Search Results (239)

Background: Comprehensive Geriatric Assessment (CGA) is essential for evaluating older cancer patients, but significant gaps persist in both research and clinical practice. This study aimed (I) to identify the CGA elements that most influence anti-cancer treatment decisions in older patients and (II) to explore the predictive value of CGA components for mortality. Methods: This observational study included older patients with newly diagnosed, histologically confirmed solid or hematological cancers, recruited consecutively from 2003 to 2023. Participants were followed for four years. The data collected included CGA measures of functional (Activities of Daily Living-ADL), cognitive (Mini-Mental State Examination-MMSE), and emotional (Geriatric Depression Scale-GDS) domains. Patients were categorized into frail, vulnerable, or fit groups based on Balducci’s criteria. Statistical analyses included decision tree modeling and Cox regression to identify predictors of mortality. Results: A total of 7022 patients (3222 females) were included, with a mean age of 78.3 ± 12.9 years. The key CGA factors influencing treatment decisions were ADL (first step), cohabitation status (second step), and age (last step). After four years, 21.9% patients had died. Higher GDS scores (OR 1.04, 95% CI 1.01–1.07, p = 0.04) were independently associated with survival in men and living with family members (OR 1.67, 95% CI 1.35–2.07, p < 0.001) in women. Younger patients (<77 years) showed both MMSE and GDS as significant risk factors for mortality. Conclusions: Functional capacity, cohabitation status, and GDS scores are crucial for guiding treatment decisions and predicting mortality in older cancer patients, emphasizing the need for a multidimensional geriatric assessment. Full article

In forests dominated by deciduous tree species, coniferous species are often disproportionately important because of their contrasting functional traits. Eastern white pine (Pinus strobus L.), once a widespread emergent canopy species, co-occurs with deciduous hardwoods in the northern Lake States, but is often uncommon in contemporary hardwood stands. To gain insights into the potential utility of hardwood management strategies for simultaneously regenerating white pine, we leveraged a northern hardwood silvicultural experiment with scattered overstory pine. Seven growing seasons post-harvest, we conducted a complete census of white pine regeneration (height ≥ 30 cm) and mapped their locations and the locations of potential seed trees. Pine regeneration was sparse and strongly spatially aggregated, with most clusters falling within potential seed shadows of overstory pines. New recruits were found to have the highest density in a scarified portion of the study area leeward of potential seed trees. Low regeneration densities within treatment units, strong spatial aggregation, and the spatial arrangement of potential seed trees precluded generalizable inferences regarding the utility of specific treatment combinations. Nevertheless, our results underscore the critical importance of residual overstory pines as seed sources and highlight the challenges associated with realizing their potential in managed northern hardwoods. Full article

Background and Objectives: Excessive social media use is repeatedly linked to negative body image outcomes, yet its association with muscle dysmorphia, especially in athletic youth, remains underexplored. We investigated how social media exposure, comparison behavior, and platform engagement relate to muscle dysmorphia symptomatology in young German athletes. Materials and Methods: An anonymous, web-based cross-sectional survey was conducted (July–October 2024) of 540 individuals (45% female; mean age = 24.6 ± 5.3 years; 79% ≥ 3 h sport/week) recruited via Instagram. The questionnaire comprised demographics, sport type, detailed social media usage metrics, and the validated German Muscle Dysmorphic Disorder Inventory (MDDI-1, 15 items). Correlations (Spearman’s ρ, Kendall’s τ) were calculated; multivariate importance was probed with classification-and-regression trees and CatBoost gradient boosting, interpreted via SHAP values. Results: Median daily social media time was 76 min (IQR 55–110). Participants who spent ≥ 60 min per day on social media showed higher MDDI scores (mean 38 ± 7 vs. 35 ± 6; p = 0.010). The strongest bivariate link emerged between perceived social media-induced body dissatisfaction and felt pressure to attain a specific body composition (Spearman ρ = 0.748, Kendall τ = 0.672, p < 0.001). A CatBoost gradient-boosting model out-performed linear regression in predicting elevated MDDI. The three most influential features (via SHAP values) were daily social media time, frequency of comparison with fitness influencers, and frequency of “likes”-seeking behavior. Conclusions: Intensive social media exposure substantially heightens muscle dysmorphia risk in young German athletes. Machine-learning interpretation corroborates time on social media and influencer comparisons as primary drivers. Interventions should combine social media literacy training with sport-specific psychoeducation to mitigate maladaptive comparison cycles and prevent downstream eating disorder pathology. Longitudinal research is warranted to clarify causal pathways and to test targeted digital media interventions. Full article

Long-COVID (LC) is characterized by diverse and persistent symptoms, potentially mirroring different molecular pathways. Recent data might offer that one of them is mediated by functional autoantibodies (fAAb) targeting G protein-coupled receptors (GPCR). Thus, the aim of this study was to investigate the clinical phenotype of patients with LC in relation to their GPCR-fAAb seropositivity. The present study recruited 194 patients with LC and profiled them based on self-reported symptoms. GPCR-fAAb seropositivity was identified by using a cardiomyocyte bioassay, testing the presence and functionality of the AAbs. Logistic regression, clustering, and decision tree analyses were applied to examine associations between GPCR-fAAb profiles and self-reported symptoms considering age and gender. The most prevalent GPCR-fAAbs in patients with LC were fAAB targeting the β2 adrenergic receptor (β2-fAAb, 92.8%), the muscarinergic M2 receptor (M2-fAAb, 87.1%), the Angiotensin II type 1 receptor (AT1-fAAb, 85.6%), and angiotensin (1–7) Mas receptor (MAS-fAAb, 85.6%). β2-fAAb showed a significant relation with dizziness, lack of concentration, and POTS, while Endothelin Type A receptor functional autoantibody (ET-A-fAAb) was significantly related to deterioration of pre-existing neurological disorders. Statistical analysis indicated a strong positive correlation between M2- and β2-fAAb; as in addition, an association of β2-fAAb and gender was observed to one of the major clinical symptoms (fatigue/PEM), a critical impact of GPCR-fAAb on LC-pathogenesis can be assumed. Summing up, the present data show that specific GPCR-fAAb are associated with distinct clinical phenotypes. Especially, the combination of M2- and β2-fAAb seemed to be essential for the LC-phenotype with a combination of fatigue/PEM and lack of concentration as major clinical symptoms. Full article

Transcriptomic profiling has shown that exposure to PM_2.5, a common air pollutant, can modulate gene expression, which has been linked to negative health effects and diseases. However, there are few population-based cohort studies on the association between PM_2.5 exposure and specific gene set expression. In this study, we used an unbiased transcriptomic profiling approach to examine gene expression in a mouse model exposed to PM_2.5 and to identify PM_2.5-responsive genes. The gene expressions were further validated in both the human cell lines and a population-based cohort study. Two cohorts of healthy older adults (aged ≥ 65 years) were recruited from regions characterized by differing levels of PM_2.5. Logistic regression and decision tree algorithms were then utilized to construct predictive models for PM_2.5 exposure based on these gene expression profiles. Our results indicated that the expression of five genes (FAM102B, PPP2R1B, OXR1, ITGAM, and PRP38B) increased with PM_2.5 exposure in both cell-based assay and population-based cohort studies. Furthermore, the predictive models demonstrated high accuracy in classifying high-and-low PM_2.5 exposure, potentially supporting the integration of gene biomarkers into public health practices. Full article

Background: Children, including the estimated 7% with food allergy, spend most of their waking hours in school. Variations in school-based food allergy (FA) practices exist. We aimed to examine differences in FA management practices across schools in Canada and the United States (US). Methods: Parents of children with Immunoglobulin E (IgE)-mediated FA were recruited through social media to complete a survey evaluating the schools’ stock epinephrine, epinephrine storage locations, school type, and location. Data were described, analyzed using logistic and linear regressions, and then reported as odds ratios (ORs) and standardized coefficients (b), respectively, with corresponding 95% confidence intervals (95%CIs) and p < 0.05. This study was approved by the University of Manitoba Health Research Ethics Board. Results: Overall, 177 participants (14% [26/177] Canada, 86% [151/177] US) were included. Children were, on average, 4.92 ± 3.12 years and were commonly but not mutually exclusively allergic to tree nuts (50% Canada; 40% US) and peanuts (33% Canada; 29% US). Compared to US parents, Canadian parents were more likely to report epinephrine self-carriage by their children (OR = 4.58; 95%CI = 1.67–12.59). Parents with children age > 5 years were more likely to report epinephrine self-carriage by their children (OR = 3.70; 95%CI = 1.38–9.93) but less likely to report that their children’s school had an allergen-friendly zone (OR = 0.25; 95%CI = 0.06–0.99). Compared to US parents, Canadian parents were more likely to report their child’s school had anaphylaxis management policies (OR = 8.98; 95%CI = 1.11–72.42). Conclusions: Significant in-school FA management differences exist between countries. These findings stress the need for consistent policies and practices to ensure effective care. Full article

Aprostocetus nitens Prinsloo & Kelly (Hymenoptera: Eulophidae) was identified as one of four hymenopteran ectoparasitoids utilizing three erythrina gall wasps, Quadrastichus bardus, Q. erythrinae, and Q. gallicola) (Hymenoptera: Eulophidae) in the native eastern Africa. In Hawaiʻi, the eurytomid wasp, Eurytoma erythrinae Gates & Delvare (Hymenoptera: Eurytomidae), was introduced and approved for statewide release in 2008 to control the erythrina gall wasp (EGW) Q. erythrinae Kim. EGW has devastated the wiliwili trees, Erythrina sandwicensis Degener (Fabaceae), an ecologically and culturally important native Hawaiian tree species. However, the parasitoid’s impact on the galled inflorescences and shoots was not adequate to ensure adequate seed set and maturation for successful tree recruitment. Aprostocetus nitens was thus evaluated as a prospective natural enemy to enhance the biological control of EGW to further protect the wiliwili trees in Hawaiʻi. Both choice and no-choice host specificity tests were conducted on seven non-target gall formers in the Hawaii Department of Agriculture, Insect Containment Facility, and showed that the parasitoid was extremely specific to EGW. The potential for competition between this parasitoid and the established E. erythrinae was also investigated, showing that the release of a second parasitoid will potentially complement the success of the eurytomid wasp for control of EGW. Unlike what was found in the native region, the Hawaiian laboratory colony is thelytokous, producing only female offspring. The life cycle took 20.1 ± 0.28 days under the laboratory conditions. Non-ovipositing female survived for 102.5 ± 2.9 days when fed honey and laid eggs for 25.1 ± 2.3 days with average fecundity of 156.7 ± 22.3 offspring/female. This value is 3.9-fold higher than offspring produced by E. erythrinae. Aprostocetus nitens, host specificity, competition with E. erythrinae, and its tri-trophic association with 15 Erythrina host plants and 5 gall wasp assemblages in the native African regions were defined. Implications to reduce frequent galls on the native Erythrina plants and likely domination over E. erythrinae, are discussed. Full article

Background: Lung cancer is among the most prevalent and fatal cancers worldwide. Traditional diagnostic methods, such as computed tomography, are not ideal for screening due to their high cost and radiation exposure. In contrast, blood-based diagnostics, as non-invasive approaches, are expected to reduce patient burden, thereby increasing screening participation and ultimately improving survival rates. However, conventional tumor markers have shown limited effectiveness in early detection. Methods: We recruited 199 patients with lung cancer and 590 healthy volunteers. Nine tumor markers (CEA, CA19-9, CYFRA, AFP, PSA, CA125, CA15-3, SCC antigen, and NCC-ST439) were analyzed, along with enriched glycopeptides (EGPs) derived from serum proteins using liquid chromatography–mass spectrometry. Machine learning models, including decision trees and deep learning approaches, were employed to develop a predictive model for accurately distinguishing lung cancer from healthy controls based on tumor markers and EGP profiles. Results: We found that α1-antitrypsin with fully sialylated biantennary glycan, attached to asparagine 271 (AT271-FSG), and α2-macroglobulin with fully sialylated biantennary glycan, attached to asparagine 70 (MG70-FSG), could significantly distinguish between patients with lung cancer and healthy individuals. Comprehensive Serum Glycopeptide Spectra Analysis (CSGSA), integrating nine conventional tumor markers and 1688 EGPs using a machine learning model, enhanced diagnostic accuracy and achieved an ROC-AUC score of 0.935. It also identified stage I cases with an ROC-AUC of 0.914, indicating the possibility of early-stage detection. The PPV reached 2.8%, which was sufficient for practical application. Conclusions: This method represents a significant advancement in cancer diagnostics, combining multiple biomarkers with cutting-edge machine learning to improve the early detection of lung cancer. Full article

Seasonally dry tropical forests (SDTFs) represent about 41.5% of the planet’s tropical forests. The objective of this study was to characterize the annual mortality and recruitment patterns of stems and trees between the years 2012–2021 in a Caatinga remnant in the state of Pernambuco, Brazil, through geostatistical modeling, and to associate the drought events recorded in the region with vegetation dynamics. Mortality and recruitment of stems and trees were monitored in 80 permanent plots located in an SDTF remnant, counted year by year between 2012 and 2021. The standardized precipitation index (SPI) was calculated to quantify the deficit or excess of rainfall in the evaluated period. The data were then subjected to geostatistical analysis based on the calculation of classical semivariances. As a result, there was a loss of 68.33% of trees and 61.93% of stems in the forest community during 2012–2021, which were associated with the water deficit caused by drought events recorded based on precipitation data and SPI calculation for the region. The Gaussian semivariogram model better represented the spatial variability of mortality and recruitment of stems and trees. An accumulative effect of droughts on increasing mortality rates and reducing recruitment during the study period was observed. The relationship between tree and stem mortality and recruitment rates and drought events highlights the impact of water deficit on vegetation, emphasizing the importance of considering extreme climatic events in the proper management of natural resources. Full article

This study was conducted at a fixed monitoring site in the southern dump of the large-scale Antaibao open-pit coal mine of China Coal Pingshuo, using long-term monitoring methods. Based on data from 2019 and 2024 in the reclaimed area of the Pingshuo open-pit coal mine, all seedlings and saplings within the Robinia pseudoacacia L. + Ulmus pumila L. + Ailanthus altissima (Mill.) Swingle mixed forests were studied to analyze changes in their abundance and the driving factors influencing their survival rates from 2019 to 2024. The main conclusions are as follows: (1) The species composition of seedlings and saplings remained unchanged but the number of seedlings increased significantly. The majority of newly recruited seedlings were U. pumila., accounting for 92.22% of the total new seedlings, whereas R. pseudoacacia had the highest mortality rate among seedlings. The distribution patterns of seedling-to-sapling transition, sapling-to-tree transition, and seedling–sapling mortality were generally consistent with the overall distribution of seedlings and saplings at the community level. (2) At both the community and species levels, the optimal models for seedling and sapling survival were the height model and the biological factor model. Overall, survival rates of both seedlings and saplings showed a significant positive correlation with height. (3) The biological factors affecting the survival of U. pumila saplings were the basal area (BA) at breast height and the number of conspecific adult trees. The former was significantly negatively correlated with U. pumila seedling survival, while the latter was positively correlated. For R. pseudoacacia seedlings, the key biological factors were the number of heterospecific adult trees and the number of heterospecific seedlings. The former was significantly negatively correlated with survival, whereas the latter was significantly positively correlated. The primary factor influencing sapling survival was sapling height, which showed a significant positive correlation. Full article

This study presents a model for estimating forest productivity based on a sample of 2048 permanent field plots covering a wide range of growing sites in Mexico. Our state-space approach assumes that the growth behavior of any stand over time can be estimated on the basis of its current state, defined by the dominant height (H), number of trees per hectare (N), and stand basal area (BA). We used transition functions to estimate the change in states as a function of the current state. We also present transition functions for the change in stand volume (V) and total above-ground biomass (AGB). The first transition function relates dominant height to dominant diameter by using the guide-curve method to estimate site form. The transition function for N consists of two models, one for estimating natural mortality and the other for estimating recruitment. These models were developed in two steps: in the first step, the logistic regression and maximum likelihood approach were used to estimate the probability of the occurrence of mortality or recruitment, and in the second step, the rate of change associated with each event was modeled when mortality or recruitment was assumed to have occurred as a result of the first step. The remaining three transition functions (BA, V, and AGB) were fitted simultaneously to account for possible correlations between errors. The model estimating total above-ground biomass (AGB), which can be considered a state variable that summarizes the performance of the whole model, explained more than 97% of the observed variability, with a root mean square error value of 10.57 Mg/ha. Full article

Elephants exhibit remarkable cognitive and social abilities, which are integral to their navigation, resource acquisition, and responses to environmental challenges such as climate change and human–wildlife conflict. Their capacity to acquire, recall, and utilise spatial information enables them to traverse large, fragmented landscapes, locate essential resources, and mitigate risks. While older elephants, particularly matriarchs, are often regarded as repositories of ecological knowledge, the mechanisms by which younger individuals acquire this information remain uncertain. Existing research suggests that elephants follow established movement patterns, yet direct evidence of intergenerational knowledge transfer is limited. This review synthesises current literature on elephant navigation and decision-making, exploring how their behavioural strategies contribute to resilience amid increasing anthropogenic pressures. Empirical studies indicate that elephants integrate environmental and social cues when selecting routes, accessing water, and avoiding human-dominated areas. However, the extent to which these behaviours arise from individual memory, social learning, or passive exposure to experienced individuals requires further investigation. Additionally, elephants function as ecosystem engineers, shaping landscapes, maintaining biodiversity, and contributing to climate resilience. Recent research highlights that elephants’ ecological functions can indeed contribute to climate resilience, though the mechanisms are complex and context-dependent. In tropical forests, forest elephants (Loxodonta cyclotis) disproportionately disperse large-seeded, high-carbon-density tree species, which contribute significantly to above-ground carbon storage. Forest elephants can improve tropical forest carbon storage by 7%, as these elephants enhance the relative abundance of slow-growing, high-biomass trees through selective browsing and seed dispersal. In savannah ecosystems, elephants facilitate the turnover of woody vegetation and maintain grassland structure, which can increase albedo and promote carbon sequestration in soil through enhanced grass productivity and fire dynamics. However, the ecological benefits of such behaviours depend on population density and landscape context. While bulldozing vegetation may appear destructive, these behaviours often mimic natural disturbance regimes, promoting biodiversity and landscape heterogeneity, key components of climate-resilient ecosystems. Unlike anthropogenic clearing, elephant-led habitat modification is part of a long-evolved ecological process that supports nutrient cycling and seedling recruitment. Therefore, promoting connectivity through wildlife corridors supports not only elephant movement but also ecosystem functions that enhance resilience to climate variability. Future research should prioritise quantifying the net carbon impact of elephant movement and browsing in different biomes to further clarify their role in mitigating climate change. Conservation strategies informed by their movement patterns, such as wildlife corridors, conflict-reducing infrastructure, and habitat restoration, may enhance human–elephant coexistence while preserving their ecological roles. Protecting older individuals, who may retain critical environmental knowledge, is essential for sustaining elephant populations and the ecosystems they influence. Advancing research on elephant navigation and decision-making can provide valuable insights for biodiversity conservation and conflict mitigation efforts. Full article

Retrospective studies have suggested that performing perioperative abdominal wall exercises may decrease the incidence of parastomal hernias. Objectives: This study seeks to assess the usefulness of supervised preoperative and postoperative abdominal wall exercises in the prevention of parastomal hernia. Methods: An observational study of patients who underwent a stoma, temporary or permanent, between January 2019 and December 2020, was performed. Minimum follow-up was 12 months. During the first 12 months of recruitment, patients were enrolled on a consecutive basis and assigned to the control group, and the remaining patients were assigned to the intervention group. A propensity score matching was performed to obtain totally comparable groups. A set of exercises was designed by the Rehabilitation Department, and their performance was supervised by physiotherapists and stoma therapists. The diagnosis of parastomal hernia was made by physical examination and computed axial tomography. Descriptive statistics of the study group were performed. Subsequently, prediction models for the occurrence of parastomal hernia were created based on binary logistic regression and classification trees. Results: After propensity matching and inclusion criteria, 64 patients were included (colostomy: n = 39, ileostomy: n = 25). Independent prognostic variables for parastomal hernias in colostomy were age (p = 0.044) and perioperative exercises (p = 0.003). The binary logistic regression model based on these variables gave an AUC of 97.6. The classification tree model included only perioperative exercises with an AUC of 92.5%. In the case of ileostomy, perioperative exercises were the only independent prognostic variable identified. The classification-tree-based model reported an AUC of 84%. Conclusions: The performance of supervised abdominal wall training and strengthening exercises may be useful in the prevention of parastomal hernias. Full article

The physiological performance of clonal plants is largely linked with resource translocation among interconnected ramets. Whereas carbon (C) and nitrogen (N) transferences have been evidenced in several herbaceous clonal plants, empirical evidence in woody species is anecdotal. We evaluated physiological integration in two evergreen tree species, differing in the light requirements in a temperate rainforest of Southern Chile: Embothrium coccineum J.R. et. G. Forster (light-demanding) and Eucryphia cordifolia Cav. (shade-tolerant). We measured light availability for vegetative (root suckers) and sexual (seed-origin plants; hereafter, saplings) recruits of the two species. Then, we compared elemental and isotopic leaf traits between recruit types and species growing under similar light availability. A ¹³CO₂ field pulse labeling was performed on a set of Embothrium root suckers to quantify C transfer from moderately shaded suckers (donors) to highly shaded suckers (receivers). For the two species, leaf N concentration, δ¹³C, and δ¹⁵N were higher in suckers compared to saplings. In the labeling experiment, the δ¹³C and ¹²C equivalent excess did not differ between donor and receiver, indicating a weak C transfer between donors and receivers. Although the results from the pulse labeling were not conclusive, they suggest, together with the differences in natural isotope abundance, the existence of physiological integration in root suckers of both species. Our findings indicate that the formation of root suckers is more important for regeneration and persistence than for resource acquisition at an intermediate ecological succession of a temperate rainforest. Full article

Both topography and wildfire can exert significant influences on ecosystem processes and functions during boreal forest successions. However, their impacts on ecosystem multifunctionality (EMF) remain unclear. A mega-fire burned an area of 8700 hectares in the Great Xing’an Mountains in 2000, creating a wide range of fire severity levels across various topographic positions. This provided a unique opportunity to explore the impacts of mixed-severity fire disturbance in boreal forests. We evaluated the effect pathways of wildfire and topography on aboveground multifunctionality (AEMF), soil multifunctionality (SEMF), and overall multifunctionality (OEMF). We found that high-severity burning resulted in lower AEMF, SEMF, and OEMF relative to low-severity burning. Topographic positions significantly influenced SEMF and OEMF, but not AEMF. Specifically, both lower SEMF and OEMF were observed on south-facing slopes. The structure equation model analysis showed that aspect had exerted strong indirect effects on AEMF, SEMF, and OEMF by affecting soil moisture and regenerated tree density (RTD). Fire severity had indirect negative effects on AEMF and OEMF by reducing RTD and on SEMF by reducing soil bacterial diversity and RTD. Our study elucidates the necessity of considering postfire site environments to better manage forest ecosystems and, in turn, promote the rapid recovery of boreal ecosystem functions. Full article