University of Tennessee at Chattanooga

The figure of Saint Gallus, ostensibly the eponymous founder of Saint-Gallen, was the subject of much hagiographical treatment in the late Merovingian and early Carolingian periods. No fewer than four hagiographical texts were produced by individuals ensconced in communities that commemorated him. This process, called recently réécriture , permitted authors in iteration to employ the same basic narrative to a variety of ends. The anonymous Vita vetustissima (before 771), Wetti’s Vita Galli (before 824), Wahalfrid’s Vita Galli (833/34), and the anonymous Vita metrica Galli (between 833/34 and 837) each preserved accounts of Gallus’ career and posthumous events attributed to his intercession. Reading in parallel four episodes shared between these four texts allows us to see the various ways authors chose to frame their subject and allows us to imagine the authorial ambition of their composers. This chain of custody for the Gallus materials responded to concerns about institutional integrity, facilities, and ecclesiology by occasioning new compositions at key moments, such as moments of investment, license, and donation. It also reveals the generic conventions used by its authors to achieve their authorial ambition. The Vita vetustissima treats Gallus as a conventional late antique holy man; Wetti’s text was intended for lectionary purposes; Walahfrid’s text was encyclopedic in nature; and the Vita metrica , an ‘institutional Aeneid ,’ advances Gallus as a holy hero suited to secular letters. Principally, Abbot Gozbert (r. 816–37) stewarded this process as an exercise in community-building.

Freshwater turtles are highly diverse in the southeastern United States, yet few studies document how diversity is distributed in agricultural and rural landscapes. Furthermore, most previous work did not compare distributions between pond and river habitats with potential differences in selective pressures. We surveyed 64 sites in the Mississippi embayment and evaluated how surrounding land use, road density, and habitat type affected species' occupancy with a focus on Macrochelys temminckii. We observed that turtles were less likely to occur in locations surrounded by high road density. We observed variation in species' responses to agricultural land‐use that partially depended on preferences for lotic habitat. M. temminckii were rare and negatively affected by road density and unassociated with agricultural land‐use. Variation among species can likely be attributed to differences in species traits, but more studies evaluating land‐use effects on species occupying lentic versus lotic habitats could create more effective conservation strategies.

Parental care behavior affects parental and offspring fitness. In fish species, parental care is most often provided by the male if some form of care is provided, yet details of parental behavior remain undescribed in many fish species. Parental care was observed under laboratory conditions and formally described for the first time in the redhead goby (Elacatinus puncticulatus). An ethogram was constructed with the behavioral units gathered from video recordings of males caring at their nests. Parental care in the redhead goby was similar to behaviors documented in other gobies and included fanning, guarding, inspection, and rubbing of eggs. In contrast to most other gobies, redhead goby fathers engage in a brief form of post-hatching parental care. Specifically, parental males help larvae leave the nest after hatching. This study is the first to report this behavior in this species, and in general, post-hatching paternal care is relatively rare in fishes. Additionally, we found that guarding and fanning were the most frequent forms of care in the redhead goby, and inspection and larvae release occurred relatively infrequently. Guarding was invariant across days, whereas fanning increased significantly when eggs were closer to hatching.

Theoretical and some empirical evidence suggest that the population dynamics of cooperative breeders (i.e. species with groups including non‐reproductive individuals that raise the offspring of dominant breeders) are more likely to exhibit Allee effects at the level of social groups rather than at the population level. However, the extent to which these population dynamics are similar in species where breeding is plural, and group members communally rear their offspring remains unclear. Such species may still be subject to demographic Allee effects at the population‐level. Using a 15‐year dataset, we examined population and group‐level dynamics of communal rearing and colonial Octodon degus to determine whether population‐ and group‐level Allee effects influence population dynamics. We tested whether these effects are contingent on food availability, and whether group size is decoupled from population density, that is implying group‐level but not population‐level Allee effects. We recorded (i) population‐level Allee effects on per capita population growth rate (i.e. demographic) and on per female fecundity rate (i.e. component), (ii) no group‐level Allee effects on group per female fecundity, and (iii) that Allee effects detected are more likely whenever food availability is scarce. We further verified that group size is coupled to population density (iv). Our study highlighted how food‐mediated cooperation through a colonial setting underlies Allee effects at the population level, and that group‐living does not buffer degus against population‐level Allee effects. Thus, our findings provide a plausible mechanism underpinning the risk of local extinction in these rodents and potentially in other plurally breeding and colonial species.

The use of arthroscopy of the hand and wrist has recently increased sharply in the elective setting and this, not surprisingly, has been followed by an increasing use in the trauma setting. Advocates for the use of arthroscopy in these patients cite the improved assessment of the displacement and reduction of fractures and the early diagnosis of associated injuries, while others temper this with concerns about increased operating time and possible complications. The data relating to patient-reported benefits and costs are limited. The aim of this review was to discuss the current available literature for the use of arthroscopy in the management of injuries of the hand and wrist. Cite this article: Bone Joint J 2025;107-B(3):291–295.

INTRODUCTION Ventilator-associated pneumonia occurs in 20% to 25% of intubated trauma patients, and early effective antibiotic treatment decreases morbidity and mortality. We sought to determine the sensitivity and specificity of multiplex polymerase chain reaction amplification of bacterial DNA (Biofire FilmArray Pneumonia Panel [BFPP]) obtained during fiberoptic bronchoscopy in predicting the causative bacteria the day of bronchoalveolar lavage (BAL). METHODS This diagnostic accuracy study compared results of BAL with quantitative culture and BFPP testing on all intubated trauma and surgery patients suspected of developing pneumonia. Demographics, clinical data, BAL culture results, and BFPP results were recorded. McNemar analysis was performed. RESULTS Over a 3-year study period, 151 intubated surgical critical care patients suspected of developing pneumonia underwent 238 BALs with quantitative culture and BFPP testing. Bronchoalveolar lavages that had ≥10 ⁵ colony-forming units/mL growth were considered consistent with the diagnosis of pneumonia. Of the 238 BALs, 82 (34.5%) were considered positive and then correlated to the genomic copy number per milliliter (GCN/mL) reported by BFPP testing. CONCLUSION In ventilated patients with high clinical suspicion for pneumonia, a BFPP cutoff value of 10 ⁶ GCN/mL is a sensitive and specific test for initiating antibiotics targeted to the identified organism(s). In addition, a negative BFPP result may limit unnecessary and potentially harmful empiric antibiotic coverage, as its negative predictive value is 99.8%. LEVEL OF EVIDENCE Guide Clinical Decision-making, Health Policies, and Preventive Strategies; Level III.

Background Stroke is the leading cause of adult disability worldwide, with approximately 30% of strokes remaining cryptogenic. One potential important etiology is a patent foramen ovale (PFO), which may contribute to stroke through paradoxical thromboembolism or in situ thromboembolus formation. Recent advancements in robot-assisted transcranial Doppler (raTCD) have shown increased sensitivity in detecting right-to-left shunt (RLS) compared to transthoracic echocardiography (TTE), particularly in detecting the large shunts which are associated with higher stroke risk. Methods We conducted a retrospective quality improvement project at our regional stroke center to compare the performance of TTE and raTCD in identifying RLS in ischemic stroke patients. The study involved 148 patients admitted between February 2021 and February 2023. All patients underwent TTE and raTCD with agitated saline bubble contrast, with additional transesophageal echocardiography (TEE) at the treatment team’s discretion. The primary metrics analyzed included differences in overall RLS detection and large RLS detection rates for raTCD, TTE and TEE. Results raTCD detected RLS in 60.1% of patients compared to 37.2% with TTE (p < 0.001), with a 42.6% detection rate for large shunts on raTCD versus 23.0% on TTE (p < 0.001). The sensitivity and specificity of raTCD were 92 and 87.5%, respectively, compared to 78.57 and 71.43% for TTE, using TEE as the gold standard. Nine patients underwent PFO closure, all correctly identified with large shunts by raTCD, while TTE missed or underestimated the PFO size in 44% of the cases. Conclusion raTCD significantly outperforms TTE in detecting RLS and large shunts, suggesting its integration into standard PFO workup protocols may enhance secondary stroke prevention. These findings support the adoption of raTCD as a complementary diagnostic tool alongside TTE and TEE for more accurate PFO detection and risk stratification.

The aim of this paper is to study the oscillatory behavior of solutions of neutral second‐order noncanonical delay differential equations whose neutral terms contain both a sublinear and a superlinear part. The authors obtain some simple oscillation criteria that are new and complement existing results in the literature. Examples are provided to illustrate the main results.

Robust autonomous navigation systems rely on mapping, locomotion, path planning, and localization factors. Localization, one of the most essential factors of navigation, is a crucial requirement for a mobile robot because it needs the capability to localize itself in the environment. Global Positioning Systems (GPSs) are commonly used for outdoor mobile robot localization tasks. However, various environmental circumstances, such as high-rise buildings and trees, affect GPS signal quality, which leads to reduced precision or complete signal blockage. This study proposes a visual-based localization system for outdoor mobile robots in crowded urban environments. The proposed system comprises three steps. The first step is to detect the text in urban areas using the “Efficient and Accurate Scene Text Detector (EAST)” algorithm. Then, EasyOCR was applied to the detected text for the recognition phase to extract text from images that were obtained from EAST. The results from text detection and recognition algorithms were enhanced by applying post-processing and word similarity algorithms. In the second step, once the text detection and recognition process is completed, the recognized word (label/tag) is sent to the Places API in order to return the recognized word’s coordinates that are passed within the specified radius. Parallely, points of interest (POI) data are collected for a defined area by a certain radius while the robot has an accurate internet connection. The proposed system was tested in three distinct urban areas by creating five scenarios under different lighting conditions, such as morning and evening, using the outdoor delivery robot utilized in this study. In the case studies, it has been shown that the proposed system provides a low error of around 4 m for localization tasks. Compared to existing works, the proposed system consistently outperforms all other approaches using just one sensor. The results indicate the efficacy of the proposed system for localization tasks in environments where GPS signals are limited or completely blocked.

This study traces the development of US policy toward and narrative on Iran in the first decade after the 1978–79 Iranian revolution. It examines how the Islamic Revolutionary Guard Corps and the Iran‐Iraq War (1980–88) were portrayed in the mainstream English‐language (primarily American) news media, based on an analysis of nearly 1,200 reports. It argues that the narrative constructed by policymakers and the press significantly impacted US‐Iran relations, and this established patterns of discourse and action that have persisted to this day. This process helped solidify the official and popular conception of Iran as a dangerous threat antithetical to US values and interests, necessitating a policy of enmity and confrontation.

Timely diagnosis of SARS-CoV-2 is important for infection control and treatment. Real-time reverse transcriptase PCR (rRT-PCR) tests are the reference standard for diagnosis but often require a centralized laboratory, making them time-intensive and unsuitable for resource-limited settings. The Abbott ID NOW™ COVID-19 2.0 assay is a rapid point-of-care (POC), isothermal molecular test for qualitative detection of SARS-CoV-2. We prospectively evaluated its clinical performance against three reference rRT-PCR tests: Hologic Panther Fusion, Roche Cobas, and CDC 2019-nCoV RT-PCR Diagnostic Panel. Investigators enrolled 3,530 subjects, with 3,146 evaluable. In symptomatic subjects (n = 914), the test showed a positive percent agreement (PPA) of 91.7% (95% confidence interval [CI]: 87.8, 94.4) and a negative percent agreement (NPA) of 98.4% (95% CI: 97.1, 99.1). The PPA improved with lower cycle threshold (Ct) values: 94.7% (95% CI: 91.2, 97.2) for Ct ≤36, 97.6% (95% CI: 94.5, 99.2) for Ct ≤33, and 99.4% (95% CI: 96.8, 100.0) for Ct ≤30. Discordant results were observed among the three reference rRT-PCR tests across evaluable subjects with suspected COVID-19 infection. For 1,630 cases of symptomatic and asymptomatic subjects suspected of COVID-19, where all three rRT-PCR methods were evaluable, CDC test results differed the most, with 144 discordant results with Roche and 119 with Panther rRT-PCR tests. Roche and Panther test results differed in 67 cases. In summary, the Abbott ID NOW™ COVID-19 2.0 assay can serve as a valuable diagnostic tool in acute symptomatic subjects in point-of-care settings. IMPORTANCE The Abbott ID NOWTM COVID-19 2.0 assay is a suitable rapid test for diagnosing COVID-19 in acute symptomatic subjects and can be used in point-of-care settings and low-resource settings. With results reported in 12 minutes or less, Abbott ID NOWTM COVID-19 2.0 facilitates timely diagnosis, enabling linkage to appropriate antiviral medication.

549 Background: In the phase 2 LITESPARK-003 study (NCT03634540), belzutifan plus cabozantinib showed antitumor activity in patients with advanced ccRCC who were treatment-naive (cohort 1) or previously treated (cohort 2). We present updated results from cohorts 1 and 2 with a median follow-up of 34.4 months and 49.9 months, respectively. Methods: Eligible patients had advanced or metastatic ccRCC and ECOG performance status of 0 or 1. Cohort 1 included patients with no prior systemic therapy. Cohort 2 included patients who had received prior immunotherapy and ≤2 systemic regimens. Starting doses for patients in both cohorts were belzutifan 120 mg PO QD + cabozantinib 60 mg PO QD. The primary end point was ORR per RECIST v1.1 by investigator assessment. Secondary end points included DOR, PFS, OS, and safety. Results: 50 patients were enrolled and treated in cohort 1 and 52 patients in cohort 2. Confirmed ORR was 70% (95% CI, 55-82; 6 CRs, 29 PRs) in cohort 1 and 31% (95% CI, 19-45; 2 CRs, 14 PRs) in cohort 2. In cohort 2, ORR was 32% (95% CI, 16-52; 1 CR, 8 PRs) in patients who received prior immunotherapy only (n = 28) and 29% (95% CI, 13-51; 1 CR, 6 PRs) in patients who received both prior immunotherapy and anti-VEGFR TKIs (n = 24). ORR by IMDC risk and baseline tumor burden subgroups is shown in the Table. Median DOR was 29.1 months (range, 1.9+ to 47.4; + indicates ongoing response at the last assessment) in cohort 1 and 30.4 months (range, 4.2+ to 45.6) in cohort 2. An estimated 62% of responders in cohort 1 and 52% in cohort 2 remained in response for ≥24 months. Median PFS was 30.3 months (95% CI, 19.4-not reached) in cohort 1 and 13.8 mo (95% CI, 9.2-19.4) in cohort 2. Median OS has not been reached in cohort 1 and was 26.7 months (95% CI, 20.0-41.1) in cohort 2. Overall, 27 (54%) patients in cohort 1 and 34 (65%) patients in cohort 2 had a grade 3 or higher treatment-related adverse event (TRAE). No patients died due to a TRAE in cohort 1 and 1 patient (2%) died due to treatment-related respiratory failure in cohort 2. Conclusions: With updated follow-up,belzutifan plus cabozantinib showed durable antitumor activity in both frontline and subsequent-line treatment of patients with RCC and a safety profile consistent with prior reports. These results support further investigation of a HIF-2α inhibitor in combination with a VEGFR-TKI as a treatment option for advanced ccRCC in both settings. Clinical trial information: NCT03634540 . Cohort 1 Cohort 2 IMDC risk category Favorable n = 33ORR, 73% (95% CI, 54-87); 5 CRs, 19 PRs n = 9ORR, 67% (95% CI, 30-93); 1 CR, 5 PRs Intermediate or poor n = 17ORR, 65% (95% CI, 38-86); 1 CR, 10 PRs n = 43ORR, 23% (95% CI, 12-39); 1 CR, 9 PRs Baseline tumor burden a Low (< median) n = 25ORR, 80% (95% CI, 59-93);3 CRs, 17 PRs n = 26ORR, 27% (95% CI, 12-48); 2 CRs, 5 PRs High (≥ median) n = 25ORR, 60% (95% CI, 39-79); 3 CRs, 12 PRs n = 26ORR, 35% (95% CI, 17-56); 0 CRs, 9 PRs a Based on the sum of diameter of the target lesions at baseline.