Impact of Chronic Kidney Disease on the Outcomes of Patients Undergoing Percutaneous Left Atrial Appendage Occlusion: Insights from a Large National Database.

BACKGROUND: Studies exploring the effectiveness and safety of percutaneous left atrial appendage occlusion (pLAAO) in patients with chronic kidney disease (CKD) are limited. OBJECTIVES: We aimed to analyze trends and outcomes following pLAAO in patients with CKD. METHODS: We utilized the National Inpatient Sample (NIS) to identify hospitalizations for pLAAO from 2016-2020 and further identified cases with concomitant CKD. The primary outcome was mortality, and secondary outcomes were cerebrovascular accidents, major bleeding, vasopressor requirements, percutaneous coronary intervention, cardiac arrest, acute respiratory failure, transfusion, length of stay (LOS), and total hospital charges. Multivariable logistic regression was performed to further adjust for covariates. RESULTS: A total of 89,309 pLAAO procedures from 2016 to 2020 were identified, of which 21,559 (24.1%) reported concomitant CKD, with males comprising the majority (62.2%). An increasing trend in pLAAO procedures was seen from 2.24 to 13.9 per 10,000 patients from 2016 to 2020. Despite patients with CKD having a higher rate of most comorbidities, there was no difference in mortality (non-CKD vs. CKD, 0.07% vs. 0.42%; aOR: 1.3, 95% CI: 0.4 - 4.4, p=0.686) and complications for CKD and non-CKD patients, while CKD patients had longer LOS and higher total hospital charge. No significant sex differences in outcomes among CKD patients were observed except for a longer LOS in females. CONCLUSION: Despite generally having more comorbidities, outcomes of patients with CKD following pLAAO are similar to those without CKD, suggesting that pLAAO can be offered as a safe option for the treatment of AF in eligible patients with CKD.

Anatomical Study of the Cardiac Veins and their Tributaries in Bovines (Bos indicus) in Comparison with Humans and Other Animal Species / Estudio Anatómico de las Venas Cardiacas y sus Tributarias en Bovinos (Bos indicus) en Comparación con Humanos y Otras Especies Animales

SUMMARY: In bovines, anatomical observations of the coronary vascular tree describe qualitative characteristics. The objective of this study was to morphometrically characterize the coronary veins and their tributaries in cattle. An arcuate application with 2.0 silk was performed around the ostium of the coronary sinus of 28 bovine hearts and a number 14 catheter was placed, through which semi- synthetic polyester resin and mineral blue color was perfused. In 22 hearts (78.6 %) the great cardiac vein was originated at the cardiac apex. The configuration of the arteriovenous trigone was mainly closed inferior and superior types (50 %). The caliber of the great cardiac vein at the level of the atrioventricular sulcus was 6.7 +/- 1.2 mm. The origin of the left marginal vein was observed in the lower third of the left cardiac margin (53.6 %), its distal caliber was 4.1 +/- 0.8 mm and its drainage was at the level of the great cardiac vein. The middle cardiac vein originated from the cardiac apex in 78.6 % of the samples, emptied mainly into the coronary sinus (82.1 %) and its distal caliber was 4.7 +/- 0.9 mm. Anastomoses occurred in 28.6 % of the hearts, being found in most cases between the middle cardiac vein and the great cardiac vein (50 %), which was significant compared to other anastomoses (p<0.001). The length of the coronary sinus was 42.2 +/- 5.1 mm, its distal caliber was 13.8 +/- 2 mm, and its shape was cylindrical. Myocardial bridges were found in 3 hearts (10.7 %) mainly in the lower third of the middle cardiac vein (66.6 %). Most of the main coronary veins drained into the coronary sinus, with some cases with atypical outlets and the presence of a high percentage of anastomosis that serves to improve cardiac venous drainage in case of venous compression or obstruction.

En bovinos, las observaciones anatómicas de árbol vascular coronario describen características cualitativas. El objetivo de este estudio fue caracterizar morfométricamente las venas coronarias y sus tributarias en bovinos. Se realizó una aplicatura arciforme con seda 2.0 alrededor del ostium del seno coronario de 28 corazones de bovino y se colocó un catéter número 14, a través del cual se perfundió resina de poliéster semisintética y color azul mineral. La vena cardiaca magna se originó en 22 corazones (78,6 %) en el ápex cardiaco. La configuración del trígono arteriovenoso fue principalmente cerrado inferior y superior (50 %). El calibre de la vena cardiaca magna a nivel del surco atrioventricular fue 6,7 +/- 1,2 mm. El origen de la vena marginal izquierda se observó en el tercio inferior del margen izquierdo cardiaco (53,6 %), su calibre distal fue 4,1 +/- 0,8 mm y su desembocadura fue a nivel de la vena cardiaca magna. La vena cardiaca media se originó en el ápex cardiaco en el 78,6 % de las muestras, desembocó principalmente en el seno coronario (82.1 %) y su calibre distal fue 4,7 +/- 0,9 mm. Se presentó anastomosis en el 28,6 % de los corazones, encontrándose en la mayoría de los casos entre la vena cardiaca media y la vena cardiaca magna (50 %), lo cual fue significativo en comparación con otras anastomosis (p<0,001). La longitud del seno coronario fue 42,2 +/- 5,1 mm, su calibre distal fue 13,8 +/- 2 mm y su forma fue cilíndrica. Se encontró puentes miocárdicos en 3 corazones (10,7 %) y en el tercio inferior de la vena cardiaca media (66,6 %). La mayoría de las venas coronarias principales desembocan en el seno coronario, con algunos casos con desembocaduras atípicas y la presencia de un alto porcentaje de anastomosis que sirve para mejorar el drenaje venoso cardiaco en caso de compresión u obstrucción venosa.

Reduced genetic diversity and the success of the invasive peacock bass (Cichliformes: Cichlidae)

Abstract Several species of Cichla successfully colonized lakes and reservoirs of Brazil, since the 1960s, causing serious damage to local wildlife. In this study, 135 peacock bass were collected in a reservoir complex in order to identify if they represented a single dominant species or multiple ones, as several Cichla species have been reported in the basin. Specimens were identified by color pattern, morphometric and meristic data, and using mitochondrial markers COI, 16S rDNA and Control Region (CR). Overlapping morphological data and similar coloration patterns prevented their identification using the taxonomic keys to species identification available in the literature. However, Bayesian and maximum likelihood from sequencing data demonstrated the occurrence of a single species, Cichla kelberi. A single haplotype was observed for the 16S and CR, while three were detected for COI, with a dominant haplotype present in 98.5% of the samples. The extreme low diversity of the transplanted C. kelberi evidenced a limited number of founding maternal lineages. The success of this colonization seems to rely mainly on abiotic factors, such as increased water transparency of lentic environments that favor visual predators that along with the absence of predators, have made C. kelberi a successful invader of these reservoirs.

Resumo Muitas espécies de Cichla colonizaram com sucesso lagos e reservatórios do Brasil desde os anos 1960, causando graves prejuízos à vida selvagem nesses locais. Neste estudo, 135 tucunarés foram coletados em um complexo de reservatórios a fim de identificar se representavam uma espécie dominante ou múltiplas espécies, uma vez que diversas espécies de Cichla foram registradas na bacia. Os espécimes foram identificados com base na coloração, dados morfométricos e merísticos, e por marcadores mitocondriais COI, 16S rDNA e Região Controle (RC). A sobreposição dos dados morfométricos e o padrão similar de coloração impediram a identificação utilizando as chaves de identificação disponíveis na literatura. Entretanto, as análises bayesiana e de máxima verossimilhança de dados moleculares demonstraram a ocorrência de uma única espécie, Cichla kelberi. Um único haplótipo foi observado para o 16S e RC, enquanto três foram detectados para o COI, com um haplótipo dominante presente em 98,5% das amostras. A baixa diversidade nos exemplares introduzidos de C. kelberi evidenciou um número limitado de linhagens maternas fundadoras. O sucesso da invasão parece depender de fatores abióticos, como a maior transparência da água de ambientes lênticos que favorece predadores visuais que, atrelado à ausência de predadores, fez do C. kelberi um invasor bem-sucedido nesses reservatórios.

Reduced genetic diversity and the success of the invasive peacock bass (Cichliformes: Cichlidae) / Diversidade genética reduzida e o sucesso da espécie invasora tucunaré (Cichliformes: Cichlidae)

Abstract Several species of Cichla successfully colonized lakes and reservoirs of Brazil, since the 1960's, causing serious damage to local wildlife. In this study, 135 peacock bass were collected in a reservoir complex in order to identify if they represented a single dominant species or multiple ones, as several Cichla species have been reported in the basin. Specimens were identified by color pattern, morphometric and meristic data, and using mitochondrial markers COI, 16S rDNA and Control Region (CR). Overlapping morphological data and similar coloration patterns prevented their identification using the taxonomic keys to species identification available in the literature. However, Bayesian and maximum likelihood from sequencing data demonstrated the occurrence of a single species, Cichla kelberi. A single haplotype was observed for the 16S and CR, while three were detected for COI, with a dominant haplotype present in 98.5% of the samples. The extreme low diversity of the transplanted C. kelberi evidenced a limited number of founding maternal lineages. The success of this colonization seems to rely mainly on abiotic factors, such as increased water transparency of lentic environments that favor visual predators that along with the absence of predators, have made C. kelberi a successful invader of these reservoirs.

Resumo Muitas espécies de Cichla colonizaram com sucesso lagos e reservatórios do Brasil desde os anos 1960, causando graves prejuízos à vida selvagem nesses locais. Neste estudo, 135 tucunarés foram coletados em um complexo de reservatórios a fim de identificar se representavam uma espécie dominante ou múltiplas espécies, uma vez que diversas espécies de Cichla foram registradas na bacia. Os espécimes foram identificados com base na coloração, dados morfométricos e merísticos, e por marcadores mitocondriais COI, 16S rDNA e Região Controle (RC). A sobreposição dos dados morfométricos e o padrão similar de coloração impediram a identificação utilizando as chaves de identificação disponíveis na literatura. Entretanto, as análises bayesiana e de máxima verossimilhança de dados moleculares demonstraram a ocorrência de uma única espécie, Cichla kelberi. Um único haplótipo foi observado para o 16S e RC, enquanto três foram detectados para o COI, com um haplótipo dominante presente em 98,5% das amostras. A baixa diversidade nos exemplares introduzidos de C. kelberi evidenciou um número limitado de linhagens maternas fundadoras. O sucesso da invasão parece depender de fatores abióticos, como a maior transparência da água de ambientes lênticos que favorece predadores visuais que, atrelado à ausência de predadores, fez do C. kelberi um invasor bem-sucedido nesses reservatórios.

Fallo en la regulación de la fertilidad posparto en mujeres en vulnerabilidad social en Colombia / Failured to regulate postpartum fertility in vulnerable women in Colombia

Objetivo: Evaluar la prevalencia de fallo en la regulación de la fertilidad posparto y la asociación con otros factores en un municipio colombiano (2017). Método: Estudio observacional de corte transversal con 148 mujeres. Se aplicó un muestreo no aleatorio para incluir mujeres que hubieran tenido un parto en los últimos 5 años. Se calcularon la prevalencia y las razones de prevalencia. Se exploró la asociación con la prueba χ2 o la prueba exacta de Fisher bajo una significancia estadística de 0,05. Resultados: Se encontró una prevalencia de fallo de la regulación de la fertilidad posparto del 40,5%. La prevalencia se asoció con ejercer oficios del hogar, tener uno o dos hijos, no planificar o no acceder a métodos de planificación y haber tenido un embarazo con periodo intergenésico menor de 2 años (p < 0,05). Conclusiones: Es necesario implementar estrategias para identificar barreras de acceso a la planificación, impactando en el espaciamiento entre embarazos y el acceso a los servicios. Lo anterior para generar múltiples beneficios para la madre, su hijo/a, el sistema de salud y la sociedad.

Objective: To evaluate the prevalence of regulated postpartum fertility failure and possible associated factors in a Colombian municipality (2017). Method: Cross-sectional observational study of 148 women. A non-random sampling method was used to include women who had given birth to a child in the last five years. Prevalence and prevalence ratios were calculated. Associations were examined at 0.05 statistical significance using χ2 test or Fishers exact test. Results: The prevalence of postpartum fertility failure was found to be 40.5%. The prevalence was associated with household work, having one or two children, not planning, or not having access to planning methods, and having a pregnancy with an interval between pregnancies of less than 2 years (p < 0.05). Conclusions: It is necessary to implement strategies to identify barriers to access to planning, which have an impact on the spacing between pregnancies and access to services. This will have multiple benefits for mother, child, health system and society.

Comparison of coronary arteries morphometry and distribution in bovines with humans and other animal species.

Background: The left coronary artery (LCA) in the bovines is more developed than the right. Aim: The objective of the study is to describe the bovine coronary system from a morphological point of view, including the morphometry and its distribution. Methods: Arciform suture with 2.0 silk was applied around the sinus orifice and coronary ostium and a number 14 catheter was installed, to perfuse semi-synthetic polyester resin, consisting of a mixture of 85% GP40L palatal with 15% styrene with red color mineral. Results: The average weight of 28 bovine hearts used in our study was 1.534.1 kg. The right coronary artery had a proximal caliber of 5 +/- 0.9 mm. The LCA caliber and length were 9.4 +/- 1.2 and 18.3 +/- 4.8 mm, respectively. This artery was divided into two branches in 85.7% of the cases and trifurcated in 14.3%. The paraconal interventricular branch (PIB) ended more frequently in the apex (46.4%), and its proximal caliber was 6.4 +/- 1.4 mm. The left circumflex branch ended in 82.1% in the subsinusal interventricular sulcus, and its proximal caliber was 5.9 +/- 1.2 mm. The proximal calibers of the PIB and the left circumflex branch did not present statistically significant differences (p = 0.137). The sinoatrial branch presented a dual origin (right and LCA) in 46.4% of the cases and a single origin from the LCA in 53.6% of the samples. In the evaluated hearts, left coronary dominance was observed in most cases (96.4%). Their presence of anastomosis between the branches of the coronary arteries was observed in 57.1% of cases. Conclusion: The presence of a myocardial bridge was found in six hearts (21.4%). In bovines, a high percentage of anastomosis was found, a protective factor in obstruction of the coronary arterial branches.

Proposed solutions by the American College of Allergy, Asthma, and Immunology and advocacy experts to address racial disparities in atopic dermatitis and food allergy.

Atopic dermatitis (AD) and food allergies are more prevalent and more severe in people with skin of color than White individuals. The American College of Allergy, Asthma, and Immunology (ACAAI) sought to understand the effects of racial disparities among patients with skin of color with AD and food allergies. The ACAAI surveyed its members (N = 200 completed), conducted interviews with health care providers and advocacy leaders, and hosted a roundtable to explore the challenges of diagnosis and management of AD and food allergies in people with skin of color and to discuss potential solutions. Most of the survey respondents (68%) agreed that racial disparities make it difficult for people with skin of color to receive adequate treatment for AD and food allergies. The interviews and roundtable identified access to care, burden of costs, policies and infrastructure that limit access to safe foods and patient education, and inadequate research involving people with skin of color as obstacles to care. Proposed solutions included identifying ways to recruit more people with skin of color into clinical trials and medical school, educating health care providers about diagnosis and treating AD and food allergy in people with skin of color, improving access to safe foods, creating and disseminating culturally appropriate materials for patients, and working toward longer appointment times for patients who need them. Challenges in AD and food allergy in persons with skin of color were identified by the ACAAI members. Solutions to these challenges were proposed to inspire actions to mitigate racial disparities in AD and food allergy.

Corticosteroid exposure and cumulative effects in patients with eczema: Results from a patient survey.

BACKGROUND: Individuals with eczema may have substantial lifetime corticosteroid exposure, increasing the risk of corticosteroid-related side effects. OBJECTIVE: To conduct a patient survey evaluating corticosteroid exposure and its cumulative effects in individuals with eczema. METHODS: The multinational online survey was conducted between November 5, 2020, and January 11, 2021. Participants were aged 18 years or older and a patient (n = 1889) or a caregiver of a child (n = 271) diagnosed with having eczema by a medical professional. RESULTS: All participants reported using corticosteroids. Average duration of topical corticosteroid (TCS) use was 15.3 years in adults and 3.6 years in children; 75% used TCS 1 to 2 times a day and 50% applied TCS 15 to 30 days/mo. Frequency and duration could not be determined by varying prescription TCS potencies. Oral corticosteroid use was reported by 36% of the participants (23% for eczema), with a lifetime average of 8.4 courses in adults and 8.1 courses in children. Corticosteroids for non-eczema atopic conditions were reported by 49% of the participants. In participants using TCS, 83% of adults and 64% of children experienced worsening symptoms over time. Development of new symptoms and conditions increased with a greater number of corticosteroid treatments and longer duration of TCS use but may have been owing to eczema progression. Symptoms consistent with topical steroid withdrawal syndrome after TCS discontinuation were reported by many participants. CONCLUSION: Reported substantial corticosteroid exposure throughout their lifetime eczema experience placed participants at risk of negative outcomes. Corticosteroids are a critical component of eczema treatment for many patients. However, careful corticosteroid prescribing practices and monitoring are needed to avoid side effects. When possible, corticosteroid-sparing strategies should be explored.

Identifying genes associated with abiotic stress tolerance suitable for CRISPR/Cas9 editing in upland rice cultivars adapted to acid soils.

Five genes of large phenotypic effect known to confer abiotic stress tolerance in rice were selected to characterize allelic variation in commercial Colombian tropical japonica upland rice cultivars adapted to drought-prone acid soil environments (cv. Llanura11 and Porvenir12). Allelic variants of the genes ART1, DRO1, SUB1A, PSTOL1, and SPDT were characterized by PCR and/or Sanger sequencing in the two upland cultivars and compared with the Nipponbare and other reference genomes. Two genes were identified as possible targets for gene editing: SUB1A (Submergence 1A), to improve tolerance to flooding, and SPDT (SULTR3;4) (SULTR-like Phosphorus Distribution Transporter), to improve phosphorus utilization efficiency and grain quality. Based on technical and regulatory considerations, SPDT was targeted for editing. The two upland cultivars were shown to carry the SPDT wild-type (nondesirable) allele based on sequencing, RNA expression, and phenotypic evaluations under hydroponic and greenhouse conditions. A gene deletion was designed using the CRISPR/Cas9 system, and specialized reagents were developed for SPDT editing, including vectors targeting the gene and a protoplast transfection transient assay. The desired edits were confirmed in protoplasts and serve as the basis for ongoing plant transformation experiments aiming to improve the P-use efficiency of upland rice grown in acidic soils.

Rotary Jet Spinning (RJS): A Key Process to Produce Biopolymeric Wound Dressings.

Wounds result from different causes (e.g., trauma, surgeries, and diabetic ulcers), requiring even extended periods of intensive care for healing, according to the patient's organism and treatment. Currently, wound dressings generated by polymeric fibers at micro and nanometric scales are promising for healing the injured area. They offer great surface area and porosity, mimicking the fibrous extracellular matrix structure, facilitating cell adhesion, migration, and proliferation, and accelerating the wound healing process. Such properties resulted in countless applications of these materials in biomedical and tissue engineering, also as drug delivery systems for bioactive molecules to help tissue regeneration. The techniques used to engineer these fibers include spinning methods (electro-, rotary jet-), airbrushing, and 3D printing. These techniques have important advantages, such as easy-handle procedure and process parameters variability (type of polymer), but encounter some scalability problems. RJS is described as a simple and low-cost technique resulting in high efficiency and yield for fiber production, also capable of bioactive agents' incorporation to improve the healing potential of RJS wound dressings. This review addresses the use of RJS to produce polymeric fibers, describing the concept, type of configuration, comparison to other spinning techniques, most commonly used polymers, and the relevant parameters that influence the manufacture of the fibers, for the ultimate use in the development of wound dressings.

Discrepancies Between Implementation and Perceived Effectiveness of Leading Safety Indicators in the US Dairy Product Manufacturing Industry.

Background: In the United States, the dairy product manufacturing industry has consistently had higher rates of work-related nonfatal injuries and illnesses compared to the national average for industries in all sectors. The selection and implementation of appropriate safety performance indicators are important aspect of reducing risk within safety management systems. This study examined the leading safety indicators implemented in the dairy product-manufacturing sector (NAICS 3115) and their perceived effectiveness in reducing work-related injuries. Methods: Perceptions were collected from individuals with safety responsibilities in the dairy product manufacturing facilities. OSHA Incident Rate (OIR) and Days away, restricted and transferred (DART) rates from 2013 to 2018 were analyzed. Results: The perceived most effective leading were safety observations, stop work authority, near miss reporting, safety audits, preventative maintenance, safety inspections, safety training attendance, and job hazard analysis/safety analysis, respectively. The 6-year trend analysis showed that those implementing all eight top indicators had a slightly lower rates than those that did not implement all eight. Production focused mentality, poor training, and lack of management commitment were perceived as the leading causes of injuries in this industry. Conclusion: Collecting leading indicators with the unique interest to meet the regulatory requirements and to document the management system without the actual goal of using them as input to improve the system most probably will not lead to an effective reduction of negative safety outcomes. For leading indicators to be effective, they should be properly selected, executed, periodically evaluated and actions are taken when necessary.

Impact of clinical symptoms and diagnosis: the electronic Person-Specific Outcome Measure (ePSOM) development programme.

INTRODUCTION: Regulatory bodies recommend that outcome measures used in Alzheimer's disease (AD) clinical trials capture clinically meaningful changes for the trial participant. However, commonly used outcome measures do not reflect the individual's views on what matters to them individually. The aim of the electronic Person-Specific Outcome Measure (ePSOM) programme is to better understand what outcomes matter to patients in early Alzheimer's disease. METHODS: As part of the ePSOM programme, we designed and ran an online study to understand what matters to individuals when developing new treatments for AD. The ePSOM survey ran Aug 2019-Dec 2019 (UK) and collected primarily free text responses which were analysed using Natural Language Processing (NLP) techniques. In this paper, we focus our analyses on individuals who reported having a neurodegenerative disease diagnosis (primarily Mild Cognitive Impairment (MCI) or AD), reporting the most frequent and most important brain health priorities for this group. Due to a small sample size, the Diagnosis group was analysed as a whole. Finally, we compared the Diagnosis group to an age and gender matched control group using chi-squared tests to look for any differences between the Diagnosis and control groups' priorities. RESULTS: The survey was completed by 5808 respondents, of whom 167 (2.9%) (women n = 91, men n = 69, other n = 7) had received one of our pre-defined neurodegenerative disease diagnosis: most commonly MCI n = 52, 1.1% (mean age 69.42, SD = 10.8); or Alzheimer's disease n = 48, 1.0% (mean age 71.24, SD = 9.79). Several thematic clusters were significantly more important for the target diagnostic group, e.g.: Expressing opinions; and less important, e.g., Cognitive Games. CONCLUSION: We conclude there are a range of outcomes which individuals consider important and what potential new treatments should help maintain or improve, suggesting that outcomes that matter shift along the preclinical, prodromal and overt dementia continuum. This has important implications for the development of outcome measures in long term prevention studies that last several years where participants may pass through different stages of disease. In the final stage of our project, we will design an electronic outcomes app which will employ the methodology tested in the large-scale survey to capture what matters to individuals about their brain health at an individual level.

Sleep Disturbances During Shift Work.

Around 21% of workers reported working on shifts in 2017, and consequently, shift workers experience multiple sleep disturbances such as excessive sleepiness, insomnia, sleep deprivation, and social jet lag. These eventually lead to shift work disorder or exacerbation of other sleep disorders such as insomnia, obstructive sleep apnea, restless legs syndrome, and nonrapid eye movement parasomnia. Despite multiple interventions and guidelines, poor compliance to treatment is often encountered due to temporary relief of sleep disturbances provided by the treatment. Hence there is a need for comprehensive evaluation of those individuals who need to be awake during the night and asleep during the day.

Clinical Features and Neurodevelopmental Outcomes for Infants with Perinatal Vertical Transmission of Zika Virus, Colombia.

Transplacental transmission of Zika virus has been reported during all trimesters of pregnancy and might lead to central nervous system anomalies, including microcephaly. We report 3 cases of perinatal Zika infection identified during the epidemic in Colombia and provide detailed descriptions of clinical features, diagnosis, and neurodevelopmental outcome at 18 months of age (corrected).

Reduced genetic diversity and the success of the invasive peacock bass (Cichliformes: Cichlidae).

Several species of Cichla successfully colonized lakes and reservoirs of Brazil, since the 1960's, causing serious damage to local wildlife. In this study, 135 peacock bass were collected in a reservoir complex in order to identify if they represented a single dominant species or multiple ones, as several Cichla species have been reported in the basin. Specimens were identified by color pattern, morphometric and meristic data, and using mitochondrial markers COI, 16S rDNA and Control Region (CR). Overlapping morphological data and similar coloration patterns prevented their identification using the taxonomic keys to species identification available in the literature. However, Bayesian and maximum likelihood from sequencing data demonstrated the occurrence of a single species, Cichla kelberi. A single haplotype was observed for the 16S and CR, while three were detected for COI, with a dominant haplotype present in 98.5% of the samples. The extreme low diversity of the transplanted C. kelberi evidenced a limited number of founding maternal lineages. The success of this colonization seems to rely mainly on abiotic factors, such as increased water transparency of lentic environments that favor visual predators that along with the absence of predators, have made C. kelberi a successful invader of these reservoirs.

A UK-Wide Study Employing Natural Language Processing to Determine What Matters to People about Brain Health to Improve Drug Development: The Electronic Person-Specific Outcome Measure (ePSOM) Programme.

BACKGROUND: It is important to use outcome measures for novel interventions in Alzheimer's disease (AD) that capture the research participants' views of effectiveness. The electronic Person-Specific Outcome Measure (ePSOM) development programme is underpinned by the need to identify and detect change in early disease manifestations and the possibilities of incorporating artificial intelligence in outcome measures. OBJECTIVES: The aim of the ePSOM programme is to better understand what outcomes matter to patients in the AD population with a focus on those at the pre-dementia stages of disease. Ultimately, we aim to develop an app with robust psychometric properties to be used as a patient reported outcome measure in AD clinical trials. DESIGN: We designed and ran a nationwide study (Aug 2019 - Nov 2019, UK), collecting primarily free text responses in five pre-defined domains. We collected self-reported clinical details and sociodemographic data to analyse responses by key variables whilst keeping the survey short (around 15 minutes). We used clustering and Natural Language Processing techniques to identify themes which matter most to individuals when developing new treatments for AD. RESULTS: The study was completed by 5,808 respondents, yielding over 80,000 free text answers. The analysis resulted in 184 themes of importance. An analysis focusing on key demographics to explore how priorities differed by age, gender and education revealed that there are significant differences in what groups consider important about their brain health. DISCUSSION: The ePSOM data has generated evidence on what matters to people when developing new treatments for AD that target secondary prevention and therein maintenance of brain health. These results will form the basis for an electronic outcome measure to be used in AD clinical research and clinical practice.

The Colombian Chemoprevention Trial: 20-Year Follow-Up of a Cohort of Patients With Gastric Precancerous Lesions.

BACKGROUND & AIMS: Helicobacter pylori eradication and endoscopic surveillance of gastric precancerous lesions are strategies to reduce gastric cancer (GC) risk. To our knowledge, this study is the longest prospective cohort of an H pylori eradication trial in a Hispanic population. METHODS: A total of 800 adults with precancerous lesions were randomized to anti-H pylori treatment or placebo. Gastric biopsy samples taken at baseline and 3, 6, 12, 16, and 20 years were assessed by our Correa histopathology score. A generalized linear mixed model with a participant-level random intercept was used to estimate the effect of H pylori status on the score over time. Logistic regression models were used to estimate progression by baseline diagnosis and to estimate GC risk by intestinal metaplasia (IM) subtype and anatomic location. RESULTS: Overall, 356 individuals completed 20 years of follow-up. Anti-H pylori therapy (intention-to-treat) reduced progression of the Correa score (odds ratio [OR], 0.59; 95% confidence interval [CI], 0.38-0.93). H pylori-negative status had a beneficial effect on the score over time (P = .036). Among individuals with IM (including indefinite for dysplasia) at baseline, incidence rates per 100 person-years were 1.09 (95% CI, 0.85-1.33) for low-grade/high-grade dysplasia and 0.14 (95% CI, 0.06-0.22) for GC. Incomplete-type (vs complete-type) IM at baseline presented higher GC risk (OR, 13.4; 95% CI, 1.8-103.8). Individuals with corpus (vs antrum-restricted) IM showed an OR of 2.1 (95% CI, 0.7-6.6) for GC. CONCLUSIONS: In a high-GC-risk Hispanic population, anti-H pylori therapy had a long-term beneficial effect against histologic progression. Incomplete IM is a strong predictor of GC risk.

Workplace Sexual Harassment and Vulnerabilities among Low-Wage Hispanic Women.

Workplace sexual harassment is particularly widespread in industries with many low-wage jobs where Hispanic women are likely to work. This qualitative study examines the experiences of Hispanic women in low-income jobs to identify workplace sexual harassment situations, support seeking actions, barriers to report, and forms of retaliation. A qualitative research design with one-on-one structured interviews provided an in-depth understanding of the experiences of Hispanic women in low-wage jobs regarding workplace sexual harassment situations and potential contributing factors. Second, a conceptual framework is proposed to integrate the reported organizational factors and social vulnerabilities that interact, eroding the individual's ability to cope effectively with workplace sexual harassment. These include organizational resources for preventing and reporting, community and family resources for support, and health effects attributed to sexual harassment. Workplace sexual harassment was described by participants as escalating over time from dating invitations, sex-related comments, unwanted physical contact to explicit sexual propositions. Temporary workers reported being very often subject to explicit quid pro quo propositions. While these patterns might not differ from those reported by other groups, work organization factors overlap with individual and social characteristics of Hispanic women in low-income jobs revealing a complicated picture that requires a systems approach to achieve meaningful change for this vulnerable population.

Automated creation and tuning of personalised muscle paths for OpenSim musculoskeletal models of the knee joint.

Computational modelling is an invaluable tool for investigating features of human locomotion and motor control which cannot be measured except through invasive techniques. Recent research has focussed on creating personalised musculoskeletal models using population-based morphing or directly from medical imaging. Although progress has been made, robust definition of two critical model parameters remains challenging: (1) complete tibiofemoral (TF) and patellofemoral (PF) joint motions, and (2) muscle tendon unit (MTU) pathways and kinematics (i.e. lengths and moment arms). The aim of this study was to develop an automated framework, using population-based morphing approaches to create personalised musculoskeletal models, consisting of personalised bone geometries, TF and PF joint mechanisms, and MTU pathways and kinematics. Informed from medical imaging, personalised rigid body TF and PF joint mechanisms were created. Using atlas- and optimisation-based methods, personalised MTU pathways and kinematics were created with the aim of preventing MTU penetration into bones and achieving smooth MTU kinematics that follow patterns from existing literature. This framework was integrated into the Musculoskeletal Atlas Project Client software package to create and optimise models for 6 participants with incrementally increasing levels of personalisation with the aim of improving MTU kinematics and pathways. Three comparisons were made: (1) non-optimised (Model 1) and optimised models (Model 3) with generic joint mechanisms; (2) non-optimised (Model 2) and optimised models (Model 4) with personalised joint mechanisms; and (3) both optimised models (Model 3 and 4). Following optimisation, improvements were consistently shown in pattern similarity to cadaveric data in comparison (1) and (2). For comparison (3), a number of comparisons showed no significant difference between the two compared models. Importantly, optimisation did not produce statistically significantly worse results in any case.

Machine learning methods to support personalized neuromusculoskeletal modelling.

Many biomedical, orthopaedic, and industrial applications are emerging that will benefit from personalized neuromusculoskeletal models. Applications include refined diagnostics, prediction of treatment trajectories for neuromusculoskeletal diseases, in silico design, development, and testing of medical implants, and human-machine interfaces to support assistive technologies. This review proposes how physics-based simulation, combined with machine learning approaches from big data, can be used to develop high-fidelity personalized representations of the human neuromusculoskeletal system. The core neuromusculoskeletal model features requiring personalization are identified, and big data/machine learning approaches for implementation are presented together with recommendations for further research.