Collaborative Study Research Articles

Pseudosuchia: Masters of survival and diversification.

In the context of an increasing interest for Pseudosuchia, we have compiled a Special Issue, comprising 14 collaborative studies that deepen our understanding of pseudosuchian evolution. These contributions range from the description of a new taxon to exhaustive reviews of thermometabolism, morphological adaptation, systematics, and detailed investigations into ontogeny, paleoneurology, paleohistology, and paleobiology. Through these papers, we explore the evolutionary history of pseudosuchian archosaurs, spotlighting their rise and diversification following the end-Permian mass extinction.

Federated privacy-protected meta- and mega-omics data analysis in multi-center studies with a fully open-source analytic platform.

The importance of maintaining data privacy and complying with regulatory requirements is highlighted especially when sharing omic data between different research centers. This challenge is even more pronounced in the scenario where a multi-center effort for collaborative omics studies is necessary. OmicSHIELD is introduced as an open-source tool aimed at overcoming these challenges by enabling privacy-protected federated analysis of sensitive omic data. In order to ensure this, multiple security mechanisms have been included in the software. This innovative tool is capable of managing a wide range of omic data analyses specifically tailored to biomedical research. These include genome and epigenome wide association studies and differential gene expression analyses. OmicSHIELD is designed to support both meta- and mega-analysis, so that it offers a wide range of capabilities for different analysis designs. We present a series of use cases illustrating some examples of how the software addresses real-world analyses of omic data.

Childhood interstitial lung disease survivors in adulthood: a European collaborative study.

Interstitial lung disease (ILD) is rarer in children (chILD) than adults, but with increasing diagnostic awareness, more cases are being discovered. chILD prognosis is often poor, but increasing numbers are now surviving into adulthood. To characterize chILD-survivors and identify their impact on adult-ILD centers. European study (34 adult-ILD and chILD centers) reporting incident/prevalent cases of chILD-survivors from January to July 2023. Epidemiological, clinical, physiological and genetic data were collected. 244 patients were identified with median (years) (IQR) age at diagnosis 12.5 (6-16), age at study inclusion 25 (22-33), 51% male, 86% non-smokers, median %-predicted FVC and DLCO 70 (47-89) and 48 (32-75) respectively; 32% were prescribed long-term oxygen; 227 (93%) were followed-up in adult centers whereas 17 (7%) never transitioned. Commonest diagnoses (82%) were chILD category B1, 35% (sarcoidosis, hemosiderosis, connective tissue disorders, vasculitis); A4, 21% (surfactant-related); B2, 14% (bronchiolitis obliterans, hypersensitivity pneumonitis); Bz, 13% (unclassified-ILD). Bz patients had the worst functional status. 60% of all patients were still being prescribed corticosteroids. Re-specification of diagnosis and treatment were made after transition for 9.8% and 16% of patients respectively. Not all chILD diagnoses were recognized in adult-ILD classifications. chILD survivors are seen in most adult-ILD centers and only a minority continue follow-up in pediatric centers. Survivors have a significant loss of lung function. The heterogeneity of their etiologies and therapeutic requirements has a real impact on adult-ILD centers. Re-specification of diagnosis and treatment may contribute to precision and personalization of management.

Conceptualising Student Engagement in Higher Education

This special issue of Student Success celebrates the work of Professor Ella Kahu and her substantial contribution to the advancement of our collective understanding of student engagement. In June 2024 Professors Karen Nelson and Chi Baik, and Dr Cat Picton sat down with Ella for a reflective conversation about her work, and additional insights in her theorising and research on student experience and engagement. In this special issue, we present the interview transcript in three parts and showcase Ella’s key publications. Understanding student engagement has become essential for retention and success in higher education. This first part of the issue brings together three influential articles that have contributed to advancing our conceptualisation of student engagement. The first article, Framing Student Engagement in Higher Education (Kahu, 2013), offers a foundational review of prevailing perspectives on student engagement and proposing a comprehensive framework to address existing definitional and conceptual gaps. Building on this foundation, the second article by Ella and Karen Nelson, Student Engagement in the Educational Interface: Understanding the Mechanisms of Student Success (Kahu & Nelson, 2018) introduces the “educational interface”—a metaphor for the space where student and institutional factors interact, affecting engagement. This article refines our understanding of engagement by identifying key psychosocial constructs that mediate this interaction. The third article, Pathways to Engagement: A Longitudinal Study of the First-Year Student Experience in the Educational Interface, a collaborative study by Ella Kahu, Karen Nelson, and Catherine Picton, (Kahu et al., 2020) employs longitudinal research to trace the first-year student experience within this educational interface, providing empirical support for the framework and underscoring the importance of self-efficacy, belonging, emotions, and wellbeing in the engagement process. Together, these articles deepen our understanding of the theoretical and practical aspects of student engagement, providing educators and policymakers with insights to shape more effective engagement strategies. Journal articles: Kahu, E. R. (2013). Framing student engagement in higher education. Studies in Higher Education, 38(5), 758-773. https://doi.org/10.1080/03075079.2011.598505 Kahu, E. R., & Nelson, K. (2018) Student engagement in the educational interface: Understanding the mechanisms of student success. Higher Education Research & Development, 37(1), 58-71. https://doi.org/10.1080/07294360.2017.1344197 Kahu, E. R., & Picton, C., & Nelson, K. (2020). Pathways to engagement: A longitudinal study of the first-year student experience in the educational interface. Higher Education, 79(4), 657-673. https://doi.org/10.1007/s10734-019-00429-w

CNN-Based Device-Agnostic Feature Extraction From ONH OCT Scans.

Optical coherence tomography (OCT)-derived measurements of the optic nerve head (ONH) from different devices are not interchangeable. This poses challenges to patient follow-up and collaborative studies. Here, we present a device-agnostic method for the extraction of OCT biomarkers using artificial intelligence. ONH-centered OCT volumes from the Heidelberg SPECTRALIS, ZEISS CIRRUS HD-OCT 5000, and Topcon 3D OCT-1000 Mark I/II and 3D OCT-2000 devices were annotated by trained graders. A convolutional neural network (CNN) was trained on these segmented B-scans and utilized to obtain several ONH biomarkers, such as the retinal nerve fiber layer (RNFL) and the minimal rim width (MRW). The CNN results were compared between different devices and to the manufacturer-reported values using an independent test set. The intraclass correlation coefficient (ICC) for the circumpapillary retinal nerve fiber layer (cpRNFL) at 3.4 mm reported by the CIRRUS and 3D OCT-2000 was 0.590 (95% confidence interval [CI], -0.079 to 0.901), and our CNN resulted in a cpRNFL ICC of 0.667 (95% CI, -0.035 to 0.939). The cpRNFL at 3.5 mm on the CIRRUS, 3D OCT-2000, and SPECTRALIS generated by the CNN resulted in an ICC of 0.656 (95% CI, 0.055-0.922). Comparing the global mean MRWs from the SPECTRALIS between CNN and manufacturer yielded an ICC of 0.983 (95% CI, 0.917-0.997). The CNN ICC for the MRW among the CIRRUS, 3D OCT-2000, and SPECTRALIS was 0.917 (95% CI, 0.947-0.981). Our device-agnostic feature extraction from ONH OCT scans showed a higher reliability than the measures generated by the manufacturers for cpRNFL. MRW measurements compared very well among the manufacturers. This open-source software can robustly extract a wide range of biomarkers from any OCT device, removing the dependency on manufacturer-specific algorithms, which has significant implications for patient follow-up and collaborative research.

Factorial invariance of the Everyday Discrimination Scale among African, Caribbean, Black, and other racialized women living with and without HIV in British Columbia, Canada.

The Everyday Discrimination Scale (EDS) assesses the mistreatment racialized people experience daily. It is widely used in Canadian HIV research to measure racial discrimination among African, Caribbean, and/or Black (ACB), and other racialized women. However, no studies have examined whether the EDS provides valid estimates of racial discrimination that are objectively comparable across racial/ethnic groups or by HIV status in Canada. We aimed to address this gap. We analyzed EDS data from the British Columbia CARMA-CHIWOS Collaboration study of self-identifying women ≥ 16years of age living with and without HIV. We conducted confirmatory factor analysis (CFA) by race/ethnicity (ACB; Indigenous; other racialized; white) and also by HIV status to assess validity and reliability of the EDS within these groups. Next, we ran multigroup-CFA (mCFA) to determine whether the EDS measures the same construct to the same extent across race/ethnicity- and HIV status-based groups. Of 504 participants (202 with HIV), 62 were ACB, 152 Indigenous, 90 other racialized, and 200 white. CFA revealed adequate fit within race/ethnicity- and HIV status-based groups-all Cronbach's alpha > 0.9, factor loadings > 0.6, and acceptable fit indices, except for root mean square error of approximation. Residual correlations > 0.4 suggested redundancy between some item pairs. In the mCFA, the EDS was invariant across groups. The EDS provides racial discrimination estimates that are meaningfully comparable across race/ethnicity- and HIV status-based groups. Despite potential redundancy between item pairs that may warrant refinement, the EDS can be included in survey instruments that aim to examine and compare the prevalence and health impacts of racial discrimination among ACB and other racialized women in Canada.

Childhood trauma is associated with developmental trajectories of EEG coherence, alcohol-related outcomes, and PTSD symptoms.

Associations between childhood trauma, neurodevelopment, alcohol use disorder (AUD), and posttraumatic stress disorder (PTSD) are understudied during adolescence. Using 1652 participants (51.75% female, baseline Mage = 14.3) from the Collaborative Study of the Genetics of Alcoholism, we employed latent growth curve models to (1) examine associations of childhood physical, sexual, and non-assaultive trauma (CPAT, CSAT, and CNAT) with repeated measures of alpha band EEG coherence (EEGc), and (2) assess whether EEGc trajectories were associated with AUD and PTSD symptoms. Sex-specific models accommodated sex differences in trauma exposure, AUD prevalence, and neural development. In females, CSAT was associated with higher mean levels of EEGc in left frontocentral (LFC, ß = 0.13, p = 0.01) and interhemispheric prefrontal (PFI, ß = 0.16, p < 0.01) regions, but diminished growth in LFC (ß = -0.07, p = 0.02) and PFI (ß = -0.07, p = 0.02). In males, CPAT was associated with lower mean levels (ß = -0.17, p = 0.01) and increased growth (ß = 0.11, p = 0.01) of LFC EEGc. Slope of LFC EEGc was inversely associated with AUD symptoms in females (ß = -1.81, p = 0.01). Intercept of right frontocentral and PFI EEGc were associated with AUD symptoms in males, but in opposite directions. Significant associations between EEGc and PTSD symptoms were also observed in trauma-exposed individuals. Childhood assaultive trauma is associated with changes in frontal alpha EEGc and subsequent AUD and PTSD symptoms, though patterns differ by sex and trauma type. EEGc findings may inform emerging treatments for PTSD and AUD.

StomacH Cancer Elective Surgery MOrbidity and MortaLity at 90-Day (HOLD Study): A prospective, international collaborative cohort Study

StomacH Cancer Elective Surgery MOrbidity and MortaLity at 90-Day (HOLD Study): A prospective, international collaborative cohort Study

A historical cohort study with 27,754 individuals on the association between meat consumption and gastrointestinal tract and colorectal cancer incidence.

In order to explore the association between meat consumption and gastrointestinal/colorectal cancer (CRC) risk and to estimate the Israeli population attributable fraction (PAF), we conducted a collaborative historical cohort study using the individual participant data of seven nutritional studies from the past 6 decades. We included healthy adult men and women who underwent a nutritional interview. Dietary assessment data, using food-frequency or 24-h recall questionnaires, were harmonized. The study file was linked to the National Cancer and death registries. Among 27,754 participants, 1216 (4.4%) were diagnosed with gastrointestinal cancers and 839 (3.0%) with CRC by the end of 2016. Using meta-analysis methods applied to Cox proportional hazard models (adjusted for daily energy intake, sex, age, ethnic origin, education and smoking),100 g/day increments in beef, red meat and poultry consumption, and 50 g/day increment in processed meat consumption were associated with hazard ratios (HRs) and 95% confidence intervals of 1.46 (1.06-2.02), 1.15 (0.87-1.52), 1.06 (0.89-1.26), and 0.93 (0.76-1.12), respectively, for CRC. Similar results were obtained for gastrointestinal cancer, although red meat consumption reached statistical significance (HR = 1.27; 95%CI: 1.02-1.58). The PAFs associated with a reduction to a maximum of 50 g/day in the consumption of red meat were 2.7% (95%CI: -1.9 to 12.0) and 5.2% (0.3-13.9) for CRC and gastrointestinal cancers, respectively. Reduction of beef consumption to a maximum of 50 g/day will result in a CRC PAF reduction of 7.5% (0.7%-24.3%). While beef consumption was associated with gastrointestinal/CRC excess risk, poultry consumption was not. A substantial part of processed meat consumption in Israel is processed poultry, perhaps explaining the lack of association with CRC.

Blood Pressure Goals and Outcomes in Kidney Transplant Recipients in an Analysis of the Collaborative Transplant Study

Blood Pressure Goals and Outcomes in Kidney Transplant Recipients in an Analysis of the Collaborative Transplant Study

The impact of methylome analysis on the diagnosis and treatment of CNS tumours in children and adolescents: a population-based study in Greece.

BackgroundThe recently published WHO classification of central nervous system (CNS) tumours recognizes DNA methylation profiling as a desirable and, for some diagnoses, essential diagnostic tool adjunctive to conventional histopathology. DNA methylation profiling is not routinely available in many countries, including Greece. MethodsIn this collaborative study, we report the DNA methylation results in a series of children and adolescents with CNS tumours in Greece (2018-2023). In total, 130 tumour samples were analyzed using the latest applicable version of the Heidelberg brain tumour classifier. ResultsUpon initial analysis, 80% (104/130) achieved calibrated scores (Cs) ≥0.9 and matched an established methylation class family/subclass. Among them, methylation results confirmed (90/104, 86.5%), refined (50/104, 48%) or changed (10/104, 9.6%) the histological diagnosis. Only four results were regarded as non-contributing (4/104, 3.9%). Twenty-six tumour samples received Cs <0.9. Despite low scores, methylation results supported the initial diagnosis with lower confidence in 38.5% (10/26) and established the diagnosis in two tumours with non-conclusive histopathology. Additional t-distributed stochastic neighbour embedding (t-SNE) analysis allowed the possible classification of twelve tumours. Nine more samples reached high Cs using the newer brain tumour classifiers, since available. Samples co-tested in Greece demonstrated excellent test reproducibility, supporting the analysis' local implementation. Methylome profiling impacted the clinical management of 40% of patients, modifying stratification, prognosis, or treatment approach. ConclusionsThis study supports the need to integrate methylome analysis into routine diagnostics in our country and highlights the importance of collaboration between European pediatric oncology centres.

Leveraging Waste Banks for Green Environment Sustainability: A Case Study of Community Collaboration in the Gemuruh District, Bandung City, Indonesia

Waste management is a critical issue worldwide, including in Indonesia. In recent years, there has been a growing focus on waste management due to population growth and rapid urbanization. This initiative emphasizes the implementation of technology and innovation in waste management and its impact on communities. The results show that the use of organic waste shredding machines, waste banks, and compost bags has improved waste management efficiency. Training on sorting inorganic and organic waste, as well as using shredding machines, has enhanced the knowledge and skills of the community. Pre-tests and post-tests indicate an increase in understanding and skills in waste management, highlighting the effectiveness of the training program. The community has positively responded to the implementation of technology and innovation. This initiative demonstrates that empowering creative economy through plastic waste recycling can have a positive impact on communities, particularly in raising awareness and skills in waste management.

Clinical Characteristics and Treatment Outcomes in Unilateral Coats disease – a Global Collaborative Study

To evaluate the clinical outcomes and prognostic factors in unilateral Coats disease in the era of anti-VEGF therapy. Global, multicenter, retrospective case series. 656 eyes of 656 subjects with Coats disease were included in this study. Exclusion criteria were Coats disease secondary to retinitis pigmentosa as well as bilateral cases. Clinical data from patients with Coats disease were collected from 20 ophthalmic practices around the world. We compared early-stage (stage 1-2) and advanced-stage (stage 3-5) Coats disease in terms of clinical characteristics and treatment modalities. Functional outcomes include achieving visual acuity (VA) of 0.3 logMAR or better and VA improvement or stability. Anatomical failure was defined as the development of phthisis, chronic retinal detachment, massive fibrosis, or the requirement for enucleation. Subjects with early-stage disease were significantly older, with a mean age of 17.4 ± 17.8 years, compared to 7.1 ± 7.1 years in the advanced-stage group (p < 0.001). There was a male predominance in both early and advanced stages (84.7%). Advanced disease was associated with a higher incidence of strabismus (20.2% vs. 6.7%, p < 0.001) and leukocoria (12.3% vs. 3.2%, p < 0.001). More subjects with early-stage disease received laser photocoagulation as monotherapy (44.7% vs. 21.1%, p < 0.001). Additionally, early-stage disease received more sessions of intravitreal anti-VEGF injections as adjunct therapy (4.4 ± 6.2 vs. 2.7 ± 2.1, p = 0.005). Factors associated with poorer functional outcomes included worse presenting visual acuity, advanced disease stage, and the presence of a foveal nodule. Worse presenting visual acuity and advanced disease stage was associated with lower likelihood of anatomical success while combination therapy increased the odds of anatomical success. Unilateral Coats disease predominantly affects males, regardless of disease stage. Identifying a foveal nodule is crucial for visual prognosis. Laser photocoagulation remains the primary treatment. While anti-VEGF may prevent enucleation, its role in early-stage disease requires further clarification.

Collaborative Outcomes Study on Health and Functioning During Infection Times (COH-FIT): Global and Risk-Group Stratified Course of Well-Being and Mental Health During the COVID-19 Pandemic in Adolescents

To identify the COVID-19 impact on well-being/mental health, coping strategies and risk factors in adolescent worldwide. Anonymous online multi-national/language survey in the general population (representative/weighted non-representative samples, 14-17years), measuring change in well-being (WHO-5/range=0-100) and psychopathology (validated composite P-score/range=0-100), WHO-5 <50 and <29, pre- versus during COVID-19 pandemic (26/04/2020-26/06/2022). Coping strategies, nine a-priori defined individual/cumulative risk factors were measured. χ2, penalized cubic splines, linear regression, and correlation analyses were conducted. Analyzing 8,115 of 8,762 initiated surveys (representative=75.1%), the pre-pandemic WHO-5 and P-score remained stable during the study (excluding relevant recall bias/drift), but worsened intra-pandemic by 5.55±17.13 (standard deviation) and 6.74±16.06 points, respectively (effect size d=0.27 and d=0.28). The proportion of adolescents with WHO-5 scores suggesting depression screening (<50) and major depression (<29) increased from 9% to 17% and 2% to 6%. WHO-5 worsened (descending magnitude, with cumulative effect) in adolescents with a mental or physical disorder, female gender, and with school closure. Results were similar for P-score, with the exception of school closure (not significant) and living in a low-income country, as well as not living in a large city (significant). Changes were significantly but minimally related to COVID-19 deaths/restrictions, returning to near-pre-pandemic values after >2 years. The three most subjectively effective coping strategies were internet use, exercise/walking, and social contacts. Overall, well-being/mental health worsened (small effect sizes) during early stages of COVID-19, especially in vulnerable subpopulations. Identified at-risk groups, association with pandemic-related measures, and coping strategies can inform individual behaviours and global public health strategies.

A collaborative study to establish the second national standard for antithrombin concentrate in Korea

This study aimed to establish a second national standard for antithrombin (AT) concentrate that can be used for potency assays of AT products. A collaborative study was conducted involving four laboratories, including national control laboratories and manufacturers in Korea, and the suitability of a candidate material to serve as the second national standard for AT concentrate was evaluated. The candidate material was manufactured using a process approved for Good Manufacturing Practices. The potency of the candidate was determined using the heparin cofactor chromogenic method. The candidate was calibrated against the third International Standard for AT concentrate (code 06/166). Participants provided data from 58 independent assays. Combined potency estimates were calculated by determining the geometric means of the results obtained from all assays performed at individual laboratories. The overall potency assessments were subsequently established as the geometric means of all results collected from all laboratories. According to the collaborative study results, the intra- and inter-laboratory variability showed acceptable geometric coefficient of variation of 1.2 %–3.4 % and 2.4 % respectively, and it deemed to serve as the Korean national standard for AT concentrate with the assigned potency as follows: 32.1 IU/vial (95 % confidence interval; 31.7–32.5 IU/vial).

Reflections on Research and Research Intelligence in a Private Higher Education in South Africa: A Collaborative Autoethnographic Study

Globally, higher education remains a highly competitive environment, where striving towards good institutional reputation, as well as academic and research stature is high on the agendas. As such, research intelligence is fast becoming a topic of discussion. Measuring progress and success is a strategic and data-driven process. This paper reports on a collaborative autoethnographic study on a research capacity development project. It further explores the importance of the management of research towards creating, managing and utilising data-driven research intelligence in a private higher education institution in South Africa. Reflecting on this project, stretching over a five-year period, the study aims to shed light on further implementations by exploring how available data could translate into research intelligence. The study considers the role of research intelligence by comparing it to the strategic value of strategic and business intelligence. It explores how reliable research intelligence could inform and support strategies in developing a maturing academic environment, and how current and potential solutions could be applied for strategic decision making. The study adds knowledge to an under-researched area in higher education in South Africa. It offers recommendation for more effective management of research data and research intelligence.

Genetic heterogeneity in familial forms of genetic generalized epilepsy: from mono- to oligogenism

Genetic generalized epilepsy (GGE) including childhood absence epilepsy, juvenile absence epilepsy, juvenile myoclonic epilepsy (JME), and GGE with tonic–clonic seizures (TCS) (GGE-TCS), is genetically influenced with a two- to four- fold increased risk in the first-degree relatives of patients. Since large families with GGE are very rare, international studies have focused on sporadic GGE patients using whole exome sequencing, suggesting that GGE are highly genetically heterogeneous and rather involve rare or ultra-rare variants. Moreover, a polygenic mode of inheritance is suspected in most cases. We performed SNP microarrays and whole exome sequencing in 20 families from Sudan, focusing on those with at least four affected members. Standard genetic filters and Endeavour algorithm for functional prioritization of genes selected likely susceptibility variants in FAT1, DCHS1 or ASTN2 genes. FAT1 and DCHS1 are adhesion transmembrane proteins interacting during brain development, while ASTN2 is involved in dendrite development. Our approach on familial forms of GGE is complementary to large-scale collaborative consortia studies of sporadic cases. Our study reinforces the hypothesis that GGE is genetically heterogeneous, even in a relatively limited geographic area, and mainly oligogenic, as supported by the low familial penetrance of GGE and by the Bayesian algorithm that we developed in a large pedigree with JME. Since populations with founder effect and endogamy are appropriate to study autosomal recessive pathologies, they would be also adapted to decipher genetic components of complex diseases, using the reported bayesian model.Graphical

Evaluating Collection Time of Intragastric Fluid During Endoscopy for Point-of-care Test-based Helicobacter pylori Polymerase Chain Reaction.

Objective To evaluate the influence of sample collection time during esophagogastroduodenoscopy (EGD) on the accuracy of a newly approved point-of-care test (POCT)-based polymerase chain reaction kit for detecting Helicobacter pylori and clarithromycin susceptibility in gastric wash fluid. Methods Intragastric fluid was collected at three time points: Collection Time 1 (start of EGD), Collection Time 2 (during EGD), and Collection Time 3 (after indigo carmine spraying). POCT-based quantitative PCR (qPCR) targeting 23S rRNA domain V (2142/2143) was used to quantify H. pylori DNA in the collected fluid at all three time points and compared with qPCR targeting 16S rRNA. Patients Fifty patients with suspected H. pylori infection were consecutively enrolled in this study over a three-month period and underwent EGD. Results In 9 out of 50 EGD cases that were H. pylori-positive, no significant differences in H. pylori DNA content, quantified using POCT-based qPCR targeting 23S rRNA, were observed between the three collection times: 1 vs. 2, p=0.81; 2 vs. 3, p=0.59; 1 vs. 3. Collection Time 2 had the strongest inverse correlation with the urea breath test (r=-0.80, p=0.01) and was the only time-point at which POCT-based qPCR could detect H. pylori in case 15. Conclusion This study suggests that the optimal collection timing for the H. pylori detection POCT kit (within 60 min) using intragastric fluid (with no biopsy) may be during EGD (Collection Time 2). However, our study had a limited sample size, so the findings must be verified through large-scale, multicenter collaboration studies.

Detecting EPO in Microvolumetric Capillary Serum Shipped at Ambient Temperature for Antidoping Testing

ABSTRACTErythropoietin receptor agonist (ERA) testing for antidoping can be achieved in both urine and blood samples. Recent published work showed the comparability between the two matrices and focused on detectability in microvolumetric capillary serum samples collected using the Tasso+ device. Currently, in the antidoping field, blood samples are required to be shipped under cold, temperature‐controlled conditions. However, due to the suggested greater stability of EPO in blood compared to urine, it is believed that blood samples should be viable for ERA analysis if shipped under the ambient, not cold temperature‐controlled conditions to which urine samples are subjected. In this collaborative study with the Ultimate Fighting Championship, microvolumetric capillary serum samples were collected in the field and shipped under ambient conditions to the laboratory for ERA analysis. Resulting data showed that endogenous EPO was detectable in 100% of these samples, showing no loss in detectability despite shipping under non‐controlled conditions. Further, ERA analyses were conducted in the laboratory on additional in‐house collected samples and post‐EPO administration samples subjected to various storage and shipping conditions, also showing reliable endogenous and recombinant EPO detectability in all samples except those experiencing extreme temperature (50°C) conditions. Taken together, these data highlight the stability of EPO in blood samples and show that ERA blood samples can be collected in the field and shipped without costly temperature‐controlled shipping methods and without a loss in detectability.

Incidence of microbial keratitis associated with overnight orthokeratology: a multicenter collaborative study.

To investigate the incidence of microbial keratitis among Japanese patients wearing orthokeratology (ortho-k) lenses STUDY DESIGN: Retrospective multicenter study METHOD: This study was conducted at 4 hospitals in Japan and involved 1438 patients who had been prescribed ortho-k lenses and had worn them for at least 3 months. Data on patient demographics, lens characteristics, lens care systems, and presence of microbial keratitis were extracted from the medical records. Duration of ortho-k lens wear was calculated from the original fitting date to the patient's last visit, with the total years of lens wear used as person-years of lens wear. The incidence of microbial keratitis was calculated by dividing the number of infected cases by the total person-years of lens wear for all enrolled participants. Among the 1438 patients, 753 were male and 685 were female, with a mean age of 12.7 ± 5.4 years. The mean duration of ortho-k lens wear was 5.2 ± 4.5 years, and the mean lens power was -3.52 ± 1.41 D. The total person-years of lens wear for all enrolled patients was 7415. Four cases of microbial keratitis were identified, resulting in an overall incidence of microbial keratitis of 5.4 (95% CI: 1.0-9.8) per 10,000 patient-years among ortho-k lens wearers. This study represents the largest sample size to date for estimating the incidence of microbial keratitis associated with ortho-k lenses. The incidence was similar to or slightly lower than that of previous studies on ortho-k-related microbial keratitis and also comparable to that of daily wear soft contact lenses.