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Substance use is a rising public health concern among University students. Nowadays, most university students use substances for different purposes, but it has negative impacts on university students, ranging from social, economic, psychological, and mental problems. This impact, in turn, results in poor academic performance or dropping out of university. There were limited qualitative study designs that explored substance use among university students in Ethiopia, which were used to understand why most students use those substances. So, this study aimed to explore the reasons for substance use among Wollega University undergraduate students, Wollega, western Ethiopia, 2025. An exploratory qualitative study design was employed from March 25, 2025 to May 2, 2025. Exponential discriminatory snowball sampling and purposive sampling method were used to sample study population. Semi-structured in-depth interview and key informant interview guides in English were created to standardize data gathering by referencing a variety of previously published works. Data were audio-recorded, transcribed verbatim, and imported into qualitative data analysis software, Open Code version 4.03, for coding and analysis. Twenty participants were included, with 13 in-depth interviews and 7 key informant interviews. About six themes emerged about the reasons why the majority of Wollega University students take substances, including: due to sociocultural reasons, educational factors, to alleviate psychological distress, university-related factors, laws, and environmental considerations. The study revealed that most of Wollega university students use substances due to socio-cultural factors, educational reasons, psychological problems, laws, and university-related factors, and environmental factors. Therefore, given the potential for far-reaching consequences, immediate and effective prevention and control strategies are urgently needed to address substance use among students.
Statistics is a field that provides the methodological basis for modern scientific research, including data collection, analysis, and interpretation. The retraction procedure involves the official removal of a work from the literature due to substantial scientific concerns. Analysis of retracted publications is critical for identifying ethical violations and structural flaws in scientific publishing. This study performed a bibliometric and descriptive analysis of publications labeled as "retracted" in the Scopus database, retrieved via a search utilizing the term "statistics" on August 18, 2025. The analysis of documents was conducted based on year, country, journal, keyword, and reasons for retraction. Collaboration networks of countries and authors were displayed with VOSviewer software, and reasons for retraction were confirmed using the Retraction Watch Database. Temporal trends were assessed by linear regression analysis. A total of 680 retracted papers were examined. Retractions occurred between 2006 and 2025. A statistically significant upward trend was found in the number of retracted articles over time (P = 0.030). The most retracted publications came from China (n = 426), followed by India (n = 67), and the United States (n = 49). The Journal of Healthcare Engineering (n = 35) and Journal of Sensors (n = 25) stood out among the journals with the most retracted publications. The most common retraction reasons were investigation by journal/publisher (n = 297), unreliable results and/or conclusions (n = 189), and concerns/issues about referencing/attributions (n = 153). The number of retracted publications tagged with the keyword "statistics" has increased significantly over the years. This increase can be attributed to strengthening scientific oversight mechanisms and increased awareness of publication ethics. Increasing the involvement of statistical experts in the peer-review process, improving the statistical literacy of authors, and developing training and mentoring mechanisms to prevent ethical violations are crucial.
Elderly patients with acute appendicitis face high rates of complicated disease, yet the impact of in-hospital timing and the utility of simple biomarkers remain debated. We aimed to assess whether in-hospital timing influences severity and to evaluate the derived neutrophil-to-lymphocyte ratio (dNLR) as a risk-stratification tool. A retrospective study of 412 patients (184 aged ≥ 65 years; 228 younger controls) undergoing appendectomy (2010-2019) was conducted. We analyzed Patient Interval (symptom onset to admission) and Hospital Interval (admission to incision). Appendicitis was graded as uncomplicated or complicated (gangrenous/perforated). Multivariable regression and categorical sensitivity analyses (0-6, 6-12, 12-18, > 18 h) were used to identify predictors of severity. Elderly patients had higher rates of complicated appendicitis (29.4% vs. 9.2%) and morbidity (13.0% vs. 1.3%). While night-shift admission increased time to diagnosis, it did not increase complications. Hospital Interval was shorter in the elderly (13.5 vs. 15.4 h) but was not an independent predictor of complications and showed no adverse trend across time categories. In the elderly, dNLR ≥ 4.0 independently predicted complicated disease (AUC 0.65) alongside age, fever, and Patient Interval. Mortality spiked to 8.3% in patients ≥ 85 years, driven by medical complications. Disease severity in geriatric appendicitis appears to be largely determined prior to admission. Within the limitations of this observational design, short in-hospital delays for optimization or logistical reasons were not associated with increased perforation or morbidity. Furthermore, a dNLR ≥ 4.0 helps identify high-risk patients, suggesting that an "optimize then operate" approach-prioritizing physiological stabilization may be a safe and reasonable strategy for clinically stable elderly patients. Research Registry (UIN: researchregistry11765).
Scabies, caused by Sarcoptes scabiei var. hominis, remains a significant public health problem in Syria, where socioeconomic hardship and overcrowding contribute to persistent transmission. This study examines current treatment practices among Syrian dermatologists and evaluates the extent to which these practices align with internationally recommended management approaches. A structured online questionnaire was administered to 159 dermatologists across multiple Syrian provinces. The survey captured detailed treatment practices, including the exact permethrin regimen applied, frequency and pattern of applications, alternative or intensive regimens, reasons for deviating from guideline-recommended weekly application, management of household contacts, estimated adherence rates, perceived treatment resistance, and reported adverse effects. Additional items assessed the use of adjunctive therapies and clinician demographics. International guideline adherence was defined as applying 5% permethrin to the whole body for 8-12 h and repeating after 1 week. Responses were analyzed in SPSS using descriptive statistics and appropriate inferential tests. Only 54 physicians (34.0%) of participants reported using the classical weekly permethrin regimen, 87 (54.7%) used modified permethrin-based regimens (e.g., three times weekly for 2 weeks), and 18 (11.3%) used sulfur as first line. The most reported reasons for not following the classical protocol included poor patient or household-contact adherence (57.1%) and medication-related concerns such as perceived resistance or reduced drug effectiveness (37.1%). Skin irritation was reported variably, and combination therapy was used by nearly one-third of respondents. Most respondents (N=139, 87.4%) estimated contact adherence to be below 80%. Syrian dermatologists employ a variety of treatment strategies for scabies, largely influenced by patient adherence, perceived drug resistance, and conflict-related limitations. The findings underscore the need to strengthen patient and household education, enhance physician training, and renew adherence to guideline-based management.
There are limited data on food insecurity among college students from different marginalized backgrounds, both in Vermont and other predominantly White spaces, and what their institutions could do to improve food security and other basic needs. Thus, the aims of this study were to 1) examine food insecurity prevalence and its correlates among underrepresented college students, 2) assess their reasons for using campus food pantries and strategies for improving access to culturally appropriate foods on campus, and 3) determine their perspectives regarding how their institutions can address their basic needs. Using a mixed methods cross-sectional research design, a convenience sample of full-time students or trainees ages 18 and older enrolled at four institutions of higher education in Vermont, United States, were recruited through flyers, course announcements, newsletters, listservs, and social media posts. An online survey provided estimates of food insecurity, on-campus food pantry use, and participant perspectives on institutional strategies to address basic needs through open-ended questions. Food insecurity was assessed by the 10-item United States Department of Agriculture food security survey module. Descriptive statistics assessed frequencies and percentages along with means and standard deviations. Binary logistic regression was conducted to estimate the odds of food insecurity. Inductive coding was used to analyze qualitative data and identify emergent themes. Around 40% of all participants experienced food insecurity in the past year, with higher odds observed in students aged ≥ 30, Pell Grant recipients, first-generation students, Black students, and those who used a food pantry. The most cited reason for using a campus food pantry was ease of getting to the pantry while lack of awareness was the most reported barrier. Over 50% of participants recommended gathering feedback from students about their preferences to improve access to culturally appropriate foods. Common themes from qualitative analyses included: food access support, safe and affordable housing access, mental health and healthcare access, financial aid access, reliable and affordable transportation access, non-financial academic support, and general support services. Institutions should prioritize food assistance programs targeting college students and incorporate mental health care, housing support, and financial aid for comprehensive safety nets.
The rise of Free Open Access Medical Education (FOAM) has transformed how Emergency Medicine (EM) practitioners access educational content. While widely adopted globally, its use in South Africa has not been well studied. This study aimed to assess the use of modern (FOAM/social media) and traditional (textbooks/journals) educational resources among EM faculty in Gauteng, South Africa. A descriptive, cross-sectional survey was conducted among EM specialists and registrars (trainees/ residents) affiliated with the University of the Witwatersrand and the University of Pretoria from October 2023 to December 2024. A self-administered online questionnaire was used to collect data on resource preferences, frequency of use, perceived quality, reasons for use, and barriers to access. Descriptive statistics were used to analyse the data. Fifty-five responses were received (76% registrars, 24% consultants). FOAM use was high, with 100% of respondents using blogs, 98% using podcasts, and 91% using social media for EM education. Textbooks and journals remained widely used (89%), particularly for in-depth learning. EMCrit and Life in the Fast Lane (LITFL) were the most frequently accessed FOAM resources. The social media platform X (formerly Twitter) was commonly used on a daily basis for educational purposes. In contrast, restricted-access platforms like Challenger and ENLIGHTENme were used infrequently. The most cited reason for FOAM use was EM education (93%), while point-of-care learning was less common (69%). Notably, 22% of respondents overall reported never checking the references of FOAM content. All respondents reported adequate internet access, with no barriers related to connectivity. Modern educational resources such as FOAM and social media are widely used among EM faculty, with traditional resources still valued for foundational knowledge. Respondents preferred modern resources for their accessibility and relevance, and no major barriers to FOAM use were identified. These findings support the integration of high-quality FOAM content into EM education, alongside strategies to strengthen critical appraisal skills.
Stress urinary incontinence (SUI) remains a debilitating complication after treatment for prostate cancer or benign prostatic obstruction. While artificial urinary sphincter (AUS) implantation is the gold standard, sling procedures are widely adopted for selected patients. We aimed to analyze long-term trends, perioperative outcomes, and explantation patterns of AUS and sling procedures for male SUI in Germany. We performed a population-based study using the German Nationwide Inpatient Sample (GRAND) from 2005 to 2023. Men undergoing AUS or sling implantation were identified through procedure codes. Primary outcomes were in-hospital morbidity, mortality, and length of stay (LOS). Multivariable regression models were adjusted for age, comorbidities, prior radiotherapy, and year of surgery. Reasons for explantation and reimplantation were also assessed. A total of 24 234 men underwent SUI surgery (AUS: 63%, nonadjustable sling: 32%, and adjustable sling: 4.7%). Median age was 72 yr. AUS implantation remained most frequent, although it declined slightly in recent years. Use of nonadjustable sling peaked in 2012 but decreased thereafter, whereas use of adjustable sling procedures increased steadily. Procedure volumes markedly decreased during COVID-19. Perioperative mortality was <0.1% across groups. Nonadjustable slings were associated with a higher risk of acute urinary retention (odds ratio [OR]: 1.1, p = 0.020) but with a lower risk of wound infection (OR: 0.5, p < 0.001) than AUS. No statistically significant differences were observed between adjustable slings and AUS in terms of perioperative morbidity. LOS was longer in AUS (median 6 d) than in slings (median 5 d; p < 0.001). Two-cuff AUS were associated with longer LOS than single-cuff devices. Explantations occurred most often due to infection or mechanical failure for AUS, and for different reasons for slings. Limitations include reliance on administrative coding without functional or long-term patient-reported outcomes. Male SUI surgery is safe, with AUS remaining the most frequent procedure in Germany. Adjustable slings represent an expanding option for selected patients.
Adalimumab is the first biologic approved for moderate-to-severe hidradenitis suppurativa (HS). Considering potential cost savings, real-world data evaluating the prescribing patterns following a switch from the originator in HS remain limited. We conducted a retrospective multicenter observational study (2019-2025) at two hospitals in Saudi Arabia. Adult HS patients who received originator adalimumab for ≥3 months, and then switched to its biosimilar for non-medical reasons for ≥3 months were included. Descriptive statistics summarized baseline characteristics. A Wilcoxon paired test compared treatment durations, and a Sankey diagram illustrated treatment pathways. A total of 40 patients were included (median age: 26 years; 62.5% male; median BMI: 31.6). Most presented with nodules (55.0%), abscesses (47.5%), and sinus tracts (37.5%). Among all treatment actions/pathways, 22.6% represented treatment escalation to an alternative biologic, specifically secukinumab or ustekinumab. Patients who were switched from biosimilar therapy demonstrated more severe disease involvement. Median duration of originator therapy was 6.0 months versus 21.0 months for biosimilar (p = 0.477), with no significant difference in treatment persistence. In this small real-world cohort, treatment escalation after switching to biosimilar adalimumab was observed in a subset of patients with more complex HS features. Larger studies using standardized severity measures are needed to confirm these observations. Hidradenitis suppurativa is a long-term skin condition that can cause painful lumps, abscesses, tunnels under the skin, and scarring. Adalimumab is one of the treatments used for moderate-to-severe hidradenitis suppurativa. In some hospitals, patients may be changed from the original adalimumab product to a biosimilar version, which is designed to be highly similar to the original version and may help reduce treatment costs.In this study, we reviewed 40 patients from two hospitals in Saudi Arabia who were changed from the original adalimumab to a biosimilar adalimumab for non-medical reasons, mainly because of hospital formulary changes. We examined prescribing patterns and treatment received after the switch.Some patients continued biosimilar adalimumab, while others required changes in their treatment plan. These changes included adding other medications, such as antibiotics or topical treatments, or switching to another biologic treatment. Patients who needed treatment changes often had more complex hidradenitis suppurativa features, such as nodules, abscesses, sinus tracts, scarring, or disease affecting more than one body area.This study describes real-world treatment patterns after switching to biosimilar adalimumab. The findings suggest that follow-up after switching may be important, especially for patients with more complex disease. Larger studies using standard disease severity measures are needed.
Basal cell carcinoma (BCC) is characterized by slow growth and a low malignant potential. Recently, active surveillance (AS) has gained attention as an alternative management option for BCC patients. This study aimed to explore the experiences of patients and their proxies with AS. An interview study was conducted involving 15 patients who previously chose AS for one or more BCC and 12 accompanying proxies. Patients from two hospitals (Radboud University Medical Center, Nijmegen, the Netherlands, and University Hospital Ghent, Belgium) were included. Five themes emerged: reasons for choosing AS, experiences during AS, reasons for continuation or discontinuation, needs and barriers, and proxies' experiences. Overall, the experience with AS was positive, with minimal impact on daily life. Negative experiences included the follow-up burden and BCC symptoms. Patient's needs included clear communication about the nature of BCC and proactive discussion of AS by the healthcare provider. Impact on the proxies was limited, but they played a valuable supportive role in decision-making and follow-up. The experiences of patients and proxies indicate that AS is a valuable option for BCC, particularly for older patients and/or patients experiencing cumulative treatment burden. The need for dermatologists to proactively discuss AS was highlighted.
Waiting times for lower limb prosthesis in the public healthcare sector of South Africa can exceed 12-months. A cause of long waiting times is shortage of prosthetic components. However, sometimes prostheses are abandoned. Recycling components from unused prostheses to mitigate the shortage of components has not been studied. This study aimed to determine the reasons for lower limb prosthesis abandonment and to explore the possibility of recovering unused prostheses for component recycling in the public healthcare sector of the Eastern Cape Province, South Africa. A cross-sectional survey was conducted among individuals who had stopped using or had an unused lower limb prosthesis. Participants were recruited using total population sampling from three public hospitals with Orthotics and Prosthetics centres in the Eastern Cape. During routine follow-up (July-August 2025), 92 individuals who had received a lower limb prosthesis between January 2021 and January 2025, or their next of kin where applicable, were contacted. Individuals still using their prosthesis and children (<18 years) were excluded. The remaining 45 non-users or next of kin were invited to participate. A self-developed structured questionnaire was administered via short (10-15 minute) interviews, and data were analyzed descriptively using SPSS (version 31). A total of 43 participants aged 18-77 years (median 54; interquartile range 24), including 54% (n=23) male participants, consented to participate and completed the interviews. Twenty-two participants (51%) reported poorly fitting sockets as the reason for non-use. Forty-two (98%) participants were in favour of recycling components. Forty (93%) of the unused prostheses were modular. The majority were transtibial (81%), followed by transfemoral (12%) and knee disarticulation (7%). The main barrier to recycling identified was damaged components (19%). Thirty-nine (91%) prostheses were recovered from which 190 components can possibly be recycled. The findings extend existing knowledge on prosthesis abandonment and highlight an opportunity to implement component recycling practices to improve access, reduce waiting times, and lower costs in low-resource settings with high prosthetic service demand. The study may have important implications for prosthetic service delivery and policy in the Eastern Cape and South Africa.
Benchmarking is essential for evaluating the capabilities of large language models (LLMs). However, existing multimodal benchmarks lack dedicated resources for traditional Chinese opera, a domain rich in cultural and visual complexity. To address this gap, we introduce the TCO-Dataset, a bilingual multimodal dataset designed to assess LLMs' ability to interpret and reason about Chinese opera images. The dataset contains 1,000 multiple-choice questions paired with high-resolution images across eight major opera genres. Each sample includes a carefully selected image, a corresponding question focused on cultural and visual understanding, and an annotated answer for evaluation. The dataset supports both Chinese and English, enabling cross-lingual model assessment. All items were reviewed through multiple rounds of expert validation to ensure consistency and accuracy. The TCO-Dataset supports diverse applications, including still-image-based visual-cultural reasoning, cultural heritage preservation, and domain-specific AI development. Initial evaluations show significant performance variation across models, underscoring the dataset's challenge and value for advancing multimodal understanding.
Waldenström macroglobulinemia (WM) is a rare indolent B-cell lymphoma, characterized by lymphoplasmacytic infiltration of bone marrow and the existence of monoclonal IgM in circulation. Renal AL amyloidosis is an uncommon complication of WM, and its treatment is an enormous challenge to clinicians. This report describes a 71-year-old woman who presented with a 10-month history of recurrent bilateral lower extremity edema and a progressive fatigue. Physical and laboratory examinations revealed serum monoclonal IgMλ, nephrotic syndrome, moderate anemia and mild enlargement of bilateral inguinal superficial lymph nodes. Bone marrow aspiration demonstrated clonal lymphoplasmacytic infiltration, lymph node biopsy was consistent with lymphoplasmacytic lymphoma, and peripheral blood testing confirmed the presence of the MYD88 L265P mutation. Renal biopsy confirmed the diagnosis of renal AL amyloidosis, evidenced by Congo red-positive amorphous deposits with λ light chain restriction in glomeruli, interstitium, and small arterial walls. Following multidisciplinary consultation, the patient was treated with the bendamustine plus rituximab (BR) regimen. After three cycles, the patient achieved partial hematologic response (serum IgM levels decreased from 23.7 g/L to 7.1 g/L) with slight improvement of proteinuria (urine protein excretion decreased from 18.2 g/d to 15.0 g/d). However, during the subsequent treatment, the patient developed a severe pulmonary infection that led to death. This case underscores two critical points: First, patients with WM should be routinely tested for serum and urine monoclonal free light chains, as they can exist in WM at a high proportion and can independently induce monoclonal gammopathy-associated renal diseases, including renal amyloidosis. Second, for WM patients with renal AL amyloidosis, choosing BR regimen as the first-line treatment is reasonable. However, during the treatment process, it is essential to closely monitor and actively prevent the adverse effects of this regimen, particularly severe infections which may have fatal consequences.
Biochar is an environmentally friendly soil amendment and is widely used for improving soil properties. Especially the Cation Exchange Capacity (CEC) of soil, which is the main criterion for assessing soil nutrients. Therefore, this study proposes a method for predicting the cation exchange capacity of soil, which is of great significance for the precise application of biochar and improving soil amendment efficiency. This study collects and organizes experimental data from published literature on biochar-amended soils to construct a dataset that includes biochar properties (feedstock type, pyrolysis temperature, specific surface area, cation exchange capacity) and soil properties. The dataset is divided into seven groups based on the properties of biochar to investigate the impact of biochar properties on the model's prediction results. Using four machine learning algorithms-Light Gradient Boosting Machine (LightGBM), Deep Neural Network (DNN), Categorical gradient Boosting (CatBoost), and Random Forest (RF)-a predictive model for soil CEC after biochar was established. The results show that the CatBoost model performed best, with a coefficient of determination (R2) of 0.963, a Mean Absolute Error (MAE) of 1.346, and a Root Mean Square Error (RMSE) of 2.238, indicating that it is effective in predicting soil CEC after the addition of biochar. Shapley Additive Explanations (SHAP) analysis and Partial Dependence Plot (PDP) results indicate that the pyrolysis temperature of biochar promotes the predicted values of soil CEC, while biochar with high CEC reduces the predicted values of soil CEC. The reason for this counterintuitive result may be that biochar with a high CEC competes for cations in the soil solution. Choosing biochar produced at high pyrolysis temperatures and with a specific surface area (SSA) below 50 m2/g can achieve a good improvement effect within the studied conditions. This study develops a promising model for predicting soil CEC, which can better optimize actual soil improvement, and provides valuable insights into the mechanism of the impact of biochar on soil CEC.
Oxaliplatin-based chemotherapy is the standard adjuvant treatment for stage III colon cancer, but oral fluoropyrimidines remain widely used for patients unsuitable for combination therapy. Real-world data comparing these strategies are limited. We conducted a retrospective cohort study of patients with stage III colon cancer who received adjuvant chemotherapy at Kaohsiung Veterans General Hospital (2017-2021). Using a 12-month landmark design, we compared disease-free survival (DFS) between patients receiving FOLFOX (IV-Only) versus oral fluoropyrimidines (PO-Only). The primary analysis used overlap-weighted restricted mean survival time (RMST) differences to quantify absolute treatment effects. Cox proportional hazards regression provided complementary hazard ratio estimates. Of 157 patients included, 58 (36.9%) received FOLFOX and 99 (63.1%) received oral fluoropyrimidines. During median follow-up of 36 months, 22 DFS events occurred. The 3-year DFS was 93.1% versus 76.5% for IV-Only and PO-Only groups, respectively. The primary analysis showed that patients receiving FOLFOX had 4.0 additional months of disease-free time over 48 months (RMST difference: 4.0 months; 95% CI, 0.6-7.9; p = 0.014) and 2.4 months over 36 months (RMST difference: 2.4 months; 95% CI, 0.2-4.7; p = 0.024). The hazard ratio from overlap-weighted Cox regression with covariate adjustment was 0.37 (95% CI 0.09-1.45; p = 0.154), directionally consistent with the RMST findings but not reaching statistical significance. Hazard ratio estimates were directionally consistent across sensitivity analyses but varied in statistical significance, likely reflecting limited power: unadjusted (HR 0.23; p = 0.019), stabilized weighting with covariates (HR 0.19; p = 0.046), and multivariable adjustment (HR 0.44; p = 0.249). In this real-world cohort, oral fluoropyrimidines were associated with 4.0 fewer months of disease-free time compared with FOLFOX at 48 months among patients for whom both treatment options were appropriate. As a single-center study with limited events, these findings should be confirmed in larger multicenter cohorts. The combination of RMST with overlap weighting provides an interpretable framework for comparative effectiveness questions where treatment selection is strong. After surgery for stage III colon cancer, patients typically receive chemotherapy to reduce the risk of cancer returning. Two common options are FOLFOX (an intravenous combination of oxaliplatin and fluorouracil) and oral fluoropyrimidines (tablets taken by mouth). FOLFOX is generally more effective but causes more side effects, including nerve damage. In everyday practice, doctors often choose oral therapy for older patients or those with other health conditions, while reserving FOLFOX for younger, fitter patients. However, many patients fall somewhere in between, where either option could be reasonable. We studied 157 patients with stage III colon cancer who remained recurrence‐free at 12 months after surgery to compare outcomes between these two treatments, focusing specifically on patients who could have received either regimen. Using statistical methods to account for differences between patient groups, we found that patients who received oral fluoropyrimidines had, on average, 4 fewer months of disease‐free time over 4 years compared with those who received FOLFOX. The hazard ratio pointed in the same direction but was not statistically significant, likely due to the small number of recurrence events. Our results suggest that when both treatments are viable options, choosing oral therapy over FOLFOX may come at a measurable cost in disease‐free time, which may help inform shared decision‐making between patients and their doctors.
Social networks (SN) are used for different reasons in everyday life, often resulting in higher usage time and sometimes in a problematic use of social networks (PSNU). The I-PACE model outlines that specific predisposing variables (e.g., usage motives, personality traits, stress-appraisal, coping strategies) and affective and cognitive mechanisms (e.g., use expectancies, gratification, compensation) as well as their interactions contribute to the development and maintenance of PSNU. Our aim was to test a structural equation model with two different paths of reinforcement mechanisms: pleasure-seeking for achieving specific emotional experiences and compensation-seeking to avoid or reduce negative states. Both pathways are assumed to lead to higher symptom severity of PSNU and usage time of SN. In a pre-registered, multi-center study (DFG-funded research unit) with a mixed-method, cross-sectional, between-subject design in Germany, 306 (81% female; Age: M = 26.41 years; SD = 07.76, Range: 16-64 years) participants underwent the study procedure, including a diagnostic interview based on DSM-5 criteria for gaming disorder (modified for PSNU), thereby identifying individuals with problematic use of SN. Additional constructs were assessed by self-reports. The structural equation model provided an acceptable fit with the data. It showed that positive reinforcement mediates the effect of usage motives on SN usage time. Negative reinforcement mediates the effect of stress-appraisal and coping on PSNU and the effect of usage motives on PSNU. The pleasure-seeking pathway significantly leads to higher usage time of SN while the compensation-seeking pathway results in higher symptom severity. The results emphasize the relevance of different predisposing factors and reinforcement processes, and expands existing theoretical models.
While tissue adhesives are widely used in the closure of surgical incisions, contact dermatitis remains a poorly characterized complication. Dermabond™ (Ethicon; DB) and LiquiBand® (Advanced Medical Solutions; LB) are two commonly used tissue adhesives; however, there are no direct data comparing their risk of contact dermatitis. In this randomized controlled trial, we compare the rate of contact dermatitis associated with DB versus LB in patients undergoing laparoscopic abdominal surgery. This was a single-center, intra-patient randomized controlled trial which included patients undergoing elective laparoscopic or robotic abdominal surgery. For each patient, DB was applied to incisions on one side of the abdomen and LB was applied to the contralateral side. The side for each glue was randomized by date of the month. The primary outcome was the proportion of patients experiencing contact dermatitis within 6 weeks postoperative period. One hundred eighty patients were enrolled, and 1 was lost to follow up. Contact dermatitis occurred in 21 of 180 patients (11.7%). DB alone caused reactions in 3 patients (1.7%), LB alone in 1 patient (0.6%), and both adhesives in 17 patients (9.5%). The matched-pairs odds ratio for LB versus DB was 0.33 (95% CI 0.01-4.15, p = 0.63). A sensitivity analysis for patients lost to follow up did not change the results. 7 (33%) patients required treatment for contact dermatitis, all of whom had bilateral reactions. Contact dermatitis due to tissue adhesive was seen in 11.7% of patients; however, there was no statistically significant difference between the rates seen with DB and LB. The risks and benefits of tissue adhesive should be carefully considered when choosing to use these products in the closure of surgical incisions, and surgeons need to have a clear management algorithm for dermatitis should it occur. This risk does not seem to be mitigated by manufacturer, so adhesive choice may reasonably be guided by factors such as cost, availability, or institutional preference.
Everyday functioning and symptom reduction are rehabilitation goals for individuals with psychotic spectrum disorders (PSD). Self-rating of the World Health Organization Disability Assessment Schedule 2.0 (WHODAS) may provide insights into individuals' perspectives on their disabilities but researchers have questioned the value of self-ratings in individuals with PSD. To explore how individuals with PSD in outpatient psychiatric care reason when self-rating their disabilities on WHODAS to determine the value of doing self-ratings. Twenty community dwelling individuals diagnosed with schizophrenia or schizoaffective disorder completed the 36-item WHODAS while being interviewed using concurrent probing. Deductive content analysis was performed, while supplementary questions were analysed inductively. Most individuals showed difficulties in responding in expected ways to the questions. Three themes were identified: Poor language comprehension, Difficulties in processing and responding, and Rating issues related to time, context and experience Difficulties were observed across all WHODAS items. A positive theme concerning Meaning-making emerged. Findings suggest that self-rating WHODAS by community dwelling individuals with PSD pose challenges related to language interpretation, attention, contextual framing, emotional engagement and possible cognitive impediments. It is recommended to use WHODAS self-ratings as a tool for dialogue, and contextual understanding, supporting self-reflection, and patient participation.
We present a transient absorption (TA) setup with a broadband white-light from 600 to 1700 nm without a detection gap. This TA setup differs from typical TA implementations in two distinct details. First, instead of seeding the 800 nm fundamental laser beam directly into the white-light generation (WLG) crystal, we pump our yttrium aluminum garnet WLG crystal with the 2080 nm idler of a home-built two-pass optical parametric amplifier pumped at 800 nm. Second, we implement the B matrix referencing scheme introduced by Feng et al. to suppress the white-light fluctuations down to the shot-noise limit of our detector. As such, our implementation of the B matrix leads to a reduction of the root mean square of about an order of magnitude in the 1200-1700 nm regime compared to the ratiometric referencing approach. Furthermore, we suppress baseline oscillations frequently encountered in TA by mitigating the effects of negative pixel correlation. To allow widespread implementation of the referencing scheme in the scientific community, we provide an introduction to the B matrix focusing specifically on data processing. The B matrix referencing scheme is easy to implement and is employed directly during data acquisition, thus maintaining similar alignment and measurement times compared to typical TA implementations. Finally, we show that the noise reduction provided by the B matrix referencing scheme allows for WLG schemes that would otherwise fluctuate too much to provide high-quality data in a reasonable amount of time, enabling the construction of more specialized TA experiments.
Fetal-type posterior communicating artery (PcomA) aneurysms remain a difficult subgroup in the flow-diverter era. In these lesions, the PcomA supplies a substantial portion of the posterior cerebral artery territory because the ipsilateral P1 segment is absent, hypoplastic, or functionally insufficient. The branch therefore functions as a major outflow channel, and persistent distal demand may maintain circulation through the aneurysm-neck complex after flow diversion. This review summarizes the anatomical basis of fetal-type PcomA aneurysms and the current evidence for clipping, coiling, intrasaccular devices, and flow diversion. Among PcomA aneurysms treated with flow diverters, non-fetal lesions generally show better angiographic outcomes than fetal-type lesions. In a recent meta-analysis, complete occlusion at final follow-up was 77% in non-fetal aneurysms versus 42% in fetal-type aneurysms. A multicenter comparative cohort similarly reported complete occlusion in 81.8% versus 43.7%, with a markedly shorter median time to occlusion in non-fetal lesions (6 vs. 51 months). Earlier fetal-type series often showed persistent aneurysm filling and low complete occlusion rates, whereas more recent selected cohorts have reported complete or near-complete occlusion in 60%-80% of cases, suggesting that flow diversion can still be effective in carefully selected anatomies and with tailored strategies. Overall, clipping and coiling remain important branch-preserving options, and intrasaccular treatment may be reasonable in selected lesions with favorable geometry. Flow diversion should be considered selectively, particularly for large, recurrent, broad-necked, or morphologically complex aneurysms, while recognizing that robust fetal circulation may delay or limit aneurysm occlusion. Current evidence remains constrained by small retrospective series, inconsistent definitions of fetal anatomy, and heterogeneous device strategies.
Polyploidization is a key evolutionary force in plants, but the reasons behind its prevalence remain unclear. While the potential ecological benefits of established polyploids are well studied, little is known about the short-term genomic and epigenetic responses immediately after polyploidization, which are crucial for successful speciation. In this study, we assemble the genomes of the two progenitors of Arabidopsis kamchatica (A. halleri and A. lyrata) and examine the epigenome of synthetic and natural tetraploids of A. kamchatica to investigate the combined effect of allopolyploidization and environment on DNA methylation changes. We find the most significant methylation changes at allopolyploidization, followed by smaller changes in subsequent generations. Offspring grown under different conditions show divergent patterns, suggesting environmental effects, while their methylation patterns converge toward those of natural tetraploids over generations. Our findings highlight two key epigenetic changes post-polyploidization: convergence toward established polyploids and divergence driven by environmental factors.