A comparison of spot urinary protein-creatinine ratio with 24-hour urine protein in quantification of proteinuria in women with hypertensive disorders of pregnancy

Background: Proteinuria is a major indicator of hypertensive disorder of pregnancy. The gold standard for diagnosis of significant proteinuria is based on a 24hour urine collection which is cumbersome, time-consuming, and inconvenient to patients. A need, therefore, exists for a rapid, valid, and accurate test to identify significant urinary proteinuria. Methods: We conducted an observational cross-sectional hospital-based study wherein a total of 150 pregnant women who met the criteria of preeclampsia were taken. Spot urine samples for calculating the urine P/C ratio were taken immediately before 24hr urine collection. Correlation between 24hour urine protein and spot PCR was then determined by Pearson’s correlation coefficient(r). Results: The correlation coefficient (r) between 24hr urine protein and spot PCR was found to be 0.734 (n=150) which was highly significant with p<0.001. In this study, population the ROC curve analysis revealed the sensitivity of 90.3% and specificity of 97.3% with AUC 0.958 for a cut-off value of spot PCR as 0.43 to detect significant. Conclusions: Spot PCR is an accurate, valid, steady fast, reliable, and time-saving test which may be used as an alternative method for determining significant proteinuria in patients with pregnancy-induced hypertension

Art or Artifice? Large Language Models and the False Promise of Creativity

Researchers have argued that large language models (LLMs) exhibit high-quality writing capabilities from blogs to stories. However, evaluating objectively the creativity of a piece of writing is challenging. Inspired by the Torrance Test of Creative Thinking (TTCT), which measures creativity as a process, we use the Consensual Assessment Technique [3] and propose the Torrance Test of Creative Writing (TTCW) to evaluate creativity as a product. TTCW consists of 14 binary tests organized into the original dimensions of Fluency, Flexibility, Originality, and Elaboration. We recruit 10 creative writers and implement a human assessment of 48 stories written either by professional authors or LLMs using TTCW. Our analysis shows that LLM-generated stories pass 3-10X less TTCW tests than stories written by professionals. In addition, we explore the use of LLMs as assessors to automate the TTCW evaluation, revealing that none of the LLMs positively correlate with the expert assessments

Impact of Climate Change on Surgery: A Scoping Review to Define Existing Knowledge and Identify Gaps

With climate change accelerated at a worrisome rate, global warming also will have implications for surgery and surgical practice. The goal of this current study was to systematically survey the literature and better understand how climate change has affected surgical disease burden, surgical care delivery, and surgical outcomes. We performed a comprehensive scoping review, screening 3334 unique citations from three databases – 1766 from Embase, 1329 from Pubmed and 239 from Scopus – to identify studies that had associated climate change with surgery. After systematic searching, quality appraisal, and data extraction, we synthesized findings from qualitative and quantitative studies. Twenty-six studies that met the inclusion criteria were included in the review. The studies associating climate change with surgery spanned all surgical subspecialties, although most notable examples came from urology, trauma surgery, and burns and reconstructive surgery. Although there is increasingly strong evidence for how climate change might affect surgery, there is a paucity of research attempting to establish a more direct correlation or causal link between the two. Additionally, we identified several studies that did not directly address climate change but instead focused on chronobiology and its effects on surgery, highlighting directions for future research. The existing evidence, despite its limitations, generates hypotheses for future work, implicating climate change as an independent contributor towards increased surgical disease burden, decreased surgical care delivery, and worsened surgical outcomes

Cell-Type-Specific Complement Expression in the Healthy and Diseased Retina

Complement dysregulation is a feature of many retinal diseases, yet mechanistic understanding at the cellular level is limited. Given this knowledge gap about which retinal cells express complement, we performed single-cell RNA sequencing on similar to 92,000 mouse retinal cells and validated our results in five major purified retinal cell types. We found evidence for a distributed cell-type-specific complement expression across 11 cell types. Notably, Muller cells are the major contributor of complement activators c1s, c3, c4, and cfb. Retinal pigment epithelium (RPE) mainly expresses cfh and the terminal complement components, whereas cfi and cfp transcripts are most abundant in neurons. Aging enhances c1s, cfb, cfp, and cfi expression, while cfh expression decreases. Transient retinal ischemia increases complement expression in microglia, Muller cells, and RPE. In summary, we report a unique complement expression signature for murine retinal cell types suggesting a well-orchestrated regulation of local complement expression in the retinal microenvironment

Elite control of HIV is associated with distinct functional and transcriptional signatures in lymphoid tissue CD8+ T cells

The functional properties of circulating CD8+ T cells have been associated with immune control of HIV. However, viral replication occurs predominantly in secondary lymphoid tissues, such as lymph nodes (LNs). We used an integrated single-cell approach to characterize effective HIV-specific CD8+ T cell responses in the LNs of elite controllers (ECs), defined as individuals who suppress viral replication in the absence of antiretroviral therapy (ART). Higher frequencies of total memory and follicle-homing HIV-specific CD8+ T cells were detected in the LNs of ECs compared with the LNs of chronic progressors (CPs) who were not receiving ART. Moreover, HIV-specific CD8+ T cells potently suppressed viral replication without demonstrable cytolytic activity in the LNs of ECs, which harbored substantially lower amounts of CD4+ T cell–associated HIV DNA and RNA compared with the LNs of CPs. Single-cell RNA sequencing analyses further revealed a distinct transcriptional signature among HIV-specific CD8+ T cells from the LNs of ECs, typified by the down-regulation of inhibitory receptors and cytolytic molecules and the up-regulation of multiple cytokines, predicted secreted factors, and components of the protein translation machinery. Collectively, these results provide a mechanistic framework to expedite the identification of novel antiviral factors, highlighting a potential role for the localized deployment of noncytolytic functions as a determinant of immune efficacy against HIV