The Daniel Stern concept of the motherhood constellation describes a distinctive psychic organization that emerges in the transition to motherhood, structured by 3 relational discourses and 4 thematic concerns: safeguarding infant life and growth, establishing primary relatedness, securing a matrix of support, and reorganizing maternal identity. Formulated in the mid-1990s, this framework preceded the pervasive integration of smartphones, social media, and artificial intelligence (AI) into everyday life. Contemporary mothers now care for infants in environments saturated by online information, connectivity, and AI-mediated support, raising questions about how these factors participate in and reshape the Stern architecture. This theoretical paper argues that smartphones and AI function not as neutral tools but as systemic actors within the motherhood constellation. Drawing on the Stern model, attachment theory, mentalization research, ecological perspectives, sociotechnical theory, and empirical work on technoference, maternal smartphone use, digital parenting, online maternal communities, and AI-based mental health interventions, we conceptualize digital technologies as entities whose affordances co-structure maternal psychic life. Available findings indicate that they simultaneously expand access to information and support, introduce interactional disruptions, and create new, partially algorithmic matrices of support, with effects moderated by patterns of use, maternal reflective functioning, child characteristics, platform design, and socio-structural conditions. We propose a technologically mediated motherhood constellation, in which smartphones and AI enter all 3 discourses (mother-own-mother, mother-self-as-mother, and mother-infant) and all 4 themes. Rather than asking whether technology is "good" or "bad" for motherhood, we outline a spectrum from technology-enhanced to technology-disrupted constellations and derive implications for clinical practice, research, technology design, and social policy.
Protein kinases (PKs) are enzymes that catalyze phosphorylation of protein substrates involved in a wide variety of biological signalling pathways. PKs can be distinguished based on their mechanism of action and their regulation. They are associated with numerous pathologies, thereby constituting attractive biomarkers and targets for development of therapeutics. Given their importance, a wide variety of strategies and technologies have been devised for their detection, their quantification, and for studying their dynamic behavior, from radioactive and antibody-based approaches to biochemical, kinomic, and biosensing technologies. A wide variety of fluorescent biosensors have been tailored to report on PK activities in vitro and for imaging purposes. These tools allow researchers to monitor PK activities in a highly sensitive and dynamic fashion in complex samples, providing new avenues for investigating PK behavior in native conditions and following stimulation or inhibition with drugs, thereby providing functional information which complements genetic, transcriptomic, or proteomic approaches. This review focuses on the different families of PKs and on fluorescent biosensors and chemosensors available to report, profile and image PKs from the AGC, CMGC, CAMK, TK, and TKL kinases.
Retinitis pigmentosa (RP) is an inherited retinal disease (IRD), whereby each affected individual typically harbours pathogenic variants in a single causative gene, yet the disorder exhibits marked genetic heterogeneity, with more than 100 genes reported to underlie RP. Dual-gene defect constellations are rare but may modify disease presentation, complicating diagnosis, prognosis and therapeutic decision-making. This study aimed to characterize the clinical and genetic effects of dual-gene variants in patients with RP as the lead diagnosis. We retrospectively analysed 10 affected individuals and their parents from eight families with confirmed dual-genotype constellations in RP-associated genes. Ophthalmic evaluation included best-corrected visual acuity (BCVA), visual fields, multimodal imaging, electroretinography (ERG) and full-field stimulus threshold testing (FST). Genetic analyses comprised whole genome sequencing and targeted segregation studies; for the latter, long-read sequencing was used to clarify cis/trans variant configuration. Genes involved were CEP290, RCBTB1, ABCA4, PDE6A, CRB1, EYS, PRPH2, MYO7A, RS1, USH2A, MT-TL1, RHO and BEST1, in various genotype constellations. Phenotypes ranged from early-onset severe rod-cone dystrophy to late-onset mild RP, largely reflecting gene-specific effects (e.g. EYS > CRB1 > PRPH2) and their interactions. Long-read sequencing revealed ABCA4 variants in cis, explaining asymptomatic carriers and informing gene therapy eligibility. Functional retinal testing highlighted gene-specific patterns, including macular preservation in EYS-driven RP and Best disease-associated macular changes. Dual-gene variant constellations contribute to heterogeneous RP phenotypes. Integrating comprehensive genetic analysis with detailed clinical assessment is critical to define gene-specific contributions, inform prognosis, guide clinical management and determine eligibility for emerging gene-based therapies.
The segmented genome of Rotavirus alphagastroenteritidis facilitates the emergence of unusual reassortants, increasingly documented in the post-vaccine era. However, their long-term evolutionary dynamics and population-level persistence remain poorly understood. We investigated G1P[8] strains detected through hospital-based surveillance in northern and central Vietnam from 2012 to 2016. Electropherotyping, whole-genome sequencing, and phylogenetic analyses were performed to define genomic constellations and reconstruct evolutionary dynamics of DS-1-like reassortants. We documented four-year circulation patterns of DS-1-like G1P[8] strains, emerging in 2012/2013, peaking in mid-2014, and declining by 2016. Among 44 strains exhibiting short electropherotypes, at least three sequential genotype constellations (A-C) were identified: Constellation A likely arose in northern Vietnam through inter-genogroup reassortment between Wa-like G1P[8] (VP7/VP4) and DS-1-like G2P[4] strains; A related variant in central Vietnam suggested regional transmission from contemporaneous strains reported in Thailand and Japan; Constellation B involved acquisition of a Wa-like NSP2 gene; Constellation C included additional reassortment with bovine-like NSP2 and NSP4 genes from a co-circulating G8P[8] strain. No significant differences in clinical severity were observed between DS-1-like and Wa-like infections, and no cases of either genotype were detected among fully vaccinated children. Overall, this study describes a stepwise reassortment process involving intergenogroup, intragenogroup, and potential zoonotic events. Genomic diversification in this setting was not associated with increased virulence or evidence of immune escape. These findings highlight the need for continued genomic surveillance and broader sampling to better resolve the evolutionary dynamics of rotavirus reassortants.
To further enhance the covert communication capability of satellite-ground-integrated sensor networks, a dual-polarization constellation joint modulation scheme based on frequency-hopping double-layer multi-parameter weighted fractional Fourier transform (FH-DL-MPWFRFT) is proposed from the perspective of physical layer security. The proposed scheme integrates the constellation confusion property of weighted fractional Fourier transform (WFRFT) with the anti-interception capability of frequency-hopping (FH) phase scrambling. Specifically, the weighted parameters of conventional 4-WFRFT are extended to construct a multi-parameter and multi-layer signal representation, and FH phase scrambling is introduced to realize dynamic constellation rotation and phase-domain encryption. Furthermore, a secure transmission model for satellite-ground-integrated sensor networks is established, revealing the constellation optimization principle and the fission-fusion mechanism of dual-polarization signals. Simulation results show that, compared with the non-FH benchmark, the proposed scheme significantly improves waveform-level anti-interception performance; even when eavesdropper obtains the modulation scheme and partial transform parameters, the symbol error rate (SER) of quadrature phase shift keying (QPSK) and four-phase modulation (4PM) signals remains around 0.4 to 0.5 under parameter mismatch, indicating that effective demodulation is difficult to achieve.
Rotavirus A (RVA) G3P[3] genotype is widely reported in dogs and less frequently in cats, with only sporadic human cases worldwide. All reported human infections have occurred in children, suggesting increased susceptibility likely linked to close contact with pets and age-related hygiene practices. The identification of a novel genotype constellation in Brazilian canine G3P[3] strains in 2017 prompted full-genotype characterization of the historical RVA/Human-wt/BRA/IAL-R451/2011/G3P[3] strain, previously sequenced only for VP7 and VP4, to define its genomic constellation and relatedness to canine strains. All 11 segments were analyzed by RT-PCR, sequencing and phylogenetics. The rare genotype-lineage constellation G3.III-P[3]-I2.XX-R3.II-C2.V-M3.II-A9-N2.XXIV-T3.II-E3.II-H6.I, shared with Brazilian canine strains, was identified, supporting a potential common origin. RVA/Human-wt/BRA/IAL-R451/2011/G3P[3] strain showed high genetic similarity (93.2-99%) with canine, feline and canine/feline-like human strains worldwide, with six genes (VP1, VP6 and NSP2-NSP5) closely related to Brazilian dog isolates (97.6-99%), indicating its canine origin. NSP2 clustered with strains from domestic (bovine), synanthropic (rat) and human hosts, while VP7 and VP4 were associated with wildlife (bat; raccoon dog) and environmental (sewage; river water) strains, supporting interhost reassortment and highlighting aquatic environments as reservoirs for interspecies transmission. Identification of new lineages (VP1, VP3 and NSP2) within the AU-1-like backbone reflects its underexplored diversity. This novel constellation likely circulated in dogs and may spill over to humans via close contact, reinforcing a One Health approach to understand RVA zoonotic risk, especially in hotspot regions like Brazil.
A next-generation Mars Network is investigated to determine a configuration optimized for both communications and positioning performance for surface users. A previously proposed 6000 km altitude, 3-satellite equatorial constellation that was found to be optimal for communications to surface users located in the latitude range from 60°S to 60°N is shown to be deficient for surface positioning. Inclining the 3-satellite configuration between 30° and 50° improves positioning performance to users in this latitude range; however, due to a lack of coverage this improvement is primarily seen for positioning when using tracking data collected over long timespans. Moving to an inclined 6-satellite case and using a Walker 6/2/0 delta configuration, at selected inclinations and altitudes, greatly improves the positioning solution performance over shorter timescales, with the best performance obtained with orbits inclined at 50°. Also examined were continuous coverage global constellations that were compared to the Walker 50°: 6/2/0 configurations. The single fold continuous coverage Walker 55.7°:7/7/5 constellation slightly improves the positioning performance and provides more uniform and continuous coverage to the poles, which the Walker 50°:6/2/0 case cannot. Finally, a Walker 57.1°: 8/8/2 constellation that provides continuous twofold coverage was examined; however, the high altitude required for this case reduces its communication performance and yields poorer positioning performance relative to the Walker 55.7°:7/7/5. It is concluded that a next generation Mars Network with focused support to users between 60°S and 60°N that the Walker 50°: 6/2/0 is the best positioning and communications performance while, for continuous coverage global coverage, the Walker 55.7°: 7/7/5 is superior.
Low-pathogenicity avian influenza (LPAI) viruses of the H6Nx subtypes are widely detected in wild birds and occasionally infect poultry. During the avian influenza virus (AIV) surveillance programme in South Korea in 2023-2024 winter season, H6N1 AIVs were detected in wild birds and a broiler duck farm and the farm experienced recurrent H6N1 AIV infection. To characterise the genetic features and potential epidemiological relationships between these H6N1 AIVs, we analysed samples subjected to whole-genome sequencing (WGS), and representative isolates were selected for phylogenetic and genotype constellation analyses. We identified 18 H6N1 isolates, comprising 14 from wild birds and four from the affected farm. These isolates were classified into eight genotypes (G1-G8); notably, G1 was the most prevalent in wild birds, and all farm isolates belonged to G1. Our results strongly suggest that wild birds likely contributed to the initial introduction of G1 H6N1 AIV into the farm, and that the subsequent occurrence on the farm indicates viral persistence in the farm environment. These findings underscore that strengthened biosecurity, including thorough cleaning and disinfection of farm facilities, is required to reduce the risk of recurrent circulation of LPAI viruses in poultry production systems.
Group B Streptococcus (GBS) is a leading cause of invasive infection in newborns and infants. Yet the genomic basis of invasiveness and disease severity remains incompletely defined. We aimed to identify bacterial genomic features associated with invasive GBS disease and to explore associations between bacterial genomics and severe clinical outcomes. We performed PacBio long-read whole-genome sequencing of 381 GBS isolates, including 127 invasive isolates obtained from blood cultures of infants with GBS disease and 254 serotype-matched colonizing isolates obtained from rectovaginal swabs of pregnant women. Gene presence/absence and allele-level variation were analyzed for virulence, adhesion, hemolysis, regulatory, and antimicrobial resistance genes. Associations with invasive disease, life-threatening organ dysfunction (LTOD), and meningitis were assessed using univariable logistic regression with false discovery rate correction. Correlation matrices were constructed to identify lineage-associated genomic profiles. Invasive disease was strongly associated with clonal complex 17 (CC17), which accounted for 83/127 (65%) invasive isolates compared with 72/254 (28%) colonizing isolates. After correction for multiple testing, the presence of hylB, hvgA, and ermB was significantly associated with invasive disease, whereas pilus island 1 was negatively associated. Invasive isolates also carried CC17-associated allelic variants in genes involved in antimicrobial resistance, transcriptional regulation, virulence, and hemolysis, forming a tightly correlated genomic constellation. Among infants with invasive disease, 28/127 (22%) developed LTOD. Prematurity (17/28 vs 24/99), early-onset disease (14/28 vs 23/99), and lower birthweight were associated with LTOD, whereas no bacterial gene or allelic variant remained associated with severity after correction for multiple testing. No meningitis-specific genomic signatures were identified. Neonatal GBS invasiveness is primarily associated with a CC17-linked genomic profile comprising both specific virulence genes and lineage-associated allelic variants. In contrast, progression to life-threatening organ dysfunction appears to be driven predominantly by clinical factors rather than bacterial genomic variation.
Congenital facial palsy most commonly results from perinatal trauma. Developmental causes are rare and typically occur within syndromic constellations such as Möbius, Goldenhar, or CHARGE (coloboma, heart defects, atresia choanae, retarded growth, genital abnormalities, ear anomalies). Non-syndromic developmental facial palsy (DFP) is exceedingly uncommon and is thought to arise from disturbances in facial motor nucleus development, the intrapontine facial nerve tract, or its vascular supply. Chiari I malformation (CM-I) is characterized by ≥5 mm cerebellar tonsillar descent below the foramen magnum, producing posterior fossa crowding and impaired cerebrospinal fluid dynamics. CM-I-associated cranial neuropathies, including facial nerve involvement, have been reported in the setting of secondary structural pathology such as syringomyelia, syringobulbia, or basilar invagination. We report a 37-year-old woman with a lifelong House-Brackmann grade III left facial palsy, documented at first cry and stable since birth, who presented with a six-month history of Valsalva-exacerbated occipital headaches, positional vertigo, and posterior cervical allodynia. Magnetic resonance imaging demonstrated 12-mm tonsillar ectopia with brainstem compression, without syrinx, syringobulbia, or basilar invagination, and incidentally revealed a thin elevated corpus callosum with mild ventricular prominence. Posterior fossa decompression with suboccipital craniectomy, C1 laminectomy, and autologous duraplasty resolved her CM-I symptoms. After an extensive literature review, we found no prior reports of non-syndromic DFP coexisting with CM-I in the absence of syringomyelia, syringobulbia, basilar invagination, or syndromic features. Although coincidence cannot be excluded, the corpus callosum and ventricular findings suggest a shared prenatal disturbance. These features may reflect parallel manifestations affecting overlapping developmental programs during ontogeny, rather than a direct causal relationship. A systematic framework comprising neuroimaging, electrodiagnostics, and targeted genomic profiling in similar cases may elucidate a developmental pattern from isolated coincidence, with potential implications for early surveillance.
High-capacity inter-satellite laser communication links are essential for global coverage, remote sensing, and deep space missions, but face challenges from path loss, pointing errors, and limited aperture sizes that degrade performance at extended ranges and high data rates. This work reports simulative evaluation of an Inter-Satellite Laser Communication Transmission (Is-LCT) system with 160 Gb/s data rate. Orthogonal Frequency Division Multiplexing (OFDM), Polarization Division Multiplexing (PDM), and 32-level Quadrature Amplitude Modulation (32-QAM) techniques have been used to enhance the system baud rate, bandwidth efficiency and transmission rate of the system. Advanced signal processing techniques have been used to improve the performance of the proposed system. The proposed Is-LCT system is investigated for enhancing range, optical efficiency, aperture diameter, laser power, and pointing error using Error Vector Magnitude (EVM), Bit Error Rate (BER), and constellation as the metrics for performance evaluation. The obtained results demonstrate reliable 160 Gb/s data transmission at 7000 km Is-LCT range with BER[Formula: see text]3.8[Formula: see text], EVM[Formula: see text] 12%, and clear constellation of the received optical signal.
Erdheim-Chester Disease (ECD) constitutes a rare and clinically heterogeneous non-Langerhans cell histiocytosis, characterized by the systemic infiltration of tissues by foamy, lipid-laden histiocytes. These cells typically exhibit an immunophenotypic profile positive for CD68 and negative for CD1a. The disease's multifaceted presentation, which can span from isolated bone lesions to fulminant multi-organ failure, frequently results in considerable diagnostic delay. In this case-based review, we describe the case of a 58-year-old who presented with a primary complaint of exertional dyspnoea and fatigue. The initial diagnostic evaluation revealed a hemodynamically significant circumferential pericardial effusion and imaging findings suggestive of aortitis. Clinical presentation of ECD depends on the organs and tissues involved, and may range from bone pain to neurological symptoms, endocrine dysfunction, and cardiac involvement. Cardiovascular involvement occurs in at least 40% of ECD patients, although it is frequently underdiagnosed. Cardiac ECD is heterogeneous and may mimic many alternative aetiologies. The infiltration of the right atrioventricular sulcus, right atrial walls, or interatrial septum is one of the most typical cardiac manifestations of ECD. Recognition of pseudo-tumour intra-atrial mass, pericardial involvement, as well as the circumferential encasement of the entire aorta, the so-called coated aorta, are other frequent findings. Diagnosis often requires a multimodal approach, in particular when cardiac symptoms represent the onset of clinical manifestation of ECD. The combined use of computed tomography, fluorodeoxyglucose positron emission tomography, dedicated cardiac and abdominal magnetic resonance imaging, and X-ray of long bones can collectively reveal a constellation of findings diagnostic of ECD.
Maffucci syndrome (MS) is a rare disorder characterized by enchondromas and vascular anomalies (VAs). However, the nomenclature used to define MS in the literature is variable. The purpose of this review is to evaluate definitions of MS and characterize VAs reported in patients with MS, in relation to International Society for the Study of Vascular Anomalies (ISSVA) definitions. MEDLINE and Embase were searched for articles that discussed MS. Articles were analyzed for VAs identified in the disease definition. Case reports of MS were analyzed for VAs diagnosed in their patients. Since 1950, 265 articles have defined MS. Disease definitions have varied widely. Over half of the articles identified "hemangioma" nonspecifically as the defining VA, whereas only 2 recognized the ISSVA definition of MS as "enchondromas with venous malformations ± spindle-cell hemangiomas (SCHs)." Of 220 patients in 183 primary reports, only 36 (16%) patients had a VA diagnosis consistent with a specific ISSVA diagnostic label. Only 9 (4%) patients were reported to have venous malformations per the 2018 ISSVA definition of MS, whereas 23 (11%) were reported to have SCHs in the absence of venous malformations. The definition of MS remains inconsistent due to the use of ambiguous and outdated nomenclature for classifying VAs. This makes it difficult to identify the true constellation of VAs present in the disease. Clinicians and researchers should adhere to modern nomenclature when discussing VAs. Given multiple histologically confirmed SCHs in the absence of venous malformations, it seems that either lesion may be diagnostic for MS.
Oil pollution is one of the most persistent and harmful anthropogenic pressures on global marine and coastal ecosystems. Accidental discharges, chronic leaks, operational spills from shipping, offshore drilling, and industrial activities release millions of tons of hydrocarbons annually, threatening marine biodiversity, fisheries, and coastal livelihoods. Remote sensing has become the primary technology for oil spill detection, mapping, and monitoring, offering synoptic, repeatable, and objective coverage of extensive marine areas. This paper presents a systematic review of remote sensing for oil spill detection, mapping, and monitoring, grounded in a bibliometric analysis of 2856 verified documents authored by 6473 researchers, retrieved from five major academic databases (OpenAlex, CrossRef, EuropePMC, SemanticScholar, and CORE), spanning the period 2000 to 2026. Annual publication output grew from 16 documents in 2000 to a peak of 244 in 2025, reflecting a 15-fold growth driven by the Deepwater Horizon disaster (2010), the launch of Sentinel-1 (2014-2016), and the proliferation of deep learning frameworks. The review examines the physical principles of oil detection across the electromagnetic spectrum; compares radar, optical, hyperspectral, and thermal sensor platforms; and evaluates developments in artificial intelligence (AI) and data fusion methods for automated detection. Validation protocols, regional case studies from the Gulf of Mexico, North Sea, Mediterranean, Arctic, and Caspian Sea, and the integration of Earth observation with decision-support frameworks are also assessed. Key findings confirm that no single sensor is universally superior: synthetic aperture radar (SAR) provides all-weather, day-night capability, while optical and hyperspectral sensors deliver spectral and compositional insight. Deep learning models, particularly U-Net and transformer-based architectures, have achieved exceptional detection accuracy but face persistent challenges of data scarcity, look-alike discrimination, and limited cross-regional transferability. Emerging innovations in multi-sensor constellations, physics-informed deep learning, and cloud-native processing are identified as pathways toward real-time environmental intelligence and improved ocean governance.
Parvovirus B19 typically causes mild symptoms in healthy adults, including fever, rash, and arthralgias. Certain immunocompromised adult populations, including those with immunodeficiencies or hematologic disease, are at risk of clinically significant complications, including transient aplastic crisis. Further, in pregnant patients, there is a risk of transplacental viral transmission, which may lead to severe fetal anemia, nonimmune hydrops fetalis, and intrauterine fetal demise. The clinical course of parvovirus B19 in pregnant patients with underlying hematologic disease has not been well reported. In this case report, we present a 27-year-old pregnant patient with sickle cell beta thalassemia who was infected with parvovirus B19 at 20 weeks of gestation. She experienced a prolonged hospitalization characterized by persistent maternal vaso-occlusive crisis with concomitant transient aplastic crisis. There was suspected vertical transmission of the virus, leading to concern for severe fetal anemia and termination of the pregnancy. The patient continued to have cyclic fevers, bicytopenia, and a constellation of laboratory findings leading to a diagnosis of postviral hemophagocytic lymphohistiocytosis (HLH). She was successfully treated with pulse dose corticosteroids and an Interleukin-1 receptor antagonist with subsequent improvement of her symptoms and laboratory markers. This report highlights the distinct diagnostic and management challenges of parvovirus B19 in pregnant patients with comorbid hematologic disease, including a rare but serious sequela of the infection, and the risk for severe maternal and fetal complications.
The coexistence of mosaic trisomy 18 and Turner syndrome represents an extremely rare genetic constellation, with only a few cases reported in the literature to date. We present the case of a 7-year-old girl with esophageal atresia, full trisomy 18 in lymphocytes, and mosaic copy number changes involving trisomy 18 with coexisting monosomy X in fibroblasts, suggesting the presence of additional cell populations lacking trisomy 18. In addition, we provide a review of the relevant literature. This case is of particular clinical significance, as it describes long-term survival in a child with Edwards syndrome and illustrates the diagnostic challenges associated with tissue-limited mosaicism. Furthermore, it underscores that an established diagnosis of one genetic disorder does not preclude the coexistence of another, particularly when the clinical phenotype deviates from the classical presentation of the primary syndrome. Adequate analysis of a sufficient number of metaphases in karyotyping is essential to reliably detect or exclude mosaicism in Edwards syndrome, as the distinction between full and mosaic trisomy 18 carries important prognostic implications.
Survivors of critical illness and their caregivers often experience a complex constellation of sequelae in the aftermath of their recovery, termed post-intensive care syndrome (PICS) and PICS-Family (PICS-F), respectively. These can have a dire impact on patients and families, and thus require coordinated rehabilitative efforts. However, optimal modes of providing support services remain unclear, with traditional clinic-based strategies showing mixed results. This scoping review aimed to summarize the feasibility and effectiveness of nonclinic-based follow-up and rehabilitation strategies for adult survivors of critical illness and their caregivers. Databases were searched on July 8, 2025, and included Cochrane, Embase, PubMed, and Web of Science. Studies reporting interventions and follow-up options for adult survivors of critical illness requiring ICU stay and targeting PICS and PICS-F were included. Studies examining interventions in the outpatient clinic or ICU settings exclusively were excluded. Two team members used Covidence to screen all the deduplicated citations, with a third team member acting as a tiebreaker. The studies included were reviewed in full to extract general data, the studied syndrome (PICS, PICS-F, or both), component of PICS studied, study population, study objectives, methods, inclusion and exclusion criteria, intervention details, general results, and study conclusions. We screened 8608 studies; 45 studies met criteria and were included in this review. Most (64%) focused on the physical and psychological sequelae of PICS. Interventions varied widely, by setting, duration, and approach. Outcome measures were heterogeneous, limiting comparisons. Most studies evaluated the feasibility of interventions and not effectiveness. Only six articles targeted PICS-F exclusively. This scoping review summarizes the status of different nonclinic-based follow-up and rehabilitation strategies for adult ICU survivors. Future research focused on studies that evaluate effectiveness of these strategies in mitigating the burden of PICS and PICS-F, especially within the cognitive domain, is likely to improve aftercare for both patients and their families.
A 4-year-old spayed female mixed breed dog presented for chronic upper airway noises and dysphagia. The dog presented for inspiratory stridor and expiratory stertor. Serum creatine kinase activity was 3,296 IU/L, and cholesterol and triglyceride levels were elevated at 353 mg/dL and 201 mg/dL, respectively. In-house thyroxine levels were below the reference range, prompting the submission of a comprehensive thyroid profile to an outside reference laboratory. Head and cervical CT with contrast showed perivertebral/perilaryngeal muscle thickening and contrast enhancement. Electrodiagnostics of the pelvic limbs and head showed diffuse spontaneous activity with normal motor nerve conduction velocity. Muscle biopsies revealed an inflammatory myopathy in both masticatory muscles and pelvic limb muscles. The serum 2M antibody titer was positive. Comprehensive infectious PCR and serology testing were negative. The constellation of findings is compatible with an overlap syndrome of masticatory myositis and immune-mediated polymyositis. A comprehensive thyroid panel consisting of total thyroxine, total triiodothyronine, free thyroxine by dialysis, T4 and T3 autoantibodies, thyroid-stimulating hormone, and thyroglobulin autoantibodies later returned supported results for lymphocytic thyroiditis. Treatment with immunosuppressive doses of prednisone was effective in reducing, but not eliminating, the respiratory noises and dysphagia, with improved quality of life 763 days after initial presentation. This is a clinical description of an overlap syndrome of masticatory myositis and polymyositis, further complicated by lymphocytic thyroiditis. This case report highlights the importance of differentiating euthyroid sick syndrome and lymphocytic thyroiditis in dogs with chronic immune-mediated illness.
This report describes a unique constellation of accessory ossicles, highlighting their anatomical, clinical, and radiological significance. A 43-year-old female undergoing imaging for suspected fracture was evaluated using multi-detector computed tomography (MDCT) with 1.25 mm slice thickness. Multiplanar reconstructions (axial, coronal, sagittal) and three-dimensional volume-rendered images were analyzed. CT imaging revealed the coexistence of an os subfibulare and a tripartite os naviculare. Multiplanar and three-dimensional reconstructions confirmed the presence and configuration of variants. The combination of supernumerary bones and a multipartite ossicle represents an exceedingly uncommon anatomical presentation. This case illustrates an exceptional coexistence of multiple accessory ossicles, including an exceedingly rare tripartite os naviculare. Thorough radiological evaluation using MDCT and multiplanar reconstructions is essential for accurate identification and differentiation from fractures or other pathology.
Employees' relationships with work are multidimensional (affective, cognitive-evaluative, and motivational-behavioral) yet variable-centered studies can mask patterned heterogeneity. We integrated these strands and asked: Which naturally occurring constellations of work attitudes emerge among employees, and are they similar across Poland and Vietnam? A cross-sectional survey of Polish (N = 358) and Vietnamese (N = 305) employees assessed positive/negative organizational affect, four job-satisfaction facets (development, salary, tasks, relationships), work engagement, and working excessively/compulsively. We used: Multigroup Confirmatory Factor Analysis (MGCFA) to established measurement invariance of the tools across countries, Latent Profile Analysis (LPA) to identified profiles in the pooled sample, multigroup LPA to test cross-national profile similarity. Profile prevalence and links with gender, tenure, position, and sector were examined. A three-profile solution best balanced fit and parsimony: (1) Moderately Disengaged; (2) Overworked & Discontent; (3) Engaged & Satisfied. Configural similarity held across countries, but means and dispersions differed. Engaged & Satisfied was more prevalent in Vietnam (80%) than Poland (57%), whereas Moderately Disengaged was more common in Poland (36%) than Vietnam (11%). Gender and sector were unrelated to profile membership; managers were overrepresented in Engaged & Satisfied; this group also had longer tenure. Distinct, cross-culturally recurring configurations of work attitudes align with JD-R, Affective Events, and Self-Determination frameworks. Tailored interventions should target development, task design, and recognition to elevate Moderately Disengaged employees, and workload/recovery and social-climate improvements for the Overworked & Discontent group. Cross-national differences in levels and prevalence underscore the need for contextual adaptation of organizational policies.