With many species interacting in nature, determining which describe community dynamics is nontrivial. By applying a new Bayesian-sparse modelling approach to an extensive field survey, we assessed the importance of interactions from con- and hetero-specific plants, pollinators, and insect herbivores on plant performance. We compared the inclusion of the interaction effects as aggregate "generic" terms versus specific terms. We found that a continuum of positive to negative interactions, containing mostly generic but a few strong specific interactions, was sufficient to describe variation in plant performance. While interactions with herbivores and conspecifics varied from weakly negative to weakly positive, heterospecific plants mainly promoted competition and pollinators facilitated plants. The consistency of these empirical findings over three years suggests that a broad resolution, including the generic effects of guilds and a few specific groups rather than all pairwise and high-order interactions, can accurately describe species variation in plant performance across natural communities.

Partial migration is a phenomenon where migratory and resident individuals of the same species co-exist within a population, and has been linked to both intrinsic (e.g., genetic) as well as environmental factors. Here we investigated the genomic architecture of partial migration in the Common blackbird, a songbird that comprises resident populations in the southern distribution range, partial migratory populations in central Europe and exclusively migratory populations in northern and eastern Europe. We generated whole-genome sequencing data for 60 individuals across the species’ distribution range, including resident populations (Spain and France), obligate migrants (Russia), and a partial migratory population with equal numbers of migratory and resident individuals in Germany. We estimated genetic differentiation (FST) of single-nucleotide variants (SNVs) in 2.5 kb windows between all possible population and migratory phenotype combinations, and focused our characterization on birds from the partial migratory population in Germany that have been individually phenotyped with radio-telemetry tracking. Despite overall low differentiation within the partial migratory German population, we identified several outlier regions with elevated differentiation on four distinct chromosomes. The region with the highest relative and absolute differentiation was located on chromosome 9, overlapping PER2, which has previously been shown to be involved in the control of the circadian rhythm across vertebrates. While this region showed high levels of differentiation, no fixed variant could be identified, supporting the notion that a complex phenotype such as migratory behavior is likely controlled by a large number of genetic loci.

Objective. The purpose of this study was to explore individuals’ beliefs, values, and experiences surrounding stillbirth evaluation decisions. Design. Qualitative research Setting. University of Utah Health Population. Parents who experienced a stillbirth in the past 5 years (n=19) were interviewed about their experiences and decision to consent or decline postmortem evaluations Methods. Qualitative content analysis Main outcome measures. Barriers and facilitators to parents’stillbirth postmortem decision-making. Results. Participants communicated several facilitators and barriers that contributed to their stillbirth evaluation decision. Reasons for consenting to evaluations were belief in science, background in medicine, altruism, to inform future pregnancies, thinking about preventing another stillbirth, and how patients viewed the care of their stillborn by the medical team. Reasons for declining evaluations were receiving a diagnosis prior to being offered a postmortem evaluation, intent to avoid causing further harm to the baby, interest to spend more time with their baby, and cost of the evaluation. Conclusion. Participants identified stillbirth as one of their most difficult experiences as a parent. Diagnostic and emotional barriers create further challenges to decision-making for stillbirth postmortem evaluations. Parents often rely on inadequate information and personal values and beliefs during this time-sensitive decision process. Decision support for stillbirth evaluations and training for medical providers could benefit parents, may increase stillbirth evaluation uptake, and potentially prevent decisional regret.

Non-invasive methods are necessary for the diagnostic and follow-up of metabolic dysfunction-associated steatohepatitis (MASH). This study aims to perform a proteomic analysis on serum and liver samples from morbid obese (MO) women to identify key mediators of MASH. HPLC-MS/MS proteomics was conducted on serum and liver samples from a cohort of 174 MO women classified by liver histology: 44 normal liver (NL), 66 simple steatosis (SS) and 64 MASH. Serum proteomics identified 257 proteins. The MASH individuals had 13 altered proteins, 11 upregulated and 2 downregulated. Altered proteins are primarily involved in molecular pathways of the initial triggering and complement cascade (50%). Liver proteomics identified 2081 proteins, with 72 upregulated and 84 downregulated in MASH. These proteins are mostly involved in molecular pathways of amino acid metabolism (31,25%), antimicrobial peptides (20%), fatty acid metabolism (17,5%). We identified 13 altered proteins in serum of MASH: increased levels of fructose-bisphosphate aldolase, clusterin, collectin-10 and -11, scavenger receptor cysteine-rich-M130, attractin, pigment epithelium-derived factor, vitronectin, complement factor-H, thrombospondin-4 and apolipoprotein-AIV and decreased levels of sex hormone-binding globulin and adiponectin. These proteins can be part of a panel of biomolecules for the diagnosis or follow-up of MASH.

The architecture underpinning genomic divergence is still a largely uncharted territory and likely case-dependent. Here, we investigated genome-wide variation in Ballan wrasse, a northeastern Atlantic fish species that displays two sympatric color morphs, spotty and plain, that have been suggested to represent subspecies. We produced a chromosome-level reference genome, and thereafter investigated genomic divergence among 152 individuals including both morphs, from two localities in Spain and Norway each, and one in France. Differences between morphs dominated in Spain in accordance with sympatric divergence, whereas in Norway geographic divergence was highest supporting allopatric differentiation. Chromosomes had very large low-recombining areas that were shared across populations and have accumulated further divergence. Within the Spanish morphs, large islands of divergence covered ~11% of the genome, showed high morph-specificity, and strong selection. The same regions showed frequent admixture in the French morphs and no differentiation in Norway. In contrast, divergent regions observed between sampling localities in Norway were scattered, shorter and found throughout the genome. High inbreeding and lower diversity were observed in the Norwegian samples, consistent with the proposed recolonization bottleneck and subsequent drift. Several genomic regions were significantly associated with morphs and contained tens of genes of diverse functions, suggesting that coloration is unlikely to be the sole driver of divergence. Our results suggest that large, polygenic divergence islands were initially formed and preserved in the south but were gradually lost and uncoupled from the phenotype of the fish further north when these areas were repopulated after the last glacial maximum.

Factors affecting breeding success in seabirds result in indices that can be useful for predicting population reproductive output, without the need for invasive and intensive monitoring. Such factors include environmental conditions that affect prey availability and distribution, leading to variation in behaviours related to foraging effort, such as foraging trip duration. Further, social factors, such as divorce, may offer an opportunity for birds to seek a more suitable partner to enhance long-term reproductive success, but may negatively impact success in the short term. The relative importance of environmental, behavioural and social predictors on reproductive output is unclear, as these factors have seldom been examined in tandem. In this study, we investigated environmental factors at differing scales, alongside foraging trip duration and divorce rate, to examine the consequences on reproductive success over 13 breeding seasons in an inshore foraging seabird, the little penguin (Eudyptula minor). Population divorce rate proved to be the most useful predictor of reproductive success, with years of lower divorce associated with higher hatching and fledging success. Shorter foraging trip durations were associated with higher fledging success, but longer trips led to more successful hatching rates. After controlling for the effect of divorce, marine environmental conditions were not a strong predictor of breeding success in this study. Therefore, we propose that the divorce rate can be a powerful index and a valuable tool for predicting population level reproductive success for seabirds facing similar environmental and foraging pressures as little penguins.

Authors and affiliations: Julian Campillo Luna, MD, MHS, Department of Emergency Medicine, University of Michigan, Ann Arbor, Michigan, USA; Lauren Hartz, Yale University, New Haven, Connecticut, USA; Christine Ngaruiya, MD, MsC, DTM&H, Department of Emergency Medicine, Stanford University School of Medicine, Palo Alto, California, USA.Keywords: Lyme disease, Dermatology, Emergency Medicine, Bell’s Palsy, CellulitisCorrespondence to:Dr. Julian Campillo Luna1500 E Medical Center Dr.B1-380 Taubman Center, SPC 5305 Ann Arbor, MI 48109United StatesPhone: (650) 723-5111Email: [email protected]: https://orcid.org/0000-0001-8509-0700Email Addresses of Authors:Julian Campillo Luna: [email protected] Hartz: [email protected] Ngaruiya: [email protected]: This work has not been presented elsewhereData Statement: The data used to support the findings of this study are included within the articleFunding Statement: This research was conducted as part of the employment of the authors under the Yale New Haven HospitalConflict of Interest: The authors have no conflicts of interestPatient Consent Statement: Consent was obtained from the patient in preparation of this case report

Challenging Diagnosis of Central Nervous System Tuberculosis with Joint InvolvementAhmet Melih Şahin1, Elif Şen1*, Zehra Akkaya21Ankara University, Department of Pulmonary Diseases, Ankara, Turkiye2Ankara University, Department of Radiology, Ankara, Turkiye

not-yet-known not-yet-known not-yet-known unknown The digitalization of healthcare is being transformed through the integration of IoT, cloud environments, and blockchain technology, significantly enhancing security and infrastructure robustness. This study conducts a systematic review of over 200 articles on blockchain-enabled healthcare systems, analysing current applications, security threats, cyber-attacks, and system challenges, along with proposed solutions. Despite blockchain’s potential to revolutionize medical data handling, sharing, and processing, our findings reveal persistent issues: 17 security threats compromising privacy and data integrity, 21 cyber-attacks impacting security and quality of service, and 16 system problems such as node compromise, scalability, efficiency, regulatory challenges, computation speed, and power consumption. We propose a layered architecture for future healthcare infrastructure, categorizing issues within this framework and evaluating existing solutions. Our comparative analysis demonstrates the superiority of this architecture in terms of security, trustworthiness, and efficiency over traditional systems. Real-world case studies and a comparative evaluation of blockchain protocols and consensus mechanisms offer deeper insights into their applicability in IoMT and healthcare. This review provides a comprehensive perspective on enhancing e-healthcare services through improved security and privacy, addressing regulatory and ethical challenges. By mapping out limitations, future scopes, and emerging trends, we aim to foster the development of robust, trustworthy, and privacy-preserving healthcare systems.

not-yet-known not-yet-known not-yet-known unknown Background: Pediatric immunocompromised patients are at an increased risk of severe respiratory syncytial virus (RSV) infection. Here, we aimed to describe the clinical course and outcomes of RSV infection in immunocompromised children. Methods: This single-center study was conducted at St. Jude Children’s Research Hospital in immunocompromised children ≤21 years old, who had a positive RSV clinical test in the clinic or hospital from 2007 to 2019. Demographic and clinical characteristics, laboratory values, delays in the treatment of patients’ underlying conditions, and outcomes were extracted from the patients’ electronic medical records. Multivariate models were constructed to identify risk factors predictive of severe RSV LRTI. Results: In total, 391 patients were included. Most children (86%) were > 2 years of age, with a median age of 5 years. Acute lymphoblastic leukemia (ALL) was the most common underlying disease. Most patients presented with upper respiratory tract infections (n = 335; 85.7%). Approximately 6% of patients progressed to lower respiratory tract infections. More than half (58.8%) of the patients were hospitalized, and therapy for the underlying disease was modified or delayed due to RSV infection in one-third of the patients. Severe RSV infections were observed in 62 patients (15.9%). All-cause mortality was reported in 10 patients (2.6%), with three RSV-related deaths (0.7%). Conclusions: A high proportion of immunocompromised children with RSV infection require hospitalization. Hospitalization was observed in those aged >2 years, and an overall treatment delay for the underlying disease occurred in one-third of the patients. The burden associated with RSV in immunocompromised children is high irrespective of age and has direct and indirect consequences on their cancer treatment plans.

not-yet-known not-yet-known not-yet-known unknown Background: Globally, infections account for 10% of new cancer cases, and cancer can compromise the immune system, increasing the risk of infections. With advances in cancer treatment, widespread use of immunotherapy, and prolonged survival of cancer patients, the coexistence of tuberculosis (TB) and cancer is becoming increasingly common in clinical settings. Aim: This review aims to explore the interaction between tuberculosis (TB) and tumors, particularly lung cancer (LC), and to identify appropriate clinical management approaches. Results: LC patients with a history of TB have higher adjusted risk ratios for both all-cause and cancer-specific three-year mortality compared to those without a history of TB. TB may elevate the risk of developing tumors through mechanisms such as chronic inflammation, altered immune responses, and DNA damage. Conversely, cancer patients, whether due to the disease itself or immune dysfunction caused by anti-tumor treatments, may be more susceptible to TB. The coexistence of TB and tumors presents significant challenges in clinical management, making the development of treatment strategies and quality-of-life improvements crucial. Conclusion: There is a close relationship between TB and cancer, with TB potentially serving as a risk factor for cancer, and cancer influencing susceptibility to TB. Effective clinical management is essential to enhance treatment strategies and improve the quality of life for patients with both TB and cancer.

Carbon stock options to mitigate climate change have become a major area of interest across the globe. Climate change is a global issue, and every possible way to mitigate it, is being explored. Afforestation and ecosystem restoration activities are widely adopted to improve the potential of the land in carbon storage. The Kerala State Action Plan on Climate Change proposed the ‘Trees outside forests (Tof)’ as an effective mechanism to mitigate climate change. Due to its discrete distribution and non-uniformity, there are fewer attempts to measure the potential of these systems. This study tried to determine and compare the carbon (C) stock potential of the three “Trees outside forest (Tof)” conditions prevailing in the Palakkad district, Kerala. The carbon stock by standing biomass and soil of four sites of undisturbed natural vegetation, monoculture plantation, and home garden was estimated using allometric equations and computations. The natural vegetations was found to have a higher carbon stock potential (238.58 Mg ha -1) compared to monoculture plantation and human habitat. Also, natural vegetation’s soil organic carbon content was much higher than monoculture plantations and home gardens. The study also estimated the soil deterioration index of each land use compared to the natural vegetation and barren land. The results of the study suggested that land use has a great influence on soil quality and carbon stock potential. Proper management of these Tof systems can enhance their productivity and contribute accountable support towards mitigating climate change.

Many cellular processes and organismal behaviors are time-dependent, and asynchrony of these phenomena can facilitate speciation through prezygotic and postzygotic reinforcement mechanisms. The Mojave and Sonoran desert tortoises (Gopherus agassizii and G. morafkai, respectively) reside in adjoining deserts with distinct seasonal rainfall patterns and they exhibit asynchronous winter brumation and reproductive behaviors. We used whole genome sequencing of 21 individuals from the two tortoise species and an outgroup to understand genes potentially underlying these characteristics. Eighty percent (80%) of the mutations in the most diverged 1% of the genome (FST ≥ 0.63) mapped to putatively non-functional flanking regions. Diverged genes with putatively functional variation showed extensive mutations in regulatory elements, particularly in predicted promoter regions. Clusters of genes relating to UV nucleotide excision repair, mitonuclear, and homeostasis functions had mutations in these diverged regions. Genes mediating chronobiological (cell cycle, circadian, and circannual) processes were also among the most highly diverged regions (e.g., XPA and ZFHX3). Promoter mutations had significant enrichment of genes related to regulatory machinery (ARC-Mediator complex, HDACs) suggest transcriptional cascades driven by regulatory divergence may underlie the behavioral differences between these species, leading to asynchrony-based prezygotic isolation. Further investigation revealed extensive expansion of respiratory and intestinal mucins (MUC5B, MUC5AC) within Gopherus, particularly G. morafkai. This expansion could contribute to differential Mycoplasma agassizii infection rates between the two species, as mucins help clear bacterial infections. Overall, results highlight that evolution of transcription regulation, apart from protein changes, might play an important role in the divergence and reinforcement during speciation.

Background: No safety study has been conducted regarding PRP usage in cervical facet joints Objectives: To determine whether intra- and/or peri-articular injections of PRP in cervical facet joints in the horse is safe. Study design: Prospective, multi-centre, safety study Methods: PRP was injected via ultrasound guidance into the cervical and/or cervicothoracic facet joints in horses with diagnosed cervical complaints. Data recorded for each case included: breed, sex, age, primary reason for treatment, list of which facet joints were injected, the volume of PRP injected, whether the PRP was injected intra-articular or peri-articular, gauge of needle used. Data was collected at three time points: prior to treatment, 48 hours after treatment and a minimum of 30 days after treatment. At each time point, owners/trainers were asked to assess the level of pain the horse was suffering on a 0-10 (no pain to worst) scale. At the final evaluation the owners/trainers were also asked if the treatment met their expectations on a 0-5 scale. Results: No adverse events were reported. The average pain scores prior to treatment, at 48 hours, and at 30 days were 3.8, 3.4 and 1.1 respectively (see Figure 2). At no point did any horse have an increase in their reported pain level. Main limitations: Since PRP is not classified as a drug it does not come with a label indicating items such as dosage or route of administration. Thus, methodologies will vary amongst veterinarians. Conclusions: PRP appears to be safe for cervical and/or cervicothoracic facet joint injections in the horse. Evidence for efficacy was also recorded by means of owner/trainer reporting that the injections overwhelmingly met their expectations.

IntroductionAmeloblastoma is a benign tumor originating from odontogenic tissue, predominantly found in the maxillofacial region, with several histological subtypes. Hybrid ameloblastoma, first described by Waldron and El-Mofty in 1987, exhibits histological characteristics of both desmoplastic and conventional ameloblastoma.12,The incidence of hybrid ameloblastoma is 1.1% and most commonly occurs in individuals with a mean age of 24.5 years, with a higher prevalence in females compared to males.1 This subtype primarily affects the mandible, with a ratio of 5:3 relative to the maxilla.3Radiographically, hybrid ameloblastoma typically presents with a mixed radiolucent and radiopaque appearance and often has with irregular borders. In some cases, it may also exhibit multilocular radiolucency similar to conventional ameloblastoma.4Histopathologically, hybrid ameloblastoma features both desmoplastic patterns and conventional ameloblastoma patterns, predominantly follicular and plexiform. Although less common, acanthomatous, basal cell, and granular cell patterns may occasionally be observed.3 In this report, we present a case of hybrid ameloblastoma in a 60-year-old male patient, localized to the right mandibular region.

Zoonotic diseases account for 75% of emerging infectious diseases, posing significant global health challenges. Understanding the complex host-pathogen interactions is crucial for effective disease management. This study constructs and analyses a global bipartite network of zoonotic bacteria and their domestic mammal hosts, aiming to explore how domestication time and phylogenetic relationships influence network structure. The network, consisting of 24 domestic mammal species and 51 zoonotic bacterial species, reveals a non-random structure with high nestedness and low modularity. Results indicate that the richness of zoonotic bacteria per host is positively correlated with domestication time but not with phylogenetic distance from humans. These findings suggest that early-domesticated species act as ”sinks” for newly exposed zoonotic bacteria, driven by preferential attachment dynamics. This network-level insight provides a valuable framework for predicting and managing zoonotic disease transmission, emphasising the importance of targeted interventions for highly connected host species.

IntroductionOdontogenesis is governed by a series of intricate molecular interactions, and any disruption in these processes can lead to neoplasms specific to the jaws, known as odontogenic tumors. Because these tumors originate from various components of the tooth - forming apparatus, they typically exhibit significant histopathological diversity.1In the 5th edition of the WHO classification of odontogenic tumors and cysts of the jaws (2022), a new entity called adenoid ameloblastoma has been introduced under the category of benign epithelial odontogenic tumors, marking a significant update in the classification of odontogenic lesions.2 This tumor is rare, with fewer than 50 cases reported in the literature to date.3 The term ”adenoid ameloblastoma with dentinoid” was first introduced by Branon in 1994. The use of the term ”ameloblastoma” reflects the presence of ameloblast - like cells, alongside stellate reticulum - like cells, which shows positive expression for calretinin, indicating neoplastic ameloblastic epithelium. In adenoid ameloblastoma, the ameloblast-like cells do not express BRAF p.V600E, which is typically found in conventional ameloblastoma. This lack of BRAF mutation raises questions about their relationship, leading to the classification of adenoid ameloblastoma as a distinct entity under benign epithelial odontogenic tumors.4 Historically, various terms have been used to describe similar histopathological features, including atypical plexiform ameloblastoma with dentinoid, 5 hybrid ameloblastoma and adenomatoid odontogenic tumor, 6 and adenomatoid odontogenic tumor originating in unicystic ameloblastoma.7Adenoid ameloblastoma, typically observed in the 4th decade of life, shows a slight predilection for females. It can occur at various sites without a specific predilection. Clinically, it generally presents as a painless swelling.8 Radiographically, the majority of these tumors appear as unilocular radiolucencies, though occasional foci of radiopaque areas may also be present. 9 The key histopathological criteria for diagnosing adenoid ameloblastoma include the presence of ameloblastoma-like components, duct-like structures, morules, and cribriform architectures. Additionally, clear cells, eosinophilic dentinoid material, and focal areas of ghost cell keratinization may also be observed. 2 Differential diagnoses for this tumor include aggressive adenomatoid odontogenic tumor, clear cell odontogenic carcinoma, odontogenic carcinoma with dentinoid, ameloblastic carcinoma, adenomatoid odontogenic tumor with inductive changes, and various histopathological subtypes of ameloblastoma. 2, 10 Treatment options typically involve surgical excision, enucleation, and sometimes radiotherapy.1

Modern software development requires constant code evolution, often leading to a misalignment between evolving source code and its associated test suite. This lack of synchronization can impact software quality and longevity. This research investigates the factors influencing test co-evolution and its impact on software development practices. Our methodology involved analyzing the evolution of test code proportions, employing clustering techniques to identify distinct evolution patterns, and classifying projects based on their level of test co-evolution using the Pearson Correlation Coefficient. Our findings revealed five distinct test evolution patterns, highlighting diverse approaches to integrating testing within development workflows. Furthermore, high test co-evolution correlated significantly with smaller development teams and a lower frequency of corrective and multi-maintenance activities, indicating a potential link between consistent test updates, early defect detection, and improved code quality.