Search Results (15,514)

Background/Objectives: Warthin’s tumor (WT) is a benign parotid neoplasm increasingly managed with tissue-preserving surgical approaches to reduce postoperative morbidity. Partial superficial parotidectomy (PSP) and extracapsular dissection (ECD) are commonly performed, whereas extracapsular enucleation (EN) remains less systematically evaluated. This study compared postoperative morbidity among EN, PSP, and ECD in a matched cohort of patients with unifocal WT. Methods: A retrospective matched cohort study was conducted at a single tertiary referral center, including patients with histologically confirmed, unifocal WT treated between 2009 and 2023. A total of 360 patients were organized into 120 matched triplets (EN, PSP, ECD), with exact matching on age group and sex and balancing for smoking status, body mass index, and alcohol use. To enable comparison under technically uncomplicated conditions, cases with documented intraoperative capsular rupture or tumor spillage were excluded. The primary endpoint was overall postoperative morbidity, defined as the occurrence of at least one predefined complication. Associations between surgical technique and morbidity were assessed using conditional logistic regression, with estimation of odds ratios (ORs), absolute risk differences (RDs), and numbers needed to treat (NNT). Results: Overall complication rates were 8.3% after EN, 29.2% after ECD, and 32.5% after PSP (p < 0.001). EN was associated with lower odds of postoperative complications compared with ECD (OR 0.23, 95% CI 0.10–0.50) and PSP (OR 0.18, 95% CI 0.08–0.41). Adjusted absolute risks were 8.3% for EN, 29.3% for ECD, and 32.4% for PSP, corresponding to absolute risk differences of 21% and 24% and numbers needed to treat of 4.8 and 4.2, respectively. Conclusions: In this selected cohort of unifocal, anatomically favorable Warthin’s tumors without intraoperative capsular violation, ΕΝ was associated with lower observed postoperative morbidity compared with ECD and PSP. These findings are context-dependent and reflect outcomes achieved under strict selection and technical conditions. Therefore, they should not be extrapolated to anatomically complex, inflamed, or diagnostically uncertain lesions. Prospective multicenter studies with standardized selection criteria are warranted to better define the role of EN in contemporary WT management. Full article

Decades of traditional fertilizer subsidies have yielded modest maize productivity gains for Malawian farmers, mainly due to the twin challenges of soil degradation and intermittent weather patterns. Increasing nitrogen intake through subsidies without addressing these structural constraints has failed to close the country’s yield gap. Although climate-smart agriculture (CSA) technologies offer options for sustainable productivity growth, low and inconsistent adoption among farmers has led to insufficient evidence. Most existing studies that have examined the complementarity between CSA and inorganic fertilizers rely on experimental plot data, with limited evidence from actual farmer-managed fields. We use farm-level data collected in 2022 from 307 smallholder farmers across central and southern Malawi to investigate whether integrating CSA technologies with subsidized inorganic fertilizers enhances maize productivity. We apply the Inverse Probability Weighted Regression Adjustment (IPWRA) model to estimate the effects of CSA adoption and its integration with subsidized fertilizer. Results indicate that CSA adoption increased maize yields by 30%, confirming significant productivity gains from technologies such as mulching, agroforestry, and organic manure. However, integrating these technologies with subsidized fertilizers produced no additional yield advantage, suggesting that farmers often substitute CSA with inorganic inputs rather than combining them effectively. These findings imply that the potential synergies between CSA and subsidy programs remain unrealized under current practices. Policy reforms under Malawi’s current farm input subsidy program (FISP) should therefore emphasize extension and incentive mechanisms that promote complementary—not substitutive—use of CSA technologies and fertilizers at recommended application rates. Full article

Background: Ectopic fat deposition has been demonstrated to play a critical role in the onset and progression of renal dysfunction. However, research on renal parenchymal fat deposition and its association with renal dysfunction in type 2 diabetes mellitus (T2DM) remains limited, particularly regarding its association with early kidney injury. The present study aimed to further investigate the relationship between renal fat fraction (FF) and biomarkers of kidney injury, thereby providing new evidence for the potential link between intrarenal fat accumulation and early renal impairment in T2DM. Methods: This cross-sectional study enrolled 60 patients with T2DM. Renal FF was quantitatively assessed using magnetic resonance imaging (MRI). Clinical characteristics, body composition parameters, and biochemical indices were collected. Levels of kidney injury biomarkers, including tumor necrosis factor receptors 1 (TNF-R1), tumor necrosis factor receptors 2 (TNF-R2), chitinase-3-like protein 1 (YKL-40), and kidney injury molecule-1 (KIM-1), were measured using enzyme-linked immunosorbent assay (ELISA). To evaluate the correlations between fat distribution and inflammatory biomarkers, Pearson correlation analysis was performed. Furthermore, linear regression analysis was conducted to explore the associations between renal FF and kidney injury biomarkers with adjustments for potential confounders such as smoking status, diabetes duration, and visceral fat. Lasso regression was used to screen variables. Results: The results demonstrated that renal FF was significantly positively correlated with serum YKL-40 (r = 0.3, p = 0.021), TNF-R1 (r = 0.246, p = 0.042), and urinary KIM-1 (r = 0.396, p = 0.004), indicating a close association between renal fat accumulation and early kidney injury biomarkers. In regression analyses adjusted for age, sex, and duration of diabetes, the associations between renal FF and these biomarkers remained significant. After further adjustment for potential confounders, including smoking history, alcohol consumption, hypertension, renin-angiotensin-aldosterone system (RAAS) inhibitors, sodium-dependent glucose transporters 2 (SGLT2) inhibitors, glucagon-Like Peptide-1 (GLP-1) receptor agonists, and lipid-lowering drugs, renal FF remained significantly associated with TNF-R1 (β = 0.327, p = 0.015), KIM-1 (β = 0.352, p = 0.021), and YKL-40 (β = 0.275, p = 0.025). Moreover, even after additional adjustment for visceral fat, the associations of renal FF with TNF-R1 and KIM-1 persisted. After using the Benjamini–Hochberg procedure for false discovery rate, the relationship between renal FF and KIM-1 had a significant difference. Variables of age and gender were excluded to build the parsimonious modeling using Lasso regression. It suggested that renal fat accumulation may contribute to kidney injury independently of visceral adiposity. Conclusions: The study systematically demonstrates a significant association between renal FF and early biomarkers of kidney injury in T2DM, which may suggest the potential role of renal fat accumulation in the pathogenesis of diabetic nephropathy. These findings provide clinical data support for the development of a fat-targeted intervention study. Future research should further elucidate the long-term mechanistic role of renal FF in diabetic nephropathy, as well as its potential value in early diagnosis and therapeutic applications. Full article

Background: The incidence and mortality rates of cancer among females aged 65 years or older in the Republic of Korea are increasing; however, the national cancer screening rate (50.4%) remains low. Therefore, this study aimed to identify predictors of participation in the National Cancer Screening Program (NCSP) among women aged 65 years or older using data from the 8th Korea National Health and Nutrition Examination Survey (KNHANES VIII, 2019–2021). Methods: This cross-sectional study utilized data from the 8th Korea National Health and Nutrition Examination Survey (KNHANES VIII, 2019–2021). Study variables were selected based on Andersen’s healthcare utilization model. Participation in the National Cancer Screening Program (NCSP) was defined as the dependent variable, and independent variables included predisposing, enabling, and need factors. Descriptive analyses were conducted to examine participants’ characteristics. Chi-square tests were used to assess differences in NCSP participation according to participant characteristics. Multivariable logistic regression analysis was conducted to identify factors associated with participation, with all independent variables simultaneously included in the model to adjust for potential confounding. A p-value of <0.05 was considered statistically significant. Results: A total of 2105 women aged 65 years or older were included in the analysis. Of the 2105 women aged 65 years or older, 1429 (67.9%) reported participation in cancer screening within the past two years. NCSP participation was significantly associated with being married (OR = 1.540; 95% CI: 1.263–1.879), being a middle school (OR = 1.357; 95% CI: 1.022–1.801) or college graduate or higher (OR = 2.012; 95% CI: 1.199–3.378), having private insurance (OR = 1.930; 95% CI: 1.573–2.368), average subjective health (OR = 1.332; 95% CI: 1.004–1.766), dyslipidemia (OR = 1.347; 95% CI: 1.110–1.636), and physical activity participation (OR = 1.252; 95% CI: 1.029–1.524). In contrast, urban residence, income level, being employed, medical coverage type, hypertension, diabetes, monthly drinking status and current smoking status were not statistically significantly correlated with NCSP participation. Conclusions: These findings highlight the need for tailored outreach strategies and health education programs targeting women aged 65 years and older to enhance participation in the NCSP and ultimately improve public health outcomes. Full article

White lie-telling reflects children’s integration of moral cognition and situational adaptation, yet its mechanisms in prosocial dilemmas remain understudied in Chinese cultural contexts that prioritize “face-saving”—a core construct that shapes interpersonal behavior in Eastern societies. This study investigates how situational cues and developmental differences shape children’s white lie decisions by disentangling the interactive effects of external expectations and recipient presence. A total of 629 children aged 4–11 years (Study 1) and 6–11 years (Study 2) participated in two studies using a modified “painting evaluation task” Study 1 manipulated emotional expectation and recipient presence to establish baseline situational effects, while Study 2 introduced target expectation to create a prosocial value conflict between providing immediate emotional comfort and supporting long-term developmental goals. The Study 1 showed the highest white lie rate under the “emotional expectation + recipient presence” condition, with white lie rates exhibiting a significant developmental increase with age. Binary logistic regression identified these two factors as critical predictors of children’s white lie behavior. In Study 2, amid such prosocial value conflicts, older children showed lower white lie rates than younger peers, who prioritized others’ long-term goals via cost benefit analysis. Notably, recipient presence still moderated face-saving decisions, even for older children. This research makes three key contributions to the field. Firstly, it integrates Chinese “face culture” into situational manipulation, highlighting recipient presence as a culture-specific moderator and mitigating the Western-centric bias in prior research. Secondly, it constructs a prosocial moral dilemma to uncover children’s developmental transition from emotion-driven to value-based rational decision-making, extending existing developmental theories on moral cognition. Thirdly, it advances understanding of prosocial lying motivation beyond blind empathy by quantifying the interactive effects of dual expectations and revealing that children engage in deliberate cost benefit analysis that aligns with others’ overall long-term interests. Full article

Against the backdrop of the comprehensive advancement of the law-based governance of China and the “dual carbon” strategic goals, existing research still lacks a systematic discussion on how corporate compliance management affects ESG performance, and few studies have constructed targeted compliance management indicators from a textual perspective. To fill this research gap, this paper aims to explore the influence of corporate compliance management on ESG performance. Using Chinese A-share listed firms on the Shanghai and Shenzhen Stock Exchanges from 2010 to 2023 as research samples, this study adopts text mining techniques, combined with a panel regression model and a mediating effect model, to construct an indicator of corporate compliance management and examine its impact on ESG performance. The empirical results show that compliance management significantly improves corporate ESG performance and functions mainly through three channels: promoting corporate green innovation, fostering corporate ethical culture, and reducing agency costs. Heterogeneity tests indicate that the positive relationship is more pronounced in state-owned enterprises and in firms with higher managerial power. Further analysis reveals that compliance management also helps reduce the divergence in ESG ratings among Chinese firms, and the construction of all dimensions of compliance management can contribute to the improvement of corporate ESG performance. These findings enrich the literature on the economic consequences of compliance management and the determinants of ESG performance and provide theoretical guidance for Chinese firms to enhance ESG performance via compliance management. Full article

The study aims to analyze comprehensive effects of site quality class (SQC), stand density index (SDI), and species composition (SC) on biomass growth. Based on 5872 observations from 2040 permanent sample plots of Chinese fir (Cunninghamia lanceolata (Lamb.) Hook.) plantations from successive national forest resource inventories, five classical growth equations were employed and nonlinear regression and dummy variables were used for modeling. A dominant height (DH) growth model was first developed to determine SQC, followed by a series of stand biomass (SB) growth models incorporating SQC, SDI, and SC (pure vs. mixed stands). Growth differences among different classes or categories were analyzed using inflection age and optimal rotation age. The results show that Korf equation performed best for both DH and SB growth models; SDI contributed the most to SB growth, followed by SQC, with their interaction accounting for over half of the total contribution. Mixed stands grew faster than pure stands; higher SQC was associated with faster growth and earlier attainment of inflection age and optimal rotation age. The productivity increased with rising SDI, but the rate of increase gradually diminished. Different optimal rotation ages should be determined for pure and mixed stands across different SQCs. Reasonable adjustment of harvesting age and control of stand density represent the greatest potential for improving forest productivity. Full article

Background and Objectives: Neoadjuvant systemic therapy incorporating dual HER2 blockade has significantly improved outcomes in patients with HER2-positive breast cancer. Pathological complete response (pCR) is an important surrogate endpoint associated with improved long-term survival. However, substantial heterogeneity in treatment response persists, and identifying factors associated with pCR remains clinically relevant. In addition to established clinicopathological variables, systemic inflammation-based biomarkers have recently been investigated as potential predictors of treatment response. Materials and Methods: In this multicenter retrospective study, we evaluated patients with stage II–III HER2-positive breast cancer who received pertuzumab-based neoadjuvant therapy followed by surgery between January 2023 and June 2025 across six oncology centers in Türkiye. Clinicopathological characteristics, treatment-related variables, and baseline systemic inflammation-based biomarkers were analyzed. Logistic regression analyses were performed to identify factors associated with pCR. Results: A total of 372 patients were included, and the overall pCR rate was 61%. Higher pCR rates were observed in patients with hormone receptor-negative tumors (71.4% vs. 54.3%, p = 0.001) and in premenopausal patients (68.7% vs. 53.4%, p = 0.003). In multivariate analysis, hormone receptor status (OR 2.25, 95% CI 1.41–3.60, p < 0.001), menopausal status (OR 1.90, 95% CI 1.22–2.94, p = 0.005), neoadjuvant treatment regimen (OR 2.15, 95% CI 1.05–4.41, p = 0.037), and perineural invasion (OR 2.61, 95% CI 1.10–6.22, p = 0.030) were independently associated with pCR. In contrast, systemic inflammation-based biomarkers did not demonstrate significant associations with pCR, and ROC analyses showed limited discriminatory ability (AUC values approximately 0.5). Conclusions: In patients with HER2-positive breast cancer treated with pertuzumab-based neoadjuvant therapy, treatment response appears to be primarily influenced by clinicopathological and treatment-related factors rather than systemic inflammatory status. Peripheral blood inflammatory biomarkers derived from routine laboratory parameters showed limited value in predicting pCR in this setting. Full article

Background/Objectives: Diabetes mellitus is a common chronic disease that may lead to multimorbidity and high drug use. Therefore, this study aims to examine the prevalence of polypharmacy and hyperpolypharmacy among adult patients diagnosed with type 2 diabetes mellitus (T2DM) with its associated factors. Methods: This is a retrospective cross-sectional study conducted from 1 May 2023 to 31 October 2024. The outcomes in our study were polypharmacy (from five to nine drugs) and hyperpolypharmacy (≥10 drugs). Baseline and demographic characteristics, along with multinomial logistic regression, were used to analyze the data. Results: The total number of patients with T2DM was 2435. The prevalence rate of polypharmacy was 46.98%, while hyperpolypharmacy was 24.27%. Older age was significantly associated with a higher risk of polypharmacy [OR = 1.031, 95% (1.022–1.040)] and hyperpolypharmacy [OR = 1.037, 95% (1.026–1.049)]. In addition, patients with higher levels of hemoglobin A1c showed a significantly higher risk of polypharmacy and hyperpolypharmacy ([OR = 1.162, 95% (1.105–1.221)] and [OR = 1.284, 95% (1.209–1.364)], respectively). The comorbidities that increased the odds of hyperpolypharmacy were hypertension [OR = 2.136, 95% (1.449–3.148)], pulmonary disease [OR = 2.375, 95% (1.292–4.367)], mental disorders [OR = 6.269; 95% (3.284–11.964], and congestive heart failure [OR = 8.014, 95% (2.768–23.200)]. Conclusions: The prevalence of polypharmacy and hyperpolypharmacy is high in patients with T2DM. The predictors that may play a significant role in increasing the risk of hyperpolypharmacy are the poor control of HbA1c and the coexistence of comorbidities. Providing proper prescribing of patients’ therapy plans can improve individuals’ health outcomes. Therefore, this study highlights the important role of primary care physicians in coordinating care, along with clinical pharmacists, in the identification of polypharmacy. Full article

The integration of rapidly renewable biomass into insect production systems has been proposed as a strategy to improve resource-use efficiency in insect production. This study evaluated the graded inclusion levels of dried watermeal (Wolffia globosa) in diets of two-spotted crickets (Gryllus bimaculatus) and assessed voluntary nutrient regulation under free-choice feeding. Four fixed-inclusion diets (0%, 25%, 35%, and 45% watermeal) and one self-selection treatment were tested over 28 days. Growth performance, feed conversion ratio (FCR), survival rate (Surv), production index (PI), and whole-body composition were determined. Repeated-measures analysis using linear mixed-effects models indicated that treatment, week, and their interaction were statistically significant (p ≤ 0.024). However, partial R² analysis showed that the independent contributions of treatment and week were negligible, whereas the treatment × week interaction explained measurable variance, indicating that dietary effects were primarily expressed through time-dependent responses. Segmented regression identified a breakpoint at 35% watermeal inclusion (95% CI: 24.93–45.07), indicating that PI was the highest within a moderate supplementation range under the present fixed-diet conditions rather than at a precise single optimum. Inclusion levels beyond this threshold reduced performance. Under free-choice conditions, crickets progressively increased watermeal intake with age and maintained stable nitrogen-free extract (NFE):crude protein (CP) and gross energy (GE):CP intake ratios, selecting an average of 25–35% watermeal over the experimental period. This supplementation range improved feed efficiency and protein deposition while limiting lipid accumulation, suggesting improved energy–protein balance and nutrient partitioning. The self-selection result is interpreted as evidence of behavioral intake regulation under choice conditions and not as direct validation of the segmented-regression breakpoint. Collectively, these findings provide complementary statistical and behavioral evidence supporting a biologically relevant moderate inclusion range (approximately 30–35%) of dried watermeal. Full article

Grain and cultivated land resources constitute the most fundamental means of human subsistence, and their spatial mismatch can directly reveal issues related to the rationality of regional resource utilization and urban–rural development patterns. The downstream region of the Yangtze River Economic Belt, as a major grain-producing area in China, holds significant importance for optimizing regional arable land utilization patterns, achieving sustainable use of cultivated land resources, and ensuring national food security through the investigation of the spatiotemporal mismatch characteristics between grain production and arable land resources and their influencing factors. This study focuses on the downstream region of the Yangtze River Economic Belt, employing the Center of Gravity Transfer Model, Spatial Mismatch Model, and Geographical and Temporal Weighted Regression Model to analyze the spatiotemporal variation characteristics of grain production and cultivated land area, as well as their mismatch patterns. It further investigates the factors that influence such mismatches and their spatial heterogeneity. The research findings indicate that, in terms of temporal characteristics, grain production in the downstream region of the Yangtze River Economic Belt exhibited an upward, fluctuating trend from 2000 to 2023. The cultivated land area initially decreased, then gradually increased, while the overall quantity showed a net reduction. From the perspective of spatial changes, the migration rate of grain production was significantly higher than that of cultivated land. The center of gravity of grain production shifted 78.85 km northwestward, while the center of gravity of cultivated land moved 4.16 km in the same direction. The overall mismatch between grain production and cultivated land shows fluctuating changes, while its spatial characteristics show an increasing trend toward polarization. The average intensity order of influencing factors is as follows: effective irrigated area > fertilizer’s equivalent weight > the proportion of agricultural output value > total power of agricultural machinery > urbanization rate > the proportion of people employed in the primary industry. Meanwhile, these influencing factors exhibit significant spatial heterogeneity characteristics, with their impact directions and intensities varying across different development stages in distinct regions. From a spatiotemporal perspective, the research findings provide differentiated policy recommendations for the efficient utilization of cultivated land resources and grain production in the downstream region of the Yangtze River Economic Belt. Full article

Background/Objectives: Dysphagia leads to severe complications, but data on patient profiles are limited in Türkiye. In this study, we present swallowing characteristics across etiologies and examine the association between a history of pneumonia and videofluoroscopic swallowing study (VFSS) findings. Methods: This retrospective study included 1055 adults, comprising a large, heterogeneous outpatient population, referred for swallowing evaluation between 2015 and 2018. Clinical data (demographics, diagnoses, feeding status, etc.) and VFSS findings (Penetration–Aspiration Scale, PAS; pharyngeal residue) for liquid and semisolid consistencies were recorded from our electronic database. Associations were initially assessed using the chi-square test. A logistic regression analysis was performed to identify factors associated with pneumonia history. Results: Neurologic diseases (62.1%) were the most frequent diagnosis. VFSS identified liquid aspiration in 53.9% (61.8% silent) and semisolid aspiration in 20.1% (72.5% silent) of patients. Pharyngeal residue occurred in up to 10.6% of patients for liquids and 24.3% for semisolids. Diet recommendations were modified for 43.3% of patients (p < 0.05). Overall, 26.6% of patients had a history of pneumonia. In unadjusted, exploratory comparisons, pneumonia history was significantly associated with higher frequencies of aspiration and silent aspiration (p < 0.001), while pharyngeal residue was comparable between groups (p > 0.05). Multivariable logistic regression analysis showed that nonsilent aspiration (PAS 6–7) and silent aspiration (PAS 8) were associated with pneumonia history in both liquid (OR = 2.18 and 3.06) and semisolid consistencies (OR = 2.32 and 3.71), and that pharyngeal residue in semisolid consistency was also associated with pneumonia history (OR = 1.57). Conclusions: This study provides a comprehensive clinical profile of dysphagia in Türkiye, highlighting high rates of silent aspiration and the role of instrumental assessment in guiding safe feeding. While a significant association was observed between pneumonia history and impaired swallowing safety and efficiency, the retrospective nature of this study precludes causal interpretations. Full article

Background/Objectives: In-hospital critical outcome among palliative inpatients remains high, often driven by acute physiological instability rather than chronic comorbidities. Although diabetes mellitus (DM) is common in this population, its independent impact on critical outcome is unclear. This study aimed to determine whether acute metabolic and inflammatory markers—specifically glucose, C-reactive protein (CRP), albumin, and oxygen requirement—better predict short-term outcomes, defined as in-hospital critical outcome or ICU transfer during the same hospitalization period, than DM status alone. Methods: This retrospective study included 200 palliative inpatients admitted to the Internal Medicine Clinic of Kestel State Hospital, Bursa, Turkey, between January 2024 and January 2025. Demographic, clinical, and laboratory data were obtained from electronic records. The primary outcome was in-hospital critical outcome or ICU transfer (“critical outcome”). Logistic regression and receiver-operating characteristic (ROC) analyses identified independent predictors. The study was approved by the Bursa Yüksek İhtisas Training and Research Hospital Ethics Committee (ethics approval: protocol code 2024-TBEK 2025/05-12). Results: The mean age was 77.7 ± 12.3 years, and 47% were male. DM was present in 30.5% but did not independently predict critical outcome (p = 0.904). In contrast, oxygen requirement (OR = 4.08, p = 0.002), mean glucose (OR = 1.01, p = 0.001), and cancer (OR = 3.28, p = 0.016) were significant predictors. ROC analysis identified CRP > 64.1 mg/L and albumin < 25 g/L as optimal thresholds, and these two markers formed the basis of the low-, intermediate-, and high-risk stratification, with critical-outcome rates of 39.0%, 45.1%, and 85.4% (p < 0.001). Conclusions: Acute metabolic and inflammatory disturbances—particularly hyperglycemia, elevated CRP, hypoalbuminemia, and oxygen requirement—are stronger prognostic indicators than DM. A simple bedside model incorporating these parameters may improve prognostic accuracy and communication in palliative care. Full article

Benign prostatic hyperplasia (BPH) is an age-related disorder increasingly linked to chronic inflammation and redox imbalance, yet its systemic oxidative and nitrosative profile remains insufficiently characterized. In this cross-sectional study, fasting serum samples were collected from 47 men with clinically confirmed BPH scheduled for transurethral resection of the prostate and 40 healthy controls. We assessed antioxidant status (thiols, total antioxidant capacity), lipid peroxidation (malondialdehyde, 4-hydroxynonenal), protein nitration (3-nitrotyrosine), glycoxidation markers (Amadori products, advanced glycation end products (AGE)-associated fluorescence), and tryptophan metabolism indices (tryptophan, kynurenine, N′-formylkynurenine). Compared with controls, BPH patients showed significantly lower antioxidant capacity and thiol levels, together with increased lipid peroxidation and protein nitration. AGE-associated fluorescence was modestly elevated, whereas Amadori products and advanced oxidation protein products did not differ significantly. Tryptophan metabolism was markedly altered, with lower tryptophan and higher kynurenine and N′-formylkynurenine, indicating activation of the kynurenine pathway. After false discovery rate correction, most redox biomarkers remained significant. Multivariable logistic regression confirmed independent associations of lipid peroxidation, nitrosative stress, and kynurenine pathway activation with BPH after adjustment for age and metabolic parameters. These findings support a role for systemic oxidative and inflammatory mechanisms in BPH pathophysiology, although confirmation in age-matched and longitudinal studies is needed. Full article

Background: Air pollution, antimicrobial use, and population ageing are increasingly recognised as co-occurring pressures shaping population health. This study explores their ecological association with mortality patterns in the province of Messina (Southern Italy), within a One Health-informed framework. Methods: An ecological analysis was conducted using district-by-year data (2015–2024), integrating environmental monitoring (PM₁₀, PM_2.5, NO₂, O₃), outpatient antibiotic consumption, and cause-specific mortality rates. Multivariable regression models were used to assess associations between exposures and mortality outcomes. A post-2020 indicator was included to account for COVID-19-related disruption. Results: Marked geographic variability in pollutant concentrations was observed, with higher levels in urban-industrial districts. Infectious disease mortality increased from 13.8 to 44.6 per 100,000 inhabitants between the pre-pandemic and post-pandemic periods. In Poisson regression models, particulate matter showed a small and non-significant association with respiratory mortality (RR = 1.02, 95% CI: 0.89–1.18), while antibiotic consumption was not independently associated with mortality (RR = 0.99, 95% CI: 0.94–1.05). The post-2020 period was associated with higher mortality estimates (RR = 1.15, 95% CI: 0.72–1.83), although with wide confidence intervals. Conclusions: The findings suggest the co-occurrence of environmental, demographic, and pharmaceutical pressures within the same territories, rather than demonstrating formal synergistic interaction. The observed post-pandemic increase in mortality highlights the importance of accounting for COVID-19-related disruption. These results should be interpreted as exploratory, given the ecological design and limited sample size, but support the need for integrated surveillance approaches within a One Health perspective. Full article