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Factors that influence an individual’s decision to undergo bariatric surgery: A qualitative systematic review

Introduction Obesity is a significant health issue associated with chronic conditions such as cardiovascular disease and type 2 diabetes. Bariatric surgery is the most effective weight loss treatment for obesity. This systematic review aimed to examine factors influencing individuals’ decisions to undergo bariatric surgery. Methods This systematic review was guided by the JBI Manual for Evidence Synthesis for Qualitative Reviews and reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Literature searches were conducted in CINAHL, PubMed, Cochrane Library, APA PsycINFO, and APA PsycArticles. Results were analysed using a meta-aggregative approach. Quality appraisal was conducted using the JBI Checklist for Qualitative Research. Results Thirteen studies were included. Health concerns, fears of obesity-related comorbidities, and a desire to improve physical health and quality of life emerged as key motivators to undergoing bariatric surgery. Support from healthcare professionals and family played a crucial role in motivating individuals to consider surgery. Women particularly noted concerns about fertility as a motivator to undergo bariatric surgery. Disclosure of surgery, financial concerns, transport, family and work commitments, and perceived risks of surgery were identified as barriers to undergoing bariatric surgery. Conclusion Findings highlight the need for healthcare professionals to adopt empathetic, patient-centred approaches when discussing bariatric surgery. Addressing financial, insurance, and logistical barriers, alongside stigma and family resistance, is essential. Improving patient education, strengthening provider relationships, and offering tailored support can enhance decision-making, access, and long-term outcomes for those considering bariatric surgery.

A reevaluation of the visual phantom illusion and its impact on the motion aftereffect

A mathematical study for psoriasis transmission with immune-mediated time delays and optimal control strategies

In psoriasis, dendritic cells activate T cells, which then release excessive pro-inflammatory cytokines, leading to abnormal growth of keratinocytes in the epidermis. At the same time, anti-inflammatory cytokines attempt to restore balance. In reality, these immune processes are not immediate; they involve biological time gaps due to signal processing, cell communication, and cytokine feedback. Such immune-related delays may play a key role in triggering unstable or oscillatory behavior observed in psoriasis flare-ups. In this study, we present and analyze a mathematical model of psoriasis that explicitly includes two intracellular immune-mediated time delays to demonstrate their biological significance in disease progression. The model captures the interactions among T cells, dendritic cells, keratinocytes, and local mature stem cells. It features two cytokine-mediated feedback loops between T cells and dendritic cells, while stem cells attempt to regulate the immune response through anti-inflammatory signaling. A key challenge is identifying the critical time delays that modulate these interactions. To address this, we introduce two different delays in different interaction terms of the model system. We test the hypothesis that these delays can critically influence the onset and persistence of psoriatic pathology mathematically. Using stability analysis of the interior equilibrium, we determine parametric relations, their ranges, and delay thresholds that give rise to Hopf bifurcations, thereby linking delays to disease and deriving conditions of instability. Our analysis demonstrates that both immune-mediated delays critically influence system stability, with threshold values of τ1* and τ2* inducing oscillations through Hopf bifurcations. Further, we apply optimal control strategies on the delayed system using the effects of two biologic agents: TNF-α and IL-17 inhibitors. Incorporation of optimal controls effectively stabilizes the immune response. Numerical simulations support these analytical findings and show that biologic interventions can effectively reduce keratinocyte density. Inclusion of immune-related delays, based on both analytical and numerical results, provides a more realistic understanding of psoriasis dynamics and helps optimize therapeutic approaches for psoriasis management.

Comparison of the analgesic efficacy of dexketoprofen trometamol and paracetamol with naproxen sodium and codeine phosphate combinations in acute toothache

Fear of childbirth in primipara women and its correlation with premenstrual syndrome: A cross-sectional study

Introduction Fear of Childbirth (FOC) is the most common psychological problem among pregnant women, especially in primipara women who are more likely to fear the unknown delivery process. The causes of FOC are complex and influenced by various factors, but the impact of menstruation-related factors remains unclear. Therefore, this study aims to understand the current situation of FOC in primiparous women during late pregnancy, investigate the influencing factors of FOC, and further explore the correlation between premenstrual syndrome (PMS) and FOC. Methods This study is a multicenter cross-sectional study. A convenience sampling method is used to select 597 primiparous women who attend regular prenatal check-ups at three healthcare institutions in Nantong City, Jiangsu Province, China, between December 2023 and February 2024. Participants are required to complete the general information questionnaire, Premenstrual Syndrome Scale, Childbirth Attitude Questionnaire, Perceived Social Support Scale, Pittsburgh Sleep Quality Index, and Marital Adjustment Scale. Mann-Whitney U test and Kruskal-Wallis test are used to access the between-group differences. Multiple linear regression is used to analyze the influencing factors of FOC. Spearman correlation examines the relationship between PMS and FOC. Results The results show that 46.73% of primiparous women experience FOC. Multiple linear regression analysis shows that dysmenorrhea, unintended pregnancy, PMS, social support, sleep quality, and marital relationship are significant factors influencing FOC ( P  < 0.05). Additionally, PMS is moderately positively correlated with FOC (r = 0.549, P  < 0.01). Conclusion Our study results indicate that the social issue of FOC deserves attention. Clinical healthcare professionals should focus on the physical and mental well-being of pregnant women, particularly those with PMS. They should enhance prenatal psychological assessments and provide targeted emotional support based on individual circumstances, helping these women better cope with childbirth, improve their childbirth experience, and ensure maternal and infant health.

Bioinformatics analysis of IFI6 as a novel prognostic biomarker and its correlation with immune infiltration in breast cancer

Abstract The aim of this study was to identify biomarkers associated with breast cancer prognosis and to explore the underlying pathogenic mechanisms. Interferon alpha-inducible protein 6 (IFI6), known as a proliferative and anti-apoptotic factor, has been implicated in various malignant diseases. However, its biological roles in breast cancer remain poorly understood. To address this, we employed bioinformatics analyses to investigate the expression and prognostic significance of IFI6 in breast cancer. Our findings revealed that IFI6 was upregulated in breast cancer and was associated with histological subtypes and lymph node metastasis status. Kaplan-Meier plotter analysis demonstrated that high IFI6 expression correlated with poor prognosis in breast cancer patients with ER-positive, PR-positive, HER2-positive, and lymph node-positive subtypes. To further enhance clinical applicability, we constructed a prognostic nomogram incorporating IFI6 expression and clinicopathological factors, which showed favorable predictive performance for overall survival. Additionally, IFI6 expression showed significant correlations with infiltrating immune cells, including regulatory T cells (Tregs), M1 macrophages, naïve B cells, and plasma cells. Single-cell RNA sequencing analysis revealed that IFI6 was predominantly expressed in epithelial tumor cells and was associated with altered immune cell composition, suggesting the potential role in shaping the immune microenvironment. Moreover, IFI6 expression was closely associated with several immunomodulators. In conclusion, IFI6 serves as a potential biomarker for immune infiltration and poor prognosis in breast cancer and may offer novel insights into risk stratification and immunotherapeutic strategies.

Investigating the HIV epidemic among Black gay and bisexual men in the Southern United States: Results of the HPTN 096 pilot cross-sectional assessment

Background The HIV Prevention Trials Network (HPTN) 096 study was designed to address the markedly higher rates of HIV incidence among Black men who have sex with men (MSM) in the Southern United States (US). A cross-sectional assessment was conducted during the pilot phase of the study to determine its feasibility and collect key HIV-related metrics for the study population. Methods and findings Four hundred and twenty-two Black MSM, ≥ 15 years old and living in the four pilot communities (Dallas, TX; Houston, TX; Montgomery, AL; Greenville, SC), were enrolled via starfish sampling into the cross-sectional assessment. Each participant completed two questionnaires and had blood samples collected at a single study visit. Laboratory testing was performed to determine HIV status and use of oral pre-exposure prophylaxis (PrEP). HIV drug resistance and viral suppression were also assessed for two of the four pilot communities (Dallas and Houston). Categorical variables were summarized using frequency and percentage. Continuous variables were summarized using mean, standard deviation, median and interquartile range. Univariable and multivariable logistic regression models were used to assess various associations. HIV status was determined for 403 of the 422 participants (95.5%); 212 (52.6%) men were living with HIV, including one with acute HIV. For these participants, 163 (76.9%) reported that they were in HIV care. In Dallas and Houston, 71 of the 101 living with HIV (70.3%) were virally suppressed. Of the 191 not living with HIV, 57 (29.8%) reported ever taking PrEP, 41 (21.5%) reported being currently on PrEP, and eight (4.2%) reported never having heard of PrEP. PrEP use was documented through laboratory testing in 36 (19.1%) of 188 participants tested; of the 41 participants reporting current PrEP use, five did not have laboratory evidence of PrEP use. Conclusion During the pilot, we successfully recruited Black MSM using starfish sampling and demonstrated the feasibility of collecting primary study outcomes using a cross-sectional assessment. We found a high burden of HIV and those living with HIV had only a moderate rate of viral suppression. In addition, PrEP use was uncommon among the men living without HIV. Reducing HIV incidence in Black MSM remains a key element to addressing the HIV epidemic in the US.

KCa3.1 channels regulate the tumor infiltration of functionally competent NK cells in head and neck cancer

Abstract CD8+ T cells and natural killer (NK) cells are the primary defenses against tumor cells. The tumor microenvironment impairs their antitumor capabilities, including the ability to infiltrate the tumor. Our laboratory has shown that tumors suppress T cells by inhibiting KCa3.1 K+ channel activity that controls cytokine release, cytotoxicity, and chemotaxis. However, little is known about the role of K+ channels in the anti-tumor activity of NK cells. Here, we investigated KCa3.1 channels’ role in human NK cell function in head and neck squamous cell carcinoma (HNSCC). Selective blockade of KCa3.1 using TRAM-34 inhibited chemotaxis of NK cells from both healthy donors and patients with HNSCC, while KCa3.1pharmacological activation increased chemotaxis and cytotoxicity. SKA-31, a selective KCa3.1 activator, enhanced antitumor immune responses in a humanized HNSCC mouse model generated by implanting Cal27 cells and healthy donor peripheral blood mononuclear cells into immunodeficient mice. SKA-31 treatment resulted in a 7-fold increase in total NK cells and a 23-fold increase in functionally active (granzyme B-positive) NK cells in these tumors. These data highlight the critical role of KCa3.1 channels in antitumor immunity and open the possibility of targeting KCa3.1 to develop new immunotherapies for HNSCC.

Achieving consistency in FedSAM using local adaptive distillation on sports image classification

Federated learning (FL) is an effective distributed learning paradigm for protecting client privacy, enabling multiple clients to collaboratively train a global model without uploading private data. It has promising applications in sports image classification. However, FL faces the issue of non-independent and identically distributed (non-IID) data, which leads to excessive variance between local models and hinders the convergence of the global model. Although FedSAM and its variants attempt to reduce this variance by finding smooth solutions between local models, local smoothing does not necessarily result in global smoothing. We refer to this issue as the smoothness inconsistency problem. To address this challenge, we propose a novel FL paradigm, named A-FedSAM, which utilizes adaptive local distillation to achieve consistency in smoothing between local and global models without incurring additional communication overhead, thereby improving the convergence accuracy of the global model. Specifically, A-FedSAM employs the global model as the teacher during local training, dynamically guiding the local models to ensure that their gradients not only maintain smoothness but also align with the global objective. Extensive experiments on sports image classification tasks demonstrate that A-FedSAM outperforms state-of-the-art methods in terms of accuracy across different data heterogeneities and client sampling rates, while requiring fewer communication and computational resources to achieve the same target accuracy.

Mature CD209+CD83+CCR7+ dendritic cells infiltrate the arterial wall in giant cell arteritis and derive from in-situ monocyte differentiation

Prevalence of overweight and its associated factors among selected higher secondary schools adolescents of Kathmandu Metropolitan City, Nepal

Overweight is highly prevalent in lower- and middle-income countries (LMICs), including Nepal. Due to the rapid physical and mental growth among adolescents, they are nutritionally vulnerable and sensitive to environmental factors and dietary habits. This study aimed to determine the prevalence of overweight and its associated factors among adolescents of higher secondary schools in Kathmandu Metropolitan City (KMC) of Nepal. A cross-sectional study was conducted among 282 adolescents in higher secondary schools. A stratified random sampling technique was used to select the participants for data collection. The frequencies, percentages, mean, and standard deviation were used to describe the characteristics of the participants. Binary logistic regression was performed to determine the association between individual characteristics and the prevalence of overweight. All the tests were performed at a 95% Confidence Interval (CI), and variables with p-values below 0.05 were considered statistically significant. The mean (±SD) age of the participants was 16.8 ± 0.1 years. The majority of the participants (66.3%) were from private schools. Around 13.4% of the participants were overweight. Characteristics such as type of school (AOR: 2.6, CI: 1.9–8.2), father’s education (AOR: 2.1, CI: 1.7–6.5), access to physical activity at school (AOR: 1.2, CI: 1.1–4.6), and pocket money for lunch at school (AOR: 0.3, CI: 0.2–0.5) were found to be significantly associated with overweight among adolescents in this study. This study found that a notable proportion of adolescents were overweight and were influenced by socio-economic and demographical characteristics such as education, income level, school type, and level of physical activity. School-based interventions and programs should be carried out to promote healthy eating and physical activity among adolescents. A holistic approach, including parental education on nutrition, controlling pocket money to reduce unhealthy purchases, and adding physical activities to school programs, should be tailored to the school setting to reduce the risk of being overweight.

Genetic algorithm optimization of negative pressure wave method for robust real time leak detection in long distance pipelines

Public discourses of alternative protein foods in Facebook public pages’ posts, 2014–2024

“Alternative protein” (AP) refers to protein sources that are different from conventional animal-based proteins. This category encompasses a variety of highly processed plant-based proteins, cultured or cell-based meat, and is primarily driven by factors like sustainability, health, ethical concerns about animal welfare, and the need to feed a growing global population. The aim of this study is to map and understand public discourses around AP foods through social monitoring, in particular, computational analyses of social media big data. Through analyzing the topics and sentiments of Facebook public pages’ English content in the decade of 2014–2024, we found that (1) public attention on plant-based AP foods dropped since 2021, while attention on cell-based AP foods showed an uneven growth; (2) public sentiments towards plant-based AP foods were consistently positive, while sentiments towards cell-based AP foods were clearly more mixed; (3) discussion topics under plant-based AP foods were more practical and diverse than topics under cell-based AP foods; (4) the leading actors talking about AP foods were enterprises & industry, media, and organizations. Overall, plant-based AP foods have generated a more established and diverse public discourse, while cell-based AP foods are still emerging in public conversations and continue to face greater barriers to widespread understanding and acceptance.

Impact of changes in the wind regime on the Caspian sea level fluctuation and its relationship with SOI and NAO

Real-world pharmacovigilance of risperidone: Analysis based on FAERS reports from physicians and pharmacists

Objective Risperidone, a second-generation antipsychotic widely used in clinical practice, has not been systematically evaluated for its long-term real-world adverse events. This study analyzed risperidone-related AEs reported in the U.S. Food and Drug Administration Adverse Event Reporting System (FAERS) over nearly two decades, providing a reference for clinical medication. Methods Data on risperidone was collected from FAERS covering the period from the first quarter of 2004 to the third quarter of 2024. Signal detection was performed using the reporting odds ratio, proportional reporting ratio, Bayesian confidence propagation neural network, and multi-item gamma Poisson shrinker algorithms. Results Among the 18,089 reports collected, a total of 27 system organ classes and 452 preferred terms were identified. Nervous system disorders, Psychiatric disorders, General disorders and administration site conditions, and Injury, poisoning and procedural complications were the primary SOCs. Additionally, Reproductive system and breast disorders, Endocrine disorders, Metabolism and nutrition disorders, and Cardiac disorders showed a strong association with risperidone, warranting heightened vigilance. This study identified a substantial number of extrapyramidal-related AEs, including propulsive gait, spasmodic dysphonia, tongue thrust, respiratory dyskinesia, oromandibular dystonia, cogwheel rigidity, and pleurothotonus. Rare cardiovascular events such as Wellens’ syndrome and endocarditis fibroplastica were also uncovered through in-depth analysis. Furthermore, AEs like paroxysmal perceptual alteration, pulmonary vein occlusion, and floppy iris syndrome, although infrequent, exhibited high signal strength. This study also identified noteworthy signals not included in the risperidone label, such as rabbit syndrome (perioral tremor), jaw clicking, and portal vein cavernous transformation, which merit further investigation. Conclusion From the perspectives of physicians and pharmacists, this research provides a unique and robust theoretical foundation for evaluating the safety profile of risperidone and offers direction for future studies on its adverse events.

Enhancing carbon emission reduction strategies using OCO and ICOS data

Abstract We propose a methodology to enhance local CO2 monitoring by integrating satellite data from the Orbiting Carbon Observatories (OCO-2 and OCO-3) with ground-level observations from the Integrated Carbon Observation System (ICOS) and weather data from the ECMWF Reanalysis v5 (ERA5). Unlike traditional methods that downsample national data, our approach uses multimodal data fusion for high-resolution CO2 estimations. We employ weighted K-nearest neighbor (KNN) interpolation with machine learning models to predict ground-level CO2 from satellite measurements, achieving a Root Mean Squared Error of 3.58 ppm. Our results show the effectiveness of integrating diverse data sources in capturing local emission patterns, highlighting the value of high-resolution atmospheric transport models. The developed model improves the granularity of CO2 monitoring, providing precise insights for targeted carbon mitigation strategies, and represents a novel application of neural networks and KNN in environmental monitoring, adaptable to various regions and temporal scales.

Nonlinear control of a fully actuated robotic hand using high-order sliding mode and feedback linearization controllers

The increasing adoption of prosthetic devices in medical applications introduces complex and variable load conditions, particularly due to the diverse nature of user disabilities. To address the resulting control challenges, this paper proposes a novel High-Order Fully Actuated Sliding Mode Controller (HOFA-SMC) implemented to enhance robustness under system uncertainties and non-linearities. The proposed controller incorporates a proportional-integral (PI) framework to structure the high-order terms and effectively mitigate the chattering commonly associated with sliding mode control. Stability of both the HOFA-SMC and a feedback Linearization controller (FLC) is established using Lyapunov theory. A detailed simulation study is conducted on a full hand model, comprising four 4-degree-of-freedom (DOF) fingers and a 3-DOF thumb, implemented in Python. The controllers are evaluated across three test scenarios: flexion, extension, and ball grasping. Results indicate that HOFA-SMC achieves rapid trajectory convergence (within 0.2 s) and robust performance under varying uncertainty conditions. A comparative analysis further confirms the superiority of HOFA-SMC over traditional SMC and FLC approaches in trajectory tracking and control stability.

Neurometabolic profiles of autism spectrum disorder patients with genetic variants in specific neurotransmission and synaptic genes

Abstract Autism Spectrum Disorder (ASD) is a neurodevelopmental condition characterized by impaired social interaction, and restricted and repetitive patterns of behavior. ASD presents as a clinical spectrum, with variable levels of severity and multiple co-occurring conditions. The etiology of ASD may involve hundreds of genes and there is evidence that neurotransmitter and synaptic (NS) pathways are implicated. Proton Magnetic Resonance Spectroscopy ( 1 H-MRS) has made it possible to study the concentration of brain neurometabolites and compare their levels in the brains of ASD and control individuals. We integrated genetic variants in NS genes with 1 H-MRS analysis, and identified 12 predicted damaging variants (PDVs) in 12 NS genes in 10 ASD individuals, most mapping to genes involved in Gamma-aminobutyric acid (GABA) and glutamate pathways. Total creatine (tCr) and total N-acetyl aspartate (tNAA), markers of bioenergetics and neuronal metabolism, respectively, were lower in ASD patients with genetic alterations in NS genes compared to a control group without ASD. We conclude that PDVs in NS genes that are important for the regulation of glutamate or involved in GABAergic functions are associated with neurometabolic alterations, and that dysfunction in glutamatergic and/or GABAergic pathways may be implicated as these pathways are linked to the metabolic measures altered in cases.

FoxO3a regulated by miR-150-5p promotes the pyroptosis of macrophages in atherosclerosis

Background This study uses tissue exosome analysis to explore the role of miR-150-5p and its downstream genes in atherosclerosis (AS), an area where the functional mechanisms and pathophysiological significance of exosomal miR-150-5p remain poorly understood. Methods Exosomes from AS mouse vascular tissue were analyzed to identify miR-150-5p target genes. Dual luciferase assays validated miRNA-target interactions, while RT-qPCR and Western blot assessed FoxO3a expression. RNA interference studies determined FoxO3a’s role in pyroptosis. In vivo efficacy of the miR-150-5p inhibitor was evaluated using HE, Masson staining, and immunofluorescence. Results In AS tissue exosomes, miR-150-5p levels increased whereas FoxO3a levels decreased. miR-150-5p regulated FoxO3a, enhancing macrophage pyroptosis. The miR-150-5p inhibitor reduced ox-LDL-induced RAW264.7 injury and pyroptosis by improving cell viability, decreasing LDH levels, and downregulating pyroptosis related proteins (Caspase-1, NLRP3, GSDMD-N). FoxO3a knockdown weakened the inhibitor’s effects on NLRP3/GSDMD-mediated pyroptosis. In Apoe−/− mice, the inhibitor upregulated FoxO3a/ARC and suppressed pyroptosis signaling. Conclusion This study advances understanding of miR-150-5p-mediated pyroptosis and highlights the potential of miR-150-5p inhibitors in combating AS.

Experimental investigation of al₂o₃ nanoparticle-enhanced natural ester oil as a biodegradable liquid dielectric for transformers