Search Results (926)

Background/Objectives: Thyroid nodules are a prevalent condition with a high incidence rate of malignancy. Ultrasound (US)-based risk stratification systems have become widely utilized for the evaluation of thyroid nodules, including the American Thyroid Association (ATA) guidelines, the American College of Radiology Thyroid Imaging Reporting and Data System (ACR-TIRADS), the Korean Society of Thyroid Radiology system (K-TIRADS), and the European Thyroid Association system (EU-TIRADS). Our institution has developed a real-time computerized score for evaluating thyroid nodules. This study aims to systematically compare the diagnostic performance of these systems when applied in real time by otolaryngologists, who integrate dynamic US imaging with physical examination. Methods: Patients with thyroid nodules who underwent US evaluation, US-guided fine-needle aspiration cytology (FNAC), and subsequent thyroidectomy were included. During each examination, otolaryngologists performed real-time risk categorization according to five US-based systems, with immediate scoring based on dynamic sonographic findings. Results: From April 2021 to November 2023, 130 patients were enrolled. For categories 4 and 5, the ATA guidelines had a sensitivity of 96.6% (95% CI: 87.3–100%), specificity of 78.9%, (60.6–97.3%) PPV of 84.6% (70.7–98.5%), NPV of 93.7% (81.9–100%), and accuracy of 88.1% (78.3–97.9%). The sensitivity of the ACR-TIRADS was 95.6% (87.3–100%), the specificity was 78.9% (60.6–97.3%), the PPV was 84.6% (70.7–98.5%), the NPV was 93.7% (81.9–100%), and the accuracy was 88.1% (78.3–97.9%). Both the K-TIRADS and the EU-TIRADS had sensitivities of 95.6% (87.3–100%), specificities of 78.9% (60.6–97.3%), PPVs of 84.6% (70.7–98.5%), NPVs of 93.7% (81.9–100%), and accuracies of 88.1% (78.3–97.9%). The computerized score (>3.3 considered malignant) and TBSRTC (Category 5 or 6) both had sensitivities of 73.9% (56.0–91.9%), specificities of 100%, PPVs of 100%, NPVs of 76.0% (59.3–92.7%), and accuracies of 85.7% (75.1–96.3%). Conclusions: Otolaryngologists can achieve highly accurate diagnostic performance when applying standardized ultrasound-based risk stratification systems, and a real-time computerized scoring system provides highly specific supplemental value for immediate clinical decision-making. Full article

This study identifies key determinants shaping countries’ Sustainable Development Goals performance and develops classification models for predicting country group membership based on the SDG Index. The research addresses the urgent need to optimize development policies amid limited resources and the approaching 2030 Agenda deadline. Using data from 154 countries (2024), the analysis reveals that key SDG determinants are fundamentally method-dependent: discriminant analysis identified Goals 10, 6, 15, and 5 as most influential for differentiating countries by SDGI level, while Random Forest identified Goals 4, 9, and 2 as the most important predictors. This divergence reflects fundamentally different analytical perspectives—linear contributions to group separation versus complex nonlinear interactions and synergies between goals—with critical policy implications for prioritization strategies. Correlation analysis demonstrates that sustainable development dynamics operate differently across development stages: high-development countries show strongest associations with technological advancement and institutional capacity, while low-development countries exhibit compensation effects where basic infrastructure provision occurs alongside lagging human capital development. The discriminant model achieved 94.08% overall accuracy with perfect classification for extreme SDGI categories, while the Random Forest model provides complementary insights into interactive pathways. The scientific contribution lies in demonstrating that perceived variable importance depends on analytical framework rather than representing objective reality, and in providing validated classification tools for rapid assessment in data-limited contexts. These findings offer actionable guidance for evidence-based resource allocation and policy prioritization in the critical final years of SDG implementation. Full article

On behalf of Cell Therapy Transplant Canada (CTTC), we are pleased to present the Abstracts of the CTTC 2024 Annual Conference. The conference was held on 1–3 May 2024 in beautiful Victoria, British Columbia, at the Victoria Conference Centre, and attracted 293 in-person delegates and five virtual attendees. Several plenary sessions were held on topics such as gene therapy for hemoglobin disorders, optimizing donor selection, graft-versus-host disease (GvHD) strategies, collaborative care, survivorship, graft failure, and CAR-T therapy. Poster authors presented their work during a lively and engaging networking reception on Thursday, 2 May, and oral abstract authors were featured during the oral abstract session in the afternoon of Friday, 3 May 2024. Forty-nine (49) abstracts were selected for presentation as posters and six (6) as oral presentations. Abstracts were submitted within four categories: (1) Basic/Translational Sciences, (2) Clinical Trials/Observations, (3) Laboratory/Quality, and (4) Pharmacy/Nursing/Other Transplant Support. The top six (6) abstract authors were invited to give an oral presentation, and the top four (4) poster abstracts were selected to receive an award. All of these were marked as “Award Recipient” within the relevant category. Three abstracts were determined by the peer review panel to be inappropriate for this conference and were not invited to present at the conference, and two authors withdrew their abstract; therefore, five abstract numbers are missing from the list. We congratulate all the 2024 abstract presenters on their research and contributions to the field. Full article

The study of cognitive processes in sheep (Ovis aries) has gained interest in recent years, particularly for their potential as a model species in translational medicine. This scoping review aimed to identify, classify, and describe cognitive tasks developed to assess executive functions in sheep. A literature search followed PRISMA guidelines and used CAB Abstracts, PubMed, and Scopus to identify studies on cognitive tasks in sheep from 1 January 2010, to 4 August 2025. The search yielded 2873 records; after removing duplicates and applying inclusion criteria, 20 studies were analyzed. Data on animal categories, test methods, and timing were collected. The selected studies were grouped by cognitive domain: memory and flexibility (13), sensory discrimination (6), and problem-solving (6). All studies describe specific testing apparatuses tailored to assess distinct cognitive functions, detailing materials, apparatus dimensions, and the importance of pre-test periods, as well as the necessity of a reward system. The review emphasizes ethical testing that minimizes animal stress, supporting welfare. Standardizing cognitive tests can improve reliability, and comparability while integrating neurobiology, ethology, and welfare knowledge advances research and livestock care. Full article

The shale oil reservoirs of Member 7 of the Triassic Yanchang Formation in the Longdong Area of the Ordos Basin have attracted widespread attention due to their unique geological characteristics and enormous development potential. As the core factor controlling reservoir storage capacity and hydrocarbon flow efficiency, the precise characterization and quantitative analysis of pore structure are the prerequisite and key for reservoir evaluation and development plan optimization. All samples selected in this study were collected from the shale of Member 7 of the Triassic Yanchang Formation and were classified into two categories: medium-organic-rich shales (total organic carbon, TOC: 2–6%; TOC refers to the total organic carbon content in rocks, indicating organic matter abundance; unit: %) and high-organic-rich shales (TOC: >6%). The mineral composition and organic geochemical parameters of the shale were determined via X-ray diffraction (XRD) and Rock-Eval pyrolysis experiments, respectively. Meanwhile, pore structure characteristics were analyzed by combining low-temperature nitrogen adsorption–desorption experiments before and after extraction, and multifractal analysis was used to systematically investigate the differences in pore heterogeneity of shale and their influencing factors. The results show that the specific surface area (SSA) and total pore volume (TPV) of shale increased after extraction, while the change in average pore diameter (APD) varied. Multifractal analysis indicates that the micropores of shale both before and after extraction exhibit significant multifractal characteristics; after extraction, pore connectivity is improved, but the changes in pore heterogeneity are inconsistent. The pore connectivity of shale first increases and then decreases with the increase in TOC content and pyrolysis parameter S₂ content. The better the pore connectivity of shale, the lower the content of light-component saturated hydrocarbons and the relatively higher the content of heavy-component resins in the extractable organic matter (EOM). Brittle minerals can provide a rigid framework to inhibit compaction and are prone to forming natural microfractures under tectonic stress, thereby promoting pore connectivity. In contrast, clay minerals, due to their plasticity, are prone to deformation and filling pore throats during compaction, thus reducing pore connectivity. This study provides a theoretical basis for the evaluation and development of shale reservoirs in the Longdong Area. Full article

Background: The Psychache Scale (PS) is the most widely used scale to measure psychological pain due to its ease of application, favorable evidence of predictive validity, and adequate psychometric properties from the CTT (Classical Test Theory) approach. This paper aims to contribute to the improvement of the Spanish version of the PS by analyzing its psychometric properties using a Rasch model. Methods: Using quota sampling, 905 young adults completed an online questionnaire with the PS. Results: The items and response categories showed an acceptable fit to the model and good performance. The separation index indicated three strata for persons. The item-person map showed that persons were placed lower on the psychological pain continuum than item, and some item pairs presented small difference in their severity. The study of men-women DIF (differential item functioning) showed a slight differential functioning only for item 6. Conclusions: This study provides new evidence that supports the use of the PS to measure psychological pain. Full article

Background: Maternal obesity may influence the efficacy and course of induction of labor (IoL). Misoprostol, a prostaglandin E1 analogue, is widely used for cervical ripening, but evidence regarding its effectiveness in obese women remains limited. This study aimed to evaluate the efficacy and safety of oral misoprostol for IoL across different body mass index (BMI) categories. Methods: This prospective study was conducted at a tertiary center. Term singleton pregnancies with medical indications for IoL and an unfavorable cervix (Bishop score < 6) received oral misoprostol 50 μg every 4 h to a maximum of 200 μg. Primary outcomes were vaginal delivery (VD) rates. Secondary outcomes included cesarean section (CS) rate, oxytocin use, labor duration, analgesia, adverse events, and neonatal outcomes. Results: Among 291 participants (43.0% overweight; 40.2% obese), the Bishop score increased from 2.3 to 6.2 (p < 0.0001). VD occurred in 77.3%, and CS in 22.7%. Most women delivered within 48 h (96.6%). Higher BMI correlated with longer time to contractions, pain onset, and delivery, as well as with more misoprostol doses. Neonatal outcomes were uniformly favorable, with median Apgar scores of 10 at 1, 5, and 10 min, and mean umbilical pH values ranging from 7.2 to 7.3. Adverse events were infrequent, with tachysystole observed in 1.7% of cases. Conclusions: Oral misoprostol is an effective and safe IoL method across BMI categories, achieving high vaginal delivery rates and favorable neonatal outcomes. Obesity modestly prolongs induction and increases dose requirements, supporting individualized dosing and close monitoring. Full article

Background/Objectives: Cabozantinib is widely used as subsequent-line therapy after immune checkpoint inhibitor (ICI) treatment in metastatic renal cell carcinoma (mRCC), yet reliable on-treatment biomarkers are lacking. This study explored the prognostic value of a composite score combining early changes in serum albumin (ΔAlb) and the systemic immune–inflammation index (ΔSII) during cabozantinib therapy. Methods: We retrospectively analyzed 40 patients with mRCC who received cabozantinib after prior ICI therapy. Alb and SII were measured at baseline and 6 weeks after initiation. Patients were stratified into three categories according to the ΔAlb + ΔSII composite: both favorable, either unfavorable, or both unfavorable. Progression-free survival (PFS) was analyzed using Kaplan–Meier and Cox regression models. Results: Among 38 evaluable patients, PFS significantly differed across composite categories (p for trend < 0.05). Patients with both favorable changes achieved notably longer PFS, while those with both unfavorable changes experienced the shortest. Compared with the both-favorable group, the “either” and “both unfavorable” groups had shorter PFS (HR = 1.83, 95% CI 0.61–5.46; HR = 6.27, 95% CI 1.61–24.49). Conclusions: In this small retrospective cohort, early on-treatment changes in Alb and SII showed an association with PFS in ICI-pretreated mRCC treated with cabozantinib. The ΔAlb + ΔSII composite may serve as a hypothesis-generating framework, warranting confirmation in larger, prospective studies. Full article

Natural deep eutectic solvents (NADES) have been extensively used for the extraction of a wide spectrum of plant materials. However, limited data about the in vivo toxicity of NADES extracts restrict their future practical application. In this study, we are aiming to assess the safety of a Sorbitol–lactic acid (3:1 mol./mol.; 30% water) NADES extract of Glycyrrhiza roots (GR) in mice. LC-MS/MS analysis revealed the presence of 17 metabolites, including phenolic acids, flavonoids, their glycosides, chalcones, terpene saponins, and coumarins. Interestingly, most of the identified compounds were found in higher amounts in NADES extract compared to water and EtOH extracts. No skin edema, inflammation, or erythema was observed in mice after topical application of NADES extract of GR and NADES at the doses of 50, 100, and 150 µL/mice in comparison with the control group. The calculated primary irritation index was about 0.45 both for NADES and NADES extract of GR only in high doses and falls into mild irritant categories. The individual Draize scores indicate that erythema was evident in the first three days and that all signs had disappeared by day five. No acute toxic signs or mortality of animals was observed in mice following oral administration of single doses of 4, 6, and 20 g/kg of NADES or NADES extract of GR. The NADES and extract seem to be safe at doses of up to 20 g/kg, and the LD50 was considered to be >20 g/kg. Our results open prospects for the use of NADES extract of GR for the development of transdermal and peroral formulations in the cosmetic, food, and pharmaceutical industries. Full article

Objective: To scope the available literature on antipsychotic treatment in substance-induced psychotic disorders, summarize evidence across substance categories, and highlight priorities for future research. Methods: This scoping review followed Arksey and O’Malley’s framework and PRISMA-ScR guidelines. A systematic search of PubMed, Scopus, Embase, PsycINFO, and Cochrane Library (January 1985–August 2025) identified studies examining antipsychotic treatment in cannabis-, stimulant-, and hallucinogen-induced psychoses. Two reviewers independently screened studies and extracted data using a standardized form. Given marked heterogeneity, findings were synthesized descriptively. Results: Seventeen studies met inclusion criteria: 3 randomized controlled trials (17.6%), 10 observational studies (58.8%), and 4 case series (23.5%). Most evidence involved cannabis-induced (n = 7) and methamphetamine-induced (n = 6) psychosis. Randomized trials showed comparable efficacy between risperidone and haloperidol for cannabis-induced psychosis, and between quetiapine and haloperidol for methamphetamine-induced psychosis. Case series suggested potential benefits of third-generation antipsychotics such as lurasidone and cariprazine. No controlled studies were identified for cocaine- or hallucinogen-induced psychoses. Conclusions: Evidence for antipsychotic treatment in substance-induced psychoses remains scarce and uneven. While conventional antipsychotics appear effective for cannabis- and methamphetamine-related presentations, other substances remain virtually unstudied. Substantial evidence gaps and limited methodological quality highlight urgent research needs. Full article

Background: premature birth is a significant public health problem, especially in developing countries such as Brazil. Premature newborns require special care from birth, often requiring prolonged hospitalization and continuous monitoring by various specialists after discharge. Infant Mortality among children under five years of age in Brazil is alarming, with prematurity being the main cause of death in this age group. Objectives: we aim to analyze the prevalence and temporal trend of premature live births in the state of São Paulo, Brazil, in the period 2000–2023. Methods: this is an Ecological, Time-Series Study with secondary data on premature live births in the state of São Paulo, Brazil, from 2000 to 2023. The variables in this study are aggregated measures by year. The Annual Percentage Change and the Average Annual Percentage Change in the percentage of premature live births were estimated by Joinpoint regression. Results: the percentage of premature live births in the period 2000 to 2023 was 9.71%. The average annual percentage change showed an increase of 2.30% per year. In the 2010 to 2013 segment, there was an increase of 12.58% per year (p ≤ 0.05), with subsequent stability in the 2013 to 2016 segment (p ≥ 0.05). The largest annual increases occurred in the number of 4 to 6 prenatal consultations and cesarean sections, with an annual percentage change of 4.51% per year and 2.68% per year, respectively. In the birth weight category equal to or greater than 2500 g, there was an increase in premature live births of 2.50% per year. All categories of the variables sex, type of pregnancy, and type of delivery increased in the period 2000–2023 (p ≤ 0.05). Conclusions: given the increase in the prematurity rate in the period 2000–2023, a long-term growing trend is expected in the largest and most developed state in Brazil. Full article

Background: Bracing is an effective treatment for idiopathic scoliosis (IS), and Adherence is one of the most important factors influencing outcomes. However, evidence on the effectiveness of objective monitoring using thermal sensors in everyday clinical settings remains limited. Objective: To evaluate the impact of Adherence and brace-wearing consistency on short-term outcomes in IS patients during growth in a real clinical setting. Methods: This retrospective cohort study included 114 patients (100 with adolescent idiopathic scoliosis (AIS) and 14 with juvenile idiopathic scoliosis (JIS)) treated with a three-dimensional (3D) rigid brace equipped with a thermal sensor. Adherence was calculated as the ratio of actual to prescribed wear time; consistency was defined using the interquartile range (IQR) of daily wear time (IQR ≤ 1 h = consistent). Cobb angle was measured at baseline, in-brace, and after 6 months. Logistic regression, receiver-operating characteristic (ROC) analysis, and general linear model (GLM) analyses were performed, supported by sensitivity analyses, to assess model robustness. Results: Mean Adherence was 85.3 ± 18.9%; high Adherence was observed in 71.4% of JIS and 57.0% of AIS patients, while 19.3% showed high consistency. In-brace correction averaged 52.5 ± 23.2% (68.1% JIS vs. 50.3% AIS; p = 0.007). At 6 months, 55% improved, 42% were stable, and 3% worsened. Adherence was the only significant predictor of consistency (OR = 1.511; 95% CI 1.181–1.933; p = 0.001). The ROC analysis showed excellent discriminative ability (Area Under the Curve (AUC) = 0.908). Adherence category (p = 0.041) and Risser stage (p = 0.041) were significant predictors of short-term outcome. Conclusions: Adherence and brace-wearing consistency are key predictors of short-term bracing outcomes in IS. Objective monitoring with thermal sensors enables precise tracking, improves patient engagement, and supports individualised treatment. Full article

Background: Interactive, narrative-based digital health interventions may positively influence vaccination-related attitudes, intentions, and uptake. However, evidence on their implementation and evaluation for vaccine communication has not yet been comprehensively synthesized. Our research questions (RQs) were to describe the use of interactive, narrative-based digital health interventions for vaccine communication (RQ1), their impact on individuals’ vaccine intention or uptake (RQ2), and factors associated with their implementation (RQ3). Methods: A scoping review was conducted using Arksey and O’Malley’s 5-stage framework and the PRISMA-ScR guidelines. We searched PubMed, Embase, Scopus, Web of Science, CINAHL, and PsycINFO from inception to 18 April 2023. To be included in the review, studies had to include empirical findings from primary data collection, address vaccine communication, use narrative communication that enabled audience engagement (i.e., interactivity), and deliver the narrative through a digital health device or modality. Results: The search identified 6834 records, with 25 studies meeting the inclusion criteria. For RQ1, the interventions most often focused on HPV vaccination (12 studies). Communication objectives included addressing vaccine hesitancy and increasing vaccination confidence or knowledge. Intervention delivery formats included multi-device compatibility (utilizing more than one device type, 7 studies) and incorporated interactive features, such as gamification and push notifications. Invented narratives were the most frequent narrative approach (8 studies). For RQ2, vaccination outcomes were reported in nearly half the studies (12 studies), with vaccination intention assessed in 8 studies and both vaccination intention and uptake assessed in 4 studies. For RQ3, implementation factors were reported in nearly half the studies (12 studies), with the most frequently reported outcome being acceptability (6 studies). Conclusions: Evidence supporting interactive, narrative-based digital health interventions for vaccine communication can be strengthened by diversifying narrative strategies, expanding the range of interactivity modalities tested, and focusing on a broader range of vaccines. Further research is needed to assess the effectiveness of these interventions, particularly of vaccine uptake. The insights from this scoping review may inform the development of novel future interventions for vaccine communication. The generalizability of these findings may be limited by the small number of studies in some categories and the preponderance of studies from high-income settings. Full article

Background: Healthcare policy in the United Kingdom recognizes that teenagers and young adults (TYA:16–24 years at diagnosis) require specialist care. In England, Principal Treatment Centers (PTCs) exist, delivering enhanced care exclusively within the PTC or as ‘joint care’ with designated hospitals (DHs). We examined whether joint care impacted patient-reported outcomes when compared to care at one site. Methods: A cross-sectional survey was conducted in England, Scotland, and Wales. This included validated measures of quality of life (QoL), anxiety and depression, health status, social support, and illness perception. Comparisons were made based on young people’s exposure to specialist care within 6 months of diagnosis, defined as care in a TYA PTC: all-TYA-care (all care in a TYA unit), no-TYA-care (no care in a TYA unit, care delivered in a children’s/adult unit only), and joint-care (care in a TYA-PTC and in a children’s/adult unit). Results: Overall, 260/1009 (25.8%) participants responded (England n = 241; Scotland/Wales n = 19). Due to different healthcare policies, statistical analysis was applied to England only. Mean QoL scores were <69.7, the threshold indicating impaired QoL (mean 58.65, standard deviation 20.13). After adjustment for confounding factors, no clinically significant differences in mean QoL between categories existed. The adjusted mean difference for all-TYA-care (n = 66) versus no-TYA-care (n = 89) was −2.28 units (95% confidence interval (CI: −8.85 to 4.29) and for joint-care versus no-TYA-care (n = 85), −4.35 units (CI: −10.34 to 1.63). Similarly, no notable differences in social support, anxiety, depression, or illness perception between categories existed. Patients receiving all-TYA-care had a lower average health status compared with no-TYA-care (difference in means −0.09 (CI:−0.18 to −0.01). Conclusions: No evidence that patient-reported outcomes differ by categories of care existed. This may suggest the evolution of TYA cancer services has led to similar outcomes regardless of care category. However, given the small sample size it is not possible to draw firm conclusions. Full article

Background/Objectives: Differentiated thyroid cancer (DTC) represents over 90% of all hyroid malignancies and typically has a favorable prognosis. However, approximately 30% of patients experience recurrence within 10 years after initial treatment. Conventional risk classification frameworks such as the American Thyroid Association (ATA) and AJCC TNM systems rely heavily on pathological interpretation, which may introduce observer variability and incomplete documentation. This study aimed to develop an interpretable machine-learning framework for risk stratification in DTC and to identify major clinical predictors using SHapley Additive exPlanations (SHAP). Methods: A retrospective dataset of 345 patients was obtained from the UCI Machine Learning Repository. Thirteen clinicopathological features were analyzed, including Age, Gender, T, N, M, Hx Radiotherapy, Focality, Adenopathy, Pathology, and Response. Statistical analysis and feature selection (ReliefF and mRMR) were applied to identify the most influential variables. Two modeling scenarios were tested using an optimizable neural network classifier: (1) all 10 core features and (2) reduced features selected from machine learning criteria. SHAP analysis was used to explain model predictions and determine feature impact for each risk category. Results: Reducing the input features from 10 to 6 led to improved performance in the explainable neural network model (AUC = 0.94, accuracy = 92%), confirming that T, N, Response, Age, M, and Hx Radiotherapy were the most informative predictors. SHAP analysis highlighted N and T as the dominant drivers of high-risk classification, while Response enhanced postoperative biological interpretation. Notably, when Response was excluded (Scenario III), the optimizable tree model still achieved strong predictive performance (AUC = 0.93–0.96), demonstrating that accurate preoperative risk estimation can be achieved using only clinical baseline features. Conclusions: The proposed interpretable neural network model effectively stratifies recurrence risk in DTC while reducing dependence on subjective pathological interpretation. SHAP-based feature attribution enhances clinical transparency, supporting integration of explainable machine learning into thyroid cancer follow-up and personalized management. Full article