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Purpose This study aimed to classify variation in morphology of the suprascapular nerve (SSN), suprascapular artery (SSA), and suprascapular vein (SSV) in relation to the superior transverse scapular ligament (STSL) at the suprascapular notch (SN) to evaluate the risk of vascular injury during SSN release. Methods Dissections were performed on 104 shoulders to analyze the morphology of the SSN, SSA, and SSV at the SN. The superior transverse scapular ligament (STSL) was evaluated for dimensions, ossification, and impact on SN morphology. Configurations of the nerve and vessels were categorized, and vascular injury risk was stratified as low, moderate, or high. Results The SSN passed beneath the STSL in 99% of shoulders, while the SSA and SSV configurations varied. Low vascular injury risk was identified in 82% of shoulders, moderate risk in 10.6%, and high risk in 7.4%, with female cadavers demonstrating higher risk anatomy (13.3%) compared to males (2.0%). Ossified STSLs were significantly associated with smaller SN dimensions, including reduced height and width ( p  < 0.001). Conclusion Anatomical variations at the SN play a critical role in determining the risk of vascular injury during SSN release. Surgeons should consider these morphological differences, particularly in cases involving ossified STSLs or higher-risk configurations, to optimize surgical planning. This study underscores the importance of precise anatomical knowledge for minimizing complications in suprascapular procedures at the SN.

Abstract Disclosure: O. Varlamov: None. S. Sureshchandra: None. B.M. Doratt: None. H. True: None. U. Avilla: None. C.M. McGuire: None. C. Zaro: None. T. Hodge: None. L.D. Martin: None. L. Bader: None. D.L. Takahashi: None. I. Messaoudi: None. Maternal obesity is a growing global concern, as nearly 30% of women of reproductive age have obesity in the United States. Maternal obesity is linked to pregnancy complications, including preeclampsia, a higher likelihood of cesarean delivery, postpartum hemorrhage, and infections. Additionally, it can negatively impact fetal development, increasing the risk of metabolic syndrome, obesity, and preterm birth in offspring. While studies have begun to uncover the impact of maternal obesity on the fetal immune system, the underlying mechanisms remain poorly understood. Therefore, we initiated a study involving two groups of adult rhesus macaques—lean and obese—classified by body fat content. All animals were maintained on a regular low-fat monkey chow diet. Following metabolic testing, timed mating was performed. During pregnancy, obese dams exhibited higher body fat percentage, glucose intolerance, and insulin resistance compared to lean dams. Notably, obese dams showed signs of hypoglycemia in the third trimester. Additionally, fetuses from obese dams were significantly heavier than those from lean dams. Immunological analysis revealed that maternal obesity disrupts the development of myeloid and lymphoid immune cells in the fetus. Fetal spleen monocytes from obese dams showed increased production of IL-1 and IL-6. Single-cell analysis further revealed enhanced activation of B- and T-cells, as well as an expansion of monocytes and macrophages at the expense of hematopoietic stem cells. In conclusion, maternal obesity induces a proinflammatory state, prematurely activates fetal immune cells, and disrupts the differentiation of fetal hematopoietic stem cells. These immune alterations may contribute to the increased prevalence of infections and adverse outcomes observed in offspring of obese mothers. This study underscores the importance of maintaining a healthy weight during pregnancy across various dietary regimens. Presentation: Sunday, July 13, 2025

Pregravid obesity is associated with long term immune alterations in the offspring; however, the mechanisms remain poorly defined. To address this gap, we investigated the impact of spontaneous pregravid obesity, independent of obesogenic diet, on fetal immune ontogeny in a rhesus macaque model. Using spectral flow cytometry, multiplex cytokine profiling, functional stimulation assays, and single cell RNA sequencing, we profiled immune composition, function, transcriptional profiles, and intercellular communication in umbilical cord blood as well as fetal spleen and lung. Pregravid obesity was associated with altered fetal organ growth, elevated inflammatory mediators, altered frequencies of immune cell populations, and hyperresponsiveness to stimulation by splenic and lung leukocytes. Single cell transcriptomic analyses revealed tissue specific reprogramming of innate immune cells, including heightened inflammatory, migratory, and metabolic signatures with impaired antigen presentation. Moreover, there was evidence of impaired T cell differentiation, premature effector differentiation, and B cell dysfunction. Cell-cell communication analysis identified loss of tolerogenic signaling and enhanced proinflammatory pathways across spleen and lung myeloid cells. These findings demonstrate that spontaneous pregravid obesity fundamentally reshapes fetal circulating and tissue resident immune cells, providing mechanistic insight into the increased susceptibility to infection, respiratory diseases, and immune dysregulation observed in offspring of mothers with obesity.

Alzheimer’s disease (AD) involves pathological processing of amyloid precursor protein ( APP ) into amyloid-β and microtubule associated protein Tau ( MAPT) into hyperphosphorylated Tau tangles leading to neurodegeneration. Only 5% of AD cases are familial making it difficult to predict who will develop the disease thereby hindering our ability to treat the causes of the disease. A large population who almost certainly will, are those with Down syndrome (DS), who have a 90% lifetime incidence of AD. DS is caused by trisomy of chromosome 21 resulting in three copies of APP and other AD-associated genes, like dual specificity tyrosine-phosphorylation-regulated kinase 1A ( DYRK1A ) overexpression. This implies that DYRK1a inhibitors may have therapeutic potential for DS and AD, however It is not clear how overexpression of each of these genes contributes to the pathology of each disease as well as how effective a DYRK1A inhibitor would be at suppressing any of these. To address this knowledge gap, we used Drosophila models with human Tau , human amyloid-β or fly DYRK1A ( minibrain ( mnb )) neuronal overexpression resulting in photoreceptor neuron degeneration, premature death, decreased locomotion, sleep and memory loss. DYRK1A small molecule Type 1 kinase inhibitors (DYR219 and DYR533) were effective at suppressing these disease relevant phenotypes confirming their therapeutic potential.

Transfusion thresholds for acute upper gastrointestinal bleeding are controversial. So far, only three small, underpowered studies and one single-centre trial have been done. Findings from the single-centre trial showed reduced mortality with restrictive red blood cell (RBC) transfusion. We aimed to assess whether a multicentre, cluster randomised trial is a feasible method to substantiate or refute this finding. In this pragmatic, open-label, cluster randomised feasibility trial, done in six university hospitals in the UK, we enrolled all patients aged 18 years or older with new presentations of acute upper gastrointestinal bleeding, irrespective of comorbidity, except for exsanguinating haemorrhage. We randomly assigned hospitals (1:1) with a computer-generated randomisation sequence (random permuted block size of 6, without stratification or matching) to either a restrictive (transfusion when haemoglobin concentration fell below 80 g/L) or liberal (transfusion when haemoglobin concentration fell below 100 g/L) RBC transfusion policy. Neither patients nor investigators were masked to treatment allocation. Feasibility outcomes were recruitment rate, protocol adherence, haemoglobin concentration, RBC exposure, selection bias, and information to guide design and economic evaluation of the phase 3 trial. Main exploratory clinical outcomes were further bleeding and mortality at day 28. We did analyses on all enrolled patients for whom an outcome was available. This trial is registered, ISRCTN85757829 and NCT02105532. Between Sept 3, 2012, and March 1, 2013, we enrolled 936 patients across six hospitals (403 patients in three hospitals with a restrictive policy and 533 patients in three hospitals with a liberal policy). Recruitment rate was significantly higher for the liberal than for the restrictive policy (62% vs 55%; p=0·04). Despite some baseline imbalances, Rockall and Blatchford risk scores were identical between policies. Protocol adherence was 96% (SD 10) in the restrictive policy vs 83% (25) in the liberal policy (difference 14%; 95% CI 7–21; p=0·005). Mean last recorded haemoglobin concentration was 116 (SD 24) g/L for patients on the restrictive policy and 118 (20) g/L for those on the liberal policy (difference −2·0 [95% CI −12·0 to 7·0]; p=0·50). Fewer patients received RBCs on the restrictive policy than on the liberal policy (restrictive policy 133 [33%] vs liberal policy 247 [46%]; difference −12% [95% CI −35 to 11]; p=0·23), with fewer RBC units transfused (mean 1·2 [SD 2·1] vs 1·9 [2·8]; difference −0·7 [–1·6 to 0·3]; p=0·12), although these differences were not significant. We noted no significant difference in clinical outcomes. A cluster randomised design led to rapid recruitment, high protocol adherence, separation in degree of anaemia between groups, and non-significant reduction in RBC transfusion in the restrictive policy. A large cluster randomised trial to assess the effectiveness of transfusion strategies for acute upper gastrointestinal bleeding is both feasible and essential before clinical practice guidelines change to recommend restrictive transfusion for all patients with acute upper gastrointestinal bleeding. NHS Blood and Transplant Research and Development.

Measuring plasma parameters in the upper solar corona and inner heliosphere is challenging because of the region’s weakly emissive nature and inaccessibility for most in situ observations. Radio imaging of broadened and distorted background astronomical radio sources during solar conjunction can provide unique constraints for the coronal material along the line of sight. In this study, we present radio spectral imaging observations of the Crab Nebula (Tau A) from 2024 June 9 to June 22 when it was near the Sun with a projected heliocentric distance of 5–27 solar radii, using the Owens Valley Radio Observatory’s Long Wavelength Array at multiple frequencies in the 30–80 MHz range. The imaging data reveal frequency-dependent broadening and distortion effects caused by anisotropic wave propagation through the turbulent solar corona at different distances. We analyze the brightness, size, and anisotropy of the broadened images. Our results provide detailed observations showing that the eccentricity of the unresolved source increases as the line of sight approaches the Sun, suggesting a higher anisotropic ratio of the plasma turbulence closer to the Sun. In addition, the major axis of the elongated source is consistently oriented in the direction perpendicular to the radial direction, suggesting that the turbulence-induced scattering effect is more pronounced in the direction transverse to the coronal magnetic field. Lastly, when the source undergoes large-scale refraction as the line of sight passes through a streamer, the apparent source exhibits substructures at lower frequencies. This study demonstrates that observations of celestial radio sources with lines of sight near the Sun provide a promising method for measuring turbulence parameters in the inner heliosphere.

Objectives Data on costs associated with acute upper gastrointestinal bleeding (AUGIB) are scarce. We provide estimates of UK healthcare costs, indirect costs and health-related quality of life (HRQoL) for patients presenting to hospital with AUGIB. Setting Six UK university hospitals with >20 AUGIB admissions per month, >400 adult beds, 24 h endoscopy, and on-site access to intensive care and surgery. Participants 936 patients aged ≥18 years, admitted with AUGIB, and enrolled between August 2012 and March 2013 in the TRIGGER trial of AUGIB comparing restrictive versus liberal red blood cell (RBC) transfusion thresholds. Primary and secondary outcome measures Healthcare resource use during hospitalisation and postdischarge up to 28  days, unpaid informal care, time away from paid employment and HRQoL using the EuroQol EQ-5D at 28  days were measured prospectively. National unit costs were used to value resource use. Initial in-hospital treatment costs were upscaled to a UK level. Results Mean initial in-hospital costs were £2458 (SE=£216) per patient. Inpatient bed days, endoscopy and RBC transfusions were key cost drivers. Postdischarge healthcare costs were £391 (£44) per patient. One-third of patients received unpaid informal care and the quarter in paid employment required time away from work. Mean HRQoL for survivors was 0.74. Annual initial inhospital treatment cost for all AUGIB cases in the UK was estimated to be £155.5 million, with exploratory analyses of the incremental costs of treating hospitalised patients developing AUGIB generating figures of between £143 million and £168 million. Conclusions AUGIB is a large burden for UK hospitals with inpatient stay, endoscopy and RBC transfusions as the main cost drivers. It is anticipated that this work will enable quantification of the impact of cost reduction strategies in AUGIB and will inform economic analyses of novel or existing interventions for AUGIB. Trial registration number ISRCTN85757829 and NCT02105532.

Strong solar activities are often accompanied by a variety of radio bursts. These radio bursts not only serve as valuable diagnostics of coronal and heliospheric processes but also as potential tools in space weather monitoring and forecasting. However, space weather applications call for the capability for low-latency and high-sensitivity radio burst recording and reporting, which has remained lacking. In this work, we present the development of a near-real-time radio burst recording and reporting system with the Owens Valley Radio Observatory’s Long Wavelength Array. The system directly clips data from the real-time buffer and streams it as a live real-time radio dynamic spectrogram. The spectrograms are then fed to a deep learning–based burst identification module for type III radio bursts. The identifier is built on a You Only Look Once architecture, trained by synthetic type III radio bursts generated by using a physics-based model to achieve accurate and robust detection. This system enables continuous real-time radio spectrum streaming and the automatic reporting of type III radio bursts within ∼10 s of their occurrence.

The Space Weather Around Young Suns (SWAYS) program was introduced in I. Davis et al. as a multiwavelength monitoring program for studying the activity and particle environments of nearby, young solar-type stars. The SWAYS program currently includes the Owens Valley Radio Observatory Long Wavelength Array (OVRO-LWA) operating between 13 and 87 MHz to search for stellar equivalents of solar type II and III bursts, which are associated with bulk plasma motion in the corona and interplanetary medium. These observations are accompanied by simultaneous photometric data from the high-precision optical instrument Flarescope to identify associated flare events. These two instruments have collectively acquired nearly 900 hr of data with ≈70% overlap between 2023 November through 2024 June, dedicated to six stars. Here, we present the results of this first season of the SWAYS observing campaign, which include a superflare from the star EK Draconis with no accompanying low-frequency particle flux signal. The novelty of the coordination at these specific parts of the spectrum allow us to uniquely evaluate the conditions that may have inhibited a radio detection. We find that the exceptionally hot, dense coronae of incredibly active stars may not be conducive to the development of the instabilities required for type II and III bursts, or else inspire new expectations for when we should expect to observe a signal relative to the time of the flare. This may represent the plasma–density complement to the magnetospheric limitations to observing space-weather signatures at low frequencies.

The electron density of the solar corona is a fundamental parameter in many areas of solar physics. Traditionally, routine estimates of coronal density have relied exclusively on white-light observations. However, these density estimates, obtained by inverting the white-light data, require simplifying assumptions, which may affect the robustness of the measurements. Hence, to improve the reliability of coronal density measurements, it is highly desirable to explore other complementary methods. In this study, we estimate the coronal electron densities in the middle corona, between approximately 1.7 and 3.5 R⊙, using low-frequency radio observations from the recently commissioned Long Wavelength Array at the Owens Valley Radio Observatory (OVRO-LWA). The results demonstrate consistency with those derived from white-light coronagraph data and predictions from theoretical models. We also derive a density model valid between 1.7 and 3.5 r⊙, given by ρ(r′)=1.27r′−2+29.02r′−4+71.18r′−6 , where r′=r/R⊙ , with r the heliocentric distance. OVRO-LWA is a solar-dedicated radio interferometer that provides science-ready images with low latency, making it well suited for generating regular and independent estimates of coronal densities to complement existing white-light techniques.