Individual Variation Research Articles

Processing cataphoric they amidst pronominal innovation

AbstractWhen they encounter a cataphoric pronoun during real-time sentence processing, the comprehender begins searching actively for a feature-matched noun that can supply its reference. The present study investigates individual variation in this active search procedure, leveraging an ongoing change in the pronoun system of North American English. The types of referents compatible with the they-series of pronouns is expanding, with an increasing number of speakers allowing definite singular referents: especially but not exclusively when referring to someone with a nonbinary gender identity. Sociolinguistic work shows that the speakers who most accept innovative usages of singular they tend to be younger, or to be non-cisgender (e.g. transgender, nonbinary). Recruiting participants representing diverse ages and gender identities, the present experiment tracked reading times of sentences involving cataphora. Results shows that cataphoric they is processed differently than cataphoric s/he, across the board. There is a significant processing cost to reading a plural noun that follows cataphoric s/he, indicating that singular cataphors evoke strong number expectations. However, the cost of reading a singular noun after they is smaller and emerges later; they seems to evoke weak number expectations. Individual differences show that those expectations are especially weak for younger participants, perhaps reflecting a higher baseline familiarity with singular they. On the other hand, course-grained gender identity (cis vs. non-cis) does not seem to be a reliable predictor of how cataphoric they is processed. Integrating insights from sociolinguistics and psycholinguistics, this study offers a novel view into ongoing language change and its manifestation in real-time processing measures.

Menstrual cycle related depressive symptoms and their diurnal fluctuations – an ambulatory assessment study

Abstract Background Reproductive mood disorders indicate that within-person variation in depressive symptoms across the menstrual cycle can be related to ovarian hormone changes. Until now, such cycle-related symptom changes have been measured once daily, even though depression research indicates systematic diurnal changes in symptoms. Further, previous research often focused on aggregated depression scores. This study examined whether three daily assessments of depressive symptoms follow similar trajectories across the menstrual cycle and investigated within-person cyclical fluctuation of all individual symptoms and the aggregated score. Methods 77 naturally-cycling participants (35 with and 42 without depressive disorder) provided three daily ratings of depressive symptoms across one menstrual cycle to evaluate individual and summarized symptoms. Results Reliability estimates (w) of the three diurnal measurements ranged from 0.56 to 0.78. Cyclicity showed statistically significant interindividual differences for all symptoms, and individual symptoms differed significantly from each other in their magnitude of cyclicity. Limitations Only one menstrual cycle was assessed to reduce participant burden. Further, ovulation testing dates were based on self-reported cycle lengths, and only LH (luteinizing hormone) peaks were tested without subsequent progesterone rises. Conclusions The results highlight the need for a symptom-specific approach to assess individual variance in cyclicity of depressive symptoms. Reliability for one daily assessment can be improved by using the afternoon value, a sum score for depressiveness, or multiple items per symptom. Furthermore, this study emphasizes, that depressive symptoms can systematically change across the menstrual cycle, and it is, therefore, important to include it in depression research. Exploring female-specific risk factors of depression will enable the development of person-tailored treatments. Trial registration The study was preregistered at ClinicalTrials.gov (NCT04086316) with the first registration on 27/08/2019.

Understanding the Role of Alcohol in Metabolic Dysfunction and Male Infertility

Purpose: Over the past 40–50 years, demographic shifts and the obesity epidemic have coincided with significant changes in lifestyle habits, including a rise in excessive alcohol consumption. This increase in alcohol intake is a major public health concern due to its far-reaching effects on human health, particularly on metabolic processes and male reproductive function. This narrative review focuses on the role of alcohol consumption in altering metabolism and impairing testicular function, emphasizing the potential damage associated with both acute and chronic alcohol intake. Conclusion: Chronic alcohol consumption has been shown to disrupt liver function, impair lipid metabolism, and dysregulate blood glucose levels, contributing to the development of obesity, metabolic syndrome, and related systemic diseases. In terms of male reproductive health, alcohol can significantly affect testicular function by lowering testosterone levels, reducing sperm quality, and impairing overall fertility. The extent of these effects varies, depending on the frequency, duration, and intensity of alcohol use, with chronic and abusive consumption posing greater risks. The complexity of alcohol’s impact is further compounded by individual variability and the interaction with other lifestyle factors such as diet, stress, and physical activity. Despite growing concern, research on alcohol’s effects remains inconclusive, with significant discrepancies across studies regarding the definition and reporting of alcohol consumption. These inconsistencies highlight the need for more rigorous, methodologically sound research to better understand how alcohol consumption influences metabolic and reproductive health. Ultimately, a clearer understanding is essential for developing targeted public health interventions, particularly in light of rising alcohol use, demographic changes, and the ongoing obesity crisis.

The role of socio-demographic and psychological factors in shaping individual carbon footprints in Finland.

Household consumption emissions are a major contributor to global greenhouse gas emissions, making them a vital target for emission reductions. While previous research has studied socio-demographic and situational factors in explaining the variation in individuals' carbon footprints, a more comprehensive exploration of individual drivers, would benefit the development of effective and equitable mitigation policies. The current study examines associations between psychological and socio-demographic factors and carbon footprints of Finnish adults (n = 3,519). Income was found to be the strongest factor explaining the variation in carbon footprints. While environmental attitudes, perceived easiness and perceived importance of climate actions statistically explained differences in carbon footprints, the effect sizes were modest. The factors explaining variation in the carbon footprint varied across different domains (housing, travel, diet, and other consumption of goods and services), with psychological factors having a more substantial effect on diet compared to other domains. Overall, the findings suggest that tailoring policy interventions to reduce emissions from different domains to specific groups and factors could be beneficial. Furthermore, the greatest emission reduction potential lies among higher-income individuals. In the dietary domain, attitude-changing interventions could be more effective, while financial or choice architecture interventions might be better suited for other domains.

Services in Minoritized Autistic Adolescents and Adults Varying in Language Skills.

Racially and ethnically minoritized (minoritized) autistic individuals face intersectional disparities in service access in the transition to adulthood. Our understanding of disparities is limited by systematic exclusion from research and inadequate approaches to characterizing services. To address these gaps and effect advocacy, this study (1) examined services received, unmet service needs, and barriers in minoritized autistic adolescents and adults and (2) determined if language, NVIQ, and autism traits predict services when deployed as binary or continuous variables. Academic and community partners tailored community-based participatory research (CBPR) to a local context. Participants (N = 73, ages 13-30) completed a behavioral assessment protocol. Participants and caregivers provided information on services received, unmet service needs, and barriers to services. Data were analyzed using descriptive and regression. Participants received multiple services yet had multiple unmet service needs and barriers. Effects of services differed by approach. Language impairment, but not language scores, predicted receiving more services. High levels of autism traits and autism trait scores predicted more unmet service needs. While the number of services and unmet service needs was similar to prior work, differences in individual service variables and effects support attention to heterogeneity. Findings support intersectional approaches to CBPR and autism research.

Video-based peer assessment of collaborative teamwork in a large-scale interprofessional learning activity.

The assessment of team performance within large-scale Interprofessional Learning (IPL) initiatives is an important but underexplored area. It is essential for demonstrating the effectiveness of collaborative learning outcomes in preparing students for professional practice. Using Kane's validity framework, we investigated whether peer assessment of student-produced videos depicting collaborative teamwork in an IPL activity was sufficiently valid for decision-making about team performance, and where the sources of error might lie to optimise future iterations of the assessment. A large cohort of health professional students (n = 1218) of 8 differing professions was divided into teams containing 5-6 students. Each team collaborated on producing a short video to evidence their management of one of 12 complex patient cases. Students from two other teams, who had worked on the same case, individually rated each video using a previously developed assessment scale. A generalisability study quantified sources of error that impacted the reliability of peer assessment of collaborative teamwork. A decision study modeled the impact of differing numbers of raters. A modified Angoff determined the pass/fail mark. Within a large-scale learning activity, peer assessment of collaborative teamwork was reliable (G = 0.71) based on scoring by students from two teams (n = 10-12) for each video. The main sources of variation were the stringency and subjectivity of fellow student assessors. Whilst professions marked with differing stringency, and individual student assessors had different views of the quality of a particular video, none of that individual assessor variance was attributable to the assessors' profession. Teams performed similarly across the 12 cases overall, and no particular professions marked differently on any particular case. A peer assessment of a student-produced video depicting interprofessional collaborative teamwork around the management of complex patient cases can be valid for decision-making about student team performance. Further refining marking rubrics and student assessor training could potentially modify assessor subjectivity. The impact of professions on assessing individual peers and the case-specificity of team performances in IPL settings need further exploration. This innovative approach to assessment offers a promising avenue for enhancing the measurement of collaborative learning outcomes in large-scale Interprofessional learning initiatives.

Deep learning of structural MRI predicts fluid, crystallized, and general intelligence.

Can brain structure predict human intelligence? T1-weighted structural brain magnetic resonance images (sMRI) have been correlated with intelligence. However, the population-level association does not fully account for individual variability in intelligence. To address this, studies have emerged recently to predict individual subject's intelligence or neurocognitive scores. However, they are mostly on predicting fluid intelligence (the ability to solve new problems). Studies are lacking to predict crystallized intelligence (the ability to accumulate knowledge) or general intelligence (fluid and crystallized intelligence combined). This study tests whether deep learning of sMRI can predict an individual subject's verbal, comprehensive, and full-scale intelligence quotients (VIQ, PIQ, and FSIQ), which reflect fluid and crystallized intelligence. We performed a comprehensive set of 432 experiments, using different input image channels, six deep learning models, and two outcome settings, in 850 healthy and autistic subjects 6-64 years of age. Our findings indicate a statistically significant potential of T1-weighted sMRI in predicting intelligence, with a Pearson correlation exceeding 0.21 (p < 0.001). Interestingly, we observed that an increase in the complexity of deep learning models does not necessarily translate to higher accuracy in intelligence prediction. The interpretations of our 2D and 3D CNNs, based on GradCAM, align well with the Parieto-Frontal Integration Theory (P-FIT), reinforcing the theory's suggestion that human intelligence is a result of interactions among various brain regions, including the occipital, temporal, parietal, and frontal lobes. These promising results invite further studies and open new questions in the field.

A translation-matched, experimental comparison of three types of wh-island effects in Spanish and English

According to the historical empirical consensus in the field, wh-argument extraction from embedded wh-questions gives rise to island effects in English, but not in Spanish. This observation – which was important for the development of a parameters-based theory of cross-linguistic variation in islands – has recently been challenged by experimental studies showing wh-island effects in both languages. However, these studies typically employ different materials and experimental conditions between languages, limiting direct comparison. Our study addresses this limitation by testing wh-islands in both English and Spanish with translation-matched materials. We present twelve acceptability judgment experiments with approximately 100 participants per experiment. In each language, we examine wh-argument extraction from three wh-clause types (introduced by whether, why and when) under two matrix verb types (know and ask), amounting to six wh-islands that are relevant to assess the reported contrasts. We test (i) for the presence or absence of wh-island effects in the two languages, (ii) for a gradient contrast in effect size, and (iii) for evidence of increased individual variation in Spanish as compared to English. We find (i) that wh-island effects are present in both English and Spanish, (ii) that they are rather large in both languages and larger in Spanish for most wh-island types, and (iii) that Spanish does not show more individual variation in wh-island effects than English. Our results speak against the cross-linguistic contrast as originally proposed, suggesting that its use as evidence for theories that encode cross-linguistic variation in wh-island effects might need to be reconsidered.

Impact of integrating traditional care with the modern healthcare system in reducing tuberculosis diagnosis delays in Ethiopia: a clustered randomized controlled study.

Diagnosis and treatment initiation delays for tuberculosis (TB) are significant challenges in resource-limited settings. These delays can result in poor treatment outcomes, disease transmission, and increased costs. This study aimed to assess the effect of integrating traditional care with modern healthcare systems on reducing TB diagnosis delay. A cluster randomized controlled trial was conducted among TB patients, with 510 participants, 255 individuals were assigned to the intervention group and 255 to the control group. Training in the intervention group was provided for both traditional and modern healthcare providers in three rounds to enhance their knowledge, attitudes, and skills in TB screening and referral. A non-parametric independent sample test was used to compare the baseline and end-line data. The effect size was determined using Cohen's d. To account for individual and cluster-level variations, a mixed-effect parametric survival model was employed. Furthermore, conditional (fixed only) and marginal (random effects) graphs were used to compare between the intervention and control groups. A total of 510 participants were included in the baseline study, with a similar number of participants included in the endline study. In the intervention group, the delay in diagnosis was 4.185 per 1000 person-days post-intervention, compared to 4.608 per 1000 person-days pre-intervention. In the control group, the delay for diagnosis was 4.759 per 1000 person-days pre-intervention and 5.031 per 1000 person-days post-intervention. The median time to diagnosis was 135days. The non-parametric comparison showed that the intervention significantly reduced patient delays in the intervention group compared to the control group (p = 0.006), with a Cohen's d effect size of 0.246. The intervention also significantly reduced diagnosis delay in the intervention group compared to the control group (p = 0.036), with a Cohen's d effect size of 0.187. The diagnosis of TB was accelerated by 1.076 times due to the integration of traditional care with the modern healthcare system in the intervention group compared to the control group (δ: 1.076; 95% CI 1.021, 1.134). The involvement of traditional care providers in TB control programs significantly reduced diagnosis delays in Ethiopia. These findings suggest the need for integrating traditional care with modern healthcare systems for the effective prevention of TB in high-burden countries. Clinical trial registration ClinicalTrials.gov ID: NCT05236452.

On the taxonomy of the genus Lethe Hübner (Lepidoptera, Papilionoidea, Nymphalidae, Satyrinae) with description of a new species

New information on the genus Lethe is presented. A new species of the Lethe tristigmata-complex, L. sunglam sp. nov. is described from Mt. Fansipan, northern Vietnam. The individual variation of Lethe jianqingi Lang, 2016 is discussed and its female is reported for the first time and compared with the related taxa. Lethe lyncus de Nicéville, 1897 is found to be a good species different from the related congeners, and L. wui H. Huang, 1999 was synonymized with it (syn. nov.). Adults and male genitalia of the aforementioned taxa and related ones as well are illustrated.

REGULARITIES OF DEVELOPMENT AND FORMATION OF EMBRYOTOPOGRAPHY OF THE THYROID AND PARATHYROID GLANDS IN HUMAN EMBRYOS OF 7-9 WEEKS OF GESTATION

The article describes the peculiarities of development and formation of variants of external shape and localization of thyroid and parathyroid glands in human embryos of 7-9 weeks of gestation.Aim of the study. The objective of the study was to fi nd the regularities of development and formation of embryotopographic relations between the thyroid and parathyroid glands during 7-9 weeks of the human intrauterine development. Material and methods. The study was carried out using a complex of morphological methods on 42 samples of human embryos without external signs of anatomical deviations or developmental defects. The specimens were taken from the museums of the Department of Human Anatomy of M. H. Turkevytch and the Department of Anatomy, Clinical Anatomy and Operative Surgery of the Bukovinian State Medical University.Results and discussion. In embryos with parietococcygeal length (PCL) of 14,0-17,0 mm intensive organogenesis processes of thyroid gland occur: separation of gland lobes, loss of connection with aortic arch and establishment of close correlations with laryngeal rudiment and vagus nerves. Therefore, the thyroid gland becomes semicircular. In embryos with 18,0-24,0 mm PCL there is a separation of the isthmus from the lateral lobes of the thyroid. Initially it is caused by intensive growth of the cricoid arch. Gradually the gland becomes H-shaped and fragmentation of the caudal part of the thyroglossal duct occurs. When the PCL reaches 29.5-31.0 mm, folliculogenesis begins and the thyroid gland becomes horseshoe- shaped. 9-week embryos show clear individual variations in the external shape of the thyroid gland: semicircular, H-shaped, and horseshoe. Areas of undiff erentiated epithelial tissue are found in the thyroid parenchyma, especially in its center.Conclusions. The conducted study has shown that during the 7-9 weeks of intrauterine development the structural organization of the thyroid and parathyroid rudiments becomes more complicated. Tight embryotopographic relations are established between them. Vascularization intensifi es and the connective tissue capsules of the thyroid and parathyroid glands are formed. At the same time their linear dimensions increase rapidly.

Age differences in mental state inference of sarcasm: Contributions of facial emotion recognition and cognitive performance.

Older age is associated with poorer ability to accurately infer mental states, but some mental states are more complex than others. Sarcasm is a complex mental state because the literal and intended meaning of a speaker's words are in opposition. Individuals must rely on additional cues (e.g., facial expressions, intonation) for accurate inference. We hypothesized that understanding of sarcastic versus sincere exchanges would be more sensitive to age-related difficulty in mental state understanding. We examined accuracy at identifying sarcasm among 263 adults (ages 18-90 years) using videos of social interactions in The Awareness of Social Inference Test. Hypotheses were tested using a logistic linear mixed effects model predicting correct/incorrect trial-level responses. To characterize why sarcasm differed with age, we measured two abilities commonly implicated in mental state understanding: facial emotion recognition and cognitive performance. Sarcasm understanding declined with age, whereas understanding of sincere exchanges did not. Both better emotion recognition and cognitive performance related to better understanding of sarcastic but not sincere exchanges. Only cognitive performance showed an age-related effect such that the cognitive performance among the oldest participants facilitated their understanding of both sarcastic and sincere exchanges. We showed that individual variation related to age and social and cognitive performance is more pronounced when the use of multiple mental state cues is more (sarcasm) or less (sincerity) necessary for accurate understanding of social interactions. Naturalistic paradigms involving multiple mental state cues can address important questions about how older adults make decisions in the real world.

Innovative Production and Innovative Agricultural Products in the Food Economy in the Context of Selected Lifestyle Elements of the Inhabitants of South-Eastern Poland: Case Study

Sustainable development in the agriculture of the future will lead to innovative production, providing the possibility of obtaining better quality agricultural products. In turn, these innovative agricultural products will fit into new social lifestyles. Therefore, in this study, the authors asked the following research questions: (i) How do respondents perceive innovative agricultural production and innovative products in the area of food economy?; (ii) what is the relationship between selected lifestyle elements and the perception of innovative agricultural production and products? The research tool was a survey questionnaire. The diagnostic study was conducted using the CAWI (Computer-Assisted Web Interview) technique. The study was partial and non-probabilistic in nature. Participation in the study was voluntary and anonymous, and completion of the form could be interrupted at any time. The target group were adults aged ≥ 18 years. They were residents of south-eastern Poland, from the Podkarpackie and Lublin provinces. The study was of a correlational nature, as it sought relationships between the elements studied, without the possibility of influencing the level of individual variables. A five-point Likert scale with a neutral value was used for the assessment. Spearman correlation analysis (rS) was performed to find the relationship between the items. This type of correlation was chosen because the variables subjected to calculations were on an ordinal scale. The Kruskal–Wallis H test was also calculated to determine the effect of independent variables (lifestyle elements) on dependent variables (perception of innovative production and food products). The Mann–Whitney U test was utilized to calculate and identify differences between groups (sex and place of residence). Statistical significance was assessed at the level of α = 0.05. To illustrate these differences more clearly, categorized graphs of the average ratings of the items studied were also drawn up. The research results indicate a different approach from men and women to the issues studied. The place of residence and the approach of the respondents from south-eastern Poland to the studied lifestyle elements influenced their perception of sustainable agricultural production and innovative features of agricultural products. The examined lifestyle elements demonstrated a varied impact on the perception of innovative production and innovative food products.

Choice versus no choice: Practical considerations for increasing choices.

Choice involves engaging in a selection response when multiple options are concurrently available. Choices can be incorporated into many components of behavior-analytic treatment such as providing clients with a choice between multiple items, activities, or tasks. We reviewed the main characteristics of 38 behavior-analytic articles that compared choice and no-choice conditions. We coded the experimental arrangements of choice and no-choice conditions and analyzed potential factors affecting preferences for choice and no choice. The findings suggest that the sizing of alternatives from which to choose, the timing of choice opportunities, and the timing of the delivery of the chosen option varied across the studies. Furthermore, preferences for choice shifted with differential reinforcement history and response effort manipulations of choice or no choice. The findings suggest that individual variables should be considered when providing choices, but more research is needed.

Stability in fecal metabolites amid a diverse gut microbiome composition: a one-month longitudinal study of variability in healthy individuals

ABSTRACT An extensive network of microbial-host interactions exists in the gut, making the gut microbiome a complex ecosystem to untangle. The microbial composition and the fecal metabolites are important readouts to investigate intricate microbiota-diet-host interplay. However, this ecosystem is dynamic, and it is of interest to understand the degree and timescale of changes occurring in the gut microbiota, during disease as well as in healthy individuals. Cross-sectional study design is often used to investigate the microbiome, but this design provides a static snapshot and cannot provide evidence on the dynamic nature of the gut microbiome. Longitudinal studies are better suited to extrapolate causation in a study or assess changes over time. This study investigates longitudinal change in the gut microbiome and fecal metabolites in 14 healthy individuals with weekly sampling over a period of one-month (four time points), to elucidate the temporal changes occurring in the gut microbiome composition and fecal metabolites. Utilizing 16S rRNA amplicon sequencing for microbiome analysis and NMR spectroscopy for fecal metabolite characterization, we assessed the stability of these two types of measurable parameters in fecal samples during the period of one month. Our results show that the gut microbiome display large variations between healthy individuals, but relatively lower within-individual variations, which makes it possible to uniquely identify individuals. The fecal metabolites showed higher stability over time compared to the microbiome and exhibited consistently smaller variations both within and between individuals. This relative higher stability of the fecal metabolites suggests a balanced, consistent output even amid individual’s differences in microbial composition and they can provide a viable complementary readout to better understand the microbiome activity.

Beware of hitchhiking ticks? Clarifying the variable roles of bird species in tick movement along migratory routes

Ticks are blood‐feeding parasites which act as major vectors for various pathogenic microorganisms affecting both animal and human health. Hard ticks are known to move passively (i.e. ‘hitchhike') on migratory birds as they transit between breeding and non‐breeding grounds. This potentially leads to exchange and establishment of non‐endemic tick species in novel environments. However, it is not yet clear if all migratory bird taxa play an equal role in movement of specific tick species, especially outside of medically important tick taxa. To clarify these interactions, we performed a systematic literature review regarding primary data of ticks moving on migratory birds within the African–Western Palearctic flyways. In total, 35 studies were found which showed 123 bird species from 37 families and 12 orders connected to potential movement of 30 tick species representing six genera (Amblyomma, Dermacentor, Haemaphysalis, Hyalomma, Ixodes, Rhipicephalus). Most tick species did not show high abundance for any bird species, or, if they did, only on very few. Only Ixodes ricinus and Hyalomma marginatum were estimated to be carried at above average burdens by multiple bird species. This could indicate an increased likelihood of these species to be moved during migration. Specific tick species or whole genera were only found in certain migratory seasons as expected based on their geographic distributions. Even so, species found in both migratory seasons did not differ in their estimated abundances on birds between seasons. This result could suggest that tick abundance on migrating birds is not always a direct result of geographic distribution and may suggest an understudied importance of stopover sites towards potential tick introduction or turnover. Taken together, the results presented here provide guiding information for future analyses integrating individual level variation into the current understanding of tick movement with migratory birds.

Abstract 4137204: Classifying Left Ventricular Hypertrophy from ECG in Overall Population and Bundle Branch Blocks: Machine Learning Models are Superior to Published ECG Criteria

Background: Published ECG criteria for left ventricular hypertrophy (LVH) have low diagnostic yield, esp. with right/left bundle branch block (RBBB/LBBB). Machine learning (ML) may improve LVH classification. Hypothesis: ML performs better than published LVH criteria to classify LVH from ECG in overall population, and subgroups of RBBB/LBBB. Methods: In addition to standard ECG features like rates, intervals, axis etc., R, S and overall QRS amplitudes, and voltage-time-integrals were extracted from standard 12 leads and reconstructed vectorcardiographic X, Y, Z lead representative beats. Further, a variational autoencoder was used to extract latent encodings from the representative beats. ML algorithms (logistic regression, random forest, light gradient boosted machine, multilayered perceptron, residual network, and convolutional neural network) were trained to predict LVH (LV mass index women &gt;95, men &gt;115 g/m 2 ) from ECG features on a training set of adult ECGs and echocardiogram within 45 days of each other (general population N=240,476, RBBB n=22,110, LBBB n=12,563). We obtained ROC AUCs in a separate validation set for LVH classification by (a) individual ECG variables, (b) published LVH criteria and (c) ML models. Results: As shown in Tables 1-2 and Figure 1 , for LVH classification among the validation sets, AUCs were highest for ML models, intermediate for univariable models and least for published criteria (best ML model vs. best criteria: general population women 0.77 vs. 0.63, men 0.78 vs. 0.63; RBBB women 0.70 vs. 0.57, men 0.77 vs. 0.57; LBBB women 0.71 vs. 0.55, men 0.72 vs. 0.54). Conclusions: ML models perform better than published LVH criteria at classifying LVH from ECG in overall population, RBBB and LBBB.

Therapy for Stage IV Non-Small Cell Lung Cancer With Driver Alterations: ASCO Living Guideline, Version 2024.2.

Living guidelines are developed for selected topic areas with rapidly evolving evidence that drives frequent change in recommended clinical practice. Living guidelines are updated on a regular schedule by a standing expert panel that systematically reviews the health literature on a continuous basis, as described in the ASCO Guidelines Methodology Manual. ASCO Living Guidelines follow the ASCO Conflict of Interest Policy Implementation for Clinical Practice Guidelines. Living Guidelines and updates are not intended to substitute for independent professional judgment of the treating clinician and do not account for individual variation among patients. See the Appendix for disclaimers and other important information (Appendix 1 and Appendix 2, online only). Updates are published regularly and can be found at https://ascopubs.org/nsclc-da-living-guideline.

Clinical Evidence Regarding Spermidine–Hyaluronate Gel as a Novel Therapeutic Strategy in Vestibulodynia Management

Background: Vestibulodynia (VBD) represents a summation and overlapping of trigger factors (infections, hormonal disturbances, allergies, genetic aspects, psychological vulnerability, and others) with broad individual variability. As there are no standard treatment options for VBD, the disease is still in need of appropriate therapeutic tools. Objectives: A prospective observational trial was performed to confirm the efficacy of a topical gel containing a spermidine–hyaluronate complex (UBIGEL donna™) as either a stand-alone or companion treatment through a multicenter study on a large sample population. Methods: For women with VBD (n = 154), the treatment consisted of approximately two months (4 + 4 weeks) of applications according to the posology of UBIGEL. Evaluation of symptoms was performed on relevant clinical endpoints: dyspareunia and vulvovaginal pain/burning by a visual scale (VAS); vestibular trophism by a vestibular trophic health (VeTH) score; vulvoscopy through a cotton swab test; and the level of hypertonic pelvic floor by a physical graded assessment of levator ani hypertonus. Results: A total of 154 patients treated with UBIGEL donna™ showed significant improvements across all five evaluated parameters, including pain, dyspareunia, swab test results, muscle hypertonicity, and vestibular trophism. Pain and dyspareunia scores decreased by 46.5% and 33.5%, respectively, while significant improvements were also observed in the other parameters (p &lt; 0.0001). These improvements were consistent across various stratifications, including age and disease duration. Conclusions: The findings of the present study suggest that UBIGEL donna™ is effective in alleviating pain and dyspareunia, as well as reducing vestibular hypersensitivity in women with VBD. Although UBIGEL donna™ alone cannot serve as a comprehensive substitute for all recommended therapies, we suggest that multimodal therapy strategies may be crucial for attaining substantial improvement in any aspect of the condition.

Abstract 4115015: Hyperpolarized Carbon-13 Metabolic Imaging Detects Changes in Cardiac Mitochondrial Metabolism in Patients Before and After Coronary Artery Bypass Graft Surgery

Background: Coronary Artery Disease (CAD) is a significant global health issue, necessitating improved diagnostic tools for visualizing cardiac energetics. Traditional imaging methods such as PET and dobutamine stress echocardiography do not directly assess mitochondrial metabolism. Hyperpolarized Carbon-13 metabolic magnetic resonance imaging (HP- 13 C MRI) offers a promising non-invasive method for investigating mitochondrial function in CAD. This study utilizes HP- 13 C MRI to detect changes in mitochondrial metabolism in patients undergoing Coronary Artery Bypass Graft (CABG) surgery (Fig.1). Methods: We conducted HP- 13 C MRI examinations on two patients with advanced CAD before and (~4-6 months after CABG surgery and one healthy subject (Fig. 2 A,B). Participating subjects provided informed consent according to a protocol approved by the Institutional Review Board and Protocol Review Committee. Baseline blood samples were analyzed for pyruvate, triglycerides, free fatty acids, and insulin levels. Post-glucose load, patients received an intravenous injection of an IND-approved metabolic probe, [1- 13 C] pyruvic acid, prepared under Good Manufacturing Practice regulations. The HP solution was administered after polarization in a clinical polarizer (SPINlab™, GE Healthcare). Imaging was performed using a GE MR750 MR system with a Helmholtz loop-pair 13 C coil (PulseTeq Limited, UK). Data were reconstructed and analyzed with MATLAB scripts. Results and Discussion: Baseline blood measurements were normal for the healthy subject, but those with advanced CAD showed variable and abnormal values (Fig. 2C). HP- 13 C MRI safely assessed cardiac metabolism in patients with advanced CAD. Patients with advanced CAD exhibited reduced pyruvate metabolism compared to healthy controls, shown by lower myocardial bicarbonate/(bicarbonate+lactate) ratios (Bic/(Bic+Lac)). Following CABG, only Patient 2 showed improved Bic/(Bic+Lac), while Patient 1 did not (Fig. 3A-B). This variability may be influenced by differences in nutrition, hormonal status, medication regimens, or other factors. Changes in % Bic/(Bic+Lac) across different coronary artery segments were observed post-CABG in CAD patients (Fig. 3C). Conclusion: HP- 13 C MRI non-invasively assesses cardiac metabolism in CAD patients, demonstrating the potential to evaluate post-CABG metabolic changes. Our efforts continue to recruit large cohort to understand individual variability.