Top Research Priorities Research Articles

The effect of portulaca oleracea capsules on hemorrhage volume and postpartum pain: Clinical trial study

Background: Postpartum affects the well-being of mothers. Examining the approaches that could reduce the maternal side effects such as pain and bleeding, are among the top research priorities in midwifery. The present research aims to determine the effects of Portulaca Oleracea capsules on hemorrhage volume and postpartum pain. Methods: The double-blind clinical trial- after receiving permission from the Ethics Committee- targeted 106 women. The qualified mothers were classified into two groups using Sealed Envelope sample size. In both groups after taking Mefenamic acid as a routine treatment, the interventions were done. One group took Portulaca Oleracea capsules and the other group received placebo drugs that were similar in smell, color, and taste. In the interventional group, Portulaca Oleracea capsules were prescribed two times a day in the twelve-hour interval, after taking Mefenamic acid. In the control group, the placebo capsules were prescribed at the same intervals. To measure the amount of hemorrhage after delivery, pads were used after each intervention to determine differences in pads weighed. The IBM SPSS for Windows, version 16 was used for statistical analysis. Data analyzed by descriptive and analytic statistics Mann Whitney tests, and Generalized Estimating Equation (GEE). The level of significance was considered 0.05. Results: The average rate of pain intensity after the first intervention in the interventional group was 4.82 + 1.11 and in the placebo group was 5.22 + 1.09 (p=0.037). After the second intervention was 3.74 + 0.91 in the intervention group and 4.79 + 0.97 in the placebo group (p<0.001). The average hemorrhage volume after the second intervention was 28.33 + 6.67 in the interventional group and 35.96 + 7.59 (p<0.001) in the placebo group. Conclusion: Portulaca Oleracea capsules were effective in reducing the amount of postpartum pain and hemorrhage and can be used as herbal medicine to decrease postpartum pain and hemorrhage.

A pilot randomised controlled trial of an energy management programme for adults on maintenance haemodialysis: the fatigue-HD study

BackgroundIdentifying interventions to reduce fatigue and improve life participation are top research priorities of people on maintenance haemodialysis.ObjectiveOur primary objective was to explore the feasibility of conducting a randomised controlled...

Patient prioritization of routine and patient-reported postoperative outcome measures: a prospective, nested cross-sectional study.

Understanding which outcomes matter most and improving outcomes for the growing population of older surgical patients are top priorities for Canadian anesthesia research. Nevertheless, there is little understanding of which outcomes older surgical patients prioritize most highly. We evaluated how older people prioritized six outcomes after elective noncardiac surgery. These outcomes were recommended in core outcome sets for perioperative medicine. Following ethical approval, we conducted a prospective, nested, cross-sectional study of people one year after they had major elective noncardiac surgery. Participants were asked to rate the importance of six commonly measured outcomes (complications, length of stay, discharge disposition, days at home, disability score, and developing a new disability) on an 11-point Likert scale. Open-ended questions elicited other preferences. Pairwise comparisons were evaluated using Bayesian multivariate regression. K-means clustering identified subgroups of patients based on overall prioritization. Thematic analysis was applied to open-ended responses. One hundred and one consecutive participants responded. All outcomes scored at least 7.7/10 on average. Complications and discharge location were most highly rated, but only days at home and length of stay had substantial probability (> 99%) of being rated lower than the other four outcomes. Thematic analysis identified the need for greater procedure-specific information, support services, and physical recovery measures. Commonly recorded and recommended outcomes are reassuringly relevant to older people; however, system-related measures are less highly valued than those more directly related to health and function. Outcomes may need to be personalized to properly evaluate the success of perioperative care.

Nature-based framework for sustainable afforestation in global drylands under changing climate.

Drylands cover more than 40% of Earth's land surface and occur at the margin of forest distributions due to the limited availability of water for tree growth. Recent elevated temperature and low precipitation have driven greater forest declines and pulses of tree mortality on dryland sites compared to humid sites, particularly in temperate Eurasia and North America. Afforestation of dryland areas has been widely implemented and is expected to increase in many drylands globally to enhance carbon sequestration and benefits to the human environment, but the interplay of sometimes conflicting afforestation outcomes has not been formally evaluated yet. Most previous studies point to conflicts between additional forest area and water consumption, in particular water yield and soil conservation/desalinization in drylands, but were generally confined to local and regional scales. Our global synthesis demonstrates that additional tree cover can amplify water consumption through a nonlinear increase in evapotranspiration-depending on tree species, age, and structure-which will be further intensified by future climate change. In this review we identify substantial knowledge gaps in addressing the dryland afforestation dilemma, where there are trade-offs with planted forests between increased availability of some resources and benefits to human habitats versus the depletion of other resources that are required for sustainable development of drylands. Here we propose a method of addressing comprehensive vegetation carrying capacity, based on regulating the distribution and structure of forest plantations to better deal with these trade-offs in forest multifunctionality. We also recommend new priority research topics for dryland afforestation, including: responses and feedbacks of dryland forests to climate change; shifts in the ratio of ecosystem ET to tree cover; assessing the role of scale of afforestation in influencing the trade-offs of dryland afforestation; and comprehensive modeling of the multifunctionality of dryland forests, including both ecophysiological and socioeconomic aspects, under a changing climate.

Improving anthelmintic treatment for schistosomiasis and soil-transmitted helminthiases through sharing and reuse of individual participant data.

The Infectious Diseases Data Observatory (IDDO, https://www.iddo.org) has launched a clinical data platform for the collation, curation, standardisation and reuse of individual participant data (IPD) on treatments for two of the most globally important neglected tropical diseases (NTDs), schistosomiasis (SCH) and soil-transmitted helminthiases (STHs). This initiative aims to harness the power of data-sharing by facilitating collaborative joint analyses of pooled datasets to generate robust evidence on the efficacy and safety of anthelminthic treatment regimens. A crucial component of this endeavour has been the development of a Research Agenda to promote engagement with the SCH and STH research and disease control communities by highlighting key questions that could be tackled using data shared through the IDDO platform. Here, we give a contextual overview of the priority research themes articulated in the Research Agenda-a 'living' document hosted on the IDDO website-and describe the three-stage consultation process behind its development. We also discuss the sustainability and future directions of the platform, emphasising throughout the power and promise of ethical and equitable sharing and reuse of clinical data to support the elimination of NTDs.

Типові слідчі ситуації початкового етапу розслідування рейдерства

One of the key aspects of the fight against corruption and economic crime is to counter the seizure of business entities (raids) – as a set of criminal acts. There is no single norm in Ukrainian criminal law that provides for penalties for illegal seizure of enterprises, institutions, organizations in order to appropriate them or establishes control over their assets, and therefore existing methods of detecting and investigating raids need to be significantly improved. Also a top priority for researchers and practitioners in the field of law enforcement remain issues of updating scientific developments in order to increase the level of crime prevention. This is especially true of raider groups, whose members have expertise in the economic field, are corrupt, and resort to the most sophisticated forms of countering the investigation. Thus, without awareness of typical investigative situations and the procedure for conducting investigative (search) actions at the initial stage of a raid investigation, it is difficult to identify perpetrators, and identifying the customer may be an impossible task due to the specifics of economic crimes information to be processed. In this regard, determining the specifics of the formation of investigative situations of the initial stage of the investigation of criminal offenses related to raiding is a very important issue. The article examines the problematic issues of defining the essential features of raiding, clearly argues various approaches to the interpretation of this concept, identifies the essence of typical investigative situations, as well as highlights the provisions of raiding, which directly affect the formation of an investigative situation of this crime. Finally, the identification of typical investigative situations in the initial phase of raiding investigations contributes to the quality of pre-trial investigations, reducing the risk of tactical errors, in particular during investigative actions, which will facilitate the proper execution of criminal proceedings.

Retinal arteriolar parameters as a surrogate marker of intracranial vascular pathology.

IntroductionDevelopment of novel diagnostic tools is a top research priority in vascular dementia. A major obstacle is the lack of a simple, non‐invasive method to visualize cerebral arteriolar walls in vivo. Retinal arterioles offer a window into the cerebral circulation.Methods Intensity‐based retinal arteriolar visualization in optical coherence tomography (I‐bRAVO) was applied to evaluate mean wall thickness (MWT) and wall‐to‐lumen ratio (WLR) in 250 subjects with sporadic and genetic cerebral small vessel disease (CSVD), non‐vascular neurodegenerative diseases (NVND), and healthy controls (HC) in association with imaging and cognitive markers.ResultsMWT and WLR were higher in CSVD, associated with severity of vascular white matter lesions, and correlated with magnetic resonance imaging‐based intracranial arteriolosclerosis score. WLR correlated with gray and white matter volume and differentiated asymptomatic sporadic CSVD from HC (area under the curve = 0.82).DiscussionI‐bRAVO is a rapid, non‐invasive tool. MWT and WLR were associated with imaging markers of CSVD and could contribute to early identification of sporadic CSVD.

Identifying priorities for sport and physical activity research in Canada: an iterative priority-setting study.

Background:There is a need for better alignment between research on sport and physical activity and the needs of those who are in a position to implement the findings. To facilitate advancement and alignment, we identified the top research priorities of sport and physical activity knowledge users from various sectors.Methods:For this priority-setting study, we used an iterative process of data collection and analysis. Sport and physical activity knowledge users from multiple sectors participated in a workshop (September 2019), which included small working group exercises followed by large-group syntheses leading to the identification of issues that required better understanding. We then sent an online questionnaire to participants for content validation and interim prioritization, to reduce the number of priorities (December 2019 to January 2020). A new questionnaire containing a shortened list of research priorities was sent to an expanded group of respondents to further streamline the list of priorities (January–March 2020).Results:The 24 workshop participants identified 68 issues, of which 21 were retained by the 18 participants in the interim priority-setting questionnaire. The final prioritization questionnaire was completed by 33 stakeholder groups; this step produced a final list of 8 top research priorities. The final priorities identified for sport and physical activity research related to financial support, suboptimal promotion, dropout, best interventions, participation among Indigenous populations, volunteer engagement, safe and inclusive experiences, and knowledge exchange.Interpretation:The 8 priorities identified in this study provide guidance to Canadian sport and physical activity researchers. Research efforts on these priorities will reflect pressing issues as identified by representatives of all sport and physical activity sectors.

Ten directions for improving clinical therapeutic effect of pancreatic cancer in the future

Pancreatic cancer is one of the most malignant digestive system tumors. In the recent decade, the effect of diagnosis and treatment of pancreatic cancer has improved due to the renewal of treatment concept and the popularization of effective treatment. However, the overall efficacy of pancreatic cancer is still dismal and the 5-year survival rate is only about 10%. Further improving the diagnosis and treatment of pancreatic cancer is the top priority of oncology research and clinical practice. Based on past clinical and scientific research experience, the authors have proposed ten hot spots and future directions for a reference, which focusing on early prevention, early diagnosis, and early treatment of pancreatic cancer, molecular typing and precise treatment, new drug development and regimen combination, surgical technology and strategy change, model establishment and database development, as well as innovation of traditional Chinese medicine and breakthrough of treatment concept. A breakthrough in the diagnosis and treatment of pancreatic cancer in the next ten years is raising hope, when doctors can truly prevent and control pancreatic cancer.

Weed management in organic farming for better crop production

Weed is an unwanted plant, many reasons for controlling weeds become more complex because weeds complete with crop plants for water, light and nutrient. In organic farming principles and standards preclude the use of most herbicides, many organic farmers consider weeds their most serious barrier to successful organic production and effective organic weed control a top research priority. Weed management in organic farming is elimination of weeds expensive and hard to achieve and it would be appropriate to adopt various methods combination rather than in isolation to manage these weeds from organic source depending upon the nature and intensity of weeds. A good understanding of weed biology, such as morphology, lifecycles, seed production, etc., are essential to effective organic and integrated weed management. The basic approach is to minimize production lose caused by weeds, through weed may exist as part of whole system. In the organic agriculture one may often identify weeds as the key problem. Weed population can increase rapids during the early stages of conversion, although there are evidences that population stability with increased time of organic farming. Weed management techniques leading to less yield reductions and minimum disturbance to environment and understanding of crop-weed ecology and its management is essential for weed control in organic farming system. All means other than synthetic chemicals could be tried to minimize/manage the weeds in the organic production systems.

Top 10 research priorities for early-stage colorectal cancer: a Canadian patient-oriented priority-setting partnership.

Background:Colorectal cancer, one of the most commonly diagnosed cancers, is now being detected earlier and treatments are improving, which means that patients are living longer. Partnering with Canadian clinicians, patients and researchers, we aimed to determine research priorities for those living with early-stage colorectal cancer in Canada.Methods:We followed the well-established priority-setting partnership outlined by the James Lind Alliance to identify and prioritize unanswered questions about early-stage (i.e., stages I–III) colorectal cancer. The study was conducted from September 2018 to September 2020. We surveyed patients, caregivers and clinicians from across Canada between June 2019 and December 2019. We categorized the responses using thematic analysis to generate a list of unique questions. We conducted an interim prioritization survey from April 2020 to July 2020, with patients, caregivers and clinicians, to determine a shorter list of questions, which was then reviewed at a final meeting (involving patients, caregivers and clinicians) in September 2020. At that meeting, we used a consensus-based process to determine the top 10 priorities.Results:For the initial survey, 370 responses were submitted by 185 individuals; of the 98 individuals who provided demographic information, 44 (45%) were patients, 16 (16%) were caregivers, 7 (7%) were members of an advocacy group, 26 (27%) were health care professionals and 5 (5%) were categorized as “other.” The responses were refined to create a list of 66 unique unanswered questions. Twenty-five respondents answered the interim prioritization survey: 13 patients (52%), 2 caregivers (8%), 3 advocacy group members (12%) and 7 health care professionals (28%). This led to a list of the top 30 questions. The final consensus meeting involved 20 individuals (10 patients [50%], 3 caregivers [15%] and 7 health care professionals [35%]), who agreed to the top 10 research priorities. The priorities covered a range of topics, including screening, treatment, recurrence, management of adverse effects and decision-making.Interpretation:We determined the top research priorities for early-stage colorectal cancer using a collaborative partnership of stake-holders from across Canada. The priorities covered a broad range of topics that could be addressed by future research, including improved screening practices, the role of personalized medicine, the management of adverse effects of treatment, decision-making and prevention of recurrence.

Growing PEACHnet: Building a Practice-Based Research Network in Western Colorado.

Practice-based research networks (PBRNs) have long sought to engage with communities and address questions relevant to multiple stakeholders and real-world primary care practice. Topic-generating processes that involve these stakeholders are crucial for identifying these questions. PBRNs often focus on certain populations or geographic areas. We are forming a new PBRN to address the health concerns and research interests of people in communities in Western Colorado. To engage with and determine the questions important to multiple stakeholders in communities in western Colorado, we conducted community meetings at which we used Photovoice followed by Nominal Group Technique in group discussions across the region. We then conducted a survey to develop a list of priority research topics. Multiple stakeholders were ready and eager to engage with us to form a PBRN. Across all communities, many of the topics that emerged were related to the social determinants of health. Mental health-specifically, lack of access to services and high suicide incidence-was the most important topic according to community members. This was consistent across groups of stakeholders and corroborated other community work such as Community Health Needs Assessments. Using participatory methods increased our stakeholder engagement and helped build strong community-academic partnerships for our PBRN-related research. Use of Photovoice allowed all participants to express their thoughts and ideas and led to a clear path forward for this new research network.

Priority setting in cardiovascular research in Iran using standard indigenous methods.

Determining cardiovascular disease (CVD) research priorities is essential given the high burden of these diseases, limited financial resources, and competing priorities. This study aimed to determine the research priorities in CVD field in Iran using standard indigenous methods. An extensive search was done in relevant international and national studies. Then, an indigenous standard multistage approach based on multicriteria decision analysis steps was adapted to local situation and implemented. This process included forming a working group of experts in priority setting methodology, identifying the context and prioritization framework, discussing the methodology with the National Network of CVD Research (NCVDR) members who ultimately determined the priority research topics, weighted topics criteria, ranked topics, and reviewed all determined research priorities for final report. Thirteen cardiovascular research priorities were determined by the NCVDR members. The first five priorities based on their scores include studies in hypertension, prevention and control of ischemic heart disease (IHD) and its risk factors, burden of IHD, Registration of CVDs, and COVID-19 and CVDs. Cardiovascular research priorities were determined using a standard indigenous approach by national experts who are the NCVDR members. These priorities can be used by researchers and health decision makers.

Harnessing Innovative Technologies to Train Nurses in Suicide Safety Planning With Hospitalized Patients: Protocol for Formative and Pilot Feasibility Research.

BackgroundSuicide is the 10th leading cause of death in the United States, with >47,000 deaths in 2019. Most people who died by suicide had contact with the health care system in the year before their death. Health care provider training is a top research priority identified by the National Action Alliance for Suicide Prevention; however, evidence-based approaches that target skill-building are resource intensive and difficult to implement. Advances in artificial intelligence technology hold promise for improving the scalability and sustainability of training methods, as it is now possible for computers to assess the intervention delivery skills of trainees and provide feedback to guide skill improvements. Much remains to be known about how best to integrate these novel technologies into continuing education for health care providers.ObjectiveIn Project WISE (Workplace Integrated Support and Education), we aim to develop e-learning training in suicide safety planning, enhanced with novel skill-building technologies that can be integrated into the routine workflow of nurses serving patients hospitalized for medical or surgical reasons or traumatic injury. The research aims include identifying strategies for the implementation and workflow integration of both the training and safety planning with patients, adapting 2 existing technologies to enhance general counseling skills for use in suicide safety planning (a conversational agent and an artificial intelligence–based feedback system), observing training acceptability and nurse engagement with the training components, and assessing the feasibility of recruitment, retention, and collection of longitudinal self-report and electronic health record data for patients identified as at risk of suicide.MethodsOur developmental research includes qualitative and observational methods to explore the implementation context and technology usability, formative evaluation of the training paradigm, and pilot research to assess the feasibility of conducting a future cluster randomized pragmatic trial. The trial will examine whether patients hospitalized for medical or surgical reasons or traumatic injury who are at risk of suicide have better suicide-related postdischarge outcomes when admitted to a unit with nurses trained using the skill-building technology than those admitted to a unit with untrained nurses. The research takes place at a level 1 trauma center, which is also a safety-net hospital and academic medical center.ResultsProject WISE was funded in July 2019. As of September 2021, we have completed focus groups and usability testing with 27 acute care and 3 acute and intensive care nurses. We began data collection for research aims 3 and 4 in November 2021. All research has been approved by the University of Washington institutional review board.ConclusionsProject WISE aims to further the national agenda to improve suicide prevention in health care settings by training nurses in suicide prevention with medically hospitalized patients using novel e-learning technologies.International Registered Report Identifier (IRRID)DERR1-10.2196/33695

Gathering Global Perspectives to Establish the Research Priorities and Minimum Data Sets for Degenerative Cervical Myelopathy: Sampling Strategy of the First Round Consensus Surveys of AO Spine RECODE-DCM.

Study DesignSurvey.IntroductionAO Spine Research Objectives and Common Data Elements for Degenerative Cervical Myelopathy (AO Spine RECODE-DCM) is an international initiative that aims to accelerate knowledge discovery and improve outcomes by developing a consensus framework for research. This includes defining the top research priorities, an index term and a minimum data set (core outcome set and core data elements set – core outcome set (COS)/core data elements (CDE)).ObjectiveTo describe how perspectives were gathered and report the detailed sampling characteristics.MethodsA two-stage, electronic survey was used to gather and seek initial consensus. Perspectives were sought from spinal surgeons, other healthcare professionals and people with degenerative cervical myelopathy (DCM). Participants were allocated to one of two parallel streams: (1) priority setting or (2) minimum dataset. An email campaign was developed to advertise the survey to relevant global stakeholder individuals and organisations. People with DCM were recruited using the international DCM charity Myelopathy.org and its social media channels. A network of global partners was recruited to act as project ambassadors. Data from Google Analytics, MailChimp and Calibrum helped optimise survey dissemination.ResultsSurvey engagement was high amongst the three stakeholder groups: 208 people with DCM, 389 spinal surgeons and 157 other healthcare professionals. Individuals from 76 different countries participated; the United States, United Kingdom and Canada were the most common countries of participants.ConclusionAO Spine RECODE-DCM recruited a diverse and sufficient number of participants for an international PSP and COS/CDE process. Whilst PSP and COS/CDE have been undertaken in other fields, to our knowledge, this is the first time they have been combined in one process.

Health insurance rights and access to health care for trans people: The social construction of medical necessity

AbstractHealth care rights for transgender and/or nonbinary people have dramatically expanded in recent years, including in insurance coverage for the treatments and procedures they need. Yet, trans people themselves still identify health insurance problems as a top priority for research and policy change because of significant difficulties gaining and using coverage. Wrangling over coverage determinations happens through multiple types of interactions, bureaucratic, interpersonal, and medical. When these interactions become difficult, it is because key terms such as medical necessity are both powerful and indeterminate. This study examines how trans people and health care intermediaries navigate the health insurance process and contest the meaning of medical necessity in coverage determinations. These disputes constitute the ground-level reality for instantiating health care rights to gender affirming care. Relying on analysis of contract language and 32 interviews with people who sought gender-affirming care and allied professionals, we find that health insurance policy language, interpretation, and implementation often create disadvantages and barriers for trans people who attempt to access care. Our study highlights how the contested life of insurance policy terminology produces a reality for rights but also details the mechanisms through which insurance-mediated care is a socially contested and negotiated process

Alzheimer's disease clinical onset and age at death in people with Down syndrome: A systematic review and population‐based study

AbstractBackgroundDespite better medical care and social support, life expectancy in people with Down syndrome (DS) is still close to 60 years, about 20 years less than in the general population. Alzheimer’s disease (AD), which has a lifetime risk of >90% in DS, might be the cause. We conducted a systematic review to interrogate the age of onset of symptomatic AD and the age of death in this population.MethodsOur protocol was registered in the PROSPERO database (CRD42020203967). We performed a systematic search using PubMed, Embase, CINAHL and Web of Science. Only peer‐reviewed, original research studies written in English were considered. No time period restrictions were applied. Studies were eligible if they described research on adults with DS, had good methodological quality, and if they contained numerical results (mean and SD or standard error) of the following outcomes: age at onset or age at diagnosis of symptomatic AD (based on expert clinical judgment), age at death after onset of AD, and/or duration of the disease (time in years from onset or diagnosis to death).ResultsWe identified 6983 studies for title and abstract screening after duplicate removal. Of these, 259 articles were considered for full text review and 62 studies met the eligibility criteria (Figure 1). Excluded studies and reasons for exclusion are described in Figure 1. The weighted average for AD onset in DS was 54.1 ± 6.5 years (estimated in 4204 individuals) with a standard error of the mean across studies of 0.328. For age of death and disease duration the weighted averages were 57.7 ± 6.5 (data available from 514 individuals), and 5.4 ± 3.9 years (444 individuals), respectively.ConclusionsThe mean age of AD onset in DS is remarkably consistent across studies, with a variability comparable to that reported in autosomal dominant AD. Given the >90% penetrance, the age of onset reported in the studies and the duration of the disease, life expectancy cannot possibly increase for people with DS if we do not find a cure for AD. This disease should therefore be recognized as the top medical and research priority in this population.

Priority setting in breast reconstructive surgery: A DELPHI consensus

Breast reconstructive surgery is often performed following breast cancer treatment to restore the natural appearance of the breast. Despite various research performed in this field, there is a discrepancy between the research question that is considered crucial jointly by patients, carers and healthcare professionals and the research performed. The Breast Reconstruction Priority Setting Partnership was formed to determine the top research priorities in all aspects of breast reconstructive surgery. The Priority Setting Partnership (PSP) was conducted in line with James Lind Alliance (JLA) principles involving patients and clinicians. An online survey was conducted to gather uncertainties related to breast reconstruction by involving patients, carers and clinicians. Following this, a modified Delphi consensus process was performed to identify the top 10 research priorities. A total of 239 unique research uncertainties were identified via the online survey, which involved 100 participants. A review of literature established that 58 of these uncertainties did not have a high-quality systematic review, prompting the need for more in-depth research. A further 28 research uncertainties were obtained by performing a literature search. Of the final 86 unique questions, the Delphi panel achieved consensus on the top ten research priorities. Recommendations to address these research priorities have been put forward based on current evidence. This study involved patients, carers and healthcare professionals to establish the top 10 priority areas for research in breast reconstructive surgery. Recommendations have been put forward on the necessary future research that is required to address these uncertainties.

Performance of artificial intelligence for detection of subtle and advanced colorectal neoplasia.

There is uncertainty regarding the efficacy of artificial intelligence (AI) software to detect advanced subtle neoplasia, particularly flat lesions and sessile serrated lesions (SSLs), due to low prevalence in testing datasets and prospective trials. This has been highlighted as a top research priority for the field. An AI algorithm was evaluated on four video test datasets containing 173 polyps (35,114 polyp-positive frames and 634,988 polyp-negative frames) specifically enriched with flat lesions and SSLs, including a challenging dataset containing subtle advanced neoplasia. The challenging dataset was also evaluated by eight endoscopists (four independent, four trainees, according to the Joint Advisory Group on gastrointestinal endoscopy [JAG] standards in the UK). In the first two video datasets, the algorithm achieved per-polyp sensitivities of 100% and 98.9%. Per-frame sensitivities were 84.1% and 85.2%. In the subtle dataset, the algorithm detected a significantly higher number of polyps (P < 0.0001), compared to JAG-independent and trainee endoscopists, achieving per-polyp sensitivities of 79.5%, 37.2% and 11.5%, respectively. Furthermore, when considering subtle polyps detected by both the algorithm and at least one endoscopist, the AI detected polyps significantly faster on average. The AI based algorithm achieved high per-polyp sensitivities for advanced colorectal neoplasia, including flat lesions and SSLs, outperforming both JAG independent and trainees on a very challenging dataset containing subtle lesions that could have been overlooked easily and contribute to interval colorectal cancer. Further prospective trials should evaluate AI to detect subtle advanced neoplasia in higher risk populations for colorectal cancer.

Molecular signatures in cetacean morbillivirus and host species proteomes: Unveiling the evolutionary dynamics of an enigmatic pathogen?

Cetacean morbillivirus (CeMV) infects marine mammals often causing a fatal respiratory and neurological disease. Recently, CeMV has expanded its geographic and host species range, with cases being reported worldwide among dolphins, whales, seals, and other aquatic mammalian species, and therefore has emerged as the most threatening nonanthropogenic factor affecting marine mammal's health and conservation. Extensive research efforts have aimed to understand CeMV epidemiology and ecology, however, the molecular mechanisms underlying its transmission and pathogenesis are still poorly understood. In particular, the field suffers from a knowledge gap on the structural and functional properties of CeMV proteins and their host interactors. Nevertheless, the body of scientific literature produced in recent years has inaugurated new investigational trends, driving future directions in CeMV molecular research. In this mini-review, the most recent literature has been summarized in the context of such research trends, and categorized into four priority research topics, such as (1) the interaction between CeMV glycoprotein and its host cell receptors across several species; (2) the CeMV molecular determinants responsible for different disease phenotype; (3) the host molecular determinants responsible for differential susceptibility to CeMV infection; (4) the CeMV molecular determinants responsible for difference virulence among circulating CeMV strains. Arguably, these are the most urgent topics that need to be investigated and that most promisingly will help to shed light on the details of CeMV evolutionary dynamics in the immediate future.