimodality treatment for OGC. The studies included three randomised and one non-randomised clinical trial, each comparing a prehabilitation intervention group to controls. The prehabilitation interventions included aerobic training delivered by exercise physiologists alongside dietetic input throughout the treatment pathway. The primary outcome was survival (all-cause and disease-specific mortality). Secondary outcomes were differences in complications, cardio-respiratory fitness (changes in VO_{2 peak} and anaerobic threshold (AT)), chemotherapy completion rates, hospital length of stay, changes in body mass index, tumour regression and complication rates of anastomotic leak and pneumonia. Cox and logistic regression analysis provided hazard ratios (HR) and odds ratios (OR), respectively, with 95% confidence intervals (CI), adjusted for confounders. Results: Among 165 patients included, 88 patients were in the prehabilitation group and 77 patients were in the control group. All-cause and disease-specific mortality were not improved by prehabilitation (HR 0.67 95% CI 0.21–2.12 and HR 0.82 95% CI 0.42–1.57, respectively). The prehabilitation group experienced fewer major complications (20% vs. 36%, p = 0.034; adjusted OR of 0.54; 95%CI 0.26–1.13). There was a mitigated decline in VO_2 peak following neo-adjuvant therapy (delta prehabilitation −1.07 mL/kg/min vs. control −2.74 mL/kg/min; p = 0.035) and chemotherapy completion rates were significantly higher following prehabilitation (90% vs. 73%; p = 0.016). Hospital length of stay (10 vs. 12 days, p = 0.402) and neoadjuvant chemotherapy response (Mandard 1–3 41% vs. 35%; p = 0.494) favoured prehabilitation, albeit not statistically significantly. Conclusion: Despite some limitations in terms of heterogeneity of study methodology, this study suggests a number of meaningful clinical benefits from prehabilitation before surgery for OGC patients. Current initiatives to agree on national standards for delivering prehabilitation and the results of ongoing trials will help to further refine this important intervention and expand the evidence base to support the widespread adoption and implementation of prehabilitation programs. Full article

Mesenchymal stromal cells (MSCs) have been under clinical investigation for the treatment of cerebral palsy (CP) for over a decade. However, the field has been limited by study heterogeneity and variable reports of efficacy. We conducted a scoping review of published and registered reports of MSC treatment for CP, with meta-analysis of Gross Motor Function Measure (GMFM) outcomes to summarize research and provide future recommendations. Thirty published reports and 10 registered trials were identified, including 1292 people with CP receiving MSCs. Most received ≥2 doses (72%) of umbilical cord tissue MSCs (75%), intrathecally (40%) or intravenously (38%), and 31% were treated via compassionate/Expanded access. MSC treatment was safe and meta-analyses demonstrated that MSCs conferred significant improvements in GMFM at 3 − (1.05 (0.19–1.92), p = 0.02), 6 − (0.97 (0.30–1.64), p = 0.005) and 12 months (0.99 (0.30–1.67), p = 0.005) post-treatment. Whilst MSCs are safe and improve GMFM outcomes in CP with large effect sizes, study and participant variability continues to confound data interpretation and limits subgroup analyses. With no published Phase 3 trials and high rates of compassionate access, the field would benefit from well-designed trials with unified outcomes. Additionally, data sharing to enable Individual Participant Data Meta-Analysis would support the determination of optimal source, route and dose to progress towards regulatory approval. Full article

Laparoscopic lens fogging and contamination pose significant challenges, leading to a reduced surgical field of view. Intraoperative cleaning to address these issues extends the surgical duration and elevates the risk of surgical site infections. The authors propose that a hydrophilic diamond-like carbon (DLC) coating would effectively mitigate fogging and fouling, thereby eliminating the requirement for intraoperative cleaning, while the scratch-resistant nature of DLC would provide additional benefits. The present study investigates the efficacy of aluminum oxide (Al₂O₃) as a dopant in diamond-like carbon (DLC) films for antifogging applications. The authors hypothesized that adding oxygen to the DLC matrix would increase surface energy by increased hydrogen bonding, resulting in a highly hydrophilic coating. Varying dopant concentrations were tested to observe their effects on hydrophilicity, transparency, biocompatibility, and wear properties. The doped films displayed a notable improvement in transparency throughout the visible spectrum. Plasma-cleaned samples demonstrated a substantial reduction in contact angles, achieving values less than 8°. The biocompatibility of these films was analyzed with CellTiter-Glo assays; the films demonstrated statistically similar levels of cell viability when compared to the control media. The absence of adenosine triphosphate released by blood platelets in contact with the DLC coatings suggests in vivo hemocompatibility. These films, characterized by high transparency, biocompatibility, and biostability, could be valuable for biomedical applications necessitating transparent coatings. Full article

Background: Pancreatoduodenectomy with venous resection (PDVR) may be performed to achieve tumour clearance in patients with a pancreatic ductal adenocarcinoma (PDAC) with venous involvement. This study aimed to evaluate the impact of PDVR on PDAC outcomes. Methods: In total, 435 PDAC patients with either R0 status (n = 322) or R1 status within the superior mesenteric vein groove (n = 113) were extracted from the Recurrence After Whipple’s (RAW) study dataset. PDVR patients were matched in a 1:2 ratio with standard PD patients. Comparisons were then made between the two groups (surgical radicality and survival). Results: A total of 81 PDVRs were matched with 162 PDs. Neoadjuvant chemotherapy (5.7% vs. 13.6%, p = 0.032) and R1 resection rates (17.9% vs. 42%, p < 0.001) were higher in the PDVR group. Risk factors for R1 resection included venous resection (p < 0.001 for sleeve and p = 0.034 for segmental resection), pT3 (p = 0.007), and pN1 stage (p = 0.045). PDVR patients had lower median overall survival (OS, 21 vs. 30 months (m), p = 0.023) and disease-free survival (DFS, 17 m vs. 24 m, p = 0.043). Among PDVR patients, R status did not impact on OS (R0: 23 m, R1: 21 m, p = 0.928) or DFS (R0: 18 m, R1: 17 m, p = 0.558). Irrespective of R status, systemic recurrence was higher in the PDVR group (p = 0.034). Conclusions: Independent of R status, the PDVR group had lower overall survival and higher systemic recurrence rates. Full article

Determining the presence and abundance of uranium mineralization at legacy mine sites is important both for responsible environmental management and potential resource recovery. Technologies that can make such determinations quickly and at low costs are highly desirable. The current work focuses on demonstrating the use of simple handheld commercial-off-the-shelf (COTS) devices for rapidly determining the presence and distribution of uranyl minerals within an abandoned copper–uranium mine. Specifically, this work demonstrates the use of a COTS iPhone 13 Pro smartphone with an inbuilt solid-state LiDAR (laser) scanner in combination with a handheld LED-based UV torch to conduct a rapid fluorescence imaging photogrammetry survey aimed at rapidly determining the distribution of uranyl minerals within an abandoned copper–uranium mine in the Sierra Ancha Wilderness Area, Gila County, Arizona, USA. Such a simple methodology, presented herein, can be used to quickly determine the distribution of uranyl minerals on exposed surfaces within the underground workings and provide an indication of the presence of primary uranium ore minerals buried within the surrounding rock. Full article

The rapid advancement of artificial intelligence (AI) technologies has transformed various sectors, significantly enhancing processes and augmenting human capabilities. However, these advancements have also introduced critical concerns related to the safety, ethics, and responsibility of AI systems. To address these challenges, the principles of the robustness, interpretability, controllability, and ethical alignment framework are essential. This paper explores the integration of metacognition—defined as “thinking about thinking”—into AI systems as a promising approach to meeting these requirements. Metacognition enables AI systems to monitor, control, and regulate the system’s cognitive processes, thereby enhancing their ability to self-assess, correct errors, and adapt to changing environments. By embedding metacognitive processes within AI, this paper proposes a framework that enhances the transparency, accountability, and adaptability of AI systems, fostering trust and mitigating risks associated with autonomous decision-making. Additionally, the paper examines the current state of AI safety and responsibility, discusses the applicability of metacognition to AI, and outlines a mathematical framework for incorporating metacognitive strategies into active learning processes. The findings aim to contribute to the development of safe, responsible, and ethically aligned AI systems. Full article

Rhizomes, key carbon sequestration sinks in perennial crops, are hypothesized to exhibit a trade-off with grain yield. This study evaluated rhizomatous grain sorghum populations for increasing carbon sequestration potential. Twelve F_3:4 heterogeneous inbred families (HIFs) from a Sorghum bicolor (L.) Moench × Sorghum propinquum (Kunth) Hitchc cross were tested in a greenhouse, and two F_4:5 HIF progenies were field tested. Traits measured included rhizome biomass, root biomass, total belowground biomass, and grain yield. Rhizome biomass showed high heritability (0.723) and correlated strongly with belowground biomass (r₁ = 0.95; r₂ = 0.97) in both F_4:5 HIFs, suggesting the potential of rhizomes to sequester carbon. Contrary to the hypothesized trade-off, a positive relationship between rhizome biomass and grain yield was observed, potentially via rhizome-derived shoots, and individual plants pyramiding high rhizome biomass, biomass yield, and grain yield were also identified. Using bulked segregant analysis (BSA), twenty simple sequence repeat (SSR) markers linked to eight genomic regions associated with rhizome presence were identified, with five regions potentially being novel. This study suggests that breeding rhizomatous grain sorghum with high rhizome biomass could enhance carbon sequestration while preserving agronomic yields, offering new insights for future breeding and mapping initiatives. Full article

Endometrial cancer (EC) is a growing public health concern. This secondary data study of a case series leveraged existing samples and data to explore the potential link between exposure to heavy metals/essential elements and stage of EC. We analyzed urine samples from women with EC, measuring levels of toxic metals (cadmium, mercury, and lead) and essential elements (zinc and copper). Our findings revealed that higher levels of mercury, cadmium, and lead are associated with more advanced EC stages. Conversely, zinc showed a protective effect, potentially mitigating EC stage progression. Copper levels did not show a clear association with EC stage. These results highlight the potential impact of environmental exposures on EC stage and the crucial need for advanced statistical methods to understand the combined effects of these pollutants on health and the need for public health interventions. Further research is needed to explore the mechanisms by which these metals influence EC stage and long-term outcomes. Full article

Background/Objectives: Few studies have assessed barriers to providing care from the perspective of interprofessional healthcare providers. Despite Idaho’s predominantly rural geography, limited research exists assessing barriers to providing care within the state. This study sought to assess barriers to providing optimal healthcare using a sample of 400 healthcare providers at 22 clinic sites across the state. Methods: A barriers to providing optimal care 9-factor, 41-item survey was modified from an existing survey. Healthcare providers rated barrier items using an 11-point Likert scale. The survey was distributed to a convenience sample of healthcare providers in 22 different clinic sites in rural Idaho. Results: Four hundred interprofessional healthcare providers in Idaho across 13 professional disciplines completed surveys. Items in the Service Access (mean = 7.14), Patient Complexity (mean = 6.59), and Resource Limitations (mean = 6.18) factors were reported as the most commonly perceived barriers to providing optimal care. Conclusions: Few studies have assessed rural interprofessional providers’ perceived barriers to providing optimal, high-quality, care, specifically in the rural state of Idaho, where healthcare services are often not equitable compared to urban regions. The results suggest that commonly perceived barriers exist throughout the state, particularly Service Access, Patient Complexity, and Resource Limitations. Further research is needed to develop data-driven decisions to address these concerns. Full article

Global climate variability is projected to result in more frequent and severe droughts, which can have adverse effects on New Zealand’s endemic tree species such as the iconic kauri (Agathis australis). Several studies have investigated the physiological response of kauri to medium- and long-term water stress; however, no research has used hyperspectral technology for the early detection and characterization of water stress in this species. In this study, physiological (stomatal conductance (g_s), assimilation rate (A), equivalent water thickness (EWT)) and leaf-level hyperspectral measurements were recorded over a ten-week period on 100 potted kauri seedlings subjected to control (well-watered) and drought treatments. In addition, plant functional traits (PTs) were retrieved from spectral reflectance data via inversion of the PROSPECT-D radiative transfer model. These data were used to (i) identify key PTs and narrow-band hyperspectral indices (NBHIs) associated with the expression of water stress and (ii) develop classification models based on single-date and multitemporal datasets for the early detection of water stress. A significant decline in soil water content and physiological responses (g_s and A) occurred among the trees in the drought treatment in weeks 2 and 4, respectively. Although no significant treatment differences (p > 0.05) were observed in EWT across the whole duration of the experiment, lower mean values in the drought treatment were apparent from week 4 onwards. In contrast, several spectral bands and NBHIs exhibited significant differences the week after water was withheld. The number and category of significant NBHIs varied up to week 4, after which a substantial increase in the number of significant indices was observed until week 10. However, despite this increase, the single-date models did not show good model performance (F1 score > 0.70) until weeks 9 and 10. In contrast, when multitemporal datasets were used, the classification performance ranged from good to outstanding from weeks 2 to 10. This improvement was largely due to the enhanced temporal and feature representation in the multitemporal models. Among the input NBHIs, water indices emerged as the most important predictors, followed by photochemical indices. Furthermore, a comparison of inverted and measured EWT showed good correspondence (mean absolute percentage error (MAPE) = 8.49%, root mean squared error (RMSE) = 0.0026 g/cm²), highlighting the potential use of radiative transfer modelling for high-throughput drought monitoring. Future research is recommended to scale these measurements to the canopy level, which could prove valuable in detecting and characterizing drought stress at a larger scale. Full article