Cumulative adverse childhood experiences and risk of mental disorders: A systematic review and meta-analysis.

Sedation is a critical component of modern anesthesia and procedural medicine, particularly outside the operating room. Dexmedetomidine and remimazolam have emerged as prominent sedatives due to their unique pharmacological profiles. However, the comparative efficacy and safety of these agents remain incompletely understood, especially regarding recovery times and adverse events. In the present study, a systematic review and meta-analysis as performed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A comprehensive literature search was conducted across PubMed, Cochrane Library and Scopus from inception until March 2025. The eligible studies compared the sedation efficacy, safety and recovery time of the dexmedetomidine group with the remimazolam group. Data extraction was independently conducted by two reviewers using a standardized data collection form. The methodological quality of observational studies was assessed using the Risk of Bias in Non-randomized Studies-of Interventions (ROBINS-I) tool, while randomized controlled trials (RCTs) were evaluated using the Cochrane Risk of Bias 2.0 (RoB 2.0) tool. Meta-analyses were conducted using random-effects models, and heterogeneity was evaluated through prediction interval analysis and sensitivity testing. A total of 9 studies were included, 4 of which were RCTs and judged to have low risk of bias across all domains. The remaining 5 observational studies, with most rated as having moderate risk of bias and 1 study rated as serious due to confounding and outcome measurement concerns. The forest plot analysis revealed that there was no statistically significant difference in the sedation efficacy between the dexmedetomidine group and the remimazolam group [standardized mean difference (SMD), 0.049; 95% confidence interval (CI), -0.101 to 0.198; P=0.523]. However, the remimazolam group consistently demonstrated significantly shorter full alertness times compared with the exmedetomidine group (SMDs ranging from -0.511 to -1.852, all P<0.001). There was no significant difference in the overall risk of adverse events between the two groups [odds ratio (OR), 1.509; 95% CI, 0.246-9.153; P=0.654]; however, the subgroup analysis showed that the risk of arrhythmia in the dexmedetomidine group was significantly higher than that in the remimazolam group (OR, 2.152; 95% CI, 1.158-3.999; P=0.015). In conclusion, both dexmedetomidine and remimazolam achieved similar sedation success rates, indicating no significant difference in procedural efficacy. However, remimazolam was associated with significantly faster recovery times and a lower risk of arrhythmia, making it particularly attractive for short-duration or outpatient procedures where rapid emergence and hemodynamic stability are prioritized.

Non-pharmaceutical interventions targeting psychological health in women with polycystic ovary syndrome:a systematic review and meta-analysis.

Chemoimmunotherapy efficacy in patients with and without liver metastases: A systematic review and meta-analysis.

Explainable AI-based optimization of facility operations for excessive NOx emission control: A case study of a solid refuse fuel combustion facility

Design and optimization of grid-connected hybrid renewable energy systems with EV integration for supermarkets

Characterization of antibiotic-resistant bacteria and phylogenetic analysis of E. coli strains isolated from healthy broilers in Rawalpindi, Pakistan.

Novel freshness indicators were developed using a starch–polyvinyl alcohol matrix incorporating pomegranate juice as a natural source of anthocyanins. To ensure a sustainable production process, the anthocyanins were not isolated from the juice, thus avoiding the use of organic solvents and energy–intensive extraction processes. The resulting smart indicators were characterised in terms of their optical properties, microstructure, infrared spectrum, water affinity, color response across a range of pH values, reactivity to volatile amines (ammonia, trimethylamine and dimethylamine), and color reversibility. The smart indicators were tested in fish fillet packaging systems under controlled temperature conditions (2.8 °C), where their performance was evaluated over time. An artificial intelligence tool was employed to classify the visual appearance of the films during storage. Microstructure analysis revealed satisfactory microstructural integrity and compatibility between the pomegranate juice and the biopolymer carrier. The incorporation of pomegranate juice enhanced the hydrophilicity of the membranes. The color sensitivity test demonstrated that the smart films responded effectively to increases in pH and volatile amine concentrations. A perceptible color shift from red to purple–green was observed from the early stages of spoilage (day 4–5), with intensity increasing as degradation advanced. The indicator response aligned with changes in headspace gas composition and was consistent with microbiological and chemical quality indicators of fish flesh, highlighting their potential as effective tools for real–time monitoring of fish freshness and spoilage. • Smart films developed using pomegranate juice, eliminating the need for anthocyanin solvent extraction • Effective incorporation of pomegranate juice into the PVA/starch biopolymer matrix • Color change of indicators strongly correlated with microbiological and physicochemical markers of fish spoilage • AI-assisted analysis validated the effectiveness of the smart films for real-time freshness monitoring

Changes in visual processing have been found to be affected in the early stages of dementia, potentially limiting driving ability. This pilot study investigated the sensitivity and specificity of eye-tracking, visual processing, and dementia screening tests in evaluating driving abilities among older drivers with and without cognitive impairment. Twenty-three participants aged 65+ years (n = 10 with cognitive impairment, 13 healthy controls) underwent dementia screening assessments including Mini Mental State Examination (MMSE) and Hopkins Verbal Learning Test (HVLT), a Visual Sensitivity Test (VST) and eye-tracking tasks (prosaccade, antisaccade, prospective eye movements) and compared these against a computerised driving-related hazard perception test (HPT) and self-report driving measures. Correlation analyses and ROC curves were used to explore relationships among the outcome measures. Drivers with cognitive impairment did not report different subjective driving performance, but had significantly lower HPT scores, with most scoring below the Driving and Vehicle Licensing Agency (DVLA) requirement for licensure. Eye-tracking data (n = 19) showed that drivers with cognitive impairment exhibited greater prosaccade latency variability. Antisaccade latency and prospective eye movement tests both correlated with self-reported in-vehicle task performance. The VST and HVLT tests strongly correlated with HPT scores and were highly predictive of scoring below the HPT DVLA cut-off scores. The VST and HVLT demonstrated high sensitivity and specificity for screening poor hazard perception performance in older drivers with cognitive impairment. Impaired eye movements correlated with self-reported difficulties in operating in-vehicle tasks, but not with HPT performance. Further research is needed to verify these findings in on-road assessments and with a larger sample size. • Cognitively impaired drivers show greater variability in prosaccade latency. • Eye-tracking metrics correlate with self-reported in-vehicle task performance, not hazard perception. • Visual processing speed test strongly predicts hazard perception in dementia. • Visual screenings should be integrated into comprehensive assessments of driving.

Longitudinal study of a Scottish beef herd affected with Mycobacterium avium subsp. paratuberculosis; monitored by faecal culture, serum ELISA and the interferon-gamma release assay.

High-throughput radiation sensitivity screening of 3D-head and neck squamous cell carcinoma (HNSCC) organoids using an automated radiation modulator (ARM).

ABSTRACT Flame stabilization of autoignited lifted jet flames under oxygen-diluted conditions relevant to MILD combustion remains challenging. Motivated by the counterintuitive trend—namely, a decrease in liftoff height, H L , of methane/hydrogen jet flame with increasing jet velocity, U 0 , due to differential diffusion—we investigate whether this effect can be leveraged to enhance the stabilization of laminar autoignited lifted methane/hydrogen jet flames under MILD combustion conditions. Two-dimensional numerical simulations are performed using a detailed kinetic mechanism involving 57 species over a wide range of oxidizer oxygen mole fractions, X O 2 . The results show that the decreasing trend of H L with increasing U 0 becomes more pronounced as X O 2 decreases. At sufficiently high U 0 , H L even decreases with decreasing X O 2 , contrary to expectations based on conventional flame behavior in fuel/air mixtures. Complementary one- and two-dimensional simulations reveal that, as X O 2 decreases, the most reactive zone shifts toward the coflow, strengthening the differential diffusion effect. This shift increases the local hydrogen ratio, R H , upstream of the flamebase, thereby promoting earlier local ignition and a higher edge flame propagation speed, S e . The combined effects of enhanced local reactivity and increased edge flame propagation lead to a reduction in H L as X O 2 decreases. Sensitivity tests over inlet temperature and chemical-kinetic mechanisms further indicate that these trends are robust rather than confined to a narrow parameter window.

Colorectal cancer (CRC), a lethal tumor of the intestine, has lipotoxicity, which exerts a significant influence on the onset and development of intestinal disorders. This study provides an in-depth evaluation of lipotoxicity-related genes (LRGs) in the CRC treatment setting. Differentially expressed genes (DEGs) within The Cancer Genome Atlas-CRC dataset and LRGs were intersected to obtain the LRG-DEGs. Subsequently, univariate Cox regression and a random survival forest model were conducted to select prognostic LRGs and construct a risk model for patients with CRC. Then, prognosis was further investigated via independent prognostic analysis, nomogram construction, enrichment analysis, immune microenvironment analysis, and drug sensitivity testing. Finally, reverse transcription quantitative PCR (RT-qPCR) was used to verify the expression levels of prognostic LRGs. The constructed risk model with five prognostic LRGs (PPARGC1A, CPT2, CXCL1, FABP4, and OFCC1) showed high prognostic effectiveness. The nomogram subsequently built based on risk score, age, T stage, and M stage showed strong prognostic power. Moreover, the enrichment of diverse pathways was observed across distinct risk groups, exemplified by the PPAR signaling pathway and complement and coagulation cascades. Analysis of the immune microenvironment revealed the strongest positive association between FABP4 and natural killer cells. Drug sensitivity testing identified efficacious drugs for patients with CRC, such as midostaurin and lenalidomide. Notably, RT-qPCR confirmed elevated expression levels for CXCL1 and OFCC1 and reduced levels for FABP4, PPARGC1A, and CPT2 in patients with CRC. Five prognostic LRGs were determined for CRC, and a new risk model was developed and validated, revealing the critical role of LRGs in CRC and improving our understanding of clinical interventions for this cancer type.

Diet is a key modifiable factor influencing depression, with its impact well-documented in clinical studies. However, research on the combined effect of multiple dietary indices remains limited. This study investigates the relationship between four dietary indices and depression in American adults using data from 5030 participants in the 2017-2020 NHANES dataset. Depression was diagnosed using the Patient Health Questionnaire-9 (PHQ-9), with scores ≥ 10 indicating depression. Dietary indices were derived using the "dietary index" package, based on 24-hour dietary recall data. Various analytical methods, including multivariate logistic regression, sensitivity test, subgroup analysis, receiver operating characteristic (ROC) curves, and decision curve analysis (DCA), were used to assess the associations. Results showed that the Healthy Eating Index 2020 (HEI2020) and Dietary Inflammation Index (DII) were significantly associated with depression after adjusting for confounders. Sensitivity tests validated the strength of these results. Subgroup stratification indicated modified correlations between dietary quality scores and depression across multiple population characteristics, with significant interactive heterogeneity observed only for MEDI and DII. ROC analysis indicates that HEI2020 had the highest AUC among the indices (AUC = 0.606), although its discriminatory performance was modest, with clinical decision curves indicating potential value for depression risk stratification. A meta-analysis of protective factors revealed a notable correlation indicating lowered depression probability (OR = 0.58, 95% CI: 0.49-0.70, P < 0.001). Through the combined evaluation of risk factors, a significantly higher depression rate was observed (OR = 1.59, 95% CI: 1.34-1.88, P < 0.001). These findings suggest that healthy dietary patterns combined with anti-inflammatory diets may serve a function in lowering the chances of depression onset among American adults.

Nobiletin Restores Corneal Circadian Transcriptome Organization and Mitigates Ocular Surface Pathology in High-Fructose-Induced Metabolic Dysfunction.

Circulating tumour cells (CTCs) are mediators of cancer dissemination and the formation of metastasis, which is the leading cause of cancer-related deaths. Experimental models derived from CTCs contribute to understanding the biology of CTCs, their role in dissemination, and the discovery of potential drugs targeting CTCs. A xenograft was derived from CTCs isolated from a patient diagnosed with metastatic invasive ductal carcinoma of the breast. The characterisation of the CTCs-derived xenograft (CDX) was conducted through in vivo experimental metastatic assays, RNA-Seq, spectral flow cytometry, and drug sensitivity tests. The CTCs-enriched fraction formed a CDX within 6 months, and its metastatic potential was confirmed. CDX cells were propagated in vitro, where the enrichment of CD44+/CD24- breast cancer stem cells was confirmed. An RNA-Seq-based comparison of CDX with the primary tumour from the same patient unravelled substantial changes in genes related to cell growth, metabolism, and extracellular signalling. CDX and in vitro cell culture showed sensitivity to carboplatin. A partial response was also observed for vandetanib, which was selected through in silico analysis of transcriptomic data. We present and characterise a novel model derived from CTCs for understanding the plasticity and behaviour of CTCs and advanced breast cancer. CDX_IBP_01 was established from the CTC-enriched fraction obtained from the patient with progressing breast cancer. Once stably re-transplanted and growing in vivo, the transcriptomes of CDX and archived primary BCa1 samples were compared. 2D and 3D in vitro cell cultures were established from sorted human cancer cells from an in vivo xenograft. Phenotypes of established models and their stability were characterised using spectral flow cytometry. The metastatic potential of CDX was evaluated in an in vivo assay. Finally, the applicability of the established model for in vivo and in vitro drug screening was evaluated. Created in https://BioRender.com .

This study addresses the prediction of daily waste generation dynamics under data-limited conditions in a strategic watershed serving over 25 million residents. A machine learning framework is developed using daily proxies reconstructed from annual data (2019–2024) through an additive seasonal stochastic disaggregation approach, while maintaining consistency with official SIPSN records. Statistical analysis identifies the 2023 annual total as anomalous (+127.06% YoY) using the IQR method, while sensitivity tests to various parameter configurations indicate that the baseline setting (α = 0.95; σ_frac = 0.08) provides stable estimates. Four models—Random Forest, Support Vector Regression (SVR), XGBoost, and Long Short-Term Memory (LSTM)—are evaluated using strict chronological partitioning to maintain temporal integrity. Results indicate that the evaluation reflects the model’s ability to reproduce synthetic proxies, rather than direct field observations. SVR performed best (R2 = 0.8157; RMSE = 881.43 t/day), outperforming the persistence baseline by +32.2%. After data leakage correction, XGBoost’s performance decreased significantly (R2 = 0.1591). Feature analysis confirmed the dominance of short-term statistical indicators, while the hierarchical bootstrap approach produced more comprehensive uncertainty estimates, with SVR remaining the most stable across seasons.

This study shows that Innowave MTB/RIF/INH is a faster and more sensitive test for diagnosing osteoarticular tuberculosis (TB) than current methods. Compared with culture and Xpert MTB/RIF, Innowave detects more TB cases from bone and joint samples, which usually contain very few bacteria. Importantly, it can simultaneously identify resistance to rifampicin and isoniazid within a few hours, instead of waiting weeks for culture-based results. This allows doctors to start the right anti-TB treatment earlier, reduce unnecessary empirical therapy, and lower the risk of joint destruction and disability. Overall, Innowave offers a practical solution to improve early diagnosis and drug-resistance detection in difficult-to-diagnose extrapulmonary TB.

Functional precision oncology aims to support personalized cancer therapy by assessing drug sensitivity in patient-derived tumor cells ex vivo. However, conventional drug sensitivity and resistance testing (DSRT) platforms typically require large numbers of cells, limiting their applicability to surgically resected tumors and posing challenges for patients diagnosed at advanced stages, where only small biopsy samples are available. To address this limitation, we developed a miniaturized DSRT workflow based on a Droplet Microarray (DMA) chip, which comprises 672 hydrophilic spots separated by superhydrophobic borders and enables high-throughput screening in nanoliter volumes. Using 300 cells per 200-nL droplet, lung cancer cells freshly isolated from surgical specimens were tested against 12 compounds across five concentrations and five replicates (360 experimental conditions). This required approximately 120,000 cells total, including additional cells for handling and processing. The approach generated drug-specific dose-response profiles and variable IC50 values across tumors of the same subtype. Comparable drug responses were also observed across three spatially distinct regions of the same tumor, indicating consistent assay performance. Overall, these results demonstrate that DSRT on the DMA platform is feasible with limited numbers of cells derived from clinical samples and may be useful for functional drug testing when tissue availability is constrained.

Single-fiber electromyography (SFEMG) is a sensitive test to diagnose ocular myasthenia gravis (OMG) when the clinical suspicion is high but the predictive value of the test is also dependent on the prevalence of the condition in the referral population. In a low prevalence population, false positive results can be as common as true positive results. Most of the patients referred for SFEMG at our center do not have symptoms or signs that are strongly suggestive for OMG. A retrospective chart review was performed of all patients referred to our laboratory for possible OMG for a 1-year period and analyzed the long-term accuracy of SFEMG in a cohort of 33 patients. Eleven of these (33%) were eventually diagnosed with a disease of neuromuscular transmission and SFEMG was abnormal in all of these (100% sensitivity). With the requirement that 3 jitter pairs be abnormal or that mean jitter was elevated, SFEMG was normal in the remaining 22 patients (100% specific). The results confirm that SFEMG is an excellent confirmatory test when clinical suspicion for OMG is high and also demonstrate that when strict criteria are applied, the test accurately excludes OMG in patients with ocular complaints that are not truly suggestive of OMG.