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Real‑world analysis of Macular Oedema associated with Paclitaxel Formulations using the Japanese Adverse Drug Event Report database
Aim This study explored the potential association between paclitaxel (PTX) and macular oedema (ME), a rare adverse event, through pharmacovigilance analysis using a large-scale spontaneous reporting database. Methods Disproportionality analysis of ME associated with PTX formulations, including nanoparticle albumin-bound PTX (nab‑PTX) was conducted using the Japanese Adverse Drug Event Report database on data collected during April 2004–June 2025. Multivariable logistic regression analysis was used to estimate adjusted reporting odds ratios (RORs) for ME. A positive signal was defined as a lower 95% confidence interval (CI) for the ROR exceeding 1.0 with at least three ME cases. Results Among 585,738 reports, 123 involved ME. A significant signal was observed for overall PTX (adjusted ROR: 19.5; 95% CI: 13.5–28.3). By formulation, significant signals were identified for conventional PTX (adjusted ROR: 9.4; 95% CI: 5.5–16.1) and nab‑PTX (adjusted ROR: 47.0; 95% CI: 30.4–72.8). Multivariable logistic regression indicated significant signals for diabetes mellitus (adjusted ROR: 1.8; 95% CI: 1.2–2.9) and co-administration of prostaglandin analogue eye drops (adjusted ROR: 19.9; 95% CI: 8.6–45.7). Conclusion PTX formulations were associated with an increased reporting signal of ME. Notably, patients with diabetes mellitus and those using prostaglandin analogue eye drops may require closer ophthalmologic monitoring during PTX therapy.
A comparative analysis of readability, quality, and reliability in large language model outputs pertaining to knee osteoarthritis queries
This study aims to comparatively examine the readability, accuracy, and quality of responses provided by artificial intelligence (AI)-based chatbots such as Perplexity, ChatGPT-5, and Gemini to questions about knee osteoarthritis (KOA), which accounts for approximately four-fifths of the global osteoarthritis (OA) burden. In this study, 8 keywords were determined by excluding repetitive, irrelevant or synonymous ones from the 25 most frequently used English keywords associated with KOA based on Google Trends data, and these terms were asked as questions to three different artificial intelligence-based chatbots. The study measured readability using formulas like Coleman-Liau Index (CLI), Automated Readability Index (ARI), and Linsear Write (LW). Reliability of the information was assessed using the Journal of the American Medical Association (JAMA) benchmarks along with the modified DISCERN instrument. To determine overall content quality, the Global Quality Score (GQS) and the Ensuring Quality Information for Patients (EQIP) scale were applied. Together, these tools provided a comprehensive assessment of how understandable, reliable, and high-quality each chatbot’s responses were. The most frequently searched keywords related to OA were “osteoarthritis of knee,” “knee pain,” and “osteoarthritis knee pain.” A readability analysis of responses from three different AI-based chat systems revealed that all platforms had text levels above the Grade 6 threshold, and this difference was statistically significant (p < 0.05). Comparisons demonstrated that ChatGPT-5 produced the most readable content (FRES:45, GFOG:11.9, FKGL:9.24, CLI:14.03, SMOG:8.37, ARI:11.37, LW:7.2). However, Perplexity achieved significantly higher scores than ChatGPT-5 across all quality and reliability assessments, yielding superior median scores (DISCERN: 4, JAMA: 2, GQS: 4, EQIP: 92.8). Perplexity also outperformed Gemini in the mDISCERN reliability assessment (p = 0.001), while no significant difference in quality or reliability was found between Gemini and ChatGPT-5. No statistically significant difference was found between Gemini and ChatGPT in reliability and quality surveys. This analysis of KOA highlights significant challenges regarding the potential of popular AI chatbots for patient information. When examining readability levels, responses from these tools consistently exceed the recommended comprehensibility threshold, making it difficult for patients to absorb critical information. Furthermore, the relatively low scores recorded in reliability and content quality assessments raise significant concerns about the scientific validity and integrity of the medical information presented. Given these findings, the sufficient quality, robustness, and appropriate levels of understandability of future AI-based tools can only be ensured by the establishment and operation of an effective oversight mechanism.
Neck circumference as an anthropometric marker of overweight among school-aged children in Bharatpur, Nepal: A community-based study
Background Childhood overweight have become a major public health concern among children in developing countries. BMI, commonly used to diagnose overweight, requires standardized equipment and trained personnel, limiting their feasibility in large-scale screenings. Neck circumference (NC) has emerged as a simple and practical alternative for identifying overweight in children. This study aimed to examine the association between NC and established anthropometric indicators and to determine optimal NC cutoff values for identifying overweight among school-aged children. Methods A community-based descriptive cross-sectional study was conducted from July to October 2025 among 300 apparently healthy children aged 6–11 years in Ward No. 16, Bharatpur Metropolitan City, Nepal. Sociodemographic data were collected using structured interviews. Anthropometric measurements including height, weight, NC, waist circumference (WC), and hip circumference (HC) were obtained using standardized procedures. BMI-for-age classifications were based on WHO AnthroPlus growth references. Chi square test, pearson correlation, logistic regression, and receiver operating characteristic (ROC) curve analyses were performed using SPSS version 16. Statistical significance was set at p < 0.05. Results Among the 300 children, 48.3% had normal BMI-for-age, 10.3% were overweight and 41.3% were underweight. Chi square test revealed a statistically significant association between neck circumference and BMI-for-age (p < 0.001). Pearson correlation analysis demonstrated strong positive correlations between NC and weight (r = 0.792), height (r = 0.639), BMI (r = 0.723), waist circumference (r = 0.797), and hip circumference (r = 0.734) (p < 0.001 for all). ROC curve analysis indicated excellent diagnostic accuracy of NC for identifying overweight. The optimal cutoff values were 27.75 cm for boys (AUC = 0.884; sensitivity = 88.9%; specificity = 66.2%) and 26.75 cm for girls (AUC = 0.904; sensitivity = 100%; specificity = 69.4%). The overall cutoff value was 27.25 cm (AUC = 0.883; sensitivity = 80.6%; specificity = 74.3%). Multivariable logistic regression analysis confirmed NC had a statistically significant positive association with overweight with COR 12.077 (4.75–30.67) and AOR 20.817 (6.34–68.29). Conclusions Neck circumference is significantly correlated with established anthropometric indicators and demonstrates diagnostic accuracy for identifying overweight among school-aged children. NC measurement is a simple, reliable, and cost-effective screening tool that may be particularly useful in school-based and resource-limited settings.
Temptation as a key driver between affective states and usage outcomes of problematic usage of the Internet: A 14-day ambulatory assessment study
Theoretical models of problematic usage of the Internet (PUI) assume that stress and negative mood can trigger cravings and desires as central drivers to use certain online applications that are expected to provide pleasure and relief, which increases the likelihood of use. Learning and reinforcement mechanisms can result in increased and uncontrolled Internet use, that manifests itself in the form of, for example, neglecting important areas of life like relationships or work. To test these associations in a natural environment, we conducted a 14-day ambulatory end-of-day assessment together with a diagnostic interview at baseline to identify different severity levels of PUI. The sample (N = 900) was part of a multi-center study (FOR2974) including participants who engaged in at least one of the following online activities: gaming, pornography use, social network use, or buying-shopping in either a non-problematic ( n = 419), risky ( n = 242), or pathological ( n = 239) way. The adherence rate was about 88%. The data were analyzed using ANOVAs, generalized linear mixed modeling (GLMM), and multigroup multilevel structural equation modeling (MG-ML-SEM). In participants experiencing more severe PUI, ANOVAs revealed greater neglect of other areas of life ( f = 0.531), longer use times ( f = 0.442), and more stress ( f = 0.220–0.248) as well as worse mood in daily life ( f = 0.220–0.237). Overall, the variables and random effects in the GLMM explained R² conditional = 79.9% ( R² marginal = 22.6%) of variance in the prediction of daily usage with temptation as primary within-person effect ( OR =2.53) and PUI severity as between-person effect ( OR = 0.41 to 11.33) being the main predictors. Results of the MG-ML-SEM indicate that pleasure and relief are reinforcing factors for continued use of the Internet with temptation as the central main driver (strongest effect sizes), as theoretically expected. With the extensive sample, the longitudinal approach, and the robust statistical methods, it shows that assumptions of common theoretical models for PUI can also be found in everyday life.
Muscle activity and airflow dynamics upon gradual weight-gain volumetric enlargement or acute surgical reduction of the tongue base during chewing and swallowing
We aimed to understand changes in activity of oropharyngeal muscles and respiratory airflow during chewing and swallowing in two clinically important conditions: gradual weight-gain volumetric enlargement and acute surgical reduction of the tongue base. Six same-sex sibling pairs of 8-to-9-month-old Yucatan minipigs, 3-each-sex, were studied. Of each pair one was fed with high-calorie pellets to reach obesity with a BMI > 50 (enlargement group), and the other was normal-weighted (BMI < 38) and underwent surgical volumetric reduction of the tongue base (reduction group). Electromyograms (EMG) of the tongue (genioglossus and styloglossus), palatal (tensor veli palatini and levator veli palatini), hyoid/pharyngeal (thyrohyoid and middle pharyngeal constrictor), and jaw (masseter and digastric) muscles were recorded simultaneously with respiratory airflow monitoring and x-ray videofluoroscopy during unrestrained feeding of pellets mixed with barium-sulfate. Videofluoroscopic images and activity-bursts of the digastric and thyrohyoid muscles were references to detect chewing cycles and swallowing episodes. Recording sessions for both groups occurred at baseline (before surgery in reduction group), and weeks 1, 3, and 5 (after surgery in reduction group). EMG activity amplitudes, burst-durations, onsets (timings of muscle activity), and respiratory airflow were evaluated. Altered chewing EMG included delayed onsets of the tensor veli palatini and styloglossus in both groups at weeks 1, 3, and 5 compared to the baseline (p < 0.05). In addition, the activity amplitudes of the styloglossus and masseter muscles in the enlargement group were higher in comparison to those of the reduction group (p < 0.05). Effects on swallowing involved delayed timings of the palatal and tongue muscle activities in the reduction group with potential impaired swallowing after surgery. The enlargement group was susceptible to breathing alterations evidenced by decreased airflow velocity, airflow pressure and tidal volumes in comparison to those of the reduction group (p < 0.05). These findings reveal adaptations to ensure synchronized feeding and respiration under volumetric alterations of the tongue base, with risks of impaired swallowing and respiratory patency.
Morphology and articular configuration of the ceratopsid (Dinosauria: Ornithischia) lower hindlimb as revealed by a specimen from the Upper Cretaceous Dinosaur Park Formation of southern Alberta, Canada
Ceratopsid dinosaurs, such as Triceratops , are well-known for the striking horns and frills that are ubiquitous among members of the clade. But their postcranium has received little attention by comparison. Many questions persist regarding surprisingly fundamental aspects of the anatomy of the distal part of the hindlimb, such as the proper configuration of the metatarsals and the number and position of the distal tarsals. Here we use a taxonomically indeterminate but nearly complete lower hindlimb of a ceratopsid from the Upper Cretaceous Dinosaur Park Formation of southern Alberta, Canada, originally collected more than a century ago but never previously described, to address some of these uncertainties. The bones were CT scanned and segmented to create digital models that were then positioned based on morphological fit and comparisons with articulated specimens to establish the most plausible arrangement of the lower hindlimb elements. Proximally, the fibula articulated with the posterior surface of the laterally directed cnemial crest of the tibia and the lateral surface of the lateral condyle. The only distal tarsals present, distal tarsals III and IV, articulated with the proximal ends of the corresponding metatarsals, and their proximal surfaces were likely convex and concave, respectively. The metatarsals were closely appressed to one another throughout their lengths. The phalanges are asymmetric in varying ways and to varying degrees. Unguals of some ceratopsids have a visible shelf between the shaft and blade on the posterior side, while others, including the specimen described here, do not. The anatomical and arthrological insights obtained in this investigation of the distal part of the ceratopsid hindlimb will inform future biomechanical studies and contribute to comparisons of crural and pedal osteology among various ceratopsid taxa.
Barycentric rational interpolation collocation method for solving two-dimensional linear and nonlinear integro-differential equations
Barycentric rational interpolation is characterized by excellent numerical stability, high approximation accuracy, and strong adaptability to node distribution. In this paper, we propose a high-precision barycentric rational interpolation collocation method to provide approximate solutions for both linear and nonlinear two-dimensional integro-differential equations (2D-IDEs) subject to specified boundary conditions. Firstly, the discrete scheme for 2D-IDEs is derived by employing the two-dimensional barycentric rational interpolation formula and the two-dimensional Gauss-Legendre numerical integration formula. Then, the error estimation of the approximate solution and the convergence of the method are analyzed. Finally, numerical examples are provided to validate the effectiveness and accuracy of the proposed method.
Use of a hypercaloric and hyperprotein supplement enriched with immunonutrients in multi-pathological malnourished patients to improve the incidence and prevalence of pressure sores: A randomized controlled trial
Background Predisposing factors for the development of pressure-related injuries (PRIs) include the presence of chronic diseases, polypharmacy, immobility and malnutrition. Nutrients such as arginine play an essential role in wound healing. Methods and findings A single-blind randomized controlled trial was carried out. Intervention group received a complete hyperproteic and hypercaloric oral nutritional supplement with a fiber mixture enriched in omega 3, L-arginine and nucleotides, providing vitamin C and Zinc, and the control group received a hyperproteic and hypercaloric oral nutritional supplement with fiber mixture. Results Descriptive analysis indicated a lower frequency of PRIs at 15 and 30 days in the Atémpero ® group compared to the control group, although these differences did not reach statistical significance. However, both improved at the end of the study. In addition, the high risk decreased in both groups, with a higher decrease in the Atémpero ® group (72.5% vs 40.9%), as well as the categorization and parameters of the PUSH scale, with a reduction of the same in the Atémpero ® group. Conclusions While statistical significance was not achieved, the observed trends in PUSH scale scores and clinical observations within the Atémpero ® group suggest areas for further investigation. These preliminary data highlight a potential avenue for the nutritional management of multi-pathological patients, establishing a solid foundation for future large-scale confirmatory trials to validate the efficacy of immunonutrient-enriched ONS in pressure injury care. Trial registration. ClinicalTrials.gov NCT06726486 .
Investigation of certain miRNA expression levels in bovine mastitis cases caused by Escherichia coli and Coagulase-Negative Staphylococci
MicroRNAs (miRNAs) are small, non-coding RNA molecules approximately 18–25 nucleotides in length that function as essential regulators in numerous biological processes, including immune system function and inflammatory conditions such as bovine mastitis. They hold considerable potential as biomarkers for this disease. This study aimed to investigate the expression levels of inflammation-associated miRNAs in the milk of cows with clinical and subclinical mastitis. In this study, 15 whole milk samples were collected from dairy cows, comprising three groups: clinical mastitis (N = 5), subclinical mastitis (N = 5), and healthy (N = 5). The expression levels of nine inflammation-related miRNAs (miR-146a, miR-92a, miR-155, miR-383, miR-29B-2, miR-223, miR-148a, miR-200a, and miR-205) were measured and analyzed using real-time quantitative PCR (qPCR). The results revealed a significant upregulation in the expression levels of miR-92a, miR-155, miR-223, and miR-200a in clinical mastitis cases induced by Escherichia coli infection. In contrast, subclinical mastitis caused by coagulase-negativestaphylococci (CoNS) showed a significant downregulation of miR-146a, miR-92a, miR-148a, and miR-205. Furthermore, the expression levels of miR-223 and miR-200a were significantly upregulated in both clinical and subclinical forms of the disease. The findings of this study revealed significant alterations in the expression levels of miR-223 and miR-200a, particularly in clinical mastitis, which highlights greater discriminatory power of these miRNAs as diagnostic biomarkers. Accordingly, milk miRNAs appear to have considerable potential for use as non-invasive biomarkers in the early and differential diagnosis of mastitis.
Indicator condition-guided HIV testing in patients with mononucleosis-like illness and community-acquired pneumonia in an Emergency Department setting: A prospective study from Poland (2015–2018)
Background Despite advances in HIV care, late diagnosis remains a major public health challenge in Europe, with nearly half of HIV diagnoses in the EU/EEA occurring at a late stage. In Poland, a substantial proportion of people living with HIV remain undiagnosed. Indicator condition–guided testing has been proposed as an effective strategy to reduce missed opportunities for earlier diagnosis. Methods A prospective cohort study was conducted at the Emergency Department of the Hospital for Infectious Diseases in Warsaw, Poland, between May 2015 and March 2018, as part of the European OptTEST project. HIV DUO testing was offered to patients aged 18–65 years presenting with mononucleosis-like illness (MONO) or community-acquired pneumonia (CAP). We evaluated the prevalence of HIV infection and assessed linkage to HIV care among those testing positive. Confirmatory testing, CD4 cell counts at diagnosis, and linkage-to-care outcomes were collected. Results Among 885 patients with indicator conditions (MONO: 794; CAP: 91), 636 (71.9%) accepted HIV testing. Twenty-two patients (3.5%) were confirmed HIV-positive. HIV prevalence was 2.6% among patients with MONO and 11.1% among those with CAP. Most HIV-positive patients were male (90.9%), with 59% identifying as men who have sex with men or bisexual. The median age was 32.5 years. The median CD4 cell count at diagnosis was 341 cells/µL overall and was lower in patients presenting with CAP than MONO (61 vs. 366.5 cells/µL). All patients diagnosed with HIV were linked to care, and 95.5% initiated antiretroviral therapy, with a median time to treatment of 8 days. Conclusions HIV seroprevalence among patients presenting with MONO or CAP was higher than the national average, particularly among those with CAP. These findings support routine indicator condition–guided HIV testing in Emergency Departments to improve early HIV diagnosis and timely linkage to care.
Incidence of mortality and its predictors among low birth weight neonates in Ethiopia: Systematic review and meta-analysis
Background Low birth weight neonates are twentyfold at risk of death. Notably, it is a major public health concern in sub-Saharan Africa, including Ethiopia. Despite the presence of several primary studies on this issue in Ethiopia, the study findings are inconsistent. Hence, this review aimed to assess the pooled incidence and proportion of mortality and predictors among low birth weight neonates. Method A search of articles from databases (PubMed, CINAHL, Global Index Medicus, and HINAR), and other sources (Google, Google Scholar) were done. All observational studies that assess mortality of low birth weight neonates were included. The Joana Brigs Quality appraisal checklist was used. The pooled incidence rate, proportion, and the effect size of predictors were estimated using a random-effects model. Heterogeneity was assessed using I 2 test. Subgroup and sensitivity analysis was conducted. Eggers test and funnel plot were used to assess publication bias. Trim and fill analysis was conducted. Result Fifteen studies with 7539 study participants were included. The pooled incidence rate of mortality was found to be 36.31 (95 CI: 26.37–46.25) per 1000 neonates’ day observation and the proportion of mortality was 26.67% (95% CI: 21.83–31.51). Preeclampsia (AHR = 1.38; 95% CI: 1.09–1.75), respiratory distress syndrome (AHR: 1.67; 95% CI:1.25–2.23), perinatal asphyxia (AHR: 1.66; 95% CI: 95%:1.35–2.05), sepsis (AHR: 2.04; 95% CI: 1.59–2.63), not breastfeeding (AHR:5.16; 95% CI: 2.61–9.96), not using KMC (AHR: 4.46, 95% CI: 2.19–9.10), extremely low birth weight (AHR: 3.67; 95% CI: 2.55–5.29), very low birth weight (AHR = 1.75; 95% CI: 1.44–2.12), and prematurity (AHR: 1.55; 95% CI: 1.07–2.24) were predictors. Conclusion Based on the pooled proportion of mortality, above one-fourth of low birth weight neonates died in Ethiopia, and the incidence rate of mortality was significantly high. Preeclampsia, respiratory distress syndrome, perinatal asphyxia, sepsis, not breastfeeding, not using kangaroo mother care, hypothermia, extremely low and very low birth weight, and prematurity were predictors of mortality. Hence, the concerned stakeholder should focus on LBW neonates presented with these predictors. Maternal and neonatal screening, kangaroo mother care, and breastfeeding need to be strictly practiced to reduce mortality. Furthermore, community-based essential newborn care needs to be strengthened. Registration CRD42024524189.
Texture-enhanced thermography for joint inflammation detection using consumer-grade thermal cameras
Background Early identification of active synovitis is essential for treat-to-target management in inflammatory arthritis. While MRI and ultrasound are highly sensitive, their clinical use is constrained by high costs, operator dependence, and lack of portability. Infrared thermography (IRT) is rapid and contactless, but conventional temperature-based approaches are sensitive to ambient conditions and inter-individual baseline variability, and contralateral comparison is unreliable in bilaterally involved disease. This study evaluates whether consumer-grade thermal cameras, augmented with texture-based features and complementary differencing strategies, can detect and differentiate joint inflammation. Methods Thermal images of knees, ankles, wrists, and metacarpophalangeal (MCP) joints were acquired from 239 participants (167 with inflammatory arthritis, osteoarthritis (OA), or fibromyalgia; 72 healthy controls). Beyond absolute temperature, higher-order texture features (e.g., entropy, skewness) were extracted to quantify spatial heterogeneity in heat distributions. To reduce environmental and inter-individual variability, two normalization strategies were applied: contralateral left–right (L-R) differencing for unilateral disease and a novel anterior–posterior (A-P) differencing for bilateral or subclinical presentations. Group comparisons used the Mann-Whitney U test ( p < 0.05), and effect sizes were summarized using Cohen’s d . Results Compared with non-differenced features, contralateral differencing markedly strengthened discrimination for unilateral inflammation, with very large effects at the knee ( d = 2.15) and ankle ( d = 1.83). Texture features, specifically entropy and skewness, outperformed absolute temperature in detecting latent (subclinical) wrist inflammation via A-P differencing ( d = − 1.11 ). Thermographic signatures also supported differential characterization, distinguishing inflammatory arthritis from OA ( d = − 1.49 ) and fibromyalgia ( d = − 1.17 ). Furthermore, A-P gradients showed anatomical specificity, with inflammation reducing gradients in wrists but increasing them in MCP joints ( d = 0.64). Conclusion Texture-enhanced thermography, combined with L-R and A-P differencing, shows promise as an accessible approach for identifying active and subclinical joint inflammation. This approach addresses the limitations of bilateral disease in traditional thermography and widens the clinical applicability of IRT screening.
Dynamic transmission and evolutionary analysis of the HIV-1 subtype CRF01_AE pol region in Ningxia, China
The CRF01_AE recombinant is the dominant HIV strain in Ningxia, characterized by rapid disease progression and imposing a significant local burden. Current prevention strategies, often based on broad subtype classifications, are insufficient to address the distinct transmission dynamics of such specific recombinants. To delineate the spatiotemporal migration patterns and epidemic trends of CRF01_AE in Ningxia, this study conducted a systematic analysis of 206 local sequences. The results reveal extensive viral spread with clear geographic diffusion routes, particularly strong migration from Yinchuan to other major cities. Key demographic groups driving transmission are individuals aged 20–39, retired/unemployed persons, and those with junior high school education. Although the transmission intensity has fluctuated, the current effective reproductive number remains above 1, indicating ongoing epidemic expansion, while the viral evolutionary rate appears stable. The study demonstrates that the CRF01_AE epidemic in Ningxia is still expanding and evolving, and identifies core transmission hubs and population clusters. These findings not only align with some prior understanding but also uncover more complex transmission networks and demographic patterns, highlighting the necessity for implementing targeted interventions specific to this strain to effectively control its spread.
Predicting daily lactation costs of marine mammals for use in bioenergetic models
Empirical estimates of energetic processes are limited or absent for many marine mammal species, hindering the ability to quantify disturbance-related impacts on population dynamics using bioenergetic approaches. In this study, published estimates of mass-specific milk intake rates and milk energy density from marine mammals and taxonomically related terrestrial mammals were used to examine how these variables changed as a function of the percentage of time into the lactation interval. Predictions of milk energy intake derived from these relationships were compared with independent estimates from other approaches to inform their utility in estimating daily lactation costs of data-poor species. Daily mass-specific milk intake rates declined between the start and end of lactation for all taxonomic groups, but the rate of decline was much steeper for ursids, artiodactyls, and mustelids than it was for otariids or phocids. Similarly, most taxonomic groups exhibited some increases in milk energy density as lactation progressed, but the magnitude and timing varied among families. Comparisons with independent estimates revealed the likely utility for using the derived relationships in estimating daily lactation costs of data-poor phocids, otariids, and mustelids, with some caveats. There was a large mismatch in the temporal pattern between independent estimates for cetaceans and predictions derived from semi-aquatic and terrestrial species, indicating that cetaceans have higher mass-specific milk intake rates early in lactation compared to most other species that then rapidly decline during the first 10–25% of the lactation interval. Such differences may be an adaptation to a fully aquatic lifestyle and highlight the importance of other methods for estimating daily lactation costs of data-poor cetaceans in bioenergetic models.
Association between female reproductive factors and intraocular pressure according to glaucoma status: A cross-sectional study of the Korea National Health and Nutrition Examination Survey
Background To investigate the association between endogenous estrogen exposure and intraocular pressure (IOP) in postmenopausal women stratified by glaucoma status. Methods This population-based, cross-sectional study analyzed 1,823 postmenopausal women aged ≥50 years from the Korea National Health and Nutrition Examination Survey (2010–2011). Age at menarche, and menopause, reproductive span, and time since menopause were used as surrogate markers of lifetime estrogen exposure. Multivariate linear regression analyses were performed for the non-glaucoma and glaucoma groups, adjusting for confounders. Results Among women without glaucoma, indicators of longer estrogen exposure were significantly associated with higher IOP. Menopause at the age of ≥49 years and reproductive span of ≥33 years were associated with IOP increases of 0.79 mmHg and 0.88 mmHg, respectively. Conversely, in women with glaucoma, longer estimated estrogen exposure was associated with lower IOP. Menopause at ≥48 years of age and reproductive span at ≥31 years were not associated with IOP reduction. These findings demonstrate distinct associations between endogenous estrogen exposure proxies and IOP in women with and without glaucoma. Conclusions Our results suggest a context-dependent role of estrogen in ocular physiology, with potential implications for glaucoma risk assessment and the development of preventive strategies in aging women.
Third-generation cephalosporin use is frequently non-guideline-concordant in severe community-acquired pneumonia: Findings from a French critical care cohort
Background and objectives Severe community-acquired pneumonia (CAP) remains a major cause of morbidity and mortality, requiring prompt empirical antibiotic therapy. The choice between amoxicillin/clavulanic acid (AMC) and third-generation cephalosporin (3GC) as first-line beta-lactam therapy in the ICU is still debated. To assess AMC and 3GC susceptibility in severe CAP or community-acquired aspiration pneumonia (CAAP) caused by Streptococcus pneumoniae (SP) , Haemophilus influenzae (HI) and/or Staphylococcus aureus (SA) , and to evaluate the appropriateness of empirical antibiotic therapy. Methodology We conducted a single-center retrospective study including patients admitted to the ICU between 01/01/2018 and 30/11/2022 for severe CAP/CAAP with microbiological documentation of at least one of the targeted pathogens. Clinical, microbiological, therapeutic, and outcome data were collected. The primary endpoint was AMC and 3GC susceptibility rates (expressed as percentage and [95% confidence intervals]). Principal findings Among 104 included patients (median age 64 [48–71] years; 67% male), 60 (57.7%) had CAAP. AMC susceptibility rates were 81.5% [61.9–93.7], 78.0% [62.4–89.4], and 100% [92.6–100.0], while 3GC susceptibility rates were 96.3% [81.0–99.9], 95.1% [83.5–99.4], and 100% [92.6–100.0], for SP , HI , and SA , respectively. AMC was the empirical treatment in 59% of cases, and this choice was microbiologically appropriate in 86.9% of these prescriptions. Conversely, 3GC were prescribed empirically in 20% of cases, but this broad-spectrum choice was unjustified in 80% of those situations. Antibiotic de-escalation was performed in 28% of cases. Conclusion In this single-center retrospective cohort, AMC appears to be a relevant empirical option for severe CAP/CAAP in the ICU, while 3GCs seem frequently overused. These findings required prospective multicenter validation before practice change can be recommended.
Event detection via graph convolutional networks for multi-source multimodal integration
In real-time event detection, social media platforms like Twitter, Instagram, and Weibo provide valuable data, where users share updates, opinions, and multimedia content. However, existing event detection algorithms typically rely on a single data source or modality, limiting their ability to process the complex, multimodal nature of event information. To address this, we propose a novel framework that integrates multi-source, multimodal data to improve event detection robustness. Using graph convolutional networks, the framework captures both textual and visual information, incorporating syntactic and dependency details. It employs cross-modal attention to combine features from text and images, enhancing the system’s understanding of how these modalities complement each other. The model identifies event trigger words in the text and classifies events based on both textual and visual cues. Our approach improves event detection accuracy and reliability. Evaluation using news data from the same period as social media posts shows that combining text, images, and news data increases event detection and classification accuracy, offering a more dynamic and comprehensive solution.
Beliefs about animal emotions are associated with self-reported consumer behaviors related to animal use
Human-held beliefs about the emotional capacity and experience of non-human animals appear to be related to attitudes concerning animal use, but direct links between such beliefs and consumer behaviors that affect animals have not been investigated. Two survey-based studies were conducted to test whether scores on the Beliefs about Animal Emotions Scale (BAES) are associated with self-reported consumer behaviors. In Study 1, beliefs about animal emotions statistically predicted reported frequency of non-dietary animal use avoidances (e.g., avoiding animal-tested products, animal-based competitions), over and above age, gender, and educational attainment in a U.S.-based sample. Study 2, which involved targeted recruitment of self-identified vegetarians and vegans, largely replicated these findings, and further showed that BAES scores predicted the number of reported animal-product food avoidances. Having established a link between beliefs about animal emotions and animal-related behavioral choices, additional analyses were conducted to investigate potential factors that contribute to such beliefs. Educational attainment was a consistent negative predictor of BAES scores across both studies: more highly educated participants attributed less emotional capacity and experience to animals. Exploratory analyses indicated that, based on self-report, there are numerous sources of information that contribute to beliefs about animal emotions including, most notably, direct interaction with pets and personal belief systems (e.g., moral, spiritual). Together, these results indicate that individual differences in beliefs about animal emotions, in particular beliefs concerning emotional complexity and authenticity, as well as beliefs about the moral relevance of animal emotions, are importantly related to self-reported consumer behaviors that have implications for animals.
Numerical optimization of process parameters in HLLW spray calcination
To address the issues of incomplete reactions and potential solids accumulation in high‑level liquid waste (HLLW) spray calcination, this study developed a 3D computational domain utilizing a species transport model to simulate the combustion of a nitric acid, sucrose, and nitrate solution. The impacts of wall heating temperature (200–1200 °C), porous media porosity (0–1), inlet velocity (0.001–0.2 m/s), and reactant concentrations on the sodium oxide (Na 2 O) product mass fraction were systematically investigated. Simulation results demonstrate: (1) wall temperature positively correlates with Na 2 O formation, with the mass fraction rising from 0.089 to 0.360 as temperature increases from 200 °C to 1200 °C; (2) higher porosity facilitates product formation, though growth stagnates within the 0.2–0.8 range; (3) inlet velocity dictates reaction kinetics, peaking at an optimal 0.01 m/s (Na 2 O mass fraction 0.287), whereas velocities >0.05 m/s cause incomplete reactions; and (4) doubling sucrose concentration boosts Na 2 O yield by 115% and 180% more than equivalent increases in nitric acid and nitrates, respectively. Enhancing solid product recovery requires elevating wall temperature, regulating inlet velocity at approximately 0.01 m/s, and optimizing the sucrose reductant ratio.
Polar questions in Dutch Sign Language (NGT): A production experiment
Polar questions play a fundamental role in communication and have been investigated across a wide range of spoken languages, from which we know that polar question forms may vary considerably across varying contexts. Much less is known about polar question forms in different contexts in sign languages. This paper concentrates on one particular sign language, namely Dutch Sign Language (NGT). It investigates (i) which polar question forms exist in NGT, (ii) in which types of context these different forms are used, and (iii) what the semantic contribution is of specific elements that may occur in polar questions. We present a production experiment in which two contextual factors are manipulated through role play between the participant and two confederates: (i) the prior expectations of the person asking the question with respect to the truth of the proposition that the question is about, and (ii) the evidence available in the immediate context of utterance with respect to the truth of this proposition. We identify a broad range of polar question forms, differing in terms of polarity marking (positive, negative, null), the presence or absence of question tags , and use of non-manual markers . We observe that each question form has a distinct distribution across the different contexts of use under consideration. With regard to non-manuals, a notable finding is that, contrary to expectation given the previous literature on polar questions in sign languages, raised eyebrows are not consistently used in the polar questions in our dataset; in fact, brow lowering is also rather common. This leads us to suggest that a head or body forward position – not raised eyebrows – is the main polar question marker in NGT. We suggest that raised and lowered eyebrows mark a broad range of other functions that may be relevant in (non-canonical) polar questions.