Search Results (104)

Various SARS-CoV-2 remdesivir resistance-associated substitutions (RAS) have been reported, but a comprehensive comparison of their resistance levels is lacking. We identified novel RAS and performed head-to-head comparisons with known RAS in Vero E6 cells. A remdesivir escape polyclonal virus exhibited a 3.6-fold increase in remdesivir EC₅₀ and mutations throughout the genome, including substitutions in nsp12 (E796D) and nsp14 (A255S). However, in reverse-genetics infectious assays, viruses harboring both these substitutions exhibited only a slight decrease in remdesivir susceptibility (1.3-fold increase in EC₅₀). The nsp12-E796D substitution did not impair viral fitness (Vero E6 cells or Syrian hamsters) and was reported in a remdesivir-treated COVID-19 patient. In replication assays, a subgenomic replicon containing nsp12-E796D+nsp14-A255S led to a 16.1-fold increase in replication under remdesivir treatment. A comparison with known RAS showed that S759A, located in the active site of nsp12, conferred the highest remdesivir resistance (106.1-fold increase in replication). Nsp12-RAS V166A/L, V792I, E796D or C799F, all adjacent to the active site, caused intermediate resistance (2.0- to 11.5-fold), whereas N198S, D484Y, or E802D, located farther from the active site, showed no resistance (≤2.0-fold). In conclusion, our classification system, correlating replication under remdesivir treatment with RAS location in nsp12, shows that most nsp12-RAS cause moderate resistance. Full article

Quantifying future changes in extreme events and associated flooding is challenging yet fundamental for stormwater managers. Along the U.S. Atlantic Coast, Eastern North Carolina (ENC) is frequently exposed to catastrophic floods from extreme rainfall that is typically associated with tropical cyclones. This study presents a novel approach that uses rainfall data from five dynamically and statistically downscaled (DD and SD) global climate models under two scenarios to visualize a potential future extent of flooding in ENC. Here, we use DD data (at 36-km grid spacing) to compute future changes in precipitation intensity–duration–frequency (PIDF) curves at the end of the 21st century. These PIDF curves are further applied to observed rainfall from Hurricane Matthew—a landfalling storm that created widespread flooding across ENC in 2016—to project versions of “Matthew 2100” that reflect changes in extreme precipitation under those scenarios. Each Matthew-2100 rainfall distribution was then used in hydrologic models (HEC-HMS and HEC-RAS) to simulate “2100” discharges and flooding extents in the Neuse River Basin (4686 km²) in ENC. The results show that DD datasets better represented historical changes in extreme rainfall than SD datasets. The projected changes in ENC rainfall (up to 112%) exceed values published for the U.S. but do not exceed historical values. The peak discharges for Matthew-2100 could increase by 23–69%, with 0.4–3 m increases in water surface elevation and 8–57% increases in flooded area. The projected increases in flooding would threaten people, ecosystems, agriculture, infrastructure, and the economy throughout ENC. Full article

Background/Objectives: Since the World Health Organization (WHO) recommended HIV self-testing as an alternative to traditional facility-based testing in 2016, it has been increasingly adopted worldwide. This study aimed to evaluate the performance of the ConfiSign HIV Self-Test (GenBody Inc., Republic of Korea), a newly developed blood-based immunochromatographic assay for the qualitative detection of total antibodies (IgG and IgM) against HIV-1/HIV-2. Methods: The evaluation included four components: (1) retrospective analysis of 1400 archived serum samples (400 HIV-positive and 1000 HIV-negative samples), (2) prospective self-testing by 335 participants (112 HIV-positive participants and 223 individuals with an unknown HIV status, including healthy volunteers), (3) assessment using seroconversion panels and diverse HIV subtypes, and (4) analytical specificity testing for cross-reactivity and interference. The Elecsys HIV combi PT and Alinity I HIV Ag/Ab Combo assays were used as reference assays. Results: In retrospective testing, the ConfiSign HIV Self-Test achieved a positive percent agreement (PPA) of 100%, a negative percent agreement (NPA) of 99.2%, and a Cohen’s kappa value of 0.986, showing excellent agreement with the reference assays. In the prospective study, the test showed 100% sensitivity and specificity, with a low invalid result rate of 1.8%. All HIV-positive samples, including those with low signal-to-cutoff (S/Co) values in the Alinity I assay, were correctly identified. The test also reliably detected early seroconversion samples and accurately identified a broad range of HIV-1 subtypes (A, B, C, D, F, G, CRF01_AE, CRF02_AG, and group O) as well as HIV-2. No cross-reactivity or interference was observed with samples that were positive for hepatitis viruses, cytomegalovirus, Epstein–Barr virus, varicella zoster virus, influenza, HTLV-1, HTLV-2, or malaria. Conclusions: The ConfiSign HIV Self-Test demonstrated excellent sensitivity, specificity, and robustness across diverse clinical samples, supporting its reliability and practicality as a self-testing option for HIV-1/2 antibody detection. Full article

Abies nephrolepis and Picea jezoensis are native Pinaceae trees distributed in high mountainous regions of Northeast Asia (typically above ~1000 m a.s.l. on the Korean peninsula, northeastern China, Sakhalin, and the Russian Far East) and southern boreal forests, vulnerable to climate change and human disturbances, necessitating accurate habitat identification for effective conservation. While protected areas (PAs) are essential, merely expanding existing ones often fail to protect populations under human pressure and climate change. Using species distribution models with current and projected climate data, we mapped potential habitats across Northeast Asia. Spatial clustering analyses integrated with PA and land cover data helped identify optimal sites and priorities for new conservation areas. Ensemble species distribution models indicated extensive suitable habitats, especially in southern Sikhote-Alin, influenced by maritime-continental climates. Specific climate variables strongly affected habitat suitability for both species. The Kamchatka peninsula consistently emerged as an optimal habitat under future climate scenarios. Our study highlights essential environmental characteristics shaping the habitats of these species, reinforcing the importance of strategically enhancing existing PAs, and establishing new ones. These insights inform proactive conservation strategies for current and future challenges, by focusing on climate refugia and future habitat stability. Full article

The galaxy NGC 7469 is a bright infrared source with an active galactic nucleus (AGN) and an intense star-forming region with a radius of approximately 500 parsecs, where the star formation rate is estimated to be 20–50 $M_{\odot }{\mathrm{yr}}^{-1}$. This study presents the results of spectral and photometric observations carried out during the period from 2020 to 2024 at the Fesenkov Astrophysical Institute (Almaty, Kazakhstan) and the Nasreddin Tusi Shamakhy Astrophysical Observatory (Shamakhy, Azerbaijan). Photometric data were obtained using B, V, and Rc filters, while spectroscopic observations covered the wavelength range of $\lambda$ 4000–7000 Å. Data reduction was performed using the IRAF and MaxIm DL Pro6 software packages. An analysis of the light curves revealed that after the 2019–2020 outburst, the luminosity level of NGC 7469 remained relatively stable until the end of 2024. In November–December 2024, an increase in brightness (∼0.3–0.5 magnitudes) was recorded. Spectral data show variations in the Ha fluxes and an enhancement of them at the end of 2024. On BPT diagrams, the emission line flux ratios [OIII]/H $\beta$ and [NII]/H $\alpha$ place NGC 7469 on the boundary between regions dominated by different ionization sources: AGN and star-forming regions. The electron density of the gas, estimated from the intensity ratios of the [SII] 6717, 6731 Ålines, is about $900–1000{\mathrm{cm}}^{-3}$. Continued observations will help to determine whether the trend of increasing brightness and emission line fluxes recorded at the end of 2024 will persist. Full article

Background/Objectives: Kyphoplasty and vertebroplasty are minimally invasive approaches for spinal fractures aiming to reduce pain, increase mobilization, and prevent further vertebral height loss. Their efficacy in treating burst fractures has been questioned due to fragment mobility and concerns for cement leakage. We aim to report outcomes in patients who underwent kyphoplasty for spinal burst fractures. Methods: We conducted a retrospective review of patients with burst fractures treated from 2018 to 2023. Those who underwent kyphoplasty or vertebroplasty and had follow-up imaging were included. Clinical characteristics and follow-up outcomes were obtained through chart review. The primary outcome was the need for surgical intervention after kyphoplasty. Results: We identified ten patients (mean age 67.9 years, range 36–93 years) with burst fractures who underwent kyphoplasty/vertebroplasty. Six received kyphoplasty/vertebroplasty within 1 week of injury and four between 1 and 4 months post-injury. Nine patients had a TLICS score of 2, and one had a TLICS score of 5. Kyphoplasty/vertebroplasty was performed for pain management in seven patients and significant/worsening vertebral height loss in three patients. At follow-up, 70% of patients reported an improvement in pain and 75% of patients reported improved mobility. One patient experienced progression of an L2 burst fracture but improved with conservative management. No patient required additional surgical fixation. Conclusions: In this series of ten patients with spinal burst fractures, standalone kyphoplasty was a safe and effective treatment. Our findings suggest kyphoplasty may be a viable treatment option for select spinal traumatic burst fractures, offering potential pain relief and mobility improvement in the short term. Full article

Background: Lung ultrasound (LUS) can be used at follow-up for patients with stable interstitial lung disease (ILD). LUS could also help guide the diagnosis of etiology for acute respiratory episodes. Methods: We conducted a prospective, one-center, observational study including patients with ILD hospitalized in the pulmonology unit or in the intensive care unit of the Tours University Hospital for acute dyspnea. LUS was performed at admission and then at a follow-up visit in the six months following discharge. We compared the number of B-lines between the two LUSs. We also compared the features of the first LUS between the different etiologies responsible for increased dyspnea. Results: Of 24 patients, 16 had acute ILD exacerbation (67%), 6 had pulmonary infections (25%) and 2 had acute heart failure (8%). LUS was feasible in all patients and always showed lung sliding, pleural irregularities and B-lines. There were pleural effusions in four cases (17%) and pulmonary consolidations in two cases (8%). Seven patients had A-lines in at least one thoracic space on the initial LUS. We found a significant decrease in the number of B-lines at follow-up (76; IQR, [59–86.75]) compared to admission (86.5; IQR, [71.5–94.5]) (p-value = 0.02). There was a trend of more A-lines in patients with infection (1 [0.25–1.75]) compared to AE-ILD (0 [0–0]). Conclusions: Following an episode of acute dyspnea in patients with ILD, LUS shows a decrease in the number of B-lines. Patients with ILD and concurrent pulmonary infection may have more A-lines than patients with AE-ILD. Full article

Objectives: CA19-9 elevation in non-gastrointestinal tumor patients may be influenced by various non-tumor factors, which poses challenges for clinical diagnosis. This study aims to assess the consistency between initial elevated CA19-9 levels detected by the ARCHITECT/Alinity i system (Abbott Diagnostics) and subsequent retesting using the Elecsys CA19-9 assay (Roche Diagnostics) in 5372 non-gastrointestinal tumor patients, and to explore potential factors contributing to CA19-9 non-specific elevation. Methods: Bland-Altman and Passing-Bablok analyses were used to assess the agreement between the two assays. Nonparametric Spearman and Pearson’s chi-square tests were used to assess the correlation between CA19-9 and different clinical comorbidities/antigen concentration strata and to compare the categorization by age/disease, respectively. Results: Bland–Altman and Passing–Bablok regression analyses revealed that the CA19-9 test results from Abbott and Roche platforms show significant systematic bias and weak correlation, making the two methods not directly interchangeable. After excluding common confounders, the study focused on heterophilic antibodies (HAs) as target. Blood samples were treated with a commercial blocking agent demonstrated alignment with baseline Elecsys CA19-9 results but differed significantly from initial ARCHITECT/Alinity i measurements. Furthermore, non-specific CA19-9 elevation was also associated with comorbidities such as diabetes mellitus, pulmonary infections, breast nodules, uterine leiomyoma, and its incidence increased with age. Conclusions: The study highlights the need to consider potential interferences and underlying disorders when results conflict with clinical diagnoses. Method-specific validation and comprehensive clinical correlation are crucial for accurate interpretation of CA19-9 levels to prevent misdiagnosis and ensure appropriate patient management. Full article

In this report, we document and analyze a case in which the Irkut virus (IRKV) (Mononegavirales: Rhabdoviridae) caused a fatal human case following a bat bite in June 2021. Unfortunately, the available data did not permit a detailed taxonomic classification of the carrier bat (Chiroptera). The event occurred in the southwestern part of the Sikhote-Alin mountain region (Russian Far East) covered by the Ussuri taiga forest. The symptoms of the illness began with the following: fever; pronounced psychomotor and motor agitation; tremor of the lower jaw and tongue; aphasia; dyslexia; and dysphagia. These rapidly developed, leading to a severe and fatal encephalitis. The patient was not vaccinated for rabies and did not receive rabies immunoglobulin. Using brain sections prepared from the deceased, molecular diagnostics were performed: immunofluorescence (polyclonal anti-rabies immunoglobulin) indicating the presence of the lyssavirus antigen; and RT-PCR indicating traces of viral RNA. Sectional material (brain) was used for whole-genome sequencing, resulting in a near-complete sequence of the lyssavirus genome. The obtained genomic sequence was identified as the Irkut virus. A comparative analysis of the new sequence and other currently available IRKV sequences (NCBI) revealed differences. Specifically, amino acid differences between antigenic sites in the isolate and those of the rabies vaccine strain used regionally were noted. The patient history and subsequent analysis confirm human IRKV infection following bat contact. Like other fatal cases of IRKV infection described earlier, this case occurred in the southern part of the Russian Far East. Two have occurred in the southwestern part of the Sikhote-Alin mountain region. This indicates the possible existence of an active, natural viral focus. Full article

The Shuixie Cu–Co polymetallic orefield, located in western Yunnan Province (southeastern margin of the Qinghai–Tibet Plateau), is renowned for its Cu–Co mineralization. A recent resource reassessment identified Sb–Au and Cu–Co–Bi (Sb–Au) orebodies as genetically associated with primary Cu–Co mineralization. The mineralization characteristics and microscopic observations indicate that gold mineralization in the Sb–Au orebodies follow a pulsating fluid injection model. The model includes four pulses: (1) euhedral gold-poor pyrite (PyI₁) precipitation; (2) margin-parallel growth of gold-rich pyrite (PyI₂) on PyI₁; (3) continued growth of gold-rich pyrite (PyI₃) along PyI₂; and (4) outermost concentric gold-rich pyrite (PyI₄) formation. This study examined gold-bearing pyrite in orebodies and host rocks. In situ laser ablation inductively coupled plasma mass spectrometry (LA–ICP–MS) analysis of pyrite and inductively coupled plasma mass spectrometry (ICP–MS) whole-rock trace element analysis were conducted to track the ore-forming fluid evolution. Compared with CI chondrite, pyrites from all pulses were enriched in LREEs over HREEs. The pyrite REE distribution curves exhibited right-skewed patterns, reflecting LREE enrichment. The Hf/Sm, Nb/La, and Th/La ratios were generally below 1, indicating high-field-strength element depletion. These results suggest a Cl-rich, F-poor ore-forming fluid. The pyrite trace elements showed enrichment in the chalcophile elements (e.g., Cu and Pb) and exceptionally high Bi levels compared with the continental crust. The chalcophile elements (e.g., Zn and Cd) were depleted, whereas iron-group elements (e.g., Co) were enriched and Ni was depleted. The pyrite δCe values (0.87–1.28, mean = 1.01) showed weak anomalies, indicating a reducing ore-forming environment. The δEu values of pyrite during pulses 1 to 4 ranged widely, from 0.2–3.01 (mean of 1.17), 0.27–1.39 (0.6), and 0.41–1.40 (0.96) to 0.4–1.36 (0.84), respectively, suggesting an initial temperature decline and subsequent increase in the ore-forming fluid. Significant variations were found in the Y/Ho, Zr/Hf, and Nb/Ta ratios across pulses, indicating the potential involvement of high-temperature hydrothermal fluids or late-stage alteration during ore formation. The Y/Ho ratio of pyrite overlapped most closely with that of the continental crust of China, indicating a close relationship between the ore-forming fluids and the crust. Full article

Background: International guidelines recommend the use of high-sensitivity cardiac troponin (hs-cTn) I and T methods for the detection of myocardial injury as a pre-requisite for the diagnosis of acute myocardial infarction (AMI) in patients admitted to the emergency department. Recently, Mindray (Mindray Bio-Medical Electronics Co., Ltd., Shenzhen, China) has introduced a new chemiluminescence immunoassay (CLIA) for the detection of the cTn complex. The present study aims to verify and validate the hs-cTnI Mindray assay on the new automated CL2600i analyzer compared to the routine Alinity-i series instrument by Abbott (Abbott, Chicago, IL, USA). Methods: This study evaluated linearity, precision through the 5 × 5 protocol, methodological comparison on plasma and serum matrices, hs-cTnI 99th percentile imprecision, and the hs-cTnI detection rate in a healthy population. Results: The results obtained proved that the performance of the Mindray hs-cTnI test on the CL2600i platform was closely comparable to the Abbott Alinity-i system (plasma R²: 0.974; serum R²: 0.995). The CVs were consistently low, and no significant differences were reported. Excellent analytical performance, with high sensitivity, was also observed in the healthy population (overall detection rate: 79%), as well as good linearity within the measuring range (R²: 0.994). Conclusions: The Mindray hs-cTnI test confirms its robustness and utility in routine practice as an advanced assay. The new technology, with more sensitive detection methods, may improve the accuracy and reliability of cardiac biomarker testing, ultimately leading to better outcomes in the management of patients with AMI and other cardiac conditions. Full article

Lung ultrasound (LUS) is a non-invasive bedside imaging technique for diagnosing pulmonary conditions, especially in critical care settings. A-lines and B-lines are important features in LUS images that help to assess lung health and identify changes in lung tissue. However, accurately detecting and segmenting these lines remains challenging, due to their subtle blurred boundaries. To address this, we propose TransBound-UNet, a novel segmentation model that integrates a transformer-based encoder with boundary-aware Dice loss to enhance medical image segmentation. This loss function incorporates boundary-specific penalties into a hybrid Dice-BCE formulation, allowing for more accurate segmentation of critical structures. The proposed framework was tested on a dataset of 4599 LUS images. The model achieved a Dice Score of 0.80, outperforming state-of-the-art segmentation networks. Additionally, it demonstrated superior performance in Specificity (0.97) and Precision (0.85), with a significantly reduced Hausdorff Distance of 15.13, indicating improved boundary delineation and overall segmentation quality. Post-processing techniques were applied to automatically detect and count A-lines and B-lines, demonstrating the potential of the segmented outputs in diagnostic workflows. This framework provides an efficient solution for automated LUS interpretation, with improved boundary precision. Full article

This paper proposes an underwater image enhancement technology based on an artificial lateral inhibition network (ALIN) generated in the compound eye of a bionic horseshoe crab robot (BHCR). The concept of a horizontal suppression network is applied to underwater image processing with the aim of achieving low energy consumption, high efficiency processing, and adaptability to limited computing resources. The lateral inhibition network has the effect of “enhancing the center and suppressing the surroundings”. In this paper, a pattern recognition algorithm is used to compare and analyze the images obtained by an artificial lateral inhibition network and eight main underwater enhancement algorithms (white balance, histogram equalization, multi-scale Retinex, and dark channel). Therefore, we can evaluate the application of the artificial lateral inhibition network in underwater image enhancement and the deficiency of the algorithm. The experimental results show that the ALIN plays an obvious role in enhancing the important information in underwater image processing technology. Compared with other algorithms, this algorithm can effectively improve the contrast between the highlight area and the shadow area in underwater image processing, solve the problem that the information of the characteristic points of the collected image is not prominent, and achieve the unique effect of suppressing the intensity of other pixel points without information. Finally, we conduct target recognition verification experiments to assess the ALIN’s performance in identifying targets underwater with the BHCR in static water environments. The experiments confirm that the BHCR can maneuver underwater using multiple degrees of freedom (MDOF) and successfully acquire underwater targets. Full article

Background/Objectives: Synthetic polyethylene glycol (PEG)-based hydrogel sealants, such as Adherus, are commonly used in spinal surgeries to achieve watertight dural closure and prevent cerebrospinal fluid (CSF) leaks. This case report describes an unusual instance of suspected hydrogel sealant migration resulting in an intradural collection at a spinal level remote from the original surgery. Methods: A 57-year-old female with a history of osteoarthritis and prediabetes underwent a minimally invasive L5-S1 laminectomy for the removal of an epidural abscess causing cauda equina and S1 nerve root compression. During the procedure, a dural puncture occurred, which was repaired using Duragen (collagen matrix) and Adherus (synthetic PEG hydrogel sealant). Postoperatively, the patient developed urinary retention and new bilateral posterior leg pain. An MRI on postoperative day four revealed a new peripherally enhancing dorsal intradural collection at the L2 level, causing significant thecal sac narrowing and compression of the cauda equina nerve roots, suggestive of migration of the hydrogel sealant used during surgery. Conservative management was adopted. Results: The patients symptoms gradually resolved. Follow-up imaging at five months showed resolution of the intradural collection, with residual intradural inflammatory changes and arachnoiditis. Conclusions: While PEG-based hydrogel sealants like Adherus are effective in preventing CSF leaks, they can, in rare instances, migrate and cause remote intradural collections with neurological symptoms. Surgeons should exercise meticulous application techniques, thoroughly document the use of sealants, and maintain vigilant postoperative monitoring to mitigate these risks. Full article