Search Results (23,321)

Background: Emerging evidence highlights the importance of the MIF–sCD74 axis in health and disease, including its role in regulating cell death. While studies in routine cardiac surgery suggest perioperative relevance, its role in end-stage heart failure (ESFH) patients undergoing left ventricular assist device (LVAD) implantation remains unexplored. Moreover, although MIF and sCD74 induce necroptosis in neonatal cardiac myofibroblasts, the effects of MIF, its paralog D-DT, and sCD74 on adult cardiac myofibroblasts (CMFs) are unknown. Methods: Plasma concentrations of sCD74, MIF and D-DT were measured perioperatively in a small cohort of patients with ESHF undergoing LVAD implantation (n = 20). As a preclinical model of ESHF, primary adult CMFs were treated with recombinant MIF, D-DT and sCD74 to evaluate their effects on cellular viability and health. Results: In LVAD patients, sCD74 and D-DT levels were significantly increased 24 h postoperatively, whereas MIF levels were reduced compared to baseline. ROC curve analysis demonstrated a good discriminatory power of 24 h post-OP sCD74 (AUC = 0.83), sCD74/MIF ratio (AUC = 0.82), and D-DT levels (AUC = 0.88) for acute kidney injury, composite outcome, and right heart failure (RHF), respectively. In adult CMFs, MIF and sCD74 synergistically reduced viable cell counts (p = 0.0083), whereas D-DT reduced cell counts in an sCD74-independent manner (p = 0.0004). Yet, measures of metabolism, proliferation, apoptosis and necrosis along with inflammatory gene expression remained unchanged. Conclusions: Our findings indicate that the balance of MIF, D-DT, and sCD74 during LVAD implantation may be clinically relevant. In particular, an imbalance characterized by elevated sCD74 or D-DT and reduced MIF levels 24 h post-surgery was associated with unfavorable clinical outcomes. Yet, the current findings are exploratory and hypothesis-generating because of a small sample size. Thus, the prognostic value of plasma levels for postoperative complications after LVAD implantation, and the effects of MIF/D-DT/sCD74 imbalance on cardiac myofibroblasts, need to be validated in larger cohorts and in advanced human experimental models. Full article

Climate change and environmental degradation are increasingly recognized as major drivers of human mobility, operating through both sudden-onset disasters and slow-onset processes such as sea-level rise, desertification and resource scarcity. Although estimates vary widely, projections suggest that millions of people may become displaced by 2050 because of climate change, predominantly within their own countries but also across international borders. This article examines the emerging phenomenon of “environmental migration” against the backdrop of international refugee law and broader human rights frameworks. It first maps the diverse environmental scenarios that trigger displacement before analyzing the existing international legal landscape. Particular attention is paid to the contested terminology surrounding “climate refugees”, “environmental migrants” and “environmentally displaced persons” and to the protection gaps that arise from current categorizations. This article argues that, while existing norms on human rights, disaster risk reduction and internal displacement offer partial safeguards, they do not provide coherent legal status or systematic protection for people displaced across borders by climate-related harms. It concludes that climate-related displacement should be addressed through a combination of evolving human rights-based climate litigation, enhanced use of existing instruments and the progressive elaboration of specific normative frameworks. Full article

Background: Oncocytic lipoadenoma is an exceptionally rare benign fat-containing salivary gland tumor that most commonly arises in the parotid gland. Previous case reports have largely focused on histopathology with limited or single-modality imaging documentation; therefore, practical preoperative radiological characterization remains challenging. Case Presentation: A 46-year-old male presented with a 2-year history of a slowly enlarging right-sided parotid mass. Computed tomography and magnetic resonance imaging showed a well-circumscribed fat-containing mass with a discrete medially enhancing solid component, mild diffusion restriction and small cystic foci without aggressive features. Ultrasonography revealed a heterogeneously hypoechoic parotid mass; however, limited acoustic penetration hindered evaluation of the deep portion. A core-needle biopsy was inconclusive, and an atypical lipomatous tumor could not be excluded. Subsequent surgical excision confirmed an oncocytic lipoadenoma, a biphasic tumor comprising mature adipose tissue and cytokeratin 7-positive oncocytic epithelial nests. The patient has remained recurrence-free for 7 years after surgery. Conclusions: Fat-containing parotid tumors can be diagnostically challenging because imaging findings are often nonspecific, and biphasic lipoepithelial entities are rarely encountered. This case highlights that awareness of the pattern of macroscopic fat with a discrete enhancing non-fat component, interpreted alongside histopathological findings, may help narrow the differential diagnosis, guide management, and reduce diagnostic uncertainty. Full article

Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy of the upper extremity and results from compression of the median nerve within the fibro-osseous carpal tunnel. Anatomical variants such as a bifid median nerve (BMN) and a persistent median artery (PMA) may increase tunnel occupancy and complicate both diagnosis and treatment. High-resolution musculoskeletal ultrasound enables detailed evaluation of these anatomical variations and facilitates image-guided interventions. Ultrasound-guided hydrodissection has emerged as a minimally invasive technique capable of mechanically releasing perineural adhesions and restoring nerve mobility. Alpha-2 macroglobulin (A2M), an autologous plasma protease inhibitor with anti-inflammatory and cytokine-binding properties, has recently been explored as a biologic adjunct in musculoskeletal conditions. We report the case of a 60-year-old right-handed woman who presented with a one-year history of numbness, paresthesia, and pain within the median nerve distribution of her dominant hand. Ultrasound examination demonstrated a bifid median nerve accompanied by a persistent median artery and perineural edema within the proximal carpal tunnel. The patient underwent three weekly sessions of ultrasound-guided hydrodissection using autologous A2M prepared through the APEX filtration system. The patient reported progressive clinical improvement following treatment. Grip strength increased from 12 kg at baseline to 22 kg at week twelve. Follow-up ultrasound performed ten months after treatment showed restoration of median nerve fascicular architecture and normalization of nerve morphology, findings consistent with interval structural improvement. This case highlights the role of ultrasound in the integrated evaluation and management of CTS with anatomical variants, including diagnosis, procedural guidance, and longitudinal assessment. Ultrasound-guided hydrodissection with A2M may represent a feasible minimally invasive approach in selected patients; however, further prospective studies are required to determine its safety and therapeutic efficacy. Full article

Farmland management rights (FMR) mortgage lending has been advanced as a central instrument of rural credit reform in China, yet the program has consistently failed to sustain itself in the absence of direct government facilitation. Drawing on five national and provincial pilot counties in Henan Province, this study investigates the structural factors underlying this sustainability failure. We employ a sequential mixed-methods design: grounded theory analysis of in-depth interviews, policy documents, and media reports from five focal sites to inductively construct a constraint framework, followed by structural equation modeling (SEM) validation using 1055 survey responses. Our grounded theory analysis identifies three internal constraint categories—property rights insecurity, a thin secondary land market, and subject-level agricultural risk—and one external environmental constraint, which together produce a state of mutual non-recognition: neither financial institutions nor farming households regard FMR as legitimate collateral. Notably, the effect of collateral acceptance on farmer mortgage willingness is statistically insignificant, revealing that demand-side barriers are more deeply entrenched than supply-side institutional improvements alone can resolve. These findings challenge the premise that legal formalization of land rights is sufficient to generate market-driven credit activity, and call attention to the equally important role of institutional ecosystem development—encompassing land markets, appraisal capacity, supervisory infrastructure, and rural credit culture. The insights carry direct relevance for developing economies exploring land-backed agricultural credit as a rural finance strategy. Full article

Background and Objectives: Previous comparisons between right anterior mini-thoracotomy (RAT) and partial upper sternotomy (PS) for aortic valve replacement (AVR) have shown similar clinical outcomes. This study aims to assess the potential in-hospital cost differences in one technique over the other. Materials and Methods: Between 2018 and 2023, 303 patients at our institution underwent minimally invasive isolated AVR (241 PS vs. 62 RAT). Endocarditis, emergencies, and reinterventions were excluded. A 1:1 nearest neighbor propensity-matched analysis without replacement was performed. Perioperative clinical outcomes and hospital costs were analyzed, comparing total and average (per patient) direct, indirect, and total hospital costs between the two groups. Multivariable linear regression identified significant predictors of hospital costs. Results: Sixty-two well-matched pairs were analyzed. Significant differences were found in intraoperative (PS: 27/62, 43.5% vs. RAT: 10/62, 16.1%, p = 0.002) and postoperative transfusions (PS: 33/62, 53.2% vs. RAT: 16/62, 25.8%, p = 0.003), and median intensive care unit (ICU) hours (PS: 52.2 vs. RAT: 45.7, p = 0.007). Average direct, indirect, and total hospital costs were significantly higher for PS (p = 0.038, p = 0.040, and p = 0.035, respectively), with significant blood bank cost differences favoring RAT (p = 0.010). Multivariable linear regression showed that intraoperative and postoperative transfusions, ICU, and hospital length of stay were significantly associated with hospital costs, but not the surgical approach. Conclusions: PS and RAT have comparable perioperative clinical outcomes, with differences observed only in the number of transfusions and ICU stay, both favoring RAT. Given the significant perioperative differences and regression analysis results, the cost advantage of RAT is likely mediated through its impact on these perioperative outcomes. Full article

Nowadays, it is central to generate innovations that convert agricultural by-products and food waste into valuable animal products while promoting the long-term resilience and sustainability of vulnerable animal production systems. Nutraceuticals (i.e., ‘nutrition + pharmaceutical’) are derived from foods that offer health benefits. In animal production, nutraceutical supplementation with Withania somnifera and Lepidium meyenii has shown positive effects on the endocrine, cardiopulmonary, and central nervous systems. We aimed to evaluate the possible impact of nutraceutical supplementation on rams fed a diet based on surplus feed from a highly industrialized Holstein cow production system, on corporal (live weight [LW], kg; body condition score [BCS], units), metabolic (blood glucose [GLU], mg dL⁻¹; serum protein [PRO], g 100 mL⁻¹), and sexual–testicular variables [sexual odor (ODOR, units); scrotal circumference (SC, cm); testicular volumes (TVOL, cm³); and estimated daily sperm production (EDSP, millions)]. Black Belly rams (n = 12; LW = 70.36 ± 1.2 kg; BCS = 2.96 ± 0.03 units; age = 3.8 ± 0.2 years; 25° N) were divided into 3 experimental groups: (1) WITH, supplemented with Withania somnifera (400 mg kg⁻¹ LW d⁻¹); (2) LEPI, supplemented with Lepidium meyenii (400 mg kg⁻¹ LW d⁻¹); and (3) CONT, not supplemented. The variables LW, BCS, GLU, PRO, and SC, as well as some components of TVOL, did not differ (p > 0.05) among the main effects of treatment or time; only ODOR, right transverse testicular diameter, and total testicular volume differed among treatments, generally favoring the WITH group. Furthermore, the TRT × T interaction demonstrated superior performance (p < 0.05) in the WITH group, with the largest values for LW, GLU, PRO, ODOR, SC, width of the right testicle, volume of the right testicle, total testicular volume, and EDSP. From a productive–reproductive perspective, the Robin Hood Effect—through the use of rejected dairy cattle rations as the base diet for rams—and supplemented with nutraceuticals (WITH and LEPI), emerges as a viable alternative to improve not only the productive–reproductive performance of Black Belly rams, but also other productive and socioeconomic outcomes; the latter contributing to the strengthening of producer and family well-being. Full article

Typhoon passages typically induce significant upper-ocean responses, especially on the right side of the typhoon track. However, how mesoscale eddies modulate this left–right asymmetry remains insufficiently understood. Using high-resolution remote sensing data and reanalysis datasets, this study examines the impacts of a mesoscale eddy dipole influenced by Typhoon Ma-on (2011). The study finds that: (1) The eddy responses exhibit significant asymmetry: during Typhoon Ma-on (2011), the amplitude, circulation speed, and radius of the left side cyclonic eddy (CE) showed anomaly increases of 8.6 cm, 4.3 cm/s, and 54.3 km, respectively, whereas those of the right-side anticyclonic eddy (AE) showed anomaly decreases of 2.9 cm, 4.8 cm/s, and 13.9 km. (2) Mesoscale eddies modulate sea surface cooling with significant left–right asymmetry, differing from the conventional pattern of stronger right-side cooling. The left side CE enhanced surface cooling by up to 2.38 °C, while the right-side AE exerted a suppressing effect, with a cooling magnitude of 0.96 °C. (3) Within the CE, a significant negative temperature anomaly develops below about 20 m. Despite a relatively high Richardson number ($Ri$) and weak vertical shear that suppress excessive turbulent mixing, negative $W_s$-driven upwelling dominates, allowing cold water to be efficiently uplifted and maintaining or intensifying surface cooling. In contrast, the AE exhibits surface cooling but persistent positive anomalies below about 40 m, reflecting the partial retention of its subsurface warm water. In this case, reduced $Ri$ and enhanced shear instability promote stronger vertical mixing, enabling subsurface heat to be transported upward, thereby offsetting and weakening the surface cooling signal. Full article

The Akseki–Kuyucak bauxite deposits, located in the Western Taurus Belt in southwestern Türkiye, represent karst-type bauxite mineralization derived from carbonate platform phases. This work integrates field observations, X-ray diffraction (XRD) analysis, and extensive geochemical data, including major, trace, and rare earth elements (REEs), to clarify the mineralogical characteristics, geochemical processes, and genetic implications of the deposits. Field and petrographic investigations indicate that the bauxite deposits occur as irregular fills and lens-shaped formations on paleokarstic surfaces of carbonate substrates. The XRD examination reveals that the major minerals in the bauxite samples are boehmite, hematite, and anatase, with some samples exhibiting a predominance of calcite, indicating a strong genetic relationship between the ore bodies and the carbonate host rocks. Major oxide analysis reveals a distinct compositional disparity between bauxitic and carbonate-dominated materials: bauxitic samples exhibit elevated Al₂O₃ and Fe₂O₃ levels, with reduced SiO₂ and CaO concentrations. In contrast, carbonate-rich samples show higher CaO and loss-on-ignition values. Ternary discrimination diagrams categorize most bauxitic samples into the ferritic bauxite and robust lateritization domains, indicating substantial weathering and residual enrichment processes. The trace element and REE studies reveal ΣLREE values ranging from 22.3 to 240.2 ppm, with a right-skewed distribution indicating heterogeneous enrichment. Correlation studies indicate that ΣLREE has a positive correlation with SiO₂ and K₂O, suggesting that the enrichment of REEs is more closely associated with silicate/clay minerals than with iron oxide phases. Furthermore, spider diagrams and the study of immobile components emphasize the significance of residual concentration processes in bauxitization. In contrast, modest TiO₂ levels indicate a composite source derived from both insoluble carbonate remnants and detrital siliciclastic materials. In summary, the Akseki–Kuyucak deposits are categorized as intricate karst bauxite systems, characterized by significant lateritization, regulated accumulation governed by paleokarst characteristics, and a complex geochemical evolution. The results demonstrate that integrating mineralogical, geochemical, and statistical methods provides a thorough framework for evaluating REE behaviors and the effects of source-related factors in karst bauxite deposits. Full article

Background: Iron overload cardiomyopathy (IOC) is a major determinant of outcomes in hemochromatosis, and conventional echocardiography may miss early myocardial toxicity. Comparative data on primary (PH) versus secondary hemochromatosis (SH) using myocardial work (MW) indices are limited. Methods: We performed a retrospective cross-sectional study of 34 adults (16 PH and 18 SH patients) at a tertiary center. They all underwent echocardiography with speckle-tracking to obtain LV global longitudinal strain (GLS) and non-invasive MW indices from pressure-strain loops: global work index (GWI), global constructive work (GCW), global wasted work (GWW), and global work efficiency (GWE). Echocardiographic phenotypes were classified as a Normal, Dilated, Restrictive, or right ventricular/pulmonary hypertension (RVPH) phenotype. Results: SH patients showed higher iron burden and neurohormonal activation than PH patients (maximum ferritin 2954 vs. 444 ng/mL; BNP 93 vs. 13.5 pg/mL; both p < 0.001) and accounted for all deaths (33% vs. 0%) despite similar 3D LVEFs and GLSs. PH patients predominantly exhibited Normal phenotypes (81%), whereas SH patients more often showed advanced phenotypes, mainly RVPH and Dilated. GWI correlated inversely with ferritin (ρ ≈ −0.40), particularly ferritin at echocardiography in SH patients, while PH patients showed no significant correlations. GWW was higher in Dilated/RVPH compared to Normal phenotypes, and in SH patients, higher maximum ferritin was associated with impaired right ventricular free-wall strain. Conclusions: PH and SH patients exhibit distinct IOC phenotypes, with SH patients showing more advanced remodeling and worse outcomes. In this exploratory analysis, MW indices showed modest associations with iron burden markers, suggesting they may provide complementary information beyond LVEF and GLS. These preliminary findings require validation in larger, prospective studies. Full article

Africa is historically celebrated as the cradle of humankind. However, there is doubt on whether she is maintaining her own originality and position as the motherland and fatherland of all humanity. Although globalisation has impacted all continents and states, its negative effects seem to be skewing towards African and in particular Zimbabwean Shona families. This paper examines how DNA testing has impacted on some of the Shona families in Zimbabwe. The Shona community in Zimbabwe is culturally porous and receptive in terms of traditional, religious, linguistic and cultural values. They embraced Western democracy that is premised on human rights principles, constitutionalism, and citizenship, which, however, do not guarantee their belongingness. As some of the Shona families in Zimbabwe drifted away from the traditional cultural belief system campus, they got into a foreign and alien worldview that is dictated by the host in the name of technology. This has led to excessive reliance on foreign systems that are appearing like global standards yet they are disempowering them and causing them emotional and social distress. The reliance is a result of neocolonialism, linguistic and cultural imperialism that needs decolonisation. Thus, the paper adopts a qualitative approach based on an illuminating multiple case study design of six purposively selected scenarios aired on the The Closure DNA Show programme broadcasted on Zimbabwe Television (ZTV). The Afrocentric paradigm serves as a lens to uncover some of the perceptions of Shona families in Zimbabwe on DNA testing and its implications on parenthood, the family unit, and identity. The findings reveal that DNA testing is perceived as gender divisive and a destroyer of the family unit and exposing children to vulnerability, while it is also perceived positively as a way of (dis)affirming identity, which is crucial among the Shona. The paper recommends that other television programmes be screened based on their implications on gender relations, the family unit and identity. Full article

The praṇidhi paintings of Cave 20 at Bezeklik in Turfan are murals representing the cultural sophistication of the Gaochang Uyghur kingdom (866–1283). Building on Grünwedel’s rearrangement of the murals in his 1924 book, this paper examines praṇidhi paintings of Cave 20, with a particular focus on analyzing the accompanying inscriptions in relation to Mūlasarvāstivāda-vinaya Bhaiṣajyavastu. Le Coq’s numbering system, used in existing literature, has made it difficult to comprehend not only the sequential arrangement among 15 themes but also the order in which inscriptions were derived from the text. Using an alternative arrangement of the paintings, this paper provides a systematic pattern in the derivation of inscriptions from the text, with the following results: The inscriptions of Subject 9 (Ratnaśikin Buddha), Subject 7 (Dīpaṃkara Buddha), and Subject 10 (Kāśyapa Buddha) correspond respectively to three asaṅkhya kalpas of the verses, each conveying a pivotal moment in its period. Seen from left toward the right corridors, the inscriptions follow a sequence tracing from the second to the third, and then the first asaṅkhya kalpa. Following the pictorial narrative, the cycle begins with inviting the Buddha, the donor’s offering and worship, continues with making vows and receiving prophecies from the three Buddhas, and concludes with Buddha being seen off and renewal of devotional engagement by the viewer. These findings help clarify an issue in previous scholarship concerning how the inscriptions correspond to the Mūlasarvāstivāda-vinaya Bhaiṣajyavastu. This also supports Grünwedel’s early insight that the praṇidhi paintings of Cave 20 were interconnected with circumambulatory religious practice. Full article

Background/Objectives: Test anxiety can impair working memory, attention, and executive function, raising questions about what might increase cognitive readiness prior to testing. Methods: This study examined how brief meditation, social media use, and calming or upbeat music influence neural activity and performance on a second-language exam using functional near-infrared spectroscopy (fNIRS). Results: Forty-five advanced German students completed two matched exams—one preceded by a randomly assigned three-minute activity and one taken without a pre-test activity. fNIRS measured cortical activity in the prefrontal cortex, Broca’s area, and Wernicke’s area during both the pre-test activity and the exam. Behaviorally, meditation significantly improved exam scores compared to control (p < 0.02), social media use significantly reduced scores (p < 0.002), calming music showed no effect (p = 0.06), and upbeat music had no effect (p = 0.27). Neural analyses revealed that social media increased activation in socially oriented prefrontal regions, including the right dorsolateral prefrontal cortex (DLPFC), while reducing activation in right Broca’s area, corresponding with lower performance. Due to technical issues, fNIRS data during the meditation condition were excluded from neural analyses. Conclusions: These findings indicate that short pre-exam interventions can influence neural engagement and academic performance, highlighting the potential benefits of meditation and the possible negative impact of social media immediately before testing. Full article

Although Vietnam is committed to complying with international frameworks on gender equality such as CEDAW, the Beijing Platform, and the 2030 Agenda, women still face many barriers in exercising their land use rights in practice. This study uses a doctrinal legal research method combined with comparative analysis to: (i) systematically analyze the provisions on gender equality in the 2024 Land Law; (ii) compare these provisions with the 2013 Land Law and relevant international standards; and (iii) assess the challenges in implementation from the perspective of substantive equality. The results show three notable areas of progress: (1) gender equality is recognized for the first time as a specific right of land users; (2) gender discrimination is included in the list of prohibited acts in land management and use; and (3) the scope and procedures for joint land use rights certification for spouses are clarified. However, gaps in legislative drafting, enforcement mechanisms, and the persistence of patriarchal social norms continue to widen the gap between equality on paper and equality in practice, as evidenced by the persistent 32% proportion of certificates registered solely in men’s names with no updated official data released nearly four years later; the absence of specific sanctions for gender discrimination in land use under Decree 123/2024/ND-CP; and the lack of mandatory enforcement mechanisms for joint spousal certification under the 2024 Law’s implementing regulations. Based on this, the article proposes several recommendations to improve the law and strengthen enforcement mechanisms to better align with CEDAW and SDG 5.a standards. Full article

Language is social, as it is used by individuals to communicate and exchange ideas in society. Language is also cognitive, as the primary function of language, even before communicating and exchanging ideas, is to think. This article connects the social representations of what bilingualism is in the United States and how transnational youth are talked about in U.S. society with how both of these social representations create cognitive representations (e.g., thoughts, ideas, and beliefs) about transnational youth that result in negative educational policies and practices and shameful psychological and behavioral experiences for these youth. We begin with an ethnosemantic analysis of the word “bilingual” in the U.S. and then use the cognitive linguistic phenomena of conceptual metaphor and conceptual metonymy to explain how bilingualism is cognitively viewed as a “shameful problem” in society for transnational youth. We link linguistic shame, brought on by the social cognitive representations of bilingualism as transnational youth metonymically being incomplete, broken, in disrepair, fractured, unsettled, displaced, lacking fully built linguistic structures, not fully in possession of any language, to the phenomenon of and conceptual metaphor of TRANSNATIONAL YOUTH’S BILINGUALISM IS LINGUISTIC HOMELESSNESS. We conclude by putting forth a new metaphor, TRANSNATIONAL YOUTH FUNDS OF KNOWLEDGE ARE MYCELIAL NETWORKS, that rejects the concept of linguistic homelessness by pointing to these youth’s expanding networks of fluid languaging practices, transnational academic skills, and ever adapting identities. Through this new discourse, we advocate for new ways of socially talking about transnational youth and their languaging practices that may lead to different cognitive representations of these students; reorienting bilingualism from a problem to a resource and a right. Full article