Browse Articles

Sphingolipids as indicators of exposure to long-term air pollution: a targeted metabolomics approach

Correction: Impact of patients’ age and comorbidities on prostate cancer overdiagnosis in clinical practice

A statistical approach to model soil microbiota versus heavy metals: a case study on soil samples from Foggia, Southern Italy

Reconstructing the spatial and temporal dynamics of Ecuador’s artisanal small-scale fisheries from fishers’ perspective

Despite their crucial role in livelihoods and commercial activities in coastal communities, numerous artisanal fisheries are often underreported and underestimated because of the absence of proper monitoring programs since they started. This lack of data hinders the assessment of the spatial dynamics and status of the resources these fisheries have targeted over time. This is especially concerning, considering the severe overexploitation faced by many coastal resources. Using tools to assess local ecological knowledge, the present study summarizes the perceptions of artisanal fishers regarding spatial and temporal changes in their fishing grounds across nearshore and offshore coastal environments in Ecuador, South America. From April to September 2023, 1,366 fishers from 22 fishing villages were interviewed about the state of their resources and how their fishing grounds and catches changed over the decades of the 1980s, 1990s, 2000s, and 2010s. We employed a semi-quantitative virtual abundance change framework to convert categorical trend values into numerical data and to associate these with the fishing grounds described by each fisher per decade. Almost all fishers interviewed (approximately 99%) indicated that fishing yields have declined significantly, that the number of targeted species has increased, and that their fishing areas have expanded and shifted farther from the coast. Specifically, the overall perceived trends indicate that catches in the 2010s were 30% lower than in the pre-1980s and approximately 59.5% lower than in the 2000s. While there was an important increase in the distance to the port of origin through the decades, the core fishing grounds (where 60–100% of fishers operate) were located near the coast within the first 8 nautical miles. The results of this assessment highlight the importance of collaboration between fishers and scientists in reconstructing the historical dynamics of under-assessed coastal fisheries.

Exploring the social-ecological potential for indigenous agroforestry in peri-urban areas: a participatory mapping approach

Abstract Peri-urban agroforestry can provide affordable, fresh, and nutritious food and a departure from conventional forms of cropping. Indigenous foods are well-adapted to local conditions, and may hold cultural and economic value for peri-urban residents. Social, ecological, and economic variables influence the feasibility of indigenous agroforestry in peri-urban areas. This study uses participatory mapping and geographic information systems (GIS) to assess these variables and to map suitable spaces and species for peri-urban indigenous agroforestry at three peri-urban sites in Durban, South Africa. We find that: land tenure, livelihood opportunities, and indigenous food perceptions factor into socioeconomic preferences; topography and soil quality influence ecological feasibility; access to water and roads influences perceived economic viability. Although GIS techniques can identify land suitability, participatory mapping adds local fine-scale context to enhance decision-making. Based on the social-ecological conditions at the three sites, we suggest specific configurations of locally adapted foods and farm designs for peri-urban agroforestry. Our study demonstrates how agroforestry is more feasible in places where basic living conditions are fulfilled, and how co-design can improve recognition of local needs, accessibility to services, and balancing urban green equity.

Correction: Comparison of frailty instruments for predicting mortality and prolon ged hospitalization in acute coronary syndrome patients

Harnessing Eisenia fetida for the vermconversion of biodegradable wastes in Dambi Dollo town, Ethiopia

Surgical versus conservative treatment of odontoid fractures in the elderly: A randomized controlled clinical study (SCORE)

Background Odontoid fractures of the second cervical vertebra commonly affect elderly patients due to osteoporosis and low-energy trauma. Treatment is controversial, with prolonged cervical collar immobilization risking non-union and complications, and surgical C1–C2 stabilization involving higher upfront surgical risks. High-level evidence from randomized controlled trials to guide optimal treatment decisions is lacking. The SCORE study aims to determine whether surgical stabilization is non-inferior to conservative collar management in maintaining functional independence for elderly patients with unstable odontoid fractures. Methods SCORE is a multicenter, parallel-group, randomized controlled non-inferiority trial enrolling 322 patients aged ≥70 years with acute (≤2 weeks) unstable odontoid Type II, III, or atypical fractures. Participants will be randomized 1:1, stratified by center, to receive surgical stabilization via posterior C1–C2 fixation or conservative management with a rigid cervical collar. The primary outcome measure is the change in Barthel Index (BI) from baseline to 12 weeks. Secondary outcomes include quality of life (EQ-5D), neck pain (Visual Analog Scale, VAS), neck disability (Neck Disability Index, NDI), radiographic fusion, treatment compliance, cross-over rates to surgery, and incidence of adverse and serious adverse events up to 6 months. Follow-ups will take place at 12 weeks and 6 months post-injury, with an additional visit at approximately 2 weeks post-surgery for surgical patients. Analysis will use mixed models for repeated measures, targeting 90% power to detect non-inferiority within a 5-point margin on the BI (one-sided α = 0.025), accounting for 15% attrition. Discussion This trial addresses a critical evidence gap by directly comparing surgical and conservative treatments, aiming to guide clinical decision-making and improve functional outcomes and quality of life in elderly patients. Trial registration ClinicalTrials.gov, ID: NCT06961578

Antiproliferative activity of Moringa oleifera (L.) Lam. and Moringa stenopetala (Bak.) Cufod. leaves extract against selected cancer cells in primary cell culture

Abstract Natural compounds possess anti-tumor capabilities for a wide range of cancers. The present study aims to analyze and compare the antiproliferative activity of Moringa oleifera and Moringa stenopetala leaf extracts against anaplastic thyroid carcinoma and lung adenocarcinoma cells in primary cell culture. Samples were collected from Arba Minch, Ethiopia. Water-soluble tetrazolium salt-1 assay was used to assess the antiproliferative activity of these samples against anaplastic thyroid carcinoma and lung adenocarcinoma cells in primary cell culture. Cell number counting was another method used to confirm cell proliferation. The results showed that, in comparison to the control, both Moringa species significantly lowered cancer cell proliferation in a dose-responsive manner. Although Moringa oleifera showed a stronger inhibitory effect compared to Moringa stenopetala , there was no statistically significant difference ( p  > 0.05) in the proliferation of anaplastic thyroid carcinoma and lung adenocarcinoma cells between the two species. Moringa oleifera extract had a lower IC 50 value in anaplastic thyroid carcinoma cells, 84.2 µg/ml, than Moringa stenopetala leaf extract, 90.6 µg/ml. Moringa oleifera leaf extract has a lower IC 50 value in lung adenocarcinoma cells, 64.7 µg/ml, than Moringa stenopetala leaf extract, 75.3 µg/ml. In conclusion, the two species have antiproliferative activity on anaplastic thyroid carcinoma and lung adenocarcinoma cells in primary cell culture. These findings indicated that both extracts may serve as a basis for future cancer therapeutic applications.

Deer impact seedbanks and plant communities over 18 years of post-agricultural succession

White-tailed deer ( Odocoileus virginianus ) are known to alter the composition of plant communities and the course of secondary succession. We present 18 years of data from a long-term deer exclosure experiment near Ithaca, NY, USA, to evaluate seedbank dynamics and the resulting aboveground community. Seedbank data were collected annually from 2005 to 2021 through a germination assay in which 280,674 emerged seedlings were identified. Aboveground data were collected from 2019 to 2022. Across all years, deer increased Shannon-Wiener diversity of seeds germinated from the soil by 8% relative to exclosure plots but did not affect abundance or species richness. Deer altered seedbank composition but not the percentage of biennial/perennial (vs. annual) or native (vs. non-native) species in the seedbank. Deer had little effect on aboveground plant communities (total cover, diversity, percentage biennial/perennial, percentage native) in 2019 or 2022. Nonetheless, deer reduced the abundance of woody plants by 50% and only the exclosure treatment had trees exceeding 1 cm diameter at breast height after 16 years. Although seedbank and aboveground plant communities changed over the study period, there was generally no interaction between the effects of exclosure treatment and year. Overall, our findings show that deer increased seedbank diversity, altered seedbank community composition, and suppressed woody plants aboveground. These changes are likely to impact the process of secondary succession. Increased seedbank diversity might increase the feasibility of passive restoration, whereas suppression of woody plants would delay forest recovery.

A hybrid RRT-DWA path planning framework for UAVs in dynamic environments

From fragmentation to resilience: Connectivity and habitat diversity as drivers of fish persistence in California watersheds

This study evaluates how well key elements of freshwater resilience (e.g., hydrographic, physical habitat, and condition variables) explain the persistence of native fish species over time. Using the Temporal Beta Index (TBI), we quantify the change in fish species presence-absence in functionally connected networks within California to determine which watersheds within the network experienced significant changes in fish community composition. Random forest (RF) models were used to explore how the suite of network attributes influenced TBI and how the relationships varied by ecoregion. By integrating historical and contemporary fish distribution records with comprehensive datasets on fish passage barriers, stream habitat typologies, and watershed conditions, the analysis provides evidence that fragmentation—primarily driven by a century of dam construction—has impacted the persistence of fish species throughout the state. These results underscore the importance of maintaining and restoring interconnected river networks to preserve habitat heterogeneity, ensure the continued functionality of freshwater processes, and promote long-term ecological stability amidst ongoing and future environmental challenges. This research provides a framework to evaluate what factors contributed to fish loss in the past, thereby offering insights into enhancing the resilience of freshwater ecosystems and persistence of freshwater species into the future.

Biomechanics of the mandibular middle ear of the cynodont <i>Thrinaxodon</i> and the evolution of mammal hearing

The middle ear of mammals is a major functional innovation, distinctive in that it is detached from the mandible and has a tympanic membrane supported by a ring-like ectotympanic. These novelties of the middle ear have enabled modern mammals to develop more sensitive hearing than all other tetrapods, especially at higher frequencies. Fossils from recent decades have clarified the evolution of the detached middle ear from the jaw bones of Paleozoic therapsids and Mesozoic cynodonts, and the evolution of the tympanum. These discoveries make it possible to answer important questions about the functional significance of these features. Here, we evaluate the relative hearing efficacy of a well-known cynodont precursor to mammals, Thrinaxodon liorhinus . Using finite element analysis (FEA), we calculated the harmonic response of the Thrinaxodon ear to bone-conducted and airborne sound and estimated the sound pressure level (SPL) at the stapedial footplate across a broad range of frequencies. We provide evidence that airborne sound received at the tympanum was the most effective mode of sound reception in Thrinaxodon . In contrast, bone conducted sound through the mandibular bones barely met our estimated hearing threshold. Our findings suggest that, like modern mammals, cynodonts were already reliant on a soft tissue tympanum to receive airborne sound, albeit with limited sensitivity to high frequencies. This is a detailed biomechanical evaluation of tympanum function in the cynodont predecessors of mammals and yields insight into the sequence of functional innovations during the evolution of mammal hearing.

The sobol sensitivity analysis of the pressure, stresses, and displacement arising from poroelastic modelling of hard mechanical systems

Abstract We perform a sensitivity analysis to investigate the influence of material input parameters on the pressure, stresses, and displacement of an isotropic porous solid cylinder representing hard mechanical systems such as the bone. We model the system using the governing equations of Biot’s poroelasticity in cylindrical polar coordinates, where the solutions are found by enforcing radial boundary conditions. The sensitivity analysis is carried out on the solutions for the pressure, stress components and displacement using ranges of the investigated parameters representative of the bone. Our study finds that the time $$t^*$$ has the highest influence on the pressure, the stress components and displacements. We find that the Poisson ratio $$\nu$$ plays a greater role than shear $$\mu$$ in the pressure response, and the shear $$\mu$$ counts more than the other parameters in the radial and circumferential stresses. There are key joint interactions between the Biot’s coefficient $$\alpha$$ and the Poisson ratio $$\nu$$ , the non-dimensionalised radius $$R^*$$ of the bone, and the Biot’s modulus M when investigating interstitial pressure, which is a key value in bone remodelling and fracture healing. This study paves the way to a deeper understanding of the interplay of all the parameters that are necessary to capture the true behaviour of hard mechanical systems such as the bone and its potential remodelling.

Followership among jordanian nurses: A cross-sectional online study

Background In recent years, the concept of followership has gained significant attention, challenging the traditional leadership-centric view of organizational management positions. While effective followership is vital to the success of any organization, it has often been overlooked, especially in healthcare, where teamwork is crucial. Aim The current study aimed to identify the followership styles of nurses in Jordan and examine how these styles relate to nurses’ demographic and work-related characteristics. Method A descriptive cross-sectional design was employed. Using a multistage sampling approach, 351 registered nurses were recruited from governmental, private, and teaching hospitals across northern, central, and southern Jordan. Data were collected through an online survey using the validated Kelley Followership Questionnaire–Revised (KFQ-R). Both descriptive and inferential statistical analyses were conducted. Results Findings revealed that the predominant followership style was exemplary (68.7%), followed by the pragmatist (31.3%). Chi square test revealed statistically significant difference between followership style and marital status (χ² (1) = 6.193, p = .013), working area (χ² (2) = 7.405, p = .025), nursing care delivery system (χ² (3) = 13.926, p = .003), and Decision-making style (χ² (3) = 17.173, p = .001). The binary logistic regression was significant, χ² (26) = 67.77, p &lt; .001, identifying participatory decision-making style, working area, and nursing care delivery system as significant predictors of exemplary followership. Conclusion The study found that nurses working in participatory decision-making environments, team-based models of care, and high-intensity units such as emergency departments were more likely to exhibit the characteristics of exemplary followers. Nurse leaders and managers should foster work environments that promote autonomy, support shared decision-making, and encourage active team engagement. These findings emphasize the critical role of effective followership in advancing collaborative practice, optimizing clinical decision-making, and strengthening workforce performance, underscoring its integration into nursing education, leadership development program, and organizational policy.

Assessing São Paulo’s public transport efficiency and coverage through data-driven modeling of autonomous vehicle and vehicle-as-a-service integration

Abstract São Paulo, the largest Brazilian metropolis, faces complex challenges in urban mobility, exacerbated by growing population demands and the unequal distribution of public transport infrastructure. This study analyzed the efficiency of the city’s public transportation system using geospatial visualization techniques and data analysis. Significant disparities were identified between central areas, which exhibit higher density and connectivity, and peripheral neighbourhoods, which experience lower vehicle frequency and longer waiting times. To address these challenges, the study explored the potential of emerging technologies, such as autonomous vehicles and the Vehicle-as-a-Service (VaaS) model, to expand coverage and enhance public transportation efficiency. Autonomous vehicles can help reduce accidents caused by human error and alleviate traffic congestion, while the VaaS model offers an intelligent integration of vehicles and urban infrastructure, fostering a more flexible and scalable mobility system. Despite the promising prospects of these innovations, their implementation faces several challenges, including the need for specific regulations, robust technological infrastructure, and public acceptance. This study concludes that adopting analytical technologies and emerging solutions is crucial to transforming urban mobility in São Paulo, fostering a more efficient, inclusive, and sustainable public transportation system.

Trends in self-reported dilated eye examinations among diabetic adults in California from 2011 to 2021

Although prior studies have documented disparities in eye care utilization by age, race/ethnicity, sex, and socioeconomic status, limited research has tracked long-term trends within the diabetic population in California, particularly in the context of the COVID-19 pandemic. We aimed to estimate the 11-year secular trend in eye care utilization among adult diabetic patients in California, USA. This was a secondary analysis of public-use data from the California Health Interview Survey (CHIS), an annual population-based survey in California conducted from 2011 to 2021. CHIS samples a representative portion of the California population, with over 20,000 adults in each survey cycle. Data analyses were conducted from January 2023 to April 2024. The primary outcome was the weighted percentage of diabetic adults who reported undergoing a dilated eye exam within the past year. Survey-weighted multivariable logistic regression analyses were conducted to evaluate the association between sociodemographic risk factors and the outcome. The prevalence of recent dilated eye exams declined by 8.3% (95% confidence interval -– CI: 4.7%−11.8%; P &lt; 0.0001) in the two years following the onset of the COVID-19 pandemic (2020−2021) compared to the two years prior (2018−2019) among adults with diabetes in California. This decline was more pronounced among adults aged ≥ 60 years (P = 0.040 for age interaction) and was limited to urban residents (P = 0.030 for interaction with geographic area). However, it did not disproportionately affect Hispanic or Black Americans (P = 0.71 for race/ethnicity interaction). In conclusion, eye care utilization among the diabetic adults in California declined significantly from 2018−2019–2020−2021, a trend largely attributable to the impact of the COVID-19 pandemic.

Frailty and prolonged preoperative waiting time as independent predictors of postoperative delirium in older hip fracture patients

Abstract Background Postoperative Delirium (POD) is a relatively common acute neurocognitive complication in elderly patients with hip fractures. However, its incidence and independent risk factors remain incompletely defined. This analysis utilized prospectively collected data from 238 consecutive patients with hip fractures aged ≥ 60 years. Univariate analyses were first used to assess potential risk factors for POD. Variables showing significant associations underwent collinearity testing, and those with high variance inflation factors (VIF &gt; 5.0) were excluded. To ensure model stability per the Events Per Variable (EPV) principle and to focus on clinically meaningful predictors, a final set of 7 variables was entered into a multivariate logistic regression model to identify independent predictors of POD. The analysis included 238 patients with an average age of 79.0 years, of whom 73.1% were women. The overall incidence of POD was 31.9%. Those who developed POD were significantly older (82.5 vs. 77.3 years) and a higher proportion were female (77.6% vs. 71.0%). Multivariate analysis identified four independent predictors of POD: frailty (OR = 2.62, 95% CI 1.22–5.62, P  = 0.014), a preoperative waiting time exceeding 90 h (OR = 2.59, 95% CI 1.31–5.15, P  = 0.007), postoperative infection (OR = 2.41, 95% CI 1.21–4.82, P  = 0.013), and advanced age over 82 years (OR = 2.44, 95% CI 1.26–4.73, P  = 0.008). Patients with POD experienced longer ICU stays (median 17.8 days vs. 0 days, P  &lt; 0.001) and longer total hospitalization (13 days vs. 10 days, P  &lt; 0.001). Frailty, prolonged preoperative waiting time, postoperative infection, and advanced age were identified as independent predictors of POD in older hip fracture patients. These findings may help improve understanding of delirium risk in this population and suggest areas for further investigation. Further studies are warranted to explore causal mechanisms and to evaluate whether perioperative interventions aimed at reducing waiting time, assessing frailty, or preventing infections might mitigate the risk of POD.

Reliability, validity, and correlates of an AI voice emotion recognition app among nurses

Background Digital tools are increasingly widespread in healthcare, particularly in the fields of emotion recognition and mental health assessment. Objectives This study evaluated whether an artificial intelligence (AI) voice emotion recognition (VER) app could identify nurses’ emotions and explored its associations with their background and health conditions. Methods The emotions of 349 clinical nurses at a medical center in northern Taiwan were analyzed using an AI VER app and several standardized psychological questionnaires. To control for potential confounding variables, demographic and health-related factors including age, gender, work experience, exercise habits, and history of physical symptoms were collected and statistically adjusted in correlation analyses. Convergent validity was tested with Pearson’s correlations, and test-retest reliability was evaluated in 30 nurses using intraclass correlation coefficients (ICCs). Results Significant correlations were observed between app-derived emotions and standard scales (anger: Novaco Anger Inventory-Short Form, r  = .42; fear: Perceived Stress Scale, r  = .41; happiness: Oxford Happiness Questionnaire, r  = .45; and sadness: Beck Depression Inventory-II, r  = .47; all p  &lt; .001). Multiple regression identified significant lifestyle and health predictors of emotions: less exercise predicted higher anger (β = .11, p  = .025), peptic ulcers predicted greater fear (β = .19, p  &lt; .001), daily coffee predicted higher happiness (β = .11, p  = .041), and irregular menstrual cycles predicted lower happiness (β = −.13, p  = .014) and greater sadness (β = .30, p  &lt; .001). The AI VER app demonstrated good test-retest reliability (ICC = 0.73–0.80). Conclusion Peptic ulcers, irregular menstrual cycles, and lack of exercise were associated with negative emotions such as fear, sadness, and anger. The AI VER app could objectively detect these emotional patterns in nurses, helping to identify emotional fluctuations early and support timely mental healthcare.

Linking knowledge, attitudes, and practices to sustainable solid waste, water, and energy use in Egyptian households

Abstract Municipal solid waste management (SWM) and water and energy conservation in Egypt have been the subject of several prior studies. However, less is reported concerning household-level knowledge, attitudes, and behaviors (KAP) in these domains. Therefore, this study aimed to evaluate the Kap of Egyptian households and identify the factors impacting SWM and conservation actions. It utilized an online questionnaire to collect data on KAP regarding SWM, as well as water and energy conservation, from Egyptian households. The results revealed that participants had a high level of knowledge and positive attitudes toward SWM, as well as water and energy conservation. However, their actual practices related to SWM were moderate, while their practices concerning water and energy conservation were relatively low. The results also indicated that gender, age, marital status, and educational level were significantly related to the knowledge of SWM. In contrast, age and education were found to be the only key indicators of knowledge in water and energy conservation. Furthermore, it was found that higher levels of education were associated with higher knowledge, attitudes, and practices (KAP) ratings in SWM as well as water and energy conservation.