Introduction: Plain language summaries (PLSs) make complex healthcare evidence accessible to patients and the public. Large language models (LLMs) may assist in generating accurate, readable PLSs. This study explored using the LLM Claude 2 to create PLSs of evidence reviews from the Agency for Healthcare Research and Quality (AHRQ) Effective Health Care Program. Methods: We selected 10 evidence reviews published from 2021-2023, representing a range of methods and topics. We iteratively developed a prompt to guide Claude 2 in creating PLSs which included specifications for plain language, reading level, length, organizational structure, active voice, and inclusive language. PLSs were assessed for adherence to prompt specifications, comprehensiveness, accuracy, readability, and cultural sensitivity. Results: All PLSs met the word count. We judged one PLS as fully comprehensive; 7 mostly comprehensive. We judged 2 PLSs as fully capturing the PICO elements; 5 with minor PICO errors. We judged 3 PLSs as accurately reporting the results; 4 with minor result errors. We judged 3 PLSs as having major result errors for incorrectly reporting total participants. Five PLSs met the target 6th-8th grade reading level. Passive voice use averaged 16%. All PLSs used inclusive language. Conclusions: LLMs show promise for assisting in PLS creation but likely require human input to ensure accuracy, comprehensiveness, and the appropriate nuances of interpretation. Iterative prompt refinement may improve results and address the needs of specific reviews and audiences. As text-only summaries, the AI-generated PLSs could not meet all consumer communication criteria, such as textual design and visual representations. Further testing should explore how to best leverage LLM support in drafting PLS text for complex evidence reviews.
Aquatic ectotherms often attain smaller body sizes at higher temperatures. By analysing ~15,000 coastal-reef fish surveys across a 15oC spatial sea surface temperature (SST) gradient, we found that the mean length of fish length in communities decreases by ~5% for each 1oC temperature increase across space. This equated to a 50% decrease in mean length from 14 to 29oC mean annual SST. We found that trophic guild composition shifts from domination by herbivores and planktivores in the tropics, to invertivores and piscivores in cooler waters. By investigating the contribution of trophic composition to community-level mean length, we show ~25% of temperature-related changes could be attributed to trophic composition at the warmest sites, but <1% at colder temperatures. Our findings suggest that small changes in temperature will lead to large changes in fish community body sizes, driven both by community trophic composition in warm waters and mean sizes within trophic guilds.
Human activities have altered the species composition of assemblages through introductions and extinctions, but it remains unclear how those changes can affect the different facets of biodiversity. Here we assessed the impact of changes in species composition on taxonomic, functional, and phylogenetic diversity across 281 bird assemblages worldwide. To provide a more nuanced understanding of functional diversity, we distinguished morphological from life-history traits. We showed that shifts in species composition could trigger a global decline in avian biodiversity due to the high number of potential extinctions. Moreover, these extinctions were not random but unique in terms of function and phylogeny at the regional level. Our findings demonstrated that non-native species cannot compensate for these losses, as they are both morphologically and phylogenetically close to the native fauna. In the context of the ongoing biodiversity crisis, such alterations in the functional and phylogenetic structure of bird assemblages could heighten ecosystem vulnerability.
Biodiversity-function relationships in ecosystems are known to be driven by environmental conditions, including climate change. Plant functional groups (PFGs), specifically their evolutionary history, nitrogen-fixation capacity or photosynthetic-pathway likely play a critical role in shaping microbial communities and their impact on ecosystem functions, but experimental evidence is limited. Here, we simultaneously manipulated plant and microbial diversity in a microcosm study to investigate their interactions and impact on soil functions during drought. Our results highlight the dominant role of PFGs in explaining the effects of biodiversity loss on soil functions. Microbial diversity loss significantly influenced microbially-driven soil N and P pools and processes, with PFGs moderating these effects, especially under drought. Our findings offer crucial mechanistic insights for ecosystem management in the face of climate change, emphasizing the significance of PFGs in shaping soil functions and their resilience. This study underscores the importance of considering above- and belowground biodiversity, for preserving belowground functions in changing environments.
Perineural anaesthesia is a useful technique in equine surgery, providing pre-emptive targeted anaesthesia of the surgical site, reducing volatile anaesthetic requirements, improving recovery quality and providing post-operative pain relief. Surgery under standing sedation in horses has increased in popularity, mandating the need for effective locoregional anaesthesia and analgesic techniques. Nerve location techniques offer greater accuracy than blind techniques when placing injectate. These methods can help to avoid structures such as blood vessels and minimise direct nerve damage during needle placement, reducing the chance of procedure-related complications. This review will discuss the most pertinent research in the veterinary literature where objective methods of nerve location have been used to perform peripheral nerve blocks in horses. The efficacy of using objective methods to perform nerve blocks in equine anaesthesia is discussed by the authors, providing useful information to equine anaesthetists, and potentially improve the quality of anaesthesia and analgesia in horses.
This study examines turbulent convective heat transfer performance (CHTP) and entropy production rate (EPR) of distilled water flowing in outwardly corrugated converging pipes (CCPs) of various diameter ratios (DR). The SST k - ω turbulence models were used to simulate the flow of H 2O inside the pipe. The effects of Reynolds number ( 5 . 0 × 10 3 ≤ Re ≤ 5 . 0 × 10 4 ), and DR ( 1 ≤ DR ≤ 2 ) on average Nusselt number ( Nu ), Poiseuille number (fRe) thermal performance evaluation criterion (PEC), EPR, and thermal effectiveness number ( I ) Nu were investigated parametrically. The findings revealed a significant improvement in Nu in the modified pipe compared with the straight pipe. This improvement is attributed to flow acceleration and increases in the mixing rate of hot fluid near the wall with cold fluid at the core fluid zone. Also, Nu , fRe , and EPR increase with increasing Re and DR. However, the opposite is the case for PEC and I . Finally, the values of PEC, and I revealed that the modified pipe is advantageous compared with a straight pipe at ( 5 × 10 3 ≤ Re ≤ 1 . 0 × 10 4 ) .
Hatching plasticity allows fish and amphibians to initiate hatching in response to environmental cues including predation, flooding, and hypoxia. In species with terrestrial eggs, hatching plasticity often manifests as extended development of embryos when water is not available. Although these effects are taxonomically widespread, little attention has focused on differences in plasticity across closely related species with terrestrial and aquatic embryos. We propose that terrestrial embryonic environment that favors slower and extended development that, together, result in a more advanced stage at hatching than an aquatic embryonic environment. We test this hypothesis by comparing embryonic development between two fall-breeding mole salamanders, Ambystoma opacum and A. annulatum. Most Ambystoma lay eggs submerged in ponds but A. opacum lays its eggs on land, where hatching is triggered when eggs are submerged by rising pond levels. We compared embryonic development of A. opacum with A. annulatum, which lays eggs in water, in a common laboratory environment. Embryos of both species were reared in environments simulating either aquatic or terrestrial nests sites. We found that the A. opacum embryos exhibited slower development and took longer to hatch than A. annulatum embryos. We also found that A. opacum hatched at a more advanced stage, but only when reared in an environment that mimicked a terrestrial nest. This plasticity was absent in A. annulatum. Our results suggest that the terrestrial-laying A. opacum has evolved a developmental plasticity that allows its embryos to extend development when in terrestrial nests, while retaining the ability to hatch at a stage more typical of congeners when submerged in water.
Objective: Childhood spinal tumors often present with musculoskeletal symptoms, potentially causing a misdiagnosis and delays in diagnosis and treatment. This study aims to identify, characterize, and compare children with spinal tumors who had prior musculoskeletal misdiagnoses to those without, analyzing clinical presentation, diagnostic interval, and outcome. Study design: This retrospective cohort study evaluated all children aged 0-14 years diagnosed with a spinal tumor in Denmark from 1996 to 2018. The cohort was identified through the Danish Childhood Cancer Registry, and the registry data were supplemented with data from medical records. The survival was compared using the Kaplan-Meier method. Results: Among 58 patients, 57% (33/58) recieved musculoskeletal misdiagnoses before the spinal tumor diagnosis. Misdiagnoses were mostly non-specific (64%, 21/33), involving pain and accidental lesions, while 36% (12/33) were rheumatic diagnoses. The patients with prior misdiagnosis had less aggressive tumors, fewer neurological/general symptoms, and 5.5 months median diagnostic interval versus 3 months for those without a misdiagnosis. Those with prior misdiagnoses tended to have a higher 5-year survival of 83% (95% CI 63-92%) compared to 66% (95% CI 44-82%) for those without (p=0.15) Conclusion: Less aggressive spinal tumors may manifest as gradual skeletal abnormalities and musculoskeletal symptoms without neurological/general symptoms, leading to misdiagnoses and delays.
In this article, a fractional-order sliding mode control (FOSMC) method is presented for a wind energy conversion system (WECS) with variable-speed direct-drive permanent magnet synchronous generator (PMSG) under both normal and fault conditions. Under normal operation of the system, the machine side converter (MSC) is employed to meet maximum power point tracking (MPPT) requirements of the wind turbine and the grid side converter (GSC) controls the DC-link voltage and the injected reactive. Under fault condition, to meet grid code obligations, such as low voltage ride through (LVRT), the MSC adjusts the DC-link voltage instead of the GSC. Meanwhile, the active and reactive powers are controlled by the GSC. Moreover, the suggested control method is compared to the conventional control system. The results depicted that the proposed control approach has better faster dynamic response and robustness under both balanced and unbalanced condition. In addition, improving LVRT capability and injecting reactive power, the suggested control method results in smaller spikes in the injected current and DC link voltage. For the sake of further validation, simulations are run in offline MATLAB/Simulink simulation. Then, the results have been validated via experimental real-time implementation.
The aims of the current review were to identify, in the context of people with acquired communication disorders: factors which influence medication adherence, current interventions targeting medication adherence, and how medication adherence is currently measured. This study was conducted and reported in accordance with both PRISMA and SWiM guidelines. Two authors independently screened the results of a literature search, assessed risk of bias, and extracted relevant data. Eight studies were identified for inclusion. Four of the studies presented information relating to current interventions which target medication adherence for people with acquired communication disorders. Four of the studies investigated factors which influence medication adherence for people with acquired communication disorders. Seven of these eight studies outlined methods used for measuring medication adherence. The results of this review indicate that patient related factors are most associated with medication non-adherence in a population with acquired communication disorders, followed by socio-economic factors and medication-related factors. Despite the recognised importance of medication adherence, no gold standard of assessment or intervention currently exist for this population. Half of the included studies replaced patients with communication difficulties with caregiver proxies, thus reducing opportunities for patients to participate meaningfully in research. The term “acquired communication disorders” encompasses a range of conditions with diverse aetiologies, presentations, and needs, and future research should be tailored to specific patient groups most at risk of medication non-adherence, namely those with aphasia and cognitive-communication impairments. Patients should be empowered to participate in future research to ensure the literature accurately represents their lived experience.
Genomes from yeast to human are subject to pervasive transcription. A single round of pervasive transcription is sufficient to alter local chromatin conformation, nucleosome dynamics and gene expression, but experimentally is can be hard to distinguish from background signals. Size selected native elongating transcript sequencing (ssNET-Seq) was developed to precisely map transcription units (TU) independent of expression levels. RNAPII-associated nascent transcripts are fractionation into different size ranges before library construction. When anchored to the transcription start sites (TSS) of annotated genes, the combined pattern of the output metagenes define the expected reference pattern for a TU. Bioinformatic pattern matching to the reference identified 9542 TU in Saccharomyces cerevisiae, of which 47% are coding and 53% are non-coding. 3113 (33%) are newly identified unannotated non-coding TU. Anchoring all TU to the TSS or polyadenylation site (PAS) of annotated coding regions reveals distinctive architectures of linked pairs of divergent TU approximately 200nt apart. The Reb1 transcription factor is enriched 30nt downstream of the PAS only when an upstream (TSS-60nt) non-coding TU co-occurs with a downstream (TSS+150nt) coding TU and supports nucleosome depletion in the generation of the pervasive nascent transcriptome. The potential for extensive transcriptional interference is evident from low abundance unannotated TUs with variable TSS (median-240nt) initiating within a 500nt window upstream of, and transcribing over, the promoters of protein coding genes. This study confirms a highly interleaved yeast genome with different types of transcription units altering the chromatin landscape in distinctive ways, with the potential to exert extensive regulatory control.
Elevated concentrations of arsenic, lithium and boron in drinking water have already been reported in the Bolivian Andes. Arsenic causes genotoxicity but that caused by lithium and boron is less well known. The aim of the present study was to evaluate associations between arsenic, lithium and boron exposure and genotoxicity, while taking genetic susceptibility into account. Women (n=230) were recruited in ten villages around Lake Poopó. Arsenic exposure was determined as the sum of concentrations of arsenic metabolites (iAs, MMA, and DMA) in urine. Exposure to lithium and boron was determined based on their concentrations in urine. Genetic susceptibility was determined by GSTM1 and GSTT1 null genotypes and AS3MT rs3740393,. Genotoxicity (DNA strand breaks) was measured peripheral blood by the comet assay. Median arsenic, lithium, and boron concentrations were 60 µg/L, 989 µg/L, and 3929 µg/L, respectively. GSTM1 and GSTT1 null carriers showed more DNA strand breaks than gene carriers (p=0.008, p=0.005). We found no correlation between urinary arsenic and DNA strand breaks (rS=0.03, p=0.64), and only a weak non-significant positive association in the multivariate analysis (β=0.09, p=0.14). Unexpectedly, increasing concentrations of lithium in urine were negatively correlated with DNA strand breaks (rS=-0.24, p=0.0006), and the association persisted in multivariate analysis after adjusting for arsenic (β=-0.22, p=0.003). We found no association between boron and DNA strand breaks. The lack of genotoxic effect of arsenic could be associated with the specific metabolic adaptation to arsenic previously reported in this population. The apparent protective effect of lithium against genotoxicity merits further investigation.
Species Distribution Model (SDM) is a useful tool for conserving rare species. However, the ‘rare species modeling paradox’ presents challenges in modeling the rarest species, such as Corybas species, which have a narrow distribution and are known only from a few localities, making them difficult to model using conventional methods. An Approximate SDM (ASDMs) method was developed specifically for these species, employing a subtraction formula weighted by niche overlap metrics. This method was created in the hope that other rare species with between 5-20 occurrence records could also be modeled in the future. Our ASDMs demonstrated a good fit with directly modeled SDMs and successfully predicted the distributions of rare species with very few occurrence records. Hence, ASDMs present a promising and user-friendly approach for modeling potential distributions of rare species.
Deterministic and stochastic factors shape ecological communities. However, a quantitative synthesis of the factors underlying the balance among different assembly processes is lacking. Here, we synthesized data from 149 datasets covering major biotic groups and ecosystem types globally. We used a null model approach based on Raup-Crick dissimilarities and Bayesian meta-regression to analyze the data. We found that communities were more under homogeneous selection than heterogeneous selection across biotic taxa and ecosystems. Environment selected species homogeneously more often at small scales while heterogeneously more often at large scales. Stochasticity also showed scale-dependence as stochastic community assembly increased with study scale. Homogeneous and heterogeneous selection were strongest at high latitudes while stochastic factors were strongest in tropics. Marine systems had the highest degree of homogeneous selection and the lowest stochasticity. We provide the first analysis of community assembly across taxa and ecosystems which should be important for a better understanding of how communities respond to environmental change.
Plant-associated microbes play a key role in mediating the relationship between plant diversity and productivity. However, previous studies have generally focused on a sole microbial guild (i.e. plant-beneficial microbes or pathogens), and on either aboveground or belowground microbes. As a result, the interplay among different microbial guilds and the overall impact of above- and belowground microbes on plant diversity-productivity relationships have rarely been investigated. Here we carried out an experiment where we applied microbial inocula collected from leaves and soils in the field onto plant leaves and soil in a greenhouse experiment with a herbaceous plant community. We showed that microbial inoculation of leaves reduced plant productivity and this negative effect was weaker at higher plant diversity, which promoted positive diversity-productivity relationships through complementarity effects. In contrast, microbial inoculation of soil alone had no impact on plant diversity-productivity relationships, but it counteracted the negative effects of leaf inoculum on plant productivity and weakened the leaf microbe-induced positive diversity-productivity relationships. We found that the abundance of arbuscular mycorrhizal fungi and Streptomyces bacteria increased when soil microbes were inoculated, and such increase was more significant at lower plant diversity, potentially explaining the effects of soil inoculation on plant productivity. These results suggest that the belowground plant beneficial microbes can counteract the effect of aboveground plant pathogens in mediating positive plant diversity-productivity relationships. Simultaneous study of plant-pathogenic and -beneficial microbes both above- and belowground is required to better understand the contributions of plant-associated microbes to biodiversity-ecosystem function relationships.
Proton exchange-membrane fuel cell (PEMFC) is a clean and efficient type of energy storage device. However, the sluggish reaction rate of the cathode oxygen reduction reaction (ORR) has been a significant problem in its development. This review reports the recent progress of advanced electrocatalysts focusing on the interface/surface electronic structure and exploring the synergistic relationship of precious-based and non-precious metal-based catalysts and support materials. The support materials contain non-metal (C/N/Si, etc.) and metal-based structures, which have demonstrated a crucial role in the synergistic enhancement of electrocatalytic properties, especially for high-temperature fuel cell systems. To improve the strong interaction, some exciting synergistic strategies by doping and coating heterogeneous elements or connecting polymeric ligands containing carbon and nitrogen were also shown herein. Besides the typical role of the crystal surface, phase structure and lattice strain, etc, the evolution of structure-performance relations was also highlighted in real-time tests. The advanced in-situ characterization techniques were also reviewed to emphasize the accurate structure-performance relations. Finally, the challenge and prospect for developing the ORR electrocatalysts were concluded for commercial applications in low- and high-temperature fuel cell systems.
In this work, we reported a series of monolithic 3D-printed Ni-Mo alloy electrodes for highly efficient water splitting at high current density (1500 mA cm-2) with excellent stability, which provides a solution to scale up Ni-Mo catalysts for HER to industry use. All possible Ni-Mo metal/alloy phases were achieved by tuning the atomic composition and heat treatment procedure, and they were investigated through both experiment and simulation, and the optimal NiMo phase shows the best performance. Density functional theory (DFT) calculations elucidate that the NiMo phase has the lowest H2O dissociation energy, which further explains the exceptional performance of NiMo. In addition, the microporosity was modulated via controlled thermal treatment, indicating that the 1100 C sintered sample has the best catalytic performance，which is attributed to the high electrochemical surface area (ECSA). Finally, the 4 different macrostructures were achieved by 3D printing, and they further improved the catalytic performance. The gyroid structure exhibits the best catalytic performance of driving 500 mA cm-2 at a low overpotential of 228 mV and 1500 mA cm-2 at 325 mV as it maximizes the efficient bubble removal from the electrode surface, which offers the great potential for high current density water splitting.
Electrocatalytic reduction of CO2 into high energy-density fuels and value-added chemicals under mild conditions can promote the sustainable cycle of carbon and decrease current energy and environmental problems. Constructing electrocatalyst with high activity, selectivity, stability and low cost is really matter to realize industrial application of electrocatalytic CO2 reduction (ECR). Metal-nitrogen-carbon (M-N-C) electrocatalysts, especially Ni-N-C, display excellent performance, such as nearly 100% CO selectivity, high current density, outstanding tolerance, etc., which is considered to possess broad application prospects. Based on the current research status, starting from the mechanism of ECR and the existence form of Ni active species, the latest research progress of Ni-N-C electrocatalysts in CO2 electroreduction is systematically summarized. An overview is emphatically interpreted on the regulatory strategies for activity optimization over Ni-N-C, including N coordination modulation, vacancy defects construction, morphology design, surface modification, heteroatom activation, bimetallic cooperation. Finally, some urgent problems and future prospects on designing Ni-N-C catalyst for ECR are discussed. This review aims to provide the guidance for the design and development of Ni-N-C catalyst with practical application.