Browse Articles

Leveraging machine learning for enhanced and interpretable risk prediction of venous thromboembolism in acute ischemic stroke care

Background Venous thromboembolism (VTE) is a life-threatening complication commonly occurring after acute ischemic stroke (AIS), with an increased risk of mortality. Traditional risk assessment tools lack precision in predicting VTE in AIS patients due to the omission of stroke-specific factors. Methods We developed a machine learning model using clinical data from patients with acute ischemic stroke (AIS) admitted between December 2021 and December 2023. Predictive models were developed using machine learning algorithms, including Gradient Boosting Machine (GBM), Random Forest (RF), and Logistic Regression (LR). Feature selection involved stepwise logistic regression and LASSO, with SHapley Additive exPlanations (SHAP) used to enhance model interpretability. Model performance was evaluated using area under the receiver operating characteristic curve (AUC), sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Results Among the 1,632 AIS patients analyzed, 4.17% developed VTE. The GBM model achieved the highest predictive accuracy with an AUC of 0.923, outperforming other models such as Random Forest and Logistic Regression. The model demonstrated strong sensitivity (90.83%) and specificity (93.83%) in identifying high-risk patients. SHAP analysis revealed that key predictors of VTE risk included elevated D-dimer levels, premorbid mRS, and large vessel occlusion, offering clinicians valuable insights for personalized treatment decisions. Conclusion This study provides an accurate and interpretable method to predict VTE risk in patients with AIS using the GBM model, potentially improving early detection rates and reducing morbidity. Further validation is needed to assess its broader clinical applicability.

Hair cortisol as a marker of stress in mild traumatic brain injury: a challenging measure

Signalling strategies and opportunistic behaviour: Insights from dark-net markets

The emergence of social order on darknet markets presents social scientists with a unique puzzle. Because these markets operate outside of conventional regulatory frameworks, there is a lack of legitimate oversight to monitor transactions and protect users from opportunistic behaviour. While existing literature often examines the role of reputation in increasing sales, little attention has been paid to mechanisms that mitigate fraud. This study fills this gap by examining one of the largest known darknet platforms, Alphabay, which was operational from December 2014 to July 2017. Using two Generalised Additive Models (GAMs), results show that costly signals, such as a positive reputation, sellers’ seniority and escrow services, are inversely associated with fraudulent activity on darknet markets. Conversely, cheap signals, such as long product descriptions characterised by complex vocabulary and a positive tone, correlate positively with opportunistic behaviour. The study provides empirical support for signalling theory, by showing that costly signals are more difficult to fake or manipulate and can reduce fraud. Conversely, the study also demonstrates empirically that cheap signals, while potentially effective in initially generating trust among buyers, are associated with an increase in fraud and opportunistic behaviour.

Coastal business perception of coral value and payment for coral restoration

Abstract Coral reefs provide important economic benefits to coastal businesses, supporting recreation and tourism and protecting property from storms. Yet, these benefits are at risk worldwide as corals decline rapidly, and investment in restoration is lacking. With their direct dependence on coral health, coastal businesses may represent an important sector for funding coral restoration; however, it is unclear whether businesses perceive coral reef services as valuable or themselves as reef stewards. We measured business perceptions of coral health and value in Hawaiʻi and identified traits correlated with business decisions to participate in coral restoration at three payment thresholds. We found that businesses see limited economic value in coral reefs. In areas where corals provide substantial ecosystem services (flood protection, tourism revenue), businesses did not consistently rate coral value as high. Nonetheless, businesses showed strong willingness to pay for coral restoration, which was linked to pro-nature motives, reputation, and Native Hawaiian ownership. Results highlight key strategies for engaging private entities in coral restoration.

Livelihood vulnerability index: Assessment of climatic changes in flood affected areas of Mianwali district, Punjab, Pakitan

The world is facing substantial threats from climate change such as extreme weather events, floods, biodiversity loss, sea-level rise, and ecosystem degradation. The objective of this study is to assess the livelihood vulnerability index of communities in flood-prone areas, specifically investigating the reasons behind their vulnerability, their income sources, and the impact of flooding on economic activities. Pakistan is an agrarian country and known to be a climate vulnerable country, flood possess higher threat to rural livelihood. Mianwali district of Punjab, Pakistan was selected as the study area because it is among the poorest districts, and is most severely impacted district during 2010 catastrophe. The study employed qualitative methods like focus group discussions, interviews, and transect walks, alongside quantitative approaches such as the Livelihood Vulnerability Index (LVI). Primary data was collected from 200 households through structured questionnaires by applying simple random sampling technique. Results demonstrated that the overall vulnerability of the local community of Mianwali to flood was high 0.4 score (out of 5) as per Livelihood Vulnerability Index criteria. It was revealed that the exposure factor (0.424) significantly influenced vulnerability and communities had low adaptive capacity (0.077) in the face of flood hazard. While the sensitivity of Mianwali’s community to flood scored 0.088. These findings are crucial for policymakers to assess baseline causes of livelihood vulnerability and formulate adaptation for other rural communities. It can be concluded that addressing these factors effectively in planning strategies may mitigate vulnerability and increase communities’ capacity to deal with potential flooding.

Association between consumption of ultra processed foods and obesity among Jordanian children and adolescents

A riddle of culprit only vs multivessel or immediate vs staged revascularization in patients with non-ST elevation acute coronary syndrome: A meta-analysis

Background Percutaneous coronary intervention (PCI) is a revolutionary breakthrough in saving many lives from myocardial infarction. However, little is known about the PCI strategy in multivessel disease (MVD) Non-ST Elevation Acute Coronary Syndrome (NSTE-ACS) patients. Should complete revascularization be achieved or culprit-only is sufficient, then when the appropriate time of multivessel revascularization is, whether it is staged or immediate. Limited evidence is available on this matter compared to ST-elevation myocardial infarction (STEMI), even though NSTE-ACS patients carry poorer long-term prognoses compared to STEMI. Methods A thorough search for appropriate studies was executed across PubMed, Embase, Medline, Science Direct, and Scopus databases until July 4th, 2023. The risk ratio (RR) underwent analysis through Review Manager 5.4. Results Twenty-six studies with 222,350 MVD NSTE-ACS patients were included. Culprit-only revascularization was significantly related to a higher risk of non-fatal MI (RR: 1.41, 95% CI: 1.04-1.91, p = 0.03, I2: 65%) and all-repeat revascularization (RR 1.86, 95% CI 1.07-3.25, p = 0.03). While multistage multivessel revascularization was related to significantly higher all-cause mortality (RR: 1.73; 95% CI 1.43-2.10; p < 0.01; I2: 0%), TVR repeat (RR 1.38 95% CI 1.11-1.73, I2 =  18%, p = 0.004), and non-TVR repeat (RR 2.59; 95% CI 1,56-4.30; p = 0.0002; I2: 70%). Conclusion Patients with MVD NSTE-ACS treated with multivessel revascularization showed more favorable results than culprit-only. One-stage multivessel revascularization resulted in fewer adverse events than multistage. Additionally, a comprehensive and methodical prospective investigation is required to validate the factors accountable for these outcomes.

Strigolactone insensitivity affects the hormonal homeostasis in barley

Abstract In response to environmental changes, plants continuously make architectural changes in order to optimize their growth and development. The regulation of plant branching, influenced by environmental conditions and affecting hormone balance and gene expression, is crucial for agronomic purposes due to its direct correlation with yield. Strigolactones (SL), the youngest class of phytohormones, function to shape the architecture of plants by inhibiting axillary outgrowth. Barley plants harboring the mutation in the HvDWARF14 (HvD14) gene, which encodes the SL-specific receptor, produce almost twice as many tillers as wild-type (WT) Sebastian plants. Here, through hormone profiling and comparison of transcriptomic and proteomic changes between 2- and 4-week-old plants of WT and hvd14 genotypes, we elucidate a regulatory mechanism that might affect the tillering of SL-insensitive plants. The analysis showed statistically significant increased cytokinin content and decreased auxin and abscisic acid content in ‘bushy’ hvd14 compared to WT, which aligns with the commonly known actions of these hormones regarding branching regulation. Further, transcriptomic and proteomic analysis revealed a set of differentially expressed genes (DEG) and abundant proteins (DAP), among which 11.6% and 14.6% were associated with phytohormone-related processes, respectively. Bioinformatics analyses then identified a series of potential SL-dependent transcription factors (TF), which may control the differences observed in the hvd14 transcriptome and proteome. Comparison to available Arabidopsis thaliana data implicates a sub-selection of these TF as being involved in the transduction of SL signal in both monocotyledonous and dicotyledonous plants.

Clusters and associations of adverse neonatal events with adult risk of multimorbidity: A secondary analysis of birth cohort data

Objective To investigate associations between clustered adverse neonatal events and later-life multimorbidity. Design Secondary analysis of birth cohort data. Setting Prospective birth cohort study of individuals born in Britain in one week of 1970. Population Respondents provided data at birth (n = 17,196), age 34 (n = 11,261), age 38 (n = 9,665), age 42 (n = 9,840), and age 46 (n = 8,580). Methods Mixed components analysis determined included factors, ‘Birthweight’; ‘Neonatal cyanosis’; ‘Neonatal cerebral signs’; ‘Neonatal illnesses’; ‘Neonatal breathing difficulties’; and ‘Prolonged duration to establishment of respiratory rate at birth’, within the composite adverse neonatal event score. Log-binomial regression quantified the unadjusted and covariate-adjusted (paternal employment status and social class; maternal smoking status; maternal age; parity; cohort member smoking status and Body Mass Index) associations between the adverse neonatal event score and risk of multimorbidity in adulthood. Outcome measures Multimorbidity at each adult data sweep, defined as the presence of two or more Long-Term Conditions (LTCs). Results 13.7% of respondents experienced one or more adverse neonatal event(s) at birth. The percentage reporting multimorbidity increased steadily from 14.6% at age 34 to 25.5% at age 46. A significant association was only observed at the 38 years sweep; those who had experienced two or more adverse neonatal events had a 41.0% (95% CI: 1.05 – 1.88) increased risk of multimorbidity, compared to those who had not suffered any adverse neonatal events at birth. This association was maintained following adjustment for parental confounders and adult smoking status. Conclusions Adverse neonatal events at birth may be independently associated with the development of midlife multimorbidity. Programmes and policies aimed at tackling the growing public health burden of multimorbidity may also need to consider interventions to reduce adverse neonatal events at birth.

RETRACTED ARTICLE: Synthesis, antimicrobial, anti-inflammatory, antioxidant and cytotoxicity of new pyrimidine and pyrimidopyrimidine derivatives

Abstract A series of novel pyrimidine and pyrimidopyrimidine analogs were synthesized in good yield from 6-amino-4-aryl-2-oxo-pyrimidine-5-carbonitrile ( 1a-d ). The synthesized compounds were characterized using various spectral studies, including FT-IR, 1 H NMR, 13 C NMR, mass spectrometry, and elemental analysis. Newly synthesized pyrimidopyrimidines and 2-(substituted-pyrazolyl)pyrimidine derivatives were assessed in vitro for their cytotoxic activities against three cancerous cell lines: colorectal carcinoma ( HCT-116 ), mammary gland breast cancer ( MCF-7 ), and hepatocellular carcinoma ( HEPG-2 ), as well as normal fibroblasts ( W138 ). The results indicated that compounds 3b , 10b , and 10c exhibited the highest cytotoxic activities, with IC 50 values very close to those of the reference drug (doxorubicin) across all studied cancerous cell lines, while also demonstrating good safety effects on the normal human lung fibroblast cell line. Furthermore, all the synthesized compounds were examined for their antimicrobial activity against two Gram-positive bacteria ( Staphylococcus aureus and Bacillus subtilis ), one Gram negative bacterium ( Escherichia coli ) and two fungal species ( Candida albicans and Aspergillus flavus ). The antimicrobial results of the synthesized compounds, when compared with the reference drugs ampicillin and clotrimazole, revealed that compounds 3a , 3b , 3d , 4a-d , 9c and 10b exhibited excellent antimicrobial activities. Moreover, membrane stabilization or anti-hemolytic activity was employed as a method to study the in vitro anti-inflammatory activity of the prepared heterocyclic compounds. Antioxidant activities were also assessed by measuring the percentage of free radical scavenging. Compounds 4b , 10c and 11a-c demonstrated strong anti-hemolytic and antioxidant effects, which can be attributed to their ability to protect red blood cells from hemolysis.

Retraction: Does the New Rural Pension Scheme improve residents’ livelihoods? Empirical evidence from Northwestern China

First-principles investigations on the conducting photocatalytic behaviour in SrZrxGe1−xO3 (x = 1, 0.96, 0.92 and 0.88)

Diagnostic angiography for identification and management of late vascular injuries in war-related traumatic peripheral vascular injuries: A retrospective cohort study

Purpose One of the feared complications of war-related peripheral vascular injury is the development of delayed hemorrhage. This study describes our experience with an innovative protocol of surveillance diagnostic angiography to detect occult late vascular complications in an effort to prevent delayed hemorrhage. Materials and Methods This retrospective cohort study was conducted at a single level one trauma center, reviewing patients with war-related peripheral vascular injuries caused by penetrating trauma from October 7th, 2023, to January 21st, 2024. Data collected included patient demographics, primary injury characteristics, associated complications, incidence of late vascular injuries (either symptomatic or occult), means of diagnosis, treatment strategies and outcomes. Results The cohort included 41 patients with war-related peripheral vascular injuries affecting 51 limbs. All patients were male (100%) with a median age of 25 years, the majority being soldiers (85%). 24 occurrences of late vascular injuries were observed in 22 (43%) out of 51 limbs (100%). Half were symptomatic, with delayed hemorrhage occurring in 5 limbs in total (10%), and half were asymptomatic. A total of 17 surveillance diagnostic angiographies were performed with the sole indication of identifying occult late vascular injuries in asymptomatic patients, of which 4 (24%) were positive for findings. Five additional diagnostic angiographies were performed to assess late injuries discovered incidentally on imaging studies that were performed for other indications, and all were positive for late vascular injuries. Of all late vascular injuries, a total of 83% required subsequent treatment. Conclusions Late vascular injuries are a potentially lethal complication of war-related peripheral vascular injury. Aggressive surveillance with diagnostic angiography prior to discharge from a high intensity care unit can detect asymptomatic late vascular injuries, the treatment of which may prevent life-threatening hemorrhage.

Prevalence and determinants of mental distress among patients admitted in medical and surgical wards of public hospitals in South Gondar zone, Ethiopia

Argumentative style of parent-child interactions: A case study

Parent-child argumentation is a unique form of communication, as it combines persuasion, emotional exchange, and instructional dynamics shaped by contextual factors and cultural norms. To fully understand how a parent balances dialectical reasonableness with rhetorical adaptability to resolve conflicts and foster cooperation with the child within specific context, this study investigates the argumentative style of parent-child interaction within the Chinese context, focusing on the interplay of cultural values, educational goals, and argumentative practices in family interaction. Within a corpus of 20 hours of recordings of parent-child conversations concerning educational topics from 5 Chinese families, a conversation between a mother and a son during homework was selected and qualitatively analyzed, based on the framework of Argumentative Style developed from the standard model of pragma-dialectics. The findings highlight the predominant use of an engaged argumentative style in the case, which features the parent’s radiating commitment in topical selection, communality in adaptation to audience demand and inclusiveness in presentational devices. An occasional shift to a detached style was also identified, particularly when the authority figure of the teacher was invoked. The subtle balance between nurturing parental involvement and reinforcing respect for established norms is reflective of the broad Chinese cultural values that parents bear significant responsibilities for children’s academic success, and act as guides and enforcers in family education. By investigating the roles different argumentative styles play in real-life parent-child interaction, this study provides implications for developing effective communication strategies in family education and highlights the significance of culturally informed argumentative practices.

Investigation of incipient cavitation in various liquids based on PIV quantification and numerical simulations

Cold low-latitude Ordovician paleotemperatures may be in hot water

Non-customized data asset evaluation based on knowledge graph and value entropy

With the rapid expansion of non-customized data assets, developing reliable and objective methods for their valuation has become essential. However, current evaluation techniques often face challenges such as incomplete indicator systems and an over-reliance on subjective judgment. To address these issues, this study presents a structured framework comprising 17 key indicators for assessing data asset value. A neural network is employed to calculate indicator weights, which reduces subjectivity and enhances the accuracy of the assessment. Additionally, knowledge graph techniques are used to organize and visualize relationships among the indicators, providing a comprehensive evaluation view. The proposed model combines information entropy and the TOPSIS method to refine asset valuation by integrating indicator weights and performance metrics. To validate the model, it is applied to two datasets: Bitcoin market data from the past seven years and BYD stock data. The Bitcoin dataset demonstrates the model’s capability to capture market trends and assess purchasing potential, while the BYD stock dataset highlights its adaptability across diverse financial assets. The successful application of these cases confirms the model’s effectiveness in supporting data-driven asset management and pricing. This framework provides a systematic methodology for data asset valuation, offering significant theoretical and practical implications for asset pricing and management.

Effect of extended egg quiescence and elevation in carbon dioxide on life history traits of Aedes aegypti

Abstract Elevation in carbon dioxide is a global threat, driving anthropogenic climate change. How disease-vectoring mosquitoes respond to these changes is currently largely unknown. The dengue vector, Aedes aegypti, has adapted to urban environments, which are more affected by climatic changes, especially CO2. Aedes aegypti lay eggs around ephemeral water bodies that are prone to desiccation, with the pharate larvae possessing the ability to resist the desiccation, during which the permeability across the chorion is compromised. The study investigates the combined effects of elevated atmospheric CO2 and extended egg quiescence duration on life-history traits of immature and adult stages, including development rate, survival and size. Furthermore, we analysed the metabolic reserves of newly emerged females and whether mosquitoes display compensatory feeding in response to restricted reserves. Extended egg quiescence duration, combined with elevated CO2 level, differentially affected developmental duration and larval survival, with carry-over effects on adult metabolic reserves, size and survival. The interaction of elevated CO2 conditions and egg quiescence period differentially impact life-history traits of Ae. aegypti. The findings of this study provide evidential support for assertion that changing climatic conditions significantly impact survival and population dynamics, as well as feeding propensity, which directly affect the vectorial capacity of Ae. aegypti.

Spatial association of biosocial and economic factors with reproductive women obesity in urban India

Obesity creates several health complications among the urban women from reproductive age group. So far it is most ignored public health concern particularly in Indian context. The study aims to focus on the identification of cluster of districts with obese urban women and its spatial association with selected spatial determining explanatory factors.This study utilized secondary data obtained from the fifth round of the National Family Health Survey (NFHS-5), 2019-2021.The study performed spatial cluster of districts through univariate Moran’s I and its association with selected determining factors through bivariate Local Indicator of Spatial Association (BiLISA). Geographically Weighted Regression (GWR) was applied to measure the magnitude of independent factors over the space affecting the prevalence of outome of urban obese women.The spatial autocorrelation value of obesity among the urban women was found 0.429, depicting the moderate concentration of obesity coverage among the urban women over the districts of India. The results of bivariate LISA revealed that the highest bivariate Moran’ I value among all the predictors were identified for those women who had caesarean delivery (I = 0.274), followed by non-poor population (I = 0.208). The adjusted R2 value evidenced by the GWR model was 0.727 indicated that the employed explanatory variables was explaining about 73% for making influence on the prevalence of obesity among urban women of reproductive age group across the districts of India. This study recommends for an urgent need of interventions of the target areas focusing predominantly the urban women belonging from higher socio-economic status.