Browse Articles

Dynamical analysis of financial stocks network: Improving forecasting using network properties

Applying a network analysis to stock return correlations, we study the dynamical properties of the network and how they correlate with the market return, finding meaningful variables that partially capture the complex dynamical processes of stock interactions and the market structure. We then use the individual properties of stocks within the network along with the global ones, to find correlations with the future returns of individual S&P 500 stocks. Applying these properties as input variables for forecasting, we find a 21% improvement on the R2score in the prediction of stock returns on long time scales (per year), and 3% on short time scales (2 days), relative to baseline models without network variables. These findings highlight the potential of integrating network-based variables into stock return prediction models, which could enhance forecasting accuracy and provide a deeper understanding of market dynamics. This approach could be valuable for both investors and researchers seeking to model and predict stock behaviour in complex financial networks.

Retraction: Machine learning-based anomaly detection and prediction in commercial aircraft using autonomous surveillance data

Anchor-free real-time vehicle tracking using LiDAR data

Roadside LiDAR systems can generate real-time microscopic vehicle trajectories applicable to develop intelligent transportation systems and aid the operations of connected and autonomous vehicles. Tracking is the most crucial data processing step to generate accurate and reliable trajectories of road users from raw point clouds collected from LiDAR sensors. In this paper, a new tracking mechanism is proposed for real-time tracking, which is based on the 2D LiDAR data structure with the Simple Online and Real-Time Tracking (SORT) algorithm. The traditional method of using bounding boxes to identify vehicles is replaced by center points of vehicles inspired by track-by-point approach. The developed index that integrates the distance between the LiDAR serves as a more accurate way of defining the spatial location of vehicles. The proposed methodology was evaluated using data collected by a 32-channel portable LiDAR at three signalized intersections. The results showed that the proposed method has a higher tracking accuracy and a faster computation speed compared to the traditional bounding box approach, indicating improvement toward real-time applications. Index Terms—Real-time tracking; Roadside LiDAR; Trajectory; Track by point; SORT.

Challenges faced and coping strategies used by Malaysian International Medical Graduates surviving internships: A Qualitative Study

Background Malaysian International Medical Graduates (MIMGs) faced unique challenges during their medical internships in Malaysia, impacting their training experience and overall well-being. This study aims to explore these challenges and identify the coping strategies MIMGs employ to navigate their internships successfully. By understanding these factors, the study seeks to provide insights for improving the internship experience and reducing attrition rates among MIMGs. Methods A qualitative research design was employed, utilising in-depth interviews with eleven MIMGs to gather detailed insights into their internship experiences. Thematic analysis was used to identify and analyse common themes and subthemes related to individual, training system, and working environment challenges and the strategies employed to cope with these challenges. Findings The study identified three main themes, eight subthemes of challenges faced by MIMGs, and thirteen subthemes for coping strategies to survive an internship. The themes are individual challenges, training system issues, and working environment difficulties. Individual challenges included high levels of stress and burnout due to long working hours, heavy patient loads, and emotional tolls. Training system issues encompassed bureaucratic hurdles, inadequate infrastructure, and low financial incentives. The challenges of the working environment involved difficulties with cultural adaptation, hierarchical structures, and language barriers. MIMGs employed various coping strategies, with peer support emerging as a powerful tool, along with resilience, self-care practices, and proactive communication. Conclusion This study provides valuable insights into the challenges and coping strategies of MIMGs during their internships in Malaysia. The results suggest that targeted interventions and systemic changes are necessary to support MIMGs effectively and enhance their training experience. Future research should explore these issues further, with larger samples and in different contexts, to develop comprehensive strategies for improving medical internships globally.

Clinical trials for Wolfram syndrome neurodegeneration: Novel design, endpoints, and analysis models

Objective Wolfram syndrome, an ultra-rare condition, currently lacks effective treatment options. The rarity of this disease presents significant challenges in conducting clinical trials, particularly in achieving sufficient statistical power (e.g., 80%). The objective of this study is to propose a novel clinical trial design based on real-world data to reduce the sample size required for conducting clinical trials for Wolfram syndrome. Methods We propose a novel clinical trial design with three key features aimed at reducing sample size and improve efficiency: (i) Pooling historical/external controls from a longitudinal observational study conducted by the Washington University Wolfram Research Clinic. (ii) Utilizing run-in data to estimate model parameters. (iii) Simultaneously tracking treatment effects in two endpoints using a multivariate proportional linear mixed effects model. Results Comprehensive simulations were conducted based on real-world data obtained through the Wolfram syndrome longitudinal observational study. Our simulations demonstrate that this proposed design can substantially reduce sample size requirements. Specifically, with a bivariate endpoint and the inclusion of run-in data, a sample size of approximately 30 per group can achieve over 80% power, assuming the placebo progression rate remains consistent during both the run-in and randomized periods. In cases where the placebo progression rate varies, the sample size increases to approximately 50 per group. Conclusions For rare diseases like Wolfram syndrome, leveraging existing resources such as historical/external controls and run-in data, along with evaluating comprehensive treatment effects using bivariate/multivariate endpoints, can significantly expedite the development of new drugs.

Obstetric, foetal and neonatal outcomes in adolescent pregnancy in sub-Saharan Africa: Systematic review and meta-analysis protocol

Background Teenage pregnancy remains an important public health challenge in sub-Saharan Africa (SSA), with significant adverse health outcomes for the mother, their foetuses and infants. This systematic review will assess the impact of teenage or adolescent pregnancy on maternal obstetric, foetal and infant health outcomes, with the aim to inform evidence-based implementation of context-sensitive interventions and policies across countries in SSA. Methods This protocol has been informed by the Cochrane handbook and other published works and reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for protocols (PRISMA-P) guidelines. We will search CINAHL, PubMed, Google Scholar, Scopus, Web of Science, Cochrane Library and LILACS, from inception to April 30, 2025, without language restriction. The search terms include ‘teenage pregnancy’, ‘adolescent pregnancy’, ‘maternal outcomes’, ‘obstetric outcomes’, ‘maternal death’, ‘maternal mortality’, ‘foetal outcomes’, ‘infant outcomes’ and ‘APGAR score’, together with their synonyms or alternate words, American or British spelling, singular or plural forms of the search terms or concepts. The names of all the 48 countries in SSA will be included as search terms. We will also search HINARI, African Journals Online, conference proceedings, preprint repositories, database of thesis, Specialized Obstetrics and World Bank Open Knowledge Repositories, WHO, PATH, and UNICEF databases. We will review the reference lists of relevant papers, and where necessary, contact experts in the field for their knowledge about studies missed by our searches. The retrieved studies will be managed in Endnote version X9 and duplicates removed. The deduplicated studies will be exported to Rayyan for study selection. At least two reviewers will independently screen and select studies using pre-tested study selection flow chart developed from the pre-specified eligibility criteria, extract the data using pretested data extraction form, and assess risk of bias in the included studies using ROBINS-E for non-randomized studies of exposure effects. Any disagreements will be resolved through discussion among the reviewers. We will analyze continuous outcomes as mean difference (MD) for studies using the same scales with their standard deviation (SD) and for studies measuring outcomes on different scales, the standardized mean difference (SMD) will be used. Binary/dichotomous outcome data will be expressed as odds ratio (OR) or risk ratio (RR). All the effect measures will be presented with their 95% confidence intervals (CIs). Pooled proportions will be used to determine prevalence or incidence of specific maternal, foetal and infant health outcomes. Heterogeneity will be assessed graphically and quantitatively using the I2 statistic. Random-effects meta-analysis will be used to synthesize data from the included studies, expected to be heterogeneous and with varying effect sizes. Where data permits, we will conduct subgroup analysis on key factors such age, trimester, gestation at delivery etc. to address the sources of heterogeneity. Where possible, sensitivity analysis will be performed to test the robustness of the pooled estimates around outlier variables and key risk of bias domains. The Grading of Recommendations Assessment Development and Evaluation (GRADE) approach will be used to assess the overall certainty of the evidence generated. Expected outcomes This systematic review will inspire countries in Sub-Saharan Africa to implement innovative and context-sensitive programs that will improve the health and outcomes of adolescent pregnancy. An important step toward achieving this is to collate all empirical data through robust systematic review and meta-analysis to distill evidence at the highest level possible. Being the first review to rigorously identify and assess teenage pregnancy-related obstetric, foetal, and neonatal outcomes through the antenatal, labour to post-delivery (post-partum) periods within SSA, the review’s key findings will provide important evidence that will support efforts towards improving the wellbeing of teenage mothers and their newborns. Additionally, in countries across SSA where adolescent pregnancy rates are high and healthcare systems are constrained, this study may highlight important knowledge gaps that can be crucial in directing future research and resource allocation, for example, identifying the subgroup that will benefit from the limited resources. Also, the accumulated data to be pooled from these countries can shed light on the key factors influencing pregnancy outcomes and the trimesters during which these young mothers and their foetuses are most at risk and vulnerable. Such knowledge can help inform future policies and clinical practice. Protocol registration This systematic review protocol has been registered in PROSPERO [CRD42024575044].

Analyzing the coupling coordination between aviation logistics and the regional economy: Identifying coupling mechanisms and critical influencing factors

The relationship between aviation logistics and the regional economy (AL&RE) is mutually reinforcing. This study aims to develop a research framework for evaluating the coupling coordination level and identifying critical influencing factors in regional AL&RE by integrating the coupling coordination degree model with grey relational analysis. The framework is designed to guide regional policy formulation, fostering economic development through the coordinated advancement of AL&RE. To validate its effectiveness, an empirical analysis is conducted using data from Sichuan Province in China for the period 2013–2023. The key findings are as follows: (1) In Sichuan Province, local government expenditures on civil aviation development funds play a crucial role in supporting aviation logistics, while GDP and the proportion of investment in environmental pollution control relative to GDP significantly impact the regional economy. (2) The coupling degree between AL&RE remains high, with coordination generally improving, although occasional declines occur due to internal imbalances caused by external factors. (3) The influence of each indicator on coupling coordination varies, with civil aviation cargo turnover, throughput, and civil aviation take-off and landing sorties being the most significant. (4) Critical factors influencing AL&RE development differ from those affecting their coupling coordination, underscoring the nonlinear nature of this composite system. The study theoretically constructs a composite system for AL&RE and analyzes their coupling mechanism, addressing a significant research gap. It also integrates green indicators into the regional economic subsystem, offering a novel perspective for future research. Practically, the study provides recommendations for enhancing AL&RE coordination in Sichuan.

Optimization control of all-terrain rescue lift vehicle safety performance based on state feedback

The all-terrain rescue lift vehicle is instrumental in mining emergency rescue operations, with its operational stability being of utmost importance. This study focuses on the XZJ5240JQZ30 all-terrain rescue lift vehicle, optimizing its vehicle structure and steering system. A linear 2DOF model and a PID gain model were developed based on actual vehicle parameters. A feedback system was employed to adjust the rear-wheel steering angle, enabling four-wheel steering (4WS) vehicle control. Numerical simulations were conducted using TruckSim and Simulink software. Utilizing the classic Double lane-change scenario as a test scenario, the study compared variations in the vehicle's centroid slip angle and yaw rate at different speeds, analyzing the impact of PID gain on steering stability. Moreover, the relationship between the centroid height and 4WS vehicle stability at low speeds was examined. Based on these findings, practical application tests were performed on the XZJ5240JQZ30 all-terrain rescue lift vehicle, obtaining relevant data on steering angle error. The results indicate that vehicles equipped with the PID-optimized control system demonstrate significantly higher steering stability than those without it. Furthermore, in practical applications, the actual steering angle closely aligns with the theoretical values. This demonstrates that the proposed optimized control system has substantial practical application value.

Exploring exercise, emotional eating, and body dissatisfaction in depression risk: Using structural equation modeling

In order to fill the relevant research gap on the influence of body dissatisfaction on depression in Chinese college students, we used structural equation modeling to explore the relationships between physical activity, body dissatisfaction, eating behavior, and depression. Participants were 1,714 undergraduate students in Southern China. Exercise served as a significant mediator between body mass index and depression, as well as between body dissatisfaction and emotional eating, accounting for 30% and 19.8% of the total effects, respectively. Emotional eating behavior mediated the relationship between exercise and depression. This study underscores the influences of body dissatisfaction on both physical inactivity and emotional eating patterns among Chinese university students. It suggests that reducing body dissatisfaction and emotional eating holds significant potential for preventing depression.

“Falling between the cracks”: Investigating the competing challenges experienced by professionals working with people who hoard

Hoarding disorder is characterised by both the distress associated with discarding and the resulting accumulation of possessions that clutter the home environment, and represents a substantial public health and social problem, requiring an effective multi-agency response. Although a recognised psychiatric condition since 2013, hoarding disorder is under-recognised within mental health treatment provision, and evidence-based treatment pathways are lacking. This study aimed to explore multi-agency working in practice and similarities and differences in how hoarding support is perceived across a broad range of front-line professionals. 35 semi-structured interviews representing a wide range of services from health, social care, housing, and the voluntary sector were conducted and analysed thematically. Three overarching themes are reported: Unique challenges of supporting people who hoard, Conflicting needs of client vs. needs of the organisation, Managing role boundaries and psychological tensions. Findings consistently highlight the challenges specific to these cases. However, they also point to a lack of consensus between professional groups in terms of perceived problems and risks to be addressed. Collaborating effectively with others to meet the psychological needs of clients while ensuring risk mitigation and addressing broader organisational, environmental, and community concerns was found to be a key challenge and associated with often going beyond designated role boundaries to support the person. Our findings point to a need for greater support and training of a diverse set of professionals in psychological models of people who hoard to enhance knowledge, awareness, and confidence of the psychological dimensions of hoarding disorder, and to support them in feeling more emotionally and practically prepared. The results indicate a need for greater integration of mental health measures in the assessment of hoarding cases, and to ensure adequate care pathways with dedicated psychological support along with assignment of case workers/coordination.

Retraction: Influence of the use of various imaging units and projections on the radiation dose received by children during chest digital radiography

Antibiotic prophylaxis for childbirth-related perineal trauma: A systematic review and meta-analysis

Introduction Childbirth-related perineal trauma affects the vast majority of women who give birth vaginally and subsequent complications such as wound infection occur frequently. Antibiotic prophylaxis is not currently recommended following first or second degree tears, or episiotomies. We aimed to evaluate the effectiveness of prophylactic antibiotics for preventing complications from perineal trauma across all types of childbirth-related perineal trauma. Materials and methods Databases were searched from inception to February 2024. Randomised controlled trials, non-randomised interventional studies and observational studies were eligible for inclusion where women experienced childbirth-related perineal trauma and received antibiotic prophylaxis or placebo, including any type of tear or episiotomy. The primary outcome was perineal wound infection. Results were combined into meta-analysis using a random effects model. Results 14 studies were eligible for inclusion (eight randomised controlled trials, six observational) involving 8,878 women. Ten studies were deemed to have a high overall risk of bias. Overall the GRADE certainty of findings were low. Twelve studies were included in the analysis for perineal wound infection, involving 8,438 women. There was a reduced rate of perineal wound infection when prophylactic antibiotics were received (relative risk 0.57, 95% confidence interval 0.48 to 0.67). The subgroup analysis by type of tear demonstrated association with reduced risk of infection when prophylactic antibiotics were received, in the non-obstetric anal sphincter injuries combined subgroup (relative risk 0.50, 95% confidence interval 0.41–0.63) and the episiotomy only subgroup (relative risk 0.57, 95% confidence interval 0.36–0.91). Conclusions Prophylactic antibiotics are associated with a reduced risk of perineal wound infection. Despite these findings, there are not sufficient high-quality randomised controlled trials to adequately inform guideline change amongst women with first/second degree tears or episiotomies. We recommend that an adequately powered, robust, randomised controlled trial is needed amongst women with first/second degree tears or episiotomies after spontaneous birth.

Person-directed burnout intervention for nurses: A systematic review of psychoeducational approaches

Background Nurse burnout is a pervasive issue impacting their well-being and patient care quality. Recognized by the World Health Organization as an “occupational phenomenon,” burnout results from inadequately managed chronic workplace stress and manifests as emotional exhaustion, depersonalization, and reduced personal accomplishment. This can lower the quality of life and increase turnover. Effective interventions are vital to overcome nurse burnout and its consequences. Objective This systematic review explored and analyzed the effectiveness of person-directed psychoeducational interventions in reducing nurse burnout. Materials and methods A comprehensive search of five databases was conducted for studies published between 2014 and 2023, following PRISMA guidelines. Eligible studies that reported outcomes of psychoeducational interventions using validated evaluation tools were included. Data were extracted using standardized forms, and quality was assessed with Joanna Briggs Institute critical appraisal tools. A thematic narrative synthesis was performed. Results 27 studies met the inclusion criteria. Interventions including mindfulness-based interventions and cognitive-behavioral therapy, delivered either in combination or on their own, were shown to be effective in reducing nurses’ burnout in 24 studies. However, the sustainability of these effects varied, with limited long-term follow-up data. Additionally, delivery formats (physical, digital, or combined), also influenced effectiveness, suggesting the importance of tailored interventions to specific contexts and needs of the target population. Conclusions Psychoeducational interventions effectively reduce nurse burnout but need further investigation to ensure long-term sustainability. Future research should target diverse settings, incorporate objective and subjective outcome measures, and explore a broader range of interventions to strengthen evidence of burnout management strategies.

Differences in rehabilitation for high-risk newborns: The impact of neonatal intensive care unit hospitalization

There is growing recognition of the importance of rehabilitation through immediate and long-term follow-up, and neonatal intensive care unit (NICU) aftercare is emerging as an important field to consider rehabilitation services. An increasing number of children born are admitted to the NICU with complications commonly related to low birth weight, premature birth, and development of underlying diseases. Early initiation of rehabilitation services in the NICU has become more common and includes therapies relating to feeding tube removal and pulmonary breathing. We investigated the patterns of rehabilitation utilization (rehabilitation frequency, moving to an area for rehabilitation treatment) and medical expenses based on NICU hospitalization history. Data from the Korean National Health Insurance Service Database over a span of ten years were reviewed, with an observation period of 3 years after the first rehabilitation session. The newborns were divided into two groups: 16,626 in the NICU group and the non-NICU group, matched 1:1 based on NICU hospitalization history. The number of rehabilitation treatments in the non-NICU group was significantly higher over the two years following the initial rehabilitation session (p < 0.05). In contrast, the total medical expenses during the 6 months following the initial rehabilitation session were more than six times higher in the NICU group (KRW 1,868,516 vs. 11,348,940, p < 0.0001). The NICU group showed significantly more discrepancies between their residence and the first rehabilitation treatment area (9.5% vs. 13.4%, p < 0.001). Results indicate that the amount of rehabilitation sessions and access to rehabilitation for individuals with a NICU history is lower compared to those without a NICU history. Therefore, national support is needed to revitalize rehabilitation procedures and reduce medical expenses in the NICU group, and further studies should focus on novel methods to revitalize NICU rehabilitation.

Waning of anti-SARS-CoV-2 antibodies after the first wave of the COVID-19 pandemic in 2020: A 12-month-evaluation in three population-based European studies

Objectives We described waning in anti-SARS-CoV-2 IgG in adult general populations infected during the first wave of the COVID-19 pandemic in 2020 across three European countries. Methods Coordinated analyses were conducted separately in three population-based cohorts with complementary follow-up schedules: the KoCo19 (Germany), EpiCov (France), and CON-VINCE (Luxembourg) cohorts. Serological follow-up was based on the anti-SARS-CoV-2 ELISA-S IgG (Euroimmun) assay. We selected all adults aged 18–79 who had a positive serology (IgG optical density (OD) ratio ≥1.1) between February and July 2020, and at least one subsequent IgG measurement within the following 12 months, while still non-vaccinated. Results The proportion of seroreversion was 0% within the four first months, based on Koco19 data (n = 65 participants). In the longer term, 31.3% of participants had seroreverted at 6 months (95%CI: 24.4–39.1) (based on EpiCov data, n = 599), 31.3% (95%CI: 11.0–58.7) at 12 months (based on CON-VINCE data, n = 16). From EpiCov data, both baseline low IgG levels and seroneutralization negativity remained predictive of seroreversion in multivariable analysis. Conclusion From population-based cohorts, anti-S IgG levels remained stable during the first 4 months following SARS-CoV-2 infection. Most of the decay occurred afterward; nearly one-third of people seroreverted 6 and 12 months later. Low IgG levels and seroneutralization negativity were independent predictors of seroreversion.

Efficacy of online mindfulness for the treatment of insomnia in pregnancy: A randomized clinical trial

Sleep deficiency is common during pregnancy, with consequences for maternal and fetal health. This pilot study assessed the efficacy, feasibility, and acceptability of a six-week, online, mindfulness-based intervention (OPTIMISM) in pregnant women with sleep deficiency. Participants were randomized to either mindfulness (self-directed learning modules about mindfulness meditation, sleep challenges in pregnancy, and behavioral strategies) or education-only control conditions. Participants completed surveys and wore an actigraph with daily sleep diaries for 8 days at baseline and post-intervention. The primary outcome was sleep quality. Secondary outcomes included actigraphy, sleep-related impairment, sleep disturbance, fatigue, depression, anxiety, postnatal depressive symptoms, well-being, and quality of life. Exploratory outcomes included feasibility, acceptability, self-management, and behavior change. Efficacy was estimated with analysis of covariance, comparing mean post-test scores corrected for baseline. Of the 351 women screened, 163 were eligible, 64 enrolled, and 59 were randomized. 45 participants (OPTIMISM, 23; control, 22) completed post-intervention assessments and were included in the analysis. The mean satisfaction with the OPTIMISM was higher than the control group (OPTIMISM, 4.1; control, 3.8). The mean sleep quality score was significantly improved in the OPTIMISM group compared to that in the control group after adjusting for baseline score (OPTIMISM, 5.4; control, 7.6; p =.008; partial h2 =.157). There were similar improvements in sleep-related impairment, sleep disturbance, fatigue, and depressive symptoms, but no differences in other outcomes. Findings suggest that OPTIMISM improves subjective sleep quality and psychological distress, including fatigue, depression, and anxiety during pregnancy and should be tested in larger trials with longitudinal follow-up. Trial registration: ClinicalTrials.gov, NCT04016428. Registered on 11 July 2019.

Electric trains for reduction of fuel consumption and emissions from the freight transport in Jordan

Transport modes (trucks and diesel trains) used to move phosphate on the corridor connecting Shidiya mine and Aqaba port in Jordan are causing pollutant emissions exceeding global average values. The study proposed the use of electric trains and compared their fuel consumption (FC) and emissions to those of existing transport modes in an attempt to regulate FC and reduce emissions from freight in Jordan. For a more comprehensive view of the three transport modes, FC and emissions were evaluated in various operating conditions in relation to varying speeds, loads, road gradients, and curvatures. Results showed that the three vehicle types were greatly impacted by increasing payloads and speeds. On the other hand, diesel trains were less affected by the road’s curvature and more by its gradient. Electric trains can significantly reduce FC and CO2 emissions at 100% payload and an average speed of 60 km/h compared to trucks and diesel trains. Also, the use of electric trains would maintain CO and N2O emissions at acceptable levels. Regression analysis demonstrated significant negative correlations (R2 > 0.9) between FC and pollutant emissions with increasing payloads for the three vehicles. However, positive correlations were obtained with increasing speeds for diesel (R2 = 0.91) and electric trains (R2 = 0.77). The study offers insights into Jordan’s future strategies for reducing pollution in the transport sector. Based on the findings of the study, drivers may preferably use 100% payload and maintain an average speed of 60 km/h on the selected corridor. Besides, the use of renewable energy sources could potentially further reduce carbon emissions from electric rails.

Psychometric properties of the polish version of the Dysfunctional Thoughts about Caregiving Questionnaire (DTCQ)

Dysfunctional thoughts about caregiving are defined as rigid and inappropriate interpretations of one’s experiences, behaviors, thoughts, or feelings that are associated with providing care to a dependent relative. The present study examined the psychometric properties of the Polish adaptation of the Dysfunctional Thoughts about Caregiving Questionnaire (DTCQ). DTCQ was administered to 618 family caregivers of people with chronic health problems. As the Confirmatory factor analysis supported both one and two-factor structure of the DTCQ, following the principle of parsimony, one-factor model was considered more appropriate. Construct validity was also supported by significant and theoretically expected relationships between DTCQ and depression, identity formation or sociodemographic variables. In conclusion, this study is the first to provide preliminary evidence for the reliability and validity of the DTCQ as a measure of dysfunctional thoughts in Polish family caregivers.

Pain perception in personality disorders

Research has focused on pain perception of individuals with Borderline Personality Disorder, but there is a lack of research regarding pain perception for other types of Personality Disorders. The present study explored associations between the perception of experimentally-induced acute pain of individuals without acute or chronic pain with Borderline, as well as Histrionic, and Schizotypal, Personality Disorders traits. The primary question of interest was whether any personality disorders were associated with altered pain perception. Fifty-two participants had pain induced by a cold-pressor task, and were evaluated for personality disorder traits. Psychophysiological perception of pain was measured using pain threshold and tolerance tests, subjective reports of pain were taken using the McGill Pain Questionnaire, and physiological aspects were measured using Galvanic Skin Response as an index of physiological arousal. The results showed significant associations between Histrionic Personality Disorder and subjective reports of the sensory aspects, and intensity, of pain, but not with psychophysiological or physiological responses (although caution is needed in interpreting the results of multiple tests). There were no significant associations regarding pain perception and Borderline, or Schizotypal, Personality Disorders. These results are preliminary, but provide novel suggestions regarding the impact of Personality Disorder on pain perception and guidance for future research has been provided.

Association between stress hyperglycemia ratio and poor outcomes in Trauma surgery ICU patients

Background Patients in the Trauma Surgery Intensive Care Unit (TSICU) often experience severe stress responses, which may lead to the occurrence of stress hyperglycemia. The stress hyperglycemia ratio (SHR), a biomarker quantifying the relative severity of stress hyperglycemia, has garnered increasing attention. This study aims to investigate the association between SHR and poor outcomes in TSICU patients. Methods A retrospective cohort study was conducted based on the Medical Information Mart for Intensive Care IV database. Patients in the TSICU were stratified into tertiles based on SHR values. The primary outcomes were 30-day and 365-day all-cause mortality, and the secondary outcome was hospital mortality. Kaplan-Meier survival analysis, logistic regression, Cox proportional hazards models, and restricted cubic spline analysis were employed to examine the relationship between SHR and poor outcomes. The potential incremental value of incorporating SHR into traditional disease severity scoring systems was also explored. Results A total of 569 eligible TSICU patients were included. The 30-day and 365-day all-cause mortality rates were 20.7% (118 patients) and 32.5% (185 patients), respectively. Higher SHR was associated with significantly increased risks of 30-day, 365-day, and hospital mortality (HR/OR > 1, P < 0.05). Restricted cubic spline analysis demonstrated no significant non-linear relationship between SHR and mortality risk (P > 0.05). Furthermore, SHR provided incremental prognostic value when integrated into traditional disease severity scoring systems. Conclusion High SHR is significantly associated with increased all-cause mortality in TSICU patients, particularly among non-diabetic individuals. As a prognostic marker, SHR shows potential clinical utility for early risk stratification and management optimization.