Search Results (2,998)

Social communication difficulties characterize autism spectrum disorders (ASD). Gastrointestinal (GI) symptoms are more common in ASD than in the general population. The identification of GI problems in individuals with ASD is challenging due to their altered pain perception and irregular behaviors. Importantly, GI symptoms and ASD can potentially aggravate each other. However, it is unclear if GI problems cause ASD symptoms or vice versa. A crosstalk between the digestive system, gut microbiota, and the central and enteric nervous systems (CNS and ENS, respectively) has been repeatedly reported. The ENS regulates the GI tract with the CNS and the autonomic nervous system (ANS), as well as independently through specific neural circuits. Several mechanisms contribute to GI problems in ASD, including genetic mutations that affect the ENS, dysregulation of the ANS, alterations in gut microbiota, unhealthy dietary preferences, and changes in metabolomic profiles. Furthermore, studies have shown molecular and cellular differences in the GI biopsy of children with and without ASD. These findings highlight the unique nature of GI issues in ASD, underscoring the importance of further investigating the changes that occur in the digestive system and ENS in ASD models. Full article

Background/Objectives: Ketone bodies are increasingly studied for their potential therapeutic effects, particularly through exogenous ketosis, in a variety of diseases. This systematic review aimed to rigorously assess the clinical efficacy of exogenous ketosis in adults with medical conditions. Methods: Following PRISMA guidelines, we systematically searched MEDLINE and Scopus databases. Our inclusion criteria were defined according to the PICOS framework, focusing on studies involving exogenous ketosis in adult patients with specific diseases. The study is registered in the International Prospective Register of Systematic Reviews (PROSPERO; CRD42023492846). Results: After a stringent selection process, fifty-one studies were analyzed. Twenty-two studies focused on neurological disorders, one on psychiatric disorders, twenty-two on metabolic disorders, five on cardiovascular disorders, and one on an inflammatory disorder. Exogenous ketosis demonstrated potential benefits across multiple conditions, including Alzheimer’s disease, mild cognitive impairment, McArdle’s disease, various forms of heart failure, cardiogenic shock, pulmonary hypertension, and COVID-19-related acute respiratory distress syndrome, although evidence is mostly limited to surrogate endpoints with insufficient hard outcome data. Subtherapeutic ketone concentrations induced by medium-chain triglycerides and limited follow-up periods often precluded firm conclusions regarding clinically meaningful outcomes. Conclusions: Exogenous ketosis shows potential in neurological, metabolic, and cardiovascular disorders, while evidence in psychiatric and inflammatory conditions remains scarce and preliminary. Ketone esters appear preferable for effective and tolerable ketosis. Future research should focus on identifying responsive patient populations, optimizing treatment regimens, and conducting long-term clinical trials with hard endpoints to validate these findings. Full article

Background/Objectives: Metallic surgical implants are commonly used in Orthopaedic surgery. There is a paucity of the literature on patient perspectives and awareness regarding their use. This study aims to investigate patients’ self-perceived awareness, knowledge and concerns toward metallic implant usage in Orthopaedic surgery, in order to provide a tailored and efficient means of pre-operative counselling. Methods: A single-centred, cross-sectional questionnaire-based study was performed in a single tertiary centre in Singapore. Patients between 21 and 75 years who were on follow-up with an Orthopaedic surgeon were recruited from the Orthopaedic specialist outpatient clinic. This questionnaire consisted of three main parts. Firstly, patients were asked to grade their self-perceived knowledge on metallic implants on a Likert scale of 1 to 5. The second part included questions designed to determine the level of knowledge of patients on metallic implants. For the third part, patients were asked to grade how comfortable they were with having metal implants in their bodies on a Likert scale of 0 (Strongly Disagree) to 4 (Strongly Agree). Results: A total of 100 patients were recruited, with 56 males and 44 females. The majority of the patients were Chinese (59%), and 32% had tertiary education. The self-perceived awareness regarding metallic implants was low with a median score of 3 (IQR 1–9) (1—unaware, 10—fully aware). There was no significant difference between younger and older patients (>50 years) or between patients of different educational levels. In total, 17% of the participants stated that they preferred to use non-metallic implants. The most significant concerns were surgical costs (51%), post-operation discomfort (50%) and potential rejection of metallic implants (50%). Conclusions: There is a poor level of self-reported awareness on metallic implants and a lack of knowledge regarding the use of metallic implants in Orthopaedic procedures among patients in our local population. The top concerns regarding the usage of metallic implants were cost, adverse reaction to metal and persistent discomfort. A significant percentage of patients prefer to use non-metallic implant options if available. This highlights the need for tailored pre-operative counselling for the provision of information and to address patients’ concerns accurately. Full article

Public events serve as a foundational mechanism for shaping the social and spatial dynamics of urban environments. Despite widespread recognition of their physical, psychological, and social impacts at the city scale, a significant gap persists in research addressing the social and spatial suitability of public spaces at the neighborhood level, particularly within the Arab urban context. This study investigates residential neighborhoods in Riyadh, Saudi Arabia, to assess how public events foster community engagement, cultural diversity, and social cohesion. Drawing on survey data from 510 residents, statistical analysis reveals that demographic variables such as age, gender, and professional sector influence participation, with youth and women demonstrating notably higher levels of engagement. Moreover, population density emerges as a critical factor in determining the appropriateness of event settings, with medium-sized gatherings in open spaces especially parks proving most effective. The findings emphasize the importance of designing inclusive and culturally responsive events, offering actionable insights for urban planning in rapidly growing cities. The study further highlights the need to reimagine neighborhood parks and open spaces as adaptable venues, equipped with essential infrastructure and governed by streamlined regulatory frameworks. Participants expressed a clear preference for accessible, medium-scale cultural events that prioritize safety, environmental sustainability, and enhanced public amenities, including transportation and sanitation services. Full article

The digital transformation of civic life has created new opportunities for older adults to engage in virtual volunteer activities. However, their participation still remains limited. This study investigates the factors that influence older adults’ interest in virtual volunteering. It integrated theoretical framework combining the Technology Acceptance Model (TAM), Self-Efficacy, and Digital Divide Theories to examine the drivers of virtual volunteerism interest among this target population. This study presents ordered logistic regression models with data on 814 adult volunteers in multiple imputation procedures. The final reduced model identifies two key predictors: a preference for virtual activities and interest in technology training, respectively, representing TAM and the Digital Divide Theory. While the self-efficacy-related variable showed statistical significance in earlier models, its explanatory power diminished when controlling for other factors. The findings indicate that older adults’ interest in virtual volunteering is primarily shaped by perceived usefulness of digital tools and their willingness to improve technical competence. This study confirms the relevance of the TAM and Digital Divide theories regarding virtual volunteerism. In practical terms, the findings indicate that program design should combine usability-focused platform features and targeted support that lower both technological and motivational barriers for older adults interested in virtual volunteering. Full article

The Asian citrus psyllid (ACP), Diaphorina citri Kuwayama (Hemiptera: Liviidae), is a vector of Candidatus Liberibacter asiaticus (CLas), the causal agent of citrus Huanglongbing (HLB). We examine the effectiveness of spraying adhesive on new shoots of orange jasmine (Murraya paniculata) to trap ACP in laboratory and field conditions and for the monitoring of ACP population dynamics and directional preferences. After 36 h of observation, orange jasmine plants with new shoots, with and without adhesive, are significantly (p < 0.05) more attractive to ACP than plants without new shoots. In field trials, orange jasmine with new shoots attracted more ACP, particularly females, than plants without new shoots. A male-biased ACP sex ratio occurred in a near-natural population. Orange jasmine with new shoots coated with adhesive more effectively trapped ACP than yellow sticky traps, particularly during the winter and early spring, when ACP densities were low. ACP has a strong phototropic response, preferring to feed and rest in south- and east-facing positions. Adhesive trapping shows potential for attracting adult ACP, especially in citrus orchards during cooler seasons, when host trees lack new shoots, and it may be particularly effective in doing so in urban areas and unmanaged citrus refugia (the primary sources of ACP infestations for commercial groves). Full article

Effective station–city integration is crucial for sustainable development around high-speed rail stations. However, research assessing public preferences regarding the aspects of this integration remains limited. We constructed a performance evaluation model for station–city integration in high-speed rail station areas. By considering the high-speed rail station area in the Yangtze River Delta region as a research object, which is located in the metropolitan cities centered on Shanghai, China, we dissected the five dimensions of population, industry, land use, function, and environment into 15 indicators that flow into the three value objectives of attraction–retention–integration (NPI). Subsequently, we systematically analyzed the performance differentiation characteristics of station–city integration in the Yangtze River Delta region’s high-speed rail station areas by employing a multiple regression model to delve into the influence mechanisms affecting the performance differentiation patterns of station–city integration. Our findings indicate the following. (1) Regarding station–city integration performance grade differentiation, a few high-speed rail station areas in the Yangtze River Delta region exhibit a high-efficiency integration level, whereas more areas fall within the higher and general integration levels. (2) Spatially, the station–city integration performance in high-speed rail station areas within the Yangtze River Delta region exhibits a distinct distribution characterized by “high-grade point-block dependence and low-grade concentrated contiguous patches.” (3) The spatial distribution of the five dimensions of station–city integration performance exhibits significant disparities. (4) Regarding the development types of station–city integration performance advantages, efficient integration of stations and cities represents a multidimensional advantageous development type and higher integration falls into the same category. (5) Station–city integration performance results from the comprehensive effects of four factors: government policy inducement, station energy level attraction, station–city relationship adhesion, and urban energy level promotion. This study advances a systematic framework—encompassing performance measurement, mechanistic inquiry, and strategy formulation—for examining station–city integration in HSR station areas. By integrating the perspective of cyclical cumulative development into the node–place model from urban planning and geographical viewpoints, we articulate a new performance model that clarifies critical influencing factors and mechanisms, thus broadening the theoretical scope of HSR station area research. We believe that the NPI evaluation model can provide valuable insights for guiding the integrated development of high-speed rail station areas and enhancing the quality of urban development. Full article

Skin color is a crucial phenotypic trait in poultry that influences consumer preference, market value, and breed identification. However, the mechanisms underlying skin color variation in Lingshan chickens remain poorly understood. This study aimed to elucidate the physiological, metabolic, and microbial characteristics associated with skin color differences in male Lingshan chickens. A total of 210 castrated male Lingshan chickens were categorized into white-shanked (WS), yellow-shanked (YS), and red-shanked (RS) groups based on the Roche color fan scores. The results showed that chickens in the YS and RS groups exhibited significantly higher body weights and pigmentation levels in the shank, breast, and abdominal skin compared to those in the WS group (p < 0.05). Serum concentrations of triglycerides (TG), total cholesterol (TC), high-density lipoprotein (HDL), low-density lipoprotein (LDL), and very-low-density lipoprotein (VLDL) were markedly elevated in RS chickens. Additionally, carotenoid profiles revealed higher deposition of lutein and β-carotene in the skin and adipose tissues of YS and RS birds. Gene expression analysis indicated differential regulation of carotenoid transport and metabolism-related genes among groups. Furthermore, 16S rRNA sequencing of cecal microbiota revealed significant compositional shifts in microbial communities associated with shank pigmentation. Collectively, these findings suggest that differences in shank color in Lingshan chickens are closely linked to lipid metabolism, carotenoid transport, and gut microbiota composition. This study provides novel insights into the biological mechanisms driving skin pigmentation, offering valuable implications for breeding and functional trait selection in indigenous chicken populations. Full article

Background/Objectives: The intergenerational transmission of suicidal risk is a major global health concern. Evidence on the role of parental psychopathology, including suicidal behavior, in predicting adolescent suicidality remains inconsistent. This systematic review and meta-analysis aimed to synthesize recent findings and quantify these associations. Methods: The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the Population, Intervention/Exposure, Comparator, Outcome (PICO) framework. Searches (2015–2025) identified observational studies on parental suicidal behavior, depression, or psychiatric disorders predicting adolescent suicidal ideation or attempts. Thirty-one studies met eligibility, including over 12 million adolescents. Random-effects meta-analyses estimated pooled associations. Study quality was rated with the Newcastle–Ottawa Scale (NOS), and evidence certainty with the Grading of Recommendations, Assessment, Development and Evaluation (GRADE). Results: Both parental suicidal behavior and psychiatric disorders were consistently linked to increased adolescent suicidality. The pooled odds ratio (OR) for any parental psychopathology was 2.77 (95% confidence interval, CI: 2.22–3.47), indicating nearly a threefold higher risk of suicidal ideation or attempts in exposed youth. Subgroup analyses showed comparable risks for parental suicidal behavior (OR = 2.69, 95% CI: 2.30–3.14) and parental psychiatric morbidity (OR = 2.72, 95% CI: 2.05–3.60). Conclusions: Parental psychopathology, whether manifesting as suicidal behavior or psychiatric disorder, is a strong and universal risk factor for adolescent suicidal ideation and attempts. These findings underscore the need for family-centered prevention, early identification, and targeted interventions to disrupt intergenerational transmission of suicide risk. Full article

First-line options for chronic lymphocytic leukemia (CLL) are evolving, recently returning to a fixed-duration (FD) approach incorporating regimens such as venetoclax + obinutuzumab, ibrutinib + venetoclax, and soon acalabrutinib + venetoclax ± obinutuzumab. Five Canadian hematologists convened to share perspectives regarding the attributes of these options and considerations for clinically appropriate integration within Canada’s publicly funded healthcare system. The hematologists underscored the importance of shared decision-making with patients, family members, and caregivers involving careful consideration of disease profile and patient characteristics, preferences, and values. They indicated that although a role persists for continuous therapy with approved covalent Bruton’s tyrosine kinase inhibitors (typically in high-risk disease), newer FD regimens offer multiple benefits related to the treatment-free period, quality of life, safety, re-treatment, healthcare resource utilization, and costs. The hematologists highlighted the appeal of all-oral FD combinations given their convenience and impact on treatment equity, factors especially compelling given Canada’s vast geography and large segment of rural populations. In closing, they emphasized the quickly evolving therapeutic setting of CLL in the 1L and beyond, underscoring the need for ongoing patient involvement in decision-making to support optimal treatment selection based on patient goals and within the confines of provincial funding. Full article

The current agent-based evolutionary models for animal communication rely on simplified signal representations that differ significantly from natural vocalizations. We propose a novel agent-based evolutionary model based on text-to-audio (TTA) models to generate realistic animal vocalizations, advancing from VAE-based real-valued genotypes to TTA-based textual genotypes that generate bird songs using a fine-tuned Stable Audio Open 1.0 model. In our sexual selection framework, males vocalize songs encoded by their genotypes while females probabilistically select mates based on the similarity between males’ songs and their preference patterns, with mutations and crossovers applied to textual genotypes using a large language model (Gemma-3). As a proof of concept, we compared TTA-based and VAE-based sexual selection models for the Blue-and-white Flycatcher (Cyanoptila cyanomelana)’s songs and preferences. While the VAE-based model produces population clustering but constrains the evolution to a narrow region near the latent space’s origin where reconstructed songs remain clear, the TTA-based model enhances the genotypic and phenotypic diversity, drives song diversification, and fosters the creation of novel bird songs. Generated songs were validated by a virtual expert using the BirdNET classifier, confirming their acoustic realism through classification into related taxa. These findings highlight the potential of combining large language models and TTA models in agent-based evolutionary models for animal communication. Full article

The European wildcat exhibits considerable plasticity in its habitat requirements across its distribution, with differences increasing along a continental-scale latitudinal gradient. While wildcats often favor deciduous and mixed forests with dense cover and prey, studies show these preferences vary across their expansion. Range-wide conservation efforts will benefit from incorporating knowledge generated by robust regional ecological models. We used data from a large camera trap grid (n = 292 stations), spanning across eight wildcat-associated habitats, within its range in northern Greece, to understand the regional ecological parameters affecting the species’ habitat selection. We analyzed the data using single-season density-induced detection heterogeneity occupancy models (Royle–Nichols), considering 12 environmental and anthropogenic parameters. The global model’s GoF was high (p = 0.9). Elevation and percent forest cover were both significantly negatively related to wildcat occupancy (as derived from the modeled “relative abundance index” N). Likewise, there was a negative, but moderate, relation between distance to freshwater bodies and human settlements with wildcat occupancy. We used the model-average coefficients to generate a predictive map of wildcat relative abundance across northern Greece, which identified 47,930 km² of potential wildcat habitat. Assuming a range of densities between 0.05 and 0.3 ind/km² in areas with predicted low, medium, and high relative abundance, we speculate the putative wildcat population in northern Greece to be between 3535 and 7070 individuals. The findings, which vary from ecological models of the species in northern Europe, show the need for regional models and the importance of Greece, and the Balkan peninsula, for the species. Full article

Population ageing and the increase in life expectancy have heightened the demand for long-term care in residential facilities. In Spain, it is projected that by 2054 the functional dependency rate among those aged 65 and over will exceed 53.0%, posing significant challenges for person-centred care. This study aims to examine institutionalised older adults’ perceptions of care in relation to their functional dependency, and how these perceptions shape their dignity and participation in residential life. A qualitative study with a phenomenological approach was conducted in a residential facility located in the north-east of Andalusia, Spain, involving eight residents with varying degrees of autonomy and dependency. Data were collected through individual semi-structured interviews and analysed using Colaizzi’s phenomenological method. The findings revealed that, as dependency increases, care is perceived as more impersonal, generating feelings of diminished dignity and greater exclusion. In addition, limitations were observed in communication and participation in residential life. Respect for privacy and personal preferences was particularly relevant for women. The study concludes that the care received is conditioned by the degree of dependency and the resources available. It is recommended to enhance staff training, increase staffing levels, and promote the active participation of residents. Full article

Background: Enterobiasis, caused by Enterobius vermicularis, is recognized as a common intestinal helminthiasis worldwide. Despite multiple surveys in Thailand, no pooled synthesis at the country level has been carried out to evaluate prevalence patterns, temporal trends, or vulnerable groups. Therefore, this systematic review and meta-analysis were undertaken to provide an updated and comprehensive estimate of the prevalence of E. vermicularis in Thailand and to identify high-risk populations for targeted interventions. Methods: The systematic review and meta-analysis were conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (PROSPERO: CRD420251053217). Studies reporting E. vermicularis infection in Thailand were systematically searched in international and Thai databases. Pooled prevalence and odds ratios (ORs) were calculated using random-effects models. Subgroup analyses and meta-regression were performed according to year, region, age, population type, and diagnostic method. Results: A total of 56 studies, including 52,765 participants, were analyzed. The overall pooled prevalence was estimated at 3.6% (95% confidence interval [CI]: 2.1–5.9%), with a decline observed in the subgroup analysis by publication year, from 4.75% in 2000–2009 to 1.15% in 2020–2023. The highest prevalence was reported in Central Thailand (7.93%). High infection rates were found among immigrant children (25.2%), hilltribe children (19.9%), Karen students (15.5%), and children in orphanages (11.4%). A markedly higher prevalence was detected by the Scotch tape method compared with direct smear/concentration (12.9% vs. 0.33%). No significant difference in infection risk was observed between males and females (OR = 1.03, p = 0.65). Conclusions: The pooled prevalence of E. vermicularis in Thailand was estimated at 3.6%, but this figure should be interpreted with caution due to high heterogeneity across studies. More meaningful insights were identified in subgroup analyses, which revealed a temporal decline in prevalence, geographic clustering in Central Thailand, and disproportionately high infection rates among socioeconomically disadvantaged child populations. No statistically significant association was found between gender and risk of infection. These patterns underscore the need for targeted screening, deworming, and hygiene interventions, along with the standardized use of the Scotch tape technique for accurate surveillance and comparability of future studies. Full article

Background and Objectives: The benefits of aspirin for primary prevention of atherosclerotic cardiovascular disease (ASCVD) among high-risk patients with diabetes are controversial owing to bleeding risk. Current guidelines recommend the use of aspirin in high-risk patients with diabetes; however, the supporting evidence is inconsistent, primarily due to an increased risk of gastrointestinal (GI) bleeding. Given these concerns, it is important to explore alternative antiplatelet strategies. Clopidogrel, a widely used P2Y12 inhibitor, has been suggested to cause fewer GI bleeding events than aspirin. Accordingly, we aimed to compare the efficacy and bleeding risk of clopidogrel versus aspirin in high- and very high-risk populations with diabetes without prior ASCVD using the Korean National Health Insurance Service data. Materials and Methods: Propensity score-matching was performed to reduce baseline imbalances. The primary endpoint was net adverse clinical events (NACEs), defined as a composite of all-cause death, myocardial infarction (MI), stroke, intracranial hemorrhage (ICH), and gastrointestinal GI bleeding. Secondary endpoints included efficacy (composite of all-cause death, MI, and stroke) and bleeding outcomes (GI bleeding and ICH). Results: Among 10,453 patients (9550 on aspirin and 903 on clopidogrel), 902 matched pairs were analyzed. Clopidogrel showed no significant difference compared with aspirin in NACE incidence (hazard ratio [HR]: 0.97; 95% confidence interval [CI]: 0.79–1.19), efficacy endpoints (HR: 1.02; 95% CI: 0.82–1.26), or individual outcomes (MI, stroke, all-cause death). Clopidogrel demonstrated a trend towards lower GI bleeding (HR: 0.48; 95% CI: 0.23–1.01), although not significant. In subgroup analysis, male patients on clopidogrel had significantly lower NACE risk than those on aspirin (HR: 0.73; 95% CI: 0.54–0.99). Conclusions: These findings suggest that clopidogrel may be considered a preferable alternative to aspirin for primary prevention in high-risk male patients with diabetes, particularly those with an elevated risk for gastrointestinal bleeding, guiding personalized antiplatelet therapy choices in clinical practice. Full article