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We present a dataset of 1,119 radiocarbon dates and their contexts for Oaxaca, Mexico, a best effort to include all published dates, plus hundreds of unpublished samples. We illustrate its potential and limitations with five examples: (1) dated stratigraphy in stream cutbanks show how aggradation, downcutting, and stability responded to global climate and human activities; (2) 14C samples from Late/Terminal Formative contexts allow interregional comparisons of temple and palace construction, use, and abandonment; (3) new 14C dates provide better understanding of events during the Late Classic/Epiclassic, a problematic time in the ceramic chronology; (4) individual Classic/Postclassic residential contexts had long durations—several hundred years; and (5) model constraints from other data permit refinement at times of calibration curve deviation, as during AD 1400–1600. We recommend further chronological refinement with best-practice standards, new samples, existing collections, and statistical modeling.
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.
Since 2015, four non-invasive campaigns have surveyed the San José Galleon shipwreck in the Colombian Caribbean, providing valuable insights into the age and provenance of artefacts found on the seabed. Numismatic, archaeological and historical approaches have been employed to analyse a collection of gold coins recorded within this underwater context.
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).
Artificial intelligence (AI) has the potential to enhance clinical decision-making, including in infectious diseases. By improving antimicrobial resistance prediction and optimizing antibiotic prescriptions, these technologies may support treatment strategies and address critical gaps in healthcare. This study evaluates the effectiveness of AI in guiding appropriate antibiotic prescriptions for infectious diseases through a systematic literature review.
Methods:
We conducted a systematic review of studies evaluating AI (machine learning or large language models) used for guidance on prescribing appropriate antibiotics in infectious disease cases. Searches were performed in PubMed, CINAHL, Embase, Scopus, Web of Science, and Google Scholar for articles published up to October 25, 2024. Inclusion criteria focused on studies assessing the performance of AI in clinical practice, with outcomes related to antimicrobial management and decision-making.
Results:
Seventeen studies used machine learning as part of clinical decision support systems (CDSS). They improved prediction of antimicrobial resistance and optimized antimicrobial use. Six studies focused on large language models to guide antimicrobial therapy; they had higher prescribing error rates, patient safety risks, and needed precise prompts to ensure accurate responses.
Conclusions:
AI, particularly machine learning integrated into CDSS, holds promise in enhancing clinical decision-making and improving antimicrobial management. However, large language models currently lack the reliability required for complex clinical applications. The indispensable role of infectious disease specialists remains critical for ensuring accurate, personalized, and safe treatment strategies. Rigorous validation and regular updates are essential before the successful integration of AI into clinical practice.
Readers encounter the environment through literature in ways not available to everyday perception. This is especially clear when a text integrates the grand vistas of what is known as the bird's-eye view. In this welcome contribution to the contemporary theoretical discussion about storied environments and non-human perceptions, David Rodriguez presents an original interpretation of the aesthetics of the view from above. Focusing on fiction by twentieth-century American writers including Willa Cather, Paul Bowles and Don DeLillo, Rodriguez skilfully combines ecocriticism, narrative theory and phenomenological approaches to literature to develop the term 'form of environment'. This theory of literary fiction foregrounds the environment not as setting or historical context, but as an equal agent with the human figures and scales that are normally the focus of literary analysis.
Achieving sustainability on the ground poses a challenge in decoding globallydefined goals, such as sustainable development goals, and aligning them withlocal perspectives and realities. This decoding necessitates theunderstanding of the multifaceted dimensions of the sustainabilitychallenges in a given context, including their underlying causes. In casestudies from Brazilian drylands, we illustrate how an enhanced multiscaleparticipatory method, combined with systems thinking tools, can shed lighton systemic structures that currently entrench unsustainable developmenttrajectories. This method offers insights into co-designing potentialpathways toward sustainable futures and unlocking transformative capacitiesof the local population.
Technical summary
Translating United Nations global sustainable development goals (SDGs) intoactions that address local realities and aspirations is an urgent challenge.It requires new thinking and approaches that foster the discussion about themain challenges to implementing the SDGs at multiple levels. This paperpresents a novel multiscale participatory approach that combines the popularThree Horizons diagram with the formalism of causal loop diagrams in systemsthinking. We present results from six multi-stakeholder dialogues heldacross drylands in Brazil with a focus on desired futures aligned with SDGs.Focusing on identifying the root causes and systemic structures ofunsustainability, participants identified lock-ins, leverage points, andinterventions for how these could be changed. The core lock-ins are thediscontinuity of public policies, and the historical land and powerconcentration reinforced by the current expansion of large-scaleagricultural, mining, and energy projects. The proposed interventions arestructural and – if implemented – would contribute toachieving SDGs in an integrated manner. The unique approach developed inthis study can provide leverage as it bridges the inclusivity ofparticipatory visioning with the change potential of systems thinking toolsto tackle root causes and unleash societal transformations.
Social media summary
We are not achieving SDGs. Understanding root causes of unsustainability iscritical to move toward sustainable and just futures.
The establishment of the possible presence of life on Mars (past or present) is based on the study of planetary analogues, which allow in situ analysis of the environments in which living organisms adapt to often extreme conditions. Although Mars has been a candidate for hosting life, based on observations made decades ago, it is thanks to the characteristics identified in environments, mainly volcanic, that it has been possible to calibrate instruments and detail the features of the red planet. In this paper, we present a review of the main characteristics of different planetary analogues, particularly deepening the study of Antarctica, to later expose the factors studied in Deception Island that have contributed to considering it as an analogue of Mars from different perspectives. Although geological and geomorphological studies on the analogies of the island already exist, detailed analyses that present the approach of astrobiological analogues are required, thus allowing further research.
Living with major depressive disorder (MDD) reduces life expectancy, with respiratory disease being a significant threat. However, evidence on respiratory disease in this population has not yet been meta-analyzed.
Methods
This meta-analysis examines respiratory disease prevalence and odds ratio (OR) in patients with MDD and treatment resistant depression (TRD). A systematic literature search was conducted, with a snowball search of reference and citation lists. Inclusion criteria covered studies in MDD and TRD patients with confirmed diagnoses of respiratory diseases (asthma, chronic obstructive pulmonary disease [COPD], pneumonia, lung cancer, and tuberculosis), comparing with a control group when possible.
Results
From 4,138 retrieved articles, 15 (including 476,927 individuals with MDD, 50,680 with TRD, and 1,108,979 control group) met the inclusion criteria. In MDD patients, COPD prevalence was 9.0% (95% CI: 3.8–19.6%), asthma 8.6% (95% CI: 5.7–12.8%), and pneumonia 2.5% (95% CI: 2.2–2.9%). In TRD patients, COPD prevalence was 9.9% (95% CI: 4.2–21.9%) and asthma 10.9% (95% CI: 10.7–11.2%), but meta-analysis limited to those diseases showed no significant relative risk differences. Compared to the general population, individuals with MDD had significantly higher rates of COPD (OR 1.79, 95% CI: 1.49–2.16), even higher in younger populations (1.85 [95% CI: 1.74–1.97]) and more prevalent in women.
Conclusions
This first meta-analysis on this topic shows that MDD is associated with an increased risk of respiratory illness compared to the general population. The prevalence of asthma doubles the mean described in the general population worldwide, and in COPD, women and younger people are at particular risk. Prevention policies are urgently needed.
Between 1817 and 1831, four German scientists – Karl von Martius, Georg Langsdorff, Ludwig Riedel, and Friedrich Sello – undertook expeditions in Brazil with the goal of collecting natural specimens, particularly focusing on Brazilian cinchona plants. Renowned for their medicinal properties, especially in the treatment of fever diseases, cinchona specimens were extensively utilized by local Brazilian communities. The widespread use of cinchona raises important questions regarding how German scientists acquired knowledge of the therapeutic properties of plants, previously unknown within German pharmacology. This paper argues that the German understanding of Brazil's cinchona trees was situated within an imperialist endeavor that not only appropriated indigenous knowledge but also involved conducting experiments on these plants and their effects on local populations. This hybridization of knowledge about cinchona was characterized by an asymmetrical dominance of German pharmacological experimentation, which sought to enhance organic life and establish utopian, “healthy” German societies, in both German territories and Brazil. Consequently, German chemical experiments with Brazilian cinchona specimens intersected with biopolitical practices, aimed at manipulating both plant and human life through therapeutic interventions.
Pain is a frequent symptom in cancer patients (CP), and its multidimensional assessment is essential for a comprehensive approach and to establish clinical prognoses. The Short-Form McGill Pain Questionnaire (SF-MPQ) is an internationally recognized tool for the multidimensional assessment of pain, both in clinical and research settings. However, no studies have been reported in Latin America that determine its psychometric properties in CP and chronic pain.
Objectives
To determine the psychometric properties of the SF-MPQ in adult Mexican cancer patients with chronic pain.
Methods
An instrumental design was used with a non-probabilistic convenience sample of 222 cancer patients treated at the pain clinic of a tertiary care hospital. Analyses were conducted to evaluate factorial structure (exploratory and confirmatory factor analysis [CFA]), reliability (internal consistency), measurement invariance, and criterion validity (concurrent and divergent).
Results
CFA verified a 9-item structure divided into 2 factors: (1) Affective-Nociceptive and (2) Neuropathic. A global Cronbach’s alpha coefficient of .82 and a global McDonald’s Omega index of .82 were identified. Configural, metric, and scalar invariance (ΔCFI ≤ .01; ΔRMSEA ≤ .015) were confirmed regarding the sex variable. Finally, the SF-MPQ showed a positive correlation with the Numerical Rating Scale (rho = .436, p< .01) and a negative correlation with the EORTC-QLQ C30 (rho = −.396, p< .01).
Significance of results
The Mexican version of the SF-MPQ presented adequate psychometric properties and fit indices, making it a valid and reliable instrument for use in clinical and research settings in Mexico. Its use is recommended for the comprehensive assessment of pain in oncology in Mexico, as it allows for the understanding of pain characteristics beyond intensity, guiding the establishment of clinical prognoses.
In healthcare and medical research, advisory boards are now commonplace, but most boards consist of a relatively homogenous, geographically collocated group, often demonstrating demographic imbalance. It is crucial to include individuals from diverse backgrounds on community advisory boards for healthcare and medical research to address ongoing health disparities and ensure studies are more culturally competent so that we can achieve more inclusive representation. We conducted purposeful recruitment to attract a demographically diverse group of community members across the United States (U.S.) to partner with the All of Us Research Program to inform our strategies including program recruitment, engagement, retention, and incentives. Recruitment of a diverse group of advisors and purposeful community building has created a psychologically safe environment where members openly share their opinions, thoughts, and perspectives to shape various aspects of this ambitious, nationwide research program.
The Nasrid emirate of southern Iberia emanated power through architecture; this project aims to better understand how this was made possible, via an interdisciplinary exploration of the Alhambra monument and other Al-Andalus constructions. Initial results of archaeological campaigns, structure chronologies and communication plans undertaken in 2021 and 2022 are presented.
Both childhood adversity (CA) and first-episode psychosis (FEP) have been linked to alterations in cortical thickness (CT). The interactive effects between different types of CAs and FEP on CT remain understudied.
Methods
One-hundred sixteen individuals with FEP (mean age = 23.8 ± 6.9 years, 34% females, 80.2% non-affective FEP) and 98 healthy controls (HCs) (mean age = 24.4 ± 6.2 years, 43% females) reported the presence/absence of CA <17 years using an adapted version of the Childhood Experience of Care and Abuse (CECA.Q) and the Retrospective Bullying Questionnaire (RBQ) and underwent magnetic resonance imaging (MRI) scans. Correlation analyses were used to assess associations between brain maps of CA and FEP effects. General linear models (GLMs) were performed to assess the interaction effects of CA and FEP on CT.
Results
Eighty-three individuals with FEP and 83 HCs reported exposure to at least one CA. CT alterations in FEP were similar to those found in participants exposed to separation from parents, bullying, parental discord, household poverty, and sexual abuse (r = 0.50 to 0.25). Exposure to neglect (β = −0.24, 95% CI [−0.37 to −0.12], p = 0.016) and overall maltreatment (β = −0.13, 95% CI [−0.20 to −0.06], p = 0.043) were associated with cortical thinning in the right medial orbitofrontal region.
Conclusions
Cortical alterations in individuals with FEP are similar to those observed in the context of socio-environmental adversity. Neglect and maltreatment may contribute to CT reductions in FEP. Our findings provide new insights into the specific neurobiological effects of CA in early psychosis.
The rat lungworm Angiostrongylus cantonensis is a zoonotic metastrongyloid nematode currently considered an emerging pathogen. Originating in Southeast Asia, this nematode has spread to tropical and subtropical parts of the world via its invasive rodent and gastropod hosts.
On the island of Tenerife in the Canary archipelago, the A. cantonensis invasion was recognized more than a decade ago. The endemic lizard Gallotia galloti has been identified as a paratenic host of this nematode in the Canary Island ecosystem. Because this lizard species is the most abundant reptile in Tenerife, we tested its suitability as a possible sentinel for A. cantonensis presence. Lizards were captured alive in nine localities, spanning an environmental gradient across the island. Tail muscle tissue was obtained by provoked caudal autotomy and tested for the nematode infection by a species-specific qPCR. Infection intensities were assessed by detecting A. cantonensis DNA quantities based on a calibrated standard curve. Of the 129 samples tested, 31 were positive. The prevalence varied among localities, with the highest (63.6%) recorded in a humid laurel forest. Even though the prevalence in Valle San Lorenzo was the lowest, this is the first record of A. cantonensis from the arid south of Tenerife. Variation in prevalence at different localities was significantly and positively correlated with increasing vegetation cover and negatively correlated with seasonal variability of precipitation, as determined by Spearman correlation coefficients. Fisher’s exact test was used to determine the variation in the prevalence of A. cantonensis among adult males, females, and juveniles and showed no significant difference. Also, there was no significant difference in infection intensity between males and females (as determined by GEE-g). We demonstrated that provoking caudal autotomy can be an effective non-lethal method of A. cantonensis mapping in island ecosystems with abundant lizard species, particularly those with a sharp climatic and vegetation gradient, from xeric to humid conditions.
This study aims to outline Clostridioides difficile infection (CDI) trends and outcomes in Mexican healthcare facilities during the COVID-19 pandemic.
Design:
Observational study of case series.
Setting:
Sixteen public hospitals and private academic healthcare institutions across eight states in Mexico from January 2016 to December 2022.
Patients:
CDI patients.
Methods:
Demographic, clinical, and laboratory data of CDI patients were obtained from clinical records. Cases were classified as community or healthcare-associated infections, with incidence rates calculated as cases per 10,000 patient days. Risk factors for 30-day all-cause mortality were analyzed by multivariate logistic regression.
Results:
We identified 2,356 CDI cases: 2,118 (90%) were healthcare-associated, and 232 (10%) were community-associated. Common comorbidities included hypertension, diabetes, and cancer. Previous high use of proton-pump inhibitors, steroids, and antibiotics was observed. Recurrent infection occurred in 112 (5%) patients, and 30-day mortality in 371 (16%). Risk factors associated with death were a high Charlson score, prior use of steroids, concomitant use of antibiotics, leukopenia, leukocytosis, elevated serum creatine, hypoalbuminemia, septic shock or abdominal sepsis, and SARS-CoV-2 coinfection. The healthcare-associated CDI incidence remained stable at 4.78 cases per 10,000 patient days during the pre-and pandemic periods. However, the incidence was higher in public hospitals.
Conclusions:
Our study underscores the need for routine epidemiology surveillance and standardized CDI classification protocols in Mexican institutions. Though CDI rates in our country align with those in some European countries, disparities between public and private healthcare sectors emphasize the importance of targeted interventions.
Staphylococcus aureus infection patterns in Yuma, Arizona show a 2.25x higher infection rate in non-Hispanics. Males had higher infection rates in most age classes. These disparities in infection are mostly consistent with previously observed patterns in colonization, suggesting that sex and ethnicity do not differentially impact colonization and infection.
Background: Infection prevention and control assessments in healthcare settings serve as a primary resource for obtaining data and providing recommendations based on safety, compliance, and quality assurance guidelines. In Puerto Rico (PR), surgical site infections are underreported in the Epi Info platform used by the Puerto Rico Department of Health (PRDOH), mainly due to the complexity of their identification. By focusing on evaluating Operating Rooms/Sterile Processing and Distribution (OR/SPD) units in acute care facilities (ACFs), our goal is to generate new data within the Healthcare-Associated Infection/Antibiotic Resistance (HAI/AR) Program, specifically related to patient management throughout preoperative, intraoperative, and postoperative phases, as well as reprocessing practices. Methods: Nineteen evaluations of ACFs' OR/SPDs were conducted from May through December 2023. Direct observations, file reviews, and personnel assessments were performed using an infection control assessment and response (ICAR) tool developed collaboratively by a team from an acute facility in PR and the HAI/AR Program staff. This ICAR Tool was customized based on guidelines from the certified Board for Sterile Processing and Distribution (CBSPD), the Association of periOperative Registered Nurses (AORN), and the Association for the Advancement of Medical Instrumentation (AAMI), among other regulatory agencies. The Division of Health Quality Promotion (DHQP) reviewed and approved the tool for use in these evaluations. Results: Key findings indicate that 32% of Sterile Processing Department (SPD) units restrict access to dedicated personnel with available manufacturer’s instructions, yet only 36% of SPD personnel are certified in CBSPD and packaging practices. Only 10% of facilities had a water treatment system for sterilization and Immediate Use Steam Sterilization (IUSS) policies. Notably, 84% of endoscopy areas require additional equipment for cultivating endoscopes, and no facility possessed a borescope for visually inspecting endoscope lumens. Tray inspection occurred in 21%, and only 31% of staff knew the Spaulding Classification and Class V Indicators. Conclusion: These data underscore the necessity of evaluating OR/SPD units in ACFs to provide updated recommendations and mitigate the incidence of surgical site infections (SSI). They offer insight into the structural and functional status of OR/SPD units in Puerto Rico, aligning reporting with OR/SPD practices to enhance patient care and minimize infection risks.
After St James the Apostle, Bishop Teodomiro of Iria-Flavia is the most important figure associated with the pilgrimage to Santiago de Compostela. He supposedly discovered the apostolic tomb after a divine revelation between AD 820 and 830 yet, until the discovery, in 1955, of a tombstone inscribed with his name, his very existence was a matter of some debate. Here, the authors employ a multi-stranded analytical approach, combining osteoarchaeology, radiocarbon dating, stable isotope and ancient DNA analyses to demonstrate that human bones associated with the tombstone, in all likelihood, represent the earthly remains of Bishop Teodomiro.
Harry Mathews's very short story ‘Franz Kafka in Riga’ from The American Experience (1991) presents a compact example of the complexity of aerial images in fiction. The narrator recalls a time when he ‘decided to climb these steps in order to enjoy the view to which I imagined they would bring me’. The first paragraph of the story briefly describes the castles in Riga, then, in the second paragraph, the first-person narrator describes the tricky (and embarrassing) process of ascending to the top of a tower:
I finished my ascent more or less on my hands and knees, or rather my hand and knees, with my other hand clapped on top of my head – a posture that provoked derisive laughter from my companions below, although I scarcely heard them through the shudders of dizziness that had by now begun to afflict me. When at last I reached the vantage point so laboriously striven for, I beheld, instead of Riga and the waters of the Baltic, only unbroken fog, as dingy as an old newspaper under the clouded sky.
The next paragraph transitions to sometime after the trip, when the narrator has learned that Kafka once took this same trip to Riga and describes it in his notebooks. The fourth paragraph is Kafka's quoted description, a nearly word-for-word reproduction of the second paragraph; Kafka has already written down the experience of the narrator. The narrator concludes: ‘I was angry that Kafka had rendered this experience with such unaccountable inaccuracy.’ This is a punchline, but notably the only difference in the two passages is in the first sentence. Kafka's written account omits ‘I imagined’: ‘I decided to climb these steps in order to enjoy the view to which they would bring me.’ He does not imagine beforehand the view that would be afforded by the climb.
The narrator attempts to create an image of the clear view from the tower before climbing and is disappointed. Kafka's image is deferred until after he climbs and cannot see the city, and so he creates an image of the newspaper-fog in his notebooks.