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BACKGROUND: Cardiovascular disease (CVD) is the leading cause of death worldwide. It has been known for some considerable time that radiation is associated with excess risk of CVD. A recent systematic review of radiation and CVD highlighted substantial inter-study heterogeneity in effect, possibly a result of confounding or modifications of radiation effect by non-radiation factors, in particular by the major lifestyle/environmental/medical risk factors and latent period. METHODS: We assessed effects of confounding by lifestyle/environmental/medical risk factors on radiation-associated CVD and investigated evidence for modifying effects of these variables on CVD radiation dose-response, using data assembled for a recent systematic review. RESULTS: There are 43 epidemiologic studies which are informative on effects of adjustment for confounding or risk modifying factors on radiation-associated CVD. Of these 22 were studies of groups exposed to substantial doses of medical radiation for therapy or diagnosis. The remaining 21 studies were of groups exposed at much lower levels of dose and/or dose rate. Only four studies suggest substantial effects of adjustment for lifestyle/environmental/medical risk factors on radiation risk of CVD; however, there were also substantial uncertainties in the estimates in all of these studies. There are fewer suggestions of effects that modify the radiation dose response; only two studies, both at lower levels of dose, report the most serious level of modifying effect. CONCLUSIONS: There are still large uncertainties about confounding factors or lifestyle/environmental/medical variables that may influence radiation-associated CVD, although indications are that there are not many studies in which there are substantial confounding effects of these risk factors.

Chimeric antigen receptor (CAR) T-cell therapy is a novel immunotherapy approved for the treatment of hematologic malignancies. This therapy leads to a variety of immunologic deficits that could place patients at risk for invasive fungal disease (IFD). Studies assessing IFD in this setting are limited by inconsistent definitions and heterogeneity in prophylaxis use, although the incidence of IFD after CAR T-cell therapy, particularly for lymphoma and myeloma, appears to be low. This review evaluates the incidence of IFD after CAR T-cell therapy, and discusses optimal approaches to prevention, highlighting areas that require further study as well as future applications of cellular therapy that may impact IFD risk. As the use of CAR T-cell therapy continues to expand for hematologic malignancies, solid tumors, and most recently to include non-oncologic diseases, understanding the risk for IFD in this uniquely immunosuppressed population is imperative to prevent morbidity and mortality.

A detailed model of the outside world is an essential ingredient of human cognition, enabling us to navigate, form goals, execute plans, and avoid danger. Critically, these world models are flexible—they can arbitrarily expand to introduce previously-undetected objects when new information suggests their presence. Although the number of possible undetected objects is theoretically infinite, people rapidly and accurately infer unseen objects in everyday situations. How? Here we investigate one approach to characterizing this behavior—as nonparametric clustering over low-level cues—and report preliminary results comparing a computational model to human physical inferences from real-world video.

The increasing frequency and severity of UK wildfires, attributed in part to the effects of climate change, highlights the critical role of fuel moisture content (FMC) of live and dead vegetation in shaping wildfire behaviour. However, current models used to assess wildfire danger do not perform well in shrub-type fuels such as Calluna vulgaris, requiring in part an improved understanding of fuel moisture dynamics on diurnal and seasonal scales. To this end, 554 samples of upper live Calluna canopy, live Calluna stems, upper dead Calluna canopy, dead Calluna stems, moss, litter and organic layer (top 5 cm of organic material above mineral soil) were sampled hourly between 10:00 and 18:00 on seven days from March-August. Using a novel statistical method for investigating diurnal patterns, we found distinctive diurnal and seasonal trends in FMC for all fuel layers. Notably, significant diurnal patterns were evident in dead Calluna across nearly all sampled months, while diurnal trends in live Calluna canopy were pronounced in March, June, and August, coinciding with the peak occurrence of UK wildfires. In addition, the moisture content of moss and litter was found to fluctuate above and below their relative ignition thresholds throughout the day on some sampling days. These findings underscore the impact of diurnal FMC variations on wildfire danger during early spring and late summer in Calluna dominated peatlands and the need to consider such fluctuations in management and fire suppression strategies.

Design thinking, an approach traditionally used to develop or improve products, services, or processes within design and engineering sectors, has emerged as a novel pedagogical approach. As design thinking becomes more widely established within education contexts, it is important to gain deeper insight as to how such learning environments operate. The aim of this study was to explore online design thinking through the lens of psychological safety. We used a qualitative single-case study design to investigate nine students’ experiences across a nine-week design-thinking project. Data were collected via semi-structured interviews and reflective journal entries, and analysed through reflexive thematic analysis. Our findings suggested that psychological safety is a valuable consideration in the design and implementation of online design-thinking learning environments. Facilitators of psychological safety included having collaborative environments, encouraging leadership, and a focus on team formation. Barriers to psychological safety included difficulties connecting, fear of speaking, and cultural considerations. Our findings also highlighted several outcomes of psychologically safe team climates, including creativity, collaboration, and the development of approaches to working with uncertainty.

In recent years, there has been a significant increase in asexual representation in television. Despite this increased visibility, asexuality remains one of the least represented queer identities on television, causing the limited existing depictions to be positioned as a foundational base upon which broader cultural understandings are constructed. Therefore, the examination of asexual representation in television becomes imperative to understand the (re)construction of asexuality within Western society. The British Netflix series Sex Education (2014) introduces an asexual character, Sarah Owen, in its fourth and final season. This season undergoes a notable change in its setting, taking place in Cavendish College, a new school, which is portrayed as a utopia where queer students are sexually liberated. Despite this, the series struggles to fully integrate asexuality into its narrative, resembling broader issues in contemporary queer politics, thus making it an interesting case study for the representation of asexuality. Therefore, the series Sex Education was examined, using a textual analysis, to answer the following research question: How does Sex Education (2014) represent asexuality within a queer utopia? The analysis utilized concepts from José Esteban Muñoz’s queer utopia and Kristina Gupta’s compulsory sexuality, incorporating asexual stereotypes mapped out by various scholars as a framework to examine how Sex Education represents asexuality within a queer utopia. A textual analysis was conducted following Richard Dyer’s three-step method of description, contextualisation, and interpretation. The analysis revealed Cavendish as a queer utopia through the features of queer failure, collectivity, and challenging heteronormativity, depicted through the formal elements of mise-en-scene. By examining Sarah’s characterisation in relation to asexual stereotypes and the features of the queer utopia, the series represents asexuality as not queer enough due to her dive

This paper seeks to outline the history, market situation, clinical management and product performance related to the correction of presbyopia with both contact lenses and spectacles. The history of the development of various optical forms of presbyopic correction are reviewed, and an overview is presented of the current market status of contact lenses and spectacles. Clinical considerations in the fitting and aftercare of presbyopic contact lens and spectacle lens wearers are presented, with general recommendations for best practice. Current options for contact lens correction of presbyopia include soft simultaneous, rigid translating and rigid simultaneous designs, in addition to monovision. Spectacle options include single vision lenses, bifocal lenses and a range of progressive addition lenses. The comparative performance of both contact lens and spectacle lens options is presented. With a significant proportion of the global population now being presbyopic, this overview is particularly timely and is designed to act as a guide for researchers, industry and eyecare practitioners alike.

This paper seeks to outline the history, market situation, clinical management and product performance related to the correction of presbyopia with both contact lenses and spectacles. The history of the development of various optical forms of presbyopic correction are reviewed, and an overview is presented of the current market status of contact lenses and spectacles. Clinical considerations in the fitting and aftercare of presbyopic contact lens and spectacle lens wearers are presented, with general recommendations for best practice. Current options for contact lens correction of presbyopia include soft simultaneous, rigid translating and rigid simultaneous designs, in addition to monovision. Spectacle options include single vision lenses, bifocal lenses and a range of progressive addition lenses. The comparative performance of both contact lens and spectacle lens options is presented. With a significant proportion of the global population now being presbyopic, this overview is particularly timely and is designed to act as a guide for researchers, industry and eyecare practitioners alike.

Sleep disturbances profoundly affect the quality of life in individuals with neurological disorders. Closed-loop deep brain stimulation (DBS) holds promise for alleviating sleep symptoms, however, this technique necessitates automated sleep stage decoding from intracranial signals. We leveraged overnight data from 121 patients with movement disorders (Parkinsons disease, Essential Tremor, Dystonia, Essential Tremor, Huntingtons disease, and Tourettes syndrome) in whom synchronized polysomnograms and basal ganglia local field potentials were recorded, to develop a generalized, multi-class, sleep specific decoder - BGOOSE. This generalized model achieved 85% average accuracy across patients and across disease conditions, even in the presence of recordings from different basal ganglia targets. Furthermore, we also investigated the role of electrocorticography on decoding performances and proposed an optimal decoding map, which was shown to facilitate channel selection for optimal model performances. BGOOSE emerges as a powerful tool for generalized sleep decoding, offering exciting potentials for the precision stimulation delivery of DBS and better management of sleep disturbances in movement disorders.

Circadian rhythms have been shown in the subthalamic nucleus (STN) in Parkinsons disease (PD), but only a few studies have focused on the globus pallidus internus (GPi). This retrospective study investigates GPi circadian rhythms in a large cohort of subjects with PD (130 recordings from 93 subjects) with GPi activity chronically recorded in their home environment. We found a significant change in GPi activity between daytime and nighttime in most subjects (82.4%), with a reduction in GPi activity at nighttime in 56.2% of recordings and an increase in activity in 26.2%. GPi activity in higher frequency bands ( > 20 Hz) was more likely to decrease at night and in patients taking extended-release levodopa medication. Our results suggest that circadian fluctuations in the GPi vary across individuals and that increased power at night might be due to the reemergence of pathological neural activity. These findings should be considered to ensure successful implementation of adaptive neurostimulation paradigms in the real-world.

BackgroundHIV molecular epidemiology (HIV ME) can support the early detection of emerging clusters of new HIV infections by combining HIV sequence data routinely obtained during the clinical treatment of people living with HIV with behavioral, geographic, and sociodemographic information. While information about emerging clusters promises to facilitate HIV prevention and treatment efforts, the use of this data also raises several ethical concerns. We sought to assess how those working on the frontlines of HIV ME, specifically public health practitioners (PHPs) and researchers, prioritized these issues.MethodsEthical issues were identified through literature review, qualitative in-depth interviews, and stakeholder engagement. PHPs and researchers using HIV ME prioritized the issues using best-worst scaling (BWS). A balanced incomplete block design was used to generate 11 choice tasks each consisting of a sub-set of 5 ethical concerns. In each task, respondents were asked to assess the most and least concerning issue. Data were analyzed using conditional logit, with a Swait-Louviere test of poolability. Latent class analysis was then used to explore preference heterogeneity.ResultsIn total, 57 respondents completed the BWS experiment May-June 2023 with the Swait-Louviere test indicating that researchers and PHPs could be pooled (p = 0.512). Latent class analysis identified two classes, those highlighting "Harms" (n = 29) (prioritizing concerns about potential risk of legal prosecution, individual harm, and group stigma) and those highlighting "Utility" (n = 28) (prioritizing concerns about limited evidence, resource allocation, non-disclosure of data use for HIV ME, and the potential to infer the directionality of HIV transmission). There were no differences in the characteristics of members across classes.ConclusionsThe ethical issues of HIV ME vary in importance among stakeholders, reflecting different perspectives on the potential impact and usefulness of the data.

ObjectiveEvaluate whether total elbow replacement (TER) through a lateral approach is accurate and stable.Animals12 skeletally mature large-breed dog cadavers were used.MethodsLimb alignment, elbow joint motion, and collateral ligament laxity were evaluated preoperatively. The order of surgery (left or right) and the approach (lateral or medial) were randomly selected for TER in each dog. The other approach was used in the contralateral elbow. Intraoperative technical difficulties, duration of surgery, and anatomic complications were recorded. Limb alignment, elbow joint motion, collateral ligament laxity, and prosthetic component alignment were evaluated after surgery. Data were collected from June 11 to 15, 2023.ResultsThe duration of surgery using a lateral or medial approach did not differ (P = .499). Anatomic complications were not observed. The lateral approach resulted in 8° more elbow extension (P = .003), 1.58° less lateral collateral ligament constraint (P = .033), 2.80° less medial collateral ligament constraint (P = .002), 4.38° less frontal plane constraint (P = .004), 8° greater humeral component inclination (P = .033), and 5.6° greater radioulnar component varus (P = .001) than the medial approach. Varus of the radius, mechanical axis deviation, limb supination, elbow flexion, mediolateral humeral component and craniocaudal radioulnar component orientation did not differ among joints operated using a lateral or medial approach. In normal cadaveric elbows, a lateral approach for TER appears feasible, producing equivalent limb alignment, joint laxity, and joint motion to normal elbows and to TER placed using a medial approach.Clinical relevanceIn dogs, TER can be performed using a lateral surgical approach.

Quantification of motor symptom progression in Parkinsons disease (PD) patients is crucial for assessing disease progression and for optimizing therapeutic interventions, such as dopaminergic medications and deep brain stimulation. Cumulative and heuristic clinical experience has identified various clinical signs associated with PD severity, but these are neither objectively quantifiable nor robustly validated. Video-based objective symptom quantification enabled by machine learning (ML) introduces a potential solution. However, video-based diagnostic tools often have implementation challenges due to expensive and inaccessible technology, and typical black-box ML implementations are not tailored to be clinically interpretable. Here, we address these needs by releasing a comprehensive kinematic dataset and developing an interpretable video-based framework that predicts high versus low PD motor symptom severity according to MDS-UPDRS Part III metrics. This data driven approach validated and robustly quantified canonical movement features and identified new clinical insights, not previously appreciated as related to clinical severity, including pinkie finger movements and lower limb and axial features of gait. Our framework is enabled by retrospective, single-view, seconds-long videos recorded on consumer-grade devices such as smartphones, tablets, and digital cameras, thereby eliminating the requirement for specialized equipment. Following interpretable ML principles, our framework enforces robustness and interpretability by integrating (1) automatic, data-driven kinematic metric evaluation guided by pre-defined digital features of movement, (2) combination of bi-domain (body and hand) kinematic features, and (3) sparsity-inducing and stability-driven ML analysis with simple-to-interpret models. These elements ensure that the proposed framework quantifies clinically meaningful motor features useful for both ML predictions and clinical analysis.

BACKGROUND: Autonomic dysfunction is common and disabling in Parkinsons disease (PD). The effects of deep brain stimulation (DBS) on the cardiovascular system in PD remain poorly understood. We aimed to assess the effect of DBS on cardiovascular symptoms and objective measures in PD patients. METHODS: We conducted a systematic literature search in PubMed/MEDLINE. RESULTS: 36 out of 472 studies were included, mostly involving DBS of the subthalamic nucleus, and to a lesser extent the globus pallidus pars interna and pedunculopontine nucleus. Seventeen studies evaluated the effect of DBS on patient-reported or clinician-rated cardiovascular symptoms, showing an improvement in the first year after surgery but not with longer-term follow-up. DBS has no clear direct effects on blood pressure during an orthostatic challenge (n = 10 studies). DBS has inconsistent effects on heart rate variability (n = 10 studies). CONCLUSION: Current evidence on the impact of DBS on cardiovascular functions in PD is inconclusive. DBS may offer short-term improvement of cardiovascular symptoms in PD, particularly orthostatic hypotension, which may be attributed to dopaminergic medication reduction after surgery. There is insufficient evidence to draw conclusions on the direct effect of DBS on blood pressure and heart rate variability.

Respiratory reductases enable microorganisms to use molecules present in anaerobic ecosystems as energy-generating respiratory electron acceptors. Here we identify three taxonomically distinct families of human gut bacteria (Burkholderiaceae, Eggerthellaceae and Erysipelotrichaceae) that encode large arsenals of tens to hundreds of respiratory-like reductases per genome. Screening species from each family (Sutterella wadsworthensis, Eggerthella lenta and Holdemania filiformis), we discover 22 metabolites used as respiratory electron acceptors in a species-specific manner. Identified reactions transform multiple classes of dietary- and host-derived metabolites, including bioactive molecules resveratrol and itaconate. Products of identified respiratory metabolisms highlight poorly characterized compounds, such as the itaconate-derived 2-methylsuccinate. Reductase substrate profiling defines enzyme–substrate pairs and reveals a complex picture of reductase evolution, providing evidence that reductases with specificities for related cinnamate substrates independently emerged at least four times. These studies thus establish an exceptionally versatile form of anaerobic respiration that directly links microbial energy metabolism to the gut metabolome.

The University of California, San Francisco (UCSF) Library has been actively engaged in promoting diversity, equity, inclusion, and accessibility (DEIA) goals through a variety of approaches, including outreach and education to targeted campus groups, research collaborations, exhibits and public programming, participation in UC-wide groups, and collections. The library has incorporated DEIA into the library’s strategic plan goals, created rubrics for use in the hiring process, and incorporated DEIA activities and goals into the performance evaluation process for library employees. The University of California has also developed transformative publishing agreements with multiple publishers, allowing UC authors the option of publishing their articles open access with no or low article processing charges (APCs). These agreements allow UC authors to maintain their copyrights and encourage young researchers, LGBTQ+ researchers and other minority researchers to publish and promote their projects from the diversity of our campus populations. All of these activities promote UCSF’s PRIDE values of professionalism, respect, integrity, diversity, and excellence. This poster will highlight numerous activities and initiatives both within the library and on the UCSF campus promoting DEIA and beyond that, the campus mission of Advancing Health Worldwide.  Presented at the American Library Association 2024 Conference.

Choosing whether to exert effort to obtain rewards is fundamental to human motivated behavior. However, the neural dynamics underlying the evaluation of reward and effort in humans is poorly understood. Here, we report an exploratory investigation into this with chronic intracranial recordings from the prefrontal cortex (PFC) and basal ganglia (BG; subthalamic nuclei and globus pallidus) in people with Parkinsons disease performing a decision-making task with offers that varied in levels of reward and physical effort required. This revealed dissociable neural signatures of reward and effort, with BG beta (12 to 20 Hz) oscillations tracking effort on a single-trial basis and PFC theta (4 to 7 Hz) signaling previous trial reward, with no effects of net subjective value. Stimulation of PFC increased overall acceptance of offers and sensitivity to reward while decreasing the impact of effort on choices. This work uncovers oscillatory mechanisms that guide fundamental decisions to exert effort for reward across BG and PFC, supports a causal role of PFC for such choices, and seeds hypotheses for future studies.

Background: In patients with low-gradient aortic stenosis (AS) and low transvalvular flow, dobutamine stress echocardiography (DSE) is recommended to determine AS severity, whereas the degree of aortic valve calcification (AVC) supposedly correlates with AS severity according to current European and American guidelines. Objectives: The purpose of this study was to assess the relationship between AVC and AS severity as determined using echocardiography and DSE in patients with aortic valve area <1 cm2 and peak aortic valve velocity <4.0 m/s. Methods: All patients underwent DSE to determine AS severity and multislice computed tomography to quantify AVC. Receiver-operating characteristics curve analysis was used to assess the diagnostic value of AVC for AS severity grading as determined using echocardiography and DSE in men and women. Results: A total of 214 patients were included. Median age was 78 years (25th-75th percentile: 71-84 years) and 25% were women. Left ventricular ejection fraction was reduced (<50%) in 197 (92.1%) patients. Severe AS was diagnosed in 106 patients (49.5%). Moderate AS was diagnosed in 108 patients (50.5%; in 77 based on resting transthoracic echocardiography, in 31 confirmed using DSE). AVC score was high (≥2,000 for men or ≥1,200 for women) in 47 (44.3%) patients with severe AS and in 47 (43.5%) patients with moderate AS. AVC sensitivity was 44.3%, specificity was 56.5%, and positive and negative predictive values for severe AS were 50.0% and 50.8%, respectively. Area under the receiver-operating characteristics curve was 0.508 for men and 0.524 for women. Conclusions: Multi-slice computed tomography–derived AVC scores showed poor discrimination between grades of AS severity using DSE and cannot replace DSE in the diagnostic work-up of low-gradient severe AS.

Turner syndrome (TS) affects 50 per 100 000 females. TS affects multiple organs through all stages of life, necessitating multidisciplinary care. This guideline extends previous ones and includes important new advances, within diagnostics and genetics, estrogen treatment, fertility, co-morbidities, and neurocognition and neuropsychology. Exploratory meetings were held in 2021 in Europe and United States culminating with a consensus meeting in Aarhus, Denmark in June 2023. Prior to this, eight groups addressed important areas in TS care: (1) diagnosis and genetics, (2) growth, (3) puberty and estrogen treatment, (4) cardiovascular health, (5) transition, (6) fertility assessment, monitoring, and counselling, (7) health surveillance for comorbidities throughout the lifespan, and (8) neurocognition and its implications for mental health and well-being. Each group produced proposals for the present guidelines, which were meticulously discussed by the entire group. Four pertinent questions were submitted for formal GRADE (Grading of Recommendations, Assessment, Development and Evaluation) evaluation with systematic review of the literature. The guidelines project was initiated by the European Society for Endocrinology and the Pediatric Endocrine Society, in collaboration with members from the European Society for Pediatric Endocrinology, the European Society of Human Reproduction and Embryology, the European Reference Network on Rare Endocrine Conditions, the Society for Endocrinology, and the European Society of Cardiology, Japanese Society for Pediatric Endocrinology, Australia and New Zealand Society for Pediatric Endocrinology and Diabetes, Latin American Society for Pediatric Endocrinology, Arab Society for Pediatric Endocrinology and Diabetes, and the Asia Pacific Pediatric Endocrine Society. Advocacy groups appointed representatives for pre-meeting discussions and the consensus meeting.

Bone and antler points, found on Dutch beaches, give a new insight in life on Mesolithic Doggerland. Doggerland is the North sea basin, stretching from the Netherlands to Great Britain, Norway and Denmark, once part of Europe’s mainland. After the last glaciation it was dry land inhabited by hunter-gatherers, until around the beginning of the Mesolithic (10,000 cal. BC), sea levels began to rise. This lasted until around 6050 cal. BC, when Doggerland was completely drowned. Due to the submersion, Doggerland holds the most complete archaeological record of human presence in Mesolithic north-western Europe. This archaeological record is however disturbed by sand extraction for beach reinforcements, which use sand from areas off the coast of South-Holland. Therefore remains from Doggerland, such as flint, osseous artefacts and even human remains, are found on Dutch beaches. Artefact biographies provide new insights on Doggerland’s inhabitants. Most artefacts are made of bone or antler, with (barbed) points being the largest part of the assemblage. Many of these bone and antler points were studied by the authors to construct their artefact biography: from raw material to discard or deposition. Material selection was studied using ZooMS, showing that there may be a preference for the use of red deer as raw material. Furthermore, ZooMS analysis identified two points made of human bone, highlighting the possible symbolic and cultural meaning of these objects. The production process of grinding the points on stone (and scraping with flint), cutting barbs with flint and hafting them using a combination of fibres and birch tar was inferred through techno-functional analysis. A high degree of wear on the points and reworked barbs on some, suggests that they were (heavily) curated weapon tips. Most were probably used as arrowheads, based on their small size. This suggests hunting wit

BACKGROUND: Many persons with HIV remain out of care (PWH-OOC). We evaluated InstaCare, a complex intervention integrating the brief behavioral intervention 60 minutes for Health with the rapid restart of antiretroviral therapy (rapid ART). SETTING: Prospective open-label randomized controlled trial among PWH-OOC in San Diego, USA. METHODS: PWH-OOC were randomized 1:1 to InstaCare or a time-and-attention control integrating a diet-and-nutrition behavioral intervention also with rapid ART initiation (restart ≤7 days from enrollment). All participants had access to support services (free transport, HIV peer navigation, adherence counseling, and linkage to care) and primary care services (mental health, case management, social work, medication-assisted treatment, and specialist pharmacy). The primary outcomes were viral suppression (<50 copies/mL) and re-engagement with care (≥2 HIV care visits >90 days apart) by 24 weeks. Outcomes were reported on an intention-to-treat basis. RESULTS: Between November 2020 and August 2022, 52 PWH-OOC were enrolled. Baseline substance use in the preceding month (49%), unstable housing (51%), moderate/severe depression (49%), and moderate/severe anxiety (41.7%) were prevalent. Rapid ART was provided for all participants. At week 24, the proportion with HIV viral load <50 copies/mL was 37.3% (19/51) (InstaCare 28.0%, control 46.2%, P = 0.25). Fourteen (27.5%) were engaged with care (InstaCare 7/25 [28.0%], control 7/26 [26.9%], P = 1.00). Most participants (94%) reported low or very low emotional distress associated with rapid ART. Study lost to follow-up by week 24 was high (23/51, 45%). CONCLUSIONS: The InstaCare complex intervention did not improve viral suppression or reengagement with care among PWH-OOC. Investigation of high-intensity, individually adapted interventions is needed among PWH-OOC.

To navigate changes within a highly dynamic and complex environment, it is crucial to compare current visual representations of a scene to previously formed representations stored in memory. This process of mental comparison requires integrating information from multiple sources to inform decisions about changes within the environment. In the present article, we combine a novel systems factorial technology change detection task (Blunden et al., 2022) with a set size manipulation. Participants were required to detect 0, 1, or 2 changes of low and high detectability between a memory and probe array of 1-4 spatially separated luminance discs. Analyses using systems factorial technology indicated that the processing architecture was consistent across set sizes but that capacity was always limited and decreased as the number of distractors increased. We developed a novel model of change detection based on the statistical principles of basic sampling theory (Palmer, 1990; Sewell et al., 2014). The sample size model, instantiated parametrically, predicts the architecture and capacity results a priori and quantitatively accounted for several key results observed in the data: (a) increasing set size acted to decrease sensitivity (d') in proportion to the square root of the number of items in the display; (b) the effect of redundancy benefited performance by a factor of the square root of the number of changes; and (c) the effect of change detectability was separable and independent of the sample size costs and redundancy benefits. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Many cultures share common constellations and common narratives about the stars in the night sky. Previous research has shown that this overlap in asterisms, minimal star groupings inside constellations, is clearly present across 27 distinct culture groups and can be explained in part by properties of individual stars (brightness) and properties of pairs of stars (proximity) (Kemp, Hamacher, Little, & Cropper, 2022). The same work, however, found no evidence that properties of triples (angle) and quadruples (good continuation) predicted constellation formation. We developed a behavioral experiment to explore how individuals form constellations under conditions that reduce cultural learning. We found that participants independently selected and connected similar stars, and that their responses were predicted by two properties of triples (angle and even spacing) in addition to the properties of brightness and proximity supported by previous work. Our findings lend further evidence to the theory that commonality of constellations across cultures is not a result of shared human history but rather stems from shared human nature.

With a high incidence of acute kidney injury among hospitalized COVID-19 patients, considerable attention has been focussed on whether SARS-CoV-2 specifically targets kidney cells to directly impact renal function, or whether renal damage is primarily an indirect outcome. To date, several studies have utilized kidney organoids to understand the pathogenesis of COVID-19, revealing the ability for SARS-CoV-2 to predominantly infect cells of the proximal tubule (PT), with reduced infectivity following administration of soluble ACE2. However, the immaturity of standard human kidney organoids represents a significant hurdle, leaving the preferred SARS-CoV-2 processing pathway, existence of alternate viral receptors, and the effect of common hypertensive medications on the expression of ACE2 in the context of SARS-CoV-2 exposure incompletely understood. Utilizing a novel kidney organoid model with enhanced PT maturity, genetic- and drug-mediated inhibition of viral entry and processing factors confirmed the requirement for ACE2 for SARS-CoV-2 entry but showed that the virus can utilize dual viral spike protein processing pathways downstream of ACE2 receptor binding. These include TMPRSS- and CTSL/CTSB-mediated non-endosomal and endocytic pathways, with TMPRSS10 likely playing a more significant role in the non-endosomal pathway in renal cells than TMPRSS2. Finally, treatment with the antihypertensive ACE inhibitor, lisinopril, showed negligible impact on receptor expression or susceptibility of renal cells to infection. This study represents the first in-depth characterization of viral entry in stem cell-derived human kidney organoids with enhanced PTs, providing deeper insight into the renal implications of the ongoing COVID-19 pandemic.

Graphical perception is an important part of the scientific endeavour, and the interpretation of graphical information is increasingly important among educated consumers of popular media, who are often presented with graphs of data in support of different policy positions. However, graphs are multidimensional and data in graphs are comprised not only of overall global trends but also local perturbations. We presented a novel function estimation task in which scatterplots of noisy data that varied in the number of data points, the scale of the data, and the true generating function were shown to observers. 170 psychology undergraduates with mixed experience of mathematical functions were asked to draw the function that they believe generated the data. Our results indicated not only a general influence of various aspects of the presented graph (e.g., increasing the number of data points results in smoother generated functions) but also clear individual differences, with some observers tending to generate functions that track the local changes in the data and others following global trends in the data.

Natural products possess pleiotropic cardiovascular protective effects owing to their anti-oxidation, anti-inflammation and anti-thrombotic properties. Kaempferol, (3,5,7-trihydroxy-2-(4-hydroxyphenyl)-4H-1-benzopyran-4-one), is a kind of naturally occurring flavonoid existing in many common fruits and vegetables (e.g., onions, broccoli, strawberries and grapes) and particularly in traditional Chinese medicine as exemplified by Ginkgo biloba. Epidemiological, preclinical and clinical studies have revealed an inverse association between the consumption of kaempferol-containing foods and medicines and the risk of developing cardiovascular diseases. Numerous translational studies in experimental animal models and cultured cells have demonstrated a wide range of pharmacological activities of kaempferol. In this article, we reviewed the antioxidant, anti-inflammatory and cardio-protective activities of kaempferol and elucidated the potential molecular basis of the therapeutic capacity of kaempferol by focusing on its anti-atherosclerotic effects. Overall, the review presents the health benefits of kaempferol-containing plants and medicines and reflects on the potential of kaempferol as a possible drug candidate to prevent and treat atherosclerosis, the underlying pathology of most cardiovascular diseases.

Even small changes in physicochemical properties of nanoforms (NFs), can drive differences in their environmental fate and hazard. The large number of new materials being developed means it will not be feasible to test and characterise the fate, behaviour and (eco)toxicity of each individual NF. This is further amplified by transformations of NFs over their lifecycle, changing the processes governing their risk. A common complexity arises from dissolution, where the combined toxicity of the exposure arises from both the solutes and any remaining particles contribution to the overall toxicity of the exposure. For efficient and effective risk assessment, it is the most relevant form of the NF for a given exposure that should be targeted for testing and assessment. In aquatic systems, functional fate processes (including dissolution, dispersion stability and chemical and biological transformations) determine the NF’s exposure relevant form. Whilst transformations in the environment alter the initial properties of an NF, different NFs may follow a shared functional fate pathway and ultimately present a similar fate and hazard profile in the environment. Therefore, these processes may be used to scientifically justify grouping NFs and read-across for specific endpoints from data rich NF(s) to verified members of the group that have not been tested yet. Integrated Approaches to Testing and Assessment (IATA) have been used in other regulatory contexts to support the collection and integration of relevant existing information as well as the targeted generation of new data to support grouping and read-across. Here, a new IATA is presented consisting of decision nodes focused on dissolution, dispersion stability, chemical transformations and the relative contribution to toxicity of the particle and dissolved component of the overall exposure. The IATA focuses on the fate of NFs in aquatic systems outside of the body, but it can be considered a template for future assessment o

The increasing frequency and severity of UK wildfires, attributed in part to the effects of climate change, highlights the critical role of fuel moisture content (FMC) of live and dead vegetation in shaping wildfire behaviour. However, current models used to assess wildfire danger do not perform well in shrub-type fuels such as Calluna vulgaris, requiring in part an improved understanding of fuel moisture dynamics on diurnal and seasonal scales. To this end, 554 samples of upper live Calluna canopy, live Calluna stems, upper dead Calluna canopy, dead Calluna stems, moss, litter and organic layer (top 5 cm of organic material above mineral soil) were sampled hourly between 10:00 and 18:00 on seven days from March-August. Using a novel statistical method for investigating diurnal patterns, we found distinctive diurnal and seasonal trends in FMC for all fuel layers. Notably, significant diurnal patterns were evident in dead Calluna across nearly all sampled months, while diurnal trends in live Calluna canopy were pronounced in March, June, and August, coinciding with the peak occurrence of UK wildfires. In addition, the moisture content of moss and litter was found to fluctuate above and below their relative ignition thresholds throughout the day on some sampling days. These findings underscore the impact of diurnal FMC variations on wildfire danger during early spring and late summer in Calluna dominated peatlands and the need to consider such fluctuations in management and fire suppression strategies.

The increasing frequency and severity of UK wildfires, attributed in part to the effects of climate change, highlights the critical role of fuel moisture content (FMC) of live and dead vegetation in shaping wildfire behaviour. However, current models used to assess wildfire danger do not perform well in shrub-type fuels such as Calluna vulgaris, requiring in part an improved understanding of fuel moisture dynamics on diurnal and seasonal scales. To this end, 554 samples of upper live Calluna canopy, live Calluna stems, upper dead Calluna canopy, dead Calluna stems, moss, litter and organic layer (top 5 cm of organic material above mineral soil) were sampled hourly between 10:00 and 18:00 on seven days from March-August. Using a novel statistical method for investigating diurnal patterns, we found distinctive diurnal and seasonal trends in FMC for all fuel layers. Notably, significant diurnal patterns were evident in dead Calluna across nearly all sampled months, while diurnal trends in live Calluna canopy were pronounced in March, June, and August, coinciding with the peak occurrence of UK wildfires. In addition, the moisture content of moss and litter was found to fluctuate above and below their relative ignition thresholds throughout the day on some sampling days. These findings underscore the impact of diurnal FMC variations on wildfire danger during early spring and late summer in Calluna dominated peatlands and the need to consider such fluctuations in management and fire suppression strategies.

In the ENSEMBLE randomized, placebo-controlled phase 3 trial (NCT04505722), estimated single-dose Ad26.COV2.S vaccine efficacy (VE) was 56% against moderate to severe-critical COVID-19. SARS-CoV-2 Spike sequences were determined from 484 vaccine and 1,067 placebo recipients who acquired COVID-19. In this set of prespecified analyses, we show that in Latin America, VE was significantly lower against Lambda vs. Reference and against Lambda vs. non-Lambda [family-wise error rate (FWER) p < 0.05]. VE differed by residue match vs. mismatch to the vaccine-insert at 16 amino acid positions (4 FWER p < 0.05; 12 q-value ≤ 0.20); significantly decreased with physicochemical-weighted Hamming distance to the vaccine-strain sequence for Spike, receptor-binding domain, N-terminal domain, and S1 (FWER p < 0.001); differed (FWER ≤ 0.05) by distance to the vaccine strain measured by 9 antibody-epitope escape scores and 4 NTD neutralization-impacting features; and decreased (p = 0.011) with neutralization resistance level to vaccinee sera. VE against severe-critical COVID-19 was stable across most sequence features but lower against the most distant viruses.

BackgroundHIV molecular epidemiology (ME) is the analysis of sequence data together with individual-level clinical, demographic, and behavioral data to understand HIV epidemiology. The use of ME has raised concerns regarding identification of the putative source in direct transmission events. This could result in harm ranging from stigma to criminal prosecution in some jurisdictions. Here we assessed the risks of ME using simulated HIV genetic sequencing data.MethodsWe simulated social networks of men-who-have-sex-with-men, calibrating the simulations to data from San Diego. We used these networks to simulate consensus and next-generation sequence (NGS) data to evaluate the risks of identifying direct transmissions using different HIV sequence lengths, and population sampling depths. To identify the source of transmissions, we calculated infector probability and used phyloscanner software for the analysis of consensus and NGS data, respectively.ResultsConsensus sequence analyses showed that the risk of correctly inferring the source (direct transmission) within identified transmission pairs was very small and independent of sampling depth. Alternatively, NGS analyses showed that identification of the source of a transmission was very accurate, but only for 6.5% of inferred pairs. False positive transmissions were also observed, where one or more unobserved intermediaries were present when compared to the true network.ConclusionSource attribution using consensus sequences rarely infers direct transmission pairs with high confidence but is still useful for population studies. In contrast, source attribution using NGS data was much more accurate in identifying direct transmission pairs, but for only a small percentage of transmission pairs analyzed.

ObjectiveTo evaluate the kinematics and stability of the temporomandibular joint (TMJ) of cats and dogs with and without a TMJ replacement (TMJR) prosthesis under simulated bite forces and mouth opening.AnimalsSixteen cadaver skulls from domestic cats (n = 8) and medium- to large-breed dogs (n = 8).MethodsIntact TMJs were tested. Following condylectomy and coronoidectomy, the skulls were fitted with a TMJR prosthesis unilaterally and retested. Prosthesis was similarly implanted in the contralateral TMJ in 4 cats and 4 dogs before retesting. Left and right bite motions were evaluated before bite contact to peak bite force (200 N in dogs, 63 N in cats). Mouth opening motion was recorded. Mandibular displacement under load was evaluated in 3 orthogonal planes. Maximal displacement was compared between TMJR groups and native TMJ. Prosthesis-bone motion of the temporal and mandibular components was evaluated during simulated bites and mouth opening.ResultsTMJR resulted in joint motion not demonstrably different from the native TMJ, with the ability to fully open and close the mouth and with minimal laterotrusion. The TMJR prosthesis demonstrated similar stability after unilateral and bilateral replacement during bite force and with an open mouth. Mean implant-bone motion during bite simulations for the temporal and mandibular TMJR components was ≤ 60 µm in cats and ≤ 30 µm in dogs.Clinical relevanceA novel TMJR can be implanted and allows normal jaw motion. Joint stability is maintained after TMJR implantation in the TMJ of dogs and cats TMJ that is devoid of muscular support.

ObjectiveThe objective of this study is to compare drilling variables and torsional mechanical properties of rabbit femora after bicortical drilling with a 1.5-mm standard surgical drill bit, acrylic drill bit, and K-wire.Samples24 pairs of rabbit femora.MethodsAfter drilling under controlled axial displacement rate, each bone was biaxially loaded in compression followed by rapid external torsion to failure. Maximum axial thrust force, maximum drill torque, integral of force and displacement, change in temperature, maximum power spectral density of the torque signal, torque vibration, and torque and angle at the yield and failure points were collected. Pre- and postyield stiffness, yield and failure energies, and postyield energy were calculated.ResultsThe work required to drill through the cis- and transcortices (integral of force and displacement) was greater for the K-wire, followed by the acrylic and then standard drill bits, respectively. The K-wire demonstrated higher maximum torque than the drill bits at the ciscortex, and the force of drilling was significantly greater. The vibration data was greater with the acrylic and standard drill bits than the K-wire. There was no difference in torsional strength between drilling types.Clinical relevanceMechanical differences exist between different drill bits and K-wire and demonstrate that the K-wire is overall more damaging than the surgical drill bit.

Although primarily studied through the lens of community ecology, phenomena consistent with priority effects appear to be widespread across many different scenarios spanning a broad range of spatial, temporal, and biological scales. However, communication between these research fields is inconsistent and has resulted in a fragmented co-citation landscape, likely due to the diversity of terms used to refer to priority effects across these fields. We review these related terms, and the biological contexts in which they are used, to facilitate greater cross-disciplinary cohesion in research on priority effects. In breaking down these semantic barriers, we aim to provide a framework to better understand the conditions and mechanisms of priority effects, and their consequences across spatial and temporal scales.

With a high incidence of acute kidney injury among hospitalized COVID-19 patients, considerable attention has been focussed on whether SARS-CoV-2 specifically targets kidney cells to directly impact renal function, or whether renal damage is primarily an indirect outcome. To date, several studies have utilized kidney organoids to understand the pathogenesis of COVID-19, revealing the ability for SARS-CoV-2 to predominantly infect cells of the proximal tubule (PT), with reduced infectivity following administration of soluble ACE2. However, the immaturity of standard human kidney organoids represents a significant hurdle, leaving the preferred SARS-CoV-2 processing pathway, existence of alternate viral receptors, and the effect of common hypertensive medications on the expression of ACE2 in the context of SARS-CoV-2 exposure incompletely understood. Utilizing a novel kidney organoid model with enhanced PT maturity, genetic- and drug-mediated inhibition of viral entry and processing factors confirmed the requirement for ACE2 for SARS-CoV-2 entry but showed that the virus can utilize dual viral spike protein processing pathways downstream of ACE2 receptor binding. These include TMPRSS- and CTSL/CTSB-mediated non-endosomal and endocytic pathways, with TMPRSS10 likely playing a more significant role in the non-endosomal pathway in renal cells than TMPRSS2. Finally, treatment with the antihypertensive ACE inhibitor, lisinopril, showed negligible impact on receptor expression or susceptibility of renal cells to infection. This study represents the first in-depth characterization of viral entry in stem cell-derived human kidney organoids with enhanced PTs, providing deeper insight into the renal implications of the ongoing COVID-19 pandemic.

Planetary exploration relies considerably on mineral characterization to advance our understanding of the solar system, the planets and their evolution. Thus, we must understand past and present processes that can alter materials exposed on the surface, affecting space mission data. Here, we analyze the first dataset monitoring the evolution of a known mineral target in situ on the Martian surface, brought there as a SuperCam calibration target onboard the Perseverance rover. We used Raman spectroscopy to monitor the crystalline state of a synthetic apatite sample over the first 950 Martian days (sols) of the Mars2020 mission. We note significant variations in the Raman spectra acquired on this target, specifically a decrease in the relative contribution of the Raman signal to the total signal. These observations are consistent with the results of a UV-irradiation test performed in the laboratory under conditions mimicking ambient Martian conditions. We conclude that the observed evolution reflects an alteration of the material, specifically the creation of electronic defects, due to its exposure to the Martian environment and, in particular, UV irradiation. This ongoing process of alteration of the Martian surface needs to be taken into account for mineralogical space mission data analysis.

With a high incidence of acute kidney injury among hospitalized COVID-19 patients, considerable attention has been focussed on whether SARS-CoV-2 specifically targets kidney cells to directly impact renal function, or whether renal damage is primarily an indirect outcome. To date, several studies have utilized kidney organoids to understand the pathogenesis of COVID-19, revealing the ability for SARS-CoV-2 to predominantly infect cells of the proximal tubule (PT), with reduced infectivity following administration of soluble ACE2. However, the immaturity of standard human kidney organoids represents a significant hurdle, leaving the preferred SARS-CoV-2 processing pathway, existence of alternate viral receptors, and the effect of common hypertensive medications on the expression of ACE2 in the context of SARS-CoV-2 exposure incompletely understood. Utilizing a novel kidney organoid model with enhanced PT maturity, genetic- and drug-mediated inhibition of viral entry and processing factors confirmed the requirement for ACE2 for SARS-CoV-2 entry but showed that the virus can utilize dual viral spike protein processing pathways downstream of ACE2 receptor binding. These include TMPRSS- and CTSL/CTSB-mediated non-endosomal and endocytic pathways, with TMPRSS10 likely playing a more significant role in the non-endosomal pathway in renal cells than TMPRSS2. Finally, treatment with the antihypertensive ACE inhibitor, lisinopril, showed negligible impact on receptor expression or susceptibility of renal cells to infection. This study represents the first in-depth characterization of viral entry in stem cell-derived human kidney organoids with enhanced PTs, providing deeper insight into the renal implications of the ongoing COVID-19 pandemic.

Wild fish used as aquafeeds could be redirected towards human consumption to support sustainable marine resource use. Here we use mass-balance fish-in/fish-out ratio approaches to assess nutrient retention in salmon farming and identify scenarios that provide more nutrient-rich food to people. Using data on Norway’s salmon farms, our study revealed that six of nine dietary nutrients had higher yields in wild fish used for feeds, such as anchovies and mackerel, than in farmed salmon production. Reallocating one-third of food-grade wild feed fish towards direct human consumption would increase seafood production, while also retaining by-products for use as aquafeeds, thus maximizing nutrient utilization of marine resources.

We present a novel experimental concept to search for proton decay. Using paleo-detectors, ancient minerals acquired from deep underground which can hold traces of charged particles, it may be possible to conduct a search for $p \to \bar{\nu} K^+$ via the track produced at the endpoint of the kaon. Such a search is not possible on Earth due to large atmospheric-neutrino-induced backgrounds. However, the Moon offers a reprieve from this background, since the conventional component of the cosmic-ray-induced neutrino flux at the Moon is significantly suppressed due to the Moon's lack of atmosphere. For a 100 g, $10^9$ year old (100 kton$\cdot$year exposure) sample of olivine extracted from the Moon, we expect about 0.5 kaon endpoints due to neutrino backgrounds, including secondary interactions. If such a lunar paleo-detector sample can be acquired and efficiently analyzed, proton decay sensitivity exceeding $\tau_p\sim10^{34}$ years may be achieved, competitive with Super-Kamiokande's current published limit ($\tau_p>5.9\times 10^{33}$ years at 90% CL) and the projected reach of DUNE and Hyper-Kamiokande in the $p \to \bar{\nu} K^+$ channel. This concept is clearly futuristic, not least since it relies on extracting mineral samples from a few kilometers below the surface of the Moon and then efficiently scanning them for kaon endpoint induced crystal defects with sub-micron-scale resolution. However, the search for proton decay is in urgent need of a paradigm shift, and paleo-detectors could provide a promising alternative to conventional experiments., Comment: 12 pages, 4 figures

JSNS$^2$ searches for short baseline neutrino oscillations with a baseline of 24~meters and a target of 17~tonnes of the Gd-loaded liquid scintillator. The correct algorithm on the event reconstruction of events, which determines the position and energy of neutrino interactions in the detector, are essential for the physics analysis of the data from the experiment. Therefore, the performance of the event reconstruction is carefully checked with calibrations using $^{252}$Cf source. This manuscript describes the methodology and the performance of the event reconstruction.

JSNS$^2$ (J-PARC Sterile Neutrino Search at J-PARC Spallation Neutron Source) is an experiment that is searching for sterile neutrinos via the observation of $\bar{\nu}_{\mu} \rightarrow \bar{\nu}_e$ appearance oscillations using neutrinos with muon decay-at-rest. For this search, rejecting cosmic-ray-induced neutron events by Pulse Shape Discrimination (PSD) is essential because the JSNS$^2$ detector is located above ground, on the third floor of the building. We have achieved 95$\%$ rejection of neutron events while keeping 90$\%$ of signal, electron-like events using a data driven likelihood method., Comment: arXiv admin note: text overlap with arXiv:2111.07482, arXiv:2308.02722

Causal identification in causal Bayes nets (CBNs) is an important tool in causal inference allowing the derivation of interventional distributions from observational distributions where this is possible in principle. However, most existing formulations of causal identification using techniques such as d-separation and do-calculus are expressed within the mathematical language of classical probability theory on CBNs. However, there are many causal settings where probability theory and hence current causal identification techniques are inapplicable such as relational databases, dataflow programs such as hardware description languages, distributed systems and most modern machine learning algorithms. We show that this restriction can be lifted by replacing the use of classical probability theory with the alternative axiomatic foundation of symmetric monoidal categories. In this alternative axiomatization, we show how an unambiguous and clean distinction can be drawn between the general syntax of causal models and any specific semantic implementation of that causal model. This allows a purely syntactic algorithmic description of general causal identification by a translation of recent formulations of the general ID algorithm through fixing. Our description is given entirely in terms of the non-parametric ADMG structure specifying a causal model and the algebraic signature of the corresponding monoidal category, to which a sequence of manipulations is then applied so as to arrive at a modified monoidal category in which the desired, purely syntactic interventional causal model, is obtained. We use this idea to derive purely syntactic analogues of classical back-door and front-door causal adjustment, and illustrate an application to a more complex causal model., Comment: 11 pages, 2 TikZ figures

Motivated by modern data applications such as cryo-electron microscopy, the goal of classic multi-reference alignment (MRA) is to recover an unknown signal $f: \mathbb{R} \to \mathbb{R}$ from many observations that have been randomly translated and corrupted by additive noise. We consider a generalization of classic MRA where signals are also corrupted by a random scale change, i.e. dilation. We propose a novel data-driven unbiasing procedure which can recover an unbiased estimator of the bispectrum of the unknown signal, given knowledge of the dilation distribution. Lastly, we invert the recovered bispectrum to achieve full signal recovery, and validate our methodology on a set of synthetic signals.

Existing domain adaptation (DA) methods often involve pre-training on the source domain and fine-tuning on the target domain. For multi-target domain adaptation, having a dedicated/separate fine-tuned network for each target domain, that retain all the pre-trained model parameters, is prohibitively expensive. To address this limitation, we propose Convolutional Low-Rank Adaptation (ConvLoRA). ConvLoRA freezes pre-trained model weights, adds trainable low-rank decomposition matrices to convolutional layers, and backpropagates the gradient through these matrices thus greatly reducing the number of trainable parameters. To further boost adaptation, we utilize Adaptive Batch Normalization (AdaBN) which computes target-specific running statistics and use it along with ConvLoRA. Our method has fewer trainable parameters and performs better or on-par with large independent fine-tuned networks (with less than 0.9% trainable parameters of the total base model) when tested on the segmentation of Calgary-Campinas dataset containing brain MRI images. Our approach is simple, yet effective and can be applied to any deep learning-based architecture which uses convolutional and batch normalization layers. Code is available at: https://github.com/aleemsidra/ConvLoRA.

This study explores the utilization of Dermatoscopic synthetic data generated through stable diffusion models as a strategy for enhancing the robustness of machine learning model training. Synthetic data generation plays a pivotal role in mitigating challenges associated with limited labeled datasets, thereby facilitating more effective model training. In this context, we aim to incorporate enhanced data transformation techniques by extending the recent success of few-shot learning and a small amount of data representation in text-to-image latent diffusion models. The optimally tuned model is further used for rendering high-quality skin lesion synthetic data with diverse and realistic characteristics, providing a valuable supplement and diversity to the existing training data. We investigate the impact of incorporating newly generated synthetic data into the training pipeline of state-of-art machine learning models, assessing its effectiveness in enhancing model performance and generalization to unseen real-world data. Our experimental results demonstrate the efficacy of the synthetic data generated through stable diffusion models helps in improving the robustness and adaptability of end-to-end CNN and vision transformer models on two different real-world skin lesion datasets., Comment: Paper is submitted in EMBC 2024 Conference