Outcomes of single- versus multi-port video-assisted thoracoscopic surgery: Data from a multicenter randomized controlled trial of video-assisted thoracoscopic surgery versus thoracotomy for lung cancer.

Objectives: Surgery through a single port may be less painful because access is supplied by 1 intercostal nerve or more painful because multiple instruments are used in 1 port. We analyzed data collected from the video-assisted thoracoscopic surgery group of a randomized controlled trial to compare differences in pain up to 1 year.

Methods: Groups were compared in a prespecified exploratory analysis using direct (regression) and indirect comparison (difference with respect to thoracotomy).

Influence of resampling techniques on Bayesian network performance in predicting increased algal activity.

Early warning of increased algal activity is important to mitigate potential impacts on aquatic life and human health. While many methods have been developed to predict increased algal activity, an ongoing issue is that severe algal blooms often occur with low frequency in water bodies. This results in imbalanced data sets available for model specification, leading to poor predictions of the frequency of increased algal activity.

Water Sensitive Urban Design (WSUD) Spatial Prioritisation through Global Sensitivity Analysis for Effective Urban Pluvial Flood Mitigation.

Water Sensitive Urban Design (WSUD) has attracted growing attention as a sustainable approach for mitigating pluvial flooding (also known as flash flooding), which is expected to increase in frequency and intensity under the impacts of climate change and urbanisation. However, spatial planning of WSUD is not an easy task, not only due to the complex urban environment, but also the fact that not all locations in the catchment are equally effective for flood mitigation. In this study, we developed a new WSUD spatial prioritisation framework that applies global sensitivity analysis (GSA) to identify priority subcatchments where WSUD implementation will be most effective for flood mitigation.

A critical review of Natural Flood Management application and spatial prioritisation approaches in tropical island catchments.

Tropical island communities face substantial hydrometrological threats, including flood inundation. Flood risk is increasing, driven by climate change but also other factors including urbanisation, land-cover and land-use (LCLU) change, making flood management challenging to address in practice. Protecting, restoring, and emulating the natural functions of catchments to reduce flood risk, also known as Natural Flood Management (NFM), is a promising method for improving flood management.

Cardiovascular risk communication strategies in primary prevention. A systematic review with narrative synthesis.

Aim: To evaluate the effectiveness of cardiovascular risk communication strategies to improve understanding and promote risk factor modification.

Design: Systematic review with narrative synthesis.

Data Sources: A comprehensive database search for quantitative and qualitative studies was conducted in five databases, Cumulative Index to Nursing and Allied health Literature (CINAHL), Medical Literature Analysis and Retrieval System Online (MEDLINE), EMBASE, Applied Social Sciences Index and Abstracts (ASSIA) and Web of Science.

Association with HLA-DRβ1 position 37 distinguishes juvenile dermatomyositis from adult-onset myositis.

Juvenile dermatomyositis (JDM) is a rare, severe autoimmune disease and the most common idiopathic inflammatory myopathy of children. JDM and adult-onset dermatomyositis (DM) have similar clinical, biological and serological features, although these features differ in prevalence between childhood-onset and adult-onset disease, suggesting that age of disease onset may influence pathogenesis. Therefore, a JDM-focused genetic analysis was performed using the largest collection of JDM samples to date.

Transboundary river basins: Scenarios of hydropower development and operation under extreme climate conditions.

Transboundary river basins across developing countries, such as the Lower Mekong River Basin (LMB), are challenging to manage given frequent divergences on development and conservation priorities. Driven by needs to sustain economic performance and reduce poverty, the LMB countries are embarking on significant land use changes in the form of more hydropower dams, to satisfy growing energy demands. This pathway could lead to irreversible changes to the ecosystem of the Mekong River, if not properly managed.

Favorable antibody responses to human coronaviruses in children and adolescents with autoimmune rheumatic diseases.

Background: Differences in humoral immunity to coronaviruses, including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), between children and adults remain unexplained, and the effect of underlying immune dysfunction or suppression is unknown. Here, we sought to examine the antibody immune competence of children and adolescents with prevalent inflammatory rheumatic diseases, juvenile idiopathic arthritis (JIA), juvenile dermatomyositis (JDM), and juvenile systemic lupus erythematosus (JSLE) against the seasonal human coronavirus (HCoV)-OC43 that frequently infects this age group.

Methods: Sera were collected from JIA (n = 118), JDM (n = 49), and JSLE (n = 30) patients and from healthy control (n = 54) children and adolescents prior to the coronavirus disease 19 (COVID-19) pandemic.

Preexisting and de novo humoral immunity to SARS-CoV-2 in humans.

Zoonotic introduction of novel coronaviruses may encounter preexisting immunity in humans. Using diverse assays for antibodies recognizing SARS-CoV-2 proteins, we detected preexisting humoral immunity. SARS-CoV-2 spike glycoprotein (S)-reactive antibodies were detectable using a flow cytometry-based method in SARS-CoV-2-uninfected individuals and were particularly prevalent in children and adolescents.

Simulation of streamflow and instream loads of total suspended solids and nitrate in a large transboundary river basin using Source model and geospatial analysis.

The management of LULC changes in transboundary river basins continues to challenge water resources managers due to the differences in development and conservation priorities of the countries sharing the basin. While various watershed models (WMs) exist to support decision making, basin-wide sustainable application of the instituted WM depends on the management priorities, resources, data availability, and knowledge gaps at national and sub-basin levels. Building on the results of our prior comparative analysis of WMs for a large transboundary river basin, we applied the 'Source' model to the Lower Mekong Basin (LMB).

Exploring Patient Experience of Chest Pain Before and After Implementation of an Early Rule-Out Pathway for Myocardial Infarction: A Qualitative Study.

Study Objective: High-sensitivity cardiac troponin assays enable myocardial infarction to be excluded in the emergency department (ED). As part of a prospective clinical trial, we explore how introducing an early rule-out pathway may affect patient experience of chest pain.

Methods: In a qualitative study, participants presenting to the ED with suspected acute coronary syndrome, and for whom the diagnosis of myocardial infarction was excluded, were interviewed before (n=23) or after (n=26) implementation of an early rule-out pathway.

High-Sensitivity Troponin and the Application of Risk Stratification Thresholds in Patients With Suspected Acute Coronary Syndrome.

Background: Guidelines acknowledge the emerging role of high-sensitivity cardiac troponin (hs-cTnl) for risk stratification and the early rule-out of myocardial infarction, but multiple thresholds have been described. We evaluate the safety and effectiveness of risk stratification thresholds in patients with suspected acute coronary syndrome.

Methods: Consecutive patients with suspected acute coronary syndrome (n=48 282) were enrolled in a multicenter trial across 10 hospitals in Scotland.

Perception of the ethical acceptability of live prey feeding to aquatic species kept in captivity.

Previous research into public perceptions of live prey feeding has been focused on terrestrial animals. The reasons for this likely relate to the difficulty humans have in being compassionate to animals who are phylogenetically distantly related. In order to test these assumptions, the general public (two groups; one who had just visited an aquarium; and one group who had just visited a zoo), aquarium professionals in the UK/US and terrestrial zoo animal professionals (UK) were investigated to see how they would differ in their responses when asked about feeding various live aquatic animals to one another.

Presenting Symptoms in Men and Women Diagnosed With Myocardial Infarction Using Sex-Specific Criteria.

Background Sex-specific criteria are recommended for the diagnosis of myocardial infarction, but the impact of these on presenting characteristics is unknown. Methods and Results We evaluated patient-reported symptoms in 1941 patients (39% women) with suspected acute coronary syndrome attending the emergency department in a substudy of a prospective trial. Standardized criteria defined typical and atypical presentations based on pain nature, location, radiation, and additional symptoms.

CD161 contributes to prenatal immune suppression of IFNγ-producing PLZF+ T cells.

Background: While the human fetal immune system defaults to a program of tolerance, there is concurrent need for protective immunity to meet the antigenic challenges encountered after birth. Activation of T cells in utero is associated with the fetal inflammatory response with broad implications for the health of the fetus and of the pregnancy. However, the characteristics of the fetal effector T cells that contribute to this process are largely unknown.

Novel high-sensitivity cardiac troponin I assay in patients with suspected acute coronary syndrome.

Background: High-sensitivity cardiac troponin assays enable the early risk stratification of patients with suspected acute coronary syndrome to identify those at low risk of myocardial infarction or cardiac death. We evaluated the performance of a novel high-sensitivity cardiac troponin I assay in early rule out pathways.

Methods: In 1920 patients with suspected acute coronary syndrome, cardiac troponin was measured using the Siemens Atellica high-sensitivity cardiac troponin I assay (99th centile: 34 ng/L women, 53 ng/L men).

High-Sensitivity Cardiac Troponin I and Clinical Risk Scores in Patients With Suspected Acute Coronary Syndrome.

Background: High-sensitivity cardiac troponin assays can help to identify patients who are at low risk of myocardial infarction in the emergency department. We aimed to determine whether the addition of clinical risk scores would improve the safety of early rule-out pathways for myocardial infarction.

Methods: In 1935 patients with suspected acute coronary syndrome, we evaluated the safety and efficacy of 2 rule-out pathways alone or in conjunction with low-risk TIMI (Thrombolysis In Myocardial Infarction) (0 or 1), GRACE (Global Registry of Acute Coronary Events) (≤108), EDACS (Emergency Department Assessment of Chest Pain Score) (<16), or HEART (History, ECG, Age, Risk factors, Troponin) (≤3) scores.

Homeostasis, regeneration and tumour formation in the mammalian epidermis.

The epidermis is the outer covering of the skin and provides a protective interface between the body and the environment. It is well established that the epidermis is maintained by stem cells that self-renew and generate differentiated cells. In this review, we discuss how recent technological advances, including single cell transcriptomics and in vivo imaging, have provided new insights into the nature and plasticity of the stem cell compartment and the differing roles of stem cells in homeostasis, wound repair and cancer.

A quantitative approach for integrating multiple lines of evidence for the evaluation of environmental health risks.

Decision analysis often considers multiple lines of evidence during the decision making process. Researchers and government agencies have advocated for quantitative weight-of-evidence approaches in which multiple lines of evidence can be considered when estimating risk. Therefore, we utilized Bayesian Markov Chain Monte Carlo to integrate several human-health risk assessment, biomonitoring, and epidemiology studies that have been conducted for two common insecticides (malathion and permethrin) used for adult mosquito management to generate an overall estimate of risk quotient (RQ).

Environmental fate model for ultra-low-volume insecticide applications used for adult mosquito management.

One of the more effective ways of managing high densities of adult mosquitoes that vector human and animal pathogens is ultra-low-volume (ULV) aerosol applications of insecticides. The U.S.