Journals
2026 EN
Kentel Jenna · Burke Tianna · Kell Steven
+1 more
Abstract Roads are pervasive linear features that bisect landscapes, altering how female turtles use and move between critical habitats during nesting migrations. We evaluated a new mitigation strategy aimed at deterring females from nesting along road shoulders at wetland crossings in eastern Georgian Bay, Ontario, Canada. The mitigation strategy was designed to reduce roadside nesting habitat by covering gravel on road embankments near wetlands with rock rip‐rap (large angular rocks; in ~100‐m‐long sections) paired with paved road shoulders (paved using tar‐and‐chip; in ~300‐m‐long sections). We evaluated the mitigation strategy using a mark‐recapture study and a before‐during‐after comparison of nest observations at mitigated and unmitigated sites and nesting hot spots on the road. We found a significant reduction in the number of females nesting at mitigated sites in the after period, and no females of any species nested in the rip‐rap on road embankments. However, females continued to nest in the nearest available roadside habitat in unmitigated and mitigated road sections (including in the semi‐compact tar‐and‐chip shoulders). Notably, we found a high proportion of the local populations of Blanding's turtles ( Emydoidea blandingii ; 45% [36/80]) and snapping turtles ( Chelydra serpentina ; 52% [91/172]) nesting on the road in the during and after periods. Our findings suggest that the mitigation strategy was unsuccessful at deterring female turtles from nesting on roads and indicate that the application of rip‐rap and paved road shoulders as a mitigation strategy to reduce roadside nesting should not be applied without further research. Females will likely continue to nest in the roadside habitat if a barrier (e.g., exclusion fencing) is not deployed. Our study elucidates the importance of incorporating species‐specific behavior and movements into all aspects of road planning and highlights that new road‐effect mitigation strategies should be empirically tested before widespread adoption.
Journals
2026 EN
Liu ChinNung · Yan HongYu · Liao Steven ChunKang
+5 more
We presented a series of patients with a mitochondrial DNA mutation who presented to our clinic with sudden bilateral sudden on chronic sensorineural hearing loss; these patients responded well to cochlear implantation. In cases of sudden sensorineural hearing loss—particularly when clinical features raise suspicion for an underlying mitochondrial disorder—genetic testing may offer valuable diagnostic insight and assist in guiding appropriate management strategies.
Journals
2026 EN
Chamoun Joseph · Larson Peter · Altaye Mekibib
+3 more
ABSTRACT Objective Determine if tinnitus is a potential confounding variable in the study of hearing loss and depression in older populations. Methods This is a retrospective cross‐sectional study using data from the 2005 to 2006, 2009 to 2010 and 2017 to 2020 National Health and Nutrition Examination Survey. The subpopulation ( n = 2352) was aged > 69 years. We selected a cutoff of 69 years to focus specifically on elderly adults; as a result, these findings are not generalizable to younger adults with tinnitus and hearing loss. A logistic regression model used depression as the binary response variable and tinnitus burden and speech frequency hearing loss as predictor variables. “Tinnitus burden” was determined via subjective responses from survey participants. Multiple covariates were used for the adjusted regression model. Results Hearing loss was not associated with an increased risk of depression in this cohort. Surprisingly, mild speech frequency hearing loss showed a potential protective effect [Adjusted OR (95% CI) = 0.55 (0.31–0.97), p = 0.039]. A high tinnitus burden was a significant risk factor for depression in both crude and adjusted models [Adjusted OR (95% CI) = 7.05 (3.42–14.55), p < 0.001]. This effect was consistent when stratifying for hearing loss as well. Conclusion The burden of tinnitus appears to have a significant association with depression even while accounting for measured hearing loss. Most studies outlining the impact of hearing loss on depression have not adequately controlled for tinnitus. These findings suggest that tinnitus should be controlled for in future studies examining the relationship between hearing loss and depression. Level of Evidence 3
Journals
2026 EN
Erickson Taylor S. · Civantos Alyssa M. · Messner Anna H.
+2 more
Artificial intelligence (AI) tools to facilitate residency application review are available to all residency programs using the Electronic Residency Application System (ERAS) through the Thalamus Cortex system. Responsible use of this technology requires rigorous quality control in the high‐stakes process of residency selection. This article documents persistent errors in the Thalamus Cortex system with potential to negatively impact residency applicants and programs.
Journals
2026 EN
Johnson Robert A. · Butts Tyler J. · Albright Ellen A.
+3 more
Abstract Ponds are significant emitters of greenhouse gases (GHGs). While eutrophication stimulates GHG emissions, responses to nutrient pulses and weather events are less clear. We investigated both immediate and cumulative effects of experimental storm‐scale nutrient pulses, along with unplanned extreme heat and wind events during the experiment, on GHG fluxes in nutrient‐enriched ponds compared to reference ponds. Physical disturbances had greater immediate effects on GHG fluxes than did nutrient pulses due to effects on stratification and oxygen. Extreme heat increased CO 2 flux and methanogenesis potential, while extreme wind increased CO 2 flux. The combination of nutrients and extreme heat, however, triggered physicochemical changes that stimulated GHG emissions, doubling CH 4 efflux from nutrient‐enriched ponds prior to late‐summer mixing. Late‐summer emissions from reference ponds closed the gap in cumulative CH 4 and CO 2 efflux between treatments; however, suggesting that storm‐driven nutrient loading may not increase total within‐season GHG emissions from shallow aquatic systems.
Journals
2026 EN
Mnich Alanna · Zhang Mingming · Gerard Trika
+3 more
Abstract The stable isotope ratio of oxygen (δ 18 O) stored in otoliths is a common and reliable tool for studying life history events including natal origin and migratory behavior of marine fish species. This approach is useful particularly in cases where traditional tagging is impossible, such as in early larval stages. However, small amounts of available otolith material have historically precluded analysis of δ 18 O in individual larval otoliths by traditional isotope ratio mass spectrometer (IRMS). The use of secondary ion mass spectrometer (SIMS) resolves this challenge, allowing users to obtain δ 18 O signatures in otoliths at the scale of tens of microns. This paper presents a method for the preparation of larval fish otoliths compatible with SIMS δ 18 O analysis through placement of larval otoliths (~ 20 to ~ 150 μ m diameter) on a single epoxy mount and use of a Cesium ion beam, 133 Cs + , of 12 μ m in diameter with 1 μ m penetration depth to excite source larval otolith material. In this pilot study, otoliths from Atlantic bluefin tuna ( Thunnus thynnus ) larvae were used to assess the efficacy of generating quality δ 18 O data using the newly developed preparation method for establishing spawning site baselines. The applied methods led to usable δ 18 O signatures in > 90% of the otoliths selected for analysis. Challenges and unanticipated considerations that became apparent during the use of this method include the inverse relationship between 16 OH − / 16 O − , an indicator of hydrogen content, and δ 18 O, resulting in a limitation of using otoliths from preflexion larvae, as well as a statistically significant difference in δ 18 O (−0.17‰) after storage in Type B immersion oil.
Journals
2026 EN
Bolton Rendelle · Zeliadt Steven B. · Hyde Justeen
+6 more
ABSTRACT Objective Embedded research partnerships can advance the implementation of evidence‐based policies and practices, including those aligned with person‐centered care. Care delivery model transformations, such as the VA's person‐centered Whole Health System (WHS), can benefit from an ongoing cycle of program implementation and their evaluation to inform future evolution. This paper describes how embedded researchers partnered with policy makers leading VA's WHS transformation to support its development, implementation, and scaling to illustrate lessons learned for embedded research. Data Sources and Study Setting Fifty‐eight embedded research projects were conducted from FY2013 to FY2024. Study Design We recorded each project's scope, methodology, results, products, and impact. Through a group reflection process, we identified common cross‐project lessons that fostered this successful embedded research partnership. Finally, we mapped projects to phases of Kilbourne's Knowledge to Action Framework (Pre‐Implementation, Implementation, and Sustainment) to demonstrate how embedded researchers defined evaluation questions, evaluated WHS transformation, and assessed outcomes to inform the implementation and sustainment of VA's WHS transformation. Data Collection/Extraction Methods Projects used multiple qualitative, survey, and large database methods. Principal Findings Across 58 projects, 380 discrete products were used by our operational partner to refine the WHS model, improve implementation support, scale effective practices, inform new policy, and sustain transformation. Three practices cut across these projects to contribute to our successful embedded research partnership: agility, collaboration, and continuous learning and improvement. Additionally, the purpose, questions, and methods of embedded research projects varied as operational partner activities moved across pre‐implementation, implementation, and sustainment phases, iteratively impacting WHS transformation. Conclusions Embedded research can transform a healthcare system through the timely translation of data into practice, enabling evidence‐based policy and practice decisions. Our embedded research‐operations partnership, characterized by trust, respect, and strong communication, ensured that evaluations generated an evidence base to inform both implementation and impact.
Journals
2026 EN
Jinnah Hyder A. · Velucci Vittorio · Belvisi Daniele
+36 more
Abstract Background Whether the traditional distinction between segmental and multifocal dystonia is clinically or scientifically useful remains unclear. Objective To evaluate whether idiopathic isolated adult‐onset segmental and multifocal dystonia can be differentiated based on clinical features other than the contiguity of affected body regions. Methods We compared data on segmental and multifocal dystonia from two large dystonia databases established in the USA and Italy that used similar criteria for patient recruitment and assessment. Results Compared to segmental dystonia, multifocal dystonia was characterized by a higher proportion of men, a younger age at dystonia onset, a greater frequency of upper limb dystonia, and a lower frequency of cranial dystonia at both onset and last examination. Segmental and multifocal dystonia had a similar frequency of alleviating maneuvers, non‐motor eye symptoms in blepharospasm, and neck pain and tremor in cervical dystonia. Although the initial spread pattern from focal to segmental or multifocal appeared faster in the segmental dystonia group, adjusting the analysis for the initial body site involved revealed no significant differences between the two groups. Segmental and multifocal dystonia starting in the same body site showed similar age, sex, and spread characteristics. The observed differences and similarities were consistent across both independent databases. Conclusions Segmental and multifocal dystonia share differences and similarities. The observed differences may reflect a difference in the predominant site of dystonia onset. From a clinical perspective, therefore, the segmental/multifocal distinction is probably not valuable in the dystonia classification scheme, although further data may be needed from a pathophysiological perspective.
Journals
2026 EN
Lin HsuHeng · Chen HuiAn · Lin ShyhJer
+8 more
ABSTRACT Background Acid sphingomyelinase deficiency (ASMD) is a rare lysosomal disorder with diverse clinical presentations and often delayed diagnosis. This study investigates the clinical features, genetic variants, and treatment outcomes in Taiwanese patients. Methods We retrospectively reviewed nine ASMD cases in Taiwan, including genetic data and responses to olipudase alfa. Newborn screening data using the NeoLSD MS/MS kit for dried blood spot enzyme activity, followed by lyso‐sphingomyelin and molecular testing, were also analysed. Results The SMPD1 c.1497_1498inv variant was found in 62.5% of alleles among chronic neurovisceral ASMD cases, while c.995C > G appeared in 37.5% of chronic visceral ASMD cases and was also frequent in partial ASMD from newborn screening. Four patients received olipudase alfa; Patient 1, treated for 3 years starting at age 41, showed improved pulmonary function despite persistent thrombocytopenia and splenomegaly. Patients 2, 6, and 7, treated from early childhood, exhibited marked improvements in hepatosplenomegaly, interstitial lung disease, and growth within 1 year of therapy. Conclusion This study highlights distinct genotype–phenotype correlations in ASMD and supports the clinical benefits of olipudase alfa. Increased awareness and early diagnosis, potentially through newborn screening, are essential for optimizing outcomes in ASMD.
Journals
2026 EN
Wang Yiran · Huh Yoonsuk · Matthay Katherine K.
+4 more
Abstract Background 131 I‐metaiodobenzylguanidine ( 131 I‐MIBG) therapy is an established and effective treatment for metastatic neuroblastoma. Due to the substantial variability in absorbed dose across different tumor sites and organs, 131 I‐MIBG dosimetry, such as achieved via SPECT imaging, is critical for enabling personalized therapy planning. However, conventional imaging‐based dosimetry typically requires three or more imaging sessions to reliably estimate time‐integrated activity (TIA) of tumors and organs, which imposes workflow burdens and increases patient inconvenience. Therefore, there is a clear need for dosimetry methods that can maintain accuracy while requiring fewer imaging sessions. Purpose This study aims to develop and validate a simplified dosimetry method for 131 I‐MIBG therapy that enables robust estimation of TIA using only two imaging time points. The method leverages kinetic modeling to estimate tumor and organ time‐activity curves (TACs) and TIAs from limited imaging data and was validated using 124 I‐MIBG PET imaging data. Methods Five subjects with neuroblastoma underwent 124 I‐MIBG PET/CT imaging at three or four time points post‐administration. Two imaging time points (∼28 and ∼113 h post‐administration) were selected for TIA estimation using a kinetic modeling framework. To obtain the blood input function, left ventricular activity at the two time points was extracted and fitted to a mono‐exponential function. With this input function, a one‐tissue compartmental model was then applied to estimate tumor and organ TACs from the two‐time‐point data, and the corresponding TIAs were calculated by integrating the modeled TACs. The proposed method was compared with (1) a conventional mono‐exponential fitting method using the same two‐time‐point data, and (2) a reference standard based on bi‐exponential fitting of all available three‐ or four‐time‐point data. To evaluate the performance of the proposed method, relative errors in TIA estimation for tumors and organs were calculated using the bi‐exponential fitting results as the reference. Results The proposed method achieved substantially improved accuracy over mono‐exponential fitting. Taking the bi‐exponential method as the reference, the proposed method yielded an average TIA estimation bias of 0.3%, a standard deviation of 13.8%, and a root mean square error (RMSE) of 14.2%. In contrast, mono‐exponential fitting resulted in a higher bias of 14.9%, a standard deviation of 36.3%, and an RMSE of 39.5%. Specifically, the proposed method outperformed mono‐exponential fitting in tumors, adrenal glands, brain, and thyroid. Conclusions We developed a novel dosimetry method based on two‐time‐point imaging and kinetic modeling that enables simplified TIA estimation in 131 I‐MIBG therapy. Validated using 124 I‐MIBG PET data, this approach demonstrated improved TIA estimation performance compared with conventional mono‐exponential fitting. It may offer a physiologically motivated and more clinically applicable solution that supports personalized dosimetry and facilitates individualized treatment planning in radiopharmaceutical therapy.