Mathematical methodology-spanning statistics, time series analysis, modeling, and AI-driven approaches-functions as a foundational language of biomedical research rather than a mere instrument, profoundly shaping the field by extracting structure from complex biological data. Yet as these methods grow more sophisticated, a quieter problem emerges: when the reasoning encoded in our methods is not made readable, scrutiny becomes harder-it grows more difficult to separate signal from artifact, mechanism from correlation, or insight from overfitting. The capacity for such distinctions is not lost to us; rather, the controls that data science has developed to enforce them are applied unevenly, and the expectation that quantitative methods remain legible to their users has eroded. We term this the "magicalization" of mathematics-the transformation of quantitative methods into oracular pronouncements accepted on faith or incantations rejected wholesale, rather than transparent arguments open to challenge. We treat this less as an accomplished verdict than as a tendency whose costs compound if current practice fails to correct it. This departs fundamentally from the vision of Poincaré and Wiener, who held that mathematics must function as a shared language sustaining dialogue between quantitative and domain experts. We readily concede that achieving operational understanding of mathematical constructs across disciplinary boundaries is inherently difficult; yet abandoning mutual intelligibility is neither scientifically sound nor methodologically neutral-it limits scrutiny and obstructs mechanistic understanding. We trace how magicalization manifests in clinical translation, black-box deployment, and research evaluation; identify its structural causes in complexity escalation, incentive misalignment, and disciplinary siloing; and argue that recovering mathematical interpretability serves as more than an academic luxury-it stands as a prerequisite for rigorous, mechanistically grounded biomedical science.
Recently, cross-spectral image patch matching based on feature relation learning has attracted extensive attention. However, existing methods focus on mining richer feature relations by building complex relation extraction structures. Meanwhile, performance bottlenecks have gradually emerged. To address this, we make the first attempt to explore a stable and efficient bridge between descriptor learning and metric learning, and construct a Knowledge-Guided Learning Network (KGL-Net), which achieves significant performance improvements while abandoning complex network structures. Specifically, we find that there is feature extraction consistency between metric learning based on feature difference learning and descriptor learning based on Euclidean distance. This provides the foundation for bridge building. To ensure the stability and efficiency of the constructed bridge, on the one hand, we conduct an in-depth exploration of 20 combined network architectures. On the other hand, a feature-guided loss is constructed to achieve mutual guidance of features. In addition, unlike existing methods, we consider that the feature mapping ability of the metric branch should receive more attention. Therefore, a hard negative sample mining for metric learning (HNSM-M) strategy is constructed. To the best of our knowledge, this is the first time that hard negative sample mining for metric networks has been implemented and brings significant performance gains. Extensive experimental results show that our KGL-Net achieves SOTA performance in multiple cross-spectral image patch matching datasets. Our code is available at https://github.com/YuChuang1205/KGL-Net.
This paper examines Ghana's COVID-19 response through a biopolitical and biosecurity lens. Drawing on Michel Foucault's concept of biopolitics, it analyzes how interventions such as lockdowns, biosurveillance, and vaccination campaigns functioned both as technologies of care and instruments of control, expanding state authority over biological and social life. The study shows that biopolitics in Ghana did not replicate Western models but emerged as a provincialized and context-dependent form of power shaped by infrastructural constraints, informal economies, and postcolonial state formation. Pandemic governance was, therefore, adaptive and improvisational, requiring negotiation between epidemiological control and socioeconomic survival. By bringing biopolitics into dialogue with postcolonial theory and necropolitics, the paper conceptualizes pandemic governance as a hybrid regime in which life-preserving and life-abandoning logics coexist. It thus challenges universalist assumptions and repositions the Global South as central to rethinking the governance of life.
This paper examines the "expressivist objection" to physician-assisted dying (PAD) laws, which argues that limiting eligibility to terminal or incurable conditions expresses a discriminatory message devaluing such patients' lives. It critiques three common responses-abolishing PAD, removing medical criteria, and consequentialist justification-as inadequate. Instead, the author proposes that legally protecting healthcare professionals' conscientious objection can counterbalance this expressive harm. By accommodating conscientious objectors, the legal system actively affirms that the lives of incurably or terminally ill patients remain worthy of respect and preservation. This expressivist rationale grounds conscientious objection as a legal right rather than a mere permission, offering a key mechanism to address the moral residue generated by PAD legislation. Furthermore, this expressivist rationale addresses concerns about the reasonableness, genuineness, and professional ethics of conscientious objection. Finally, the paper provides a principled defence of conscience protections that preserves value pluralism without undermining access to PAD or abandoning the clinical foundations of PAD.
HER2-positive breast cancer is an aggressive subtype associated with high rates of early recurrence and brain metastasis. Standard adjuvant therapy, including anti-HER2 targeted agents, significantly improves outcomes. This case illustrates the natural history of untreated HER2-positive breast cancer and documents an exceptionally rare metastatic site. We report a case of a 63-year-old woman with HER2-positive (3+, FISH amplified), ER-positive (80-90%), PR-negative, Ki-67 15% invasive ductal carcinoma of the left breast (pT1cN2aM0, 7/12 axillary lymph nodes positive). The patient refused all standard adjuvant therapies (chemotherapy, radiotherapy, endocrine therapy, and anti-HER2 therapy) and opted for sole Chinese herbal medicine. After seven years of follow-up (with a disease-free interval of approximately four years, she developed a right cerebellar hemisphere metastasis (2.3×2.7 cm with extensive edema), widespread lymphadenopathy, and a pathologically confirmed thyroid metastasis-an extremely rare event in breast cancer. Fine-needle aspiration of the thyroid nodule demonstrated atypical cells, and subsequent immunohistochemistry confirmed breast cancer origin (GATA3+, GCDFP-15+, HER2 3+, ER+, TTF-1-, TG-). This case provides compelling in vivo evidence of the aggressive natural history of untreated HER2-positive breast cancer. The development of brain metastasis underscores the critical importance of anti-HER2 agents that penetrate the blood-brain barrier. The rare thyroid metastasis adds to the literature on unusual metastatic patterns. This report serves as a powerful warning of the consequences of abandoning evidence-based adjuvant therapy in high-risk breast cancer.
Solid fundamental skills in periodontal diagnosis and treatment constitute the cornerstone of professional development and clinical competence for every dentist, particularly for periodontists. This article highlights the practical significance and urgency of strengthening such fundamental training within the current landscape of oral healthcare. These essential competencies, mandatory for both periodontists and general dentists, include periodontal examination, manual supragingival scaling, subgingival scaling and root planning, ultrasonic instrumentation, as well as basic periodontal surgical procedures such as gingivectomy and periodontal flap surgery. Proficiency in these skills is crucial for preventing periodontal diseases, arresting disease progression, and achieving long-term clinical stability. Furthermore, this article identifies seven common cognitive and operational misconceptions in current periodontal practice and proposes corresponding strategies. Neglecting fundamental skills while blindly pursuing advanced devices, complex procedures, or techniques absence of scientific evidence equates to abandoning the foundation of periodontal therapy. Therefore, continuous enhancement and innovating fundamental skills training in undergraduate, postgraduate, and dental continuing education hold strategic importance for improving the overall standard of periodontal disease prevention and treatment in China. 扎实的牙周病诊治基本功是每一位口腔医师，尤其是牙周专科医师专业发展与临床实践的基石。本文旨在探讨在当前口腔医疗环境下，加强牙周病诊治基本功训练的现实意义与紧迫性。牙周诊治基本功是牙周专科及口腔全科医师必须掌握的操作技能，涵盖牙周检查、手工龈上洁治术、龈下刮治与根面平整术、超声技术等基础治疗操作，以及牙龈切除术和牙周翻瓣术等基础性手术。熟练掌握并运用这些技能，是预防牙周疾病发生、控制其进展并获得长期稳定疗效的关键路径。本文进一步指出了当前牙周临床实践中存在的七大认知与操作误区，并提出相应对策。若忽视基本功而盲目追求高端器械、复杂操作或缺乏科学依据的新技术，无异于舍本逐末。因此，在院校教育、毕业后教育以及继续教育中持续强化并创新基本功训练模式，对全面提升我国牙周病防治水平具有重要的战略意义。.
Kultanaruangnonth et al. recently reported a well-conducted double-blind randomized trial comparing intraoperative irrigation with 0.05% aqueous chlorhexidine gluconate (CHG) against normal saline for the prevention of surgical site infection (SSI) in abdominal surgery, concluding that CHG did not significantly reduce SSI. We raise three interpretive points. First, the antimicrobial rationale offered for CHG draws on clean-field trials (arthroplasty, caesarean delivery, breast reconstruction) in which SSI is driven by skin flora, whereas this trial's population was predominantly colorectal and hepatobiliary/contaminated surgery, fields dominated by enteric gram-negative and anaerobic organisms against which chlorhexidine is comparatively less active a plausible explanation for the smaller-than-expected effect. Second, the trial's own 95% confidence interval for the primary risk ratio (0.45-1.25) spans a 55% relative reduction to a 25% relative increase in SSI, and is compounded by a statistically fragile exploratory multivariable model (49 events across eight covariates, several dichotomized); we argue the result is more accurately described as statistically inconclusive than as a negative finding. Third, the Discussion's suggestion of particular benefit 'in high-risk populations' is not supported by any treatment-by-subgroup interaction analysis in the manuscript. We conclude that these findings argue for a larger, stratified, culture-informed confirmatory trial rather than for adopting or abandoning CHG wound irrigation in contaminated abdominal surgery.
Syncope, as a symptom, remains poorly understood and handled in the UK. Personal involvement stemmed from successful abolition of syncope by cardiac pacing, initially in atrioventricular block then other bradycardias; UK facilities were sparse in the late 1970s. The aim was to broaden distribution and encourage understanding. To achieve this required abandoning the typical cardiology mindset and re-engaging with internal medicine. Syncope is poorly taught in medical schools, which implies that few physicians understand it and, therefore, cannot practise it to benefit patients. Syncope patients presenting in emergency departments (>1% of all) are frequently admitted to hospital to undergo numerous non-diagnostic tests, then discharged without diagnosis. Syncope has life-threatening causes in >1% of patients; given its prevalence, this represents a large number. Treatment is now possible. Syncope science has notably advanced, offering valuable diagnostic and therapeutic strategies. Ubiquitous delivery in the UK requires a new approach, which has been applied in the Netherlands. Now, more than ever, is the time to take syncope seriously, with action now to address this critical situation.
Although several barriers that discourage women physicians from pursuing surgical careers have been described, the factors that dissuade female medical students from choosing surgery during their training remain insufficiently understood. This was a descriptive, cross-sectional, exploratory study approach among female medical students in the state of Rio Grande do Sul (RS), Brazil. Data were collected through a non-probability convenience sample between November 2022 and March 2023 using an online questionnaire. A total of 584 valid responses were analyzed. Most respondents (75.5%) had considered pursuing a surgical career at some point, with initial interest most commonly arising before medical school admission. No statistically significant association was found between stage of training progression and interest in surgery (p = 0.564). The primary reason for abandoning interest in surgery was dissatisfaction with the perceived lifestyle associated with the specialty. Overall, 59.6% of participants reported perceiving gender as a limiting factor in surgical careers. A substantial majority (75.9%) indicated they would be more likely to pursue a surgical career if there were greater female representation among faculty. Additionally, 70.2% reported experiencing gender bias during medical school, with many incidents attributed to faculty members. Faculty engagement and institutional support emerged as key strategies to promote greater female participation in surgery. Despite the limitations inherent to the sample and study design, the findings highlight multiple factors contributing to the underrepresentation of women in surgical specialties and underscore the critical role of the educational environment in shaping career trajectories. These results may contribute to broader national discussions, given the shared curricular framework among Brazilian medical schools.
The radial artery (RA), a branch of the brachial artery, is frequently utilized in a variety of medical procedures: by cardiologists for cardiac catheterization, by nephrologists for arteriovenous fistula creation, by interventional radiologists, and by plastic surgeons for free flap reconstruction. Knowledge of RA anatomical variants is particularly important in patients with end-stage renal disease, as they often require fistula creation for hemodialysis. Failure to recognize such variants may lead to procedural complications. We describe the case of a 35-year-old man with diabetes whose preoperative ultrasound examination, performed before the creation of an arteriovenous fistula, revealed a high division of the radial artery into the superficial radial artery and the deep branch of the radial artery. The deep palmar branch of the radial artery was successfully used for anastomosis in the wrist. In this publication, we provide the data regarding this rare anomaly and indicate that such a finding should not lead to abandoning the creation of a radial-cephalic fistula.
Slater, J. (2025. The Overgeneralization of the Future Like Ours Argument. The New Bioethics, 31 (1), 1-12. doi:10.1080/20502877.2025.2483588) argues that Don Marquis's Future-Like-Ours (FLO) account overgeneralizes by producing conclusions about cognitively enhanced animals and alien 'seeds'. This article defends FLO by showing that Slater's reductios depend on a permissive conception of present potential, according to which any externally producible valuable future confers moral status. I instead propose an intrinsic-nature account grounded in the distinction between active and passive potentiality. A being possesses potential for a valuable future only where that future would develop from its own first-order nature under supportive conditions, rather than being externally installed. This account defeats the enhanced-dog case and either resolves the alien-seed case or recasts it as an objection about positive duties. It also avoids disputed empirical claims about contraception and clarifies FLO's metaphysical commitments without abandoning its central deprivation-based account of killing.
Succession is a foundational concept in ecology, describing changes in populations, communities, and ecosystems over time following a disturbance. Predicting successional pathways is challenging because of high spatiotemporal variability. Here, we present a unifying mechanistic framework that integrates three core components of succession (start, speed, and direction) that define successional pathways. We monitored the first 5 years of forest succession in recently abandoned agricultural fields in six tropical landscapes across three countries that differ in land-use intensity and between dry and wet forests. We found that (i) secondary succession typically started with woody legacies and progressed slowly but directionally toward structurally complex, biodiverse forests, and (ii) the start and speed were greater in areas with short-duration, low-intensity (nonmechanized) land use associated with more biological legacies. This framework advances mechanistic understanding of succession by disentangling the start, speed, and direction, and provides a tool for designing effective forest restoration strategies.
Pollinators are important to humans and nature due to their role in ecosystem functioning and services. Research on the effects of pollinator management in protected areas is insufficient compared with that on farmlands and urban areas, potentially hindering appropriate policy implementation. We addressed this knowledge gap by conducting a data-based synthesis on measures to promote pollinators (especially bees, butterflies, and flies) across European protected areas. To compare the effects of management practices that enhance pollinators (pollinator-friendly; treatment) and those not focused on pollinators (conventional; control) in protected areas, we used vegetation, floral resource, and pollinator datasets. Our synthesis involved 10 countries, 34 datasets, and 639 sampling sites with different management activities (land abandonment, mowing, grazing, mulching, flower sowing, gap creation, and uprooting and girdling trees) and habitats (grasslands, forests, reed beds, and sandpits). Pooled analysis indicated that pollinator-friendly management had mainly neutral effects on floral resources and pollinators, with some positive effects but no negative effects. Dataset-level details revealed mostly neutral effects from pollinator-friendly management with some positive (15%) and fewer negative (3%) effects. Management slightly improved pollinator overall abundance and species richness, particularly for butterflies and wild bees (excluding bumblebees). Comparing our synthesis with previous studies suggests that implementing management practices for pollinators in protected areas is more challenging than in farmlands and cities, possibly because protected areas already host higher quality habitats. Alternatively, pollinator-friendly approaches commonly implemented in protected areas may be insufficient. Although the Nature Restoration Regulation provides new opportunities for pollinator conservation, implementation will require careful planning for target areas, as effective management, including pollinator requirements, requires more focused and context-specific measures than those applied in cities and farmlands. Although focused on Europe, our synthesis provides broadly applicable lessons for pollinator conservation in other highly modified landscapes but with adaptation to local ecological and socioeconomic conditions. Síntesis de las prácticas de gestión favorables a los polinizadores en áreas protegidas europeas Resumen Los polinizadores son importantes para los seres humanos y la naturaleza debido a su papel en el funcionamiento de los ecosistemas y los servicios ecosistémicos. La investigación sobre los efectos de la gestión de los polinizadores en las áreas protegidas es insuficiente en comparación con la realizada en tierras de cultivo y zonas urbanas, lo que podría dificultar la aplicación de políticas adecuadas. Abordamos esta laguna de conocimiento realizando una síntesis basada en datos sobre las medidas para fomentar la presencia de polinizadores (especialmente abejas, mariposas y moscas) en las áreas protegidas europeas. Para comparar los efectos de las prácticas de gestión que favorecen a los polinizadores (favorables a los polinizadores; tratamiento) y aquellas que no se centran en ellos (convencionales; control) en las áreas protegidas, utilizamos conjuntos de datos sobre vegetación, recursos florales y polinizadores. Nuestra síntesis abarcó 10 países, 34 conjuntos de datos y 639 puntos de muestreo con diferentes actividades de gestión (abandono de tierras, siega, pastoreo, acolchado, siembra de flores, creación de claros y arranque y anillado de árboles) y hábitats (praderas, bosques, cañaverales y canteras de arena). El análisis conjunto indicó que la gestión favorable a los polinizadores tuvo efectos principalmente neutros sobre los recursos florales y los polinizadores, con algunos efectos positivos, pero sin efectos negativos. Los detalles a nivel de los conjuntos de datos revelaron que la gestión favorable a los polinizadores tuvo efectos mayoritariamente neutros, con algunos efectos positivos (15 %) y un número menor de efectos negativos (3 %). La gestión mejoró ligeramente la abundancia general de los polinizadores y la riqueza de especies, especialmente en el caso de las mariposas y las abejas silvestres (excluidos los abejorros). La comparación de nuestra síntesis con estudios anteriores sugiere que la aplicación de prácticas de gestión en favor de los polinizadores en las áreas protegidas resulta más compleja que en las tierras de cultivo y las ciudades, posiblemente porque las áreas protegidas ya albergan hábitats de mayor calidad. Por otra parte, es posible que los enfoques favorables a los polinizadores que se aplican habitualmente en las áreas protegidas resulten insuficientes. Aunque el Reglamento sobre la restauración de la naturaleza ofrece nuevas oportunidades para la conservación de los polinizadores, su aplicación requerirá una planificación cuidadosa de las zonas objetivo, ya que una gestión eficaz —que tenga en cuenta las necesidades de los polinizadores— exige medidas más específicas y adaptadas al contexto que las que se aplican en las ciudades y las tierras de cultivo. Aunque se centra en Europa, nuestra síntesis ofrece lecciones de amplia aplicabilidad para la conservación de los polinizadores en otros paisajes altamente modificados, siempre que se adapten a las condiciones ecológicas y socioeconómicas locales.
This cohort study analyzes factors associated with abandonment of newly prescribed buprenorphine among US adults from 2020 to 2024.
Parasocial attachments are one-sided emotional relationships with public figures that are generally benign and may provide emotional comfort, social connection, and identity development. In vulnerable individuals, however, these attachments may become maladaptive when associated with significant emotional distress, functional impairment, or suicidal behavior. Limited literature exists regarding the role of parasocial attachments in individuals with borderline personality pathology and severe mental illness. We present the case of a 30-year-old woman with schizoaffective disorder, depressive type, and borderline personality disorder who developed a longstanding parasocial attachment to a celebrity figure. For more than 10 years, she maintained an intense emotional investment in the celebrity despite having no personal contact. She acknowledged that the celebrity was unaware of her existence and did not reciprocate her feelings. Nevertheless, she experienced profound distress related to the unattainability of the relationship in the context of chronic feelings of emptiness and fears of abandonment. She presented following a suicide attempt involving the ingestion of apixaban and metoprolol, stating that she no longer wished to live because she could not be with the celebrity. Despite a history of auditory and visual hallucinations involving the celebrity, she denied active hallucinations at presentation. She demonstrated preserved reality testing, recognizing that the relationship was one-sided and unattainable. This case highlights how parasocial attachments may become clinically significant in the setting of underlying psychiatric vulnerabilities. Not all parasocial attachments are clinically significant. However, when they are accompanied by emotional distress, functional impairment, or suicidal ideation, clinicians may benefit from exploring their role in a patient's presentation. Assessing reality testing can help distinguish maladaptive parasocial attachment from erotomanic or other delusional beliefs. Further research is needed to clarify the relationship between parasocial attachments, borderline personality disorder, and suicidal behavior.
Medicaid Home and Community Based Service (HCBS) waivers provide services for individuals with disabilities in the United States (U.S.) who are at risk of institutionalization. Assistive technology (AT) is a covered service category that includes devices, systems, and supports such as adapted or mainstream technologies to enhance independence and participation. However, variation in state HCBS waiver policies may facilitate or hinder access to AT devices and related services, resulting in differences in availability, coverage, and implementation. This study examined the availability, scope, and disparities in AT services across state Medicaid HCBS waivers serving persons with physical disabilities (PwPD) in the U.S. Methods We conducted a content analysis of standalone AT services and AT-related services within Medicaid HCBS waivers for PwPD. AT-related services include home modifications, personal emergency response systems (PERS), remote supports, specialized medical equipment and supplies (SMES), and state-created AT services. The analysis included 57 waivers (22% of all HCBS waivers) from 38 states serving PwPD and included an AT service, AT-related service, or both. Seventeen waivers (30%) across 13 states included both AT and AT-related services, while 40 waivers (70%) across 30 states offered only AT-related services. Collectively, these waivers provided 20 AT services, 55 home modification services, 46 PERS services, three remote support services, 36 SMES services, and 11 state-created AT services. Substantial variability exists in AT coverage within HCBS waivers for PwPD. Many states lack clear AT definitions, and some exclude mainstream technology acquisition, potentially creating service gaps that hinder long-term AT use and increase institutionalization risk. The study shows that inconsistent inclusion of standalone AT services within Medicaid HCBS waivers may limit awareness and access for persons with physical disabilities. When AT is embedded within broader service categories rather than clearly identified, rehabilitation professionals must actively help waiver recipients recognise and navigate available pathways for acquiring needed technology.Inconsistent coverage of essential service delivery components, such as assessment, customisation, training, and ongoing technical support, may increase the risk of inappropriate device selection and technology abandonment. Comprehensive AT service provision should be integrated into rehabilitation planning to promote long-term functional independence and sustained technology use.The selective inclusion or exclusion of mainstream technologies within waiver language may restrict access to cost-effective, socially integrated solutions that enhance partici­pation and independence. Rehabilitation providers should document functional needs clearly and frame mainstream technology recommendations around independence, safety, and prevention of institutionalisation to improve approval outcomes.
The protracted conflict in Yemen has led to profound disruptions in the health system, fundamentally reshaping patterns of healthcare access and utilization. This commentary engages with a recent study that conceptualizes self-medication and informal antibiotic use as forms of coping and agency in constrained settings, and re-examines this interpretation within the context of systemic collapse. Drawing on a structural perspective, the analysis argues that self-directed care practices in Yemen are not temporary responses to episodic constraints but are embedded within enduring structural conditions shaped by infrastructure destruction, workforce depletion, and disruptions in medical supply chains. These conditions have produced overlapping physical, financial, and sociocultural barriers to healthcare access, contributing to the normalization of informal care practices, including self-prescription and reliance on community-based networks. The commentary also examines the role of psychological distress in shaping health-seeking behaviour, highlighting how the absence of accessible mental health services reinforces reliance on self-directed care. By reframing self-medication as an outcome of structural conditions rather than individual choice, this analysis contributes to debates on health system collapse in conflict settings and underscores the limitations of behaviour-focused interventions while emphasizing the need to address structural determinants of healthcare access.
Non-suicidal self-injury behaviors are relatively common among adolescents with depression, seriously endangering their physical and mental health as well as the prognosis of the disease. Currently, the relationship between explicit self-injury behaviors, implicit self-injury attitudes and self-esteem levels of adolescents with depression is not clear. Therefore, this study systematically analyzed the correlation between explicit self-injury behaviors, implicit self-injury attitudes and self-esteem levels of adolescents with depression, aiming to provide theoretical basis for reducing self-injury behaviors and improving their self-esteem levels. A cross-sectional study was conducted from April 2025 to March 2026 at a mental health specialty hospital in Xinxiang City, Henan Province, China. Using the convenience sampling method, 116 adolescent patients with depression were selected to measure the Non-Suicidal Self-Injury Behavior Questionnaire, the Self-Esteem Level Scale, and to explore the patients' implicit attitudes toward self-injury through the Implicit Association Test. The score of explicit self-injury behavior in adolescent patients with depression was (25.66 ± 12.11); Correlation analysis showed that the explicit self-injury behavior of the patients was significantly negatively correlated with their self-esteem level (P < 0.05). The effect value of the implicit self-injury attitude of the patients was (0.26 ± 1.06), which was different from 0 and the difference was statistically significant; this suggested that the patients had a significant implicit tendency toward self-injury; there was no significant correlation between the implicit self-injury attitude and the explicit self-injury behavior, or the self-esteem level (P > 0.05). The explicit self-injury behaviors of adolescent patients with depression are at a medium-high level, and the implicit self-injury attitudes are significant and have an independent association effect. When conducting intervention for adolescent patients with depression in clinical settings, it is necessary to abandon the single explicit behavior intervention model and take into account the patient's implicit cognitive characteristics and self-esteem level. A comprehensive intervention system that integrates both internal and external aspects should be constructed to effectively reduce the risk of self-harm behaviors, enhance the patient's self-esteem level and overall mental health level.
The municipality of Solofra (Avellino, Italy) is a major center for the tanning industry, where long-term leather processing has generated significant environmental pressure. An abandoned industrial site used to treat organic tannery waste was found to contain illegally dumped materials. A characterization campaign conducted in 2016 involved drilling 68 boreholes to depths of about 10 m and collecting 235 samples. Concentrations of 16 potentially toxic elements were determined, georeferenced, and visualized in a three-dimensional model. A novel methodological framework combining multivariate statistics and three-dimensional geostatistical modelling was applied. Empirical Bayesian Kriging generated spatial models for individual elements. At the same time, Principal Component Analysis identified the main geochemical associations, distinguishing natural volcanic soil signatures (V, As, and Be) from anthropogenic inputs associated with tanning activities, particularly Cr, Sb, Sn, and Tl. Fuzzy Cluster Analysis applied to PCA scores further delineated two main compositional domains: a widespread cluster of tannery waste mixed with volcanic soils and a second cluster of relatively pure tannery waste enriched in chromium and associated elements. Chromium valence partitioning was inferred under assumed reducing conditions, with the data indicating Cr(VI) below detection limits. The observed correlation with organic matter is consistent with possible retention of Cr(III) via adsorption and organic complexation. However, this pattern should be interpreted as indirect evidence of inferred speciation rather than direct confirmation. The integration of multivariate statistics with three-dimensional modelling enabled reconstruction of the landfill's internal geochemical architecture, providing a powerful tool for identifying contaminant hotspots and supporting targeted investigation and remediation in complex industrial waste sites.
Lymphoma is one of the most common cancers affecting young adults in Sub-Saharan Africa, yet survival outcomes lag far behind those in high-resource settings. A significant contributor to these disparities is treatment abandonment, driven by limited access to essential palliative care support and lack of symptom management medications. This study aimed to assess the feasibility and early uptake of a Symptom Toolkit intervention to support symptom recognition and self-management. We designed and implemented a novel, low-cost, culturally appropriate Symptom Toolkit into an oncology clinic in Malawi. The toolkit included nurse-delivered patient education and take-home essential therapies targeting high-burden symptoms, including pain, nausea and vomiting, insomnia, gastritis, mucositis, and constipation, with pictorial labels and a journal to record use. Included therapies were selected based on local clinical guidelines and availability. At follow-up visits, a palliative care nurse completed survey assessments and distributed new Symptom Toolkits, noting both symptom occurrence and rates of medication use. A total of 65 patients with lymphoma (median age 39) participated, including individuals with acute lymphoblastic leukemia, Burkitt lymphoma, diffuse large B-cell lymphoma, and Hodgkin's lymphoma. Across the 602 toolkit reports completed, use of symptom-directed medications increased over time, indicating improved uptake and engagement with the intervention. This pilot intervention demonstrates the feasibility of a nurse-delivered Symptom Toolkit as a means to enhance symptom recognition and self-management in a low-resource oncology setting. Further evaluation of the Toolkit in future studies will assess its impact on symptom burden and quality of life.