Browse Articles

Multi-scale feature integration with enhanced cytomorph for high-accuracy cervical cytology classification

Accurate classification of cervical cytology images plays a crucial role in early detection and prevention of cervical cancer, which remains a significant global health challenge. Despite advancements in deep learning for medical image analysis, the unique characteristics of cervical cells, including subtle morphological differences and complex nuclear patterns, pose considerable challenges for automated classification systems. In this paper, we present a novel deep learning architecture specifically designed for cervical cytology image classification. Our approach integrates three key components: (1) a specialized data augmentation pipeline tailored for cytopathology images, (2) a Morphology Attention Module (MAM) that captures multi-scale cellular features with adaptive feature fusion, and (3) a Spatial-Channel Mixer (SCM) that efficiently encodes nuclear neighborhood spatial information. Extensive experiments on both the SIPaKMeD and Mendeley LBC datasets demonstrate the superior performance of our model, achieving state-of-the-art accuracy of 99.06% on the 5-class SIPaKMeD dataset and 98.55% on the Mendeley LBC dataset. Importantly, our approach reduces error rates by up to 82.5% compared to conventional CNN architectures and 61.8% compared to recent Vision Transformer approaches. The proposed architecture demonstrates robust generalization across different cell types and imaging conditions, making it a promising tool for enhancing cervical cancer screening programs. Our work contributes to the advancement of automated cytology analysis and has the potential to improve early detection of cervical abnormalities, particularly in resource-limited settings where expert cytopathologists may be scarce.

Housing ableism in finding and maintaining housing among people with disabilities: A scoping review

Background Access to safe and affordable housing is a human right; however, people with disabilities are more likely to live in inaccessible, insecure, unaffordable and poor-quality housing than people without disabilities. They often experience many forms of disability-related discrimination (ableism) in finding and maintaining adequate housing. The objective of our study was to synthesize the literature on housing ableism among people with disabilities seeking or maintaining independent housing. Methods We conducted a scoping review that involved searching six international databases that identified 10,082 studies, 52 of which met our inclusion criteria involving empirical research, without language or date restrictions, that had a sample focusing on people with disabilities, that had findings related to independent housing and ableism. We followed the best practices of scoping review methodology and applied an inductive data analysis approach. Results The studies included in the review involved 13 countries over a 47-year period. Our review identified the following findings: (1) ableism in finding and maintaining appropriate housing through renting and ownership (i.e., lack of suitable housing, barriers to accessing or viewing properties, affordability); (2) factors affecting housing ableism (i.e., lack of knowledge about the needs of people with disabilities, and intersectional factors (i.e., socio-economic status, type of disability, housing type, systemic and policy barriers); and (3) the impact of housing ableism (i.e., challenges with neighborhood environment). Conclusions Our findings highlight the extent to which people with disabilities encounter multiple forms of discrimination in trying to find suitable housing. Our review emphasizes the urgent need to reduce the ableism that people with disabilities by addressing structural barriers and prioritizing housing accessibility. Policy reforms, increased attention and investment towards accessible housing are needed for a more inclusive housing sector.

“Backed into a Corner”: Lived experiences of receiving and providing involuntary psychiatric treatment under British Columbia’s Mental Health Act

British Columbia’s Mental Health Act permits the involuntarily detention and treatment of individuals who meet specific criteria. Over the past 15 years, British Columbia has seen an increasing trend in the number of involuntary psychiatric admissions. This qualitative study explores the experiences of people receiving and providing involuntary psychiatric treatment within two health organizations in British Columbia, Canada. Five focus groups were conducted with 23 individuals who had previously received involuntary psychiatric treatment at a facility operated by one of the two health organizations. All sessions were facilitated by individuals with lived experience of involuntary psychiatric treatment. Additionally, semi-structured interviews were conducted with 11 clinical staff and 10 non-clinical support personnel involved in delivering involuntary psychiatric treatment or associated services. Data were analyzed using reflexive thematic analysis, guided by an equity-oriented care framework. Seven themes were generated, including the limited availability of voluntary care options, the compounding role of social determinants of health in mental health crises, the lack of conclusive evidence supporting involuntary psychiatric treatment, the negative impacts on both patients and providers, and the importance of peer support. Across themes, participants described involuntary psychiatric care as shaped by systemic constraints with limited access to upstream, voluntary and community-based alternatives. These findings highlight the need for system-level reform to reduce reliance on coercive practices and to expand access to voluntary, community-based mental health supports that address underlying social and structural factors contributing to mental health crises.

Understanding atypical eating behaviours in women with obsessive-compulsive disorder: A qualitative study

Atypical eating behaviours in adults with obsessive-compulsive disorder (OCD) are often overlooked or misdiagnosed, possibly due to some eating difficulties being synonymous with their associated OCD. This study explored eating experiences from the perspective of eleven females with OCD, aged between 20 and 45 years. A series of semi-structured interviews were conducted and analysed using reflexive thematic analysis. Three central themes were generated from the data: the hidden burden; the importance of control; the detrimental impact of OCD on eating. These themes encapsulated how prevalent atypical eating difficulties were among the females with OCD, often emerging in response to heightened states of emotions, the need for control and/or as a reflection of their OCD symptoms. Whilst the reported eating behaviours did not always meet the diagnostic threshold for an eating disorder, participants described them as posing significant challenges to their daily functioning, as well as negatively affecting those around them. The current findings suggest that individuals with OCD often perceive their eating behaviours to be directly associated with their OC symptoms, highlighting the need to acknowledge these challenges in clinical practice. A better understanding of the broader implications of OCD, particularly on eating behaviours, is warranted to facilitate tailored interventions and prevent additional complications associated with eating behaviours in this group.

Incidence and predictors of neonatal hyperbilirubinemia requiring phototherapy: A prospective cohort study at a tertiary hospital in Uganda

Background Neonatal hyperbilirubinemia remains a leading cause of preventable neurological impairment and death in low-resource settings, particularly in sub-Saharan Africa. Despite its burden, data on incidence and risk factors in Uganda are limited. This study aimed to determine the incidence and predictors of hyperbilirubinemia among neonates at a Ugandan referral hospital. Methods A prospective cohort study was conducted at Mubende Regional Referral Hospital from November 2024 to February 2025. A total of 539 mother-infant pairs were enrolled, with 534 completing follow-up. Neonates were followed from birth up to 7 days of life. Data on maternal and neonatal characteristics were collected through interviews and medical records. Laboratory tests included total serum bilirubin and ABO/Rh blood grouping. Modified Poisson regression was used to identify independent predictors of hyperbilirubinemia, with statistical significance set at p < 0.05. Results The risk of hyperbilirubinemia requiring phototherapy was increased by close to two times among neonates born to mothers who were underweight, overweight, or obese (based on maternal BMI during pregnancy) (aIRR = 1.703, CI = 1.082–2.680, P = 0.021; aIRR = 1.916, CI = 1.447–3.183, P < 0.001; aIRR = 1.930, CI = 1.233–3.022, P = 0.004), those from households with monthly income <200,000 UGX (aIRR = 1.798, CI = 1.306–2.477, P < 0.001), those delivered by cesarean section (aIRR = 1.835, CI = 1.291–2.610, P = 0.001), and those with premature rupture of membranes (PROM) ( aIRR = 1.538, CI = 1.109–2.132, P = 0.010). The risk of hyperbilirubinemia requiring phototherapy was increased by over two times for the preterm (aIR = 2.776, CI = 1.978–3.895, P < 0.001), those in whom feeding was initiated after 1 hour (aIRR = 2.145, CI = 1.411–3.261, P < 0.001), instrumental delivery (aIRR = 2.005, CI = 1.109–3.625, P = 0.021) and ABO incompatibility (aIRR = 2.985, CI = 2.060–4.325, P < 0.001). Conclusion 2 in 10 neonates developed hyperbilirubinemia requiring phototherapy. The condition was associated with both modifiable factors, such as delayed initiation of breastfeeding, and non-modifiable factors, including ABO incompatibility, prematurity, and mode of delivery.

Confirmation that bryozoan animals were present during the Cambrian explosion

Geriatric nutritional risk index as an independent predictor of 1-year mortality in elderly patients with hip fractures

Background Hip fractures are a major cause of morbidity and mortality in the elderly, with 1-year mortality rates up to 40%. Malnutrition is a key determinant of adverse outcomes. The Geriatric Nutritional Risk Index (GNRI), based on serum albumin and body weight, is a simple nutritional tool. This study investigated whether GNRI independently predicts 1-year mortality after hip fracture surgery beyond conventional risk factors. Methods We retrospectively analyzed 624 patients aged ≥65 years who underwent hip fracture surgery at two tertiary centers. Demographic, clinical, and perioperative data were collected. GNRI was calculated for all patients. Independent predictors of mortality were identified using logistic regression, and ROC analysis determined the optimal GNRI cut-off. Results The 1-year mortality rate was 22.3%. In univariate analysis, older age, ASA class III–IV, low albumin, low GNRI, and multiple comorbidities were significantly associated with mortality. Each 0.1 g/dL increase in albumin was associated with 26% lower odds of 1-year mortality, and each 1-point increase in GNRI was associated with 25.5% lower odds of mortality (p < 0.001). In multivariate analysis, only age, ASA classification, and GNRI remained independent predictors. ROC analysis showed excellent discrimination for GNRI (AUC: 0.928), with a cut-off of 91.45 (sensitivity 87.8%, specificity 90.3%). Patients with GNRI ≤91.45 had a markedly higher 1-year mortality (72.2% vs. 3.7%; RR: 19.32, 95% CI: 12.01–31.09). Conclusions GNRI independently predicted 1-year mortality in elderly hip fracture patients. A GNRI ≤91.45 was associated with a 19-fold higher risk, while higher scores had a protective effect, underscoring GNRI as a practical tool for perioperative risk stratification.

Newly discovered whale graveyard dates back millions of years

Exploring staff and service user experiences of personality disorder services in open prisons: A qualitative study of Pathways Enhanced Resettlement Support

Re-entering the community following a prison sentence is a critical period for rehabilitation, especially for people in prison with a likely diagnosis of personality disorder. A joint health and criminal justice initiative across England and Wales, called the Offender Personality Disorder (OPD) Pathway, aims to support individuals with a likely diagnosis of personality disorder with services across different prison and community settings. Pathways Enhanced Resettlement Services (PERS) are OPD services operating in five open prisons in England, which aim to support people at high risk of being returned to closed conditions or reoffending in the community after release. We aimed to understand how service users and staff experience PERS. We purposively selected staff and service users within male prisons to encompass a range of staff roles and current and ex-service users. We conducted semi-structured interviews with ten staff and nine service users (seven current and two ex-service users). We conducted a reflexive thematic analysis, generating three themes: (1) “A shock to the system”: this theme describes the challenges of adapting to open prison culture as a liminal space between closed conditions and the community; and understanding and accepting PERS as a service to provide support within and beyond that space. (2) “We’ve got some understanding of their journey”: This theme describes how service users felt valued by PERS support that was centred around their needs, a personalised approach that enabled the development of trusting, therapeutic relationships. (3) “Internal states can be real barriers to progression”: this theme describes how PERS staff were able to use the therapeutic relationships they developed with service users to support them to progress through their sentence. Staff and service users felt that PERS provided support to progress through open prison, largely by developing positive trusting relationships and individualised support plans.

Cost-effectiveness of semaglutide versus dulaglutide for Type 2 Diabetes in China: A Markov Model analysis

Objective From the perspective of China’s basic medical insurance, to evaluate the cost-effectiveness of semaglutide versus dulaglutide for type 2 diabetes mellitus (T2DM) in China, informing clinical and health policy decisions. Methods This study employed a Markov model to simulate the disease progression of T2DM over a 25-year time horizon. Transition probabilities between health states were sourced from the UK Prospective Diabetes Study Outcomes Model (UKPDS 82) and the SUSTAIN 7 clinical trial, while health utility values were obtained from published literature using the Chinese EQ-5D-5L value set. Long-term cost-effectiveness was projected through cohort simulation, with both one-way sensitivity analysis and probabilistic sensitivity analysis (PSA) conducted to evaluate the robustness of the model. Results After 25 years of simulation, the total cost for dulaglutide was ¥193,353.07, with 11.628 quality-adjusted life-years (QALYs) gained. The total cost for semaglutide was ¥240,925.08, yielding 11.900 QALYs. Compared with dulaglutide, semaglutide had an incremental cost-effectiveness ratio (ICER) of ¥174,904 per QALY gained, approximately twice China’s 2023 per capita GDP (¥89,358). According to the Chinese Guidelines for Pharmacoeconomic Evaluation (2020), this result falls within the economically acceptable range (1 × GDP < ICER ≤ 3 × GDP). One-way sensitivity analysis showed that although health state utility values were the most influential parameter, the model results remained robust. PSA indicated that at a willingness-to-pay (WTP) threshold of 3 times the per capita GDP (¥268,074), semaglutide had an 89.6% probability of being considered economically acceptable. Conclusion From the perspective of China’s basic medical insurance, semaglutide demonstrates cost-acceptable outcomes compared to dulaglutide in managing type 2 diabetes. This analysis provides crucial evidence for clinical decision-making and health policy formulation.

UBC/UBA52 silencing restores PINK1-Parkin-mediated mitochondrial autophagy in allergic rhinitis

Allergic rhinitis (AR) is a common chronic inflammatory disease of the upper respiratory tract, and recent studies suggest that mitochondrial dysfunction may play a role in its pathogenesis. This study aimed to identify key genes related to AR and mitochondrial autophagy through bioinformatics analysis and to verify their functional roles in vitro. Transcriptomic data from the GEO database were analyzed, and ubiquitin C (UBC) and ubiquitin A-52 residue ribosomal protein fusion product 1 (UBA52) were identified as potential genes associated with AR and mitophagy. In vitro , IL-13–stimulated human nasal epithelial cells (HNEpCs) were used to establish an AR model. RT-qPCR and Western blotting showed that UBC and UBA52 were significantly upregulated, while mitophagy-related genes PINK1 and Parkin were downregulated. Flow cytometry and TMRE staining demonstrated increased ROS levels and reduced mitochondrial membrane potential (MMP), indicating mitochondrial dysfunction. Co-immunoprecipitation confirmed an interaction between UBC and UBA52. Silencing UBC downregulated UBA52 expression, restored PINK1 and Parkin levels, decreased ROS accumulation, and improved MMP, suggesting potential reactivation of the PINK1–Parkin–mediated mitophagy pathway. These findings suggest that UBC and UBA52 may be involved in the regulation of mitophagy and contribute to mitochondrial dysfunction in AR. Targeting the UBC–UBA52 axis may provide a novel therapeutic strategy for restoring mitochondrial homeostasis in allergic inflammation.

Longitudinal association of quality of life and health behaviors with service member readiness

Background This study aimed to assess whether self-reported physical and mental health-related quality of life (HRQOL) scores could be useful indicators of military health readiness. Methods Survey data and Department of Defense administrative and medical records from 51,589 active duty Millennium Cohort Study participants across four enrollment panels (2001, 2004, 2007, 2011) were examined at baseline and 3- to 5- year follow-up endpoints. Baseline measures included HRQOL measured by the Veterans RAND 12-Item Health Survey (VR-12) mental and physical component summary scores, health behaviors (e.g., smoking, insomnia symptoms), and demographic and military covariates. Readiness outcomes measured at follow-up included health care utilization, separation status, military satisfaction, lost workdays, and non-obese body mass index (BMI). Poisson regression models with a robust error variance were used to examine the prospective relationship between HRQOL and military readiness outcomes. Results HRQOL remained a significant predictor of all five readiness outcomes after adjustment for covariates and other health behaviors. Participants with baseline physical HRQOL scores in the highest 15th percentile were more likely to meet readiness metrics (e.g., increased odds of non-obese BMI, fewer annual lost workdays, less annual health care utilization, and a higher likelihood of remaining in service or completing their service term) compared with those in the middle 70th percentile. Scoring in the lowest 15th percentile for baseline physical or mental HRQOL was associated with being less likely to meet readiness metrics 3–5 years later. Conclusion Higher physical HRQOL may be a positive indicator of military readiness, while lower physical and mental HRQOL may signal impaired readiness. Assessment of HRQOL using the VR-12 is an easy, patient-centered tool that may help military leaders identify service members needing early interventions and improve readiness and retention.

Gauging support for autonomous delivery drones powered by artificial intelligence: A public survey in Singapore

There has been emerging empirical evidence supporting the role of artificial intelligence (AI) knowledge in public support for AI. These findings stand in sharp contrast to the long-standing cognitive miser view in determining technological acceptance. In this study, by contrasting models of knowledge deficit against cognitive miser using data from a large-scale public opinion survey about autonomous delivery drones in Singapore ( N  = 1,002), we investigated whether knowledge and various heuristic cues were associated with AI support. Our results revealed that objective knowledge was not a direct determinant of support, while various heuristic cues such as propensity to trust in AI, news media attention, perceived source credibility in scientists and authorities, as well as risk and benefit perceptions presented significant associations. Mediation analyses further revealed knowledge was indirectly associated with support through heuristic cues such as source credibility perceptions as well as risk and benefit perceptions. Our findings were largely consistent with the cognitive miser model in that AI acceptance is immediately associated with cognitive heuristics rather than knowledge. Theoretical and practical implications are discussed.

Does resistance training make a difference to the quality of life or heart health for older adults compared to aerobic exercise? A systematic review protocol from The People’s Review

Background Systematic reviews bring together all the evidence on a health topic in an organised and careful way. The People’s Review aims to help the public understand what systematic reviews are and why they matter by designing and conducting their own systematic review. The question chosen for The People’s Review is: Does resistance training make a difference to quality of life and/or heart health for older adults compared to aerobic exercise? This paper outlines how we will carry out this review. Methods This is a systematic review involving the public throughout. This review will search for, include and summarise: randomised controlled trials, with older adults (50 + years), that compare resistance training (such as lifting weights) with aerobic exercise (such as walking or running), and measure quality of life or heart health. First, the technical team will search research databases to find possible studies. The public will look at summaries of these to find studies that might be relevant. Then, two members of the technical team will read the full studies and decide which ones to include. Next, the public will help collect some of the key information from the included studies. The technical team will record the rest. The public and the technical team will work together to check for biases (or flaws in how the studies were done) in the studies. Finally, if possible, the team will combine the study results using a method called meta-analysis (a way of pooling numbers together). If we can’t combine the numbers, we will write a summary of what the studies found Discussion This review will summarise all the available evidence that addresses the review question. This review could support the public to make decisions about what type of exercise to engage in as they age, and influence exercise guidelines, clinical practice and future research.

Coordinate aware implicit neural representation for UAV small object detection

Small object detection in unmanned aerial vehicle (UAV) imagery remains challenging due to low resolution, complex backgrounds, and limited pixel occupancy. Conventional CNN-based detectors rely on fixed receptive fields, which often fail to capture fine-grained spatial details and implicit geometric relationships. To address these limitations, this paper proposes a Coordinate-Aware Implicit Neural Representation Enhanced C2INR module that integrates coordinate-based representations into convolutional feature extraction. The Multi-Scale Coordinate Encoder (MSCE) constructs frequency-aware positional embeddings through sinusoidal encoding to enhance spatial continuity at multiple scales. The INR Feature Enhancer (IFE) further fuses encoded coordinates with visual features via lightweight MLP modulation, improving sensitivity to small-scale variations. Additionally, a Small Object Attention mechanism combines global context, local detail, and high-frequency cues to strengthen responses to tiny targets. Experiments on three UAV benchmarks—AI-TOD, UAVDT, and VisDrone—demonstrate consistent improvements over existing methods with minimal computational overhead. Further evaluation on PASCAL VOC verifies strong cross-domain generalization. These findings confirm that coordinate-aware implicit representation provides an effective and broadly applicable solution for improving spatial continuity, geometric fidelity, and localization precision in small-object detection.

Daily briefing: Ancient ground squirrels ate like ‘zombies of the Pleistocene’

Predictors of infant birth weights: Role of the Lebanese mediterranean diet, psychosocial factors and maternal health status

Background The Mediterranean diet (MeD) is associated with favorable pregnancy outcomes, but contribution of this dietary pattern during pregnancy with small (SGA), appropriate (AGA) and large (LGA) for gestational age births is limited. Methods For this prospective national cohort study 618 Lebanese pregnant women were recruited. Infant birth weight was categorized into SGA (n = 73), AGA (n = 447) and LGA (n = 98). Modifiers of birth weight outcomes included dietary adherence to Lebanese MeD (LMeD), trimestral and total weight gain, MAP (mean arterial pressure) and PP (pulse pressure) and psychosocial, socio-demographic, and maternal health factors. Descriptive statistics compared differences among SGA, AGA, and LGA infants. Hierarchical linear regression modeling identified determinants for birth weight categories and hierarchical logistic regression modeling was used to identify factors associated with increasing the likelihood of SGA or LGA compared to AGA births. Results Adherence to the LMeD was associated with AGA birth weights where intakes of dairy products were associated with lower normal AGA births and dried fruits with higher normal AGA births. Adherence to LMeD did not enter models for SGA or LGA but intakes of specific foods and maternal health status indicators did. For SGA infants, appropriate gestational weight gain (GWG) mitigated against a low birth weight whereas higher burghul intake in T1 and higher MAP in T2 and T3 were linked to increased SGA risk. For LGA infants, greater parity, previous macrosomia and poor sleep quality in T3, and higher intake of olive oil in T2 were associated with higher risk of a LGA birth whereas higher PP in T1 decreased the odds of a LGA birth. Conclusions Screening for family history of diabetes and macrosomia, targeting trimester-specific gestational weight gain, monitoring maternal blood pressure, pulse pressure, and sleep quality, and promoting adherence to the Lebanese Mediterranean diet are important strategies to optimize infant birth outcomes.

Correction: ESG rating disagreement and bank loan availability: Evidence from China

Mutation-dependent responses to sleep and exercise in clonal haematopoiesis

Seeking HELP beyond the pill: Women’s perceptions of informed consent for medication abortion: Mixed methods research

Informed consent is a cornerstone of patient autonomy, yet its implementation in medication abortion, especially in the context of rapidly expanding telehealth and online access, remains understudied. This study explores how informed consent is experienced by women who undergo medication abortion, focusing on the information they receive and the gaps they perceive. Using an exploratory sequential mixed methods design, we first conducted a thematic analysis of online narratives to examine how women described their experiences with information, support, and uncertainty. We then developed and administered a national survey informed by these findings to assess how women perceive the informed consent process. Thematic analysis of online narratives revealed four key patterns: women sought information about medication abortion symptoms and side effects; emotional support; urgent reassurance during the process; and clarification of the information provided. Survey results showed that concerns about fetal remains, emotional well-being, and the risk of an incomplete abortion (retained tissue) were strongly associated with women’s sense of being informed. Emotional responses also shaped these perceptions, where women who felt stressed were less likely to feel adequately informed, while those women who felt happy were more likely to report receiving sufficient information. Integration of qualitative and quantitative findings revealed consistent concerns, particularly about unanticipated symptoms, emotional distress, and the need for clearer guidance. Our results suggest that some women experience uncertainty or unmet informational needs prior to taking abortion medications, regardless of care setting. This informational gap raises the possibility of preference misalignment, whereby patients’ expectations may not fully reflect their lived experience. The findings highlight a pressing need for clearer, more comprehensive, and emotionally supportive consent practices, particularly as medication abortion becomes increasingly accessible and utilized by women. Addressing these gaps can strengthen patient-centered care and ensure that women’s choices are informed, respected, and aligned with their values.