Search Results (219)

Type 2 diabetes mellitus (T2DM) represents a growing public health concern in Indigenous populations, where early risk identification remains limited. This study aimed to analyze the association between estimated T2DM risk and cardiorespiratory endurance in a Zenú Indigenous community in northern Colombia. A cross-sectional study was conducted among adults aged 18–70 years belonging to the Momil Urban Minor Indigenous Cabildo (Córdoba, Colombia). T2DM risk was assessed using the Finnish Diabetes Risk Score (FINDRISC), and cardiorespiratory endurance was evaluated through the Ruffier index. Associations were examined using a multivariable ordinal logistic regression model, and discriminative performance was evaluated using receiver operating characteristic (ROC) curve analysis. A total of 95 participants were included, most of whom were classified as low risk according to FINDRISC, while cardiorespiratory endurance assessed by the Ruffier index was predominantly classified as moderate to good. Age was significantly associated with higher risk categories in the adjusted model, whereas cardiorespiratory endurance was not significantly associated with estimated T2DM risk. The model demonstrated excellent discriminative capacity (AUC = 0.912; 95% CI: 0.850–0.973). In this population, age and family history were key determinants of estimated T2DM risk. Findings regarding cardiorespiratory endurance should be interpreted cautiously given sample size limitations. Full article

Background/Objectives: Postoperative pulmonary complications (PPCs) significantly contribute to surgical morbidity, mortality, and healthcare costs, yet their definition remains heterogeneous in clinical literature. We aimed to develop and apply a standardized system for defining and measuring PPCs and their severity among a general, low-risk surgical population. Methods: A retrospective, observational design evaluated data from 95,808 adult patients undergoing elective surgery with general anesthesia between 2015 and 2023 at a large tertiary medical center. PPCs were identified using a curated list of ICD-10 codes based on the StEP-COMPAC consensus and were categorized into mild, moderate, or severe based on the intensity of postoperative oxygen delivery. Multivariable logistic and ordinal regression models were utilized to identify risk factors for the occurrence and clinical severity of PPCs. Results: The overall incidence of PPCs was 7.52% (n = 7206), with mild cases accounting for the majority (5.65%), followed by moderate (1.47%), and severe (0.40%) cases. Key risk factors for PPCs included ASA class 3 or 4, OSA, COPD, increased case duration, and the use of home oxygen devices. Higher mean pre-operative oxygen saturation was identified as a protective factor against PPCs. Conclusions: A feasible and promising framework for standardizing PPC measurement using EHR data and interprofessional collaboration is presented for use in ongoing initiatives aimed at reducing rates of PPCs. Identified risk factors may serve as critical triggers for implementing perioperative strategies to mitigate complications in the general surgical population. Full article

Background/Objectives: Tinnitus is a prevalent auditory condition associated with significant psychological burden and limited treatment efficacy. While physical activity confers broad health benefits, its relationship with tinnitus remains understudied. This study examined associations between domain-specific physical activity and tinnitus in a nationally representative sample of U.S. adults. Methods: Data from NHANES 2015–2018 were analyzed. The final analytic sample comprised 4301 adults aged 20 years and older. Tinnitus was assessed via the NHANES audiometry questionnaire. Physical activity was categorized as low, moderate, and high (MET-min/week) separately for work-related (WORK) and non-work-related (NW) domains. Survey-weighted multivariable logistic regression models, adjusted for age, sex, race, BMI, poverty–income ratio, sedentary time, smoking, education, noise exposure, hypertension, diabetes, and depressive symptoms, were used to examine associations. Linear trends across ordered physical activity categories were evaluated using ordinal trend analyses. Results: The weighted prevalence of tinnitus was 17.3%. High NW physical activity (PA) was associated with significantly lower odds of tinnitus (OR = 0.70, 95% CI: 0.488–0.995, p = 0.0475), while high WORK PA was associated with significantly higher odds (OR = 1.30, 95% CI: 1.06–1.60, p = 0.018). Trend analyses confirmed opposing linear trends across ordered categories: inverse for NW PA (OR = 0.83 per category, p-trend = 0.0406) and positive for WORK PA (OR = 1.14 per category, p-trend = 0.017). Noise exposure and depressive symptoms were independently associated with tinnitus across both models. Conclusions: These findings suggest a domain-specific paradox: NW PA was associated with lower odds of tinnitus, whereas WORK PA was associated with higher odds. These results highlight the importance of domain-specific assessment and identify recreational activity as a potential modifiable factor warranting further investigation. Given the cross-sectional design, these associations should not be interpreted as causal. Full article

Background/Objectives: Short-term functional outcomes after outpatient pulmonary rehabilitation are heterogeneous. We examined whether a study-derived cardio-nutrition-inflammation-oxygen (CNIO) index integrating echocardiographic filling pressure, nutritional status, inflammation, and oxygen requirement was associated with 3-month functional outcomes in chronic respiratory disease. Methods: This single-center retrospective cohort study included 60 adults with chronic obstructive pulmonary disease, interstitial lung disease, or bronchiectasis who completed outpatient pulmonary rehabilitation and had baseline and 3-month functional assessments. The CNIO index was calculated as standardized E/e′ plus standardized ln(neutrophil-to-lymphocyte ratio) plus standardized resting oxygen flow rate minus standardized Geriatric Nutritional Risk Index, and the summed score was then standardized to mean 0 and SD 1. The primary outcome was 3-month 6 min walk test (6MWT) distance, and the exploratory secondary outcome was 3-month Short Physical Performance Battery (SPPB) score. The primary 6MWT analysis used multivariable analysis of covariance adjusted for baseline 6MWT, age, sex, body mass index, and diagnosis, whereas the exploratory SPPB analysis used ordinal logistic regression adjusted for baseline SPPB and the same covariates. Results: Mean 6MWT increased from 340.3 ± 61.0 m to 368.0 ± 102.0 m, corresponding to a mean change of 27.7 ± 90.3 m. Each 1-SD increase in CNIO was associated with a lower 3-month 6MWT distance (β = −43.42 m; 95% confidence interval [CI], −77.55 to −9.30; p = 0.014). In the exploratory ordinal logistic regression model for SPPB, each 1-SD increase in CNIO was associated with lower odds of being in a higher 3-month SPPB category, although the estimate was fragile and the confidence interval was close to the null (odds ratio = 0.39; 95% CI, 0.15 to 0.99; p = 0.048). Bootstrap internal stability analysis for the primary 6MWT model showed a wide percentile bootstrap 95% CI of −76.05 to −13.97 m per 1-SD increase in CNIO, supporting the need for cautious interpretation. Conclusions: In this hypothesis-generating derivation study, a higher standardized CNIO index was associated with lower 3-month 6MWT distance among adults with chronic respiratory disease who completed outpatient pulmonary rehabilitation. The association with SPPB was weaker and should be interpreted cautiously. These findings are not generalizable to patients who discontinue rehabilitation or are hospitalized for exacerbation during follow-up, and prospective external validation in larger, diagnostically stratified cohorts is required before CNIO can be considered for clinical risk stratification or rehabilitation planning. Full article

Background/Objectives: Effective communication between medical practices and community pharmacists is essential for safe and efficient outpatient care, yet quantitative evidence from the perspective of community pharmacies regarding the frequency, content, and efficiency of routine pharmacist–physician communication in Germany is limited. This study aimed to investigate, from the perspective of community pharmacies, the reasons for and outcomes of initiating contact with medical practices following the submission of patient prescriptions in routine outpatient care. Methods: In this observational study, 45 community pharmacies in Leipzig and the surrounding region (Germany) documented simultaneously all contacts with medical practices related to prescriptions over a 14-day period (November 2023) using a standardized documentation form. Data included reasons for contact, communication channels, number of contact attempts, outcomes, satisfaction ratings, and case duration. Multivariable linear regression was used to identify factors associated with satisfaction with contact outcomes, and ordinal regression to examine determinants of case duration. Results: In total, 498 documented contacts were analyzed. The most frequent reasons for contact were drug availability issues and formal or content-related prescription errors. Consultations related to drug interactions or contraindications were rare. Overall satisfaction with contact outcomes was high, but lower satisfaction was associated with repeated contact attempts, non-acceptance of pharmacists’ recommendations, and contacts related to formal prescription errors. Case resolution was faster when fewer contact attempts were required and when communicating with general practices rather than specialist practices. Conclusions: Pharmacy-initiated communication with medical practices in outpatient care is largely driven by administrative and logistical issues rather than clinical consultations. Improving prescription quality, enhancing transparency of drug availability, and strengthening efficient communication pathways may reduce workload and increase satisfaction. Full article

This study investigates the role of single nucleotide polymorphisms (SNPs) in the SNCA gene, encoding alpha-synuclein, in Alzheimer’s disease (AD). A case–control study was conducted including 95 AD patients and 97 healthy controls. Four SNCA polymorphisms (rs2583988, rs2619363, rs2619364, rs10005233) were analyzed using logistic regression, haplotype estimation, genotype combination analysis, and Random Forest modeling. Significant associations were identified for rs2583988, rs2619364, and rs2619363, while rs10005233 showed no association. The rs2583988 C allele and rs2619364 G allele were more frequent in patients, suggesting increased disease risk. Linkage disequilibrium analysis revealed weak correlations (low r²), indicating largely independent genetic effects. Multivariate logistic regression showed that clinical parameters, rather than genetic variants, were independently associated with AD. Multi-locus genotype analysis demonstrated that specific SNP combinations were linked to increased disease risk. Firth regression confirmed associations in low-frequency genotypes. The outcomes derived from the Random Forest methodology were classified as exploratory and not as proof of clinical predictive utility, attributed to the limited sample size, the absence of external validation, and the educational imbalance. Ordinal logistic regression indicated no association between SNCA variants and cognitive severity, while education had a protective effect. The selected SNCA variants showed exploratory associations with AD in this cohort; however, they failed to maintain their validity as independent predictors in multivariate logistic regression analysis. Before drawing any conclusions regarding screening or risk stratification, these findings require independent replication, correction for multiple testing and functional validation. Full article

Dog aggression toward humans represents a relevant public health issue. In Italy, small animal veterinarians are expected to contribute to the early identification of at-risk situations and to aggression prevention. This study aimed to assess, through a nationwide survey, veterinarians’ perception of this role, regulatory awareness, and clinical practices related to dog aggression prevention in Italy. A cross-sectional study was conducted between November 2025 and February 2026 using an anonymous online questionnaire disseminated through provincial veterinary boards to private veterinarians working in small animal practice. A total of 1088 valid responses were analyzed using descriptive, inferential, and multivariable analyses. Almost all respondents reported frequent encounters with aggressive behavior, with more than 60% managing at least five aggressive dogs per year. Although 80% recognized an active preventive role for veterinarians, only 55% were aware of the current Ministerial Ordinance and 19% had ever submitted a report to public veterinary services. Specific training in behavioral medicine was independently associated with greater regulatory awareness and reporting behavior. Strong support also emerged for mandatory owner training and early behavioral assessment. A substantial gap persists between the preventive role assigned to veterinarians and the practical implementation of preventive tools. These findings support the need for strengthened behavioral medicine training and improved integration between private practitioners and public veterinary services. Full article

The information available on cervical myelopathies (CMs) and cervical pain (CP) in non-chondrodystrophic breeds remains limited compared to chondrodystrophic breeds. The expression of CP in CMs may depend on lesion type, severity and onset of clinical signs. This retrospective single-centre study reviewed the medical records of 112 purebred non-chondrodystrophic dogs referred for neurological evaluation, in which C1-T2 lesions were subsequently confirmed by magnetic resonance imaging (MRI). Clinical onset was categorised as acute (≤7 days) or chronic (>7 days). Neurological grade was classified into four neurological groups (G1–G4). CP was graded using a study-specific, non-validated five-point ordinal clinical scale. Multifactorial analysis of variance (ANOVA), odds ratios with 95% confidence intervals, and multivariable binomial logistic regression were performed. ANOVA showed significant effects of group (p < 0.0001), disease category (p < 0.05), and clinical onset (p < 0.02) on CP scores. Post-hoc comparison showed significantly lower CP scores in chronic onset than in acute onset (p < 0.0001). Acute onset was associated with CP in G2 (OR = 71.0; p < 0.0002) and remained associated with CP after adjustment for groups (adjusted OR = 4.42; 95% CI: 1.28–15.28; p = 0.019). These findings suggest that clinical onset may contribute to CP expression in non-chondrodystrophic dogs with CMs. Acute onset, particularly in ambulatory myelopathic patients, appears more frequently associated with CP. However, due to the retrospective design, the heterogeneous diagnostic composition, and the study-specific nature of the CP score, these associations should be interpreted cautiously. Full article

Background/Objectives: Psoriasis (PsO) is a chronic immune-mediated disease associated with a substantial multidimensional burden extending beyond skin involvement. Sleep disturbance represents an important yet underexplored domain of patient-reported outcomes. This study aimed to investigate the relationship between PsO disease activity and sleep quality, focusing on specific sleep domains, and to evaluate whether disease severity independently predicts sleep latency and daytime dysfunction. Methods: We conducted a cross-sectional study including 136 consecutive patients with PsO from two Italian centers. Disease severity was assessed using the Psoriasis Area and Severity Index (PASI). Sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI), while quality of life was measured by the SF-36. Patients were stratified according to disease severity (PASI < 10 vs. ≥10). Associations between disease activity and sleep domains were analyzed using univariable and multivariable ordinal regression models adjusted for demographic and clinical variables. Results: The study population had predominantly low disease activity (median PASI 2). The median global PSQI score was 5, indicating overall borderline sleep impairment. Patients with PASI ≥ 10 showed significantly worse sleep latency (p = 0.01) and greater daytime dysfunction (p = 0.02), while no significant differences were observed in global PSQI scores. In multivariable analyses, PASI ≥ 10 remained independently associated with increased sleep latency (β = 0.95, 95% CI 0.08–1.82; p = 0.032) and daytime dysfunction (β = 2.52, 95% CI 1.31–3.73; p < 0.001), after adjustment for confounders. Conclusions: Higher PsO disease activity is independently associated with impairment in specific sleep domains, particularly sleep latency and daytime dysfunction, rather than global sleep quality. These findings highlight the importance of assessing domain-specific sleep disturbances and support the integration of sleep outcomes into a holistic, patient-centered approach to PsO management. Full article

Large language models (LLMs) are being increasingly explored to support clinical documentation, yet the influence of prompting architecture on documentation quality in complex longitudinal contexts remains insufficiently characterized. This controlled retrospective methodological study evaluated three prompting strategies—single prompt (SP), section-based prompt (SBP), and section-based prompt with writing refinement (SBP+W)—for generating inpatient rehabilitation discharge reports using OpenAI large language model (GPT-5.2). Twenty anonymized inpatient rehabilitation cases involving prolonged hospital stays and multidimensional functional documentation were processed under standardized model conditions. AI-generated reports were compared with human-authored summaries. Two blinded board-certified rehabilitation physicians independently evaluated outputs using a structured four-point ordinal scale assessing structural integrity, clinical coherence, completeness, and readability. Inter-rater reliability was estimated with quadratic weighted Cohen’s kappa and bootstrap confidence intervals. Group differences were analyzed using non-parametric testing and exploratory multivariable modeling. All LLM prompting strategies achieved significantly higher expert-rated quality scores than human-authored reports (p < 0.025). SBP demonstrated the highest median performance and strongest regression effect, although differences among LLM-based strategies were not statistically significant after correction. Prompting strategies explained more variability in expert ratings than case-level factors. Structured section-based prompting may represent a practical design lever for improving perceived quality in AI-assisted clinical documentation workflows. Larger prospective studies are needed to evaluate reliability, safety, clinical utility, and implementation in real-world workflows. Full article

Background: Iron deficiency (ID) progresses through three stages: iron deficiency stores (IDS), iron deficiency erythropoiesis (IDE), and iron deficiency anemia (IDA). Neglecting subclinical ID may be harmful to school-aged children and increase the public health burden. Although diet is a key modifiable factor, most studies only focus on overall ID or merely the clinical IDA stage. This study combines a dietary index with pattern analysis to take advantage of their complementary strengths and explore their associations with ID progression. Methods: This cross-sectional study included 2493 participants from rural Guangzhou between June 2022 and May 2023. Demographic, lifestyle, anthropometric, and dietary data were collected via structured questionnaires. Blood samples were analyzed for iron status. Factor analysis identified dietary patterns, and the Chinese Dietary Guidelines Index for Children and Adolescents [CDGI(2021)-C] assessed dietary quality. We used ordinal logistic regression, multivariable logistic regression, and restricted cubic spline (RCS) models to examine dietary associations with ID stages. Results: IDS, IDE, and IDA proportions were 68.22%, 17.45%, and 14.33%, respectively. All four dietary patterns correlated positively with CDGI(2021)-C, most strongly for the fruit–vegetable (r_s = 0.552) and cereal–tuber–legume patterns (r_s = 0.386). Higher CDGI(2021)-C (OR = 0.852, 95% CI: 0.751–0.966, p-trend = 0.012), fruit–vegetable (OR = 0.866, 95%CI: 0.748–0.993, p-trend = 0.047), and meat–offal patterns (OR = 0.733, 95%CI: 0.611–0.868, p-trend < 0.001) were inversely associated with advancing ID stages, while the snack–fast food pattern was positively associated (OR = 1.233, 95% CI: 1.094–1.381, p-trend < 0.001). In IDS, higher adherence to CDGI(2021)-C, fruit–vegetable, and meat–offal patterns was associated with lower odds (all p-trend < 0.05). RCS showed nonlinear associations for the snack–fast food and cereal–tuber–legume patterns, with risk peaking at moderate-to-high adherence to these patterns (both p-nonlinear < 0.05). In IDE and IDA, the snack–fast food pattern risk rose steeply at moderate-to-high adherence (p-nonlinear = 0.036), whereas the cereal–tuber–legume pattern’s ORs fluctuated near 1 (p-nonlinear = 0.020). Conclusions: Dietary pattern and index analyses showed consistent associations across ID stages. Adherence to dietary guidelines slows ID progression, especially in early subclinical stages. More fruits, vegetables, and heme-iron-rich foods, alongside less fast food and snacks, slow ID progression. Though dietary intervention effects weaken in later stages, reducing fast food and snacks confers long-term benefits. These findings inform targeted nutrition policies to prevent ID progression in children. Full article

Background: Deep medullary vein (DMV) drainage has been suggested as a new biomarker for predicting clinical outcomes in patients with acute ischemic stroke (AIS). We evaluated this hypothesis in patients who received endovascular treatment (EVT) within 24 h of symptom onset. Methods: We performed a retrospective study of consecutive AIS patients at a single institution treated with EVT achieving successful recanalization (final mTICI score ≥2b). DMV drainage was graded on a three-point scale (0-1-2) during the second peak venous phase of mCTA by assessing contrast filling, with grade 2 indicating a favorable DMV profile. Our primary outcomes were functional independence, defined as a modified Rankin Scale (mRS) score of 0–2 at 90 days, and ordinal mRS shift at 90 days. Secondary outcomes were excellent clinical status (mRS 0–1 at 90 days), hemorrhagic transformation, and symptomatic intracranial hemorrhage. We investigated independent associations using multivariable logistic and ordinal regression analyses as appropriate, adjusting for age, sex, baseline mRS, NIHSS at onset, occlusion site, intravenous thrombolysis, onset-to-CT time, and ASPECTS. Results: We included 506 patients; the mean age was 76 years. A favorable DMV profile was present in 394 (78%) patients. We found that DMV doubled the odds of achieving functional independence (OR = 2.22; 95% CI = 1.28–3.85) and was associated with a shift towards better functional outcomes in ordinal regression analysis (cOR = 1.93; 95% CI = 1.24–3.02), whereas we did not find any association between a favorable DMV profile and secondary outcomes. Conclusions: In AIS patients successfully recanalized with EVT, a favorable DMV profile was associated with better functional outcomes. Further investigations may clarify the clinical use and predictive ability of this novel radiological marker. Full article

Background: The extent of coronary artery disease (CAD) is a major determinant of prognosis in patients with myocardial infarction (MI). While structured exercise is known to be cardioprotective, the association between habitual daily physical activity and angiographic CAD extension remains insufficiently characterized. Methods: In this prospective observational study, 269 patients were hospitalized with acute MI underwent coronary angiography. Habitual daily physical activity during the four weeks preceding admission was assessed using 10-point self-reported daily preadmission effort questions to help the patients to report a final effort score. CAD extension was classified as single-, double- or triple-vessel disease. Differences in daily effort across CAD categories were evaluated using the Kruskal–Wallis test. Independent predictors of CAD extension were identified using ordinal logistic regression adjusted for age, sex, smoking, hypertension, diabetes mellitus, hyperlipidemia and body mass index. Results: Daily preadmission effort decreased progressively with increasing CAD severity (mean scores: 7.44 in single-vessel, 4.93 in double-vessel and 3.69 in triple-vessel disease; p < 0.0001). In multivariable ordinal logistic regression analysis, older age, hypertension, diabetes mellitus and hyperlipidemia were independently associated with greater CAD extension. Higher daily preadmission effort was strongly and independently associated with lower CAD severity; each one-point increase in effort score was associated with a 46% reduction in the odds of more extensive CAD (odds ratio 0.54, 95% confidence interval 0.45–0.64; p < 0.0001). Conclusions: Greater habitual daily physical activity prior to myocardial infarction is independently associated with less extensive coronary artery disease. Assessment of daily preadmission effort may provide clinically useful information regarding coronary disease burden and highlights the potential importance of everyday physical activity in cardiovascular prevention. These findings should be interpreted with caution given the use of a non-validated, self-reported measure of physical activity and the observational study design. Full article

High-Andean grasslands in the Central Andes of Peru are severely degraded by Lepidium meyenii (maca) cultivation, compromising pasture structure and forage availability for sustainable livestock production. A factorial field experiment evaluated restoration timing and pasture-oriented seed mixtures by manipulating resting time after abandonment (0, 1, 2, and 3 years) and restoration treatment (control; Festuca dolichophylla monoculture; full mixture of Dactylis glomerata + Lolium spp. + Trifolium repens + F. dolichophylla; and mixture without F. dolichophylla) across 64 plots. Vegetation was assessed eight months after seeding, and responses were analysed with ordination, PERMANOVA with restricted permutations, PERMDISP, and generalised linear models and mixed-effects models for diversity metrics. Community composition differed significantly among resting times and seed treatments, with resting time explaining the largest proportion of variance (R² = 0.353), followed by treatment (R² = 0.236), while the interaction was significant but smaller (R² = 0.102, p = 0.002). PERMDISP detected significant differences in multivariate dispersion for both Resting Time and Treatment, indicating that compositional differences may reflect both centroid shifts and heterogeneity among groups. Passive recovery and Festuca-only plots showed slower, more variable compositional change, whereas productive mixtures produced clearer, treatment-specific trajectories over time, suggesting possible divergence in community development patterns, rather than providing formal evidence of distinct alternative stable states. Establishment was consistently high for D. glomerata and Lolium spp., supporting rapid ground cover, which may be associated with short-term forage potential, while F. dolichophylla showed chronically low establishment consistent with limited germination performance. The invasive Pennisetum clandestinum was most pronounced under passive recovery and was reduced under seeded mixtures, suggesting a potential competitive suppression effect. Overall, early seeding with productive mixtures appeared to influence community assembly trajectories, while resting time remained the dominant driver of compositional variation, suggesting potential implications for restoration management in maca-degraded landscapes, although outcomes related to sustainable grazing systems were not directly evaluated. Full article

Soil organic matter (SOM) dynamics in tropical montane ecosystems remain poorly understood, particularly regarding the relative importance of particulate versus mineral-associated fractions under varying disturbance regimes. This study investigated SOM fraction distribution across the Ericaceous and Afroalpine belts of Bale Mountains National Park, Ethiopia, an Andosol-dominated landscape subject to recurrent fire. Using a stratified sampling design (n = 30 plots) across four vegetation classes (Ericaceous belt, fragmented Ericaceous belt, herbaceous and heathland, and giant Lobelia areas), three fire history categories (<10, 10–25, and >25 years since fire), and three topographic positions (northern slopes, southern slopes, and central plateau), we quantified coarse particulate organic matter (cPOM: 149–2000 μm), fine particulate organic matter (fPOM: 53–149 μm), and mineral-associated organic matter (MAOM: <53 μm). Particulate fractions dominated the SOM pool, with cPOM and fPOM together accounting for >99% of measured organic carbon. Multivariate ordination revealed a primary gradient (PC1, 61.7%) contrasting particulate-dominated soils in less disturbed areas with relatively MAOM-enriched soils in fire-impacted and fragmented zones. A global comparison reveals a profound stability gap: the Bale Mountains utilize <2% of the mineral stabilization potential of comparable Andosols, demonstrating that extreme fire frequency (<25 yr return interval) overrides even the most reactive mineralogy. We critically evaluate whether standard size-based fractionation adequately captures mineral-associated carbon in volcanic soils and discuss methodological limitations. These results provide baseline data for conservation planning in this biodiversity hotspot and underscore the need for fire management strategies that balance ecological integrity with carbon storage objectives. Full article