Boston University

Merkel cell carcinoma (MCC) is a dermal neuroendocrine malignancy driven by inactivation of the tumor suppressors Rb and p53 either through Merkel cell polyomavirus (MCPyV) infection or ultraviolet (UV)-induced mutations. Virus-positive MCC exhibits pure neuroendocrine morphology, low UV-induced mutational burden, retained Rb protein, and low p53 expression. Viral-negative MCC includes pure neuroendocrine carcinomas and combined tumors with squamous and neuroendocrine components. These tumors typically exhibit loss of Rb expression and either overexpression of mutated p53 or a complete absence of p53. Intraepidermal, insitu MCC (MCCis) is a rare, primarily viral-negative variant that often coexists with actinic keratosis (AK) and squamous cell carcinoma insitu (SCCis), supporting a UV-driven pathogenesis. While MCCis is hypothesized as a potential precursor to select cases of combined MCC, its p53 and Rb expression remain largely uncharacterized. We report a CM2B4-negative MCCis in an 87-year-old man associated with AK and SCCis. Compared to normal epidermis, AK and SCCis exhibited increased Rb and p53 expression, whereas MCCis demonstrated loss of expression of both tumor suppressors. These findings suggest that dual downregulation of Rb and p53 may drive select cases of MCCis in sun-damaged skin.

There is dual endemicity of malaria and helminthic infections in low- and middle-income countries. Coinfection with both infectious diseases may have compounding negative effects on the health of school-aged children (SAC) in endemic areas. The prevalence of coinfection with malaria and intestinal helminths, including soil-transmitted helminths, Schistosoma mansoni, and Hymenolepis nana, was assessed among SAC in rural northern Uganda. A school-based cross-sectional study was conducted at four randomly selected schools from June 2 to June 10, 2025 in Nwoya District, Uganda. Children aged 5-18 years provided stool and blood samples, and were surveyed to assess demographic, environmental, and health-related factors. Intestinal helminth diagnosis was performed using a modified Kato-Katz method (Odongo-Aginya stain); malaria was detected using Plasmodium falciparum (P. falciparum) histidine-rich protein 2 rapid diagnostic tests (RDTs) and blood smears. Overall, 190 SAC with a median age of 13 years were enrolled. Although 75.3% (n = 143) of SAC tested positive for P. falciparum on an RDT, only 13.2% (n = 25) had microscopically detected parasitemia. Intestinal helminth infections were uncommon and involved Ascaris lumbricoides (0.5%; n = 1), Hymenolepis nana (1.6%; n = 3), and Schistosoma mansoni (1.1%; n = 2). All SAC with intestinal helminth infections (3.2%; n = 6) had positive malaria RDT results. The high rate of malaria RDT positivity with negative blood smears may be due to persistent antigenemia post-treatment or false negative blood smear results due to chronic low-grade parasitemia. The low rate of malaria-helminth coinfection among SAC observed in the present study is supported by other recent studies in Uganda and suggests a high efficacy of national mass drug administration programming for the control of intestinal helminths.

Practicing CBT skills outside of therapy sessions is a core component of effective treatment, yet meaningful engagement can be difficult during periods of elevated psychological distress. Smartphone-based ecological momentary interventions (EMIs) offer a promising approach to support real-time skill use, but most research has focused on frequency rather than quality of engagement. This study examined the quality of CBT skills practice in a 28-day smartphone-based EMI following inpatient discharge and explored its associations with internal context and intervention effectiveness. Twenty-three adults hospitalized for suicidal thoughts and behaviors participated, selecting and practicing one of three guided CBT skills exercises (Mindful Emotional Awareness, Countering Emotional Behavior, or Cognitive Flexibility) up to three times daily. A structured coding system was used to rate the completeness and relevance of 945 total exercises (0-2 scale). Quality varied primarily within individuals and was lower during moments of high suicidal intent and urge. When combining across all skills, quality was not associated with proximal change. However, higher-quality Countering Emotional Behavior practice predicted greater reductions in suicidal intent, and higher-quality Countering Emotional Behavior and Cognitive Flexibility practice predicted greater reductions in anger. These findings suggest that momentary distress can impact engagement quality, and that the short-term impact of skills practice may depend on both the specific CBT strategy and type of distress targeted. Understanding and enhancing engagement quality is a key step toward optimizing mobile interventions for individuals in the midst of psychological distress.

• Geochemical analysis identifies chemical groups in the ceramics studied. • Three main petrographic paste groups are identified in the Igbo Ukwu assemblage. • Multiple petrofabrics reflect differences in clay sources and clay processing techniques. • The ceramics are consistent with broadly local geology. • The results from this study refine the understanding of raw material sourcing and ceramic production practices at ancient Igbo Ukwu. The 1st and 2nd Millennium CE marked significant shifts in West African economy and sociopolitical systems with commensurate changes to craft economies in the region, including expanded trade networks and increasing urbanism across the region. This study investigates ceramic production at Igbo Ukwu (9th-12th Century CE), one of the most significant archaeological sites in West Africa, renowned for its elaborate material culture and early technological sophistication. Drawing on legacy collections from Thurstan Shaw’s 1959 – 1964 excavations, this paper examines ceramic samples from Igbo Isaiah, Igbo Richard, and Igbo Jonah, the three excavated sites, using petrographic and portable X-ray fluorescence (pXRF) analyses. The results reveal three major petrographic groups (Argillaceous, Quartzitic, and Transitionary) representing locally sourced clays and distinct chemical composition groups, highlighting substantial variation in broadly locally sourced raw material and preparation techniques. The findings from this work reveal multiple paste types that were used to produce macroscopically similar vessels, suggesting multiple potting traditions or workshops. However, it remains unclear if production was directed towards local consumption, regional exchange, or if the potting industry was organized to meet both local and external demands. These findings offer new insights into the organization of ceramic production at Igbo Ukwu and contribute to a broader understanding of craft production and technological knowledge in early West African societies.