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Blood-Pressure Control after Intracerebral Hemorrhage — An Unbroken Glass Ceiling
An optimization method for railway alignment schemes based on game-theoretic combination weighting and an interval number model
Three Low-Dose Antihypertensive Agents in a Single Pill after Intracerebral Hemorrhage
Author Correction: Foliar application of green-synthesized Cu–Zn nanocomposites: improve physiological responses, isozymes activity, and photosynthetic traits in lead-stressed pea (Pisum sativum L.) plants
Same Pill, Different Impact — Reassessing the Efficacy of Nirmatrelvir–Ritonavir
Pre-incision structures reveal principles of DNA nucleotide excision repair
Attention-deficit/hyperactivity disorder and autism spectrum disorder in chronic pain: a study in Japanese pain centers
Abstract Chronic pain is influenced by physical and psychosocial factors and associated with symptoms of attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD); however, the specific symptom dimension related to pain severity and the underlying psychosocial pathways remain unclear. This cross-sectional screening study included 958 adult patients with persistent chronic pain despite standard care at their initial visit to multidisciplinary pain centers (Japan). Screening positivity rates were 17.1% for ADHD and 4.4% for ASD. ADHD symptoms, but not ASD symptoms, were considerably associated with higher pain intensity and extremely severe pain [average numerical rating scale score: 9–10]. Among patients with extremely severe pain, 27.4% were screened positive for ADHD. Hierarchical logistic regression analyses revealed that the association between ADHD symptoms and extremely severe pain was attenuated after adjustment for anxiety/depression and pain catastrophizing. Path analyses further indicated that ADHD symptoms were indirectly associated with severe chronic pain through anxiety/depression alone or through anxiety/depression combined with pain catastrophizing. Thus, ADHD symptoms are more strongly associated with pain severity than ASD symptoms in patients with persistent chronic pain, and emotional and cognitive factors may play a key mediating role. Screening for ADHD symptoms is crucial for comprehensive management of severe chronic pain.
Goals of Care and the Importance of Being Polish
One woman, three autoimmune diseases: CAR-T therapy vanquishes ultra-rare disease trio
Automated detection of stereotyped animal sounds using data augmentation and transfer learning
Oral Nirmatrelvir–Ritonavir for Covid-19 in Higher-Risk Outpatients
Material values, environmental attitudes, and pro-environmental behaviors among future physicians in a coastal setting
Abstract Human–environment interactions are increasingly strained by unsustainable consumption patterns shaped by cultural values and social norms. Materialism, defined as prioritizing possessions and financial success, has been consistently linked to lower environmental concern and reduced engagement in pro-environmental behaviors (PEBs). However, PEBs are not uniform: private behaviors (e.g., personal conservation) and public behaviors (e.g., advocacy, group participation) may have distinct determinants, including social visibility and status considerations. This study examined material values, environmental attitudes, and both private and public PEBs among medical students in Alexandria, a coastal Mediterranean city, using a cross-sectional survey with quota sampling. Students reported moderate materialism, high environmental attitudes, moderate private PEBs, and low public PEBs. Bivariate analyses indicated negative associations between material values (MV) and environmental attitudes and private PEBs, while public PEBs were linked to sociodemographic factors and MV. Regression models revealed that private PEBs were predicted by nationality and MV-centrality, whereas public PEBs—including environmental group membership, donations to environmental groups, and attendance of conferences on environmental issues—were differentially associated with MV orientations and cultural background. These findings highlight domain-specific determinants of environmental behavior and underscore the importance of embedding sustainability education and experiential engagement in medical curricula, tailored to diverse socio-cultural and economic contexts, to foster environmentally responsible practices among future healthcare professionals.
Balanced Fluid or 0.9% Saline in Children Treated for Septic Shock
Correction: Biotic and abiotic drivers of biomass carbon storage in peri-urban forests in Burkina Faso
Utah’s Prescription-Renewal Pilot Program — Autonomous AI Managing Patient Care
Vitexin attenuates gastric precancerous lesions with EGFR as a potential target based on network pharmacology and molecular simulations
Abstract Precancerous gastric lesions (PLGC) represent a critical transitional stage toward gastric cancer, yet effective interventions to halt progression remain limited. Vitexin, a naturally occurring flavonoid, exhibits anti-cancer potential; however, its molecular targets and mechanisms in PLGC have not been fully defined. This study aimed to elucidate the targets and mechanisms of vitexin against PLGC using an integrative strategy combining network pharmacology, molecular docking/molecular dynamics (MD), and cellular validation. Putative targets of vitexin and PLGC-associated genes were intersected to obtain 33 common targets, followed by protein–protein interaction network construction and pathway enrichment analyses. Molecular docking was performed against core targets, and MD simulations were conducted to assess the stability of the EGFR–vitexin complex. In vitro validation was carried out in MNNG-induced MC cells using cell viability, migration, and invasion assays, phase-contrast imaging, and immunofluorescence staining of EGFR and E-cadherin. Network analysis highlighted CCND1, EGFR, and ABL1 as central nodes and implicated oncogenic programs including cell-cycle regulation and PI3K–Akt signaling pathway. Docking suggested favorable binding of vitexin to the core targets. MD simulations further supported a stable binding mode of vitexin within the EGFR pocket over 100 ns with preserved global compactness; a late-stage conformational adaptation accompanied by hydrogen-bond network reorganization was observed without signs of global unfolding. Functionally, vitexin reduced MC cell viability in a dose-dependent manner, reaching ~ 50% inhibition at 20 μM, and significantly suppressed cell migration and invasion. Immunofluorescence demonstrated decreased EGFR expression and altered membrane localization, together with restored E-cadherin expression and membrane localization, suggesting a shift toward an epithelial phenotype. Vitexin inhibits PLGC-associated malignant phenotypes through multi-target modulation. Among the identified candidates, EGFR may serve as a putative and functionally relevant target, while modulation of EGFR-associated signaling together with restoration of E-cadherin may contribute to the reversal of EMT-related phenotypes. These findings provide mechanistic and structural support for the further preclinical evaluation of vitexin in preventing gastric cancer progression.
Beta-Blockers after Myocardial Infarction with Normal Ejection Fraction
Rumen bacteria, feed utilization, and milk production of Damascus goats fed different levels of azolla meal
Abstract Azolla could be a promising alternative feed as it is a rich source of nutrients and bioactive compounds that can modulate rumen microbiota and improve animal productivity. This study evaluated the effects of inclusion dietary Azolla ( Azolla pinnata ) as a partial replacement of concentrate feed mixture (CFM) on rumen bacteria, nutrient digestibility, and milk production in lactating Damascus goats. Thirty-two goats were assigned to four groups (n = 8): a control group (C), A10, A20, and A30 to receive 0, 10%, 20%, and 30% of Azolla as a replacement of CFM, respectively. Microbial diversity increased in Azolla-fed goats, with enrichment of phylum Firmicutes in Azolla-supplemented groups C=13.36%, A10= 31.09%, A20= 25.15%, and A30= 29.85%. Fiber-degrading bacterial genera such as Prevotella , Ruminococcus , and Christensenellaceae R-7 group . .Crude protein digestibility was declined in supplemented groups and was found in order 74.76>69.11>68.24>63.93 %. Total volatile fatty acids (TVFA) and the concentration of acetate, propionate, and butyrate were higher in supplemented groups (p < 0.01). Fat-corrected milk (FCM) was higher in A20 (1139 mL/head) compared to other groups (C=992, A10=1050, A30=888 mL/head and feed efficiency followed the same trend (p < 0.05). Azolla could replace 20% of CFM in goats’ diet, and it is a viable alternative feed resource, particularly under challenges associated with the availability of conventional concentrate mixtures.