Browse Articles

The association between Vapor Pressure Deficit and arthritis: Evidence from a 10-year longitudinal study of middle-aged and elderly Chinese adults

Objective To investigate the association between vapor pressure deficit (VPD) and arthritis in middle-aged and older Chinese adults. Methods This study utilized data from the China Health and Retirement Longitudinal Survey (CHARLS) spanning the years 2011–2020. Participants without arthritis in 2011 were selected as the study population, with VPD designated as the primary exposure factor and newly diagnosed arthritis cases as the outcome variable. Logistic regression models were used to estimate the association between VPD and incident arthritis. Restricted cubic spline (RCS) analyses were conducted to assess potential nonlinearity. Subgroup analyses were performed to examine effect heterogeneity across population subgroups. Results A total of 4615 subjects were included, and a total of 1317 subjects were reported to be diagnosed with arthritis during approximately 10 years of follow-up (2011–2020). The VPD level in the arthritis group was lower than that in the non-arthritis group (5.184 ± 0.828 vs 5.291 ± 0.818, p < 0.001). All logistic regression models showed that VPD was linearly related to the incidence of arthritis, and the relationship remained consistent even when VPD was categorized. RCS analysis showed that the incidence of arthritis decreased significantly with increasing VPD (p < 0.05), especially when VPD was lower than 5.28. Subgroup analysis indicated that VPD exerted a stronger protective effect against arthritis among rural residents (p for interaction = 0.006). Conclusion VPD was found to be negatively associated with the incidence of arthritis among middle-aged and elderly populations, with a particularly stronger effect observed in rural residents. These findings highlight VPD as an environmental factor associated with arthritis and may help improve understanding of environmental influences on arthritis development.

Ant parasitoidism in checkered beetles: Phyllobaenus obscurus developing inside intact cocoons of two species of the Ectatomma ruidum species complex

Known parasitoids of ants include species from several families of flies, wasps, strepsipterans, nematodes, and mites. Curiously, while myrmecophily is heavily biased towards Coleoptera, one of the most diverse and speciose insect orders, no beetles specialized as parasitoids of ants have been recorded, although the parasitoid habit has evolved at least 13 times within this order. Here we report on observations that strongly suggest that a checkered beetle species behaves as a parasitoid of ant brood. A total of 146 colonies or part of colonies of three species of the Ectatomma ruidum species complex ( E. ruidum sp. 2, 3, 4) were excavated in several sites along the Pacific coastal plains of Oaxaca, Mexico, during three collecting campaigns (2015–2017). Overall, 11060 adults, 5795 cocoons and 2185 larvae were examined. Upon dissection, four intact, ethanol-preserved cocoons contained ant prepupae/pupae parasitized by characteristic campodeiform beetle larvae (prognathous head, three pairs of segmented legs, no prolegs, body with sparse but long pubescence), and a fifth cocoon presented a round exit hole. Sequencing of the COI gene fragment support assignment of the larva to Cleridae, consistent with the genus Phyllobaenus (Cleridae). An active, pink-colored larva that emerged from a cocoon containing the remains of the ant host pupa, was reared to adulthood and could be identified as Phyllobaenus obscurus (Gorham). Beetle larvae were found inside intact cocoons of two species: E. ruidum sp. 3 and sp. 4. The prevalence of parasitism is extremely low, representing less than 0.6% of available cocoons. Predatory during both adult and larval stages, checkered beetles are broadly known as predators of wood-boring and cone-boring beetles, and some species are facultative parasitoids of solitary bees or wasps or, very rarely, specialized in predating social insects. We assert that the novel discovery of clerid-ant brood parasitoidism within the subterranean host colony deviates yet further from any adaptation known to date among clerids.

Assessment of acute pain and its management in an urban emergency department in Ghana

Introduction Acute pain is classified as pain that lasts less than three to six months. Globally, pain is the third most common health problem with more than a quarter of patients reporting to the Emergency Department (ED) with pain-related chief complaints. This study aimed to determine the prevalence of acute pain and assess the pain management practices in the Komfo Anokye Teaching Hospital Emergency Department (KATH ED). Methods Using the Numeric Rating Scale (NRS), the characteristics of acute pain among 378 patients presenting to KATH ED were measured. Additionally, the waiting time for the first pain treatment was calculated for each patient. Pain scores (pre- and post-treatment) were also taken to further inform patients’ satisfaction. Results Out of 378 patients, 76% [95% CI: 71.3–80.2] reported to the ED with severe pain, 21% [95% CI: 16.9–25.4] reported with moderate pain, and 3% [95% CI: 1.5–5.1] reported with mild pain. The average waiting time for the initial assessment of pain was 83.97 minutes while the average waiting time for the administration of analgesia was 184.07 minutes. Having completed primary (AOR, 5.36; 95% CI, 1.03–27.97), JHS (AOR, 5.8; 95% CI, 1.19–28.35), SHS (AOR, 7.24; 95% CI, 1.38–38.01) and tertiary (AOR, 9.42; 95% CI, 1.60–55.62) were predictive of Door‑to‑Analgesia (DTA) time ≤ 90 minutes. Nearly three quarters of the study participants had maximum satisfaction with the pain management services in the ED. Conclusion The study revealed that documentation of pain severity scores of patients presenting with acute pain at KATH ED was encouraging, however, most patients did not receive timely pain relief. The average waiting time for the initial assessment of pain as well as the administration of analgesia was extremely prolonged. Despite this, three out of every four of the study participants had maximum satisfaction for the overall pain treatment services in the ED. These findings suggest that pain management practices at KATH ED need improvement.

Attitude and knowledge of healthcare providers towards female genital cosmetic surgery: A cross-sectional study

Background Female genital cosmetic surgery (FGCS) has experienced increasing popularity over the past decades. This procedure includes surgical and non-surgical intervention to alter genital appearance, often without medical indications. As many women are unfamiliar with normal genital anatomy, healthcare providers play a critical role in guiding patients. Therefore, evaluating their attitudes and knowledge for identifying gaps in training and ethical issues could be valuable. Materials and methods This cross-sectional study was conducted from 17 January 2023 to August 2024 among 320 healthcare providers in Iran. Participants included obstetricians and gynecologists, plastic surgeons, midwives, gynecology residents, urologists, and general practitioners. Data were collected using a validated web-based questionnaire about participants’ demographics, clinical experience, knowledge of FGCS, risk awareness, ethical considerations, and attitudes toward FGCS. SPSS version 27 was used for statistical analysis. Results The majority of participants (57.6%) were obstetricians and gynecologists. Most respondents reported being approached by patients seeking FGCS, with body image dissatisfaction (65.4%) and partner requests (62.2%) being the primary complaints. Awareness of short-term risks varied significantly across specialties (p < 0.001), with obstetricians and gynecologists being the most informed. Confidence in performing procedures was highest among plastic surgeons, while ethical considerations were more recognized among obstetricians and gynecologists. Although most participants in all groups (68.6% of OB/GYN, 90.0% of plastic surgeons and 75.2% of others) reported formal training, long-term risk awareness and procedural confidence gaps persisted. Only a minority endorsed FGCS for purely aesthetic reasons (8.6% of obstetricians and gynecologists, and 1.6% of others). More than half of respondents (56.8% of obstetricians and gynecologists, 60% of plastic surgeons, and 55.6% of others) agreed that all women should undergo consultation before FGCS. Conclusion Healthcare providers demonstrated diverse levels of knowledge and confidence in FGCS, which is influenced by specialty and training. Attitudes towards performing procedures solely for aesthetic purposes, including for those under 18, were generally positive, although pre-procedure counseling was also emphasized. While ethical considerations were widely acknowledged, a targeted training program is needed to address gaps in risk awareness and improve providers’ confidence.

A randomised controlled feasibility study of the Carers-ID intervention to support the mental health of family carers of people with intellectual disabilities

Background Intellectual disability (ID) refers to significant limitations in intellectual and adaptive functioning beginning in childhood. Globally, ID affects 1–3% of the population—over 200 million people. Family carers of individuals with ID experience high levels of stress, poor health, and reduced quality of life due to ongoing caregiving demands. These pressures intensified during the COVID-19 pandemic, prompting the development of Carers-ID, an online intervention designed to support carers’ mental health. Objective To assess the feasibility of delivering the Carers-ID programme to family carers of people with ID. Methods A parallel randomised controlled trial was conducted to evaluate recruitment and retention rates, feasibility of data collection, and potential effect sizes. Carers were recruited via UK-based voluntary organisations and NHS learning disability teams and randomly assigned to either the Carers-ID intervention (n = 51) or waitlist control (n = 48). Randomisation was conducted by an independent third party. The intervention spanned two weeks with assessments at baseline, post-intervention, and three-month follow-up. Outcomes included measures of well-being, resilience, social connectedness, depression, anxiety, and stress. The trial followed CONSORT reporting guidelines. Results Of 150 carers screened, 99 met inclusion criteria, and 84 completed the baseline assessment (85%). Retention was 55% post-intervention and 41% at three-month follow-up. Adjusted mean differences between-groups at T2 (2 weeks from baseline) across the four measures were as follows: 3.42 (SE = 2.84, p = 0.23) for wellbeing, 12.20 (SE = 5.83, p = 0.04) for resilience, 5.09 (SE = 5.12, p = 0.32) for social connectedness, 0.98 (SE = 1.40, p = 0.49) for depression, 0.42 (SE = 1.26, p = 0.74) for stress, and 1.06 (SE = 1.32, p = 0.43) for anxiety. Conclusion Family carers face time and resource pressures which may exclude them from clinical trials. Challenges in retaining carers highlight the need for flexible intervention formats. Despite retention issues, results suggest feasibility in delivering the Carers-ID intervention. Future effectiveness trials should address barriers to participation and tailor interventions for this underserved population. Trial registration ClinicalTrials.gov: NCT05737823

Tuberculosis in advanced chronic kidney disease: An Observational Study at a Tertiary Care Center in Mexico

Background The management of Tuberculosis (TB) in patients with chronic kidney disease (CKD) presents unique challenges, including an immunosuppressive state, altered drug pharmacokinetics, and limited access to single-drug formulations in our setting. There is a scarcity of real-world evidence on TB outcomes in this population in Latin America. Our study aimed to compare mortality, cure, and relapse rates between TB patients with ACKD and without ACKD. Methods We conducted an observational-analytical study of all patients aged ≥18 years with microbiologically or histologically confirmed TB between 2013 and 2024. Patients with ACKD (GFR < 30 mL/min/1.73 m² were compared against age- and sex-matched non-ACKD (GFR ≥ 30 mL/min/1.73 m²) patients. Due to differential HIV distribution, we also performed a sensitivity analysis excluding HIV-positive patients. The primary outcome was all-cause mortality at 1 year. Outcomes were compared using the Chi-squared and Mann-Whitney U tests, as well as logistic regression. Results A total of 51 patients with tuberculosis were included (17 with ACKD, 34 without ACKD). CKD was caused by lupus or diabetes in 29% of patients each. Most CKD patients (68%) received a local pragmatic alternating regimen. One-year all-cause mortality was 18% in both groups (p > 0.999), and TB-related mortality was 9% in the control group, vs 0% in the ACKD group. The cure rate was similar between groups (ACKD: 88% vs. non-ACKD: 82%; p = 0.586). No relapses occurred. In a sensitivity analysis excluding HIV-positive patients (n = 44), findings were consistent with the primary analysis, with no significant difference in mortality between groups. Due to the low event rate, we conducted a bivariate analysis in an exploratory fashion and did not perform a multivariate analysis. Conclusions In this Mexican small cohort, ACKD didn’t significantly worsen TB outcomes compared with non-ACKD patients. An local pragmatic alternating regimen was used without apparent harm. These preliminary findings are limited by small sample size, limited statistical power, and lack of pharmacokinetic validation. Larger studies with drug monitoring are needed to optimize treatment for this vulnerable group.

The triglyceride-glucose index and neutrophil-to-lymphocyte ratio jointly predict the no-reflow phenomenon in T2DM patients with STEMI after primary PCI

Background Patients suffering from ST-segment elevation myocardial infarction (STEMI) and type 2 diabetes mellitus (T2DM) face an elevated risk of the no-reflow phenomenon even after successful primary percutaneous coronary intervention (PPCI). This study aimed to develop an integrated predictive model combining the triglyceride-glucose (TyG) index and the neutrophil-to-lymphocyte ratio (NLR) for no-reflow in this high-risk population. Methods A retrospective cohort of 524 patients with T2DM and STEMI undergoing PPCI was analyzed. No-reflow was defined as post-procedural TIMI flow grade ≤2. Multivariable logistic regression and receiver operating characteristic (ROC) curve analyses were employed. Results The incidence of no-reflow was 8.97% (47/524). Both TyG index (adjusted odds ratio [aOR] 2.98) and NLR (aOR 1.23) were identified as independent predictors. Patients were stratified into four groups based on the optimal cut-offs for NLR (2.831) and TyG (9.347). The group with high levels of both markers had a substantially higher no-reflow incidence (23.21%) compared to the low-risk group (1.49%). The combined model (TyG + NLR) demonstrated superior predictive performance (AUC 0.785) over models containing either marker alone or baseline clinical factors. Conclusion The combination of TyG index and NLR effectively stratifies the risk of no-reflow in T2DM-STEMI patients, potentially aiding the early identification of patients in need of targeted management.

A virtual screening and molecular dynamics approach in search of novel antibiotic chemotypes

Due to the constantly evolving threat of antibiotic resistance, there is a dire need for novel antibacterial agents. Dihydropteroate synthase (DHPS) is a key bacterial enzyme which has been targeted for nearly a century as a means of selective treatment of microbial infections and exhibits two orthosteric binding sites – the p -aminobenzoic acid ( p ABA) site and the pterin site. The former is the target of sulfonamides, the earliest class of synthetic antibiotics, and its mutant forms have conferred resistance to this drug class, diminishing its utility in the clinic. Conversely, the pterin site, which is highly conserved across bacterial species, is purported to be less tolerant of mutations, rendering it an attractive target for novel antibiotics. Inspired by this, we conducted a large virtual screen of more than 450,000 compounds from commercial databases, identifying compounds 8802 and 7034 as potential pterin-site inhibitors. Compound 8802 was quite attractive as a hit due to the ease of generating analogues, leading to the synthesis of novel compounds LST-1 and LST-2 . Rigid docking and molecular dynamics suggested favorable binding of these compounds to the pterin site of DHPS, and compound 8802 exhibited superior antibacterial activity compared to its analogues and 7034 . Fluorescence polarization assays did not indicate competitive inhibition of pterin-derived probe binding, and surface plasmon resonance (SPR) suggested these compounds bind very weakly to DHPS, in a nonspecific manner. The in silico assessment of the physicochemical and pharmacological properties predicted a favorable overall profile, indicating that these are suitable leads for further study to improve their activity and determine their precise mode of action.

Intrinsic over extrinsic: Species identity shapes spatial and interannual Mg/Ca patterns in Arctic marine calcifiers

Marine calcifiers incorporate magnesium into their calcium carbonate skeletons through processes influenced by both ambient environmental conditions and species-specific physiological regulation. As a result, their carbonate structures can serve as valuable archives of past and present oceanic conditions, provided that biological controls are explicitly considered. This study investigated how skeletal magnesium-to-calcium (Mg/Ca) ratios vary in space and time among three Arctic benthic invertebrates differing in phylogeny, evolutionary history, and biomineralization strategy: the barnacle Semibalanus balanoides , the spirorbid Paradexiospira violacea , and the bryozoan Harmeria scutulata . Mg/Ca ratios were quantified using inductively coupled plasma atomic emission spectroscopy (ICP-AES) across three Svalbard fjords and over a four-year temporal interval (2006–2009). Kruskal–Wallis analyses revealed that species identity was the dominant factor controlling Mg/Ca ratios among the studied taxa. S. balanoides exhibited the lowest values of mean Mg/Ca ratios but highly variable (mean = 35.2 mmol/mol ± 16.8 SD), whereas P. violacea (62.5 mmol/mol ± 14.3) and H. scutulata (65.3 mmol/mol ± 14.1) showed higher and more consistent Mg/Ca ratio. Significant differences in Mg/Ca ratios were observed among sites for all species, following a consistent Hornsund < Kongsfjorden < Isfjorden pattern. However, the magnitude of site-level variability in Mg/Ca differed among species, confirming that species-specific physiological controls exert a stronger influence on skeletal Mg incorporation than external, site-specific environmental conditions. In Isfjorden, interannual trends in Mg/Ca between 2006 and 2009 were found to be species-specific but non-significant for all species. Weak, negative, and statistically significant relationships with bottom-water temperatures in Isfjorden was found only in P. violacea. Overall, these results highlight the predominant role of intrinsic biological controls over ambient environmental conditions in shaping skeletal Mg/Ca ratios and underscore the importance of species-resolved approaches when applying geochemical proxies in rapidly changing Arctic ecosystems.

Functional group analysis of cigarette butts in beach sand and their association with microplastics: Bocagrande Beach, Cartagena, Colombia

Cigarette butts are one of the most abundant litter items on beaches and represent an emerging source of microplastic pollution due to the degradation of their cellulose acetate filters. When improperly discarded on beach sand, cigarette butts release chemical contaminants and undergo physical and photo-oxidative fragmentation, generating persistent fiber-type microplastics in coastal environments. This study assessed the presence and characteristics of microplastics (MPs) associated with cigarette butt (CB) and cigarette butt fiber (CBF) residues in beach sand at a pilot tourist site. Monthly sampling was conducted across 16 campaigns between 2021 and 2022 to evaluate temporal trends in microplastic categories. Triplicate samples of CBs, CBFs, and beach sand were collected from usage-based zones and analyzed using Fourier-transform infrared spectroscopy (FTIR) to identify functional groups and polymeric composition. The results indicated that 44% of the CB-related functional groups reported in the literature were detected in the service area, with 36% associated with cellulose acetate degradation. The correspondence between functional groups identified in CBs and those detected in fiber-type MPs in sediments suggests that cigarette butts constitute a relevant source of hazardous MP fibers in beach environments. These findings support the need for improved waste management strategies and policy measures aimed at reducing CB pollution in coastal areas.

Exploring brain lobe-specific insights in an explainable framework for EEG-based schizophrenia detection

Schizophrenia (ScZ) is a growing global health concern that affects millions of people and puts severe pressure on healthcare systems. Early detection and accurate diagnosis are crucial for adequate management. Electroencephalography (EEG) has evolved into a promising non-invasive tool for detecting ScZ in contemporary research. However, specific biomarkers, especially those related to brain lobes, cannot often be identified by current EEG-based diagnostic methods. Different brain lobes are associated with distinct cognitive functions and patterns of diseases. Also, there is a gap in the incorporation of the explainable artificial intelligence (XAI) technique, as medical diagnosis needs trustworthiness and explainability. This study strives to address these gaps by developing a framework using mel-spectrogram images with Convolutional Neural Networks (CNNs). EEG signals are converted into mel-spectrogram images using Short-Time Fourier Transform (STFT). After that, these images are analyzed using a CNN model to perform classification between ScZ and healthy control (HC). To identify the most critical brain regions, the full brain regions are divided into five different regions, and the same classification process is performed. The performance of the proposed framework is evaluated using two publicly available EEG datasets: repOD and the kaggle basic sensory task dataset, which provides a remarkable accuracy of 99.82% and 98.31% respectively. Among regions, the frontal lobe has the most significant performance with an accuracy of 97.02% and 88.03%, respectively, in these datasets, followed by the temporal lobe. Conversely, the occipital lobe shows the lowest accuracy among lobes, with only 79.30% and 68.33% accuracy on both occasions, showing its lower significance in the diagnosis. To enhance result explainability, three existing XAI technologies—Local Interpretable Model-agnostic Explanations (LIME), SHapley Additive exPlanations (SHAP), and Gradient-weighted Class Activation Mapping (Grad-CAM)—are applied to demonstrate which factors are responsible for the actual outcomes. These findings emphasize the potential of EEG-based brain lobe analysis in enhancing ScZ detection, diagnostic accuracy, explainability, and clinical guidance.

Global burden and temporal trend of thyroid cancer associated with high BMI from 1990 to 2021

The global incidence of thyroid cancer (TC) has risen markedly, ranking as the tenth most common malignancy in 2020. Simultaneously, obesity now affects over one billion individuals worldwide, with its prevalence more than doubling since 1990. Emerging evidence suggests a significant association between high body mass index (BMI) and elevated TC risk, potentially mediated by mechanisms such as chronic inflammation and insulin resistance. This study aims to evaluate the global burden of thyroid cancer attributable to high BMI (TC-HBMI) from 1990 to 2021, examine temporal trends, and project future burden through 2036. We utilized data from the Global Burden of Disease Study 2021 to assess deaths, disability-adjusted life years (DALYs), and age-standardized rates (ASRs). Temporal trends were examined using estimated annual percentage change (EAPC), joinpoint regression, and decomposition analysis. Inequality and future burden assessments were conducted through slope and concentration indices, frontier analysis, and Bayesian age-period-cohort modeling.

From medicine price control to deregulation: assessing policy effects on insulin access in Pakistan’s private pharmacies

Background Pakistan faces the highest global prevalence of diabetes and has recently implemented a price deregulation policy for medicines not listed on the National Essential Medicines List (NEML). Pakistan’s NEML 2023 is a direct adoption of the 23 rd WHO Model EML rather than a country-specific prioritization; nonetheless, it has been used to identify medicines for exemption from price controls. Methods This study evaluated the effect of the price deregulation policy on insulin access in Pakistan. We surveyed 30 retail pharmacies across six regions using an adapted WHO/HAI approach. Post-deregulation data on consumer prices and availability were collected. Pre-deregulation prices were extracted from published sources. The insulin prices were standardized to 10 ml at 100 IU/ml. Difference-in-Differences (DiD) analysis was used to compare price changes between non-NEML insulins (treatment group) and NEML-listed insulins (control group), with each insulin product serving as the unit of analysis. The percentage of available insulin products and their affordability for the lowest-paid worker were calculated. Non-parametric tests were performed for categorical analyses. Results Overall, the median price of insulins increased by 31.87% ( p  < 0.001) i.e., from PKR 2030 (7.3 USD) to PKR 2678 (9.6 USD), after deregulation, except for short-acting human biosimilar (BS) insulins that stayed stable. As per the DiD-interaction term, prices of non-NEML insulins increased by 4.1 USD ( p  < 0.001) more than NEML insulins after deregulation. The median number of days’ wages for the lowest-paid worker increased from 1.90 days before deregulation to 2.51 days after, to obtain a month’s insulin supply. All surveyed outlets had at least one insulin product available. Originator brands (OB) had higher availability than BS, with 78.0% of human and 48.8% of analogue insulins available as OBs, compared to 51.1% and only 8.3% as BS insulins, respectively. Conclusion Insulin prices increased significantly following the deregulation policy, particularly for non-NEML OBs, leading to reduced affordability despite fair availability. A policy review and stronger financial protection measures are needed to ensure equitable access to insulin.

Amplitude Versus Angle (AVA) feature restoration in prestack gathers via dictionary learning

With the expansion of oil and gas exploration into deep and complex reservoirs, the prestack amplitude versus angle (AVA) inversion technique faces challenges due to amplitude attenuation and phase distortion caused by formation absorption effects, which limit the accuracy of seismic attribute characterization. To address the limitations of existing compensation methods, particularly poor noise robustness and insufficient lateral continuity, we propose a dictionary learning–based AVA feature restoration method for prestack gathers. First, local AVA features extracted from well–log data are used to construct a training dataset using a sliding time window, and the K–Singular Value Decomposition (K–SVD) algorithm is used to train an overcomplete dictionary that sparsely represents attenuation-free signals. Subsequently, the dictionary learning process is embedded into the absorption compensation objective function, where dictionary atoms and sparse coefficients are alternately optimized via orthogonal matching pursuit (OMP) algorithm and gradient descent (GD) algorithm to achieve effective signal-noise separation. Synthetic tests show that, compared with conventional methods, the proposed approach restores weak reflection energy, compensates for angle-dependent amplitude distortion, and exhibits reduced dependence on Q-model accuracy with markedly improved noise robustness. Field data applications demonstrate the advantages of the proposed method in improving lateral continuity and restoring AVA responses under complex geological conditions, providing data-driven support for high-precision prestack elastic-parameter inversion.

Correction: Measuring political radicalism and extremism in surveys: Three new scales

Application of VVI layered strain technology to analyze changes in left ventricular myocardial motion in patients with uremia

Objective Velocity vector imaging (VVI) stratified strain analysis was used to assess circumferential strain across myocardial layers in uremic patients using a 16-segment left ventricular model. Methods Data were accessed for research purposes from 1/5/2025–1/6/2025. Sixty hemodialysis patients were divided into left ventricular hypertrophy (LVH, n = 30) and normal LV conformation (LVN, n = 30) groups based on LV mass index, alongside 27 healthy controls (CON). Clinical and echocardiographic data were analyzed, with VVI quantifying systolic circumferential strain (CS) in endocardial (Endo), mid-myocardial (Myo), and epicardial (Epi) layers. Results The LVH and LVN groups exhibited significant differences compared to the CON group in SBP, Hb, BUN, Scr, eGFR, and hsCRP levels ( P  < 0.001). Hb levels were uniquely reduced in LVH versus LVN ( P  < 0.05). Both uremic groups had larger cardiac dimensions (LAD, LVPTW, IVST, LVIDd, LVIDs) than CON ( P  < 0.001), but similar LVEF ( P  > 0.05). Basal and mid-segment global strain were impaired in LVH/LVN ( P  < 0.05), while apical strain differences were only significant in the Epi layer. LVH showed reduced anteroseptal basal strain (Endo/Myo/Epi-2CS) and inferoseptal basal (Endo/Myo-3CS) and anterolateral mid (Epi-12CS) strain versus LVN. Anteroseptal (Endo/Myo/Epi-2CS) and inferoseptal (Endo/Myo-3CS) strains correlated with Hb levels ( P  < 0.01). Anteroseptal basal strains (Endo/Myo/Epi-2CS) and their combined values significantly predicted myocardial remodeling (AUC, P  < 0.001). While Epi-3CS and its combined values (Endo/Myo/Epi-2CS) did not ( P  > 0.05). Conclusions The VVI layered strain technique is a precise and sensitive tool for evaluating LV myocardial motion in uremic patients.

Predictors of non-suicidal self-injury and moderating effects of cognitive emotion regulation strategies in Korean undergraduate students: Secondary data analysis of a cross-sectional survey

Background Non-suicidal self-injury (NSSI) is an emerging mental health issue in both clinical practice and public health worldwide, refers to intentional self-harm without suicidal intent. Exploring protective and moderating factors of NSSI is important for its prevention and intervention. However, most existing studies have focused primarily on risk factors. This study aimed to identify predictors of NSSI and examine the moderating effects of cognitive emotion regulation strategies on the relationship between psychological discomfort and NSSI. Methods This study involved a secondary analysis of data from 188 self-reported questionnaires collected via a web-based survey in South Korea between August and September 2020 during COVID-19 pandemic. NSSI was measured using the modified NSSI subscale of the Korean version of the Self-Harm Inventory. Psychological discomfort was assessed using a 20-item symptom checklist, and cognitive emotional regulation strategies were measured using the Cognitive Emotion Regulation Questionnaire. Data were analyzed using zero-inflated negative binomial regression. The Hayes PROCESS macro (Model 1) was used to examine moderating effects. Results Of the 188 participants, 159 were female. A total of 30.3% reported experiencing NSSI within the past six months. NSSI was associated with being female and lower use of positive cognitive emotion regulation strategies. Psychological discomfort was positively associated with NSSI. Positive cognitive emotion regulation strategies had a conditional moderating effect on the relationship between psychological discomfort and NSSI. However, negative cognitive emotion regulation strategies did not show a significant moderating effect. Conclusions Psychological discomfort is a salient risk factor for NSSI. Positive cognitive emotion regulation strategies may be an important protective factor. Therefore, prevention and intervention efforts should emphasize strengthening positive—rather than negative—cognitive emotion regulation strategies. To reduce NSSI among undergraduates with a history of NSSI, policies or psychoeducation should focus on increasing positive cognitive coping. Moreover, tailored interventions are needed to reduce psychological discomfort among students with no history of NSSI.

Maternal prothrombin time as an independent predictor of neonatal sepsis: A retrospective case–control study

Objective To evaluate the diagnostic performance of maternal hemostatic and inflammatory markers in predicting neonatal sepsis. Methods This retrospective case–control study included 176 newborns, of whom 37 were diagnosed with neonatal sepsis and 139 were healthy controls. Maternal blood samples collected at delivery were analyzed for white blood cell count (WBC), neutrophil-to-lymphocyte ratio (NLR), platelet count (PLT), prothrombin time (PT), activated partial thromboplastin time (aPTT), international normalized ratio (INR), and systemic inflammatory indices (SII, SIRI, PIV). Group comparisons were performed using the Mann-Whitney U and Chi-square tests. Predictive markers were assessed using multivariate logistic regression and ROC curve analysis. Results Maternal PT was significantly higher in the sepsis group (p < 0.001), and multivariate logistic regression identified PT as the only independent predictor of neonatal sepsis (OR: 1.79; 95% CI: 1.39–2.31; p < 0.001). ROC analysis showed PT had the highest diagnostic accuracy (AUC: 0.909). The optimal cut-off value for PT was 10.25 seconds, yielding a sensitivity of 89.2% and specificity of 68.3%. Conclusion Maternal PT demonstrates excellent diagnostic accuracy in predicting neonatal sepsis. As one of the first studies to apply logistic regression and ROC analysis solely to maternal hemostatic and inflammatory markers, our findings suggest that maternal PT could serve as a valuable, easily obtainable biomarker for early neonatal sepsis risk stratification.

Intestinal barrier damage is associated with fine particulate matter (PM2.5)-induced pathological aortic injury in mice

Chronic exposure to air pollution is associated with an increased cardiovascular disease (CVD) risk, and inflammation induced by fine particulate matter (PM 2.5 ) exposure is a key driver in CVD development. However, the mechanism by which PM 2.5 causes cardiacovescular damage remains unclear. Here, Balb/c mice were intratracheally instilled with PM 2.5 suspension at doses of 2.0 mg/kg or 4.0 mg/kg body weight for 7 consecutive days to establish an aortic injury model. Pathological changes were assessed by hematoxylin and eosin (H&E), elastic Van Gieson, and Masson’s trichrome staining. Potential pathways were identified through GeneCards database analysis, R language, and Metascape pathway enrichment analysis. Immune cell profiles in the blood were analyzed by flow cytometry, and serum inflammatory cytokines were measured by enzyme-linked immunosorbent assay. Confocal microscopy was used to evaluate inflammatory cell infiltration in the aorta. Intestinal barrier integrity was assessed by transmission electron microscopy; H&E, and immunofluorescence staining; and western blotting. We found that high-dose PM 2.5 exposure led to inflammatory cell infiltration, disorganization of elastic fiber layers, and aortic tissue fibrosis. Pathway enrichment analyses indicated the involvement of pathways related to the regulation of inflammatory responses and responses to bacterial molecules. Increased inflammatory cells and pro-inflammatory cytokines were detected in the blood, accompanied by an increase in circulating lipopolysaccharide. PM 2.5 exposure disrupted the intestinal mucosal barrier, leading to reduced claudin-1 and occludin (tight junction protein) expression, which exacerbated systemic inflammation and induced aortic injury. In conclusion, PM 2.5 exposure caused pathological aortic damage and exacerbated systemic inflammation, potentially mediated by compromised intestinal barrier integrity.

Behavior–biological mismatch in metabolic health: Evidence from South Korean adults before, during, and after COVID-19 (KNHANES 2019–2022)

Objective Regular physical activity (PA) is recommended for cardiometabolic prevention, yet emerging evidence suggests that meeting PA guidelines alone does not guarantee metabolic health. Pandemic-related disruptions may have intensified behavior–biology discrepancies. This study examined the prevalence and sociodemographic determinants of the physically active but metabolically unhealthy (PA–NH) group before, during, and after the COVID-19 pandemic in Korea. Methods We analyzed 17,719 adults aged ≥19 years using the 2019–2022 Korea National Health and Nutrition Examination Survey. Participants were classified into four groups: PA–H, NPA–H, NPA–NH, and PA–NH. Temporal patterns across the pre- (2019), during- (2020–2021), and post-pandemic period (2022) were assessed using χ² tests and ANOVA. Multinomial logistic regression identified determinants of PA–NH membership. Results From 2019 to 2022, PA–H declined during the pandemic and rebounded thereafter, whereas PA–NH increased from 31.2% to 34.0%. Older adults had markedly higher odds of PA–NH (OR 7.30 for ≥70 y vs 19–29 y). Women were less likely to belong to PA–NH. Higher education reduced the odds of mismatch relative to PA–H but increased them compared with NPA–NH. Metabolic risk factors such as hypertension and hypercholesterolemia rose despite recovery in PA. Conclusions The persistence and rise of PA–NH after the pandemic show an association suggesting that adherence to PA guidelines alone is insufficient for cardiometabolic protection. Post-pandemic public health strategies should integrate aerobic and resistance exercise with dietary modification, stress management, and routine screening, prioritizing older adults and other high-risk groups.