Search Results (9,251)

Objectives: Early death after trauma has been described several times. Little is known about it after traumatic brain injury (TBI) and decompressive craniectomy (DC). The aim of this study was to characterize patients who die after a TBI and DC during their in-hospital stay. Methods: In a subgroup analysis of a retrospective, multicenter, and observational study, non-survivors from in-hospital stays treated for severe TBI and DC were included. Propensity score matching (PSM) was used. Results: A total of 223 patients with severe TBI were treated with DC, and there were 65 (29.1%) patients who did not survive. Of these, 22 (33.8%) died within the first 24 h. Non-survivors were older (p = 0.010), and pupillomotor dysfunction and a higher heart rate on admission were more common (p < 0.001). PSM patients for overall survival (41, 18.4%) differed in mean heart rate from the deceased (p = 0.030). In a multivariate model, age (OR: 1.045, p = 0.013, CI95%: 1.010 to 1.082), Quick value (OR: 0.965, p = 0.049, CI95%: 0.931 to 1.000), and heart rate (OR: 1.099, p = 0.030, CI95%: 1.009 to 1.197) were confirmed as predictive factors. Conclusions: Even after DC, known factors, such as chronological age and comorbidities, have a significant influence on mortality. The value of DC in an aging society for a particular severity of TBI should be further assessed on the basis of prospective studies. Full article

Colorectal cancer (CRC) constitutes a major global health concern, ranking as the third most common cancer and the second leading cause of cancer-related mortality. The current review explores sex-based differences in CRC epidemiology, risk factors, tumor biology, and clinical outcomes. Males exhibit a higher incidence and mortality rate, with left-sided (distal) CRC predominating, while females are more frequently diagnosed with right-sided (proximal) tumors, which tend to be more aggressive and less responsive to conventional chemotherapy. Genetic disparities, including microsatellite instability and X-chromosome tumor suppressor genes, contribute to sex-specific differences in tumor progression and treatment response. Immune variations also influence disease outcomes, with females exhibiting stronger immune surveillance but higher exhaustion markers. Lifestyle factors such as body mass index (BMI), smoking, and hormonal influences further modulate CRC risk. While males are more vulnerable to obesity-related CRC, central obesity (waist-to-hip ratio) emerges as a stronger predictor in females. Additionally, smoking increases CRC risk differentially by tumor location. These findings underscore the importance of sex-specific approaches in CRC prevention, screening, and treatment, advocating for personalized medicine strategies tailored to gender-based biological and clinical distinctions. Full article

Background/Objectives: Lateral patellar dislocation (LPD) is a common pathology of the adolescent knee and a major predisposing factor for patellofemoral instability (PFI). The pathogenesis of PFI involves a combination of anatomical and biomechanical contributors, with increasing evidence pointing to sex-specific differences in knee morphology. Despite this, the developmental course of these parameters and their variation between sexes remain insufficiently characterized. This study aims to investigate sex-related differences in patellofemoral joint geometry among skeletally immature patients with a history of PFI, focusing on how these anatomical variations evolve with increasing knee size, as represented by femoral condylar width. Methods: A total of 315 knee MRIs from patients under 18 years with documented PFI were retrospectively analyzed. Trochlear morphology, patellar tilt, axial positioning, and sagittal alignment were assessed using established MRI-based parameters. All measurements were normalized to bicondylar width to account for individual knee size. Sex-specific comparisons were performed using independent t-tests and linear regression analysis. Results: Females exhibited significantly smaller femoral widths, shallower trochlear depth (TD), shorter tibial tubercle–posterior cruciate ligament (TTPCL) distances, and lower patellar trochlear index (PTI) values compared to males (p < 0.05). In males, increasing femoral width was associated with progressive normalization of patellar tilt and sagittal alignment parameters. In contrast, these alignment parameters in females remained largely unchanged or worsened across different femoral sizes. Additionally, patellar inclination angle and PTI were significantly influenced by knee size in males (p < 0.05), whereas no such relationship was identified in females. Conclusions: Sex-specific morphological differences in patellofemoral geometry are evident early in development and evolve distinctly with growth. These differences may contribute to the higher prevalence of PFI in females and underscore the importance of considering sex and knee size in anatomical assessments. Full article

Background: Breast cancer is the most prevalent malignancy among women globally. In Romania, it is the most frequent form of cancer affecting women, with approximately 12,000 new cases diagnosed annually, and the second most common cause of cancer-related mortality, second only to lung cancer. Methods: This study looked at 79 breast cancer patients from Oltenia, concentrating on epidemiology, histology, diagnostic features, and treatments. Patients were chosen based on inclusion criteria such as histopathologically verified diagnosis, availability of clinical and treatment data, and follow-up information. The analyzed biological material consisted of tissue samples taken from the breast parenchyma and axillary lymph nodes. Even though not the primary subject of this paper, all patients underwent immunohistochemical (IHC) evaluation both preoperatively and postoperatively. Results: We found invasive ductal carcinoma to be the predominant type, while ductal carcinoma in situ (DCIS) and mixed types were rare. We performed cross-tabulations of metastasis versus nodal status and age versus therapy type; none reached significance (all p > 0.05), suggesting observed differences were likely due to chance. A chi-square test comparing surgical interventions (breast-conserving vs. mastectomy) in patients who did or did not receive chemotherapy showed, χ² = 3.17, p = 0.367, indicating that chemotherapy did not significantly influence surgical choice. Importantly, adjuvant chemotherapy and radiotherapy were used at similar rates across age groups, whereas neoadjuvant hormonal (endocrine) therapy was more common in older patients (but without statistical significance). Conclusions: Finally, we discussed the consequences of individualized care and early detection. Romania’s shockingly low screening rate, which contributes to delayed diagnosis, emphasizes the importance of improved population medical examination and tailored treatment options. Also, the country has one of the lowest rates of mammography uptake in Europe and no systematic population screening program. Full article

Background: Eating disorders (EDs) and self-harm (SH) are both associated with distress, poor psychosocial functioning, and increased risk of mortality. Much of the literature discusses the complex interplay between SH and ED behaviours where co-occurrence is common. The onset of both is typically seen during teenage years into early adulthood. A better understanding of the functions of these behaviours is needed to guide effective prevention and treatment, particularly during the crucial developmental years. An earlier review has explored the functions of self-harm, but an equivalent review for eating disorder behaviours does not appear to have been completed. Objectives: This evidence synthesis had two objectives. First, to identify and synthesise published first-hand accounts of the reasons why people engage in eating disorder behaviours with the view to develop a broad theoretical framework of functions. Second, to draw comparisons between the functions of eating disorder behaviours and self-harm. Methods: A qualitative evidence synthesis reporting first-hand accounts of the reasons for engaging in eating disorder behaviours. A ‘best fit’ framework synthesis, using the a priori framework from the review of self-harm functions, was undertaken with thematic analysis to categorise responses. Results: Following a systematic search and rigorous screening process, 144 studies were included in the final review. The most commonly reported functions of eating disorder behaviours were distress management (affect regulation) and interpersonal influence. This review identified significant overlap in functions between self-harm and eating disorder behaviours. Gender identity, responding to food insecurity, to delay growing up and responding to weight, shape, and body ideals were identified as functions more salient to eating disorder behaviours. Similarly, some self-harm functions were not identified in the eating disorder literature. These were experimenting, averting suicide, personal language, and exploring/maintaining boundaries. Conclusions: This evidence synthesis identified a prominent overlap between psychological functions of eating disorder behaviours and self-harm, specifically in relation to distress management (affect regulation). Despite clear overlap in certain areas, some functions were found to be distinct to each behaviour. The implications for delivering and adapting targeted interventions are discussed. Full article

With the global economic restructuring and the consequent population mobility, urban shrinkage has become a common phenomenon. The Qinling–Daba Mountains, a zone with a key ecological function in China, have long experienced population decline and functional degradation. Clarifying the dynamics and influencing factors of urban shrinkage plays a vital role in supporting the sustainable development of the region. This study, using permanent resident population growth rates and nighttime light data, classified cities in the region into four spatial patterns: expansion–growth, intensive growth, expansion–shrinkage, and intensive shrinkage. It further examined the spatial characteristics of shrinkage across four periods (2005–2010, 2010–2015, 2015–2020, and 2020–2022). A Geographically and Temporally Weighted Regression (GTWR) model was applied to examine core influencing factors and their spatiotemporal heterogeneity. The results indicated the following: (1) The dominant pattern of urban shrinkage in the Qinling–Daba Mountains shifted from expansion–growth to expansion–shrinkage, highlighting the paradox of population decline alongside continued spatial expansion. (2) Three critical indicators significantly influenced urban shrinkage: the number of students enrolled in general secondary schools (X₅), the per capita disposable income of urban residents (X₇), and the number of commercial and residential service facilities (X₁₂), with their effects exhibiting significant spatiotemporal heterogeneity. Temporally, X₁₂ was the most influential factor in 2005 and 2010, while in 2015, 2020, and 2022, X₅ and X₇ became the dominant factors. Spatially, X₇ significantly affected both eastern and western areas; X₅’s influence was most pronounced in the west; and X₁₂ had the greatest impact in the east. This study explored the patterns and underlying drivers of urban shrinkage in underdeveloped areas, aiming to inform sustainable development practices in regions facing comparable challenges. Full article

Most academic papers on Jordanian colloquial Arabic allophonic consonant variants have primarily examined their influence on the social status of speakers and their role in shaping linguistic prestige. However, there is a significant lack of research exploring the potential for manipulation and establishment of power through the deliberate use of consonantal variants by Jordanian speakers in Arabic. Using a variety of allophonic consonantal variants, this study investigates how speakers of Jordanian colloquial Arabic attempt to construct their discourse of power. The targeted phonemes in the current study were /q/, /θ/, /ð/, and /k/. Focus groups were used to gather data, which were then examined within the framework of Fairclough’s technologized discourse and thematic approaches. Twenty persons, 10 women and 10 men, ranging in age from 18 to 45 years, comprised each of the two groups. The duration of each focus group session was 50 min. Analysis of the data indicates that the presence of [q], [θ], [ð], and [k] allophones in Standard Arabic is restricted to particular social circumstances, such as official and scientific environments. This usage is a common trait among those who have received formal education and privileged social standing. The findings also reveal that participants strategically utilize the allophonic variants [g], [ʔ], [k], [t̪], [d̪], and [tʃ] to exert influence over interlocutors by demonstrating authority related to social identity, gender, and emotional state. This study intends to advance discussions on allophonic consonant variants in Jordanian colloquial Arabic by providing insights into their manipulative functions. Full article

Brain metastases are a common and deadly complication of many primary tumors. The progression of these tumors is poorly understood, and treatment options are limited. Two important components of tumor growth are hypoxia and angiogenesis. We conducted a review to look at the possibility of a symbiotic relationship between two transcription factors, Hypoxia-Inducible Factor 1α (HIF1α) and Vascular Endothelial Growth Factor (VEGF), and the role they play in metastasis to the brain. We delve further into this possible relationship by examining commonly used chemotherapeutic agents and their targets. Through an extensive literature review, we identified articles that provided evidence of a strong connection between these transcription factors and the growth of brain metastases, many highlighting a symbiotic relationship. Further supporting this, combinations of chemotherapeutic drugs with varying targets have increased the efficacy of treatment. Angiogenesis and hypoxia have long been known to play a large role in the invasion, growth, and poor outcomes of tumors. However, it is not fully understood how these factors influence one another during metastases. While prior studies have investigated the effects separately, we specifically delve into the synergistic and compounding effects that may exist between them. Our findings underscore the need for greater research allocation to investigate the possible symbiotic relationship between angiogenesis and hypoxia in brain metastasis. Full article

In the era of digital intelligence, digital media landscapes increasingly influence cultural tourism consumption. Consumerism capitalizes on tourists’ superficial aesthetic commonalities, constructing a homogenized media imagination that leads to collective convergence in travel decisions, which obscures aspects of local culture, poses safety risks, and results in fleeting local tourism booms. In this study, semistructured interviews were conducted with 36 tourists, and NVivo12.0 was used for three-level node coding in a qualitative analysis to explore the digital media attributions of conformist travel behavior. The findings indicate that digital media landscapes exert a “digital persuasion” effect by reconstructing self-experience models, directing the individual gaze, and projecting idealized self-images. These mechanisms drive tourists to follow digital traffic trends and engage in imitative behaviors, ultimately shaping the phenomenon of “group roaming”, grounded in the psychological effect of herd behavior. Full article

This study investigates indoor and outdoor air quality monitoring in a student dormitory located in northern Milan (Italy) using low-cost sensors. This research compares two monitoring periods in June and October 2024 to examine common PM_2.5 vertical patterns and differences at the building level, as well as their influence on the indoor spaces at the corresponding positions. In each period, around 30 sensors were installed at various heights and orientations across indoor and outdoor spots for 2 weeks to capture spatial variations around the building. Meanwhile, qualitative surveys on occupation presence, satisfaction, and well-being were distributed in selected rooms. The analysis of PM_2.5 data reveals that the building’s lower floors tended to have slightly higher outdoor PM_2.5 concentrations, while the upper floors generally had lower PM_2.5 indoor/outdoor (I/O) ratios, with the top-floor rooms often below 1. High outdoor humidity reduced PM infiltration, but when outdoor PM fell below 20 µg/m³ in these two periods, indoor sources became dominant, especially on the lower floors. Air pressure I/O differences had minimal impact on PM_2.5 I/O ratios, though slightly positive indoor pressure might help prevent indoor PM infiltration. Lower ventilation in Period-2 possibly contributed to more reported symptoms, especially in rooms with higher PM from shared kitchens. While outdoor air quality affects IAQ, occupant behavior—especially window opening and ventilation management—remains crucial in minimizing indoor pollutants. Users can also manage exposure by ventilating at night based on comfort and avoiding periods of high outdoor PM. Full article

Funka Bay, located in southwest Hokkaido, is a vital fishing area with a shallow depth of less than 100 m. Seasonal flows of the Oyashio and Tsugaru Warm Current affect the marine environment, leading to significant changes in zooplankton communities, yet limited information is available on these variations. This study used ZooScan imaging to analyze seasonal and interannual changes in zooplankton abundance, biovolume, community structure, and size composition from 2019 to 2023. Water temperature was low in March–April and high in September–November, with chlorophyll a peaks occurring from February to April. Notable taxa such as Thaliacea, Noctiluca, and cladocerans were more common in the latter half of the year. Interannual variations included a decline in large cold-water copepods, Eucalanus bungii and Neocalanus spp., which were abundant in 2019 but decreased by 2023. Zooplankton abundance and biovolume showed synchronized seasonal changes, correlating with shifts in the Normalized Biovolume Size Spectra (NBSS) index, which measures size composition. Cluster analysis identified eight zooplankton communities, with Community A dominant from July to December across all years, while Community D was prevalent in early 2019 but was replaced in subsequent years. Community E emerged from March to April in 2021–2023. In 2019, large cold-water copepods were dominant, but from 2020 to 2023, appendicularians became the dominant group during the March–April period. The decline in large copepods is likely linked to marine heat waves, influencing yearly zooplankton community changes. Full article

Nuclear receptors are involved in multiple biological processes, among which RORγ can regulate the expression of inflammation-related genes and is thus frequently used as a therapeutic target for cancer. Canine mammary cancer is one of the most common tumor diseases in dogs, with a relative incidence rate of 46.71% for CMT in China over the past five years, severely threatening the life and health of dogs. Therefore, the search for novel drugs targeting canine mammary cancer is of great significance. This study aims to investigate how the RORγ inhibitors W6134 and XY018 affect the expression of inflammatory genes through histone modifications in CMT-N7 cells. These results show that W6134 and XY018 can upregulate signaling pathways related to inflammation and apoptosis and influence the expression of associated genes. The close link between RORγ and inflammation-related genes further confirms that RORγ may serve as a therapeutic target for canine cancer. Additionally, ChIP-qPCR was used to detect the enrichment of histone markers such as P300, H3K27ac, H3K4me1, H3K9la, and H3K9bhb at the target loci of CXCL10 and MECOM genes. Collectively, our findings provide molecular evidence for the protective role of RORγ in canine mammary cancer, potentially by regulating inflammatory pathways via histone modifications, offering new insights for improving the cure rate and survival of affected dogs. Full article

Skin dullness contributes to a fatigued and aged appearance, often exceeding one’s biological age. It is a common dermatological concern influenced by aging and poor lifestyle habits, regardless of ethnicity or age. This study aimed to examine advanced glycation end products (AGEs) and their receptor (receptor for AGEs [RAGE]) as contributing factors to skin dullness. AGEs themselves have a yellowish hue, contributing to “yellow dullness.” Additionally, AGE–RAGE signaling promotes melanin production in melanocytes and impairs keratinocyte differentiation as a result of inflammation. Therefore, regulating the AGE–RAGE interaction may help reduce skin dullness. Through screening various natural ingredients, we found that peony root extract (PRE) inhibits AGE formation and blocks AGE–RAGE binding. Furthermore, the presence of PRE leads to the suppression of AGE-induced melanin production in melanocytes and the restoration of impaired keratinocyte differentiation in glycated basement membrane components. In a human clinical study, topical application of a 1% PRE-containing lotion for 2 weeks significantly reduced melanin content, with a trend toward decreased AGE accumulation and visible spots on the cheeks. These findings support the potential of PRE as a multifunctional cosmetic ingredient that comprehensively addresses skin dullness by modulating the AGE–RAGE interaction. Full article

Schizophrenia (SZ) is a complex neuropsychiatric disorder characterized by heterogeneous symptoms, relatively poor clinical outcome, and widespread disruptions in neural connectivity and oscillatory dynamics. This article attempts to review current evidence linking genomic and proteomic alterations with aberrant neural oscillations observed in SZ, including aberrations in all oscillatory frequency bands obtained via human EEG. The numerous genes discussed are mainly involved in modulating synaptic transmission, synaptic function, interneuron excitability, and excitation/inhibition balance, thereby influencing the generation and synchronization of neural oscillations at specific frequency bands (e.g., gamma frequency band) critical for different cognitive, emotional, and perceptual processes in humans. The review highlights how polygenic influences and gene–circuit interactions underlie the neural oscillatory and connectivity abnormalities central to SZ pathophysiology, providing a framework for future research on common genetic-neural function interactions and on potential therapeutic interventions targeting local and global network-level neural dysfunction in SZ patients. As will be discussed, many of these genes affecting neural oscillations in SZ also affect other neurological disorders, ranging from autism to epilepsy. In time, it is hoped that future research will show why the same genetic anomaly leads to one illness in one person and to another illness in a different person. Full article

This paper examines the changing role of emissions trading systems (ETSs) within the macro-financial framework of energy markets, emphasizing price dynamics and systemic spillovers. Utilizing monthly data from seven ETS jurisdictions spanning January 2021 to December 2024 (N = 287 observations after log transformation and first differencing), which includes four auction-based markets (United States, Canada, United Kingdom, South Korea), two secondary markets (China, New Zealand), and a government-set fixed-price scheme (Germany), this research estimates a panel vector autoregression (PVAR) employing a Common Correlated Effects (CCE) model and augments it with machine learning analysis utilizing XGBoost and explainable AI methodologies. The PVAR-CEE reveals numerous unexpected findings related to carbon markets: ETS returns exhibit persistence with an autoregressive coefficient of −0.137 after a four-month lag, while increasing inflation results in rising ETS after the same period. Furthermore, ETSs generate spillover effects in the real economy, as elevated ETSs today forecast a 0.125-point reduction in unemployment one month later and a 0.0173 increase in inflation after two months. Impulse response analysis indicates that exogenous shocks, including Brent oil prices, policy uncertainty, and financial volatility, are swiftly assimilated by ETS pricing, with effects dissipating completely within three to eight months. XGBoost models ascertain that policy uncertainty and Brent oil prices are the most significant predictors of one-month-ahead ETSs, whereas ESG factors are relevant only beyond certain thresholds and in conditions of low policy uncertainty. These findings establish ETS markets as dynamic transmitters of macroeconomic signals, influencing energy management, labor changes, and sustainable finance under carbon pricing frameworks. Full article