Search Results (2,043)

Autonomous vehicles (AVs) hold strong potential to redefine traffic operations, yet their impacts at varying penetration levels within mixed traffic remain insufficiently quantified. This study evaluates the influence of SAE Level 5 AVs on traffic performance at two typical urban signalized intersections using a hybrid microsimulation approach that integrates behavioral AV modeling and performance evaluation. The analysis covers two typical intersection layouts, one with two through lanes and another with three, tested under varying traffic volumes and left-turn shares. A total of 324 simulation scenarios were conducted with AV penetration ranging from 0% to 100% (in 20% increments) and left-turn proportions of 15%, 30%, and 45%. The results show that 100% AV penetration lowers the average delay by up to 40% in the two-lane intersection scenario and 32% in the three-lane scenario, relative to the 0% AV baseline. Even 20% AV penetration yields about half of the maximum improvement. The greatest benefits occur with aggressive AV driving profiles, balanced approach volumes, and small left-turn shares. These findings provide preliminary evidence of AVs’ potential to enhance intersection efficiency and support Sustainable Development Goals (SDGs) 11 and 13, offering insights to guide intersection design and AV deployment strategies for data-driven, sustainable urban mobility. Full article

Research and public attention on violence directed toward school teachers are increasing. Yet to date, our knowledge on violence against teachers is limited, because most research has focused on student-perpetrated violence, largely overlooking the aggression directed at teachers by parents. To fill this gap in knowledge, this study used a qualitative approach based on in-depth semistructured interviews with 46 teachers, school leaders and policy-level managers to explore the phenomenon of parents’ violence against teachers, including manifestation of the problem, risk factors, and effective coping strategies. Following the principles of grounded theory, the results suggest that parents’ violence toward teachers takes various forms, mostly rudeness, shouting, intimidation, and verbal threats. These behaviors create complex challenges that affect teachers both personally and professionally, requiring coping mechanisms at the societal, school, community and individual levels. Effective strategies encompass improving the social and organizational climate in schools, providing mentoring and support, offering conflict management training for educators, and implementing comprehensive family–school partnership policies at the school level. Implications for research and policy are discussed. Full article

Parental adverse childhood experiences (ACEs) are linked to negative outcomes in children, including emotional and behavioral problems, developmental delays, and higher risk for psychopathology. Most research focuses on school-aged children or community samples, with few studies examining preschool-aged children in child psychiatric care. Understanding parental ACEs in this population is crucial, as early childhood is a sensitive developmental period, and intergenerational effects may be particularly pronounced in children already presenting with psychiatric symptoms. Background/Objectives: The goal of this study was to analyze how parents of patients in an early childhood (0–5.9 yrs) mental health outpatient clinic differ from the general population in terms of the frequency of ACEs. In addition, we investigated the connection between mental health disorders in young children and the specific ACE scores of their parents. Methods: A total of 116 caregivers (34.45 years (SD = 5.28)) and their children (71.6% boys, 28.4% girls) at an average age of 3.99 years (SD = 1.35, range = 0.31–5.95) were included in the analysis. The legal guardians completed the 10-item ACE questionnaire. The young children were diagnosed as part of outpatient treatment using the DC:0–5 classification system. We analyzed the ACE scores and diagnoses descriptively and in comparison to a community sample. Results: An average value of 2.38 parental ACEs was reported by our sample, and 68.1% (n = 79) reported at least one ACE. The high-risk group with four or more ACEs comprised 30.2% (n = 35). The most common diagnosis in young children was the Disorder of Dysregulated Anger and Aggression of Early Childhood, followed by global developmental delay. Adjustment disorder was third in terms of frequency. Among the examined child psychiatric diagnoses, adjustment disorder showed a significant correlation with parents being affected by the ACE category of neglect (OR = 2.54; 95% CI: 1.012–6.369; p = 0.047). Conclusions: Parents who presented their children at an early childhood mental health outpatient clinic reported significantly more ACEs as compared to representative data on ACEs in adulthood. These results highlight the need for further studies with larger samples to enable a more in-depth analysis of the general intergenerational transmission processes and the differential transmission of specific ACEs to specific diagnoses in preschool-aged children. Full article

Background: Visceral pleural invasion (VPI) has traditionally been regarded as a negative prognostic indicator in non-small-cell lung cancer (NSCLC). However, with the increasing adoption of sublobar resection for small-sized NSCLC, the clinical significance of VPI is being fundamentally reassessed. Specifically, it remains uncertain whether VPI is indicative of tumor size or represents distinct metastatic behavior. Methods: We conducted a retrospective comprehensive multicenter study involving 2464 patients with pathologically confirmed NSCLC ≤ 3 cm who underwent complete resection at three Japanese institutions. The prevalence, metastatic patterns, and prognostic impact of VPI were systematically evaluated, with particular focus on histological growth patterns. Results: VPI was identified in 370 patients (15%). Notably, VPI-positive tumors demonstrated a doubled incidence of lymph node metastasis (31% vs. 15%, p < 0.001) and a distinct metastatic profile characterized by preferential hilar spread (#12, 16.9%) and an increased risk of skip N2 metastasis (4.0% vs. 2.0%). Five-year recurrence-free survival was significantly reduced in the VPI group (33.7% vs. 50.6%, respectively). Conversely, adenocarcinomas with lepidic characteristics demonstrated a minimal risk of VPI or nodal metastasis, with incidences of 2% and 1%, respectively. This finding highlights the heterogeneity in the biological aggressiveness of small-sized NSCLC. Conclusions: Our findings suggest that VPI is not merely a histopathological descriptor but also acts as a clinically significant indicator of aggressive metastatic behavior, potentially enhancing surgical and staging approaches beyond just considering tumor size. With the increasing adoption of sublobar resection for small-sized NSCLC, recognizing that VPI appears to be associated with predominant hilar involvement and an elevated risk of skip N2 metastasis may help refine decisions on the extent of lung and lymph node resection. Full article

In many vertebrates, ritualized behaviors serve to settle conflicts while minimizing the risk of injury. The Jamaican fruit bat (Artibeus jamaicensis) is a polygynous species that roosts in caves, where dominant males form and defend harems by displaying agonistic behaviors against satellite males attempting to mate with females. We examined how the distance of satellite males from the harem and the number of females influenced the latency of approach by dominant males during agonistic encounters, and whether these encounters follow a defined behavioral sequence. We analyzed 50 agonistic interactions from video recordings of A. jamaicensis harems collected between May and October 2021 in “Cantil Blanco” cave, Veracruz, Mexico. We quantified the number of females per harem and measured the distance of satellite males to the nearest female just before the dominant male initiated an approach. Our results show that satellite male distance determined dominant male approach latency, reflecting a minimum tolerable distance, whereas harem size had no effect. Furthermore, the succession of behaviors observed indicates that these encounters are sequential, escalating from ritualized displays to physical aggression. Full article

Thymic carcinoma (TC) is a rare, aggressive cancer that originates from thymus’s epithelial cells. It distinguishes itself from other thymic epithelial tumors with its unique pathological structure, clinical behavior, and immune characteristics. Immune checkpoint inhibitors (ICIs) targeting the Programmed cell death protein 1/Programmed cell death protein ligand 1 (PD-1/PD-L1) pathway have shown promise in advanced TC, potentially benefiting from frequent PD-L1 overexpression and abundant CD8⁺ tumor-infiltrating lymphocytes (TILs), despite typically low tumor mutational burden (TMB). While ICI monotherapy can achieve disease control in some patients, its overall efficacy is limited and it is associated with a distinct profile of immune-related adverse events (irAEs) which occur less often than in thymomas. The predictive value of biomarkers—particularly PD-L1 expression—remains uncertain, underscoring the importance of consistent assessment criteria. In this review, we summarize evidence on ICI monotherapy as well as combination approaches that incorporate anti-angiogenic agents, chemotherapy, or dual checkpoint blockade. Emerging therapeutic targets—such as CD70, TIM-3, and B7-H4—are also considered in the context of their potential clinical relevance. Finally, we discuss future directions aimed at improving efficacy, extending response durability, and reducing treatment-related toxicity through biomarker-based patient selection and tailored therapeutic strategies. Full article

Background: Bethesda III and IV thyroid nodules, which fall under the category of indeterminate cytology, pose challenges in clinical decision-making due to their ambiguous risk of malignancy. Molecular testing has been increasingly employed to aid risk stratification and optimize the extent of surgical intervention. Methods: A retrospective review of 410 patients with Bethesda III and IV thyroid nodules who underwent thyroid surgery at McGill University teaching hospitals between January 2016 and April 2022. Patients were grouped based on whether or not they underwent preoperative molecular testing. Data were collected on demographic variables, histopathologic diagnosis, mutation profiles, and surgical outcomes. The primary outcome was to assess for concordance between surgical intervention and final pathology in both groups, with a focus on identifying optimal versus suboptimal management. Optimal management is defined as surgery appropriate to the aggressiveness of disease, meaning a hemi-thyroidectomy for a non-aggressive malignancy, total thyroidectomy for an aggressive malignancy, and no surgery for a benign nodule. Furthermore, suboptimal management includes unnecessary surgery or incorrect surgery for the level of aggressivity of the nodule. Results: Among the 410 patients, 203 underwent molecular testing, while 207 did not. Of those who underwent molecular testing, 117 had Bethesda III nodules and 86 had Bethesda IV nodules. In the non-tested group, 129 and 78 patients had Bethesda III and IV nodules, respectively. Optimal surgical intervention was achieved in 67.5% of patients who underwent molecular testing, compared with 25.1% in those who did not (p < 0.001). Subgroup analysis revealed that 61.5% of Bethesda III nodules with molecular testing received optimal care versus 21.0% of those without testing. In the Bethesda IV cohort, optimal surgery was achieved in 75.6% with testing versus 32.1% without. Among the suboptimally managed patients, 70.1% (155/221) were from the group that did not undergo molecular testing. In addition, molecular testing identified aggressive mutations such as BRAF V600E and TERT promoter mutations more frequently in Bethesda III nodules, while RAS-like mutations, associated with indolent behavior, predominated in Bethesda IV nodules. Conclusions: In this study, molecular testing significantly improved risk stratification and the likelihood of optimal surgical management in patients with Bethesda III and IV thyroid nodules. Incorporating molecular diagnostics into the standard preoperative workflow may enhance patient care, reduce unnecessary surgeries, and optimize the extent of surgery. Future studies should evaluate the cost-effectiveness and broader implementation of molecular testing in diverse healthcare settings. Full article

Spread Through Air Spaces (STAS) is an emerging pattern of tumor invasion in lung cancer, first recognized by the World Health Organization in 2015. This narrative review examines STAS from a multidisciplinary perspective, integrating pathologic, radiologic, oncologic, and surgical points of view, together with molecular biology to assess its clinical significance, diagnostic challenges, and therapeutic implications. Pathologically, STAS is characterized by tumor cells floating beyond the main tumor, contributing to recurrence and poor prognosis. Radiologic advancements suggest potential imaging markers for STAS, such as spiculation, the absence of an air bronchogram, solid tumor components, as well as high fluorodeoxyglucose uptake, though definitive preoperative identification remains challenging. Oncologic studies link STAS to aggressive tumor behavior and lympho-vascular invasion, suggesting a role for adjuvant chemotherapy even in the earliest stages of disease; furthermore, specific molecular alterations have been discovered, including EGFR wild-type status and ALK/ROS1 rearrangements together with high Ki-67 expression, tumor necrosis, and alterations in cell adhesion proteins like E-cadherin. Surgical aspects highlight the increased risk of recurrence following limited resection, raising concerns about optimal surgical strategies. The debate over STAS as a true invasion mechanism versus an artifact from surgical handling underscores the need for standardized pathological evaluation. This review aims to refine STAS detection, integrate it into multidisciplinary treatment decision-making, and assess its potential as a staging criterion in lung cancer management. Full article

This study focuses on the susceptibility and surface degradation of low-alloy carbon steel 42CrMo4 to corrosion and cavitation erosion, as this steel is widely used in marine environments with aggressive chemical species and harsh conditions. Due to its high strength and fatigue resistance, 42CrMo4 steel is often employed in offshore mechanical components such as shafts and fasteners as well as crane parts in ports and harbors. Various experimental methods, including corrosion and cavitation tests, were used to assess the steel’s surface integrity under extreme conditions. Surface changes were monitored using modern analytical tools for precise assessments, including image and morphological analyses, to quantify degradation levels and specific parameters of defects induced by corrosion and cavitation. Non-destructive techniques such as optical microscopy (OM), scanning electron microscopy (SEM), energy-dispersive spectroscopy (EDS), and image analysis software were employed for the quantitative assessment of morphological parameters and elemental analysis. EDS analysis revealed changes in elemental composition, indicating corrosion products that caused significant mass loss and defect formation, with degradation increasing over time. The average corrosion rate of 42CrMo4 steel in a 3.5% NaCl solution reached a peak value of 0.846 mm/year after 120 days of exposure. Cavitation erosion behavior was measured based on mass loss, indicating the occurrence of different cavitation periods, with the steady-state period achieved after 60 min. The number of formed pits increased until 120 min, after which it decreased slightly. This indicates that a time frame of 120 min was identified as significant for changes in the mechanism of pit formation. Specifically, up to 120 min, pit formation was the dominant mechanism of cavitation erosion, while after that, as the number of pits slightly declined, the growth and merging of formed pits became the dominant mechanism. The cavitation erosion tests showed mass loss and mechanical damage, characterized by the formation of pits and cavities. The findings indicate that the levels of surface degradation were higher for corrosion than for cavitation. The presented approach also provides an assessment of the degradation mechanisms of 42CrMo4 steel exposed to corrosive and cavitation conditions. Full article

Glioblastoma is the most aggressive and treatment-resistant form of primary brain tumors, characterized by rapid invasion and a poor prognosis. Its complex behavior continues to challenge both clinical interventions and research efforts. Mathematical modeling provides a valuable approach to unraveling a tumor’s spatiotemporal dynamics and supporting the development of more effective therapies. In this study, we built on the existing literature by refining and adapting mathematical models to better capture glioblastoma infiltration, using a partial differential equation (PDE) framework to simulate how cancer cell density evolves across both time and space. In particular, the role of cell diffusion and growth in tumor progression and their limitations due to cell crowding and competition were investigated. Experimental data of glioblastoma taken from the literature were exploited for the identification of the model parameters. The improved data reproduction when the limitations of cell diffusion and growth were taken into account proves the relevant impact of the considered mechanisms on the spread of the tumor population, which underscores the potential of the proposed framework. Full article

The peroxisome proliferator-activated receptors (PPAR-α, PPAR-δ, and PPAR-γ) are transcription factors that belong to the nuclear hormone receptor superfamily. Upon activation by specific lipids, they regulate gene expression by directly binding to PPAR response elements (PPREs) in the DNA. Although the functions of the different PPARs are specific to the isoform, tissue, and context, all three PPARs are generally involved in energy homeostasis through lipid sensing in physiological conditions. Importantly, there is increasing evidence linking PPARs with malignant behavior in cancer, regulating features frequently attributed to the aggressive subpopulation of cancer stem cells (CSCs): self-renewal, tumor initiation, chemoresistance, metastasis, and immune evasion. However, contradictory effects have been described for each isoform in various cancer types, and their implication in these malignant features may not consistently follow a pro- or anti-tumoral pattern. In this review, we revise the current knowledge on the role of the PPAR family members in cancer, with a special focus on cancer stemness, and discuss the potential for PPARs as therapeutic targets in CSC-driven relapse and resistance. Full article

This work investigates and compare the corrosion behavior in artificial saliva of oxide thin films grown on commercially pure titanium (cp-Ti), via electrochemical oxidation (EO) in sulphate bath at 1 V and thermal treatment (TT) at 450 °C, for durations between 20 min and 4 h. The ultimate goal is to determine which method and duration provide the optimal protection for titanium against degradation in dental environment particularly in varying fluoride concentration and acidity. Surface characterizations were performed through morphological and microstructural analysis using scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDS) and X-ray diffraction (XRD). Electrochemical behavior was conducted in Fusayama-Meyer solution (pH = 6.50 and T = 37 °C) using potentiodynamic polarization curve (PPC) and electrochemical impedance spectroscopy (EIS), under varying pH and fluoride ion concentrations. The results demonstrated that a 3-h duration treatment provided the optimal corrosion resistance for both EO and TT processes. The pH of the environment influenced corrosion performance markedly: both acidic (pH 2.5) and basic (pH 9.0) conditions increased I_corr and decreased R_p, indicating degradation of the passive oxide layer outside neutral conditions. Similarly, increasing fluoride concentrations (1000; 5000; and 12,300 ppm) significantly impaired corrosion resistance. At 12,300 ppm F⁻, untreated Ti showed severe degradation, with EIS revealing the formation of a porous outer layer and a weakened inner barrier layer (R_f = 33 W·cm² for the outer layer and R_ct = 21 kW·cm² for the barrier layer). In contrast, the TT-treated surface remained highly protective even under these aggressive conditions, with minimal surface damage and the highest resistances for both the outer and the inner layers (R_f = 1610 kW·cm²; R_ct = 1583 kW·cm²), significantly outperforming the EO film. These findings highlight the superior performance of thermal oxidation at 450 °C for 3 h as a promising surface treatment for enhancing the corrosion resistance of titanium in fluoride-rich oral environments. Understanding these strategies helps improve the longevity and security of titanium dental implants. Full article

The emergence or mutation of aggressive viruses represents a latent threat to human health that could lead to new pandemics, so it is important to constantly monitor and analyze the behavior of the diseases they can cause. In this sense, the purpose of this work was to generate models to predict the behavior of recoveries and deaths from COVID-19 in Mexico in the post-pandemic era, applying machine learning techniques to data related to this disease, published by the Mexican government. Models based on artificial neural networks, logistic regression, and classification algorithms were generated and validated, yielding high rates of correct classification, accuracy, and recall, so that they could be used to make predictions about future cases of patients infected with the SARS-CoV-2 virus. Full article

Background/Objectives: Colorectal neuroendocrine carcinomas (NECs) are rare, aggressive tumors with poorly defined clinicopathologic and molecular features. Their biological behavior and optimal treatment strategies remain unclear. Additionally, a subset of anorectal NECs may be associated with high-risk human papillomavirus (HPV) infection, suggesting potential heterogeneity in pathogenesis. Methods: We retrospectively reviewed 12 cases of colorectal NECs. Clinical outcomes, histologic morphology, immunohistochemistry, molecular profiling, including common oncogenic mutations, and HPV status were analyzed. Results: Seven cases demonstrated small cell NECs, and five showed large cell NECs. The majority of NECs (n = 9) arose in the rectum. TP53 mutations were the most common (75%), followed by KRAS, RB1, FBXW7, and BRAF mutations. One case demonstrated mismatch repair (MMR) deficiency. High-risk HPV was detected in one rectal NEC, which lacked common oncogenic mutations and was the only long-term survivor (54 months). p16 expression did not correlate consistently with HPV in situ hybridization (ISH) status. Among small cell NECs with follow-up, platinum-based chemotherapy resulted in significantly longer survival than FOLFOX (13.5 vs. 4 months, p = 0.0209). Conclusions: Colorectal NECs display histologic and molecular heterogeneity. The tumors of small cell NECs potentially benefit more from platinum-based chemotherapy. HPV-associated NECs may represent a distinct subset with better prognosis, but p16 is not a reliable surrogate marker. Routine subclassification into small vs. large cell types and comprehensive molecular profiling, including HPV testing, may aid clinical decision-making and prognostication. Full article

Background: Pancreatic ductal adenocarcinoma (PDAC) is characterized by its aggressive clinical behavior and intricate microenvironment regulation, leading to dismal prognosis. Elucidating the molecular mechanisms underlying PDAC pathogenesis is crucial for developing improved therapeutic approaches. The functional significance and molecular basis of transcobalamin 1 (TCN1) in PDAC remain largely unexplored. Methods and Results: Through integrated analysis of TCGA and GTEx datasets combined with 80 clinical specimens, we identified significant TCN1 overexpression in PDAC, showing a positive association with tumor stage and negative associations with histological differentiation and overall survival. Functional investigations showed that TCN1 enhanced pancreatic cancer cell proliferation, migration, invasion, and epithelial–mesenchymal transition (EMT) in both in vitro and in vivo models. Mechanistically, TCN1 physically interacts with signal transducer and activator of transcription 4 (STAT4) to enhance its transcriptional activity. Chromatin immunoprecipitation (ChIP) assays showed that STAT4-mediated transcriptional activation of dual oxidase 2 (DUOX2) occurs through direct promoter binding. As a pivotal reactive oxygen species (ROS)-generating enzyme, DUOX2 overexpression elevates intracellular ROS levels, thereby promoting EMT progression and activating proliferation-related signaling cascades. Antioxidant treatment effectively abrogated TCN1-driven oncogenic phenotypes, establishing ROS as the critical downstream mediator. Conclusions: Collectively, our findings reveal a novel TCN1/STAT4/DUOX2 regulatory axis that exacerbates PDAC progression by remodeling redox homeostasis. This signaling cascade may serve as a prognostic biomarker and a potential therapeutic target for ROS-directed precision therapy in PDAC. Full article