To identify potential infectious agents in cases of seasonal hyperacute panuveitis syndrome (SHAPU) from vitreous biopsies of patients with this disorder. A retrospective cohort analysis. Vitreous biopsies were obtained during the course of care from 53 subjects with SHAPU. DNA extraction and whole genome shotgun sequencing was performed using Oxford Nanopore long read sequencing. Sequences were matched against microbial and human databases. Visual outcomes at presentation and at 6 months were recorded. Identification and characterization of metagenomic sequences in vitreous isolates from subjects with SHAPU. Adequate DNA for sequencing was obtained from 32 SHAPU subjects. Fifteen samples yielded bacteria on culture, with 14 S. pneumoniae and 1 S. aureus isolate recovered. Bacterial DNA was detected by whole genome sequencing in 29 of 32 cases. S. pneumoniae was the predominant organism recovered. Bacterial genomic loads ranged up to 10 000 bacteria/human cell, indicating active infection. No pathogens were detected in control samples. Reconstruction of bacterial genome was possible in 7 SHAPU cases and indicated diverse S. pneumoniae subtypes associated with individual cases. Sufficient DNA remained for analysis of torque teno virus by qualitative polymerase chain reaction in 17 cases, of which 13 were positive. Visual outcomes were mixed, with 7 patients having hypotonous eyes at 6 months, but 8 patients having better than 20/200 vision. No relationship could be discerned between presenting bacterial load and visual outcome. The majority of SHAPU cases show molecular evidence for concurrent S. pneumoniae infection. Good visual results are possible in treating SHAPU as endophthalmitis. The authors have no proprietary or commercial interest in any materials discussed in this article.

On-road mobile monitoring is increasingly used to assess air pollution, but the implications of monitoring and analytic decisions on exposure prediction and health inferences remain unclear. This study evaluated the influence of on-road monitoring approaches in environmental epidemiology, specifically ultrafine particle (UFP) exposures and late-life cognitive function. We used data from a Seattle-based mobile monitoring campaign to develop a reference roadside UFP exposure model based on repeated measurements at 309 roadside locations and examine associations with cognitive function (Cognitive Abilities Screening Instrument-Item Response Theory [CASI-IRT]), in the Adult Changes in Thought cohort (N = 5283). To evaluate alternative designs, we subsampled on-road UFP measurements collected along 600 km of roadways, varying location visit frequencies, spatial balancing, and sampling times. New UFP models, some incorporating temporal and plume adjustments, were developed using universal kriging with partial least squares and used to estimate associations between UFP and CASI-IRT, after adjusting for age, year, sex, education, race, and socioeconomic status. Using the reference exposure model in the primary health model, the mean baseline CASI-IRT score increased by 0.007 (95% CI: -0.013, 0.027) per 1900 pt/cm³ increment in PNC. Associations were similar but relatively attenuated for all on-road sampling designs. Route-based sampling (which accounted for logistical field constraints and spatiotemporal correlation in the data) and very short (4- vs 12-visit) campaigns produced more variable health estimates. Applying temporal and plume adjustments had a minimal impact on the inferential results. In analyses where no association was observed between UFP and cognitive function, the on-road monitoring design produced similar but slightly attenuated point estimates. Secondary analyses with a reduced health model, which indicated a statistically significant but potentially confounded association, suggest that on-road design-particularly monitoring beyond weekday business hours-may have greater implications in other contexts. How does mobile monitoring design impact health studies? We assess UFP data and health measures to evaluate visit number, spatial balance, timing, and adjustments to assess their influence on exposure and health models. Mobile monitoring is increasingly used to develop air pollution exposure models, yet the influence of monitoring design on health inferences remains unclear. Using extensive ultrafine particle (UFP) data from a monitoring campaign and health measures from a long-standing cohort study, we assess how on-road campaigns can be designed for epidemiologic research. We evaluate the effects of visit number, spatial balance, time selection, temporal adjustment methods, and plume adjustments on exposure and health models, providing guidance for mobile monitoring design in air pollution health research.

Surgeons pursuing improvement in the aesthetic outcomes of their cleft lip repairs may benefit from a granular scale evaluating individual objectives of the repair. A working group of 9 surgeons convened to develop an assessment scale for nasolabial aesthetics after unilateral cleft lip repair. The group identified objectives of the repair that could be evaluated using two-dimensional facial photographs. Scale items were developed to appraise success or failure in achieving each objective. Scale items were iteratively tested and refined. The scale was subsequently implemented as part of a Continuing Medical Education course that included self-evaluation and peer-to-peer education, culminating in the formation of individual plans for improvement. Twelve distinct objectives of unilateral cleft lip repair were identified, of which 10 could be evaluated using photographs routinely obtained in clinical practice. A comprehensive scale was developed, incorporating these 10 objectives. Each scale item takes the form of a binary (yes/no) question evaluating a specific aesthetic concept, with accompanying reference images. Intrarater reliability for each item ranged from moderate to substantial (kappa value, 0.57 to 0.81). Interrater reliability ranged from fair to substantial (kappa value, 0.27 to 0.81). When implemented in a Continuing Medical Education course, the scale enabled surgeons to identify specific opportunities for improvement in their repair and specific surgical maneuvers to adopt in pursuit of these improvements. A new scale for evaluating outcomes of unilateral cleft lip repair is presented. The scale provides specific, actionable evaluations for individual objectives of the repair.

Understanding the long-term biological consequences of crude oil exposure on marine fish is essential for the sustainability of ecologically and economically important species such as Atlantic cod (Gadus morhua). While the direct effects of crude oil on early life stages are well documented, adult reproductive vulnerability and intergenerational consequences remain poorly understood, despite their pivotal role in spawning stock viability. Paternal contributions to next-generation outcomes are particularly underexplored. This study examined how parental exposure to a water-soluble fraction of crude oil affects transcriptomic profiles and survival outcomes in Atlantic cod offspring. Adult fish were exposed for 20days prior to spawning, and offspring were produced by in vitro cross-fertilization to generate four groups: control (unexposed parents), maternally exposed, paternally exposed and biparentally exposed. Embryos were reared under control conditions, and transcriptome profiles were analyzed from fertilization to hatching, alongside assessments of cardiac function and morphology post-hatch. Offspring from exposed females failed to survive to hatching. Eggs were smaller, and transcriptomic data revealed severe downregulation of genes involved in early developmental processes. Chemical analyses confirmed maternal transfer of a diverse range of petroleum aromatic hydrocarbons to oocytes. Our findings point to disrupted oocyte provisioning, likely linked to endocrine and epigenetic disturbances during oocyte maturation. Paternal exposure had minimal effect on RNA expression, and morphology at hatching. However, reduced survival in early larval stages suggests sublethal effects emerging later, possibly through epigenetic mechanisms, a hypothesis requiring further investigation.

To examine the risk of hospital readmission after an index hospitalization for TBI in older adults. Using data from the Atherosclerosis Risk in Communities (ARIC) study, we used propensity score matching of individuals with an index TBI-related hospitalization to individuals with (1) non-TBI hospitalizations (primary analysis) and (2) orthopedic injury hospitalizations (secondary analysis). The rate of all-cause hospital readmission was estimated using adjusted Fine-Gray proportional hazards regression models within strata defined by time since hospitalization. Follow-up extended from the date of index hospitalization after study enrollment (1987-1989) through December 31, 2019. Six hundred sixty-seven participants with an index TBI-related hospitalization were matched using propensity scores with replacement with a ratio of 1:4-2668 participants with non-TBI-related hospitalizations and 1:3 with 2001 participants with orthopedic injury-related hospitalizations. Median age was 68 years (IQR = 46-95) at index hospitalization. Compared to participants with an index non-TBI-related hospitalization, readmission rates were lower among participants with an index TBI-related hospitalization (HR = 0.80, 95% CI = 0.74, 0.87) over a median follow-up of 2.7 years, although similar readmission rates were observed within the first year of follow-up (HR = 1.03, 95% CI = 0.88, 1.21). Rates of hospital readmission among persons with an index TBI-related hospitalization were similarly decreased compared with persons with an orthopedic injury-related hospitalization (HR = 0.78, 95% CI = 0.72, 0.85) over a median follow-up of 3.1 years. Among community-dwelling older adults with a TBI-related hospitalization, rates of hospital readmission were similar to individuals hospitalized for a non-TBI cause in the first year, but lower subsequently. Targeted interventions in the first year post-hospitalization may be most beneficial for reducing readmissions among individuals with TBI.

Macaque primary visual cortex (V1) exhibits exquisite columnar organization, while midlevel area V4 does not. Here we investigated the functional organization and representational bases of intervening area V2 in three macaques (one male, two females) with high-density Neuropixels recordings and a variety of visual stimuli-shape, texture, drifting grating, and translational motion patches. We observed dense clusters of similarly tuned neurons often spanning ∼500 µm, consistent with a columnar structure. In terms of representational bases, V2 responses were largely explained by stimulus features based on local image statistics: shape tuning is well modeled by a linear combination of orientation filters, and direction selectivity is stronger with surface compared with object motion, in striking contrast to V4. Overall, our results support the progression from columns to sparse clusters as neuronal representations transform from encoding local features and feature conjunctions in V1/V2 to a high-dimensional object-based code in V4.

Objective.Continuous blood pressure (BP) monitoring is crucial for detecting nocturnal hypertension and acute hemodynamic changes. Conventional cuff-based methods disrupt sleep and miss transient BP fluctuations from sleep-related events or instability. Cuffless methods, such as pulse transit time (PTT), offer potential but often struggle to reliably track acute BP fluctuations due to complex and nonlinear hemodynamics.Approach.We developed a capacitive sensing pad system incorporating PTT with additional hemodynamic features for unobtrusive, continuous BP monitoring in supine subjects. The pad contains ultra-sensitive single-electrode capacitive (SEC) sensors made from carbon nanotube composites. In passive contact, SEC sensor on the back of the chest captures intrathoracic blood volume changes through deep tissue permittivity and ballistocardiography, while another under the leg detects arterial pulse-induced tissue vibrations. PTT is derived from the temporal delay between chest and leg signals. A neural network model incorporates PTT and intrathoracic blood volume features to improve BP estimation.Main results.In human trials (N= 30) with arm-cuff reference, the system showed strong correlation (r⩾ 0.94), with a mean error (ME) ⩽ 0.1 mmHg and standard deviation (SD) ⩽ 5.6 mmHg. In a subset (N= 8) with continuous finger-cuff reference, it maintained strong correlation (r⩾ 0.89), with a ME ⩽ 0.2 mmHg and SD ⩽ 7.8 mmHg.Significance.These results suggest the possibility of bed-based unobtrusive and continuous BP monitoring in the supine position.