Search Results (1,493)

Triple-negative breast cancer (TNBC) lacking androgen receptor (AR) expression defines quadruple-negative breast cancer (QNBC), which is characterized by younger age at diagnosis, high Ki-67 index, and high genomic instability, however a comprehensive description of the genomic characteristics remains poorly defined. A total of 54 TNBC cases were categorized as TNBC with 100% AR expression (TNBC AR-100%) or QNBC, TNBC with 0% AR expression (TNBC AR-0%). Clinical, molecular, and genomic parameters, specifically pathogenic/likely pathogenic (P/LP) variants in homologous recombination repair (HRR) and cancer-related pathways were measured and analyzed. The QNBC cohort exhibited a high homologous recombination deficiency (HRD) score and a greater overall incidence of copy number variants (CNVs). QNBC harbored a higher mutation rate in TP53 and MYC signaling pathway than TNBC AR-100% tumors. P/LP variants corresponding to the HRR, PI3K/AKT, and RTK/RAS pathways were exclusively identified in QNBC. These results suggest that, at both molecular and genomic levels, the two groups are distinct, holding QNBC tumors more aggressive characteristics, genomic instability, and particular impairments in HRR and cancer-related pathways. In terms of actionability, these differences could potentially be leveraged through different combinations of therapies. Full article

Wheat (Triticum aestivum L.) is a major food crop that is severely affected by salt stress, resulting in significant yield losses. Glutamic acid decarboxylase (GAD) catalyzes the irreversible conversion of glutamic acid to γ-aminobutyric acid (GABA) and plays key roles in plant growth, development, and stress responses. However, the GAD gene family in hexaploid wheat and its role in salt tolerance remain poorly understood. In this study, the wheat GAD gene family was systematically identified. Genome-wide analysis revealed seven TaGAD genes with 19 gene copies. A Ka/Ks ratio < 1 indicates strong evolutionary conservation of this family. All TaGAD proteins contain a conserved Glu-decarb-GAD domain with similar motif composition and structural organization. Promoter analysis showed enrichment of stress-responsive cis-elements. Expression profiling demonstrated tissue-specific patterns, with several TaGAD genes significantly induced under salt stress. CRISPR/Cas9-mediated knockout of TaGAD1 led to markedly reduced salt tolerance, accompanied by decreased GABA content and GAD activity, reduced activities of antioxidant enzymes (SOD, POD, and CAT), and excessive accumulation of reactive oxygen species (ROS). These results demonstrate that TaGAD1 positively regulates salt tolerance in wheat through GABA-mediated ROS homeostasis. This study provides a systematic characterization of the wheat TaGAD gene family in the context of salt stress, laying a theoretical foundation for understanding GABA-mediated tolerance mechanisms and identifying TaGAD1 as a potential molecular breeding target for improving salt tolerance in wheat. Full article

Background: Missed and zero-dose children remain major barriers to polio eradication in settings affected by insecurity, poverty, weak health systems, and social exclusion. This narrative review synthesized evidence on how gender norms and related social determinants influence childhood polio vaccination in Afghanistan, Nigeria, Pakistan, and Sudan. Afghanistan and Pakistan remain the only countries with endemic wild poliovirus transmission, while northern Nigeria, especially areas affected by insurgency, and war-affected Sudan continue to report substantial numbers of polio zero-dose and under-immunized children, together with occasional reports of circulating vaccine-derived poliovirus. Methods: A comprehensive search of peer-reviewed and institutional literature was conducted in major databases and relevant grey literature sources. Eligible studies examined childhood immunization or polio vaccination among children under five and reported gender-related determinants of vaccination uptake. Findings were synthesized thematically. Results: Forty-one studies were included. Five interconnected domains emerged: women’s empowerment, autonomy, and household decision-making; male involvement, household gender norms, and family power relations; socioeconomic and structural gender-related barriers; education, information access, community perceptions, and health system responsiveness; and war, insurgency and their gendered impact on childhood polio immunization. Across countries, limited maternal autonomy, restricted mobility, dependence on male decision-makers, poverty, conflict, displacement, misinformation, and weak health services reduced access to vaccination. Supportive male engagement, female health workers, trusted community leadership, and culturally responsive outreach facilitated vaccine acceptance. Conclusions: Gender influences childhood polio vaccination through intersecting household, community, structural, and health-system pathways. Family power extends beyond male decision-making, with women’s education and influence within households shaping vaccination decisions. Strengthening women’s agency, constructively engaging men (e.g., through husband schools), and delivering culturally responsive services are essential for reaching missed and zero-dose children and accelerating polio eradication. Full article

Introduction: The Trauma Medical Home (TMH) randomized clinical trial tested the efficacy of a collaborative care intervention on the biopsychosocial recovery of older injured adults compared to usual care. Study enrollment occurred between 11 October 2017 and 13 October 2021 and study operations were impacted by the COVID-19 pandemic. It is important to measure the potential effects of COVID-19 on research study participants to ensure accurate reporting of results. The purpose of this secondary analysis was to compare depression and anxiety symptoms and health-related quality of life in older adults at TMH study enrollment pre-COVID-19 and during COVID-19. We hypothesized that those enrolled during COVID-19 would have worse symptoms and quality of life. Methods: This study was a secondary analysis of data from a multicenter randomized clinical trial (R01AG052493-01A1) TMH, that examined the ability of a collaborative care model to enhance the recovery of older injured adults compared to usual care. It was hypothesized that the TMH intervention would improve biopsychosocial recovery for injured older adults compared to usual care. The enrollment periods pre-COVID-19 and during COVID-19 were compared. Chi-square tests and Wilcoxon Rank Sum tests, then multivariable linear and logistic regressions were completed with SF-36 component scores and depression (PHQ-9) and anxiety (GAD-7) scores as the dependent variables, respectively. Results: A total of 429 participants were analyzed. There was no significant difference in anxiety and depression symptoms between the pre-COVID-19 and during-COVID-19 enrollment periods. Perceived limitations due to physical health problems were worse for those enrolled during COVID-19 (adjusted β = −9.8, 95% CI −18.3 to −1.4), but other health-related quality of life measures were similar between the two groups. Conclusions: These findings support the conclusion that the negative psychological impacts of the pandemic are likely due to individual factors other than age or COVID-19. These results suggest a high degree of psychological resiliency in older adults under stress. Future research should focus on the potential effects of socioeconomic status, demographic background, and level of physical functioning on psychological outcomes. Full article

Background/Objectives: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease associated with substantial physical and psychosocial burden. Illness acceptance is an important component of adaptation to chronic disease, yet it remains underexplored in HS. Therefore, this study aimed to assess illness acceptance in HS patients. Methods: This cross-sectional study included 123 consecutive adult HS patients. Illness acceptance was assessed using the Acceptance of Illness Scale (AIS). Disease severity was evaluated using Hurley staging and the International Hidradenitis Suppurativa Severity Score System (IHS4). Pain and itch were measured using the Numeric Rating Scale. Quality of life (QoL) was assessed with the Dermatology Life Quality Index (DLQI) and Hidradenitis Suppurativa Quality of Life (HiSQoL). Depression and anxiety were evaluated using PHQ-9, GAD-7, and HADS. Results: The mean AIS score was 31 ± 8.7 points, with 14% of patients showing low and 24% moderate illness acceptance. Lower acceptance was associated with higher Hurley stage (p = 0.031). A significant negative correlation between AIS scores and IHS4 values was found (r = −0.26; p = 0.013). Additionally, AIS scores correlated negatively with pain (r = −0.22; p = 0.019) and itch (r = −0.23; p = 0.021). Strong negative correlations were found with QoL impairment (DLQI: r = −0.63; HiSQoL: r = −0.65; p < 0.001) and psychological distress, including depression (PHQ-9: r = −0.55; HADS-D: r = −0.60) and anxiety (GAD-7: r = −0.50; HADS-A: r = −0.56; p < 0.001 for all). Conclusions: Targeting illness acceptance may improve overall patient outcomes. Full article

Background/Objectives: A hydrogel with enhanced therapeutic properties was developed using chitosan, dextran sulfate, and Aloe vera-coated nanoparticles encapsulating eucalyptus extract. Methods: The physicochemical characteristics of the synthesized nanoparticles were evaluated using transmission electron microscopy (TEM), scanning electron microscopy (SEM), dynamic light scattering (DLS), Fourier-transform infrared spectroscopy (FTIR), and antibacterial activity assays. The in vitro release profile of Eucalyptus staigeriana extract was assessed at physiological pH 7.4, and the in vivo wound healing performance was subsequently investigated in a rat model. Results: The results indicated that the nanocarrier system provided a controlled and sustained release of eucalyptus extract. Aloe vera-coated dextran sulfate/chitosan nanoparticles encapsulating E. staigeriana inhibited the growth of Staphylococcus aureus by 40%. Moreover, animals treated with Aloe vera @ DX/CS/EE nanoparticles exhibited markedly improved wound contraction, with mean reductions of 27.45%, 19.18%, 18.12%, and 7.03% compared with the control, DX/CS nanoparticles, Aloe vera @ DX/CS nanoparticles, and DX/CS/EE nanoparticles groups, respectively. Histological analysis further confirmed that treatment with Aloe vera @ DX/CS/EE nanoparticles led to superior tissue organization and accelerated dermal regeneration. Conclusions: Overall, the dextran sulfate/chitosan hydrogel coated with Aloe vera and loaded with eucalyptus extract demonstrates strong potential as an effective wound dressing material capable of enhancing healing outcomes. Full article

Cloud computing has transformed the delivery of modern applications and services by providing scalable, flexible, and cost-effective access to computing resources. One of the most critical challenges in cloud environments is the efficient distribution of dynamic workloads across heterogeneous resources, commonly addressed through load balancing and task scheduling techniques. Efficient scheduling plays a vital role in maximizing resource utilization, minimizing response time, and maintaining acceptable Quality of Service (QoS), particularly under dynamic and large-scale workloads. Despite the progress achieved by traditional heuristics such as Min-Min and metaheuristic approaches like the Improved Sparrow Search Algorithm (ISSA), challenges related to scalability, adaptability, and computational overhead remain. Metaheuristic-based approaches often involve iterative optimization processes that may limit their efficiency in real-time scheduling scenarios. In this paper, we propose a lightweight Stochastic Predictive Energy-Aware Scheduling (SPES) algorithm that integrates predictive execution estimation, multi-resource awareness, and stochastic decision-making. Unlike deterministic scheduling strategies, SPES employs a Top K candidate selection mechanism combined with probabilistic weighting and epsilon-greedy exploration to enhance adaptability and avoid suboptimal resource allocation. The proposed method considers CPU, memory, and I/O demands to achieve balanced utilization across heterogeneous hosts while implicitly addressing energy efficiency through utilization-based modeling. The proposed algorithm is implemented and evaluated using the CloudSim 5.0 simulation framework under heterogeneous multi-region cloud environments with varying workload sizes. Experimental results demonstrate that SPES consistently outperforms ISSA and achieves makespan reductions of up to 23.8% while improving scalability, resource utilization, and scheduling efficiency under dynamic cloud workloads. These results indicate that SPES provides an effective lightweight scheduling solution for large-scale and energy-aware cloud computing environments and supports green computing objectives through improved resource efficiency. Full article

Background: The global prevalence of anxiety and internalizing disorders in adolescence has increased epidemiologically over the past decade, compounded by the impact of the COVID-19 pandemic and the expansion of digital social networks. Despite the availability of empirically based interventions, their systematic implementation in Spanish educational settings—especially in socioeconomically vulnerable environments—remains insufficient. This study aimed to assess the emotional symptomatology profile in a sample of adolescents enrolled in the 2nd year of Compulsory Secondary Education (CSE) and to describe the changes in symptomatology observed after implementation of a multicomponent intervention program in an ordinary school setting. Methods: a quasi-experimental single-group repeated-measures design was used, with pretest–posttest measurements (T1–T2). The sample included 79 participants (age in completed years: M = 13.28 years, SD = 0.64; range: 12–15; 49.4% female, 44.3% male, 6.3% undisclosed), selected by convenience at IES Estuaria (Huelva). The assessment instrument was the Revised Child Anxiety and Depression Scale (RCADS-47), which measures total anxiety, total internalization, and six clinical subdimensions aligned with DSM-5: generalized anxiety disorder (GAD), major depressive disorder (MDD), panic disorder (PD), separation anxiety (SA), social phobia (SP), and obsessive–compulsive disorder (OCD). The intervention consisted of five multicomponent group workshops (45 min/session; three class groups) integrating emotional psychoeducation, receptive music therapy, cognitive–behavioral emotional regulation, assertive communication, and body expression/mindfulness. Results: At pretest, Social Phobia (SP) showed the highest clinical impairment, significantly affecting more females (66.67%) than males (20.00%). Generalized Anxiety Disorder (GAD) also presented high impairment in females. Significant correlations between pairs of subdimensions revealed a high comorbidity pattern. Following the intervention, reductions in clinically significant levels were observed across all dimensions. Matched-pairs Wilcoxon signed-rank tests confirmed statistically significant score reductions from T1 to T2 in Total Anxiety, Total Internalization, Social Phobia, and Generalized Anxiety Disorder (all p < 0.05), with the largest effect for Social Phobia (r = 0.46); no significant change was detected for Panic Disorder, Separation Anxiety, Major Depressive Disorder, or Obsessive–Compulsive Disorder, although the direction of change favored improvement in all cases. Conclusions: The multicomponent intervention program produced improvements in emotional symptomatology over the short-term follow-up period, although without achieving complete clinical remission in any subdimension. The persistent sex differences—with greater residual impairment in the female group after intervention—underscore the need to incorporate a gender perspective in the design of school emotional health programs. High comorbidity rates between subdimensions support the utility of transdiagnostic approaches. Implications for school nursing practice and future research are discussed. Full article

The study sought to examine the relationship between procrastination and anxiety as predictors of social media addiction among Peruvian university students. The research employed a cross-sectional predictive methodological design. A sample of 335 students, aged 21 to 69 years, comprising both females and males from private and public university management, was selected through non-probabilistic sampling. The instruments utilized included the Social Media Addiction Questionnaire, the Academic Procrastination Scale, and General Anxiety Disorder-7 (GAD-7). The findings indicated that anxiety (β = 0.52, p < 0.001) and academic procrastination (β = 0.17, p = 0.040) significantly predicted social media addiction. The study concluded that there is a significant relationship between procrastination and anxiety as predictors of social media addiction in Peruvian university students. Full article

Tetrabromobisphenol A mono(2-hydroxyethyl) ether (TBBPA-MHEE) is an important byproduct during the production of tetrabromobisphenol A (TBBPA) and its related derivatives. Although it has been detected in aquatic environments, its in vivo developmental toxicity and underlying mechanisms remain poorly understood. In this study, zebrafish were used as a model organism to evaluate the early developmental toxicity, neurobehavioral toxicity, and candidate molecular responses associated with TBBPA-MHEE. The 96 h median lethal concentration (96 h-LC₅₀) of TBBPA-MHEE for zebrafish embryos/larvae was 1.684 mg/L. Sublethal nominal exposure concentrations (2, 20, and 200 μg/L) caused developmental abnormalities, including reduced body length, pericardial edema, impaired swim bladder development, and significantly inhibited spontaneous motor activity as well as the response to light–dark transition and mechanical stimulation. Transgenic reporter assays further showed shortened motor neuron projections, reduced brain-region fluorescence in Tg(gad1b:mCherry) larvae, and downregulated the expression of neurodevelopment-related genes. Network toxicology analysis suggested that MTOR, SRC, MAPK3, and GSK3B were identified as candidate targets potentially associated with TBBPA-MHEE-induced neurotoxicity, with significant enrichment of the ErbB signaling pathway and possible perturbation of PI3K/Akt/mTOR-related responses. In addition, TBBPA-MHEE exposure increased the accumulation of reactive oxygen species (ROS) in the larval brain and induced inflammatory and apoptotic responses. Quercetin intervention partially alleviated ROS accumulation and inflammation and improved the developmental and motor phenotypes. Collectively, these findings indicate that TBBPA-MHEE induces neurodevelopmental toxicity in zebrafish, possibly associated with altered transcriptional responses related to ErbB signaling and the PI3K/Akt/mTOR axis, accompanied by oxidative stress, inflammatory responses, and apoptosis-related events. Because exposure concentrations were not analytically verified, all treatment levels are reported as nominal concentrations. This study provides experimental evidence for the toxicological assessment and environmental risk evaluation of TBBPA derivative pollutants. Full article

Eco-anxiety has emerged as an important construct in environmental psychology. The Hogg Eco-Anxiety Scale (HEAS-13), which consists of 13 items, is a multidimensional instrument designed to assess affective symptoms, rumination, behavioral responses, and anxiety related to environmental issues. This study examined the psychometric properties of the HEAS-13 in a general population sample from Czechia. The study assessed the scale’s validity in relation to generalized anxiety and self-reported housing damage associated with adverse weather-related events. Data were collected by conducting face-to-face interviews with a population-based sample in Czechia (n = 1027), with respondents selected using address-based sampling. The psychometric evaluation included descriptive statistics, an internal consistency analysis, inter-item correlations, an exploratory factor analysis (EFA) based on principal axis factoring with oblimin rotation, a confirmatory factor analysis (CFA) using a Weighted Least Squares Mean and Variance (WLSMV) estimator appropriate for ordinal indicators, and convergent, discriminant, and known-groups validity testing. The HEAS-13 demonstrated high internal consistency (Cronbach’s alpha = 0.962; McDonald’s omega = 0.958 for the total scale). EFA supported the original four-factor structure and CFA showed a good fit of the original model. Score distributions were positively skewed, and substantial floor effects indicated generally low levels of eco-anxiety symptom endorsement in the general population. The HEAS-13 total score was strongly correlated with the GAD-7 (rho = 0.839) supporting convergence with generalized anxiety, but also indicating possible construct overlap. Known-groups validity was supported by higher HEAS-13 scores among respondents reporting hazard-related home damage. Measurement invariance was examined across sex and age groups. The HEAS-13 appears to be a reliable and structurally well-fitted instrument for assessing multidimensional eco-anxiety in population-based research. The results provide evidence that the construct is meaningfully associated with generalized anxiety and experience of environmentally disruptive events. The HEAS-13 may serve as a useful tool for future research on environmental distress and climate- and environment-related mental health. It may also be useful for studies examining risk perception as an explanatory, associated, or contextual variable. Full article

Diabetic retinopathy (DR) is a leading cause of vision loss among working-age adults and is characterized by progressive retinal microvascular dysfunction driven by hyperglycemia-induced inflammation and oxidative stress. Histone deacetylase 6 (HDAC6), a cytoplasmic deacetylase involved in multiple cellular processes, has been implicated in vascular pathology; however, its specific role in retinal endothelial cells remains unclear. In this study, we investigated whether endothelial-specific deletion of HDAC6 protects against diabetic retinal injury. Endothelial HDAC6 knockout mice were generated using VE-cadherin–Cre recombination and subjected to streptozotocin-induced diabetes. Retinal vascular integrity, inflammatory and oxidative stress responses, endothelial senescence, and visual function were assessed during the course of hyperglycemia. Diabetic control mice developed characteristic features of DR, including vascular dysfunction, heightened inflammatory and oxidative stress responses, increased endothelial senescence, and impaired visual function. In contrast, endothelial-specific HDAC6 deletion markedly attenuated these pathological changes, preserving retinal vascular integrity and visual performance while reducing oxidative stress and inflammation. These findings identify endothelial HDAC6 as a key contributor to diabetes-induced retinal vascular injury and suggest that targeting endothelial HDAC6 may represent a promising therapeutic strategy for preventing microvascular damage and vision loss in DR. Full article

In safety-critical industrial environments such as nuclear power plants (NPPs), early detection of pipeline leakage is essential for maintaining operational safety. However, leakage events are rare, abnormal samples are difficult to collect, and obtaining sufficient condition-specific normal data is also challenging. To address these limitations, this paper proposes SiameseGAD, a generative few-shot anomaly detection framework for pipeline leakage detection in the secondary systems of NPPs. The proposed method formulates leakage detection as a few-shot normality-modeling problem rather than as a problem of directly learning anomaly patterns. The Siamese network learns similarity relationships among normal samples and constructs a normal feature manifold, while anomaly scores are computed based on the distance from the estimated normal distribution. To improve normal distribution estimation under limited data, a denoising diffusion probabilistic model (DDPM) is used to generate in-distribution normal variants to augment the support-set. The main contribution of SiameseGAD lies in combining metric-learning-based few-shot normality modeling with normal-to-normal generative augmentation, enabling anomaly detection using only a few normal samples without relying on real anomaly data or synthetic anomaly generation. In the three evaluated target classes, SiameseGAD achieved an average AUROC of 93.59% and an average accuracy of 95.26%. These results indicate the potential of SiameseGAD for few-shot anomaly detection using only normal support samples, without requiring real or synthetically generated anomaly samples during inference. Full article

TBEV is a major cause of viral central nervous system infections in Europe, with heterogeneous geographical distribution and substantial underdiagnosis in low-incidence regions. This study aimed to evaluate the validity of regional TBE risk classification in Poland by combining surveillance-based incidence data with serological markers of TBEV exposure. Plasma samples from 5541 blood donors residing in nine regions were tested by anti-TBEV IgG ELISA, followed by confirmatory VNT, IFA, and anti-NS1 IgG ELISA to differentiate infection-induced from vaccine-induced antibodies. Regions were classified based on average TBE incidence registered in surveillance systems in 2015–2019. Overall, 272 (4.9%) donors were positive in TBEV IgG ELISA and 177 (3.2%) also in a confirmatory assay. Seroprevalence expressed by markers consistent with past TBEV infection (anti-NS1 IgG) was estimated at 0.13% (95% CI 0.05–0.26%), ranging from 0.0% to 0.33% by voivodeship, whereas vaccine-induced immunity accounted for the majority of samples with detected specific antibodies (3.1%). Surprisingly, seroprevalence in a highly affected region (0.29%) was at the same level as in one that was less affected (0.33%). Moreover, all except one seropositive donor lived in urban areas. In four out of nine voivodeships, no anti-NS1 TBEV IgG was detected. By utilising precise laboratory algorithms, we demonstrated a much lower seroprevalence that estimated from prior research relying on screening tests. In addition, we confirmed low vaccination coverage. Integrating sero-epidemiological data with surveillance systems may improve risk assessment and inform targeted prevention strategies. Full article

Background/Objectives: Healthcare professionals face high occupational stress, emotional burden, and demanding conditions that increase the risk of burnout, depression, and anxiety, with recent post-pandemic evidence indicating a high and rising global prevalence. Early identification of distress is therefore essential. This review compared three widely used instruments—the Depression, Anxiety and Stress Scales (DASS), the Maslach Burnout Inventory (MBI), and the Zung Self-Rating Depression Scale (SDS)—selected because they jointly cover depression, anxiety, stress, and burnout, unlike unidimensional tools (PHQ-9, GAD-7, PSS, CBI) that would need combining for comparable coverage. Methods: A narrative integrative review searched PubMed, Scopus, Web of Science, ScienceDirect, and Google Scholar for peer-reviewed articles (English/Croatian) published up to December 2025 (final search: 26 June 2026). Two reviewers independently screened records, resolving disagreements by consensus; quality was appraised narratively. Of 55 records, 35 were included. Results: The DASS showed a replicated three-factor structure and strong reliability, with shortened forms (DASS-8, DASS-12) enabling rapid screening at reduced domain coverage. The MBI remained the most widely used burnout measure but was limited by its emotional-exhaustion focus, proprietary licensing, and scoring heterogeneity. The Zung SDS offered a brief depression screen, though dated wording and context-dependent cut-offs favor initial-screen use. Notably, much evidence is derived from non-healthcare populations—the principal limitation. Conclusions: The instruments appear complementary rather than interchangeable; their combined use is proposed—as a reasonable suggestion from the literature, not an empirically demonstrated finding—as a multidimensional approach, contingent on context, objective, and appropriate cultural validation. Full article