Automated echolocation classifiers vary in accuracy for northeastern U.S. bat species.

Acoustic surveys of bat echolocation calls are an important management tool for determining presence and probable absence of threatened and endangered bat species. In the northeastern United States, software programs such as Bat Call Identification (BCID), Kaleidoscope Pro (KPro), and Sonobat can automatically classify ultrasonic detector sound files, yet the programs' accuracy in correctly classifying calls to species has not been independently assessed. We used 1,500 full-spectrum reference calls with known identities for nine northeastern United States bat species to test the accuracy of these programs using calculations of Positive Predictive Value (PPV), Negative Predictive Value (NPV), Sensitivity (SN), Specificity (SP), Overall Accuracy, and No Information Rate. We found that BCID performed less accurately than other programs, likely because it only operates on zero-crossing data and may be less accurate for recordings converted from full-spectrum to zero-crossing. NPV and SP values were high across all species categories for SonoBat and KPro, indicating these programs' success at avoiding false positives. However, PPV and SN values were relatively low, particularly for individual Myotis species, indicating these programs are prone to false negatives. SonoBat and KPro performed better when distinguishing Myotis species from non-Myotis species. We expect less accuracy from these programs for acoustic recordings collected under normal working conditions, and caution that a bat acoustic expert should verify automatically classified files when making species-specific regulatory or conservation decisions.

Correction: Occurrence and spatial distribution of heavy metals in landfill leachates and impacted freshwater ecosystem: An environmental and human health threat.

[This corrects the article DOI: 10.1371/journal.pone.0263279.].

Cannabis and Cannabinoids in Adults With Cancer: ASCO Guideline.

PURPOSE: To guide clinicians, adults with cancer, caregivers, researchers, and oncology institutions on the medical use of cannabis and cannabinoids, including synthetic cannabinoids and herbal cannabis derivatives; single, purified cannabinoids; combinations of cannabis ingredients; and full-spectrum cannabis. METHODS: A systematic literature review identified systematic reviews, randomized controlled trials (RCTs), and cohort studies on the efficacy and safety of cannabis and cannabinoids when used by adults with cancer. Outcomes of interest included antineoplastic effects, cancer treatment toxicity, symptoms, and quality of life. PubMed and the Cochrane Library were searched from database inception to January 27, 2023. ASCO convened an Expert Panel to review the evidence and formulate recommendations. RESULTS: The evidence base consisted of 13 systematic reviews and five additional primary studies (four RCTs and one cohort study). The certainty of evidence for most outcomes was low or very low. RECOMMENDATIONS: Cannabis and/or cannabinoid access and use by adults with cancer has outpaced the science supporting their clinical use. This guideline provides strategies for open, nonjudgmental communication between clinicians and adults with cancer about the use of cannabis and/or cannabinoids. Clinicians should recommend against using cannabis or cannabinoids as a cancer-directed treatment unless within the context of a clinical trial. Cannabis and/or cannabinoids may improve refractory, chemotherapy-induced nausea and vomiting when added to guideline-concordant antiemetic regimens. Whether cannabis and/or cannabinoids can improve other supportive care outcomes remains uncertain. This guideline also highlights the critical need for more cannabis and/or cannabinoid research.Additional information is available at www.asco.org/supportive-care-guidelines.

Pathological Markers of Alzheimer's Disease and Related Dementia in the Rhesus Macaque Amygdala.

Rhesus macaques develop amyloid-ß (Aß) plaques during old age, but it is unclear how extensively they express other pathological hallmarks of dementia. Here we used immunohistochemistry to examine expression of phosphorylated tau (pTau) protein and cytoplasmic inclusions of TAR DNA binding protein 43 kDa (TDP-43) within the amygdala of young and old males, and also in old surgically-menopausal females that were maintained on regular or obesogenic diets. Only one animal, a 23-year-old female, showed pTau expression and none showed TDP-43 inclusions. What genetic and/or environmental factors protect macaques from expressing more severe human neuro-pathologies remains an interesting unresolved question.

The Dairy and Cancer Controversy: Milking the Evidence.

PURPOSE OF REVIEW: Cancer risk reduction remains a significant concern for both individuals with a cancer diagnosis and those aiming to prevent it. Dairy products, a source of beneficial dietary nutrients, have sparked controversy regarding their impact on cancer risk. RECENT FINDINGS: Evidence indicates that dairy consumption, particularly milk, can decrease colorectal cancer risk. However, cow's milk, a key dairy product, exposes individuals to growth hormones, notably insulin-like growth factor-1, potentially elevating cancer risk. Extensive research supports the link between dairy intake and heightened prostate cancer risk. Nonetheless, investigations into dairy's association with breast, ovarian, and other cancers yield mixed results. The overall data on dairy and cancer remains inconclusive. Available data suggests that a diet emphasizing fiber-rich foods such as whole grains, fruits, and vegetables, while restricting milk and dairy intake-similar to the Mediterranean dietary pattern-might mitigate cancer incidence. However, further research is crucial to elucidate the precise role of dairy products in overall cancer risk.

Silencing of the Vasa gene by RNA Interference Affects Embryonic Development and Reproductive Output in the Sea Louse Caligus rogercresseyi.

The sea louse Caligus rogercresseyi is a major ectoparasitic copepod that causes significant economic losses in the salmon farming industry. Despite recent advancements, the mechanisms underlying germline and embryo development in this species remain poorly understood. The Vasa gene encodes a highly conserved DEAD box helicase that is required for germ cell formation and function in many species. In this study, the Vasa gene was characterized in C. rogercresseyi, and its expression and function were analyzed. Phylogenetic analysis showed that the Cr-Vasa gene product formed clusters in clades with Vasa proteins from closely related species of crustaceans. Cr-Vasa gene expression patterns were assessed by qPCR, and the results showed a significantly higher relative expression level in adult females compared to copepodid, chalimus, and adult male stages. Tissue-specific localization of Cr-Vasa mRNA in C. rogercresseyi was determined using chromogenic in situ hybridization, and strong positive signal was observed in male testes, but also in the intestine and cuticle, while in females, it was observed in the ovaries, oocytes, cuticle, intestine, and egg strings. RNAi-mediated gene silencing of Cr-Vasa impacted embryonic development and reproductive output in adult female lice. Females from the dsVasa-treated group displayed unusual phenotypes, including shorter egg strings with numerous extra-embryonic inclusions, irregularly shaped abnormal embryos, and aborted egg strings. This study provides insights into the role of the Vasa gene in C. rogercresseyi embryonic development and reproductive output, which may have implications for the control of this parasitic copepod in the salmon farming industry.

Nonlinear cortical encoding of color predicts enhanced McCollough effects in anomalous trichromats.

Nonlinear encoding of chromatic contrast by the early visual cortex predicts that anomalous trichromats will show a larger McCollough effect than normal trichromats. In Experiment 1 we employed the McCollough effect to probe the cortical representation of saturation in normal trichromats, and used the results to predict enhanced McCollough effects for anomalous trichromats, which we measured in Experiment 2. In Experiment 1 three participants adapted to red and green orthogonal gratings of four different saturations. Using nulling to measure aftereffect strength, we found that halving the saturation of the inducing gratings decreased aftereffect strength only slightly, consistent with a compressive coding of saturation in early visual cortex. In anomalous trichromats, cone contrasts between red and green are greatly decreased from those of normal trichromats, but induced aftereffects are only slightly decreased, because of the non-linearity in the cortical encoding of saturation. To null the aftereffect, however, the retinal color deficiency must be overcome by adding more color to the null than required by normal trichromats. We confirmed this prediction in Experiment 2 where four anomalous trichromats required nulling stimuli approximately four times more saturated than did normal trichromats. We consider two competing models to explain our results: in a 'pigment swap' model anomalous trichromats have an altered photopigment but process color postreceptorally in the same way as normal trichromats; in a 'postreceptoral compensation' model the cortical representation of red-green contrasts is amplified to compensate for reduced cone contrasts. The latter provided a better fit to our data.

Patients Receiving Integrative Medicine Effectiveness Registry (PRIMIER) of the BraveNet practice-based research network: Outcomes of the PRIMIER cohort.

OBJECTIVE: To evaluate the real-world effectiveness of integrative medicine treatment on quality of life using the Patients Receiving Integrative Medicine Effectiveness Registry (PRIMIER). DESIGN: A prospective, longitudinal, observational evaluation of patient reported outcomes for quality of life. SETTING: Participants were patients from 17 integrative medicine clinics who received personalized, integrative medicine treatments between August 2013 and October 2017. MAIN OUTCOME MEASURES: Participants completed the Patient Reported Outcomes Measurement Information System (PROMIS)- 29, Perceived Stress Scale-4 (PSS-4), and the Patient Activation Measure (PAM) at index (baseline) visit and at 2, 4, 6, and 12 month follow-up assessments. Electronic health record data included diagnostic and billing codes/descriptions. A linear mixed-effects model was used to test whether outcomes changed from index through 12 months RESULTS: During enrollment, 4883 participants began the assessment, 3658 completed the index measures, and 2374 (65 %) completed at least 1 follow-up assessment, had electronic health record data and at least 1 integrative medicine visit. Most participants (mean age=51.4 years) were white (88.4 %), female (79.7 %), and college-educated (78.5 %). Significant improvements (p < 0.001) were observed at 12-months on all PROMIS-29 measures, PSS-4, and PAM. At 12 months, clinically meaningful improvements were found for 38 % and 28 % on PROMIS-29 Mental and Physical Health Summary scores respectively. CONCLUSIONS: PRIMIER is the largest study to assess the real-world effectiveness of integrative medicine. Results indicate a statistical and clinical improvement across all measures at 12 months. Future research could explore whether dosing, timing or combinations of integrative medicine interventions have differential impacts on quality of life.

Backgrounds and Trainings in Cannabis Therapeutics of Dispensary Personnel.

PURPOSE: A growing body of scientific research indicates that oncology teams tend to offer individuals with cancer little clinical advice regarding medicinal cannabis (MC) and that individuals with cancer instead turn to cannabis dispensaries for MC guidance. Our objective was to investigate dispensary personnel's backgrounds and trainings in MC advising. METHODS: The study design was semistructured interviews across 13 states with cannabis dispensary personnel in managerial or client-facing positions. Of 38 recruited, 26 (68%) completed interview. The primary outcome was training in MC advising. Researchers targeted thematic saturation and adhered to Consolidated Criteria for Reporting Qualitative Research. RESULTS: Of 26 participants, 54% were female, with an average age of 40 (range: 22-64) years. Half worked in client-facing roles; half worked in managerial ones. Study participants endorsed passionate commitment to their profession, often motivated by personal experience with MC therapeutics. Cannabis dispensaries often privileged sales skills over cannabis therapeutics knowledge when hiring, resulting in uneven baseline levels of cannabis therapeutics expertise among staff. Most participants reported workplace cannabis therapeutics training to be unstandardized and weak. They described dispensary personnel as resourceful in pursuing cannabis knowledge, self-financing learning in off-hours, sampling dispensary products, and exchanging knowledge. Nearly half the participants called for quality, standardized cannabis therapeutics training for dispensary personnel. CONCLUSION: The many oncology teams who defer to dispensary personnel regarding MC advising rely on a workforce who views themselves as unevenly trained. Further research should include a national survey of cannabis dispensary personnel to learn whether these findings hold true in a larger sample. If so, the oncology community must determine the best approach to clinically advising individuals with cancer about MC.

Cannabis, Cannabinoids and Cannabis-Based Medicines in Cancer Care.

As medical cannabis becomes legal in more states, cancer patients are increasingly interested in the potential utility of the ancient botanical in their treatment regimen. Although eager to discuss cannabis use with their oncologist, patients often find that their provider reports that they do not have adequate information to be helpful. Oncologists, so dependent on evidence-based data to guide their treatment plans, are dismayed by the lack of published literature on the benefits of medical cannabis. This results largely from the significant barriers that have existed to effectively thwart the ability to conduct trials investigating the potential therapeutic efficacy of the plant. This is a narrative review aimed at clinicians, summarizing cannabis phytochemistry, trials in the areas of nausea and vomiting, appetite, pain and anticancer activity, including assessment of case reports of antitumor use, with reflective assessments of the quality and quantity of evidence. Despite preclinical evidence and social media claims, the utility of cannabis, cannabinoids or cannabis-based medicines in the treatment of cancer remains to be convincingly demonstrated. With an acceptable safety profile, cannabis and its congeners may be useful in managing symptoms related to cancer or its treatment. Further clinical trials should be conducted to evaluate whether the preclinical antitumor effects translate into benefit for cancer patients. Oncologists should familiarize themselves with the available database to be able to better advise their patients on the potential uses of this complementary botanical therapy.

Occurrence and spatial distribution of heavy metals in landfill leachates and impacted freshwater ecosystem: An environmental and human health threat.

Municipal landfill leachates are a source of toxic heavy metals that have been shown to have a detrimental effect on human health and the environment. This study aimed to assess heavy metal contamination in leachates, surface water, and sediments from non-sanitary landfills in Uyo, Nigeria, and to identify potential health and environmental effects of leachate contamination. Over the wet and dry seasons, surface water and sediment samples were collected from an impacted freshwater ecosystem, and leachates samples from six monitoring wells. Elemental analyses of samples were conducted following standard analytical procedures and methods. The results indicated that leachate, surface water, and sediment samples all had elevated levels of heavy metals, implying a significant impact from landfills. Pollution indices such as the potential ecological risk index (PERI), pollution load index (PLI), degree of contamination (Cd), modified degree of contamination (mCd), enrichment factor (EF), geoaccumulation index (Igeo), and Nemerov pollution index (NPI) were used to assess the ecological impacts of landfill leachates. The following values were derived: PERI (29.09), PLI (1.96E-07), Cd (0.13), mCd (0.16), EF (0.97-1.79E-03), Igeo (0), and NPI (0.74). Pollution indicators suggested that the sediment samples were low to moderately polluted by chemical contaminants from the non-sanitary landfills, and may pose negative risks due to bioaccumulation. Human health risks were also assessed using standard risk models. For adults, children, and kids, the incremental lifetime cancer rate (ILCR) values were within the acceptable range of 1.00E-06-1.00E-04. The lifetime carcinogenicity risks associated with oral ingestion exposure to heavy metals were 9.09E-05, 1.21E-05, and 3.60 E-05 for kids, adults, and children, respectively. The mean cumulative risk values for dermal exposures were 3.24E-07, 1.89E-06, and 1.17E-05 for adults, children, and kids, respectively. These findings emphasized the risks of human and biota exposure to contaminants from landfills.

The channel for detecting contrast modulation also responds to density modulation (or vice versa).

In textures composed of black and white dots, we modulated dot density and/or dot contrast in one direction of visual space. Just as Mulligan and MacLeod (Vision Research 28 (1988) 503-519) found a strong reciprocity between density and luminance for dots viewed against a darker background, we found a strong reciprocity between density and contrast: detection thresholds for in-phase modulations of density and contrast were 30% - 55% lower than detection thresholds for density and contrast modulations that were 180° out of phase. These findings support the existence of at least one psychophysical channel that is excited by both density modulations and contrast modulations. A good, quantitative fit to our data can be obtained with a two-channel model.

A Longitudinal Integrative Course Series to Prepare Students for Advanced Pharmacy Practice Experiences.

Background: This paper describes a series of integrative courses intentionally designed to prepare students for Advanced Pharmacy Practice Experiences (APPEs) in a block system curriculum. Innovation: Three integration blocks are interspersed throughout the didactic curriculum to serve as checkpoints to ensure competency as students progress in the curriculum, rather than waiting until the end to determine competency. Complex patient case discussions and a series of high-stakes assessments are used to reinforce and evaluate cumulative retention of knowledge, skills, and attitudes. Findings: Class of 2022 exam results showed that in the cohort of students who failed the high-stakes comprehensive knowledge assessment (CKA) and pharmacy calculations exams during the first integration block (IB), failure rates decreased in subsequent IBs, indicating early detection of knowledge deficiencies and either exam performance improvement in each IB or failure to progress to the next IB. A survey of the same cohort indicated that the final integration block prior to advanced pharmacy practice experiences (APPEs) helped improve confidence in applying key knowledge and skills into practice. Conclusion: The series of integration blocks designed and implemented at WesternU provides opportunities to reinforce knowledge and skills while requiring students to demonstrate maintenance of core competency as they progress through the curriculum.

Cancer Treatment: Preclinical & Clinical.

The first evidence that cannabinoids may have in vitro and in vivo antineoplastic activity against tumor cell lines and animal tumor models was published in the Journal of the National Cancer Institute nearly 50 years ago. Cannabinoids appear to induce apoptosis in rodent brain tumors by way of direct interaction with the cannabinoid receptor. They may inhibit angiogenesis and tumor cell invasiveness. Despite preclinical findings, attempts to translate the benefits from bench to bedside have been limited. This session provides a review of the basic science supporting the use of cannabinoids in gliomas, paired with the first randomized clinical trial of a cannabis-based therapy for glioblastoma multiforme. Another preclinical presentation reports the effects of cannabinoids on triple-negative breast cancer cell lines and how cannabidiol may affect tumors. The session's second human trial raises concerns about the use of botanical cannabis in patients with advanced cancer receiving immunotherapy suggesting inferior outcomes.

Challenges for Clinical Cannabis and Cannabinoid Research in the United States.

Significant changes have occurred in the policy landscape surrounding cannabis legalization, production, and use around the globe and across the United States. With widespread availability of novel cannabis and cannabis-based products, there is an urgent need to understand their safety and effectiveness for medical indications. Three primary barriers contribute to the difficulty in initiating research geared toward answering the most pressing public health questions: the US regulatory status of cannabis and cannabinoids, sources for cannabis and cannabinoid study medications, and limited funding and resources to support studies. Despite these hurdles, research is rapidly increasing, and recent changes in the United States have paved the way for exciting new work. Here, challenges and barriers to cannabis and cannabinoid research are described from the perspectives of the National Institute on Drug Abuse, National Institutes of Health; the US Food and Drug Administration; and 2 clinical researchers. Barriers specifically to studying cannabis, cannabinoids, and cancer are emphasized.

Cannabis and the Cancer Patient.

Session 2 of the National Cancer Institute's Cannabis, Cannabinoids, and Cancer Research Workshop opened with testimony from a lymphoma survivor who detailed medicinal cannabis-related improvements in nausea, low appetite, insomnia, and mental health and the limited clinical counsel she received regarding cannabis use. Discussion next turned to the evolution of the legal landscape of cannabis in the United States, one in which state and federal laws frequently conflict and the Controlled Substance Act renders cannabis Schedule I. This legal climate creates conundrums for US medicinal cannabis researchers who contend with limited funding opportunities, avenues to source trial drug, and procedural red tape and for oncology clinicians who recommend medicinal cannabis to patients with some frequency while perceiving themselves as ill equipped to make such clinical recommendations. Ultimately, it creates challenges for cancer patients who find themselves turning to nonmedical and anecdotal information sources. The risks of cannabis use by the cancer patient were discussed next. These include infection, pharmacodynamic and pharmacokinetic drug-botanical interactions, cyclic nausea and vomiting, e-cigarette or vaping product use-associated illness, legal issues, and high cost. The session concluded with a broad survey of the research supporting oncologic cannabinoid use, conclusive evidence for chemotherapy-induced nausea and vomiting, and suggestive evidence for cancer-related pain.

Oceanic records of North American bats and implications for offshore wind energy development in the United States.

Offshore wind energy is a growing industry in the United States, and renewable energy from offshore wind is estimated to double the country's total electricity generation. There is growing concern that land-based wind development in North America is negatively impacting bat populations, primarily long-distance migrating bats, but the impacts to bats from offshore wind energy are unknown. Bats are associated with the terrestrial environment, but have been observed over the ocean. In this review, we synthesize historic and contemporary accounts of bats observed and acoustically recorded in the North American marine environment to ascertain the spatial and temporal distribution of bats flying offshore. We incorporate studies of offshore bats in Europe and of bat behavior at land-based wind energy studies to examine how offshore wind development could impact North American bat populations. We find that most offshore bat records are of long-distance migrating bats and records occur during autumn migration, the period of highest fatality rates for long-distance migrating bats at land-based wind facilities in North America. We summarize evidence that bats may be attracted to offshore turbines, potentially increasing their exposure to risk of collision. However, higher wind speeds offshore can potentially reduce the amount of time that bats are exposed to risk. We identify knowledge gaps and hypothesize that a combination of operational minimization strategies may be the most effective approach for reducing impacts to bats and maximizing offshore energy production.

Kikuchi-Fujimoto disease involving retroperitoneal lymph nodes: An uncommon presentation.

Kikuchi-Fujimoto disease is a self-limited disease of unknown etiology that is clinically defined by fevers accompanied by tender posterior cervical lymphadenopathy. It often presents acutely or sub-acutely, and due to its non-specific features, the differential diagnosis is broad and includes infectious, autoimmune, and malignant causes. Although cases of extra-cervical disease are not uncommon, involvement of retroperitoneal lymph nodes has only rarely been reported. Here, we describe a patient with Kikuchi-Fujimoto disease who presented with fever of unknown origin, abdominal pain, and enlarged hypermetabolic retroperitoneal lymph nodes.

A cannabis oracle? Delphi method not a substitute for randomized controlled trials of cannabinoids as therapeutics.

BACKGROUND: With millions of people using cannabinoids to treat a host of medical conditions, clinicians want guidance on how to utilize cannabinoids as pharmacotherapy in their practices. The Delphi method is a systematic, interactive forecasting method that aims to develop consensus best practices where guidelines are not available. BODY: A multidisciplinary group of global cannabinoid experts utilized a modified Delphi process to develop three protocols for the dosing and administration of cannabinoids to treat chronic pain. Two protocols recommend cannabidiol (CBD), for which there is limited evidence as an analgesic, starting well below doses required for other indications. Guidance on prescribing CBD for pain may demonstrate consensus recommendations based upon suboptimal evidence. CONCLUSION: Consensus processes like the Delphi method are well-meaning, but they are not a substitute for rigorous RCTs with large sample sizes, adequate duration, and standardized outcome measures.