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Marine Natural Product Chagosendine C Induces Cuproptosis in Colorectal Cancer Cells by Targeting FDX1

Neutropenic sepsis and septic shock in ICU patients: A single-center experience over the last decade

Purpose Sepsis and septic shock in patients with neutropenia are associated with high mortality. We investigated the features and outcome predictors of neutropenic sepsis in the last decade. Methods Consecutive patients who were admitted to the intensive care unit (ICU) of a French university-affiliated hospital in 2012–2022, met criteria for sepsis or septic shock, and had neutropenia were included retrospectively. Patient features were collected and compared for 2012–2017 and 2018–2022. Factors associated with hospital mortality were sought by univariate and multivariate analyses. Results Of the 185 patients, 85 were admitted in 2012–2017 and 100 in 2018–2022. The more recent group was older and had a heavier comorbidity burden but had a hospital mortality rate of 40.0% compared to 49.4% in the early group (p = 0.24). The most common source infections were pulmonary (24.8%) and hepatobiliary or gastrointestinal (23.8%). Gram-negative bacilli predominated. Predictors of in-hospital mortality were older age (odds ratio [OR], 1.04; 1.01–1.07; P = 0.005) and worse SOFA score (OR, 1.22; 1.05–1.42; P = 0.009). Aminoglycoside therapy predicted lower in-hospital mortality regardless of infection site and renal function (OR, 0.30; 0.14–0.63; P = 0.002). Early source-control interventions were not significantly associated with hospital mortality. Conclusion Intensivists are admitting patients with neutropenic sepsis who are older and have more comorbidities than was the case in earlier years. Despite this change, there is a non-statistically significant trend of declining mortality. Our findings support the initiation at ICU admission of combination antibiotic therapy including an aminoglycoside.

Convergence analysis of Suzuki’s generalized nonexpansive mappings using the Picard–Abbas iteration process

This manuscript investigates the convergence behavior of Suzuki’s generalized nonexpansive mappings using the recently introduced Picard–Abbas iteration process. We establish both weak and strong convergence results for the associated fixed-point approximations. To demonstrate the effectiveness of our approach, a numerical example is provided. Furthermore, we generate polynomiographs based on the proposed iteration process and compare them with those produced by existing methods, highlighting the advantages and visual insights offered by our scheme.

Return-to-work for people living with long COVID: A scoping review of interventions and recommendations

Introduction Long COVID is characterized by the presence of new onset or persistent symptoms 3 months after a suspected or confirmed history of SARS-CoV-2 infection. It is a complex and multi-faceted condition that affects people in different ways. Long COVID affects individuals’ labour market participation. While some cannot work, others may return to work (RTW) in a limited capacity. Determining what rehabilitation or related strategies are safe and effective for facilitating RTW is necessary. Objectives To synthesize evidence on RTW interventions for people living with Long COVID and to identify ‘promising’ interventions for enhancing work ability and RTW. Methods We followed Arksey & O’Malley’s methodology and the PRISMA extension for scoping reviews. Five electronic bibliographic databases and grey literature were searched. The literature search included various study designs, such as randomized controlled trials (RCT), quasi-experimental designs, and observational studies as well as clinical practice guidelines (CPGs). Two reviewers conducted screening and data extraction, with disagreements resolved through consensus. Intervention studies were categorized as promising (statistically significant RTW outcomes or ≥ 50% RTW), somewhat promising (20% to < 50% RTW), not promising (non-statistically significant RTW outcomes or < 20% RTW), or uncertain (did not specify proportion of RTW). Results Twelve CPGs and nineteen intervention studies were identified. Of the intervention studies, 5 were cohort studies, 3 quasi-experimental studies, 4 observational, 2 interventional, 3 RCTs, and 2 case reports. Promising interventions included multimodal and interdisciplinary work-focused rehabilitation, multidisciplinary inpatient and outpatient rehabilitation, psychoeducation, pacing, and breathing strategies, shifting focus from symptom monitoring to optimizing functional outcomes, enhanced external counterpulsation inflatable pressure to improve blood flow, and constraint-induced cognitive therapy. Conclusion Many uncertainties remain regarding which RTW interventions are effective or the optimal characteristics of these interventions.

Computational modeling for enhanced reliability in space missions: An integrated FAHP-COPRAS approach to supplier selection

Liquid Crystal Displays (LCDs) are indispensable in space science, playing critical roles in spacecraft instrumentation, data visualization, and control systems. Selecting reliable suppliers for LCD equipment is vital to ensuring optimal performance and durability in the challenging conditions of outer space. This paper presents a comprehensive decision-making framework using fuzzy multi-criteria decision-making (MCDM) methodologies tailored for aerospace applications. The framework begins with the Fuzzy Analytic Hierarchy Process (FAHP) to determine criteria weights such as technical specifications, environmental resistance, quality and reliability, cost and delivery performance, compliance, and certifications. These criteria are crucial for meeting the stringent requirements of space missions and reflect objective metrics and expert opinions. Subsequently, the Complex Proportional Assessment of Alternatives (COPRAS) is applied to rank potential suppliers based on their performance against the weighted criteria. COPRAS allows for a comparative analysis considering positive and negative preferences, ensuring suppliers meet technical specifications and align with strategic mission objectives and constraints. Integrating FAHP and COPRAS enhances supplier selection processes’ transparency, consistency, and objectivity in aerospace procurement. This approach mitigates the risks associated with supplier variability, ensuring continuity in operations critical to space exploration and scientific advancements. The study contributes to advancing decision support systems in aerospace procurement, emphasizing rigorous supplier evaluation methodologies to enhance mission success and reliability in space science applications.

Feasibility and acceptability of research-grade wearables for health and labor capacity monitoring in the context of climate change and heat stress: The case of Nouna, Burkina Faso

Current climate projections estimate a further rise of mean ambient temperatures of 1.5°C until 2040. However, the understanding of heat stress’s impact on health and labor capacity, especially in vulnerable regions such as sub-Saharan Africa, remains limited. In turn, no long-term investigations monitoring and uniting both individual-level subject and environmental data have been yet conducted in this region. To address this knowledge gap, we evaluated the feasibility and acceptability of research-grade wearables for continuous, direct, individual-level monitoring of physiological parameters in a population of subsistence farmers (one woman and one man per n=20 households) in rural Burkina Faso. We conducted a four-week pilot study, investigating data completeness and quality of heart rate and core body temperature, and data completeness for physical activity, and GPS individual tracking, simultaneously monitoring outdoor and indoor wet-bulb-globe temperature. Additionally, participants were surveyed regarding their acceptance of employed wearables. Regarding environmental indoor monitoring, we collected 85% of completed data, whereas for outdoor, it was 100%. An average of 97.5% of viable data sets were retrieved for all wearables (heart rate: 97.5%, core body temperature: 97.5%, physical activity: 97.5%, GPS: 97.5%). Individual data point completeness was > 92% for all sensors, except GPS, where it was 67% on average. Acceptance of wearables was positive, with a range of 79% to 95%. The main challenges perceived by participants were missing personalized sensor feedback (70%) and uncertainty regarding the meaning of the wearables (47.5%). We show that the implementation of research-grade wearables in sub-Saharan Africa is technically feasible and socially accepted. Further, we point out current challenges and provide a solid framework for future research in this region.

A real-world pharmacovigilance analysis of acute renal failure associated with sacubitril/valsartan based on FDA Adverse Event Reporting System (FAERS)

Background The renal safety profile of sacubitril/valsartan remains debated in clinical practice. To address this uncertainty, we conducted a pharmacovigilance analysis of acute renal adverse events associated with sacubitril/valsartan using the FDA Adverse Event Reporting System (FAERS) database. Methods Using data from the FAERS database, we conducted an observational pharmacovigilance study from the first quarter (Q1) of 2015 to the fourth quarter of 2024 (Q4). The disproportionality analysis was performed using four algorithms: the reporting odds ratio (ROR), the proportional reporting ratio (PRR), the Bayesian confidence propagation neural network (BCPNN), and the multi-item gamma Poisson shrinker (MGPS). Results A total of 16,144,939 adverse events (AEs) were available on FAERS database, among these, 132,255 cases were associated with sacubitril/valsartan, 2,205 cases related to narrow acute renal failure (SMQs) and 3,232 cases with broad SMQs. And sacubitril/valsartan and acute renal adverse showed significant association both in narrow SMQs (ROR = 2.37; PRR = 2.34, χ2 = 1703.73; EBGM05 = 2.26) and the broad SMQs (ROR = 2.55, PRR = 2.51, χ2 = 2941.80, EBGM05 = 2.43). A total of 10 (19.23% of total) positive signals were obtained using the above four algorithms. Median age was 71 years, time to onset was within 30 days, and hospitalization rates of acute renal failure outcomes were 14.33% (narrow SMQs) and 30.69% (broad SMQs). Conclusion The widespread use of sacubitril/valsartan has raised safety concerns, particularly regarding acute renal failure. Our study, leveraging real-world FAERS data, systematically analyzed this association, providing new evidence on acute renal failure risks.

Effects of woody plant encroachment on abundance of multiple tick species in the U.S. Great Plains

Vector-borne diseases are increasing in prevalence, posing a risk to 80% of the human population worldwide. In the United States, tick-borne diseases account for 75% of all nationally reported vector-borne disease cases. As the distribution of medically important ticks and tick-borne diseases increases, it is crucial to understand the factors driving their expansion. Changes in land cover are a known driver of vector-borne disease emergence and prevalence. In the U.S. Great Plains, a dominant form of land cover change affecting vectors and vector-borne diseases is woody plant encroachment (WPE), the expansion of trees and shrubs into grassland ecosystems due to fire suppression and other anthropogenic factors. In this study, we examined whether WPE by eastern redcedar (Juniperus virginiana, ERC), a widespread encroaching tree in the Great Plains, influences abundance of three medically important tick species, Amblyomma americanum, Dermacentor variabilis, and Amblyomma maculatum. Through CO2 trapping and flagging, we collected ticks in Oklahoma, USA, in sites capturing open grasslands and three intensifying stages of ERC encroachment. For all analyses, we found that abundances of A. americanum and D. variabilis were higher in the earliest stage of ERC encroachment compared to open grassland, indicating that abundances of these species increase shortly after the onset of encroachment. However, for A. maculatum, a species known to be associated with grassland ecosystems, abundance was lower in areas experiencing ERC encroachment compared to grasslands. Our results suggest that the most effective strategy to managing tick populations in association with WPE is to prevent ERC encroachment entirely or to remove encroachment early on before progression to later stages. Landowners, managers of public and private lands, and public health officials should be aware of the health risks associated with ERC encroachment and consider initiating educational and management protocols to protect their communities.

Current and future burden of gynecological cancers attributable to high body-mass index: A comprehensive global analysis and projection study

Background High body-mass index (BMI) is a major modifiable risk factor for gynecological cancers, yet its contribution to the global cancer burden remains incompletely characterized. This study provides a comprehensive analysis of the current burden of gynecological cancers attributable to high BMI and projects future trends through 2050. Methods We analyzed data from the Global Burden of Disease (GBD) 2021 study, examining uterine and ovarian cancers attributable to high BMI across 204 countries and territories. Burden was quantified using deaths and disability-adjusted life years (DALYs). Temporal trends were identified using joinpoint regression analysis, while future burden was projected using Bayesian Age-Period-Cohort (BAPC) models. We evaluated relationships between socio-demographic index (SDI) and cancer burden to identify development-associated patterns. Results Between 1990 and 2021, global deaths from gynecological cancers attributable to high BMI increased by 143.4% (from 20,743–50,479), with corresponding DALYs rising by 141.7% (from 561,515–1,357,395). Rising age-standardized rates indicated increasing individual-level risk. While burden was highest in high-SDI regions, the most rapid increases occurred in low- and middle-SDI settings. Cancer-specific patterns varied, with uterine cancer showing consistent increases across all SDI quintiles, while ovarian cancer exhibited decreasing trends in high-SDI regions after 2003. Projections indicate a 2.6-fold increase in deaths by 2050, with differential growth by cancer type: a 3.2-fold increase for ovarian cancer versus 2.3-fold for uterine cancer. Conclusions The global burden of gynecological cancers attributable to high BMI has increased substantially and is projected to accelerate through 2050, particularly in developing regions. These findings underscore the urgent need for targeted obesity prevention strategies within comprehensive cancer control programs to avert a substantial proportion of future gynecological cancer cases.

Key outcomes in treatment of activated phosphoinositide 3-kinase delta syndrome: An e-Delphi panel study and responder threshold application

Background Activated phosphoinositide 3-kinase delta syndrome (APDS) is an ultra-rare, underrecognized inborn error of immunity. This study aimed to identify outcomes important in evaluating APDS treatment effectiveness and percent change in specific outcomes indicating a clinically meaningful benefit. Methods In this e-Delphi panel study, 28 globally based APDS experts used a 5-point Likert scale (Strongly Disagree to Strongly Agree) to indicate level of agreement that an outcome was an important measure of APDS treatment effectiveness in adult and pediatric patients at 3 and 6 months after treatment initiation. A threshold of ≥75% responding with “Agree” or “Strongly Agree” was considered consensus. Percent meaningful improvement in 6 outcomes was assessed and applied to APDS trial data (NCT02435173). Results Twenty-four panelists participated; e-Delphi rounds 1–5 were completed by 23, 21, 18, 17, and 16 panelists, respectively. Outcomes with the highest degree of consensus included lymph node size/volume, clinician overall impression of disease activity, antibiotic use, patient/caregiver-reported social outcomes and patient quality of life, hospitalizations, thrombocytopenia, spleen volume, lymphopenia, and anemia. Panelists indicated within-patient clinically meaningful improvements in adult patients ranged from median values of 20%−25% in lymph nodes, naïve B-cell to total B-cell ratio, spleen volume, hemoglobin, platelets, and lymphocytes at 3 months, and 25%−30% at 6 months. Panelists indicated within-patient clinically meaningful improvements in pediatric patients ranged from median values of 20%−27.5% at 3 months and 22.5%−45% at 6 months in the same 6 outcomes. In an application of responder thresholds, treatment with leniolisib resulted in significant and meaningful improvements in disease hallmarks, including lymph node size, spleen volume, and naïve B-cell ratio. Conclusion This study provides expert consensus on outcomes important in assessing APDS treatment effectiveness and improvement thresholds in 6 treatment outcomes indicative of a clinically meaningful benefit. These outcomes may help optimize APDS treatment in the clinic.

Suicide rates around Chinese and western valentine’s days in Taiwan: The roles of gender and marriage status

Background The suicide risk on Chinese Valentine’s Day and its potential risk factors have not been examined. This study assessed whether the suicide rates around Chinese and Western Valentine’s Days differed from the rest of the year in Taiwan, and the roles of various genders and marital statuses. Methods This study analyzed daily suicide data from Taiwan’s Cause of Death Statistics between January 2012 and December 2022. We compared the suicide rate of each day in the week before and after Chinese and Western Valentine’s Days with those of the remainder of the year using Quasi-Poisson regression models stratified by gender and marital status. We then performed a moderation analysis to explore whether the effect of Valentine’s Day on suicide differed by gender. Results Married women reported a higher suicide risk on the third day after Chinese Valentine’s Day than married men did. Although a similar trend was observed in Western Valentine’s Day between married women and men, it did not reach statistical significance. Conclusion Suicide rates for certain days in the week before or after Chinese and Western Valentine’s Days were different from other days of the year, and these differences were gender- and marital status-specific.

Unimproved source of drinking water and its associated factors: Multivariable analysis of Somalia Integrated Household Budget Survey (SIHBS 2022)

This study investigates the prevalence and factors associated with the use of unimproved drinking water sources in Somalia, a nation severely impacted by conflict, climate change, and a large nomadic population, thus hindering progress towards Sustainable Development Goal 6 (SDG 6). A cross-sectional analysis was conducted using data from 11,949 households from the 2022 Somalia Integrated Household Budget Survey (SIHBS). Logistic regression was employed to identify associations between unimproved water source usage and various individual and community-level factors. The results show significant geographical disparities, with region being a strong predictor. Surprisingly, urban households demonstrated a higher likelihood of using unimproved water sources compared to rural households (Adjusted Odds Ratio [AOR] = 2.067). At the household level, unimproved water use was more prevalent in households headed by divorced (AOR = 1.598) or never-married individuals (AOR = 1.262), and in those residing in permanent or semi-permanent housing (AOR = 1.385). Conversely, food-insecure households had lower odds of using unimproved water (AOR = 0.878). The use of unimproved drinking water in Somalia is shaped by a complex interaction of community and household factors. These findings highlight the urgent need for geographically targeted interventions that address regional inequalities, the specific challenges of urban water supply, and household vulnerabilities. Further research is recommended to explore the unexpected associations with urban living and food insecurity, informing context-specific strategies by Somali authorities and international partners to improve public health and accelerate progress towards SDG Target 6.1.

Evaluation of GDH and HDP as novel serological biomarkers for Plasmodium falciparum malaria diagnosis across varying parasitemia and transmission settings in India

Malaria diagnosis has progressed significantly with the introduction of Rapid Diagnostic Tests (RDTs) targeting Histidine-Rich Protein 2 (HRP2), Lactate dehydrogenase (LDH), and aldolase. However, challenges remain, such as the presence of Plasmodium falciparum histidine-rich protein 2 (pfhrp2) gene deletions and reduced sensitivity in regions with low parasitemia. This study evaluates antibody responses to novel biomarkers—glutamate dehydrogenase (GDH) and Heam detoxification protein (HDP)—in comparison to conventional antigens (HRP2, LDH, and aldolase) across different infection, transmission settings, and parasitemia conditions. We analyzed plasma samples from 928 participants, including 886 P. falciparum-positive cases, using enzyme-linked immunosorbent assay. Our results revealed antibody levels against all studied peptides clear differentiation between malaria-positive and negative samples, with Receiver Operating Characteristic (ROC) curve analysis showing high diagnostic accuracy (Area under the ROC curve > 96%) for detecting P. falciparum infection. However, the sensitivity and specificity for differentiating between endemicity or parasitemia groups were limited for certain peptides. Specifically, GDH2 and HRP2 effectively distinguished parasitemia levels, while GDH2, HDP2, and LDH showed promise in distinguishing between varying endemicity levels. These findings suggest that GDH and HDP have significant potential as reliable serological biomarkers for malaria detection. However, further studies are needed to refine their application in categorizing endemicity and parasitemia. This research highlights the need for adaptable diagnostic tools to address the complex challenges of malaria in endemic regions.

How to jointly control a ball trajectory on a moving board: Methodological insights into Motor Learning and Rehabilitation

Motor (re-)learning can be assessed using various conceptual and methodological frameworks, each of which portrays the learner’s abilities in different ways. The present paper investigates how the direct learning theory can be applied to the assessment of perception-action couplings required for a highly-dimensional joint-action task. Eleven novice dyads were instructed to stand on an unstable surface (BOSU), while jointly manipulating a board with the aim to make a ball roll along a target. Ball and board’s three-dimensional movements were recorded with an 8-camera motion capture system. Linear regression analyses were conducted to examine how task performance – using ball kinematics – and dyadic behaviour – using board kinematics – evolved with practice. Correlation analyses between movement and informational variables were used as a first step to build information spaces. Information spaces are a direct learning tool developed to investigate how the available information is exploited when practicing a new motor task. With practice, dyads reduced the variability in task-irrelevant degrees of freedom, while increasingly coupling the task-relevant degrees of freedom to more optimal informational variables. Finally, information spaces were discussed as a valuable tool for assessing and guiding the re-learning of perception-action in rehabilitation.

RETRACTED: Do natural environmental protection, regional innovation climate, entrepreneurs’ cognition of green development positively influence the sustainable development of small rural businesses

In the era of the green economy, the Chinese government has advocated for natural environmental protection and innovation in rural areas, making the sustainable development of small rural businesses into a focal point. Currently, whether natural environmental protection promotes the sustainable development of small rural businesses remains debatable, and the roles of regional innovation climate, entrepreneurs’ cognition of green development, and technological innovation in production on the sustainable development of small rural businesses are often overlooked. Addressing this gap, this study draws inspiration from Upper Echelons Theory and Sustainable Development Theory to construct a structural equation model (SEM) and proposes 10 hypotheses. Primary data was collected from rural entrepreneurs across 17 provinces in China, yielding 439 valid samples. The data were analyzed using AMOS 28.0, SMARTPLS 4.0, and SPSS 28.0. The findings revealed that natural environmental protection did not positively influence the sustainable development of small rural businesses (β = 0.104, p > 0.05). In contrast, the regional innovation climate (β = 0.189, p = 0.001) and rural small business entrepreneurs’ cognition of green development (β = 0.261, p < 0.001) significantly affected the sustainable development of small rural businesses. Technological innovation in production (β = 0.034, p < 0.01) played a partial mediating role between the regional innovation climate and the sustainable development of small rural businesses. And, the mediating role of technological innovation in production was significant in the relationship between entrepreneurs’ cognition of green development and the sustainable development of small rural businesses (β = 0.059, p < 0.01). As a representative developing country, China’s findings in rural areas provide valuable insights for other developing countries undergoing green development transitions. This study not only questions the applicability of Porter’s hypothesis in rural contexts but also offers implications for relevant policymakers and small business entrepreneurs.

Mixed twitch and tetanus electrical stimulation via belt-electrode effectively attenuates denervation-induced muscle atrophy

Belt electrode skeletal muscle stimulation (B-SES) is a method of applying electricity to contract muscles using belt-shaped electrodes. We previously reported that twitch contractions increase mitochondrial synthesis and suppress muscle proteolysis. In contrast, tetanus contraction increases muscle protein synthesis and suppresses muscle proteolysis. This study aimed to determine whether combining twitch- and tetanus-mode stimulations, which are known to differentially regulate mitochondrial and protein synthesis pathways, can more effectively attenuate muscle atrophy induced by denervation. Male Sprague-Dawley rats were subjected to acute or chronic B-SES. In the acute study, animals were assigned to control (CONT), tetanus (60 Hz), or Combined Stimulation (CS: 7–8 Hz for 15 min to 60 Hz for 3 min) groups. Four groups were tested in the chronic study: CONT, denervation (DEN), DEN + 60 Hz, and DEN + CS groups. Acute stimulation resulted in significantly lower muscle glycogen level, increased phosphorylated AMPK and p70S6K in the gastrocnemius muscle (GAS、n = 4) at 60 and CS compared to CONT, with no difference between 60 and CONT. After seven days, both muscle wet weight and cross-sectional area (CSA) were significantly reduced in the DEN group. Although both 60 Hz and CS attenuated atrophy, CS resulted in greater preservation (GAS CSA: DEN + CS, 71% CONT; DEN + 60, 61% CONT). In conclusion, the combination of different stimulation modalities (frequencies) was more effective than continuous tetanus stimulation in preventing denervation-induced muscle atrophy owing to an increase in muscle protein synthesis and inhibition of mitochondrial reduction.

Comparison of clinical characteristics and outcomes among different age groups in elderly patients with hip fracture surgery

Background Studies comparing the clinical characteristics and outcomes among different age groups in elderly patients with hip fractures are scarce. Thus, this study aimed to 1) analyze the clinical characteristics and postoperative outcomes among different age groups in elderly patients undergoing fracture surgery. 2) provide more evidence-based basis for perioperative management. Methods In the retrospective study, 909 patients aged 65 years and above who underwent hip fracture surgery at Liaocheng People’s Hospital between October 2020 and April 2023 were categorized into three groups based on age: young old group (YO group, 65–74 years old), middle old group (MO group, 75–84 years old), and oldest-old group (OO group, ≥ 85 years old). Then, their pre-fracture conditions, fracture causes and type, anesthesia and surgical details, postoperative complication and outcomes were compared. Results In the YO, MO, and OO groups, the male-to-female ratios were 1:2.1, 1:1.8, and 1:2.3, respectively (P = 0.293). The proportion of patients with American Society of Anesthesiologists (ASA) ≥ III, Nottingham hip fracture score (NHFS) ≥ 5 and preoperative activity tolerance < 4 metabolic equivalents (METs) increased sequentially (P < 0.001), across the YO, MO, and OO groups, whereas the proportion of those with three or more internal medicine comorbidities sequentially decreased (P < 0.001). All three groups were primarily injured by falls and the older the age, the higher the proportion of injuries caused by falls (P = 0.006). There was a higher proportion of femoral neck fractures in the YO group and a higher incidence of intertrochanteric fracture in the OO group (P < 0.001). The proportion of patients undergoing spinal anesthesia in the HO group (78.8%) was higher than that in the MO (59.9%) and YO groups (55.1%) (P < 0.001). Additionally, the proportion of postoperative intensive care unit (ICU) admissions (10%) was higher in the OO group compared to the MO (6.2%) and YO groups (4.5%) (P = 0.032). Meanwhile, the incidence of postoperative complications progressively increased in the YO, MO, and OO groups (P < 0.001). The mortality rates of the HO group at the hospital, 30 days postoperatively, and 90 days postoperatively were 6.3%, 9.6%, and 13.3%, respectively, which were significantly higher than those of the MO (2.7%, 3.6%, 6.2%) and the YO groups (1.2%, 1.8%, 2.4%) (P < 0.001). Conclusions The majority of elderly patients undergoing hip fracture surgery were female, with falls being the predominant cause of injury. Increasing age was correlated with poorer preoperative mobility, a lower prevalence of three or more comorbidities, and a higher likelihood of receiving spinal anesthesia. Lastly, the probability of ICU admission, complications, and mortality rate increased after surgery.

Functions of coastal feeder bluff systems: Implications for prioritizing protection and restoration

Actively eroding cliffs, known as feeder bluffs, are important sources of sediment for coastal beaches. When shorelines have artificial armor, natural beach sediment processes can be disrupted. A recent management tool in the Salish Sea, WA, USA prioritizes efforts with high potential benefit of restoration (armor removal) or protection (preventing armor construction) to nearshore sediment supply. We conducted field sampling at 20 beaches identified as the highest or lowest priorities for restoration or protection, so we could examine local ecological and physical functions, in addition to potential landscape benefits. We sampled parameters spanning the top of the bluff to the low shore, and evaluated a total of 30 metrics including riparian vegetation, invertebrate assemblages, logs, beach wrack, fish abundance and behavior, surface epifauna and algae, beach and bluff characteristics, and sediment size and sorting. For analyses, we calculated an average score of beach function for each of four treatments: “Protect High” (unarmored, ranked as high management priority), “Protect Low” (unarmored, ranked low), “Restore High” (armored, ranked high), and “Restore Low” (armored, ranked low). Protect High and Low treatments were equivalent in local beach function, and both scored over twice as high as Restore treatments. Restore High scored only slightly higher than Restore Low, indicating a consistent degradation caused by armoring on bluffs with variable sediment source potential. Statistical models revealed that overall beach function may be largely driven by upper beach metrics including wrack, logs, and overhanging vegetation. Metrics for geomorphology and lower beach organisms were more variable, likely due to differences in geographical region and distance from the bluff. Our results indicate that beaches with natural unarmored bluffs have the highest level of localized ecological function regardless of the level of potential sediment supply, and restoring sediment supply processes at beaches with armored bluffs could double their ecological function.

Trends in Clostridioides difficile infection prevalence among pediatric cancer patients: A systematic review and meta-analysis

Introduction Pediatric cancer patients are highly susceptible to Clostridioides difficile infection (CDI) due to immunosuppression, prolonged hospitalization, and antibiotic exposure. This study determined the global pooled prevalence of CDI among pediatric cancer patients. Methods According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, 20 available articles published between 1985 and 2024 were included in this study. The extracted data from the relevant articles were analyzed using STATA version 17.0. The effect size estimate was computed using a random-effects model, considering a 95% confidence interval. The I2 statistic and Galbraith plot were used to confirm heterogeneity. Univariate meta-regression, sensitivity, and subgroup analyses were conducted to identify the source of heterogeneity. Egger’s test and a funnel plot were used to check for publication bias. Results The pooled prevalence of CDI was 15.41% (95% CI: 10.57–20.24%), with high heterogeneity (I2 = 99.90%) and statistical significance (p < 0.001). The trend in the study year was a minimum prevalence of 0.96% in 2016–2020 (Brazil) and a maximum prevalence of 38.26% in 2007–2017 (USA). In the subgroup analysis, a relatively high prevalence of CDI was observed in Asia (23.23%; 95% CI: 17.44–29.01%) and prospective studies (20.64%; 95% CI: 14.25–27.03%), and studies included pediatric patients with hematologic, solid tumors, and hematopoietic stem cell transplantation recipients (18.34%; 95% CI: 8.05–28.63%). The test of group differences (p < 0.001) in the continent in subgroup analysis and sample size (p = 0.049) in univariate meta-regression were sources of heterogeneity between the effect sizes of the individual studies. Conclusion There is a significant burden of CDI in pediatric cancer patients. These findings highlight the need for regular detection and targeted treatment of CDI, including drug-resistant strains, in cancer patients to minimize severe complications and mortality.

STAG2 mutations in the normal colon induce upregulation of oncogenic pathways in neighbouring wildtype cells

While driver mutations in the normal colon have been described, characterizing the role and function of these driver mutations in relation to colorectal oncogenesis remains incomplete. Here, we investigated the role of STAG2 mutants in the normal colon using patient-derived wildtype organoids. Using CRISPR-Cas9 gene editing, we generated STAG2 mutants, and co-cultured these mutants with wildtype organoids, mimicking the presence of such STAG2 mutants in the normal colon. We sought to determine the transcriptional impact of co-culture using scRNAseq. Surprisingly, we uncovered a possible cell-cell interaction between STAG2 mutants and wildtype organoids, in which wildtype organoids in co-culture with STAG2 mutants upregulated known oncogenic pathways. This included the upregulation of TNFα-signaling, as well as KRAS-signaling in wildtype organoids. These results suggested that STAG2 mutant cells exert a pro-oncogenic effect in a cell interactive manner, instead of via a cell autonomous approach. In conclusion, our findings demonstrate a novel mechanism of colorectal oncogenesis which can support further investigation.