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Paradoxical embolism via a patent foramen ovale (PFO) is a rare cause of acute myocardial infarction; its simultaneous or sequential occurrence with pulmonary embolism is even rarer. A 60-year-old woman with no prior cardiac history presented with anterior ST-segment elevation myocardial infarction and cardiogenic shock. Preprocedural transthoracic echocardiography showed a large mobile thrombus straddling the interatrial septum through a PFO. Coronary angiography revealed complete left main coronary artery occlusion; thrombus aspiration restored TIMI flow grade 3. Minutes after reperfusion, the patient developed refractory shock and severe hypoxemia. Repeat echocardiography demonstrated disappearance of the intracardiac thrombus and new right ventricular dysfunction; pulmonary angiography confirmed large right pulmonary artery thrombus. Despite systemic thrombolysis and intra-aortic balloon pump support, the patient could not be resuscitated. This case provides direct serial imaging of thrombus-in-transit dynamics, documenting rapid embolization from the PFO into both coronary and pulmonary circulations within minutes. Thrombus-in-transit across a PFO can produce sequential life-threatening embolization to both systemic and pulmonary circulations. Apparent disappearance of an intracardiac thrombus on repeat imaging in an unstable patient should prompt immediate evaluation for pulmonary embolism.

This study reveals that imagery plays a key role in facilitating the production of action memory. However, memory processes are often accompanied by various types of interference. Whether imagery can effectively inhibit multiple forms of interference in the encoding and retrieval stages and thus facilitate the enactment effect is unclear. The present study is aimed at addressing this issue. In experiment 1, the inhibitory effect of imagery on irrelevant perceptual interference in the encoding stage was explored under visual, motor, and visual + motor interference conditions. The results revealed that the enactment effect decreased in both the visual and motor interference conditions but disappeared only in the visual + motor interference condition, which confirms that imagery encoding in action memory formation has a certain inhibitory effect on irrelevant perceptual interference. In experiment 2, the inhibitory effect of imagery encoding on the forgetting of action memory was explored using a directed forgetting paradigm. The results revealed that in contrast to the verbal encoding condition, the directed forgetting effect disappeared in the imagery encoding condition, suggesting that imagery encoding has an inhibitory effect on forgetting. These results confirm that imagery encoding has certain inhibitory effects on irrelevant perceptual interference and forgetting.

The subunit composition and tertiary structure of DNA-dependent RNA polymerases in archaea, bacteria, and eukaryotes are currently well understood. The single RNA polymerase of archaea resembles the nuclear RNA polymerase II of eukaryotes in its composition and consists of 10-12 subunits. Perhaps the only exception that seems to confirm this rule is the Rpo8 subunit (homologue of the eukaryotic Rpb8), which only some classes of archaea have. The development of metagenomic sequencing has led to a significant revision of the classification system of prokaryotes, in particular to the identification of a number of new Archaea evolutionary lineages. This makes it possible to analyze the subunit composition and structure of RNA polymerase of all currently isolated archaeal phyla. Our analysis shows that the Rpo8 subunit is present only in the RNA polymerase of Archaea species from the Thermoproteota of the Thermoproteati superphylum and from the whole superphylum Promethearchaeati, formerly known as the Asgard. After analyzing the changes in the small Rpo6 subunit (homologue of eukaryotic Rpb6), functionally interacting with Rpo8, we noticed that the largest number of changes in the primary and domain structures of this small subunit occurred in archaeal phyla that lack Rpo8. Shortened forms of Rpo6 without N- or C-terminal regions were observed only in representatives of archaea with an RNA polymerase that does not contain the Rpo8 subunit. Our analysis shows that the changes in Rpo6 are an adaptation of a multisubunit transcription complex to the disappearance of Rpo8. Most likely, the Rpo8 subunit was present in the RNA polymerase of the Last Common Ancestor of Archaea (LCAA) and, in the course of evolution, disappeared in the superphyla Euryarchaeota and Nanobdellati and two divisions of the Thermoproteati superphylum: Bathyarchaeota and Thaumarchaeota.

Sickle cell hemoglobinopathy is not merely a genetic disorder but a deeply embedded socio-cultural phenomenon in the remote regions of Odisha. Drawing on long-term ethnographic fieldwork in Koraput and surrounding districts, this study explores the lived experiences of individuals with sickle cell trait (SCT) and sickle cell disease (SCD), focusing on social discrimination, medical uncertainty, and healthcare accessibility. The findings reveal reluctance toward screening, particularly among unmarried women, due to fears of marital exclusion and family stigma. Misconceptions about SCT, including beliefs that it can appear or disappear over time, further reinforce social anxiety and misinformation. Inconsistencies in diagnosis, limited genetic counselling, geographic isolation, and economic insecurity exacerbate these challenges. The study also examines women's caregiving roles, therapeutic pluralism involving traditional healers, and youth perspectives on reproductive futures. By foregrounding the social consequences of carrier status alongside disease, the article challenges assumptions that SCT is negligible. These findings highlight the need for culturally sensitive genetic education, decentralized health services, and community-based interventions, contributing to a holistic understanding of sickle cell hemoglobinopathy within medical anthropology.

Metallic pollution is an emerging and underappreciated stressor contributing to global bee declines, yet the evidence base remains fragmented across metals, taxa, endpoints, and geographic regions. Here, we provide the first hypothesis-driven scientometric synthesis of the global literature on metallic pollutants and bees. Using Web of Science records, we compiled 154 experimental and field-based studies and quantitatively tested five predictions regarding taxonomic, methodological, and thematic biases. Publication output increased sharply after 2013, with China, the United States, and Brazil leading research activity. Research effort was disproportionately concentrated on managed honey bees (Apis mellifera and Apis cerana), adult workers, and dietary exposure pathways, while larvae, wild bee taxa, and environmentally mediated exposures were less examined. Physiological, behavioural and mortality endpoints dominated the literature, whereas reproductive and microbiome impacts remained major blind spots. Adverse outcomes predominate across metals, although essential elements (Zn, Cu, Se) tended to produce less severe effects than non-essential toxic metals (Cd, Pb, Hg), this difference disappeared when exposure concentration and duration were considered. Experimental concentrations varied significantly among metals in food-based exposure studies, indicating substantial heterogeneity in dosing regimes across the literature. Multi-metal studies were not statistically underrepresented, although only a narrow subset of metal combinations has been repeatedly tested. Overall, this synthesis highlights strong structural biases in current knowledge production and identifies priorities for future research, including broader taxonomic coverage, inclusion of early life stages, standardised field-realistic exposures, and integration of chronic, sublethal, and multi-stressor scenarios. Expanding evidence toward more ecologically representative designs will be essential for robust risk assessment of metallic contamination in pollinator communities.

The Central-marginal hypothesis predicts that populations occurring at the periphery of a species' geographic distribution experience more adverse environmental conditions, resulting in reduced population density, lower fitness, and potential morphological changes. In insects, morphological traits are strongly associated with ecological performance and resource acquisition, making them useful indicators of how populations respond to environmental gradients. Here, we investigated whether populations of the ant Dinoponera quadriceps differ in activity density and morphofunctional traits between the center and edge of the species' geographic distribution along the Espinhaço Mountain Range, Brazil. Ants were sampled using pitfall traps in two sites approximately 610 km apart. Generalized Linear Mixed Models were used to evaluate differences in activity density and trait variation between sites, and a Principal Component Analysis summarized multivariate body size variation. The activity density of D. quadriceps was -higher in the central population in the full dataset but this difference was not robust to the removal of a single outlier trap. A positive correlation between D. quadriceps activity density and richness of other ant species was observed in the full dataset but also disappeared after outlier exclusion. Individuals from the marginal population exhibited significantly smaller overall body size. Additionally, trait-specific differences emerged, with marginal individuals displaying larger cephalic index, longer femora, and larger eyes. These findings suggest that peripheral environments impose energetic constraints that reduce body size while favoring morphological adjustments that enhance locomotor and sensory efficiency, highlighting the importance of intraspecific functional variation in understanding species responses at geographic range limits.

Rice body synovitis reports have been rarely reported in children under three years of age. We aimed to explore the clinical characteristics and treatment experience of rice body-like synovitis in children's knees. We retrospectively analyzed the clinical and imaging data of 4 cases (5 knees) of rice body-like synovitis in children treated at our hospital from January 2014 to December 2021. Among the patients, 1 was male and 3 were female, with an average age of 22.5 months. The average length of symptoms before admission was 1.86 months. Clinical presentations included swelling and limping, with no fever or rash. Three patients with unilateral onset and one patient with bilateral onset underwent unilateral arthroscopic excision of synovial lesions. All 4 patients had pathological findings consistent with chronic inflammation, leading to a postoperative diagnosis of juvenile idiopathic arthritis (JIA). Postoperatively, all patients received standardized pharmacological treatment and were followed for 24 to 48 months in collaboration with the rheumatology department. None of the 4 knees undergoing surgery experienced recurrence, and the symptoms of the knee treated conservatively resolved spontaneously. In the last follow-up session, MRI and ultrasound showed only mild synovial thickening, with effusion and loose bodies disappearing. Rice body-like synovitis may be a specific manifestation of JIA. It can be observed in younger children, presenting with insidious symptoms. Arthroscopic debridement combined with post-operative standard medical treatment can offer satisfactory therapeutic outcomes.

BackgroundThe scope of research on pregnancy and menopause is growing, but the actual workplace changes that can support women during these transitional stages are falling behind.ObjectiveTo understand various interactional processes on the work floor that hamper changes in the context of an academic hospital we (i) explore how female nurses and doctors experience pregnancy and menopause in the workplace, and (ii) what management knows about these experiences.MethodsThis is an empirical qualitative exploratory study based on semi-structured interviews (n = 21), focus groups (n = 2) and discussion groups (n = 2) with female nurses and doctors, male and female managers, occupational specialists and external experts (in total N = 33). The focus groups and dialogue sessions were used to enrich and to validate the results. The data was analysed with the use of MAXQDA and followed the grounded theory approach.ResultsThree processes were identified: (1) internalisation of work ethos that transforms maternal bodies into work instruments; (2) self-silencing and physical invisibility of maternal bodies as survival strategies; and (3) normalisation of silence about pregnancy and/or menopause at all levels of the organisation.ConclusionMaternal bodies of the female employees become instruments of providing care and disappear in the workplace. These processes are facilitated by the current structure of an academic hospital and are a part of the organisational culture within the healthcare system in the Netherlands. Making these processes open to discussion will contribute to development of the tailor-made education and interventions involving all stakeholders.

Density functional theory (DFT) and time-dependent density functional theory (TDDFT) have been employed to study the plasmonic coupling effects of silver, gold, and copper clusters supported on titania. The adsorption of metal nanoparticles on the surface of rutile TiO2 changes the electronic properties of the system, resulting in the disappearance of the TiO2 bandgap. The analysis of photoabsorption spectra allowed us to identify surface plasmons and quantify their contribution to the absorption of visible light. Using specific analysis tools, we evaluated the strength of the plasmonic coupling between metal nanoparticles and TiO2, allowing the identification of favorable configurations for the plasmonic coupling.

An increasing number of studies indicate that ferroptosis, a lethal pathway initiated by excessive iron-dependent lipid peroxidation, and pivotal to the survival of dopaminergic neurons and the progression of Parkinson's disease (PD), may be regulated by the lysosomal pathway. Mutation and loss of function of the lysosomal enzyme, glucocerebrosidase, induce the accumulation of glycosphingolipids and alterations in lysosome activity, which have been associated with a higher risk of developing PD. Our present study showed that transient inhibition of glucocerebrosidase activity had a positive effect on lipid peroxidation and ferroptosis. In a dopaminergic cell line (LUHMES cells), it was shown that a 10-day inhibition of glucocerebrosidase activity using conduritol-beta-epoxide (CBE) specifically impeded susceptibility to RSL3-induced ferroptosis, but not to several other inducers of cell death. CBE impaired the lysosomal pathway, modified lipid membrane composition by reducing ether-linked phospholipids in phosphatidylethanolamines, and promoted an increase in glutathione peroxidase 4 (GPX4) protein levels. This phenomenon was transient and disappeared after 20 days of glucocerebrosidase inhibition, suggesting that the cells have the capacity to return to their basal homeostasis. Most of the current compounds acting on GPX4 promote its degradation, thus information on drugs leading to GPX4 stability is key in order to protect neurons against excessive lipid peroxidation occurring in neurodegenerative diseases.

Adopted in 2021, Quebec's Bill 79 authorizes the disclosure of personal information to Indigenous families whose children disappeared or died following admission to a health care facility between the 1950s and 1980s. The legislation aims to address the longstanding pain of families who were denied information for decades. This article presents the historical context of the law, medical findings drawn from reviewed case files, the role of health care professionals, and the memory work undertaken by the Indigenous organization Awacak as part of a broader process of truth-seeking, healing, and transmission.

Collective motion requires coordinated movements of multiple individuals, such as people walking in the same direction and in temporal synchrony. It provides a salient social signal closely linked to coordinated group action and social cohesion. Previous research has shown that the human visual system is highly sensitive to such coordinated biological movement, efficiently representing multiple moving agents as a unified spatial entity. While coordinated biological motion also unfolds over time, it remains unclear how its temporal dynamics are processed. Here, we asked participants to complete a temporal comparison task using multiple point-light walkers, in which they indicated which of two sequentially presented displays (coordinated or uncoordinated) had a longer duration. The results revealed that coordinated biological motion sequences, defined by temporal synchrony (i.e., matched step phase) and spatial alignment (i.e., common walking direction), were perceived as shorter in duration than uncoordinated counterparts, in which both temporal synchrony and spatial alignment were disrupted. This effect persisted even when the biological motion was scrambled, but disappeared in static displays. Crucially, it was not attributable to low-level spatial perceptual organization, as it remained robust across varied stimulus configurations. Interestingly, this effect was absent in non-biological motion and object motion, suggesting that the change in perceived duration is specific to high-level bio-social signals. Moreover, the effect was stronger for temporal synchrony than for spatial alignment. These findings point to a specialized mechanism for time perception tuned to coordinated group movement, highlighting the influence of higher-order social dynamics on the subjective experience of time.

Human activities have caused major transformations to many oceanic islands worldwide, driving native species to adapt their foraging behavior to altered resources. While such trophic plasticity enables animals to persist in unstable and modified environments, it also disrupts established trophic interactions and alters ecosystem dynamics. Columbids (pigeons and doves) often dominate avian frugivore guilds on oceanic islands and play a crucial role in ecosystem functioning through their seed dispersal services. However, understanding how environmental pressures shape trophic interactions has received little attention. We investigated the trophic ecology of the Azores woodpigeon (Columba palumbus azorica), an endemic subspecies of the Azores archipelago, using DNA metabarcoding on fecal samples collected on two islands, to clarify its ecological role and assess how seasonal variations and land-use changes affect diet richness and composition. Our results reveal a diversified diet composed of a wide range of herbaceous and woody plants, with 159 plant taxa detected across 450 samples. Despite the almost complete disappearance of pristine habitats, native plants remain a significant part of the diet, but exotic and cultivated species are largely consumed, suggesting strong limitations in natural resources. As expected, we observed marked seasonal variations in diet, likely related to food availability, particularly of fruits. Strong spatial variations in foraging behavior were also observed as pigeons tended to be more generalist in simplified landscapes, and habitat disturbance resulted in a dietary shift from native to exotic plants. Overall, our study indicates a great trophic plasticity and opportunistic foraging behavior that provides resilience against environmental pressures, while it may threaten the regeneration of natural habitats.

Traumatic arteriovenous fistulas often remain undiagnosed for extended periods, only becoming evident when complications arise. A 65-year-old female presented with dyspnea and intermittent claudication of the left thigh and calf. She had a history of abdominal hysterectomy with critical care stay 30 years ago, likely involving femoral line insertion. Echocardiogram showed severe pulmonary hypertension and preserved ejection fraction. Examination revealed bruit in the left iliac fossa and groin. CT angiogram (CTA) showed a superficial femoral artery-vein fistula, external iliac vein aneurysm, and dilated inferior vena cava. Surgical repair was planned after MDT discussion. Under spinal anesthesia, retroperitoneal control of the external iliac artery was attempted but was difficult due to a large external iliac vein. Left groin was then explored, and control of the common femoral, superficial femoral, profunda femoris arteries and femoral vein was achieved. The fistulous tract was opened and repaired. Surgery was successful with the disappearance of the thrill and a favorable post-operative recovery. Prolonged critical care with probable femoral cannulation may have caused the arteriovenous fistula (AVF), though its location in the superficial femoral artery is slightly against. Here, AVF led to pulmonary hypertension, and steal syndrome with intermittent claudication. Chronic high-flow venous return caused an external iliac vein aneurysm. CTA confirmed the diagnosis, and surgical repair was preferred due to its location. Owing to pulmonary hypertension and poor tolerance to prolonged anesthesia, the venous aneurysm was left untreated. This case underscores the need for timely diagnosis of AVFs.

Cognitive distraction and potential vehicle-pedestrian conflicts are common crash risk factors, and their co-occurrence may compound the risk. Prior research has not fully characterized behavior changes, risk evolution over time, or interaction mechanisms in this combined setting. To address these gaps, we conducted a driving-simulator study with 38 licensed drivers, examining their behavioral responses to potential vehicle-pedestrian conflict scenarios under varying levels of cognitive distraction. We employed a sliding time-window approach combined with machine-learning methods to dynamically identify driving states. Multi-source indicators, including visual perception, vehicle kinematics, and response decision behavior, were integrated to develop a real-time quantitative model linking distraction level to driving risk. Results indicated that under baseline driving, drivers exhibited higher visual workload, broader environmental scanning, and more conservative control in the covert occlusion-zone scenario than in the overt noncompliant-crossing scenario. As secondary-task complexity increased, gaze became progressively more concentrated in the near-forward field, and fixation and braking response times lengthened, and control became more disordered. Consequently, behavioral differences between scenarios narrowed, and coping strategies converged under high-complexity tasks. Real-time estimates showed stepwise increases in both distraction level and driving risk as task complexity rose. Under high-complexity conditions, risk became more volatile, and peak-risk differences between scenarios nearly disappeared. These findings clarify the dynamic coupling between cognitive distraction and potential vehicle-pedestrian conflict risk, informing driver-state-aware assistance systems and context-adaptive intervention strategies.

To characterize age-related changes in the tarsal plate, with a focus on meibomian gland loss and alterations in collagen, elastic, and reticular fibers. Central sagittal sections of 31 upper eyelids from 20 East Asian cadavers, fixed in 10% formalin, aged 36 to 97 years were examined using Masson's trichrome staining. Additional sections of 25 upper eyelids from 16 cadavers, fixed in 10% formalin, aged 36-94 years were evaluated with Elastica-van Gieson and silver staining. In individuals in their 30s and 40s, acini extended to the superior tarsal region in most specimens, although 2 specimens from one 36-year-old individual showed complete acinar loss. Acinar loss became more apparent in the 50s and was pronounced after the 60s, although some specimens still retained acini in the central to superior tarsus. Acinar loss was consistently greater on the conjunctival side than on the skin side. Elastic fibers were typically present around the meibomian ducts but were nearly absent in acinar-loss areas. Reticular fibers were abundant in acinar-containing regions and remained densely distributed in acinar-loss areas, where collagen fibers filled the original acinar spaces. Meibomian gland volume generally decreased with age, although individual variation was evident. Preferential acinar loss on the conjunctival side suggests regional susceptibility. The disappearance of elastic fibers, together with dense reticular and collagen fiber deposition, raises the possibility that inflammatory remodeling may contribute to age-related meibomian gland loss.

A male patient in his 70s experienced peritoneal dissemination recurrence after resection for hepatocellular carcinoma. The disease progressed despite initial atezolizumab+bevacizumab combination therapy. Consequently, durvalumab+tremelimumab combination therapy was initiated. After one treatment course, the peritoneal disseminated lesions reduced in size, and the protein induced by vitamin K absence or antagonist-II (PIVKA-II) values remarkably decreased. After seven chemotherapy courses, the peritoneal disseminated lesions disappeared, and the PIVKA-II values decreased to normal levels. Peritoneal recurrence after liver resection is generally considered to have a poor prognosis. This case report describes the remarkable efficacy of a combination therapy with durvalumab+tremelimumab after atezolizumab+bevacizumab in advanced hepatocellular carcinoma.