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Impact of high body mass index on hepatocellular carcinoma risk in chronic liver disease: A population-based prospective cohort study

Background and aims We investigated associations between body mass index (BMI) and hepatocellular carcinoma (HCC) in patients with hepatitis B (HBV) C (HCV) virus infection, alcoholic liver disease (ALD), non-alcoholic fatty liver disease (NAFLD), and liver cirrhosis (LC). Methods We followed 350,608 Korean patients with liver disease who underwent routine health examinations from 2003–2006 until December 2018 via national hospital discharge records. Multivariable adjusted hazard ratios (HRs) per 5-kg/m2 BMI increase (BMI ≥25 kg/m2) for HCC risk were calculated using Cox models. HCC developed in 17,752 patients. Results The HRs (95% CI) were 1.17 (1.06–1.28), 1.08 (0.87–1.34), 1.34 (1.14–1.58), 1.51 (1.17–1.94), and 1.11 (1.00–1.23) for HBV, HCV, ALD, NAFLD, and LC, respectively. The HRs for HBV were 1.45 (1.23–1.70) and 1.06 (0.95–1.19) in women and men, respectively; the corresponding HRs for LC were 1.27 (1.07–1.50) and 1.02 (0.90–1.16), respectively. In patients <65 years old with HBV, HCV, and NAFLD, the HRs were 1.17 (1.07–1.29), 1.33 (1.03–1.73), and 1.20 (0.87–1.64), respectively; the corresponding HRs were 1.05 (0.70–1.59), 0.74 (0.50–1.10), and 2.40 (1.62–3.54), respectively, in patients ≥65 years old. A BMI of 27.5–29.9 kg/m2 showed significantly higher HCC risks in patients with HBV, ALD, NAFLD, and LC. Conclusions Higher BMIs were associated with increased HCC risks in patients with HBV, ALD, NAFLD, and LC. Overweight status increased HCC risk. Women with HBV and LC had stronger BMI-HCC associations than men. The effect of high BMI was stronger in older patients with NAFLD and younger patients with viral hepatitis.

Effects of clinical stage, behavioral and psychological symptoms of dementia, and living arrangement on social distance towards people with dementia

Background Dementia presents significant challenges, including social exclusion, which can be exacerbated by public stigma. This study aimed to clarify how social distances, a common measure of public stigma, towards people living with dementia and its associated factors vary with clinical stage, presence of behavioral and psychological symptoms of dementia (BPSD), and living arrangements. Methods The study involved 2,589 Japanese participants aged 40 to 90 years. They were exposed to one of four vignettes depicting an 80-year-old woman progressing from normal ageing to mild, moderate, and severe dementia: Vignette A (living with husband, without BPSD); Vignette B (living with husband, with BPSD); Vignette C (living alone, without BPSD); and Vignette D (living alone, with BPSD). Results Social distance showed no significant differences in the normal aging and mild stage of dementia across all vignettes. At the moderate stage, social distance was higher for individuals exhibiting BPSD, regardless of living arrangement. At the severe stage, the lowest social distance was observed towards individuals living with their family without BPSD, whereas the highest was towards those living alone, exhibiting BPSD. For Vignette A, possession of social capital (p<0.001) and having experience of social contact with people living with dementia (PLWD) (p = 0.001–0.007) were independently associated with lower social distance across all dementia stages. In addition, in the mild stage of dementia, high perceived social support (p = 0.005) and having knowledge about dementia (p = 0.036) were associated with lower social distance, but not in the moderate or severe stage of dementia. For Vignette D, possession of social capital (p≤0.001) and having experience of social contact with PLWD (p<0.001 to p = 0.006) were independently associated with lower social distance across all dementia stages. In mild dementia, female sex (p = 0.004) and knowledge about dementia (p = 0.026) were associated with lower social distance. Furthermore, in mild and moderate dementia, living in rural area (p = 0.003–0.048) was associated with lower social distance. Conclusions Social distance is higher toward PLWD who live alone and exhibit BPSD than toward those who live with family and/or do not show BPSD, indicating a higher risk of exclusion for the former. Moreover, factors affecting social distance towards PLWD vary across different clinical stages of dementia. While greater knowledge about dementia is associated with lower social distance toward PLWD, this effect appears to be most pronounced in the mild stage. In contrast, opportunities for social contact with PLWD are crucial for achieving lower social distance across all stages of dementia. The findings underscore the need for stage-specific interventions to address stigma, with a focus on education and opportunities for social contact. Targeted efforts are especially important for promoting the inclusion of PLWD who live alone and exhibit BPSD.

Detectability constraints on meso-scale structure in complex networks

Community, core-periphery, disassortative and other node partitions allow us to understand the organisation and function of large networks. In this work we study common meso-scale structures using the idea of block modularity. We find that the configuration model imposes strong restrictions on core-periphery and related structures in directed and undirected networks. We derive inequalities expressing when such structures can be detected under the configuration model which are closely related to the resolution limit. Nestedness is closely related to core-periphery and is similarly restricted to only be detectable under certain conditions. We then derive a general equivalence between optimising block modularity and maximum likelihood estimation of the parameters of the degree corrected Stochastic Block Model. This allows us to contrast the two approaches, how they formalise the structure detection problem and understand these constraints in inferential versus descriptive approaches to meso-scale structure detection.

High diversity of fungal ecological groups from ice-free pristine and disturbed areas in the Fildes Peninsula, King George Island, Antarctica

Ice-free areas are habitats for most of Antarctica’s terrestrial biodiversity. Although fungal communities are an important element of these habitats, knowledge of their assemblages and ecological functions is still limited. Herein, we investigated the diversity, composition, and ecological functionality of fungal communities inhabiting sediments from ice-free areas across pristine and anthropogenically impacted sites in the Fildes Peninsula on King George Island, Antarctica. Samples were collected from both pristine and disturbed areas. We used the internal transcribed spacer (ITS1) region via Illumina sequencing of 34 sediment samples for fungal identification. The Ascomycota (14.6%) and Chytridiomycota (11.8%) were the most dominant phyla, followed by Basidiomycota (8.1%), Rozellomycota (7.0%), Mucoromycota (4.0%), while 34.9% of the fungal diversity remained unidentified. From a total of 1073 OTUs, 532 OTUs corresponded to 114 fungal taxa at the genus level, and 541 OTUs remained unassigned taxonomically. The highest diversity, with 18 genera, was detected at site A-3. At the genus level, there was no preference for either pristine or disturbed sites. The most widely distributed genera were Betamyces (Chytridiomycota), occurring in 29 of the 34 sites, and Thelebolus (Ascomycota), detected in 8 pristine sites and 7 disturbed sites. The Glomeraceae gen. incertae sedis was more common in disturbed sites. A total of 23 different ecological guilds were recorded, with the most abundant guilds being undefined saprotrophs, plant pathogens, plant saprotrophs, pollen saprotrophs, and endophytes. The fungal communities did not show significant differences between pristine and disturbed sites, suggesting that the anthropogenic impact is either not too intense or prolonged, that the spatial distance between the sampled sites is small, and/or that the environmental factors are similar. Although our study revealed a high fungal diversity with various ecological specializations within these communities, nearly one-third of the diversity could not be assigned to any specific taxonomic category. These findings highlight the need for further taxonomic research on fungal species inhabiting ice-free areas. Without identifying the species present, it is difficult to assess potential biodiversity loss due to environmental changes and/or human activities.

Exploring the Vibrational Coherences in the Ultrafast Electronic Relaxation of Pyrimidine Nucleobases and Nucleosides

Comparative safety and effectiveness of oral anticoagulants in key subgroups of patients with non-valvular atrial fibrillation and at high risk of gastrointestinal bleeding: A cohort study based on the French National Health Data System (SNDS)

Background Risk factors and comorbidities can complicate management of non-valvular atrial fibrillation. We describe and compare real-world safety and effectiveness of direct oral anticoagulants (DOACs; apixaban, rivaroxaban, dabigatran) and vitamin K antagonists (VKAs) in subgroups of patients with non-valvular atrial fibrillation at high risk for gastrointestinal (GI) bleeding, utilizing data from a national quasi-exhaustive French database. Methods Anticoagulant-naïve adults with non-valvular atrial fibrillation with ≥1 gastrointestinal bleeding risk factor, initiating anticoagulant treatment January 2016–December 2019, and covered by the French national health data system were eligible. The following subgroups were evaluated: patients age ≥75 years, receiving concomitant medications, HAS-BLED score ≥3, and chronic kidney disease stage 3–4. Outcomes included major bleeding and stroke/systemic embolism. Patient characteristics were balanced using propensity score matching. Results A total of 314,184 patients were identified; characteristics were similar for propensity score-matched subgroups in VKA/DOAC and DOAC/DOAC comparisons. DOACs showed lower risk of major bleeding versus VKAs in all subgroups evaluated (p<0.0001 for all). Apixaban showed lower risk of major bleeding and gastrointestinal bleeding versus rivaroxaban in all subgroups (p≤0.05 for all) and versus dabigatran in elderly patients, patients with HAS-BLED score ≥3, and those receiving concomitant medications (p<0.05 for all). Stroke/systemic embolism risk was lower with apixaban versus rivaroxaban in elderly patients, those with HAS-BLED ≥3, and those receiving concomitant medications; risks were similar for other comparisons. Conclusions DOACs were associated with improved safety and effectiveness when compared to VKAs among subgroups of non-valvular atrial fibrillation patients at high risk of gastrointestinal bleeding. Apixaban was associated with lower risks of major bleeding, gastrointestinal bleeding, and stroke/systemic embolism versus rivaroxaban as well as lower risk of major bleeding, gastrointestinal bleeding bleed and similar risk of stroke/systemic embolism versus dabigatran among several of these patient subgroups.

Pretargeted Multimodal Tumor Imaging by Enzymatic Self-Immobilization Labeling and Bioorthogonal Reaction

Effects of a 6-month rowing training program in breast cancer survivors

The purpose of this longitudinal study was to determine the effects of a rowing training program on physical fitness and body composition in female breast cancer survivors (56.78 ± 6.38 years). Over six months, the participants (n = 40) performed two training sessions per week for an average of 75 minutes, combining resistance and muscle strength exercises with rowing. To evaluate the impact of the program, physical fitness tests and anthropometric measurements were carried out before and after the training protocol. The results show statistically significant improvements in measures such as weight (-1.84 kg), BMI (-0.7 kg/m2), hip (-3.24 cm) and waist circumference (-2.45 cm). In addition, variables associated with physical fitness also improved including leg strength (3.04 cm), dominant handgrip strength (4.24 kgf), non-dominant handgrip strength (3.49 kgf), aerobic endurance (78.35 m) and muscle flexibility (3.96 cm). We can therefore conclude that a rowing-based exercise program is an effective strategy to improve physical fitness in this type of population, yielding improvements in both anthropometric measurements and basic physical capacity variables, essential factors for better health and quality of life.

Optimal sigmoid function models for analysis of transspinal evoked potential recruitment curves recorded from different muscles

Recruitment input-output curves of transspinal evoked potentials that represent the net output of spinal neuronal networks during which cortical, spinal and peripheral inputs are integrated as well as motor evoked potentials and H-reflexes are used extensively in research as neurophysiological biomarkers to establish physiological or pathological motor behavior and post-treatment recovery. A comparison between different sigmoidal models to fit the transspinal evoked potentials recruitment curve and estimate the parameters of physiological importance has not been performed. This study sought to address this gap by fitting eight sigmoidal models (Boltzmann, Hill, Log-Logistic, Log-Normal, Weibull-1, Weibull-2, Gompertz, Extreme Value Function) to the transspinal evoked potentials recruitment curves of soleus and tibialis anterior recorded under four different cathodal stimulation settings. The sigmoidal models were ranked based on the Akaike information criterion, and their performance was assessed in terms of Akaike differences and weights values. Additionally, an interclass correlation coefficient between the predicted parameters derived from the best models fitted to the recruitment curves was also established. A Bland-Altman analysis was conducted to evaluate the agreement between the predicted parameters from the best models. The findings revealed a muscle dependency, with the Boltzmann and Hill models identified as the best fits for the soleus, while the Extreme Value Function and Boltzmann models were optimal for the tibialis anterior transspinal evoked potentials recruitment curves. Excellent agreement for the upper asymptote, slope, and inflection point parameters was found between Boltzmann and Hill models for the soleus, and for the slope and inflection point parameters between Extreme Value Function and Boltzmann models for the tibialis anterior. Notably, the Boltzmann model for soleus and the Extreme Value Function model for tibialis anterior exhibited less susceptibility to inaccuracies in estimated parameters. Based on these findings, we suggest the Boltzmann and the Extreme Value Function models for fitting the soleus and the tibialis anterior transspinal evoked potentials recruitment curve, respectively.

Phylogenetic relationships and genetic diversity of Tunisian maize landraces

Based on history, maize was first introduced into Tunisia and northern Africa, at large, from the south of Spain. Several subsequent introductions were made from diverse origins, generating new landraces by recombination and selection for adaptation to arid environments. This study aimed to investigate the phylogenetic relationships among Tunisian maize landraces with possible sources of introduction from neighboring countries. Ten Tunisian landraces were genotyped with 23656SNPs along with a panel of diversity of 171 landraces originating from Algeria, Europe, and America. The Tunisian maize landraces were very diverse and distinct from those from neighboring countries, and they were classified into three main clusters that could be the basis for investigating heterotic groups. The phylogenetic relationships among Tunisian and other landraces from neighboring countries supported the hypothesis of a first introduction from the south of Spain and subsequent introductions from other countries. These germplasm groups could be the basis for studying heterotic patterns and sample maize germplasm from Tunisia and North Africa in general. The Tunisian maize germplasm could be a basis for identifying sources of favorable alleles to improve tolerance to abiotic stresses.

Expert decision-making in clinicians: An auto-analytic ethnographic study of operational decision-making in urgent care

Objective To conceptualise the cognitive processes of early expert decision-making in urgent care. Background Expert clinicians in the UK frequently determine suitable urgent care patient pathways via telephone triage. This strategy is promoted by policymakers but how it is performed, and its effectiveness has not been evaluated. Evaluation of early senior decision-making requires knowledge of decision-processes, influences, and goals. Previous research has focused on diagnostic decision-making and rarely studied clinicians in the field. Method We triangulated analytic autoethnography of early expert decision-making with focused ethnography of experts and trainee doctors performing the task. The study took place in a medium-sized Acute Medical Unit which provided internal medical emergency care for a mixed urban and rural population in the UK. A grounded theoretical model of expert decision-making was created via Gioia Methodology. Decision types were categorised to identify differences in solutions as well as decision processes. Results The hallmarks of intuitive decision-making were found in most expert decisions. Experts made intuitive use of pattern-matching to extract key data from large volumes of information which triggered the spontaneous manifestation of solutions. Solutions were holistic and usually solitary. Upon manifestation solutions were consciously tested for viability with emotional affect playing a key role. Expert solutions were previously applied ones but were frequently entirely novel. Novel solution generation was not a feature of trainee decisions but moments of intuition were. Expert goals varied between optimal care for individual patients, system-wide efficiency, and equity of care. The decision environment had a large influence upon experts. Conclusion Expert clinicians employ intuitive decision-making supported by rational analysis in early urgent care decision-making. Expert solutions generated in this manner are pragmatic rather than optimal, context dependent, and seek to achieve goals which vary from moment-moment. Findings are crucial to inform research evaluating the effectiveness of early expert decision-making in urgent care as it is a high cost strategy. They also have implications for methodological approaches in future studies of expert clinical decision-making, developing artificial expert systems, and clinician training.

Was Aristotle right about moral decision-making? Building a new empirical model of practical wisdom

This article presents the development and validation of the Short Phronesis Measure (SPM), a novel tool to assess Aristotelian phronesis (practical wisdom). Across three studies, using large, nationally representative samples from the UK and US (demographically matched to census data), we employed a systematic and rigorous methodology to examine the structure, reliability, and validity of the SPM. In Study 1a, exploratory factor analysis identified ten distinct, internally reliable components of phronesis , challenging the traditional four-component Aristotelian model. Study 1b confirmed these findings in two additional nationally representative samples from the UK and the US. In Study 1c, the SPM demonstrated strong test-retest reliability over two months. Study 2 used network analysis to uncover interrelations among the components, allowing for the creation of a new and empirically driven neo -Aristotelian model of phronesis . In Study 3, we tested criterion validity, showing phronesis correlates positively with flourishing and predicts flourishing two months later, demonstrating strong predictive validity. Phronesis also correlated with Big 6 and Dark Tetrad personality traits, moral disengagement, and Moral Foundations in expected directions. Importantly, phronesis predicted key outcomes—related to flourishing, moral disengagement, and morally relevant aspects of personality—beyond what Moral Foundations alone explained, with an average increase in predictive power of 13.7% across all outcomes. The SPM is quick to administer (15–20 minutes), making it a valuable tool for researchers and practitioners in psychology, education, and professional ethics. The introduction of the neo-Aristotelian Phronesis Model, and the identification of central phronesis components, offers actionable insights for moral psychologists and moral educators, suggesting areas of focus that could yield broad, positive effects across related traits, providing a significant contribution to both theory and practice.

Life satisfaction around the world: Measurement invariance of the Satisfaction With Life Scale (SWLS) across 65 nations, 40 languages, gender identities, and age groups

The Satisfaction With Life Scale (SWLS) is a widely used self-report measure of subjective well-being, but studies of its measurement invariance across a large number of nations remain limited. Here, we utilised the Body Image in Nature (BINS) dataset–with data collected between 2020 and 2022 –to assess measurement invariance of the SWLS across 65 nations, 40 languages, gender identities, and age groups (N = 56,968). All participants completed the SWLS under largely uniform conditions. Multi-group confirmatory factor analysis indicated that configural and metric invariance was upheld across all nations, languages, gender identities, and age groups, suggesting that the unidimensional SWLS model has universal applicability. Full scalar invariance was achieved across gender identities and age groups. Based on alignment optimisation methods, partial scalar invariance was achieved across all but three national groups and across all languages represented in the BINS. There were large differences in latent SWLS means across nations and languages, but negligible-to-small differences across gender identities and age groups. Across nations, greater life satisfaction was significantly associated with greater financial security and being in a committed relationship or married. The results of this study suggest that the SWLS largely assesses a common unidimensional construct of life satisfaction irrespective of respondent characteristics (i.e., national group, gender identities, and age group) or survey presentation (i.e., survey language). This has important implications for the assessment of life satisfaction across nations and provides information that will be useful for practitioners aiming to promote subjective well-being internationally.

New Molecular Photoswitch Based on the Conformational Transition of Phenothiazine Derivatives and Corresponding Triplet Emission Properties

Optimizing multi label student performance prediction with GNN-TINet: A contextual multidimensional deep learning framework

As education increasingly relies on data-driven methodologies, accurately predicting student performance is essential for implementing timely and effective interventions. The California Student Performance Dataset offers a distinctive basis for analyzing complex elements that affect educational results, such as student demographics, academic behaviours, and emotional health. This study presents the GNN-Transformer-InceptionNet (GNN-TINet) model to overcome the constraints of prior models that fail to effectively capture intricate interactions in multi-label contexts, where students may display numerous performance categories concurrently. The GNN-TINet utilizes InceptionNet, transformer architectures, and graph neural networks (GNN) to improve precision in multi-label student performance forecasting. Advanced preprocessing approaches, such as Contextual Frequency Encoding (CFI) and Contextual Adaptive Imputation (CAI), were used on a dataset of 97,000 occurrences. The model achieved exceptional outcomes, exceeding current standards with a Predictive Consistency Score (PCS) of 0.92 and an accuracy of 98.5%. Exploratory data analysis revealed significant relationships between GPA, homework completion, and parental involvement, emphasizing the complex nature of academic achievement. The results illustrate the GNN-TINet’s potential to identify at-risk pupils, providing a robust resource for educators and policymakers to improve learning outcomes. This study enhances educational data mining by enabling focused interventions that promote educational equality, tackling significant challenges in the domain.

Transformation of sperm structure in Octopus vulgaris: From spermatogenesis to spermatophoric release

The present study describes the differentiation process of male germ cells in Octopus vulgaris, the morphology of sperm in the testis and spermatophore, and the sperm released after the spermatophoric reaction. During spermatogenesis, the male sperm cell gradually elongates from a round shape, with cytoplasm shifting toward the head and the acrosome forming. Additionally, in the spermatid stage, the flagellum develops within the posterior nuclear channel and extends outside the cytoplasm. The sperm is composed of a head and a tail. The head is approximately 17.9 μm long and consists of a highly electron-dense nucleus and a helical acrosome. The tail is divided into three parts: the mid-piece, principal-piece, and end-piece. The mid-piece forms a mitochondrial sheath with 7–8 mitochondria surrounding a “9+2” axoneme. The principal-piece is composed of an axoneme, outer dense fibers, and fibrous sheath, while the end piece lacks outer dense fibers or fibrous sheath. The sperm in the testis and spermatophore, and the sperm released after the spermatophoric reaction have the same structure. However, in the sperm located in the testis and spermatophore, the structure of the acrosome is unclear due to the presence of cytoplasm in the head. In contrast, sperm released after the spermatophoric reaction lack their cytoplasm, revealing the helical acrosome. This unique sperm morphology, adapted for internal fertilization, is thought to be advantageous for fertilization and long-term storage within the female reproductive system.

Interlocked 2D Covalent Organic Frameworks from Overcrowded Nodes

Community responses to a novel house design: A qualitative study of “Star Homes” in Mtwara, southeastern Tanzania

Introduction To evaluate the impact of a novel design “Star Home” on the incidence of malaria, respiratory tract infections and diarrheal diseases among children, randomly selected households in Mtwara, Tanzania were offered a free, new Star Home. Drawing on longitudinal qualitative research that accompanied the Star Homes study, this article describes the experiences of residents and the wider community of living with these buildings. Methods A total of four rounds of face-to-face interviews were undertaken with residents of Star Homes (n = 37), control (wattle/daub) homes (n = 21), neighboring households n = 6), community members (n = 17) and community leaders (n = 6). The use of Star Homes was also observed over these four time periods between 2021 and 2023. Interviews were conducted in Swahili, transcribed, and translated into English for thematic analysis. Results Star Homes residents appreciated several aspects of the Star Homes, including overall comfort, access to water and electricity, and clean toilets. There were concerns about some design elements, such as poorly closing doors, stoves perceived as inefficient, and the façade, which was susceptible to rainwater ingress. The houses were not always used as intended by their developers, for example, residents were sleeping downstairs instead of upstairs because of cold floors or difficulties using the stairs. Star Homes residents described how the structures triggered praise but also envy from other community members. Conclusions The findings highlight the need for close attention to the use of novel design houses and careful sensitization around the potential benefits of dwellings to ensure that the intended health impacts of interventions are achieved.

Upcycling Poly(vinyl chloride) and Polystyrene Plastics Using Photothermal Conversion

Walking coral: Complex phototactic mobility in the free-living coral Cycloseris cyclolites

Not all corals are attached to the substrate; some taxa are solitary and free-living, allowing them to migrate into preferred habitats. However, the lifestyle of these mobile corals, including how they move and navigate for migration, remains largely obscure. This study investigates the specific biomechanics of Cycloseris cyclolites, a free-living coral species, during phototactic behaviour in response to blue and white light stimuli. Our results indicate a strong positive phototactic response to blue light with 86.7% (n = 15) of samples moving towards the light source, while only 20% (n = 15) samples responded similarly to white light (400–700 nm). Locomotion, characterised by periodic pulses lasting 1–2 hours, involved distances up to 220 mm in blue light trials, whereas significantly shorter distances were observed in white light trials (2, 5 and 8 mm). Trails with two light sources reinforced the preference for blue light over white, with all samples consistently moving towards the blue light and away from the white (11, 15 and 3mm). High-resolution time-laps captured the biomechanics of forward motion that appeared driven by three key factors: tissue inflation, which increased contact surface area for lift and friction; the ventral foot/pads, adjusting substrate interaction/friction; and the contraction and twisting of lateral peripheral tissues, which propelled the coral forward in a coordinated manner resembling the pulsed swimming motion of jellyfish. Our findings provide new insights into coral mobility mechanisms, emphasising the role of tissue inflation in active locomotion, with potential implications for coral neural systems, vision and habitat selection.