Browse Articles

Confidence, animal spirits, and the macroeconomy in China: Based on mixed-frequency data models

This paper employs the mixed-frequency Granger causality test, reverse unconstrained mixed-frequency data sampling models, and Chinese data from January 2006 to June 2024 to test the nexus between consumer confidence and the macroeconomy. The results show that changes in the real estate market, GDP, and urban unemployment rate are Granger causes of consumer confidence. In reverse, consumer confidence is a Granger cause of the CPI. Second, GDP and the real estate market (CPI and urban unemployment rate) have a significant positive (negative) impact on consumer confidence, while the conditions of industrial production, interest rate, and stock market do not. Third, the “animal spirits” extracted from consumer confidence cannot lead to noticeable fluctuations in China’s macroeconomy. This suggests that the “animal spirits” will not dominate economic growth, even though they affect the macroeconomy slightly and inevitably. The results are robust after replacing the dependent variable and considering the influence of the global financial crisis and the COVID-19 pandemic.

Analysis of global, regional and national trends in the burden of soft tissue and other extraosseous sarcomas from 1990 to 2021: A systematic analysis of the global burden of disease study 2021

Background Soft tissue and other extraosseous sarcomas (STSES) are rare malignant tumors originating from mesenchymal tissues with complex etiologies. A systematic analysis of global burden trends is urgently needed. Methods Utilizing the Global Burden of Disease (GBD) 2021 database, we assessed STSES incidence, mortality, disability-adjusted life years (DALYs), age-standardized incidence rate (ASIR), age-standardized mortality rate (ASMR), and age-standardized DALY rate (ASDR) across regions and countries from 1990 to 2021, stratified by sociodemographic index (SDI). Spatiotemporal models, Joinpoint regression (to calculate average annual percentage changes, AAPC), and decomposition analysis were employed to evaluate the impacts of population growth, aging, and epidemiological factors on disease burden. Results In 2021, there were 96,201 new STSES cases globally, resulting in 50,203 deaths and 1.678 million DALYs. While age-standardized rates (per 100,000 person-years) showed declining trends (AAPC for ASIR = −0.13, ASMR = −0.60, ASDR = − 0.94), absolute burden increased by 77.97% due to population growth. Males exhibited consistently higher burden than females, with incidence peaking at 55–74 years. Notably, young females (10–29 years) transiently surpassed males in DALYs. Significant regional disparities emerged: High-SDI regions (e.g., Western Europe) demonstrated lower ASMR attributable to advanced diagnostics and treatment, whereas low-SDI regions (e.g., Uganda, ASMR = 1.96/100,000) faced poorer prognoses due to healthcare deficiencies. SDI exhibited a nonlinear association with disease burden—middle-SDI regions (0.4–0.8) showed rising ASIR, potentially linked to industrial pollution and improved diagnostic capabilities. These findings underscore the critical need for context-specific prevention and resource allocation strategies to address the evolving global STSES burden. Conclusions The global STSES burden is predominantly driven by population growth, necessitating targeted prevention strategies addressing occupational exposures in males and subtype-specific risks among young females. While high-SDI regions demonstrate mortality reduction through precision oncology, low-SDI regions require urgent improvements in healthcare accessibility to mitigate survival disparities. Persistent regional heterogeneity underscores the imperative for international collaboration to standardize diagnostic protocols and ensure equitable resource allocation. These insights emphasize the need for stratified surveillance systems and translational research to optimize context-specific intervention frameworks.

Correction: Chemical profile and analysis of biosynthetic pathways and genes of volatile terpenes in Pityopsis ruthii, a rare and endangered flowering plant

Utility of enhanced recovery after surgery protocols in reducing postoperative opioid use across different surgical specialties—An analysis of Iowa’s billion pill pledge program

Introduction The opioid epidemic in the United States poses a major public health challenge, particularly in the context of surgery and perioperative pain management. This study examines the effectiveness of the “Billion Pill Pledge” Enhanced Recovery After Surgery (ERAS) protocols implemented across nine Iowa hospitals, in reducing postoperative opioid prescriptions. Methods A retrospective chart review was conducted on patients treated by 24 different surgeons at 9 Iowa hospitals from November 2022 to November 2023. Patients were divided into orthopaedic surgery (n = 120) and general surgery (n = 60) groups. Opioid quantities prescribed pre- and post-ERAS implementation were measured and converted to morphine milligram equivalents (MMEs). Statistical analyses included the Wilcoxon-Signed Rank test, Mann-Whitney U test, and Chi-Squared tests. Results The mean pre-ERAS prescription was 341 MMEs (range: 25–7200 MMEs), which decreased to 151 MMEs (range: 25–2400 MMEs) post-ERAS implementation (p < .001), following all surgeries. Orthopaedic Surgery patients saw a mean 45% reduction in prescription size from 462 MMEs (range: 50–7200 MMEs) to 197 MMEs (range: 25–2400 MMEs) (p < .001), while General Surgery patients experienced a mean 38% reduction from 100 MMEs (range: 25–150 MMEs) to 60 MMEs (range: 25–150 MMEs) (p < .001). Mean percent reduction in prescription size was greater in the Orthopaedic Surgery cohort (45% versus 38%) (p = .002). No significant difference was observed in the mean percentage of prescribed MMEs leftover between the two cohorts (Orthopaedic 47% vs. General 59%), (p = .07). Orthopaedic Surgery patients had higher mean MMEs consumed (126 MMEs) than General Surgery patients (26 MMEs) (p < 0.001). Conclusion Postoperative opioid prescriptions were reduced in both patient surgical cohorts, with a more pronounced impact in Orthopaedic Surgery patients. Despite the reduction, both groups reported substantial and comparable percentages of unused opioids, indicating a need for targeted adjustments to minimize unused opioids. Level of evidence IV.

Remote physical function testing in older adults: a mixed methods study exploring test reliability, feasibility, and perceptions of participants and assessors

Impaired physical function is linked to poor health outcomes in older adults. Low-cost, remote strategies for monitoring physical function could enable timely interventions, improving health and reducing the need for support services. This study aimed to evaluate the feasibility, reliability, and perceptions of remotely assessing physical function in older adults at home. Nineteen community-dwelling older adults (68 ± 5 years; 68% female) participated in three videoconferencing sessions with trained assessors, one week apart. Participants completed nine physical function tests [standing balance test battery, single-leg balance, four-square step test (FSST), gait speed (2.44 m and 4 m, both usual and fastest pace), five-times sit-to-stand (5-STS), 30-second STS (30-STS)]. Semi-structured interviews with participants and assessors explored feasibility and acceptability. Test-retest reliability was assessed using intraclass correlation coefficients (ICCs) and Bland-Altman plots, and interview data were analysed thematically. All participants completed assessments without adverse events. Test-retest reliability ranged from poor (ICC < 0.5 for single-leg balance) to good (ICC 0.75–0.9 for 5-STS, 30-STS, gait, and FSST), improving with repeated testing. Participants identified challenges with device setup and physical demands of preparing their home. Assessors noted participant understanding as a barrier. Both groups recognised support from others during testing as a key enabler. Older adults can safely and feasibly perform physical function tests remotely. Familiarisation improves reliability and reducing technical and physical demands can enhance implementation. Support from others at home may be important for successful remote testing.

Development of a novel eye drop aid and evaluation of its efficacy

Purpose The aim of this study was to develop a new eye drop aid and investigate its efficacy in glaucoma patients. Methods The developed eye drop aid is compatible with most therapeutic eye drops and helps users with limited neck retroversion. Adult glaucoma patients admitted to the University of Yamanashi Hospital for glaucoma surgery who fulfilled the following criteria were included: a history of using glaucoma eye drops for at least 6 months, no upper limb loss or dysfunction, and no physical or cognitive disturbances that would interfere with activities of daily living. In terms of corrected visual acuity, the included patients had a logMAR score of at least 1 in at least one eye. Eye drops containing a 0.1% sodium hyaluronate ophthalmic mixture were used in this study. The eye drops were applied to the eyes in the seated position as they would normally be used. The use of the eye drop aid was explained, and the patients tried to instill eye drops with the eye drop aid after two trials. The patients then instilled one eye drop in the supine position, first without the eye drop aid and then with the eye drop aid. Success was defined as the eye drops being dropped into the conjunctival cul-de-sac without touching the ocular surface, face or eyelashes. The patients were surveyed about the usefulness of the eye drop aid. Although the aid was designed to require minimal grip force, we measured the force needed to dispense a single drop for five commonly used clinical eye drops. Results Eighty-eight patients were included (51 men and 37 women, mean age: 67.3 ± 13.4 years). The success rate in the seated position without the eye drop aid was 71.6%, and this rate decreased with increasing age; with the eye drop aid, the success rate improved significantly to 97.8%. The success rate in the supine position without the aid (86.4%) was significantly better than that in the seated position, and the eye drop aid increased the success rate to 97.8%. The eye drop aid reduced the squeeze force required to instill eye drops (reduction of 10.3%−53.5%) for all types of eye drops. Conclusion Even though the patients were accustomed to using glaucoma eye drops, 28.4% of the patients were not able to instill eye drops properly. The eye drop aid significantly improved the success rate of eye drop instillation, especially when the eye drops were administered while the patients were seated.

Structural stability-guided scaffold hopping and computational modeling of tankyrase inhibitors targeting colorectal cancer

Colorectal cancer is one of the leading causes of cancer-related deaths worldwide, mainly due to aberrant Wnt/β-catenin signaling resulting from APC mutations. Tankyrase is a key regulator of this pathway and plays a crucial role in stabilizing AXIN, a negative regulator of β-catenin, and hence an attractive therapeutic target. The present study describes a comprehensive computational approach to discovering novel tankyrase inhibitors for CRC therapy. The reference (RK-582) for ligand-based screening and comparative analysis was taken from the crystal structure of tankyrase. A similarity search in the PubChem, applying an 80% cutoff, yielded 533 structurally similar compounds. These compounds were subjected to virtual screening using a drug-likeness filter. The top-ranking binding poses of three selected compounds (PubChem CIDs: 138594346, 138594730, and 138594428) were selected for DFT calculation and re-docking. DFT calculations revealed that compound 138594428 had the largest HOMO-LUMO gap (4.979 eV), indicating high electronic stability, while 138594346 exhibited a strong balance of stability and reactivity (4.473 eV). The MD simulations were conducted on all ns protein-ligand complexes for 500 ns, exploring their stability. MD simulations confirmed the conformational stability of these compounds, with 138594346 showing the lowest RMSD and RMSF fluctuations. Additionally, a machine learning model trained on 236 known Tankyrase inhibitors accurately predicted pIC₅₀ values, with compound 138594346 (pIC₅₀ = 7.70) closely matching the reference inhibitor (pIC₅₀ = 7.71), and 138594428 also exhibiting strong predicted activity (pIC₅₀ = 7.41). Collectively, these results highlight 138594346 and 138594428 as promising candidates for further experimental validation in the development of targeted CRC therapeutics.

Differential expression and regulation of FASLG by miR-5195/miR-3941 in age-related hearing loss

Presbycusis, or age-related hearing loss (ARHL), is a progressive condition that involves a steady decline in auditory function, primarily caused by the physiological alterations that occur with aging. This disorder arises from the combined effect of multiple interconnected factors that progressively affect the auditory system over time. Genome-wide association studies (GWAS) and transcriptomic analyses in human populations are valuable approaches for identifying potential genes associated with ARHL. This research seeks to assess the potential of protective drugs or strategies for treating ARHL by analyzing target gene-miRNA interactions identified in human blood and associated with presbycusis. We performed RNA sequencing to analyze the transcriptomes of peripheral blood leukocytes from ARHL patients. To identify genes associated with ARHL, the RNA-sequencing data from the peripheral blood leukocytes were compared and further validated by real-time polymerase chain reaction (RT-qPCR) using whole blood samples from the same ARHL patients. To explore the involvement of target genes and microRNAs (miRNAs) in ARHL, we examined miRNA expression patterns using RT-qPCR and reporter gene assays. We found that four genes were up-expressed in ARHL serum: Fas Ligand (FASLG), Neural Cell Adhesion Molecule 1 (NCAM1), Nectin Cell Adhesion Molecule 1 (NECTIN1), Macrophage Receptor with Collagenous Structure (MARCO). The up-expressed FASLG is associated with cell apoptosis and aging. Additionally, we showed that miR‑5195 and miR-3941 regulated FASLG expression in House Ear Institute-Organ of Corti 1 (HEI-OC-1) and HeLa cells via targeting of FASLG using luciferase reporter assays. Finally, the over-expression of the FASLG gene may be associated with the development of ARHL, and the inhibitory role of miR-5195 and miR-3941 could be a key factor in the prevention or protection against ARHL.

Molecular mechanisms of dragon’s blood in treating ulcerative colitis based on NF-κb/NLPR3/Caspase-1 pyroptosis signaling pathway

Objective To elucidate the molecular mechanism of dragon’s blood (DB) in the treatment of ulcerative colitis (UC). Methods Bioactive metabolites of DB absorbed into the bloodstream were characterized via LC-MS. Network pharmacology and molecular docking were employed to construct a target-pathway interaction model predicting DB’s therapeutic mechanism in UC. A 4% DSS-induced UC mouse model was used for experimental validation. Results DB markedly alleviated colonic injury in DSS-induced UC. A total of 255 active compounds were identified, including 6,4’-Dimethoxy-7-hydroxyisoflavone, 7-hydroxy-2-(4-methoxyphenyl) chromen-4-one, and Apigenin. Key molecular targets included NLPR3, MAPK1, TP53, HIF1A, and PTGS2. The NF-κB/NLPR3/Caspase-1 axis was implicated as a central pathway mediating the therapeutic effects of DB. Conclusion DB acts through a multi-component, multi-target, and multi-pathway strategy. Inhibiting the NF-κB/NLPR3/Caspase-1 pyroptosis pathway positions NLPR3 as a viable target for DB in UC intervention.

Effects of sprint interval training compared to high intensity interval training on repeated sprint capacity and sport-specific performance in college-aged male tennis players

Purpose This study compared the effects of sprint interval training (SIT) versus high-intensity interval training (HIIT) on repeated sprint capacity and sport-specific performance in male tennis players. Methods Thirty collegiate tennis players (age: 22.39 ± 1.64 years) were randomly assigned to SIT (n = 15) or HIIT (n = 15) groups for an 8-week training intervention. Performance and physiological parameters were assessed using repeated sprint ability (RSA) test, hit-and-turn tennis test, and tennis-specific endurance test. Key metrics included maximal completed level, total time to exhaustion (TTE), repeated sprint parameters (RSATT, RSAbest, Sdec), maximal oxygen uptake (V˙O₂max), ventilatory efficiency, and tennis performance index. Results Significant group × time interactions were observed for maximal completed level (F(1, 28)=22.649, p < 0.001, ηp2 = 0.89), RSATT (F(1, 28) =39.74, p < 0.001, ηp2 = 0.89), and ball accuracy (F(1, 28)=13.811, p < 0.001, ηp2 = 0.901). The SIT group showed greater improvements in maximal completed level (4.00 ± 0.28 vs. 2.14 ± 0.28, p < .001), RSATT (−4.84 ± 0.33s vs. −1.87 ± 0.33s, p < 0.001), and ball accuracy (12.85 ± 1.71% vs. 3.86 ± 1.71%, p < 0.001). Both groups improved significantly in V˙O₂max (SIT: 52.84 ± 4.22 to 64.50 ± 3.85 mL.min-1.kg-1; HIIT: 51.79 ± 5.15 to 59.6 ± 4.44 mL.min-1.kg-1, p < 0.001) and TTE (SIT: ηp2 = 0.825; HIIT: ηp2 = 0.59). Time to the onset of blood lactate accumulation (OBLA) and second ventilatory threshold (VT2) showed significant main effects of time (p < .001) without group differences. Conclusion While both protocols improved aerobic fitness, SIT demonstrated superior effectiveness in enhancing tennis-specific performance, particularly in repeated sprint ability and technical stability. These findings suggest that SIT might be a more time-efficient training strategy for improving sport-specific performance in tennis players.

Spatial distribution of chickpea ascochyta blight (Ascochyta rabiei) and analyses of biophysical factors influencing disease epidemics in northwestern Ethiopia

Chickpea (Cice rarietinum L.) is one of the important grain legume crops in Ethiopia, which serves as a source of both foreign exchange and food. However, the crop production and productivity are currently challenged by ascochyta blight disease caused by Ascochyta rabiei in the study areas.A total of 120 chickpea fields were assessed from five districts in two zonesduring the 2022 main cropping season to assess the distribution, prevalence, and intensity of ascochyta blight of chickpea and its association with agro-ecological factors in northwestern Ethiopia.The results confirmed a 100% prevalence of ascochytablight disease across districts. The highest disease incidence (46.32%) and severity (32.90%) were assessed from Fogera and GondarZuria districts, respectively. The associations between disease parameters and biophysical factors were performed using a binary logistic regression model.High incidence (>40%) and severity (>25%) were strongly associated with mixed cropping, Fogera and Gondar Zuria districts, ≤ two times land preparation, Vertisol soil type, desi chickpea type, and broadleaf weed type in the model. Lower disease incidence (≤ 40%) and severity (≤ 25%) had a strong association with sole cropping, more than two times land preparation, Nitisolsoil type, and growing of kabuli chickpea type. Thus, planting chickpea in sole cropping, more than two times land preparation, growing chickpea in Nitisol soil and use of kabuli chickpea typecould be used as management options to reduce the impact of the disease in northwestern Ethiopia and other similar ecological areas of the country.

Improving segmentation precision in prostate cancer adaptive radiation therapy with a patient-specific network

Adaptive radiotherapy (ART) enhances prostate cancer treatment by accounting for daily anatomical variations, but clinical implementation remains limited due to the need for accurate and efficient auto segmentation; manual corrections after automated contouring often hinder workflow efficiency. To address this, we propose a patient-specific network (PSN) approach for clinical target volume (CTV) segmentation using cone-beam computed tomography (CBCT). This retrospective study included 26 prostate cancer patients treated with CBCT-guided online ART using the Ethos therapy system, comprising 119 retrospectively exported fractions. The PSN framework uses a two-stage strategy: initial pre-training followed by patient-specific fine-tuning via PSNadaptive or PSNsequence, implemented with the Swin UNETR architecture. This approach is distinct from static personalization methods as it continuously adapts to daily anatomical changes. Segmentation performance was compared against deformable registration and generalized deep learning models using the Dice similarity coefficient (DSC), 95th percentile Hausdorff distance (HD), and mean surface distance (MSD). PSN significantly improved segmentation performance, with PSNadaptive achieving a DSC of 0.978 ± 0.005, HD of 1.681 ± 0.743 mm, and MSD of 0.510 ± 0.035 mm by the fifth fraction, with accuracy improving across sequential fractions. Visual assessments confirmed high agreement with physician contours, especially in anatomically complex regions. These findings support the PSN framework as a clinically feasible and accurate solution for patient-specific segmentation in prostate ART, potentially reducing the need for manual editing, streamlining workflow efficiency, and enhancing the precision of adaptive treatment delivery.

Efficacy and outcomes of surgical staples as an alternative to conventional skin closure in canine mastectomy

Surgical wound closure is critical in oncologic surgeries and directly influences healing, postoperative complications, and recovery time. In canine mastectomies, conventional skin closure with nylon sutures remains the standard technique; however, surgical staples have emerged as a potential alternative that can potentially optimize surgical efficiency and outcomes. This study evaluated the efficacy of surgical staples as an alternative to routine standard suture (nylon) in female dogs undergoing mastectomies. Fifty female dogs were divided into two groups: one was treated with nylon suture (NS group, n = 25) and the other with surgical staples (SS group, n = 25). Surgical time, local wound temperature, and wound healing characteristics were evaluated. Thermographic analysis of the surgical scar was performed on a subsample. Logistic regression and multivariate linear analysis were used to compare differences between the techniques, and an independent samples t test was applied to compare surgical and suture times. No significant differences were found between the groups regarding age, weight, incision size, body size, and reproductive status. Total surgical time was significantly shorter in the SS group (p = 0.011). The closure time was 9.8 times shorter in the SS group versus the NS group (p < 0.001). The average wound temperature was higher in the NS group (p < 0.001). The SS group showed fewer occurrences of wound alterations (p = 0.029) and a lower frequency of focal inflammatory exudate (p = 0.013). The thermographic analysis showed more white pixels and higher temperatures in the surgical wound in the NS group versus the SS group (p = 0.032 and p < 0.001, respectively). Surgical staples were found to be safe and effective for wound closure in mastectomies in female dogs, offering a viable alternative to traditional nylon suture techniques. Although the cost of staples is slightly higher, the benefits of shorter surgical time and reduced complications can make this technique a favorable choice, especially for oncologic patients with additional health concerns or surgical time restrictions.

Effects of chitosan oligosaccharide on the growth performance, antioxidant capacity, immune function, intestinal digestive capacity and morphological structure in growing female minks

This study aimed to investigate the effects of dietary chitosan oligosaccharide (COS) supplementation on growth performance, antioxidant capacity, immune function, duodenal digestive enzyme activity, and jejunal morphology in growing female minks. Ninety-six 12-week-old minks were randomly assigned to six groups (0, 100, 200, 300, 400, or 500 mg/kg COS), with 8 replicates per treatment and 2 minks per replicate, for an 8-week trial. The results showed that average daily gain (ADG) increased quadratically with increasing COS levels (P < 0.05) and 100 mg/kg COS significantly enhanced ADG (P < 0.05). Fresh pelt length increased linearly, and fresh pelt weight increased quadratically as COS levels increased (P < 0.05). COS supplementation significantly elevated serum immunoglobulin (Ig) A, IgG and complement 4 levels (P < 0.05). COS supplementation significantly increased serum superoxide dismutase activity and jejunal mucosal glutathione peroxidase activity, and significantly decreased serum malondialdehyde level (P < 0.05). Duodenal trypsin activity and the villus height-to-crypt depth ratio increased quadratically as COS levels increased (P < 0.05). In conclusion, dietary COS supplementation improved antioxidant capacity, immune function, duodenal digestive enzyme activity and jejunal morphology in growing female minks, thereby enhancing growth performance. The optimal dosage of COS is 100 mg/kg.

Development and validation of a machine learning-based predictive model for clinical remission in Crohn’s disease patients receiving Adalimumab therapy

Crohn’s disease (CD), a chronic inflammatory bowel disease, is witnessing a rising global incidence. Adalimumab (ADA), a biological agent, is widely used in its treatment. However, patients exhibit significant individual variability in responses to ADA therapy. This study focuses on developing and validating a machine learning – based predictive model to assess the clinical remission of CD patients at 12 and 48 weeks post – ADA treatment, while identifying the key influencing factors. A single – center retrospective study was conducted, involving patients from the Second Xiangya Hospital of Central South University between 2017 and 2024. Comprehensive data on demographics, lifestyle, disease characteristics, and laboratory indicators were collected and preprocessed. The dataset was partitioned into an 80% training set and a 20% test set. Six machine learning models, including Random Forest and Gradient Boosting Machine, were employed to construct the prediction model. Model performance was evaluated using metrics such as accuracy, sensitivity, and specificity. The SHAP analysis was performed to elucidate the key factors. The results indicated that the XGBoost model outperformed other models across multiple evaluation metrics. Fecal calprotectin (Fc), a marker of intestinal inflammation, showed that lower levels were associated with a tendency towards mucosal healing. C - reactive protein (CRP), on the other hand, reflected systemic inflammation. Both biomarkers significantly influenced the prediction outcomes at different time points. The developed model serves as a valuable tool for clinical stratification and personalized treatment planning. Future research should expand sample diversity through multi – center collaboration and integrate multi – omics data, such as gut microbiome and metabolomics, to further enhance the model’s ability to capture the molecular mechanisms underlying the disease.

Adaptive TreeHive: Ensemble of trees for enhancing imbalanced intrusion classification

Imbalanced intrusion classification is a complex and challenging task as there are few number of instances/intrusions generally considered as minority instances/intrusions in the imbalanced intrusion datasets. Data sampling methods such as over-sampling and under-sampling methods are commonly applied for dealing with imbalanced intrusion data. In over-sampling, synthetic minority instances are generated e.g. SMOTE (Synthetic Minority Over-sampling Technique) and on the contrary, under-sampling methods remove the majority-class instances to create balanced data e.g. random under-sampling. Both over-sampling and under-sampling methods have the disadvantages as over-sampling technique creates overfitting and under-sampling technique ignores a large portion of the data. Ensemble learning in supervised machine learning is also a common technique for handling imbalanced data. Random Forest and Bagging techniques address the overfitting problem, and Boosting (AdaBoost) gives more attention to the minority-class instances in its iterations. In this paper, we have proposed a method for selecting the most informative instances that represent the overall dataset. We have applied both over-sampling and under-sampling techniques to balance the data by employing the majority and minority informative instances. We have used Random Forest, Bagging, and Boosting (AdaBoost) algorithms and have compared their performances. We have used decision tree (C4.5) as the base classifier of Random Forest and AdaBoost classifiers and naïve Bayes classifier as the base classifier of the Bagging model. The proposed method Adaptive TreeHive addresses both the issues of imbalanced ratio and high dimensionality, resulting in reduced computational power and execution time requirements. We have evaluated the proposed Adaptive TreeHive method using five large-scale public benchmark datasets. The experimental results, compared to data balancing methods such as under-sampling and over-sampling, exhibit superior performance of the Adaptive TreeHive with accuracy rates of 99.96%, 85.65%, 99.83%, 99.77%, and 95.54% on the NSL-KDD, UNSW-NB15, CIC-IDS2017, CSE-CIC-IDS2018, and CICDDoS2019 datasets, respectively, establishing the Adaptive TreeHive as a superior performer compared to the traditional ensemble classifiers.

Defining a need for rapid response and practical guidance for recurrent and metastatic squamous cell carcinoma of the head and neck (R/M SCCHN) management in France: A Delphi consensus

Background Recurrent and metastatic squamous cell carcinoma of the head and neck (R/M SCCHN) presents substantial treatment challenges due to its aggressive and heterogeneous nature. While evidence-based guidelines provide useful recommendations, they may not offer sufficient support for real-time clinical decision-making. Objective This Delphi consensus aimed to establish expert agreement on clinical parameters guiding first- and second-line treatment decisions and the management of specific clinical scenarios in R/M SCCHN in France. Methods A two-round Delphi consensus was conducted between December 2023 and June 2024. A scientific committee of six national experts developed consensus statements based on a literature review and supervised the process. An expert panel of 25 oncologists from across France participated in both rounds. Results All respondents agreed that the need for a rapid therapeutic response and the presence of comorbidities were critical factors influencing first-line treatment choice. Seven major indicators of rapid response were identified: rapidly progressive relapse, partial airway obstruction, respiratory compromise, tumour-related bleeding, uncontrolled symptoms, carotid axis lesions, and pain resistant to third-step analgesics. For patients requiring rapid response, 76% supported using cetuximab with chemotherapy as a first-line option in cases with a combined positive score (CPS) between 1 and 19. Furthermore, 84% recommended immunotherapy (alone or combined with chemotherapy) as first-line treatment for CPS ≥ 20 tumours, while 41% would consider it for CPS 1–19 cases. A strong consensus (80%) held that first-line treatment should not restrict second-line options. Notably, 100% of respondents agreed that all patients should receive immunotherapy, cetuximab, taxanes, and platinum salts within the first two treatment lines. Conclusions This Delphi consensus offers valuable, expert-based perspectives on the management of R/M SCCHN in France. It highlights a progressive shift from standardized European guideline frameworks toward a more personalized approach that accounts for individual patient profiles and tumour characteristics. The insights generated provide practical guidance for clinical decision-making and lay the groundwork for future research and optimisation of treatment strategies in real-world settings.

Healthcare providers’ perspectives of barriers and facilitators to highly active antiretroviral therapy adherence among HIV-positive women in Southern Ethiopia: A qualitative study

Background Following a strict regimen of highly active antiretroviral therapy (HAART) is the fundamental factor in achieving successful treatment outcomes for HIV/AIDS. Poor adherence to HAART not only amplifies the risk of HIV transmission but also leads to deteriorating health, treatment failures, and a rise in drug-resistant HIV strains, ultimately contributing to increased morbidity and mortality rates. Therefore, the objective of the study is to explore and describe the perceptions of healthcare providers about HAART adherence of women in Southern Ethiopia who are HIV positive. Methods Focus group discussions (FGDs) were used among 27 healthcare providers (HCPs) (13 medical doctors and 14 nurses) to determine the extent of HAART adherence among HIV-positive women in Southern Ethiopia. The interviews were conducted in the local Amharic language and were audio recorded with permission from the participants. The FGDs were transcribed verbatim, coded for themes, categories and subcategories, and analyzed using thematic data analysis. Results The findings of the study reflected two themes: barriers to and facilitators of HAART medication adherence among HIV-positive women. These included patient-related factors, treatment-related factors, psychosocial-related factors, family- and community-related factors, and healthcare service-related factors. The following were identified as barriers to HAART adherence: Stigma and discrimination, gender roles, lack of money for food and transport, depression, busy schedule, forgetting of doses, religion, drug side-effects, pills burden, and size, dosage frequency, long waiting time, and unavailability of services at weekends. However, perceived benefits of HAART, family responsibility, reminders, family support, dosage formulation, experiencing improved health on HAART, relationship with healthcare providers, adherence counselling and education, and adherence supporting peer groups were identified as facilitators of HAART adherence. Conclusions Adherence to HAART medication is a major challenge among HIV-positive women in Southern Ethiopia. Therefore, tailored strategies to enhance HAART medication adherence should be targeted to address the barriers identified in the study.

Luminance and thresholding limitations of virtual reality headsets for visual field testing

Purpose To investigate the luminance capacity and achievable threshold levels of commercially employed virtual reality (VR) devices for visual field testing. Methods This two-part study included (1) a literature review of VR headsets used for perimetry with luminance data extracted from technical specifications in publications and manufacturers; and (2) empirical evaluation of three most employed VR headsets in the literature using a custom virtual testing environment. Results Three most employed VR devices for visual field testing were Pico Neo, Oculus Quest, and HTC Vive. The maximum reported luminance was 250 cd/m2 for the HTC Vive Pro. Information on luminance measurement was not consistently available, reporting only handheld luminance meters. Empirical measurements show that handheld luminance meters significantly overestimate luminance compared to standard spectroradiometers. Measured luminance varies significantly across aperture size and decreases for peripheral stimuli up to 30 degrees peripherally. Assuming conventional background of 10 cd/m2, the best performance with lowest possible thresholding was with HTC Vive at 16dB, corresponding to luminance of 80 cd/m2 centrally. Oculus Quest 2 and Pico Neo 3 had minimum threshold of 20dB. Conclusion Commercially available VR devices do not meet luminance requirements or threshold sensitivities for visual field testing. Current VR technology is not designed—nor has the capacity—to threshold at mid-to-low dB ranges, which limits accuracy in diagnosing and monitoring defects seen in glaucoma. Translational Relevance: This study highlights the technical limitations of current commercially available VR devices for visual field testing and significant variables in evaluating luminance performance in these devices.

Comparative microfluidic and enzymatic analyses reveal multifaceted snake venom resistance and novel VWF behavior in the opossum Monodelphis domestica

Interactions between predators and prey are often characterized by strong selection pressures that shape extreme physiological adaptations. Venom resistance in large-bodied South American opossums (Clade Didelphini) is a striking example, as these marsupials prey on venomous snakes and exhibit remarkable resistance to their venom. While resistance is well documented in Didelphini, relatively little is known about venom resistance in the smaller, more diverse members of Didelphidae, which inhabit the same regions and encounter the same predators. Moreover, resistance of opossum von Willebrand factor (VWF) to the venom C-type lectin-like proteins has not been previously studied under simulated vascular flow states. Here, we use microfluidic devices to investigate venom resistance in the small-bodied opossum, Monodelphis domestica, examining platelet adhesion and fibrin deposition in response to purified venom components. Additionally, we conduct platelet aggregometry and assays of serum protease inhibitors in the presence of venom from sympatric and allopatric vipers to examine patterns of species-specificity and adaptation. Our results show that M. domestica resists venom-induced disruptions to platelet function in the presence of platelet-disrupting venom components botrocetin and convulxin, while aspercetin disrupts platelet and fibrin function similarly in opossum and human samples. Whole blood aggregometry and serum protease inhibition showed patterns consistent with species-specific adaptation of mammals to their local snake venom. Unexpectedly, we find that M. domestica VWF requires increased shear force to elongate, a previously unknown aspect of opossum blood physiology that may contribute to venom resistance and may have relevance to human coagulopathies. Our findings demonstrate resistance under natural shear stress, and document venom resistance beyond large-bodied Didelphini, suggesting it is a widespread trait in South American marsupials.