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Hurricane Irma devastated the island of Barbuda in September 2017. Motivated by the need to assess the population status of the endemic Barbuda Warbler Setophaga subita and resident Yellow Warbler S. petechia bartholemica, we used distance sampling to estimate total abundance (i.e. density and population size in a well-defined survey region, accounting for incomplete counts due to imperfect detection) in October 2017 and March 2019. Vocalising warblers were more detectable than non-vocalising warblers (two-tailed z scores >2.01, P values <0.04). In October 2017, detectability and density of the Barbuda Warbler were higher at points where the Yellow Warbler was undetected than detected (z > 2.20, P <0.03), suggesting competitive interactions following the hurricane. However, detectability did not differ (z = 0.45, P = 0.62) and density was higher (z = 2.11, P = 0.03) for the Barbuda Warbler at points where the Yellow Warbler was detected than undetected in March 2019, suggesting non-competitive coexistence after population recovery. The density (i.e. no. individuals/ha) and population size (no. individuals in the 9,000-ha survey region) of the Barbuda Warbler increased (z = -2.60, P = 0.01) from 0.27 (SE = 0.03) and 2,436 (SE = 261) in October 2017 to 0.40 (SE = 0.02) and 3,570 (SE = 171) in March 2019. The density and population size of the Yellow Warbler also increased (z = -2.40, P = 0.02) from 0.68 (SE = 0.03) and 6,093 (SE = 269) in October 2017 to 0.80 (SE = 0.04) and 7,158 (SE = 358) in March 2019. Owing to the small distribution range and threats from hurricanes and habitat loss on the island, the Barbuda Warbler should remain classified as “Vulnerable” to extinction. However, the more abundant and widely distributed Yellow Warbler should remain classified as of “Least Concern”.
Coronary artery abnormalities in children that require bypass grafting are infrequent but represent a well-recognised entity with a broad spectrum of indications beyond Kawasaki disease. Although myocardial revascularisation in children is uncommon, studies have shown that it can yield favourable short- and long-term outcomes, allowing affected children to regain health and grow up to live normal lives.
Myocardial revascularisation in children is an extremely rare intervention in Western countries, accounting for less than 1% of all paediatric cardiac surgeries in this region. It is a highly technically demanding procedure that opens a new arena in cardiac surgery, for which cardiovascular surgeons need to be trained to achieve outcomes as good as those shown in the literature.
We present the experience of paediatric coronary artery bypass grafting in a middle-income country, with a wide range of indications.
Methods:
A retrospective descriptive study was conducted on paediatric patients (under 18 years of age) who underwent coronary artery bypass grafting between 2004 and 2023 at a cardiovascular centre in Bogotá, Colombia. Data were collected from electronic medical records, including demographics, preoperative diagnoses, surgical details, and outcomes. Follow-up included clinical assessment and imaging with echocardiography. Ethical approval was obtained, and confidentiality was ensured.
Results:
Nine paediatric patients (ages 6–17) underwent coronary artery bypass grafting between 2004 and 2023. Kawasaki disease was the most common indication, but there are other aetiologies, including post-arterial switch coronary occlusion, anomalous origin of the LCA from the pulmonary artery, anomalous origin of coronary arteries from the aorta, Takayasu disease, and iatrogenic injury. The internal mammary artery was used in most cases, with successful completion of the planned revascularisation in all patients. There were no perioperative deaths or reinterventions. At a mean follow-up of 5.5 years, all patients showed clinical and biventricular improvement, and all grafts evaluated showed graft patency.
Paediatric coronary artery bypass grafting is a safe and effective treatment for selected congenital and acquired coronary pathologies, even in complex cases. Outcomes are optimised with the use of internal mammary arteries and a multidisciplinary heart team approach. In middle-income settings, favourable short- and mid-term results can be achieved despite follow-up challenges. Paediatric coronary artery bypass grafting should be considered a key component of congenital cardiac surgery training.
In the highlands of northern Chile, research on industrial mining camps and agropastoral sites (estancias) shows the relevance of a contemporary archaeology perspective for studying the impacts of capitalist expansion, ruination and deindustrialisation for local Indigenous communities.
To estimate the within-households association between change in income over time and food purchases in a national panel of households. The need to shift towards healthy and sustainable diets is widely recognised, thus the importance of identifying the factors that influence food purchase decisions.
Design:
Longitudinal observational study; for each of the thirty-three food items queried, we ran a conditional logistic fixed-effect regression model to evaluate the association between change in income per-capita and food purchases (yes/no) during the past week, adjusted by covariates.
Setting:
Mexican Family Life Survey.
Participants:
6008 households that participated in the survey for at least two of the three available waves of study (2002, 2005 and 2009).
Results:
Within-households, the OR (95 % CI) of purchasing the food in the past week for an increase in 1 sd of income was 1·09 (1·02, 1·16) for rarer fruits (other than bananas, apples and oranges); 1·11 (1·04, 1·18) for beef; 1·06 (1·00, 1·13) for canned tuna/sardines; 1·09 (1·02, 1·18) for fish/shellfish; 1·08 (1·02, 1·16) for discretionary packaged products and 1·15 (1·08, 1·23) for soft drinks. There were some differences by urban/rural area or socio-economic status (SES); mainly, those with lower SES had increased odds of purchasing the food item in more cases (ten out of thirty-three food items).
Conclusions:
Households’ income growth can have mixed effects on the healthiness and sustainability of food purchases. Public policies to improve the food environment and nutrition education are necessary to enhance the positive and counteract the negative effect of income.
Antimicrobial resistance (AMR) poses a significant global health threat, projected to cause 10 million deaths annually by 2050. Addressing AMR requires a coordinated, multidisciplinary approach encompassing infectious disease (ID) clinicians, pharmacists, microbiologists, infection preventionists, and policymakers. The inaugural AMR Summit, hosted by bioMérieux in collaboration with Tampa General Hospital and the University of South Florida Morsani College of Medicine in November 2024, convened experts from various fields to explore innovative strategies for combating AMR. Key topics discussed included the role of multidisciplinary teams in antimicrobial stewardship programs, advancements in rapid diagnostic tests and antimicrobial susceptibility testing, the application of implementation science in AMR, and the integration of next-generation sequencing in ID diagnostics. The summit underscored the importance of diagnostic innovation, interdisciplinary collaboration, policy, advocacy, and public engagement in advancing efforts against AMR.
Diagnosing HIV-Associated Neurocognitive Disorders (HAND) requires attributing neurocognitive impairment and functional decline at least partly to HIV-related brain effects. Depressive symptom severity, whether attributable to HIV or not, may influence self-reported functioning. We examined longitudinal relationships among objective global cognition, depressive symptom severity, and self-reported everyday functioning in people with HIV (PWH).
Methods:
Longitudinal data from 894 PWH were collected at a university-based research center (2002–2016). Participants completed self-report measures of everyday functioning to assess both dependence in instrumental activities of daily living (IADL) and subjective cognitive difficulties at each visit, along with depressive symptom severity (BDI-II). Multilevel modeling examined within- and between-person predictors of self-reported everyday functioning outcomes.
Results:
Participants averaged 6 visits over 5 years. Multilevel regression showed a significant interaction between visit-specific global cognitive performance and mean depression symptom severity on likelihood of dependence in IADL (p = 0.04), such that within-person association between worse cognition and greater likelihood of IADL dependence was strongest among individuals with lower mean depressive symptom severity. In contrast, participants with higher mean depressive symptom severity had higher likelihoods of IADL dependence regardless of cognition. Multilevel modelling of subjective cognitive difficulties showed no significant interaction between global cognition and mean depressive symptom severity (p > 0.05).
Conclusions:
The findings indicate a link between cognitive abilities and IADL dependence in PWH with low to moderate depressive symptoms. However, those with higher depressive symptoms severity report IADL dependence regardless of cognitive status. This is clinically significant because everyday functioning is measured through self-report rather than performance-based assessments.
Ana María Cetto Kramis (born 1946) studied physics at Universidad Nacional Autónoma de México and biophysics at Harvard University. As a faculty member back in Mexico, she spent over half a century delving into the fundamentals of quantum physics, with a singular focus on its stochastic interpretation. In addition to her theoretical work, she founded Latindex and has become a key figure in the open access movement. She has also had a long and influential contribution to international scientific cooperation. Her professional and personal journeys culminate with the dynamization of the International Year of Quantum Science and Technologies 2025, aiming to shed light on her understanding of quantum science and of science as a whole. This chapter is mostly based on an oral history, which is here also revisited as a historiographical methodology from its early use at the origins of the history of quantum physics.
Studying deep-water shark species presents inherent challenges stemming from the difficulty in accessing their habitats, coupled with factors such as low population densities, intricate behaviours, and complex biological attributes. The integration of citizen scientists, particularly fishers, offers a valuable avenue to make use of their life-long insights and expertise, thus facilitating the acquisition of crucial data that can effectively enhance the realm of shark research. Our collaborative engagement with fishers since 2017 has yielded an extensive documentation concerning elasmobranchs in the Caribbean region of Puerto Rico providing a unique opportunity to formally record species hitherto unreported. This is exemplified by the first documentation of the smalltooth sandtiger shark (Odontaspis ferox (Risso, 1810)). Despite its broad geographic range and widespread distribution in temperate and tropical marine environments, there is a lack of comprehensive scientific understanding and limited available knowledge regarding this species. A noteworthy finding on December 30, 2020, near Rincón (northwest coast) in Puerto Rico, disclosed a large shark that an experienced fisher had captured as an unidentified by-catch at a depth of 325 m. Through an interdisciplinary approach using molecular (355 bp, Cytochrome Oxidase Subunit 1) and morphological techniques, we successfully confirmed the identity of the specimen as a female smalltooth sandtiger shark. Given the limited information available (e.g., diversity, abundance, behaviour, reproduction, distribution) on shark species in the coastal and deep waters of Puerto Rico, this report provides valuable new data that can significantly contribute to the conservation efforts to protect these enigmatic yet ecologically vital predators.
The Puerto Rico Plain Pigeon Patagioenas inornata wetmorei suffered a severe population decline after hurricanes Irma and Maria in September 2017. We used distance sampling to estimate abundance (density and population size) in April–June 1986−2024, accounting for changes in detection probability. We used the distance-sampling abundance estimates to populate a Bayesian state–space logistic model and update posterior estimates of population carrying capacity, maximum population growth rate, population recovery time, and predicted abundance in April–June 2025−2034, accounting for observation and process variances. In addition, we used predicted abundance to assess potential extinction risk (probability Pr[N2025−2034 = 0|data]), population self-sustainability above 5,000 individuals (Pr[N2025−2034 >5,000|data]), and population surpassing the 2.5th percentile of carrying capacity (Pr[N2025−2034 >30,000|data]). The population has not recovered from the hurricanes, with estimated density averaging 0.0015 individuals/ha (bootstrapped standard error [SE] = 0.0006) and population size averaging 1,097 individuals (SE = 455) at the 749,000-ha survey region in April–June 2018−2024. Posterior mean estimates were 41,580 individuals (Markov Chain Monte Carlo standard deviation [SD] = 8,052) for population carrying capacity, 0.183 (SD = 0.056) for maximum population growth rate, six years (SD = 2) for recovery time, and 7,173 individuals (SD = 12,309) for predicted abundance in April–June 2025−2034. The population may reach self-sustainability levels (range Pr[N2025−2034 >5,000|data] = 0.326−0.631) but currently is undergoing a prolonged bottleneck and may become extinct (range Pr[N2025−2034 = 0|data] = 0.199−0.332), particularly if reproduction continues to be mostly unsuccessful, anthropogenic disturbances remain unabated, and on top of that another devastating hurricane makes landfall during the next 10 years. The Puerto Rico Plain Pigeon subspecies is in urgent need of management aiming to increase and maintain abundance above 5,000 individuals but preferably surpassing the 2.5th percentile of population carrying capacity as in the late 1990s (range Pr[N2025−2034 >30,000|data] = 0.000−0.181).
Bilingual adults use semantic context to manage cross-language activation while reading. An open question is how lexical, contextual and individual differences simultaneously constrain this process. We used eye-tracking to investigate how 83 French–English bilinguals read L2-English sentences containing interlingual homographs (chat) and control words (pact). Between subjects, sentences biased target language or non-target language meanings (English = conversation; French = feline). Both conditions contained unbiased control sentences. We examined the impact of word- and participant-level factors (cross-language frequency and L2 age of acquisition/AoA and reading entropy, respectively). There were three key results: (1) L2 readers showed global homograph interference in late-stage reading (total reading times) when English sentence contexts biased non-target French homograph meanings; (2) interference increased as homographs’ non-target language frequency increased and L2 AoA decreased; (3) increased reading entropy globally facilitated early-stage reading (gaze durations) in the non-target language bias condition. Thus, cross-language activation during L2 reading is constrained by multiple factors.
Endomyometritis is a postpartum uterine infection that can lead to significant morbidity and mortality if not promptly recognized and managed. This case describes a 25-year-old primiparous patient with endometritis and how her condition was evaluated and managed. Endomyometritis is a clinical diagnosis. Key to the management is early introduction of antibiotics. If fevers persist, further evaluation is necessary to exclude alternative sources of infection. Early consideration of sepsis is crucial, and scoring systems can aid in identifying patients at risk for severe morbidity. Prevention strategies include reducing vaginal exams, minimizing the time between rupture of membranes and delivery, and implementing surgical bundles and prophylactic antibiotics for cesarean deliveries.
Recent increases in homophobic and transphobic harassment, hate crimes, anti-lesbian, gay, bisexual, transgender, gender nonconforming, and queer (LGBTQ+) legislation, and discrimination in healthcare toward LGBTQ+ persons require urgent attention.
This study describes seriously ill LGBTQ+ patients’ and partners’ experiences of discriminatory care delivered by healthcare providers.
Methods
Qualitative data from a mixed-methods study using an online survey were analyzed using a grounded theory approach. Seriously ill LGBTQ+ persons, their spouses/partners and widows were recruited from a wide range of organizations serving the LGBTQ+ community. Respondents were asked to describe instances where they felt they received poor care from a healthcare provider because they were LGBTQ+.
Results
Six main themes emerged: (1) disrespectful care; (2) inadequate care; (3) abusive care; (4) discriminatory care toward persons who identify as transgender; (5) discriminatory behaviors toward partners; and (6) intersectional discrimination. The findings provide evidence that some LGBTQ+ patients receive poor care at a vulnerable time in their lives. Transgender patients experience unique forms of discrimination that disregard or belittle their identity.
Significance of Results
Professional associations, accrediting bodies, and healthcare organizations should set standards for nondiscriminatory, respectful, competent, safe and affirming care for LGBTQ+ patients. Healthcare organizations should implement mechanisms for identifying problems and ensuring nondiscrimination in services and employment; safety for patients and staff; strategies for outreach and marketing to the LGBTQ+ community, and ongoing staff training to ensure high quality care for LGBTQ+ patients, partners, families, and friends. Policy actions are needed to combat discrimination and disparities in healthcare, including passage of the Equality Act by Congress.
Although octopuses are the third most fished marine invertebrate species in Puerto Rico, there is a lack of information about this fishery. Here, we present the first small-scale study assessing the genetic diversity and connectivity of Octopus vulgaris in Puerto Rico. To achieve this, we applied double-digest restriction-site associated DNA sequencing, using the restriction enzymes EcoRI and SphI in 43 specimens captured from ten locations representing three geographic regions. We used F-statistics and Bayesian analysis to evaluate over 2000 polymorphic loci. We found high genetic connectivity (FST = 0.0008, FST = 0.005), high nucleotide diversity (π ≈ 0.1), and moderate genetic diversity (HO ≈ 0.255–0.361, HE ≈ 0.258–0.373) between the studied regions. In contrast to our expectations, given oceanographic characteristics and distance between the geographic regions, our results suggest a single admixed population of O. vulgaris in Puerto Rico, with no differentiation between the sampled regions. Even though genomics techniques are powerful for inferring population connectivity, researchers should be cognizant of protocol limitations to retain the most reliable information possible.
Despite the importance of the commercially harvested benthopelagic fish Beryx mollis, little information is available on their adult phase and reproduction. This is likely due to the low abundance of this species compared to Beryx splendens and Beryx decadactylus as well as misidentification of Beryx spp. In this study, early life stages of B. mollis were found in the southwest region off Sri Lanka during a survey with research vessel Dr Fridtjof Nansen in 2018, coinciding with the southwest monsoon period. As morphological characteristics of eggs and larval stages of the three Beryx spp. are very similar, visual identification to differentiate to species level has always been challenging. Therefore, in this study, DNA barcoding was carried out targeting the mitochondrial COI gene. Molecular analysis confirmed that the collected egg and larvae belonged to the B. mollis species due to their high identity (>99%) with reference to previously submitted adult B. mollis sequences in the GenBank. Phylogenetic analysis showed a closer evolutionary relationship among B. mollis and B. splendens than with B. decadactylus. To the best of our knowledge this is the first genetic and morphological confirmation of B. mollis egg and larvae worldwide and suggests the southwest coastal area in Sri Lanka, in the north central Indian Ocean, as a potential spawning ground for this species.
Objectives/Goals: Pregnancy increases vulnerability to stress and mental health symptoms, particularly among Hispanic women in Puerto Rico (PR), a population with unique socioenvironmental adversities, such as poverty and natural disasters. This study examined the relationships between life adversities and psychological distress in this at-risk population. Methods/Study Population: Participants (n = 50) in this cross-sectional study were recruited from an obstetrician’s office in Southern PR. All participants provided written consent and completed the Adverse Life Experiences Scale (ALES, Cronbach’s alpha = 0.71) to identify lifelong adversities faced and the overall duration (chronicity). Measures of psychological distress included the Perinatal Anxiety Screening Scale (PASS, Cronbach’s alpha = 0.96), the Edinburg Postnatal Depression Scale (EDPS, Cronbach’s alpha = 0.87), the Perceived Stress Scale (PSS, Cronbach’s alpha = 0.79), and the Brief Resilience Scale (BRS, Cronbach’s alpha = 0.86). Descriptive and Spearman’s rho correlation analyses were conducted. Results/Anticipated Results: The mean age of the participants was 27.90 years (SD = 6.05), with most in the first trimester (66.0%). On average, participants reported 4.32 (SD = 3.1) out of 23 lifetime adversities. The most common adversities were natural disasters (60.0%), loss of a beloved (58.0%), and financial difficulties (38.0%). Nearly half (44.0%) experienced five or more adversities. A significant number of participants met the clinical threshold for anxiety (38.0%, PASS), depression risk (22.0%, EPDS), moderate-to-severe perceived stress (52.0%, PSS), and low resilience (24.0%, BRS). The overall duration of adversities was significantly associated with anxiety (rs = 0.50, p = 0.001) and stress (rs = 0.50, p = 0.007). Discussion/Significance of Impact: Hispanic pregnant women in PR face high levels of adversity and distress, which can negatively affect both maternal health and fetal development, influencing long-term child outcomes. Early identification and targeted interventions addressing adversities, can improve maternal mental health and child health-development outcomes.
Objectives/Goals: The goal of this work is to understand the physiological profile of phage susceptibility and identify candidate phage defense mechanisms. Additionally, it aims to determine the host receptors targeted by bacteriophages to infect E. coli O157:H7 through random bar code transposon-site sequencing (RB-TnSeq). Methods/Study Population: A collection of 109 E. coli O157:H7 strains from environmental, food, and animal sources were analyzed, representing phylogenetic lineages corresponding to clades 2, 3, 5, 6, 7, and 8. Phage susceptibility profiles were determined using 23 bacteriophages, assessing plaque morphology. Using the O157:H7 genomes, a genomic analysis was conducted with the Prokaryotic Antiviral Defense Locator (PADLOC), which identified putative phage defense systems through sequence homology. Additionally, 5 RB-TnSeq libraries were generated in representative strains to study loss-of-function mutations. These libraries will be screened against a subset of diverse phage to identify the receptors involved in phage adsorption. Results/Anticipated Results: The phage resistance patterns showed susceptibility varied across clades, suggesting distinct mechanisms. Several defense systems were identified using PADLOC, including restriction-modification, Cas, Lamassu, and Druantia. Phage defense candidate (PDC) systems were identified, showing homology to known systems, though their specific function remains unknown. Clade 7.2 exhibited higher phage resistance and a greater presence of PDCs compared to the other clades. Five saturated RB-TnSeq libraries were constructed in O157:H7, achieving 84.5–89% gene coverage. These libraries will facilitate the identification of receptors involved in phage adsorption and resistance. Discussion/Significance of Impact: This study deepens our understanding of phage resistance in E. coli O157:H7 by identifying key defense systems and receptors. The discovery of novel antiviral mechanisms offers promising targets for phage-based interventions, potentially enhancing strategies for controlling this dangerous pathogen.
Objectives/Goals: To evaluate the impact of social determinants of health (SDOH), specifically socioeconomic status and medical insurance coverage, on access to mental health services for adults aged 60 and older served by Federally Qualified Health Centers (FQHCs) in Puerto Rico. Methods/Study Population: A secondary retrospective analysis of electronic health records from FQHCs in Puerto Rico will be conducted to examine the relationship between SDOH needs and mental health service utilization among adults aged 60 years and older receiving primary care. SDOH data will be collected using the PRAPARE® tool, assessing factors such as socioeconomic status, insurance coverage, and emotional support, with a focus on identifying unmet needs. Multivariable and logistic regression models, using Stata v.17, will be employed to evaluate correlations between these SDOH factors and mental health service utilization, adjusting for age, gender, and mental health conditions. This analysis aims to quantify the impact of SDOH on access to mental health services and elucidate key barriers to care for older adults in Puerto Rico. Results/Anticipated Results: We anticipate that lower socioeconomic status, lack of supplemental insurance, and inadequate family support will be strongly associated with the underutilization of mental health services among older adults in Puerto Rico. These disparities are expected to be more pronounced in individuals with limited income, weaker family networks, leading to significant gaps in access to necessary mental health care. Barriers such as healthcare insecurity, financial hardship, and fragmented support systems will likely emerge as major obstacles. By including patients from both rural and urban regions, the study will capture the distinct challenges each population faces, enhancing the contextual relevance of the findings to broader populations, ultimately informing policy and developing intervention strategies. Discussion/Significance of Impact: The findings will provide crucial insights for developing targeted interventions to enhance mental health care access for older adults in Puerto Rico. These results will inform policy development and public health strategies, addressing disparities and promoting equitable care in underserved populations.