Apud Genus Omne Futurum: Virgil’s Aenid in Contemporary English Translation

The archetype of classical Roman epic, Virgil’s Aeneid has enjoyed incredible literary attention since its appearance in the first century of the Common Era. More than eighty English translations of the Aeneid have been published since the beginning of the sixteenth century, and the task of the present article is to understand the place of modern-day translations within the context of such a tradition. By juxtaposing the work of contemporary translators Cecil Day Lewis, Allen Mandelbaum, Robert Fitzgerald, Robert Fagles, and Sarah Ruden, it examines the ways in which a translator’s milieu can manifest itself in subtle artefacts that converge to produce a novel reading of the text. What emerges through the course of the analysis is a plurality of interpretations that exposes the dynamic nature of the the Aeneid and accounts in no small part for its continued ability to find new meaning among audiences today

Emerging role of iron oxide nanoparticles in the diagnostic imaging of pancreatic cancer: a systematic review

Background/Aims: Pancreatic cancer is the fourth most common cause of cancer associated death worldwide with a five year survival rate less than 5%. The poor prognosis is mainly due to late presentation in 80% of patients and its drug resistant nature. Most diagnoses are made using contrast-enhanced computed-tomography (CT) or magnetic-resonance-imaging (MRI) which have a limited sensitivity between 76-86%. Iron oxide nanoparticles are increasingly used in the diagnostic imaging of pancreatic cancer, due their ability to selectively target tumour cells thereby increasing image resolution. The aim of this study is to identify studies investigating the use of iron oxide nanoparticles in the diagnostic imaging of pancreatic cancer. Methods: A systematic review was performed using PubMed for records up to 2015. Search terms used included "iron oxide nanoparticles", "pancreatic cancer" and "imaging". Results: A total of 16 studies were identified evaluating the use of iron oxide nanoparticles in the imaging of pancreatic cancer in-vitro and in in-vivo animal models. Eight of the studies evaluated the use of superparamagnetic-iron-oxide-nanoparticles (SPION), they showed SPION significantly decrease the T2 and T2* relaxation times of tumour tissue, providing a high sensitivity for MRI. Similar results were seen in eight studies that investigated the use of iron oxide nanoparticles conjugated to other molecules including gelatin, survivin, chemokine-receptor-4, silica-gold, endothelial-growth-factor-receptor, urokinase-receptor activator, Clostridium and a sonic-hedgehog target. Conclusion: Iron oxide nanoparticles in the form of SPION or conjugates are biocompatible and effective at targeting tumour cells and significantly attenuate MRI signals in T2-weighted images of pancreatic cancers from a range of cell lines

Use of active comparator tirals in dermatology: A repeated cross-sectional analysis

Introduction: Spending on medications is expected to grow to $420 billion in 2023, largely driven by introduction of new branded products. While new branded medications can transform how physicians care for patients, others may not offer meaningful benefit over existing less costly alternatives. As additional new products are approved, the need to include active comparators in dermatologic clinical trials is particularly important to guide clinical decision making. Methods: To evaluate the trends in the use of active comparator trials designs, topical medications approved between January 2002 and December 2020 were identified through the 2020 Food and Drug Administration (FDA) Orange Book. For each medication, ClinicalTrials.gov was used to identify associated Phase II, III, and IV clinical trials. The frequency of active comparator was determined based on clinical indication and clinical trial phase. A logistic regression was performed to analyze the prevalence of active comparators between the study interval. Results: 177 trials met the inclusion criteria. Between 2002 and 2020, there was a decrease in the percentage of clinical trials for acne, psoriasis, and eczema that included an active comparator (-2.5% per year; 95% CI 0.9-4.2%). Phase II studies were most likely to include an active comparator (71%), while phase III studies were least likely (32%). Conclusion: Although there is a greater need for comparative effectiveness data in the setting of a growing number of available treatments, our results highlight that use of active comparator trials is decreasing over time, which will hinder comparative effectiveness research

Donepezil Impairs Memory in Healthy Older Subjects: Behavioural, EEG and Simultaneous EEG/fMRI Biomarkers

Rising life expectancies coupled with an increasing awareness of age-related cognitive decline have led to the unwarranted use of psychopharmaceuticals, including acetylcholinesterase inhibitors (AChEIs), by significant numbers of healthy older individuals. This trend has developed despite very limited data regarding the effectiveness of such drugs on non-clinical groups and recent work indicates that AChEIs can have negative cognitive effects in healthy populations. For the first time, we use a combination of EEG and simultaneous EEG/fMRI to examine the effects of a commonly prescribed AChEI (donepezil) on cognition in healthy older participants. The short- and long-term impact of donepezil was assessed using two double-blind, placebo-controlled trials. In both cases, we utilised cognitive (paired associates learning (CPAL)) and electrophysiological measures (resting EEG power) that have demonstrated high-sensitivity to age-related cognitive decline. Experiment 1 tested the effects of 5 mg/per day dosage on cognitive and EEG markers at 6-hour, 2-week and 4-week follow-ups. In experiment 2, the same markers were further scrutinised using simultaneous EEG/fMRI after a single 5 mg dose. Experiment 1 found significant negative effects of donepezil on CPAL and resting Alpha and Beta band power. Experiment 2 replicated these results and found additional drug-related increases in the Delta band. EEG/fMRI analyses revealed that these oscillatory differences were associated with activity differences in the left hippocampus (Delta), right frontal-parietal network (Alpha), and default-mode network (Beta). We demonstrate the utility of simple cognitive and EEG measures in evaluating drug responses after acute and chronic donepezil administration. The presentation of previously established markers of age-related cognitive decline indicates that AChEIs can impair cognitive function in healthy older individuals. To our knowledge this is the first study to identify the precise neuroanatomical origins of EEG drug markers using simultaneous EEG/fMRI. The results of this study may be useful for evaluating novel drugs for cognitive enhancement

Crowdsourcing hypothesis tests: Making transparent how design choices shape research results

To what extent are research results influenced by subjective decisions that scientists make as they design studies? Fifteen research teams independently designed studies to answer fiveoriginal research questions related to moral judgments, negotiations, and implicit cognition. Participants from two separate large samples (total N > 15,000) were then randomly assigned to complete one version of each study. Effect sizes varied dramatically across different sets of materials designed to test the same hypothesis: materials from different teams renderedstatistically significant effects in opposite directions for four out of five hypotheses, with the narrowest range in estimates being d = -0.37 to +0.26. Meta-analysis and a Bayesian perspective on the results revealed overall support for two hypotheses, and a lack of support for three hypotheses. Overall, practically none of the variability in effect sizes was attributable to the skill of the research team in designing materials, while considerable variability was attributable to the hypothesis being tested. In a forecasting survey, predictions of other scientists were significantly correlated with study results, both across and within hypotheses. Crowdsourced testing of research hypotheses helps reveal the true consistency of empirical support for a scientific claim.</div

Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial

Background Post-partum haemorrhage is the leading cause of maternal death worldwide. Early administration of tranexamic acid reduces deaths due to bleeding in trauma patients. We aimed to assess the effects of early administration of tranexamic acid on death, hysterectomy, and other relevant outcomes in women with post-partum haemorrhage. Methods In this randomised, double-blind, placebo-controlled trial, we recruited women aged 16 years and older with a clinical diagnosis of post-partum haemorrhage after a vaginal birth or caesarean section from 193 hospitals in 21 countries. We randomly assigned women to receive either 1 g intravenous tranexamic acid or matching placebo in addition to usual care. If bleeding continued after 30 min, or stopped and restarted within 24 h of the first dose, a second dose of 1 g of tranexamic acid or placebo could be given. Patients were assigned by selection of a numbered treatment pack from a box containing eight numbered packs that were identical apart from the pack number. Participants, care givers, and those assessing outcomes were masked to allocation. We originally planned to enrol 15 000 women with a composite primary endpoint of death from all-causes or hysterectomy within 42 days of giving birth. However, during the trial it became apparent that the decision to conduct a hysterectomy was often made at the same time as randomisation. Although tranexamic acid could influence the risk of death in these cases, it could not affect the risk of hysterectomy. We therefore increased the sample size from 15 000 to 20 000 women in order to estimate the effect of tranexamic acid on the risk of death from post-partum haemorrhage. All analyses were done on an intention-to-treat basis. This trial is registered with ISRCTN76912190 (Dec 8, 2008); ClinicalTrials.gov, number NCT00872469; and PACTR201007000192283. Findings Between March, 2010, and April, 2016, 20 060 women were enrolled and randomly assigned to receive tranexamic acid (n=10 051) or placebo (n=10 009), of whom 10 036 and 9985, respectively, were included in the analysis. Death due to bleeding was significantly reduced in women given tranexamic acid (155 [1·5%] of 10 036 patients vs 191 [1·9%] of 9985 in the placebo group, risk ratio [RR] 0·81, 95% CI 0·65–1·00; p=0·045), especially in women given treatment within 3 h of giving birth (89 [1·2%] in the tranexamic acid group vs 127 [1·7%] in the placebo group, RR 0·69, 95% CI 0·52–0·91; p=0·008). All other causes of death did not differ significantly by group. Hysterectomy was not reduced with tranexamic acid (358 [3·6%] patients in the tranexamic acid group vs 351 [3·5%] in the placebo group, RR 1·02, 95% CI 0·88–1·07; p=0·84). The composite primary endpoint of death from all causes or hysterectomy was not reduced with tranexamic acid (534 [5·3%] deaths or hysterectomies in the tranexamic acid group vs 546 [5·5%] in the placebo group, RR 0·97, 95% CI 0·87-1·09; p=0·65). Adverse events (including thromboembolic events) did not differ significantly in the tranexamic acid versus placebo group. Interpretation Tranexamic acid reduces death due to bleeding in women with post-partum haemorrhage with no adverse effects. When used as a treatment for postpartum haemorrhage, tranexamic acid should be given as soon as possible after bleeding onset. Funding London School of Hygiene & Tropical Medicine, Pfizer, UK Department of Health, Wellcome Trust, and Bill & Melinda Gates Foundation

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

Epidemiologic Trends of Cutaneous T-Cell Lymphoma in Arkansas Reveals Demographic Disparities

Accurate demographic data are critical for comprehending and treating cutaneous T-cell lymphoma (CTCL). Our research aimed to determine the demographics and incidence trends of CTCL patients in Arkansas compared to those of the national CTCL population to recognize the underlying disparities. We collected data from 143 CTCL patients at the University of Arkansas for Medical Sciences (UAMS) and national CTCL patient data from the Surveillance, Epidemiology, and End Results (SEER) database. Our analysis revealed that males are affected more than females across all ages and races. CTCL incidence and mortality data show that CTCL has a steady increase at the national level and in Arkansas while disproportionately affecting the young black male population. In Arkansas, more than one-third of black patients presented at an advanced stage (IIB+) compared to one-fifth in the white population, and the mean age of death was more than a decade younger for black (60 years) than for white patients (74.6 years). Nationally, black male patients had the greatest mortality rate (0.5) compared to 0.32 for white males. CTCL is 2.23 and 2.38 times more prevalent in urban versus rural areas in Arkansas and nationally, respectively. Most Arkansas patients reside near major interstates and chemical-emitting sites. In conclusion, our demographic analysis of Arkansas and national CTCL patients verifies recent trends toward more aggressive presentations in young black male patients, and our geographic findings suggest possible environmental risk factors

Public Perceptions, Factors, and Incentives Influencing Patient Willingness to Share Clinical Images for Artificial Intelligence-Based Healthcare Tools

Abstract Introduction The use of artificial intelligence (AI) as a diagnostic and decision-support tool is increasing in dermatology. The accuracy of image-based AI tools is incumbent on images in training sets, which requires patient consent for sharing. This study aims to understand individuals’ willingness to share their images for AI and variables that influence willingness. Methods In an online survey administered via Amazon Mechanical Turk, sketches of the hand, face, and genitalia assigned to two use cases employing AI (research vs. personal medical care) were shown. Participants rated willingness to share the image on a 7-point Likert scale. Results Of the 1010 participants, individuals were most willing to share images of their hands (81.2%), face (70.3%), and lastly genitals (male: 56.8%, female: 46.7%). Individuals were more willing to share for personal care versus research (OR 0.77 [95% CI 0.69–0.86]). Willingness to share was higher among males, participants with higher education, tech-savvy participants, and frequent social media users. Most participants were willing to share images if offered monetary compensation, with face images requiring the highest payment (mean $18.25, SD 20.05). Only 38.7% of individuals refused image sharing regardless of any monetary compensation, with the majority of this group unwilling to share images of the genitals. Conclusions This study demonstrates overall public support for sharing images to AI-based tools in dermatology, with influencing factors including image type, context, education level, technology comfort, social media use, and monetary compensation

The effect of the COVID-19 pandemic on perceptions of teledermatology

There is limited information of the effect of the COVID-19 pandemic on the general population's perceptions towards teledermatology. This study aims to assess the pandemic's impact on people's willingness to use teledermatology as well as to investigate influencing factors. We recruited 544 participants through Amazon Mechanical Turk (MTurk) and surveyed them using REDCap. Participants' willingness to use teledermatology before, during, and after the COVID-19 pandemic was measured via a 5-point Likert scale. The survey also included questions regarding factors influencing participants' attitudes towards teledermatology and their sociodemographic characteristics. Of the 185 participants who reported unwillingness to use teledermatology prior to the COVID-19 pandemic, 79.2% and 66.5% became either neutral or willing to use teledermatology during and after the pandemic, respectively. Less than half of prior satisfactory telemedicine users reported willingness to use teledermatology before the pandemic; willingness to use teledermatology increased to 80.1% and 63.8% during and after the COVID-19 pandemic, respectively. The top reason for lack of interest in teledermatology was concern for security and privacy (24.4%). Although a useful tool, teledermatology has been met with reluctance by the public. However, the unique circumstances of the COVID-19 pandemic have improved the public's perceptions and readiness to use teledermatology