Solving unknown primary cancer with earlier diagnosis - the SUPER-ED trial: study protocol for a stepped-wedge cluster randomised controlled trial to support earlier diagnosis for people presenting with malignancy of undefined primary origin.

Background: People with malignancy of undefined primary origin (MUO) have a poor prognosis and may undergo a protracted diagnostic workup causing patient distress and high cancer related costs. Not having a primary diagnosis limits timely site-specific treatment and access to precision medicine. There is a need to improve the diagnostic process, and healthcare delivery and support for these patients.

Quinone extraction drives atmospheric carbon monoxide oxidation in bacteria.

Diverse bacteria and archaea use atmospheric CO as an energy source for long-term survival. Bacteria use [MoCu]-CO dehydrogenases (Mo-CODH) to convert atmospheric CO to carbon dioxide, transferring the obtained electrons to the aerobic respiratory chain. However, it is unknown how these enzymes oxidize CO at low concentrations and interact with the respiratory chain.

Increased plasma DOPA decarboxylase levels in Lewy body disorders are driven by dopaminergic treatment.

DOPA Decarboxylase (DDC) has been proposed as a cerebrospinal fluid (CSF) biomarker with increased concentrations in Lewy body disorders (LBDs) and highest levels in patients receiving dopaminergic treatment. Here we evaluate plasma DDC, measured by proximity extension assay, and the effect of dopaminergic treatment in three independent LBD (with a focus on dementia with Lewy bodies (DLB) and Parkinson's disease (PD)) cohorts: an autopsy-confirmed cohort (n = 71), a large multicenter, cross-dementia cohort (n = 1498) and a longitudinal cohort with detailed treatment information (n = 66, median follow-up time[IQR] = 4[4, 4] years). Plasma DDC was not altered between different LBDs and other disease groups or controls in absence of treatment.

Precession modulates the poleward expansion of atmospheric circulation to the Arctic Ocean.

Under sustained global warming, Arctic climate is projected to become more responsive to changes in North Pacific meridional heat transport as a result of teleconnections between low and high latitudes, but the underlying mechanisms remain poorly understood. Here, we reconstruct subarctic humidity changes over the past 400 kyr to investigate the role of low-to-high latitude interactions in regulating Arctic hydroclimate. Our reconstruction is based on precipitation-driven sediment input variations in the Subarctic North Pacific (SANP), which reveal a strong precessional cycle in subarctic humidity under the relatively low eccentricity variations that dominated the past four glacial-interglacial cycles.

Non-clinical Psychosocial Mental Health Support Programmes for People with Diverse Language and Cultural Backgrounds: A Critical Rapid Review.

Low accessibility to mainstream psychosocial services disadvantages culturally and linguistically diverse (CALD) populations, resulting in delayed care and high rates of unsupported psychological distress. Non-clinical interventions may play an important role in improving accessibility to psychosocial support, but what characterises best practice in this space remains unclear. This critical rapid review addressed this gap by searching for, and critically analysing, existing research on non-clinical psychosocial support services, drawing from a critical realist framework and Brossard and Chandler's (Brossard and Chandler, Explaining mental illness: Sociological perspectives, Bristol University Press, 2022) taxonomy of positions on culture and mental health.

Exploring the relationship between glycemic variability and muscle dysfunction in adults with diabetes: A systematic review.

This review is to systematically explore the relationship between muscle dysfunction and diabetes in adults, and to examine the impact of glycemic variability on muscle health and the development of diabetes-related complications. The review was conducted using three databases: MEDLINE, Scopus, and EMBASE, targeting peer-reviewed journal articles written in English and published from January 2014 to September 2024. The methodological quality assessment of the eligible studies was conducted using Joanna Briggs Institute Critical Appraisal Checklists.

Estimation of dose to a bystander from F-18 FDG patients using Monte Carlo simulation in clinical exposure scenarios.

The radiation exposure to bystanders from nuclear medicine patients is a common concern raised in nuclear medicine departments. The GATE (Geant4 Application for Tomographic Emission) Monte Carlo radiation transport application was used to estimate the dose to a bystander. Two voxelised phantoms were utilised in a GATE Monte Carlo simulation as the radiation source and target.

Superior Outcomes with Ultrasound-Guided Hyaluronidase for Impending Filler-Induced Facial Skin Necrosis: A Systematic Review and Pilot Meta-Analysis.

Background: Hyaluronidase remains the mainstay treatment for impending filler-induced facial skin necrosis. Complete resolution of impending skin necrosis following hyaluronidase injection is estimated to be around 77.8%.

Alien toxic toads suppress individual growth and phenotypic development of native predatory salamanders.

Alien species can influence populations of native species through individual-level effects such as predation, competition, and poisoning. For alien species that possess strong defensive chemicals, poisoning is one of the most powerful mechanisms of individual-level effects on native biota. Although toxic alien species could potentially negatively affect survival (lethal effects) or life history traits (sub-lethal effects) of native predators via poisoning, previous studies have mainly focused on acute lethal effects.

The Role of Gut Microbiota in Shaping Immune Responses in Tephritidae Fruit Fly and Prospective Implications for Management.

The interaction of microbial communities with host immunity has become one of the most explored research areas with significant implications for pest control strategies. It has been found that the gut microbiota plays substantial roles in immune response regulation and host-gut microbiome symbiosis, as well as in pathogen resistance and overall fitness in Tephritidae fruit flies that are major pests of agricultural importance. In this review, we discuss the modulation of immune responses of Tephritidae fruit flies by the gut microbiota with particular emphasis on the general interactions between microbiota and the immune system.

Enhanced energy storage in antiferroelectrics via antipolar frustration.

Dielectric-based energy storage capacitors characterized with fast charging and discharging speed and reliability play a vital role in cutting-edge electrical and electronic equipment. In pursuit of capacitor miniaturization and integration, dielectrics must offer high energy density and efficiency. Antiferroelectrics with antiparallel dipole configurations have been of significant interest for high-performance energy storage due to their negligible remanent polarization and high maximum polarization in the field-induced ferroelectric state.

An evaporite sequence from ancient brine recorded in Bennu samples.

Evaporation or freezing of water-rich fluids with dilute concentrations of dissolved salts can produce brines, as observed in closed basins on Earth and detected by remote sensing on icy bodies in the outer Solar System. The mineralogical evolution of these brines is well understood in regard to terrestrial environments, but poorly constrained for extraterrestrial systems owing to a lack of direct sampling. Here we report the occurrence of salt minerals in samples of the asteroid (101955) Bennu returned by the OSIRIS-REx mission.

Global meta-analysis shows action is needed to halt genetic diversity loss.

Mitigating loss of genetic diversity is a major global biodiversity challenge. To meet recent international commitments to maintain genetic diversity within species, we need to understand relationships between threats, conservation management and genetic diversity change. Here we conduct a global analysis of genetic diversity change via meta-analysis of all available temporal measures of genetic diversity from more than three decades of research.

Considerations for establishment of a private virtual hospital identified using an implementation science approach.

Virtual hospitals are rapidly being implemented internationally. Research has predominantly focused on clinical outcomes not implementation. We aimed to identify pre-implementation determinants to enable health services to tailor virtual hospital models, increasing likelihood of suitability, acceptability, uptake, clinical effectiveness, and sustainability.

Wanting and liking of Facebook functions and their correlation to problematic use.

A key question about social media use is whether it constitutes an addiction. A possible frame of reference to investigate this question is the Incentive Sensitizations Theory (IST), as it provides a solid empirical background to understand the motivational and hedonic aspects of problematic behaviors. A central assumption of IST that addiction-related cues play a pivotal role in addictive behaviors has remained relatively understudied in the context of social media use.

Convergent evidence for the temperature-dependent emergence of silicification in terrestrial plants.

Research on silicon (Si) biogeochemistry and its beneficial effects for plants has received significant attention over several decades, but the reasons for the emergence of high-Si plants remain unclear. Here, we combine experimentation, field studies and analysis of existing databases to test the role of temperature on the expression and emergence of silicification in terrestrial plants. We first show that Si is beneficial for rice under high temperature (40 °C), but harmful under low temperature (0 °C), whilst a 2 °C increase results in a 37% increase in leaf Si concentrations.

Advances in systematic conservation planning to meet global biodiversity goals.

Systematic conservation planning (SCP) involves the cost-effective placement and application of management actions to achieve biodiversity conservation objectives. Given the political momentum for greater global nature protection, restoration, and improved management of natural resources articulated in the targets of the Global Biodiversity Framework, assessing the state-of-the-art of SCP is timely. Recent advances in SCP include faster and more exact algorithms and software, inclusion of ecosystem services and multiple facets of biodiversity (e.

Emerging insights into the genetics and evolution of human same-sex sexual behavior.

Thanks to twin studies, it has been known for decades that human same-sex sexual behavior (SSB) has a substantial heritable component. However, only recently have large genome-wide association studies (GWAS) begun to illuminate the complex genetics involved. These studies have established that SSB is influenced by many common genetic variants, each with tiny but cumulative effects.

Longer term psychological trauma following the COVID-19 pandemic for children and families.

The psychological trauma following COVID-19 has been lengthy and fraught for some children and their families. The specific problems encountered by children rendered helpless and hopeless by watching others suffer, vicarious traumatisation, is explained in brief as it represents a central motif in clinical work in psychology. This paper will focus on what is known of the nature of psychological trauma in children and families with a focus on the individual clinical manifestations of personal significance.

Fast is fine, but accuracy is everything: making intraoperative transfusion decisions using point-of-care testing.

Accurate and timely diagnostic information is a vital adjunct to clinical assessment to inform therapeutic decision-making, including decisions to transfuse, or not transfuse, blood components. A prospective cohort study of diagnostic point-of-care (POC) haemoglobin measurements on arterial or central venous samples from adults undergoing major noncardiac surgery compared three widely used devices, HemoCue®, i-STAT™, and the Rad-67™ pulse CO-Oxymeter® finger sensor device, against standard laboratory haemoglobin measurements, but importantly not against a blood gas analyser. The study focused on haemoglobin results below 100 g L to establish the utility of these devices to guide red cell transfusion decisions.

How does the first index mode of birth in public or private hospitals predict subsequent births? A 16-year Australian population-based linked data study.

Objectives: In this descriptive study, we aimed to assess how the index mode of birth and subsequent birth modes vary over time for public and private hospital maternity care funding models. The second aim was to determine to what extent the index mode of birth predicts subsequent birth modes in general and whether this differs in public versus private hospital maternity care funding models. With our aim, we have an innovative approach, specifically the women's life course approach, which is hypothesis-generating and can be assessed in future studies.