Browse Articles

Dizziness in the emergency department and risk of stroke: A systematic review and meta-analysis

Background Dizziness is a frequent emergency department (ED) presentation, and a subset of patients, especially those with isolated dizziness without focal neurological deficits, have stroke but are prone to misdiagnosis and adverse outcomes. Reported stroke prevalence in ED dizziness cohorts is highly heterogeneous, and comprehensive assessments of isolated dizziness remain limited. Methods Following PRISMA guidelines, we systematically searched PubMed, Web of Science, Embase, and the Cochrane Library for relevant studies. We included cross-sectional studies reporting stroke prevalence among all ED patients with dizziness or isolated dizziness. A random-effects model was used for meta-analysis to calculate pooled prevalence. Subgroup analyses and Egger’s test were employed to explore heterogeneity and publication bias. The diagnostic accuracy of bedside diagnostic tools was also systematically reviewed. Results Twenty-nine studies involving 161,013 ED patients presenting with dizziness were included. The pooled stroke prevalence among all ED dizziness patients (n = 158,583) was 5.5% (95% CI: 4.1–7.1). Among patients with isolated dizziness (n = 2,559), the pooled prevalence was 13.9% (95% CI: 8.2–20.9), substantially higher than in the overall dizziness cohort. Subgroup analyses indicated diagnostic methods and hospital level as major contributors to heterogeneity. Summary analysis of bedside diagnostic tools showed that HINTS and STANDING examinations have high diagnostic accuracy overall, while the TriAGe+ score can be applied flexibly for screening or confirmation based on different cut-off points. Conclusions ED patients with dizziness carry a meaningful, setting-dependent stroke risk. Standardized bedside exams (HINTS, STANDING) improve early triage, and selectively deploying neuroimaging helps prevent missed strokes when risk is high.

Complete mitochondrial genomes of Pipistrellus pipistrellus and Pipistrellus nathusii, along with the resolution of the taxonomic positions of Pipistrellus and Nyctalus

Spin-transition modulated light-emitting devices in a 2D magnet

Estimating the number and percentage of children who experience parental incarceration in Canada using whole population administrative and vital statistics data

Background There is a lack of systematic data on children who experience parental incarceration in Canada. Objective To use linked data to estimate the number of children who experienced parental incarceration in five Canadian provinces from 2015 to 2021, and to describe parent and child characteristics. Methods We accessed data from the Canadian Correctional Services Survey, a Statistics Canada survey that included person-level administrative data for all people incarcerated in British Columbia, Alberta, Saskatchewan, Ontario, and Nova Scotia provincial correctional facilities between 2015 and 2021. We identified their children using three methods: children with a person in the Canadian Correctional Services Survey listed as a parent on their birth certificate, children of people in the Canadian Correctional Services Survey who had received child tax benefits, and children of females in the Canadian Correctional Services Survey with a live birth in hospital discharge records. We calculated the number and percentage of children <18 who experienced parental incarceration, and described parent and child characteristics. Results For 2015–2021, we identified 93,090 incarcerated parents of children <18 and 169,740 children <18 who experienced parental incarceration. We found that per day in the included provinces, 0.23% of children <18 in 2016 and 0.27% in 2017 experienced parental incarceration, and per year, 1.2% of children <18 in 2016 and 1.3% in 2017 experienced parental incarceration. For children who experienced parental incarceration, 87.4% had one and 12.0% had two parents who experienced incarceration during the study period, and 5.9% had at least one Black parent and 30.5% at least one Indigenous parent. Children who experienced parental incarceration had a median of 60 (IQR 11–208) and a mean of 166.5 (SD 256.5) total days of parental incarceration during the study period. For parents who experienced incarceration, 22.6% were female, 77.4% were male, 6.0% were Black, and 31.6% were Indigenous. Significance This is the first Canadian study to systematically estimate the number and percentage of children who experience parental incarceration. Given data limitations, our findings of the number and percentage of children should be treated as minimum estimates. While further research is needed to fully quantify the prevalence and burden of this adverse childhood experience, these minimum estimates can be used to raise awareness of the issue of parental incarceration in Canada. Evolving evidence, including this study, is instrumental to advancing work to measure, prevent, and mitigate the harms associated with parental incarceration for children and families.

How physical activity and gender moderate the association between parental marital conflict and adolescent depression

Retinocortical in-sensor neuromorphic vision platform for NIR-augmented artificial vision

Impact of the stress hyperglycemia ratio on short-term outcomes in critically ill patients with chronic kidney disease: A comparative analysis of diabetic and non-diabetic populations

Background Stress-induced hyperglycemia is common in critically ill patients and may worsen outcomes, especially in those with chronic kidney disease (CKD). The stress hyperglycemia ratio (SHR), defined as admission glucose divided by the estimated average glucose from HbA1c, reflects acute relative hyperglycemia, but its prognostic value in CKD remains unclear. Objective To investigate the impact of SHR on ICU and 28-day mortality in critically ill CKD patients and to compare prognostic differences between diabetic and non-diabetic populations. Methods Data of 1,836 CKD patients from the MIMIC-IV database were analyzed. SHR was categorized into quartiles, and patients were stratified by diabetes status. Kaplan–Meier survival analysis assessed ICU and 28-day mortality; Cox proportional hazards and restricted cubic spline (RCS) analyzes evaluated associations between SHR and outcomes. Subgroup analyzes explored effect modification by age, sex, and comorbidities. Results In non-diabetic patients, higher SHR levels were independently associated with increased ICU and 28-day mortality. The adjusted hazard ratios (HRs) for ICU and 28-day mortality in the highest SHR quartile were 3.19 (95% CI: 1.60–6.53, P < 0.001) and 1.93 (95% CI: 1.14–3.27, P = 0.015), respectively. In diabetic patients, similar upward trends were observed, but the associations were not statistically significant after multivariate adjustment. Conclusions Elevated SHR levels were associated with adverse short-term outcomes, particularly increased ICU and 28-day mortality in non-diabetic patients with chronic kidney disease. These findings suggest that stress-induced hyperglycemia may exert a harmful effect on critically ill patients without preexisting diabetes, emphasizing the importance of individualized glycemic management in this population.

Advancing early detection of chromophobe renal cell carcinoma: a Bayesian optimization approach to machine learning models

Controlled transfer-reduction of functional groups with ethanol by their interaction strength with the oxygen vacancies

An adaptive slicing algorithm based on model contour information

The original slicing algorithm needs to traverse all triangular facets when performing triangular facet screening, and the calculation amount is large. When performing model feature recognition, the feature standard is less, resulting in inaccurate feature recognition and the phenomenon that the position of the model feature moves. To solve these problems, an adaptive hierarchical algorithm based on model contour information is proposed. This algorithm is applicable to fused deposition additive manufacturing. By analyzing the geometric characteristics of the STL (Standard Triangulated Language) model, the model is divided into non-significant feature part, general feature part and complex feature part by using the change of contour intersection point number. For the model with non-significant feature part, the angle between the normal vector of the triangular patch and the stratification direction is used as the basis of slicing. For the model of the general feature part, the angle between the normal vectors of the adjacent triangular patches in this part is used as the basis of slicing algorithm. For the model of complex feature part, the index based on Taubin vertex normal vector is used as the basis of slicing algorithm. The equal thickness slicing algorithm, the adaptive slicing algorithm based on the normal vector of triangular facets and the algorithm proposed in this paper are used to slice the ship model, vase model and dice model respectively. The models are printed by the six-degree-of-freedom (six-DOF) additive manufacturing (AM) device and tested by a roughness meter. The experimental results show that the proposed method can better balance the printing accuracy and printing efficiency.

Biodegradable coating based on chitosan and sea buckthorn for fish fillet preservation

A plant-receptor-inspired cuprous complex for wearable trace-level ethylene gas sensing

MaxGRNet: A multi-axis vision transformer with improved generalization for eye disease classification using explainable AI with insertion-deletion operations on fundus images

Eye diseases, including diabetic retinopathy (DR), glaucoma, and cataracts, represent a major global health concern and can lead to severe visual impairment or blindness if not identified in a timely manner. This study proposes a novel eye disease classification framework based on a multi-axis vision transformer (MaxViT) applied to color fundus images with Explainable Artificial Intelligence (XAI) techniques to enhance model transparency. The proposed architecture integrates transformer-based attention mechanisms with Global Response Normalization (GRN)-based multi-layer perceptron (MLP) layers to capture complex spatial and contextual relationships within fundus images effectively. The model was evaluated on a publicly available eye disease classification dataset using a five-fold cross-validation strategy to assess its robustness and generalization. The experimental results show that the proposed approach consistently outperforms conventional Convolutional Neural Networks (CNNs) and Vision Transformer (ViT) variants, including ResNet50, Swin-T, MaxViT-T, and ViT-B16. The model achieved a macro-averaged test accuracy, precision, and recall values of 96.75%, 96.70%, and 96.80%, respectively, with paired statistical t-tests confirming that these improvements were statistically significant. Rigorous preprocessing techniques were employed to improve data consistency, and XAI-based visual explanations provided insights into the model’s decision-making process, supporting interpretability in ophthalmic image analysis. Overall, the proposed MaxViT-based framework is robust and computationally feasible for research-oriented evaluation approaches for automated fundus image classification, highlighting the potential of advanced transformer architectures for future decision-support and research-oriented ophthalmic applications.

Exploration of brain function changes in the visual cortex of astigmatic subjects based on fNIRS

Experimental and modeling demonstration of stronger population suppression by gene drive targeting doublesex from dominant female-sterile resistance alleles

Resilient distributed model predictive control for cooperative microgrids under communication loss with demand response integration

This paper introduces a resilient distributed model predictive control (RDMPC) framework for coordinating energy management across networked microgrids with demand response integration. The coordination mechanism employs an alternating direction method of multipliers (ADMM)-based distributed MPC formulation that maintains tie-line reciprocity via a shared consensus schedule; standard ADMM convergence results apply under reliable communication for the convex quadratic-program relaxation. Safe operation under communication impairments and early termination is achieved by executing the reciprocal consensus tie-line setpoints and performing a local feasibility-repair step with physically interpretable slack variables (load shedding and spillage), providing anytime feasibility while (under reliable communication) optimality improves with additional ADMM iterations. Communication failure resilience is achieved by treating tie-line mismatch as bounded disturbances and applying two-sided reserve margins (upward and downward) through constraint tightening, ensuring feasibility for any mismatch within the assumed bounds when sufficient reserve headroom exists. Demand response is incorporated using distinct models for shiftable loads (energy-by-deadline) and curtailable loads (penalized reduction). Evaluation on a five-microgrid benchmark under packet loss, burst outages, and topology changes confirms feasible reciprocal execution under loss; relative performance versus naive distributed MPC (B2) is seed-dependent, and DR ablation shows large degradations (about 5.9 × energy not served (ENS) and 5.8 × cost increases) when flexibility is removed.

Correction: ​​Rubber intercropping with arboreal and herbaceous species alleviated the global warming potential through the reduction of soil greenhouse gas emissions

Establishment of DNA methylation during primate germ cell development

Abstract DNA methylation is almost completely erased throughout the genome in primordial germ cells, and then reestablished during mammalian germ cell development. In this study, we demonstrate that in three primate species—marmosets, macaques, and humans–de novo methylation occurs postnatally in prospermatogonia in males and growing oocytes in females. In monkey prospermatogonia, de novo methylation is a prolonged process spanning 6 months to 1 year, primarily occurring within the first year after birth. In human testes, this process may occur more slowly over an extended period. Single-cell bisulfite sequencing analyses in spermatogonia of three species revealed that all genomic regions acquire DNA methylation gradually. However, DNA methylation levels increase faster in genic regions compared to intergenic regions. Unlike in mice, mitotic divisions occur during the establishment of methylation in prospermatogonia. The established methylation is likely maintained because maintenance methyltransferase DNMT1 is specifically expressed during the mitotic stage. Our findings show notable differences in the de novo DNA methylation processes in male germ cells between mice and primates.

Prevalence and social determinants of breastfeeding practices in urban slums and urban non-slum areas in India: A comparative analysis

Understanding how the prevalence and determinants of breastfeeding practices differ between urban slum areas, where living conditions are stringent, and urban non-slum areas, which have relatively more resources, is key to context-specific interventions. We conducted a comparative analysis to investigate the prevalence of breastfeeding practices in the urban slum and urban non-slum areas of India. We also used the socio-ecological framework to assess the individual, community, and policy-level correlates of breastfeeding practices. Secondary analysis of data from the National Family and Health Survey (2015–2016) in India was conducted to estimate the prevalence of early breastfeeding initiation and exclusive breastfeeding of children living in urban slum and urban non-slum areas, and the prevalence estimates were further stratified by the seven states where slums were sampled. Multilevel logistic regression analysis was used to examine the correlates of breastfeeding practices. Early breastfeeding initiation was significantly higher in the urban slum areas (50.4%) compared to urban non-slum areas (37.4%). In contrast, exclusive breastfeeding was lower in urban slums (50.1%) than in urban non-slum areas (55.8%). At the individual level in urban slum areas, preceding birth of more than 24 months was associated with early initiation of breastfeeding. At the policy level, child delivery at the health facilities was associated with early initiation of breastfeeding in the urban non-slum areas. The study showed that breastfeeding practices need to be urgently addressed in both the urban slum and urban non-slum areas, and policy-level factors such as health care facilities should be considered in designing effective interventions.

Exploring quantum annealing for coarse-grained protein folding

Abstract We explore the potential application of quantum annealing to address the protein structure problem. To this end, we compare several proposed ab initio protein folding models for quantum computers and analyze their scaling and performance for classical and quantum heuristics. Moreover, we introduce a novel encoding of coordinate-based models on the tetrahedral lattice, based on interleaved grids. Our findings reveal significant variations in model performance, with one model yielding unphysical configurations within the feasible solution space. Furthermore, we conclude that current quantum annealing hardware is not yet suited for tackling problems beyond a proof-of-concept size, primarily due to challenges in the embedding. Nonetheless, we observe a possible scaling advantage over our in-house simulated annealing implementation, which, however, is only noticeable when comparing performance on the embedded problems.