Browse Articles

Adenosquamous carcinoma of the lung: Comparative CT and pathological features versus adenocarcinoma and squamous cell carcinoma

Objective Adenosquamous carcinoma (ASC) of the lung, containing both adenocarcinoma (AC) and squamous cell carcinoma (SCC) components, is associated with aggressive behavior and poor prognosis. Due to overlapping imaging features with AC and SCC, its preoperative diagnosis remains challenging. This study aimed to compare CT and pathological characteristics among ASC, AC, and SCC; identify key differentiators. Methods This retrospective study included 27 patients with pathologically confirmed ASC who underwent surgical resection from November 2018 to January 2025. Forty cases each of AC and SCC, matched for age, sex, and smoking history, were selected for comparison. Clinical, radiological, and pathological features were analyzed. Variables with statistical significance (P < 0.05) in univariate analysis were further evaluated using multivariate logistic regression. The discriminatory performance of the models was assessed using the area under the receiver operating characteristic curve (AUC). Results Compared with SCC, ASC lesions were more peripheral and associated with higher distance ratios (DR), pleural retraction, spiculation, and lymph node metastasis (LNM). Compared with AC, ASC tumors were larger, more often solid, and exhibited lobulation, bronchial cutoff sign, and advanced staging. Among the evaluated analyses, the combined pathology–imaging approach showed the highest discriminatory performance, with AUCs of 0.909 (ASC vs SCC) and 0.900 (ASC vs AC). LNM and DR were more strongly associated with ASC relative to SCC, whereas larger tumor size, ill-defined margins, and advanced stage were more strongly associated with ASC relative to AC. Conclusion Certain CT imaging features, especially DR and LNM, were associated with ASC and may provide useful information for preoperative radiological assessment and subtype stratification.

Xerostomia among users of electronic nicotine delivery systems in a multinational web-based cross-sectional study

Intimate partner violence during lockdown in Tuscany, Italy: Economic or confinement-related shocks?

We revisit the issue of Intimate Partner Violence (IPV) during the COVID-19 pandemic asking three questions: whether IPV worsened with lockdown, what pandemic-specific ‘shocks’ had the greatest impact, and how the results change when different measures of IPV are used. The large telephone survey we leveraged for this purpose was conducted in 2021 in the Italian region of Tuscany as part of a mixed-method research project on IPV during the first lockdowns, and it is, to our knowledge, the only (locally) representative survey on IPV during lockdowns conducted in Italy. Subjective evidence from the survey shows that, on balance, IPV worsened in frequency or severity or both. Econometric evidence suggests that parental overburden due to the presence of minors had the largest influence, followed by job loss, whereas we were not able to discern a significant influence for confinement in crowded space lacking privacy. Finally, and unsurprisingly, we found that using a fuzzy measure of violence outcomes that accounts for severity and intensity as well as prevalence of violence allows us to discern between shocks like job loss that primarily influenced the occurrence of violence without significantly influencing its harshness. Our empirical strategy principally relies on the exogeneity of pandemic-specific shocks to attribute causal interpretation to our estimates. However, our dependent variables (IPV outcomes) are binary or fractional, and endogeneity of some control covariates cannot be ruled out. To address these issues, we estimate average marginal effects using a two-step Control function (CF) approach combined with a quasi-likelihood method.

Genetics and demographic simulations with captive-bred restocking for the conservation of the lanner falcon

Correction: Burden and predisposing factors of physical inactivity among adults in Africa: Systematic review and Meta-analysis

Integrated hyperspectral-multispectral mapping of shear-associated hydrothermal alteration and gold mineralization validated by geochemical and isotopic data, southern Arabian Shield

An intervention study of the general practice management of older adults with cardiovascular metabolic comorbidities

Purpose To investigate the impact of general practice management on treatment compliance, lifestyle, and clinical indicators in older adults with cardiovascular metabolic comorbidities to provide more effective disease management strategies for this population. Patients and methods This randomized controlled trial enrolled 200 older adults with type 2 diabetes and established atherosclerotic cardiovascular disease (e.g., coronary heart disease, ischemic stroke) who were discharged from Qinhuangdao First Hospital between November 2021 and May 2023. Patients were randomly divided into intervention and control groups (n = 100 per group). The intervention group received general medical management, including personalized health education during hospitalization, community outpatient follow-up after discharge, and lifestyle interventions. The control group received routine discharge guidance. Changes in medication usage, body mass index (BMI), smoking rate, and clinical indicators, such as glycated hemoglobin, low-density lipoprotein cholesterol, and creatinine levels were evaluated over a 12-month follow-up period. Dietary intake and physical activity were assessed using the Semi-Quantitative Food Frequency Survey Questionnaire and the Physical Activity Scale for the Elderly, respectively. Results After 12 months, 91 controls and 95 intervention patients remained and were analyzed per-protocol. Within-group analyses revealed that the intervention group successfully maintained high utilization rates of all recommended medications (metformin, SGLT2i, GLP-1RA, aspirin/clopidogrel, statins, ACEI/ARB), whereas the control group experienced significant declines (all P < 0.05). Both groups achieved significant reductions in BMI, but only the intervention group showed a significant decrease in smoking rates (P = 0.014). The intervention group demonstrated comprehensive dietary improvements (e.g., increased nuts, dairy, vegetables, and aquatic products; reduced refined carbohydrates, meats, and salt) and significantly increased physical activity scores (all P < 0.05). Clinically, while both groups achieved reductions in glycated hemoglobin and LDL-C, only the intervention group showed significant improvements in creatinine levels, whereas renal function in the control group significantly deteriorated (P < 0.001). Conclusion A structured general practice management model effectively sustains long-term medication adherence, promotes comprehensive healthy lifestyle modifications, and optimizes key metabolic and renal clinical indicators in older adults with cardiovascular metabolic comorbidities. Trial registration Chinese Clinical Trial Registry ChiCTR2500112212.

Classification of distinct lung diseases using novel enhanced long short-term memory based optimization methodology

Evolution Pathway from Iron Precursors to Fe–N ₄ Single-Atom Catalysts via High-Temperature Cyanide Coordination Chemistry

Research on the simplified calculation method of non-limit active earth pressure of limited soil mass in adjacent foundation pits

This study aims to solve two critical issues in close-proximity foundation pit engineering: the cumbersome calculation process of non-limit active earth pressure for confined soil masses, and the unclear quantitative relationship between earth pressure magnitude and retaining structure displacement. By establishing the coupling relationship among static earth pressure, limit active earth pressure and non-limit active earth pressure, this paper derives analytical expressions for both the intensity and resultant force of non-limit active earth pressure corresponding to five distinct soil failure modes. The proposed theoretical model is validated through systematic laboratory model tests and finite element numerical simulations. Furthermore, the concept of non-limit active earth pressure isograms is introduced, and the influence mechanisms of various engineering parameters on the isogram distribution characteristics are quantitatively analyzed, revealing their inherent nonlinear distribution laws. Finally, a practical simplified calculation method is proposed, which provides a reliable theoretical basis and technical reference for the design and construction of retaining structures in close-proximity foundation pit engineering.

Analysis of Doppler positioning with LEO and MEO satellites

Development of semantic verbal fluency in children aged 2 to 5 and its relationship with participating in music activities

This cross-sectional study investigates the development of semantic verbal fluency performance (i.e., verbal recall) and the role of music participation in 79 normally-hearing Finnish children aged 2;0–5;11. The primary outcome measure was a semantic verbal fluency task where children listed as many animals or clothes as they could in 60 seconds. Additionally, parents filled in the “Role of Music in Families” questionnaire detailing their child’s formal and informal music activities. Results showed that the number of correct words belonging to the given category, along with the number of semantic clusters, subcategories and switches between subcategories, increased significantly with age. The rate of development between age groups differed for different aspects of verbal fluency, and more informal music activities was associated with better performance. These results indicate maturation of verbal recall from age 2;00 onwards, and that informal music participation is associated with the rate of development.

Low-cost recirculating bioreactor enables long-term culture of stratified cell layers across a punctured cellophane membrane

Identifying subgroups of individuals undergoing metabolic bariatric surgery based on behavioral and psychosocial factors: A latent profile analysis

Purpose We performed a latent profile analysis (LPA) to identify subgroups in the population undergoing metabolic bariatric surgery (MBS), based on various behavioral and psychosocial characteristics. Gaining deeper insights into the variability among preoperative MBS patients may be helpful in facilitating tailored care that addresses the specific needs of each profile, in relation to physical, emotional, and psychological functioning. Methods Within a prospective cohort study, demographics and questionnaires regarding general health, quality of life, social support, problematic eating behavior (i.e., emotional eating, external eating, restrained eating, disordered eating) and depressive symptoms were collected preoperatively. LPA was performed to identify homogeneous subgroups. Results Out of 272 patients, four distinctive profiles were derived. The profiles were: (1) ‘ higher psychosocial and physical functioning profile’ (n = 122, 45%): no deficits on all domains; (2) ‘higher psychosocial and lower physical functioning’ (n = 53, 20%): moderate impairments in physical functioning and problematic eating behavior, with no to mild impairments in emotional wellbeing and high scores on social support; (3) ‘ lower psychosocial functioning and stable physical health’ (n = 36, 13%): mild impairments in physical functioning, with moderate levels of depressive symptoms and problematic eating behavior; (4) ‘ lower psychosocial and physical functioning profile’ (n = 61, 22%): moderate deficits in general health, problematic eating behavior, depressive symptoms, social support, and quality of life. Conclusion These findings suggest that subgroups can be identified, differing in behavioral and psychosocial characteristics, including psychological well-being, eating behavior, social support, and physical and emotional functioning among patients prior to MBS. Future longitudinal studies are necessary to establish the prognostic validity of these subgroups.

Comparative dementia and Parkinson’s disease risk associated with melatonin, benzodiazepine, or zolpidem use in patients with sleep disorders: a retrospective cohort study

A simulation-based approach to strengthen chronic wasting disease surveillance in captive cervid populations

Captive cervid facilities are at elevated risk for chronic wasting disease (CWD) due to high deer densities, close animal contact, environmental contamination, and frequent movement of deer between facilities and across regions. Once CWD becomes established, it spreads quickly and is nearly impossible to eliminate, making early detection critical. However, surveillance in captive herds is challenging: testing only a small portion of the herd during the early stages of CWD outbreak provides a low likelihood of detecting infected deer. Moreover, not detecting CWD in a small sample cannot be interpreted as proof that the facility is free of CWD unless the entire herd is tested using a diagnostic test with 100% sensitivity. We developed a simulation-based approach to interpret surveillance results when CWD is not detected in the sampled subset of animals within captive cervid facilities. This simulation-based approach is retrospective in nature. By integrating deer demographic data, individual movement histories, and past CWD testing records, this tool estimates facility-level CWD detection probabilities, providing a clearer assessment of the likelihood of undetected disease within a facility. Using data from 23 captive cervid facilities in Texas, we demonstrate how this tool can support risk-based monitoring and help wildlife agencies prioritize surveillance and management efforts where they are most needed.

Breast‑conserving therapy versus mastectomy in malignant phyllodes tumor of the breast: a propensity score-matched survival analysis and prognostic nomogram

Triple-Regulation Strategy toward Multivariate Isomeric Covalent Organic Frameworks for Efficient Photocatalysis

Realist process evaluation of a co-designed intervention to address the unmet information needs of people with dementia and their family carers

Information needs among people with dementia and their family carers remain often unmet, despite policy emphasis on information as the key enabler of choice, agency, and empowerment. An intervention to address these unmet information needs was co-designed and implemented in the North-East of England. This study is a realist process evaluation of the intervention’s implementation through the local community mental health services for older people. The realist process evaluation drew on three strands of qualitative data: longitudinal interviews with the service manager of the implementing services, longitudinal group interviews with practitioners, and a focus group with the co-design working group. Thematic analysis used a deductive approach to identify implementation outcomes ( Reach, Dose, Fidelity & Adaptation, Acceptability, Adoption, Appropriateness, Penetration, Feasibility, Sustainability ), followed by a retroductive approach to interpret data through the realist framework of Context, Mechanisms, and Outcomes. Participants showed different strategies for offering the leaflet in clinical practice ( Reach ), but all appeared to offer it multiple times and at every opportunity ( Dose ). Some adaptation in implementation was identified. The intervention was successfully integrated into practice ( Penetration , Feasibility ) and well received by implementers ( Acceptability , Adoption ). The intervention was perceived as addressing a genuine need and as compatible with the implementation setting ( Appropriateness ), also in the longer term ( Sustainability ). Nine levels of contextual factors and eight mechanisms appeared to contribute to the observed outcomes. The study offers an in-depth understanding of how information-giving occurs at the level of the individual practitioner and identifies some variation in information-giving practice. Some participants’ approach to information-giving was consistent with a person-centred, relational, and situated approach to care, while others embodied a rational approach to information which did not account for the circumstances of the information recipient. Policy and practice should acknowledge and address this variation to ensure that critical stances on information-giving are widely adopted.

Understanding farmers’ resistance to improved rice cultivars: insights from Northern Iran

Abstract Despite substantial public investment in rice breeding programs in Iran, the adoption of improved rice cultivars (IRCs) remains limited, particularly in Mazandaran Province, the country’s largest rice-producing region. This study aimed to identify, categorize, and prioritize the principal barriers limiting farmers’ adoption of IRCs. A qualitative and applied research design was employed using a three-phase framework consisting of: (i) literature review and interviews with subject-matter specialists (SMSs), (ii) evaluation by experienced and knowledgeable rice farmers (EKRFs), and (iii) prioritization using the Fuzzy Delphi Method (FDM). Initially, 49 potential barriers across nine dimensions were identified, of which 42 were validated through the FDM consensus process. The findings revealed that the most influential barriers were price imbalance in the sale of IRCs, weak stakeholder interaction and knowledge-sharing systems, poor marketability of IRCs, farmer-related psychological resistance, and inadequate institutional support packages. Key constraints included low market prices, absence of guaranteed purchasing systems, limited farmer participation in cultivar development, weak extension services, poor sensory quality of IRCs, and farmers’ risk aversion toward replacing traditional cultivars. The findings further demonstrate that adoption decisions are shaped not only by agronomic performance, but also by interconnected economic, institutional, behavioral, and market-driven factors. Methodologically, the study contributes to agricultural innovation research by applying a multidimensional and uncertainty-aware prioritization framework using the FDM. Practically, the results provide evidence-based insights for policymakers, extension systems, and breeding institutions seeking to promote sustainable agricultural intensification and farmer-centered cultivar dissemination strategies.