Novel B-DNA dermatophyte assay for demonstration of canonical DNA in dermatophytes: Histopathologic characterization by artificial intelligence.

We describe a novel assay and artificial intelligence-driven histopathologic approach identifying dermatophytes in human skin tissue sections (ie, B-DNA dermatophyte assay) and demonstrate, for the first time, the presence of dermatophytes in tissue using immunohistochemistry to detect canonical right-handed double-stranded (ds) B-DNA. Immunohistochemistry was performed using anti-ds-B-DNA monoclonal antibodies with formalin-fixed paraffin-embedded tissues to determine the presence of dermatophytes. The B-DNA assay resulted in a more accurate identification of dermatophytes, nuclear morphology, dimensions, and gene expression of dermatophytes (ie, optical density values) than periodic acid-Schiff (PAS), Grocott methenamine silver (GMS), or hematoxylin and eosin (H&E) stains. The novel assay guided by artificial intelligence allowed for efficient identification of different types of dermatophytes (eg, hyphae, microconidia, macroconidia, and arthroconidia). Using the B-DNA dermatophyte assay as a clinical tool for diagnosing dermatophytes is an alternative to PAS, GMS, and H&E as a fast and inexpensive way to accurately detect dermatophytosis and reduce the number of false negatives. Our assay resulted in superior identification, sensitivity, life cycle stages, and morphology compared to H&E, PAS, and GMS stains. This method detects a specific structural marker (ie, ds-B-DNA), which can assist with diagnosis of dermatophytes. It represents a significant advantage over methods currently in use.

Effect of a Biopsychosocial Intervention or Postural Therapy on Disability and Health Care Spending Among Patients With Acute and Subacute Spine Pain: The SPINE CARE Randomized Clinical Trial.

Importance: Low back and neck pain are often self-limited, but health care spending remains high. Objective: To evaluate the effects of 2 interventions that emphasize noninvasive care for spine pain. Design, Setting, and Participants: Pragmatic, cluster, randomized clinical trial conducted at 33 centers in the US that enrolled 2971 participants with neck or back pain of 3 months' duration or less (enrollment, June 2017 to March 2020; final follow-up, March 2021). Interventions: Participants were randomized at the clinic-level to (1) usual care (n = 992); (2) a risk-stratified, multidisciplinary intervention (the identify, coordinate, and enhance [ICE] care model that combines physical therapy, health coach counseling, and consultation from a specialist in pain medicine or rehabilitation) (n = 829); or (3) individualized postural therapy (IPT), a postural therapy approach that combines physical therapy with building self-efficacy and self-management (n = 1150). Main Outcomes and Measures: The primary outcomes were change in Oswestry Disability Index (ODI) score at 3 months (range, 0 [best] to 100 [worst]; minimal clinically important difference, 6) and spine-related health care spending at 1 year. A 2-sided significance threshold of .025 was used to define statistical significance. Results: Among 2971 participants randomized (mean age, 51.7 years; 1792 women [60.3%]), 2733 (92%) finished the trial. Between baseline and 3-month follow-up, mean ODI scores changed from 31.2 to 15.4 for ICE, from 29.3 to 15.4 for IPT, and from 28.9 to 19.5 for usual care. At 3-month follow-up, absolute differences compared with usual care were -5.8 (95% CI, -7.7 to -3.9; P < .001) for ICE and -4.3 (95% CI, -5.9 to -2.6; P < .001) for IPT. Mean 12-month spending was $1448, $2528, and $1587 in the ICE, IPT, and usual care groups, respectively. Differences in spending compared with usual care were -$139 (risk ratio, 0.93 [95% CI, 0.87 to 0.997]; P = .04) for ICE and $941 (risk ratio, 1.40 [95% CI, 1.35 to 1.45]; P < .001) for IPT. Conclusions and Relevance: Among patients with acute or subacute spine pain, a multidisciplinary biopsychosocial intervention or an individualized postural therapy intervention, each compared with usual care, resulted in small but statistically significant reductions in pain-related disability at 3 months. However, compared with usual care, the biopsychosocial intervention resulted in no significant difference in spine-related health care spending and the postural therapy intervention resulted in significantly greater spine-related health care spending at 1 year. Trial Registration: ClinicalTrials.gov Identifier: NCT03083886.

Ancient Tethyan Vicariance and Long-Distance Dispersal Drive Global Diversification and Cryptic Speciation in the Red Seaweed Pterocladiella.

We investigated the globally distributed red algal genus Pterocladiella, comprising 24 described species, many of which are economically important sources of agar and agarose. We used DNA-based species delimitation approaches, phylogenetic, and historical biogeographical analyses to uncover cryptic diversity and infer the drivers of biogeographic patterns. We delimited 43 species in Pterocladiella, of which 19 are undescribed. Our multigene time-calibrated phylogeny and ancestral area reconstruction indicated that Pterocladiella most likely originated during the Early Cretaceous in the Tethys Sea. Ancient Tethyan vicariance and long-distance dispersal have shaped current distribution patterns. The ancestor of Eastern Pacific species likely arose before the formation of the formidable Eastern Pacific Barrier-a first confirmation using molecular data in red algae. Divergences of Northeast and Southeast Pacific species have been driven by the Central American Seaway barrier, which, paradoxically, served as a dispersal pathway for Atlantic species. Both long- and short-distance dispersal scenarios are supported by genetic relationships within cosmopolitan species based on haplotype analysis. Asymmetrical distributions and the predominance of peripatry and sympatry between sister species suggest the importance of budding speciation in Pterocladiella. Our study highlights the underestimation of global diversity in these crucial components of coastal ecosystems and provides evidence for the complex evolution of current species distributions.

Historical biogeographical analysis of the Udoteaceae (Bryopsidales, Chlorophyta) elucidates origins of high species diversity in the Central Indo-Pacific, Western Indian Ocean and Greater Caribbean regions.

There is a growing interest in elucidating the biogeographical processes underlying biodiversity patterns of seaweeds, with recent studies largely focusing on red and brown macroalgae. This study focuses on the siphonous green algal family Udoteaceae, which is diverse and globally distributed in tropical to warm-temperate seas, and includes species that form important components of tropical reefs. We explored the historical processes that have shaped current biodiversity patterns in the family by analyzing a comprehensive dataset of 568 specimens sampled across its geographical range, and including 45 species, corresponding to 59% of the known diversity. Historical biogeographical analysis was based on a three-locus time-calibrated phylogeny, and probabilistic modeling of geographical range evolution. Many species were found to have restricted ranges, indicative of low dispersal capacity. Our analysis points toward a Western Tethys origin and early diversification of the Udoteaceae in the Triassic period. Three centers of diversity were identified, which are, in order of highest species richness, the Central Indo-Pacific, the Western Indian Ocean, and the Greater Caribbean. Different drivers have likely played a role in shaping these diversity centres. Species richness in the Central Indo-Pacific likely resulted from speciation within the region, as well as recolonization from neighbouring regions, and overlap of some wider ranged species, corroborating the "biodiversity feedback" model. Species richness in the Western Indian Ocean can be explained by ancient and more recent diversification within the region, and dispersal from the Central Indo-Pacific. The Greater Caribbean region was colonized more recently, followed by diversification within the region.

The contribution of fisheries and aquaculture to the global protein supply.

The contribution of aquatic animal protein to the global, animal-source protein supply and the relative importance of aquaculture to capture fisheries in supplying this protein is relevant in assessments and decisions related to the future of aquatic food production and its security. Meat of terrestrial animals, milk, and eggs resulted in 76,966 Kt crude protein compared with 13,950 Kt or 15.3% from aquatic animals in 2018.While aquaculture produced a greater tonnage of aquatic animals, capture fisheries resulted in 7,135 Kt crude protein while aquaculture yielded 6,815 Kt. Capture fisheries production has not increased in the past two decades, and aquaculture production must increase to assure the growing demand for fisheries products by a larger and more affluent population. We estimated based on status quo consumption, that aquaculture production would need to increase from 82,087 Kt in 2018 to 129,000 Kt by 2050 to meet the demand of the greater population. About two-thirds of finfish and crustacean production by aquaculture is feed-based, and feeds for these species include fishmeal and fish oil as ingredients. Aquaculture feeds require a major portion of the global supply of fishmeal and fish oil. An estimated 71.0% of fishmeal and 73.9% of fish oil are made from the catch with the rest coming from aquatic animal processing waste. The catch of small, pelagic fish from the ocean is not predicted to increase in the future. Aquaculture should reduce its fishmeal and oil use to lessen its dependency on small wild fish important to the integrity of marine food webs and food security for the poor in many coastal areas. Fishmeal and fish oil shortages for use in aquaculture feed will result in a limit on production in the future if goals to lessen their use in feeds are not met.

Patient Sociodemographic Characteristics Associated With Saturday Breast Imaging Clinic Utilization.

OBJECTIVE: To determine patient sociodemographic characteristics associated with breast imaging utilization on Saturdays to inform potential initiatives designed to improve access and reduce disparities in breast cancer care. METHODS: This was an IRB-approved retrospective cross-sectional study. All adult women (aged ≥18 years) who received a screening or diagnostic examination at our breast imaging facility from January 1, 2016 to December 31, 2017 were included. Patient characteristics including age, race, primary language, partnership status, insurance status, and primary care physician status were collected using the electronic medical record. Multiple variable logistic regression analyses were performed to evaluate patient characteristics associated with utilization. RESULTS: Of 53 695 patients who underwent a screening examination and 10 363 patients who underwent a diagnostic examination over our study period, 9.6% (5135/53 695) and 2.0% (209/10 363) of patients obtained their respective examination on a Saturday. In our multiple variable logistic regression analyses, racial/ethnic minorities (odds ratio [OR], 1.5; 95% confidence interval [CI]: 1.4-1.6; P < 0.01) and women who speak English as a second language (OR, 1.1; 95% CI: 1.0-1.3; P = 0.03) were more likely to obtain their screening mammogram on Saturday than their respective counterparts. CONCLUSION: Racial/ethnic minorities and women who speak English as a second language were more likely to obtain their screening mammogram on Saturdays than their respective counterparts. Initiatives to extend availability of breast imaging exams outside of standard business hours increases access for historically underserved groups, which can be used as a tool to reduce breast cancer-related disparities in care.

Trace element concentrations in white leg shrimp Litopenaeus vannamei from retail stores in the EU, UK, and USA and the ability to discern country of origin with classification models.

Shrimp are a globally traded aquaculture commodity that accounts for a large proportion of the monetary value of aquaculture. There are concerns among consumers about seafood labeling fraud and environmental sustainability. Therefore, the geographic origin of shrimp from retail stores was investigated with trace element profiling. 94 shrimp samples were collected from grocery stores across the USA, UK, and EU in 70 different grocery stores. The results of 24 elements are reported. Shrimp samples were from Thailand, India, Vietnam, Indonesia, and Ecuador were shown to have 15 elements that were statistically different across labeled country of origin, with Ecuador having unique post hoc group membership in 5 of the elements. Based on a classification procedure, shrimp were classified to labeled country of origin with an overall accuracy of 71.2%. Overall, the results suggest that elemental profiling could be a traceability tool for classifying samples of shrimp from retail stores.

A preliminary survey of antibiotic residues in frozen shrimp from retail stores in the United States.

Shrimp are an important and valuable commodity for aquaculture that are widely traded internationally. Widespread antibiotic use has been documented in shrimp farming and is a common source of criticism of aquaculture products. Additionally, previous reports have found some evidence of antibiotic residues in shrimp samples obtained from retail stores in the United States, which is a concern for consumers. To further understand the prevalence of antibiotics in retail shrimp in the United States, shrimp samples obtained from grocery stores across 16 states were analyzed for 74 antibiotic compounds/metabolites at a commercial laboratory. 68 samples were analyzed for a multiclass antibiotic panel which included 66 antibiotics while a subset of 15 samples were analyzed for ß-lactam antibiotics, Nitrofurans, and Oxytetracycline. Samples were obtained that were labeled as being from major production countries, including India, Indonesia, Thailand, and Vietnam. No detectable antibiotic residues were found in this survey in any samples. This is contrary to previous findings in frozen shrimp analyzed for antibiotics, which typically report low levels of the prevalence of antibiotics.

Nation-wide hierarchical and spatially-explicit framework to characterize seagrass meadows in New-Caledonia, and its potential application to the Indo-Pacific.

Despite their ecological role and multiple contributions to human societies, the distribution of Indo-Pacific seagrasses remains poorly known in many places. Herein, we outline a hierarchical spatially-explicit assessment framework to derive nation-wide synoptic knowledge of the distribution of seagrass species and communities. We applied the framework to New Caledonia (southwest Pacific Ocean) and its 36,200 km2 of reefs and lagoons. The framework is primarily field-based but can leverage various habitat maps derived from remote sensing. Field data collection can be stratified by map products and retrospectively contribute to developing new seagrass distribution maps. Airborne and satellite remote sensing alone do not allow for the spatial generalisation of the finest attributes (species distribution and types of seagrass beds), but staged stratified field sampling provides synoptic views of these attributes. Using three examples, we discuss how the hierarchical and spatial information generated from this framework's application can inform conservation and management objectives.

Coral larval settlement preferences linked to crustose coralline algae with distinct chemical and microbial signatures.

The resilience of coral reefs is dependent on the ability of corals to settle after disturbances. While crustose coralline algae (CCA) are considered important substrates for coral settlement, it remains unclear whether coral larvae respond to CCA metabolites and microbial cues when selecting sites for attachment and metamorphosis. This study tested the settlement preferences of an abundant coral species (Acropora cytherea) against six different CCA species from three habitats (exposed, subcryptic and cryptic), and compared these preferences with the metabolome and microbiome characterizing the CCA. While all CCA species induced settlement, only one species (Titanoderma prototypum) significantly promoted settlement on the CCA surface, rather than on nearby dead coral or plastic surfaces. This species had a very distinct bacterial community and metabolomic fingerprint. Furthermore, coral settlement rates and the CCA microbiome and metabolome were specific to the CCA preferred habitat, suggesting that microbes and/or chemicals serve as environmental indicators for coral larvae. Several amplicon sequence variants and two lipid classes-glycoglycerolipids and betaine lipids-present in T. prototypum were identified as potential omic cues influencing coral settlement. These results support that the distinct microbiome and metabolome of T. prototypum may promote the settlement and attachment of coral larvae.

Selection of parameters for seagrass management: Towards the development of integrated indicators for French Antilles.

Seagrass beds are increasingly impacted by human activities in coastal areas, particularly in tropical regions. The objective of this research program was to study seagrass beds characteristics under various environmental conditions in the French Antilles (FA, Caribbean Sea). A total of 61 parameters, from plant physiology to seagrass ecosystem, were tested along a gradient of anthropogenic conditions, distributed across 11 sites and 3 islands of the FA. A selection of 7 parameters was identified as relevant for the monitoring of seagrass meadows in the framework of public policies. They combined "early warning indicators" (e.g. nutrients and some trace metals) and long-term responding parameters (e.g. shoot density) adapted to management time scales. The ecological status of seagrass meadows was evaluated using a PCA. This work is a first step towards monitoring and management of seagrass meadows in the FA.

Diversity and taxonomic revision of tribes Rhipileae and Rhipiliopsideae (Halimedaceae, Chlorophyta) based on molecular and morphological data.

Genera and species of the tribes Rhipileae and Rhipiliopsideae are abundant in most coral reef ecosystems worldwide. However, the group has been largely overlooked, and very little genetic data is available to accurately assess its diversity, phylogenetic relationships, and geographic distribution. Our study provided an in-depth reassessment of tribes Rhipileae and Rhipiliopsideae based on a species-rich dataset and the combination of molecular species delimitation, multilocus phylogenetic analyses (tufA, rbcL, and 18S rDNA), and morpho-anatomic observations. Our results revealed an unexpected diversity of 38 morphologically validated species hypotheses, including 20 new species, two of which are described in this paper and one resurrected species (Rhipilia diaphana). Based on our phylogenetic results we proposed to redefine the genera Rhipilia and Rhipiliopsis and described two new genera, Kraftalia gen. nov. (Rhipileae) and Rhipiliospina gen. nov. (Rhipiliopsideae). Finally, we validated Rhipiliella Kraft and included it in the tribe Rhipileae. Although Rhipilia and Rhipiliopsis have a pantropical distribution, none of the species studied here appeared cosmopolitan; instead, they have restricted distributions.

Seagrass ecosystems of the Pacific Island Countries and Territories: A global bright spot.

Seagrass ecosystems exist throughout Pacific Island Countries and Territories (PICTs). Despite this area covering nearly 8% of the global ocean, information on seagrass distribution, biogeography, and status remains largely absent from the scientific literature. We confirm 16 seagrass species occur across 17 of the 22 PICTs with the highest number in Melanesia, followed by Micronesia and Polynesia respectively. The greatest diversity of seagrass occurs in Papua New Guinea (13 species), and attenuates eastward across the Pacific to two species in French Polynesia. We conservatively estimate seagrass extent to be 1446.2 km2, with the greatest extent (84%) in Melanesia. We find seagrass condition in 65% of PICTs increasing or displaying no discernible trend since records began. Marine conservation across the region overwhelmingly focuses on coral reefs, with seagrass ecosystems marginalised in conservation legislation and policy. Traditional knowledge is playing a greater role in managing local seagrass resources and these approaches are having greater success than contemporary conservation approaches. In a world where the future of seagrass ecosystems is looking progressively dire, the Pacific Islands appears as a global bright spot, where pressures remain relatively low and seagrass more resilient.

Seagrass ecosystem contributions to people's quality of life in the Pacific Island Countries and Territories.

Seagrass ecosystems provide critical contributions (goods and perceived benefits or detriments) for the livelihoods and wellbeing of Pacific Islander peoples. Through in-depth examination of the contributions provided by seagrass ecosystems across the Pacific Island Countries and Territories (PICTs), we find a greater quantity in the Near Oceania (New Guinea, the Bismarck Archipelago and the Solomon Islands) and western Micronesian (Palau and Northern Marianas) regions; indicating a stronger coupling between human society and seagrass ecosystems. We also find many non-material contributions historically have been overlooked and under-appreciated by decision-makers. Closer cultural connections likely motivate guardianship of seagrass ecosystems by Pacific communities to mitigate local anthropogenic pressures. Regional comparisons also shed light on general and specific aspects of the importance of seagrass ecosystems to Pacific Islanders, which are critical for forming evidence-based policy and management to ensure the long-term resilience of seagrass ecosystems and the contributions they provide.

Diversity, Ecology, Biogeography, and Evolution of the Prevalent Brown Algal Genus Lobophora in the Greater Caribbean Sea, Including the Description of Five New Species1.

Distributed in tropical and warm-temperate waters worldwide, Lobophora species are found across the Greater Caribbean (i.e., Caribbean sensu stricto, Gulf of Mexico, Florida, the Bahamas, and Bermuda). We presently discuss the diversity, ecology, biogeography, and evolution of the Greater Caribbean Lobophora species based on previous studies and an extensive number of samples collected across the eastern, southern, and to a lesser extent western Caribbean. A total of 18 Lobophora species are now documented from the Greater Caribbean, of which five are newly described (L. agardhii sp. nov., L. dickiei sp. nov., L. lamourouxii sp. nov., L. richardii sp. nov., and L. setchellii sp. nov.). Within the Greater Caribbean, the eastern Caribbean and the Central Province are the most diverse ecoregion and province (16 spp.), respectively. Observed distribution patterns indicate that Lobophora species from the Greater Caribbean have climate affinities (i.e., warm-temperate vs. tropical affinities). In total, 11 Lobophora species exclusively occur in the Greater Caribbean; six are present in the western Atlantic; two in the Indo-Pacific; and one in the eastern Pacific. Biogeographic analyses support that no speciation occurred across the Isthmus of Panama, and that the Greater Caribbean acted as a recipient region for species from the Indo-Pacific and as a region of diversification as well as a donor region to the North-eastern Atlantic. The Greater Caribbean is not an evolutionary dead end for Lobophora, but instead generates and exports diversity. Present results illustrate how sampling based on DNA identification is reshaping biogeographic patterns, as we know them.

An explainable deep-learning algorithm for the detection of acute intracranial haemorrhage from small datasets.

Owing to improvements in image recognition via deep learning, machine-learning algorithms could eventually be applied to automated medical diagnoses that can guide clinical decision-making. However, these algorithms remain a 'black box' in terms of how they generate the predictions from the input data. Also, high-performance deep learning requires large, high-quality training datasets. Here, we report the development of an understandable deep-learning system that detects acute intracranial haemorrhage (ICH) and classifies five ICH subtypes from unenhanced head computed-tomography scans. By using a dataset of only 904 cases for algorithm training, the system achieved a performance similar to that of expert radiologists in two independent test datasets containing 200 cases (sensitivity of 98% and specificity of 95%) and 196 cases (sensitivity of 92% and specificity of 95%). The system includes an attention map and a prediction basis retrieved from training data to enhance explainability, and an iterative process that mimics the workflow of radiologists. Our approach to algorithm development can facilitate the development of deep-learning systems for a variety of clinical applications and accelerate their adoption into clinical practice.

Metabolomic variability of four macroalgal species of the genus Lobophora using diverse approaches.

Among comparative metabolomic studies used in marine sciences, only few of them are dedicated to macroalgae despite their ecological importance in marine ecosystems. Therefore, experimental data are needed to assess the scopes and limitations of different metabolomic techniques applied to macroalgal models. Species of the genus Lobophora belong to marine brown algae (Family: Dictyotaceae) and are widely distributed, especially in tropical coral reefs. The species richness of this genus has only been unveiled recently and it includes species of diverse morphologies and habitats, with some species interacting with corals. This study aims to assess the potential of different metabolomic fingerprinting approaches in the discrimination of four well known Lobophora species (L. rosacea, L. sonderii, L. obscura and L. monticola). These species present distinct morphologies and are found in various habitats in the New Caledonian lagoon (South-Western Pacific). We compared and combined different untargeted metabolomic techniques: liquid chromatography-mass spectrometry (LC-MS), nuclear magnetic resonance (1H-NMR) and gas chromatography (GC-MS). Metabolomic separations were observed between each Lobophora species, with significant differences according to the techniques used. LC-MS was the best approach for metabotype distinction but a combination of approaches was also useful and allowed identification of chemomarkers for some species. These comparisons provide important data on the use of metabolomic approaches in the Lobophora genus and will pave the way for further studies on the sources of metabolomic variations for this ecologically important macroalgae.

High metabolic variation for seaweeds in response to environmental changes: a case study of the brown algae Lobophora in coral reefs.

In the marine environment, macroalgae face changing environmental conditions and some species are known for their high capacity to adapt to the new factors of their ecological niche. Some macroalgal metabolites play diverse ecological functions and belong to the adaptive traits of such species. Because algal metabolites are involved in many processes that shape marine biodiversity, understanding their sources of variation and regulation is therefore of utmost relevance. This work aims at exploring the possible sources of metabolic variations with time and space of four common algal species from the genus Lobophora (Dictyotales, Phaeophyceae) in the New Caledonian lagoon using a UHPLC-HRMS metabolomic fingerprinting approach. While inter-specific differences dominated, a high variability of the metabolome was noticed for each species when changing their natural habitats and types of substrates. Fatty acids derivatives and polyolefins were identified as chemomarkers of these changing conditions. The four seaweeds metabolome also displayed monthly variations over the 13-months survey and a significant correlation was made with sea surface temperature and salinity. This study highlights a relative plasticity for the metabolome of Lobophora species.