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Superior health-related physical fitness and well-being in 12–15-year-old Danish adolescents who are active in organized leisure-time sports – a cross-sectional study

Background Global reports indicate that less than 20% of 11–17-year-olds meet physical activity recommendations, and while organized sports participation increases the likelihood of meeting these guidelines, no other studies were found that examined the impact on well-being and physical fitness outcomes among Danish adolescents based on participation in leisure time sports. Methods The study employed a cross-sectional design, assessing cardiorespiratory fitness, fat percentage, and well-being, as well as several other health and fitness outcomes among 1,333 Danish adolescents (50% girls). Differences between participants in organized sports and non-participants, as well as between participants in different sport categories were assessed through ANCOVA analysis. Results Girls and boys participating in organized sports, ran longer (p<0.05) in the Yo-Yo Intermittent Recovery level1 Children's test (IR1C) (G: d = 0.72 [0.54; 0.89]; B: d = 0.70 [0.50; 0.89]) and had lower (p<0.05) fat percentages than non-participants (G: d = 0.42 [0.25; 0.59]; B: d = 0.33 [0.14; 0.51]). Organized sport participants had higher (p < 0.05) well-being than non-participants in all KIDSCREEN-27 sub-scales apart from social support and peers. Girls in individual sports had lower (p<0.05) well-being than girls in other sports in all sub-scales apart from parent relations and autonomy. Multisport participation for both sexes, as well as participation in soccer for boys, was associated with a greater distance covered in the Yo-Yo IR1C (p < 0.05). A significant drop out of sports from the previous to the current year was found among girls, but not among boys. Conclusion Participation in organized leisure-time sports is linked to better health, fitness, and well-being, especially for girls, who show greater disparities with non-participants. Participation in team sports is linked to higher well-being compared to individual sports in girls, but not in boys. High dropout rates among adolescent girls call for targeted strategies to sustain their participation and derived benefits.

Measuring the synergy between technological and management innovation in megaprojects: Empirical evidence from China

In the national innovation system, the synergistic development of technological and management innovation in megaprojects plays a critical role in achieving high-quality project delivery. This study aims to develop a quantifiable three-dimensional coordination measurement framework to explore the collaborative mechanisms between technological and management innovation and validate practical applicability. First, key influencing factors of both technological and management innovation are identified through a systematic literature review and expert interviews. Based on these factors, an innovation status measurement model is constructed using a combined subjective and objective weighting approach. Next, the coupling degree function is applied to assess the coordination levels of three subsystems: structural coordination, behavioral coordination, and performance matching. Moreover, the overall coordination degree is calculated by integrating these results using a power function. A case study of the Shuozhou-Huanghua Railway reveals that the structural coordination degree is low level, the behavioral coordination degree is medium level, the performance matching degree is medium level, and the overall coordination degree is medium level. These findings suggest that while collaboration at the behavioral level is relatively effective, there remains significant potential for improvement in structural and performance coordination. The proposed three-dimensional coordination framework and associated quantitative tools demonstrate strong diagnostic capability in evaluating the synergy, offering theoretical support for dynamic strategy formulation and resource optimization.

Mindfulness beyond secularization: Beliefs across meditators and non-meditators reflect a consensus on personal development over health and spirituality

Background Mindfulness meditation (MM), originating from spiritual traditions but widely promoted as a secular and beneficial practice, is increasingly debated due to potential adverse effects, ethical concerns, and its ties with neoliberal imperatives, challenging its image as a universal remedy. Beliefs about MM strongly influence its reception, usage, and effects but remain understudied, especially in comparing meditators and non-meditators. Understanding these beliefs is key to clarifying how lay perceptions align or diverge from scientific frameworks and to grasp individuals’ expectations and motivations, notably in clinical contexts. Existing research often overlooks belief content or comparisons between meditators and non-meditators. Objective This study explored the content of beliefs about MM, identified missing elements, and compared meditators’ and non-meditators’ beliefs. Associations with sociodemographic, motivational, health, and psychological variables were examined. Methods 167 participants (105 meditators) completed an online survey producing five words linked to MM, rated for valence, plus questionnaires on motivation, beliefs, and personal characteristics. Results 817 free associations were collected; 65% were positive. Hierarchical classification identified five belief categories: “Body-based Relaxation,” “Stereotyped Descriptions,” “Psychological and Affective Well-Being,” “Focus on Inner-Self,” and “Experience of MM.” Four categories were shared by both groups, with meditators showing more precise, experiential understanding. Beliefs varied with sociodemographic, health, and psychological factors. Core aspects in MM like attention, acceptance, health, collective dynamics and ethical concerns were largely absent. Notably, spirituality was not integrated into the beliefs about MM. Conclusions Findings emphasize MM as a self-regulatory and personal development tool shaped by social, psychological and behavioural factors. Recognizing both current and potential MM users’ beliefs can improve tailoring of mindfulness interventions and encourage instructors to address ethical and adverse aspects openly, fostering more informed, responsible practice.

Impact of stress and coping strategies on quality of life in hematological malignancies: A cross-sectional study

Background and aims While perceived stress and coping strategies have been established as significant determinants of quality of life (QoL) in patients with solid malignancies, their impact on hematological malignancy population have not been fully elucidated. This study aimed to examine how perceived stress and medical coping strategies interact with sociodemographic factors to influence QoL in patients with hematologic malignancies. Methods The study, involving 185 hematologic cancer patients in China, was conducted between August 2024 and December 2024. Self-reported scales were used to assess QoL, perceived stress and medical coping strategies. Data analysis included univariate analyses, Pearson correlation, and multivariate regression analyses using SPSS V26.0. Results 178 patients completed the survey with a response rate of 96.2%. The overall QoL score was 55.99 ± 24.6 indicating a moderate-to-low level. The functional domains averaged 64.81 ± 21.83, while the symptomatic domains averaged 24.95 ± 19.38. The overall QoL was associated with age, sex, marital status, place of residence, type of insurance (p < 0.05). Stress perception (r = −0.389, −0.591), crisis perception (r = −0.489, −0.638), and yielding coping (r = −0.479, −0.547) exhibited significant negative correlations with overall QoL and functional scores, respectively (p < 0.001). Stress perception (r = 0.435), crisis perception (r = 0.535), avoidance (r = 0.280), and yielding (r = 0.472) were positively correlated with symptom scores (p < 0.001). Multiple linear regression analysis identified sex, crisis perception, and yielding as key factors affecting overall QoL (explaining 36.5% of the variance) and functional status (explaining 45.6% of the variance), while residence, crisis perception, avoidance, and yielding significantly influenced the symptomatic fields (34.2% variance) in patients with hematological malignancies (p < 0.05). Conclusions This study revealed that the QoL of patients with hematological malignancies is generally suboptimal and influenced by sex, crisis perception, and stress-coping strategies. These findings underscore the need for integrated psychosocial interventions targeting stress management and adaptive coping strategies in clinical care. This study contributes to the growing body of evidence on psychosocial determinants of QoL in oncology and can inform tailored supportive care programs for this population.

Correction: Ictal cardiovascular autonomic dysfunction during focal seizures induced by direct electrical stimulation: An observational study research protocol

Automated segmentation of retinal vessel using HarDNet fully convolutional networks

Computer-aided diagnostic (CAD) systems for color fundus images play a critical role in the early detection of fundus diseases, including diabetes, hypertension, and cerebrovascular disorders. Although deep learning has substantially advanced automatic segmentation techniques in this field, several challenges persist, such as limited labeled datasets, significant structural variations in blood vessels, and persistent dataset discrepancies, which continue to hinder progress. These challenges lead to inconsistent segmentation performance, particularly for small vessels and branch regions. To address these limitations, we propose an enhanced HarDNet-based model that integrates HarDNet modules, Receptive Field Block (RFB) modules (designed to capture multi-scale contextual information), and Dense Aggregation modules. This innovative architecture enables the network to effectively extract multi-scale features and improve segmentation accuracy, especially for small and complex structures. The proposed model achieves superior performance in retinal vessel segmentation tasks, with accuracies of 0.9685 (±0.0035) on the DRIVE dataset and 0.9744 (±0.0029) on the CHASE_DB1 dataset, surpassing state-of-the-art models such as U-Net, ResU-Net, and R2U-Net. Notably, the model demonstrates exceptional capability in segmenting tiny vessels and branch regions, producing results that closely align with the gold standard. This highlights its significant advantage in handling intricate vascular structures. The robust and accurate performance of the proposed model underscores its effectiveness and reliability in medical image analysis, providing valuable technical support for related research and applications.

Non-thermal plasma activated water is an effective nitrogen fertilizer alternative for Arabidopsis thaliana

Nitrogen (N) fixation with non-thermal plasmas has been proposed as a sustainable alternative to meet growing N fertilizer demands for agriculture. This technology generates Plasma Activated Water (PAW) with a range of chemical compositions, including different concentrations of nitrate (NO₃⁻) and hydrogen peroxide (H 2 O 2 ), among other compounds. Potential use of PAW as an effective crop fertilizer necessitates a robust understanding of the underlying biology of the plant, which is not yet available. The lack of a unified standard in PAW production and the varying chemical make-up that results from different devices and protocols hampers comparative studies and adoption of this technology. The objective of this study was to compare the efficacy of two PAW solutions with differing concentrations of H 2 O 2 produced from a Radio Frequency (RF) glow discharge plasma source. The effect of these solutions on plant growth, ROS accumulation, gene expression and heat stress response were compared to N-equivalent controls in the model plant Arabidopsis to assess their potential as an alternative N fertilizer. While PAW solutions lacking detectable H 2 O 2 enhanced seedling growth, those containing approximately 0.3 µM of H 2 O 2 did not. ROS accumulation in root tissues was similar between PAW and chemically equivalent solutions, suggesting H 2 O 2 is the primary ROS present in the PAW at the time of treatment. Gene expression studies showed induction of genes involved in N uptake and assimilation in PAW-treated seedlings. Pre-treatment of seedlings with PAW solutions containing H 2 O 2 improved root growth under heat stress which indicates that this treatment may induce plant stress response pathways. Finally, mature plants showed similar growth when fertilized with PAW lacking H 2 O 2 or NO 3 - control regimes for over 5 weeks indicating equivalency in chemical composition, plant nutrient uptake and utilization. Overall, these results demonstrate that PAW is an effective alternative to NO 3 - fertilizers for plant cultivation but the levels of H 2 O 2 need to be carefully controlled.

Understanding the role of Shroom3 in the developing mouse myocardium

Loss of actin cytoskeleton control can hinder integral developmental and physiological processes and can be the basis for a subset of developmental defects. SHROOM3 is an actin binding protein, best characterized as being essential for neural tube closure in vertebrates. Shroom3 expression has also been identified in the developing heart, with some associated congenital heart defects. Here we show that the expression pattern of Shroom3 in the developing and adult mouse heart is specific to the myocardium. Using a gene trap line, we show that embryos with homozygous full-body Shroom3 loss die at birth due to exencephaly but also show congenital heart defects. This includes ventricular septal defects, semilunar valve abnormalities, and ventricle wall thinning. Adult mice heterozygous for Shroom3 loss also show ventricular thinning due to decreased cardiomyocyte size. To explore if SHROOM3 is operating in a cell autonomous manner in the cardiomyocytes, we utilized a floxed Shroom3 mouse line, allowing for spatial and temporal control of Shroom3 loss. Using an Nkx2–5-Cre recombinase, we targeted Shroom3 loss to the myocardium of the developing heart. Neonate pups with myocardial specific Shroom3 loss showed no significant impact on heart development, including no septal or valve defects, no ventricular thinning, and no change in viability into adulthood. Adult mice with myocardial specific Shroom3 loss showed no ventricular thinning and no change in cardiomyocyte size. These results show that the heart defects seen in full-body Shroom3 loss do not arise from myocardial specific loss. Rather, other cell types expressing Shroom3 , such as the cardiac neural crest cells, may be directly contributing to cardiac development.

Hepatitis C virus reinfection among people who inject drugs in the country of Georgia and injection-related risk factors: Implications for HCV elimination in the EECA region

Hepatitis C (HCV) infection is a major global health challenge, with particularly high prevalence among people who inject drugs (PWID) in the Eastern European and Central Asian region (EECA). While the country of Georgia has made major progress in reducing overall HCV prevalence, less is known about HCV reinfection rates and risk factors for reinfection among PWID. In this study, we aimed to: (1) estimate HCV reinfection rates and (2) identify risk factors associated with HCV reinfection among PWID. Data were from the 2022 Integrated Bio-Behavioral Surveillance Study (IBBS) of PWID in Georgia. For the present analysis, the sample was restricted to the 462 PWID who had previously received HCV treatment through the national elimination program. The survey included a behavioral component (face-to-face interviews using a standardized questionnaire covering injection-related risk behaviors), and a laboratory component (blood samples for HCV RNA testing). We conducted regression models based on bivariate analyses to identify risk factors associated with laboratory-confirmed HCV reinfection. Overall, the reinfection rate was 13% among PWID in our sample. We found that younger PWID had higher odds of HCV reinfection compared to older PWID. The highest reinfection rate was among participants aged 18–24, (33.3%), although this group comprised a small portion of the sample (n = 3). Those reporting public injecting, had an adjusted odds ratio AOR of 8.08 [95% CI: 2.13,30.98] of HCV reinfection. At the time of the study, continuous opioid injection every day during the last 12 months was also associated with reinfection with an AOR of 2.26 [95% CI: 1.06,5.01]. Reinfection presents a challenge to HCV elimination. We identified several key factors that may influence reinfection including age, injection environment, and duration of drug injection. These findings emphasize the necessity for an integrative approach to harm reduction that addresses both behavioral and environmental risk factors.

A correlation analysis between nutritional status and physical function in the elderly with pulmonary tuberculosis

Background Malnutrition is a significant risk factor contributing to the progression of the elderly with pulmonary tuberculosis (TB). This study aimed to evaluate the nutritional status of the elderly with pulmonary TB using the Mini Nutritional Assessment (MNA) and explore the relationship between their nutritional status and physical function. Methods This was a cross-sectional survey study. Data collection was from July 2023 to March 2024. 532 the elderly with pulmonary TB who were admitted to a tertiary infectious disease hospital in Chengdu were included in this analysis. The nutritional status of the patients was evaluated using MNA, and they were divided into well-nourished group (≥24 points) and abnormal-nourished group (<24 points). This study assessed physical function using the Berg Balance Scale (BBS), the Timed Up and Go test (TUG), and the Five-Times-Sit-to-Stand Test (FTSST). Clinical data and physical function of the two groups were compared, and the correlation between nutritional score and physical function was analyzed. Results There were 109 cases (20.5%) in well-nourished group and 423 cases (79.5%) in abnormal-nourished group. Compared with well-nourished group, the abnormal group showed a decrease in the BBS scores [(52.55 ± 7.10) vs (43.20 ± 16.29), p < 0.05], and an increase in the TUG [9.00 (7.00, 10.00) vs 9.00 (7.40, 12.00), p < 0.05] and the FTSST [12.00 (9.00, 14.75) vs 15.00 (10.00, 20.10), p < 0.05]. Correlation analysis showed that the nutritional score of patients was positively correlated with the BBS scores (r = 0.474, p < 0.001), and negatively correlated with the TUG (r = −0.200, p < 0.001) and the FTSST (r = −0.501, p < 0.001). Conclusions Malnutrition is common in the elderly with pulmonary TB. Nutritional status in these patients is associated with the BBS scores, the TUG, and the FTSST.

Patient capital and green total factor productivity: Evidence from Chinese listed companies

This study applies Fisher’s investment framework to investigate how patient capital affects firms’ green total factor productivity (GTFP). Using panel data from Chinese listed companies over the period 2008–2023, we measure firm-level GTFP by employing a non-radial SBM directional distance function combined with the Malmquist–Luenberger productivity index. Our analysis, based on two-way fixed-effects models and instrumental variable regressions, reveals that an increase in patient capital significantly enhances firms’ green total factor productivity. Mechanism analysis indicates that this improvement arises from reduced financing costs as well as increased green R&D investment. Furthermore, the positive impact is particularly pronounced among small and medium-sized enterprises, non-state-owned firms, and pollution-intensive industries. The findings suggest that encouraging the transition from short-term speculative capital toward long-term patient capital can effectively improve firms’ environmental efficiency. Thus, policy efforts should be directed towards expanding the supply of patient capital to promote corporate sustainability and accelerate the low-carbon economic transition without compromising economic efficiency.

Improved protocol for the vitrification and warming of rat zygotes by optimizing the warming solution and oocyte donor age

Zygotes are used to create genetically modified animals by electroporation using the CRISPR-Cas9 system. Such zygotes in rats are obtained from superovulated female rats after mating. Recently, we reported that in vivo-fertilized zygotes had higher cryotolerance and developmental ability than in vitro-fertilized zygotes in Sprague Dawley (SD) and Fischer 344 rats. To apply the in vitro-fertilized zygotes in creating genetically modified rats, we need to address their low cryotolerance and developmental ability. Hence, we evaluated the effects of warming solutions containing different sucrose concentrations (0–0.3 M) and the oocyte donor’s age (3–7-week-old SD rats) on the viability of vitrified-warmed zygotes after in vitro fertilization and on developmental ability by embryo transfer in SD rats. A warming solution containing 0.1 M sucrose enhanced the survival rate of vitrified-warmed zygotes and their rate of development to two-cell embryos. Additionally, zygotes derived from 6- and 7-week-old female rats had higher cryotolerance and developmental ability than those from 3-week-old ones. Next, vitrified-warmed rat zygotes produced using the optimized protocol underwent genome editing by electroporation with Cas9 ribonucleoprotein and gRNA introduced to disrupt the Tyr gene. We then found that 86.5% of the pups derived from zygotes demonstrated mutation of the targeted gene. Therefore, the improved protocol for vitrifying and warming rat zygotes is useful for preserving and producing genetically modified rats.

18 individual genes underwent variant screening in a northwest Chinese group comprised 83 probands diagnosed with early-onset high myopia

Purpose To investigate the variants in 18 disease-causing genes associated with nonsyndromic myopia in 83 Chinese individuals diagnosed with early-onset high myopia(eo-HM). Methods Variants in 18 candidate genes in 83 probands with eo-HM were distinguished by whole-exome sequencing (WES) and assessed by multistep bioinformatics analysis. Results Four likely pathogenic variants were detected in 4 of the 83 probands (4.8%) with eo-HM. All of these are missense variants, such as (NM_014452: c.443C > T) in TNFRSF21, (NM_013291: c.799C > G) in CPSF1, (NM_201269.3: c.3266A > G) in ZNF644, and (NM_001135195: c.577G > A) in SLC39A5. These variants were verified by Sanger sequencing, and all allele frequencies were less than 0.01 in the 1000G, ExAC, ESP6500, and gnomAD databases. In addition, the pathogenicity of these variants was determined using several computational tools including SIFT, Mutation Taster, Polyphen-2, PROVEAN, M-CAP, CADD, and DANN. However, it should be noted that the Tyr1089Cys variant was classified as neutral solely using PROVEAN. Conclusion Our findings support the hypothesis that the variants observed in TNFRSF21, CPSF1, ZNF644, and SLC39A5 are the causative genes of eo-HM and expand the spectrum of eo-HM variants observed across various ethnic groups. The dissemination of knowledge on the impact of TNFRSF21, CPSF1, ZNF644, and SLC39A5 on eo-HM is under investigation.

Effects of yeast beta-1,3/1,6-glucans on nutrient digestibility, intestinal functionality, and immune and antioxidant variables in growing dogs submitted to spay or neutering surgery

This study aimed to assess the impact of yeast beta-1,3/1,6-glucans (BG) on apparent digestibility coefficients (ADC) of nutrients, intestinal fermentative metabolites, fecal microbiota profile, and immune and antioxidant variables in puppies before and after surgical challenge. Two treatments were evaluated: control, without, and test, with oral supplementation of 65 mg/kg body weight/day of purified BG from Saccharomyces cerevisiae for 120 days. For this, 16 growing Beagle dogs were distributed in a completely randomized design (n = 8/treatment). On day 31, dogs were submitted to spay or neutering surgery. Diet ADC and fecal characteristics analyses were performed on days 55–60. Fecal (days 0, 15, 30, 34, and 60) and blood (days 0, 30, 34, and 60) samples were collected to evaluate intestinal fermentative metabolites, fecal IgA and microbiota, intestinal permeability, and immune and antioxidant variables. On day 80, all dogs were vaccinated for rabies and blood samples were collected on day 120 to determine antibody titers. The supplementation of BG promoted an increase in fecal IgA concentrations on day 15 (P < 0.05) and an increase in fecal concentrations of butyrate (P < 0.05) when day 30 minus day 0 were compared. Dogs of the BG group presented higher fecal concentrations of serotonin (day 15), spermidine (days 15, 30, and 34), and a reduction in tyramine, histamine, and cadaverine on day 60 (P < 0.001). BG consumption promoted an increase in richness and a clear differentiation in the fecal microbiota profile on days 34 and 60 (P < 0.05). BG group also presented an increase in fecal Faecalibacterium, Blautia, and Turicibacter on day 34 (P < 0.05). Reduced glutathione and catalase activities were higher in the BG group (P < 0.05), regardless of the day. In conclusion, the supplementation of BG does not alter the ADC of nutrients, beneficially modulates the intestinal functionality, and stimulates the activity of antioxidant enzymes in growing dogs submitted to a surgical challenge.

Correction: Global socio-economic losses and environmental gains from the Coronavirus pandemic

Sedentary behavior mediates the association between weight-adjusted waist index and cardiovascular disease in patients with diabetes

Background Obesity and cardiovascular disease (CVD) are both associated with sedentary behavior. However, the role that sedentary behavior plays in the relationship between obesity and CVD in patients with diabetes remains unclear. This study aimed to examine how the weight-adjusted waist index (WWI) relates to CVD risk in patients with diabetes and to explore sedentary behavior’s potential mediating role in this relationship. Methods The present study analyzed data from 4,937 participants across seven NHANES cycles (2007–2020). Using logistic regression models and restricted cubic spline analyses, we evaluated the associations between WWI, sedentary behavior, and CVD in patients with diabetes. Subgroup and sensitivity analyses were conducted to confirm the stability of the results. Mediation analysis explored the mediating role of sedentary behavior in the associations between WWI and CVD. Results The present study found that diabetic patients with CVD had higher WWI levels (11.8 ± 0.69cmkg)compared to diabetic patients without CVD (11.60 ± 0.73cmkg). WWI was positively associated with CVD in patients with diabetes(OR = 1.27, 95% CI: 1.06–1.53; P < 0.01), even after accounting for potential confounders. Sedentary behavior was also positively associated with CVD(OR = 1.04, 95% CI: 1.02–1.07; P < 0.01). In a restricted cubic spline analysis, we found that WWI and sedentary time were positively correlated and approximately linearly associated with CVD risk in patients with diabetes. As WWI levels and sedentary time increased, the risk of CVD increased in patients with diabetes. Mediating analysis revealed that sedentary behaviour mediated 13.43% of the association between WWI and CVD in patients with diabetes. Conclusion We found that WWI is associated with an increased risk of CVD in patients with diabetes, and sedentary behavior partially mediates this relationship. Reducing sedentary behavior may be a key strategy to reduce obesity and CVD risk in patients with diabetes.

The mediating role of hope in the relationship between purpose in life and anxiety: A cross-cultural analysis in university students

Objective To examine the direct effect of purpose in life (PIL) on anxiety and its indirect effect through hope in a sample of university students from Ecuador, Bolivia, and Colombia, while assessing the cross-national measurement equivalence of the mediation model. Method A descriptive, correlational, and cross-sectional study was conducted using Structural Equation Modelling (SEM) to test mediation effects and Multigroup Confirmatory Factor Analysis (MG-CFA) to assess measurement invariance. The sample included 1,459 university students from Ecuador, Colombia, and Bolivia. Results PIL, hope, and anxiety exhibited significant latent correlations and formed a well-fitted structural model. PIL had both a direct effect on anxiety in Colombia and an indirect effect through hope across all three countries. In Ecuador and Bolivia, full mediation was observed, whereas in Colombia, mediation was partial. PIL and hope together explained 20.1% of the variance in anxiety, though this percentage varied across countries. Measurement invariance analyses confirmed that the mediation model was structurally equivalent across cultures, but differences in effect sizes suggest cultural modulation in the relationship between PIL, hope, and anxiety. Conclusion Anxiety were associated with cognitive processes related to meaning-making and hope, supporting their role as protective psychological variables. However, cultural context modulates the strength of these relationships, highlighting the need for context-sensitive interventions.

Looking beyond digital broadband speeds: Rural British Columbian’s experiences with internet connectivity as a basic necessity

Aim This study examined the experience of digital connectivity among rural-living British Columbians both with and without access to high-speed Internet at home. Background Evidence indicates that fewer rural communities have access to high-speed Internet compared to urban communities in Canada, despite government commitments to bring high-speed Internet to all British Columbians by 2027. Yet, differences within rural areas relative to those with access to high-speed compared to those with lower speeds remains a relatively unexplored area. Methods A cross-sectional survey of rural British Columbians both with and without high-speed Internet was conducted between October 2023 and April 2024. Closed and open-ended questions gathered participants’ thoughts and experiences with digital technology access and use. Findings Overall, 461 (M age = 56 years, 72% female) rural BC community members (47% with access to 50 + Mbps download speeds) completed the survey. Despite similar overall digital readiness, skill, and confidence using digital technology, those without high-speed Internet were older, more remote-living, reported using fewer connected devices alongside greater frustration with technology, yet had comparable frequency of Internet use except for less streaming compared to those with access to high-speed Internet. Similar themes were found among open-ended responses of both those with and without high-speed Internet access and surrounded: i) the actual and potential benefits of high-speed connectivity, and ii.) disconnects on many levels, but particularly between expectations for and reality of high-speed connectivity. Conclusion Regardless of broadband speed, there were greater similarities than there were differences across rural community participants, with common perceptions of the benefits of connectivity amid experiences with pervasive disconnections on a number of levels.

Outcomes and complications among nonagenarians undergoing cardiac surgery: A scoping review

Introduction This review was aimed at understanding the scope of evidence regarding outcomes and complications in nonagenarians (90–99 years of age) undergoing open cardiac surgery. Methods The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Extension for Scoping Review Protocol guidelines. A search of three databases, MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials, identified articles pertaining to nonagenarians undergoing various open cardiac surgical procedures. No restrictions were applied to study design or publication date. Results From the initial 1826 articles identified, we included 28 studies from eight countries in a total of 6411 nonagenarians. The median 30-day mortality rate was 10.5% (IQR 7.2–14.6). Postoperative complication rates were reported in 20 studies (71%), and the median major complication rate was 71.4%. Respiratory, cardiac, renal, neurologic, gastrointestinal, and/or infectious complications were reported in 19%, 20%, 14%, 18%, 5%, and 9% of cases, respectively. The median length of hospital stay was 12.5 days (IQR 10.4–18.0). No studies reported unplanned readmissions to the intensive care unit or detailed patient-centered outcome measures. Conclusions Although age alone should not preclude nonagenarians from undergoing cardiac surgery, the procedure is associated with a significantly elevated risk of morbidity and a relatively high mortality rate. The review findings emphasize the need for international registry data to identify risk factors associated with adverse outcomes, explore strategies to decrease the risk of major complications, and improve postoperative quality of life. Moreover, creating and implementing uniform preoperative frailty assessments, and correlating them with surgical outcomes, will be crucial. Developing standardized patient-reported experience and outcome measures will also be imperative. Scoping review registered on OSF registries (https://osf.io/4mg7n).

Biological findings from a newly developed photo-identification catalog for the critically endangered Rice’s whale (Balaenoptera ricei)

The Rice’s whale is among the world’s most endangered whales. It has a small population size, low genetic diversity, and is exposed to several anthropogenic threats. In this study, we compiled photographs taken from whale sightings during vessel-based research surveys conducted by the U.S. National Marine Fisheries Service, Southeast Fisheries Science Center between 2004 and 2019 and used photo-ID techniques to develop an identification catalog. Thirty-one whales were individually identified based on dorsal fin attributes and body marks. On the dorsal fin, lacerations, nicks and notches were the most commonly available attributes used for identification and matching. Cookiecutter shark bite scars were widely present on the body of the whales and also served for identification and matching. Of the 31 whales, 28 were sighted multiple times with time between sightings ranging from seven days to more than 15 years. Individual genotyping and sexing were available for 25 cataloged whales. Genotyping confirmed that whales identified via photographs were genetically unique and sexing resulted in 14 females and 11 males. Here we also present insights into rarely recorded presumed mother and calf pairs, with three female whales identified as presumed mothers. Finally, we document dorsal fin disfigurements, body deformities and confirm the identity of a whale mortality. Our study reveals the need for the long-term monitoring of Rice’s whale individuals, especially presumed mothers and calves, and to further investigate potential human threats to this population using photo-identification techniques.