Impact of sex on chemotherapy toxicity and efficacy in biliary tract cancer: Analysis of ABC, BILCAP trials and population data.

Impact of health policies on opioid tapering and discontinuation among patients receiving long-term opioid therapy for chronic noncancer pain.

Can transit-oriented development (TOD) cool the city? A multi-scale geospatial assessment of daytime surface heat exposure in Tokyo

Rate and Risk of Nonarteritic Anterior Ischemic Optic Neuropathy with Semaglutide Use for Diabetes and Weight Loss: A Systematic Review and Meta-Analysis.

Accurate identification of recent hepatitis E virus (HEV) and Toxoplasma gondii infections during pregnancy is essential for clinical management, yet diagnostic performance data in HIV-positive populations remain limited. We evaluated serological and molecular diagnostic approaches for detecting recent coinfection across gestation. In a prospective cohort of 780 HIV-positive pregnant women (CD4 + 200-400 cells/µL) in central Nigeria, we performed serial HEV and T. gondii IgG/IgM testing using recomLine immunoblot assays. A validation subset (n = 80) underwent HEV RNA detection by RT-qPCR and T. gondii IgG avidity testing. Diagnostic performance was calculated using molecular and avidity markers as reference standards. HEV IgM demonstrated 100% sensitivity (34/34) and 69.6% specificity for detecting HEV RNA-positive viraemia, the latter reflecting post-viraemic IgM persistence rather than serological false positivity, with 100% negative predictive value. Among IgM-positive participants, 70.8% (34/48) had detectable HEV RNA (mean Ct 31.6 ± 1.8). T. gondii IgM showed 100% concordance with low/intermediate avidity results, achieving 100% sensitivity and specificity for recent infection classification. Coinfection incidence increased from 1.9 to 7.8 per 100 person-months across gestation (adjusted HR 4.12, 95% CI 2.47-6.87). Dual IgM-positive cases showed 80% molecular/avidity confirmation of recent coinfection. Coinfection was associated with substantially elevated risks of adverse foetomaternal outcomes, including preterm birth (aRR 2.89, 95% CI 1.94-4.31), low birth weight (aRR 3.12, 95% CI 2.18-4.47), and perinatal mortality (aRR 4.17, 95% CI 2.04-8.52), all p < 0.001. Serological screening shows a very high negative predictive value, which is helpful in ruling out recent infections of HEV and T. gondii in HIV-positive pregnant women. If IgM antibodies are found, further testing using molecular or avidity-based methods is necessary.

Childhood sexual abuse and bullying victimization: National, regional and global trend analysis from global burden of disease data 1990-2021.

Background incidence rates and observed-to-expected ratios of adverse events of special interest after covid-19 mRNA vaccination during pregnancy in France: a nationwide population-based study.

Seven-year data trends in mental health of refugees in transit: a repeated cross-sectional study.

Prediction of ankle kinematics and kinetics in stair ascent motion using surface EMG feature inputs of lower extremity muscle combinations.

The goal of this study was to curate a prostate MRI dataset from a screening population and to train and evaluate a deep-learning segmentation method on the same data. An artificial intelligence (AI) system, based on a deep-learning-based segmentation model (nnU-Net method), was trained and evaluated with MRI data from a prostate cancer screening population (G2-trial). The goal of the AI was to detect clinically significant prostate cancer (csPC), defined as International Society of Urological Pathology (ISUP) grade 2 or higher. The AI system was compared to the performance of radiologists using PI-RADS v2 evaluation metrics. Histopathology was used as the reference standard in the dataset. To better verify negative cases, 288 men were subject to systematic biopsies regardless of MRI findings, and all men had at least 3 years of follow-up. A total of 1354 MRI examinations in 1254 men with a median age of 58 years (range 50-63 years) were randomly divided into a training set (1086 examinations) and a test set (268 examinations). The resulting area under the receiver operating characteristic curve (AUROC) was 0.83 (95% CI 0.73-0.92) for the AI system; however, with significantly lower specificity at matched sensitivity levels compared to radiologists. A prostate MRI dataset from a screening population with histological confirmation was curated and evaluated with AI. The neural network trained and tested on this data produced lower specificities than the radiologists. Question Does an AI system trained in a screening cohort perform as well as radiologists? Findings An AI trained on screening data achieved an AUROC of 0.83 (95% CI 0.73-0.92) with lower specificity at the same sensitivity levels as radiologists. Clinical relevance An AI system trained in a screening population has lower specificity than radiologists using PI-RADS v2.

• Resilience of urban vitality during the COVID-19 pandemic was measured in Seoul. • Three resilience dimensions were resistance, recovery capacity, and adaptability. • Neighborhood characteristics shaped resilience differently across dimensions. • Context-specific effects revealed heterogeneous and dynamic resilience patterns. • Findings provide insights for sustainable urban planning and tailored strategies. Although urban vitality and resilience are often examined as distinct phenomena, little is known about how vitality evolves across different phases of resilience under external shocks. This study investigates the resilience of urban vitality in Seoul during the COVID-19 pandemic by distinguishing three dimensions: resistance, recovery capacity, and adaptability. Using de facto population data (2018–2024), we trace resilience trajectories with a dynamic measurement framework that operationalizes these dimensions. Structural equation modeling is then applied to identify how neighborhood-level indicators for 424 administrative units shaped these three dimensions. The results show that resilience varied across neighborhoods: resistance declined in office-dominated areas but was partially supported by lodging and school facilities, recovery capacity was constrained by industrial land use but strengthened by favorable demographic composition and green space, and adaptability was reinforced by high levels of public transport accessibility. By contrast, several land-use and facility variables demonstrated inconsistent or marginal effects, indicating that resilience was shaped more by social composition, spatial openness, and connectivity than by static density measures. These findings highlight the heterogeneous and dynamic nature of resilience and underscore the need for differentiated strategies in sustainable urban planning.

Romania had the third highest total fertility rate (TFR) among EU countries in 2021 (1.81 children per woman), according to Eurostat data. As the country with population decline and mass emigration for many years, it is questionable whether this relatively high TFR corresponds to the actual level of fertility in Romania. The purpose of this article is to describe fertility changes in Romania based on statistics from the National Statistical Institute (INS) available in the TEMPO-Online database. The INS collects population data (including fertility rates) through two registers - one for the legally resident population and another for the usually resident population. Fertility rates within the two registries differ significantly - fertility is higher among residents. Although there are 20% fewer women of reproductive age in the usually resident population than in the legally resident population, the number of births registered under the two registries differs little (3-4 thousand per year). The observed increase in the number of births and fertility rate in Romania between 2012 and 2021 was due to the inclusion of children born abroad in the resident population. Births abroad accounted for 15-20% of births registered in the country. The problem of registration errors particularly affected counties bordering the Republic of Moldova, as evidenced by extremely high age-specific fertility rates in the cities of Vaslui counties. In the North – East region, the overestimation of the number of births and fertility rates is not only the result of registering children born abroad according to the mother's place of legal residence, but also the effect of an inflow of immigrants from Bessarabia who registered their children in Romania and migrated to other EU countries.

Purpose To evaluate whether the COVID-19 pandemic was associated with changes in the incidence of retinal vascular occlusions. Methods We performed a retrospective cohort study at the Jules-Gonin Eye Hospital (Lausanne). All new diagnoses of central retinal vein occlusion (CRVO), branch retinal vein occlusion (BRVO), central retinal artery occlusion (CRAO), and branch retinal artery occlusion (BRAO) between January 1, 2019 and December 31, 2020 were included. Regional COVID-19 case counts were obtained from public health records. Incidence rate ratios (IRR) comparing 2019 cases versus 2020 were calculated using official population data. Pearson correlation was used to explore temporal associations between monthly COVID-19 cases and retinal vascular events. The study period largely reflects natural infection exposure, as COVID-19 vaccination in Switzerland began on December 23, 2020. Results In 2019, 66 retinal vein occlusions (38 CRVO, 28 BRVO) and 20 arterial occlusions (9 CRAO, 11 BRAO) were recorded. In 2020, 49 retinal vein occlusions (34 CRVO, 15 BRVO) and 21 arterial occlusions (14 CRAO, 7 BRAO) were recorded. The IRR for 2020 versus 2019 was 0.73 for vein occlusions (95% CI 0.51–1.05; p =.093) and 1.04 for arterial occlusions (95% CI 0.57–1.90; p =.896). Monthly analysis showed no significant temporal association between COVID-19 incidence and retinal vascular events ( p =.08). Conclusions In this regional study, we did not observe an increase in retinal vascular occlusive events during the early phase of the COVID-19 pandemic. While biologically plausible mechanisms have been proposed, these population-level trends do not support a strong association.

West Nile virus (WNV), a mosquito-borne flavivirus, has circulated in the United States since 1999. In 2025, Florida was home to 24 million people, with projected increases in population and urbanization in a changing climate. The southern house mosquito, Culex quinquefasciatus, is found in every county, and is a major vector for WNV. Describing shifting WNV transmission risk is important to inform public health and vector control planning. Using published estimates of thermal suitability of WNV transmission by Cx. quinquefasciatus, with climate models and population data, we calculated and mapped baseline and projected county-level transmission suitability and people at risk for 2000, 2030, and 2050. Five general circulation models and two mitigation scenarios (SSP2-4.5, SSP5-8.5) were used to explore future trajectories. At baseline, all 67 counties in Florida experienced 5-9 months of transmission suitability. Using the year 2000 census estimates, 2.33 million people in 2 counties experienced 9 months, and in 2030, across climate models, 8.93-12.26 million people (10-20 counties; SSP2-4.5), and 8.95-18.10 million people (11-26 counties; SSP5-8.5) are projected to experience 9 or more months of transmission suitability. In 2050, for both SSP2-4.5 and SSP5-8.5, 17.08-20.42 million people (23-26 counties), ranging to approximately 70% of the projected population of Florida will experience 9 or more months. The 10 most populated counties in 2000 are projected to experience 1-3 months of additional climate-driven transmission suitability in the future. The southern house mosquito was previously managed as a seasonal nuisance in Florida, but now represents an increasing public health exposure risk. Projections across climate trajectories underscore an increasing suitability and exposure risk for WNV in Florida, ranging as high as around 70% of the population exposed to suitable climate conditions for transmission for 9 or more months of the year in the 2050s. This means the types of operations and number of employees needed in vector control and public health will also increase.

Circulating long non-coding RNAs (lncRNAs) have emerged as promising non-invasive biomarkers for colorectal cancer (CRC) detection; however, data in Vietnamese populations remain limited. In this study, a total of 218 participants (106 CRC, 80 adenomas, and 32 healthy controls) were included. Relative expression levels and diagnostic performance of three circulating lncRNAs—CCAT1, HOTAIR, and NEAT1—were quantified using RT-qPCR and analyzed by the 2−ΔΔCt method. Receiver operating characteristic (ROC) curve analysis was performed to assess the diagnostic accuracy of individual lncRNAs and their combinations. CCAT1, HOTAIR, and NEAT1 were significantly upregulated in CRC patients compared with adenoma patients and healthy controls (all p &lt; 0.001). Expression levels were higher in advanced-stage (TNM III–IV) CRC than in early-stage disease. Among individual markers, HOTAIR demonstrated the highest diagnostic accuracy (AUC = 0.918), followed by CCAT1 (AUC = 0.908) and NEAT1 (AUC = 0.890). Combined biomarker models showed improved performance, with the CCAT1 + HOTAIR combination achieving the highest AUC (0.944). Overall, circulating CCAT1, HOTAIR, and NEAT1 demonstrated favorable diagnostic performance in a Vietnamese population and outperformed conventional markers (CEA and CA19-9). These findings support the potential utility of multi-lncRNA panels as non-invasive biomarkers for CRC detection, warranting further validation in larger, independent cohorts.

This study analyzes the spatial pattern of demographic ageing in Turkey using a bivariate mapping technique. The research is based on the smallest administrative units in the country-villages and neighborhoods-and simultaneously evaluates the elderly population count (numerical ageing) and the proportion of elderly individuals (structural ageing). Utilising 2023 population data from the Turkish Statistical Institute (TurkStat) and applying the bivariate mapping tool in ArcGIS Pro, four ageing categories were identified: low-low (L-L), high-low (H-L), high-high (H-H), and low-high (L-H). The findings indicate that while the elderly are numerically concentrated in urban areas, structural ageing is more pronounced in rural villages and neighbourhoods, where "deep ageing" is observed. Moreover, the spatial patterns of the identified ageing categories are associated with other demographic phenomena, such as internal migration and fertility. The results demonstrate that ageing in Turkey is not a uniform phenomenon but rather one marked by spatial heterogeneity. This underscores the importance of spatial scale and regional differentiation in policymaking. Ultimately, the study contributes to social service planning by making the local dynamics of ageing—often obscured in national aggregates—more visible and strategically actionable.

Objectives Hematopoietic stem cell transplantation (HSCT) is preferred for several malignant and non-malignant hematopoietic conditions. However, high diversity in the histocompatibility genes, i.e., human leukocyte antigen (HLA) , poses a challenge due to the unavailability of HLA-identical donors for most cases. This has increased haplo-identical HSCT in the last few years, which can lead to enhanced allorecognition and propensity for graft-versus-host disease (GvHD). The population-specific molecular diversity of peptide-binding domains (PBD) of HLA alleles defines allo-sensitivity. Therefore, we attempted to analyze reported Indian HLA diversity for their phylogenetic relatedness in PBD, towards plausible implications for population-specific donor selection for haplo-identical HSCT here. Material and Methods For this observational study, published literature, allelefrequencies.net, and immuno polymorphism database (IPD) - international ImMunoGeneTics information system (IMGT)/HLA databases were referred to cumulatively estimate the degree of reported HLA diversity in the Indian population for the PBD region, with reference to global diversity. CLUSTAL omega and interactive tree of life (iTOL) were used for estimating phylogenetic relatedness. Results Comprehensive analysis of reported HLA data for Indian population revealed a heterogenous distribution pattern representing the majority of globally present allelic groups (one field). At two fields, 114 HLA-A, 185 HLA-B and 68 HLA-C alleles for HLA class I are reported for Indian population. The dendrograms highlighted phylogenetic relatedness between small clusters usually having same allele group (one field level), though few exceptions were also observed. Conclusion The observed heterogeneity in distribution of class I and class II and their phylogenetic relatedness could be attributed to diverse microflora and environmental conditions. Our analyses could plausibly facilitate formulating algorithms guiding optimal selection of permissible histocompatible donor for transplantation.

It has been proposed that there is a relationship between chromosomal nondisjunction and folate metabolism. Previous studies in mothers of girls with Turner syndrome (TS) and TS patients have suggested that 5,10-methylentetrahydrofolate reductase (MTHFR) C677T and A1298C gene variants might contribute to the risk of TS. However, data in different populations have yielded contradictory results. Here, we design a case-control study to evaluate the MTHFR C677T and A1298C gene variants in TS patients and their mothers as potential risk factors for TS. Using the TaqMan allelic discrimination assay, the frequency of the MTHFR C677T and A1298C gene variants was compared in two study groups, one of 54 girls with TS versus 93 control girls and another of 49 mothers of girls with TS versus 97 control mothers. The allele and genotype frequencies of the MTHFR C677T and A1298C variants were not significantly different nor showed association among TS patients compared with control girls, nor among TS mothers compared with control mothers. The risk of having a child with TS did not appear to be associated with the MTHFR C677T and A1298C variants in the studied population.

ABSTRACT Sexual and gender-based violence remains pervasive in South Africa, where rape incidence is among the highest globally. In sexual offence casework, conventional autosomal STR typing is often limited when male DNA is overwhelmed by female DNA, semen is absent, or samples are collected late. Y-chromosome STR (Y-STR) profiling provides a male-specific alternative for detecting male DNA in complex mixtures, while rapidly mutating (RM) Y-STRs improve discrimination between closely related males. However, Y-STRs also raise challenges relating to database design, match statistics, and ethical governance because Y-chromosomes are shared along paternal lines and may implicate unsampled male relatives. This narrative, problem-oriented review examines the staged implementation of Y-STR and RM Y-STR profiling in forensic services, particularly for sexual offence casework and the National Forensic DNA Database of South Africa (NFDD-ZA). It synthesises evidence on kinship and familial searching, laboratory workflows, software and databases, statistical interpretation, and legal-ethical safeguards. We propose a practical model for cautious implementation, showing that Y-STRs offer clear value in mixed or degraded samples, provided their use is supported by local population data, validated likelihood ratio frameworks, clear reporting standards, and strong constitutional safeguards.

The hypoglossal canal can develop bony ingrowths that create the appearance of hypoglossal canal duplication, encroach upon neurovasculature, and complicate condylectomy and transcondylar neurosurgical approaches. Numerous reports have identified the prevalence of the duplicated hypoglossal canal in adults; yet, data in the pediatric population remains limited. Therefore, this study assesses hypoglossal canal duplication among a fetal and infantile population. The study assessed hypoglossal canals in dry exoccipital bones from a modern population of 112 fetal and infantile crania of varied sex and population affinity, documented only as "black" and "white" in archival records, ranging in age from 5-month intrauterine development to 12-month postnatal development. Complete duplicated hypoglossal canals were found in 8:107 (7.48%) crania, 4:63 (6.35%) of fetal crania and 4:44 of infantile crania (9.09%); 8:205 (3.9%) exoccipital bones, 4:124 (3.23%) of fetal exoccipital bones, and 4:81 (4.94%) of infantile exoccipital bones. Regarding sex, complete duplicated hypoglossal canals were found in 4:91 (4.4%) female exoccipital bones and 4:114 (3.5%) male exoccipital bones. In "black" individuals, complete duplication was found in 3:115 (2.6%) exoccipital bones; and in "white" individuals, complete duplication was found in 5:90 (5.55%) exoccipital bones. Duplication was more common on the left, 5:107 (4.67%), as compared to the right, 3:107 (2.8%). No bilateral duplications were found. Incomplete duplications were found in 4:107 crania (3.74%) and only on the right side. Hypoglossal canal duplication can be present in the youngest of patients regardless of age, sex, and ancestry. Duplications may cause radiological and surgical confusion; thus, this report may help prevent adverse neurosurgical events.