Nipah virus (NiV) causes recurrent outbreaks in Bangladesh with high mortality and persistent health consequences among survivors. As outbreak detection and clinical management improve, the number of survivors is likely to increase, creating an urgent need for long-term clinical, psychosocial, and rehabilitation support. To explore the lived experience of NiV survivors in Bangladesh and how physical, psychological, social, and economic challenges shape life after acute illness. We conducted a qualitative study with a phenomenological orientation among 27 adult NiV survivors in Bangladesh. Survivors were purposively selected to capture variation in sex, age, exposure route, years since illness, and severity of acute disease. Where survivors had substantial communication difficulties or limited recall of the acute illness, caregivers provided supplementary contextual information on illness and recovery. In-person, semi-structured interviews were conducted in May 2022. Data were analysed inductively using reflexive thematic analysis with analyst triangulation to enhance credibility. Participants were interviewed between 2 and 21 years after illness. Survivors described persistent functional limitations, including fatigue, mobility and balance problems, headaches, and visual changes, as well as cognitive and emotional difficulties, including memory problems, irritability, sleep disturbance, and anxiety. These challenges altered daily routines, self-perception, and expectations for the future. Survivors also described stigma and fear of contagion in healthcare and community settings, which restricted social participation, education, and marriage prospects. Households experienced substantial economic hardship through income loss, borrowing, mortgaging land, and sale of assets to pay for treatment and recovery. Coping responses included practical adjustments and reliance on family support and religious faith, although many participants reported ongoing uncertainty about health, livelihoods, and the future. Survivorship after Nipah virus infection in Bangladesh involves continuing functional, cognitive, psychosocial, and economic hardship that extends well beyond acute recovery. Priority actions include survivor-centred rehabilitation, brief mental health support, and counselling for caregivers on safe care practices. Stigma-sensitive risk communication and targeted financial support should also be integrated into existing Nipah surveillance and response systems.
This retrospective cohort study examined the effects of the Danish legislative amendment extending the permitted duration of embryo cryopreservation from five years until the woman reaches 46 years on frozen embryo transfer (FET) during Assisted Reproductive Technology (ART). The number of embryos discarded across the eight public fertility clinics due to the five-year storage limit was quantified between January 1st, 2017, and December 31st, 2019, with an average annual destruction of 1,399 embryos. As of March 2024, 29,591 embryos were cryopreserved in the public fertility clinics. FET cycles from the public clinics between October 2020 and March 2024 were included in the outcome analysis (n=14,677), of which 1.9% (n=284) involved embryos cryopreserved >5 years. Ongoing pregnancy rate (OPR) and live birth rate (LBR) were assessed by parity and cryopreservation duration (≤5 years vs. >5 years). OPR and LBR increased significantly with parity (36.7% and 31.3% for first, 42.6% and 35.6% for second, and 48.8% and 39.0% for third/fourth child), although the increase in LBR for first vs. third/fourth child was not statistically significant. OPR and LBR in FET cycles with embryos cryopreserved >5 years were not significantly different from cycles with embryos cryopreserved ≤5 years (OPR: 36.4% vs. 38.0%; LBR: 30.9% vs. 32.2%). During the study period, 84 children were born from embryos cryopreserved >5 years that previously would have been destroyed. The findings suggest that the amendment has enabled patients to use surplus embryos for family expansion and prevented the disposal of many good embryos. In fertility treatment, cryopreservation is the process of freezing fertilized eggs called embryos. Embryos can be warmed and transferred to the uterus in a future treatment cycle, giving patients another chance at pregnancy without repeating egg retrieval and fertilization. In Denmark, a recent legislative amendment extended the storage limit for embryos from five years to the woman's 46th birthday. The study investigated how this amendment affected the use of cryopreserved embryos as well as pregnancy and live birth outcomes after frozen embryo transfer. Few transfers involved embryos cryopreserved over five years. Pregnancy and live birth rates were similar whether embryos had been frozen under or over five years, and 84 children were born from embryos stored over five years that previously would have been destroyed. The findings suggest that the amendment has enabled patients to use embryos from previous treatments for family expansion and reduced unnecessary destruction of good embryos.
We map and estimate the economic impact of the Israel-Hamas war on the Gaza Strip that began after the 2023 October 7 attacks by Palestinian militant groups. We measure the extent of likely damage to Gaza's built environment derived from satellite radar time series data and estimate the impact caused by the conflict on Gazan economic activity via night-time luminosity measurements. After the first year of war, we find that 82% of each square kilometer of the Gaza Strip had been damaged at least once and that 67.9% of its built-up area has been destroyed. We estimate an average loss of night-time luminosity due to the conflict of 68.5%, and find that the 2023 November ceasefire coincided with a small but significant increase in luminosity. We translate our night-time luminosity losses into economic indicators: our results show that more than three quarters of Gaza's economy has been destroyed since the start of the conflict, and we estimate a loss of 2.6 billion USD of household expenditures caused by the damage. Our work establishes a novel framework for estimating the economic impact caused by conflicts with low latency, detailed spatial resolution and which is agnostic with respect to field data sourced from political actors.
Soils are unique in their intricate, 3D structure, harbouring 59% of global biodiversity. Yet, this structure is easily destroyed. Soils have no formal protected status, and we do not know where the oldest undisturbed soils are located. In this forum article, I argue that applying the old-growth concept to soils will aid their protection.
A 1-year-old domestic cat was presented with lameness and progressive swelling of the right stifle joint. The condition had been present for 1 month; during the consultation, it was evident that the cat was not bearing weight on the limb, which also exhibited muscle atrophy and tremors, as well as signs of pain upon manipulation. After sedation, crepitus was noted at the femorotibial-patellar joint. Radiographic examination showed osteolysis, and during clinical exploration, tumor cells destroying the joint were confirmed by cytology. Surgical excision was performed via limb amputation, and the mass was found to measure 3 × 5 × 3 cm. Histopathological analysis showed a biphasic neoplasm composed of spindle-shaped mesenchymal-like cells and large epithelial-like cells. Normal joint structures, including the capsule and articular cartilage, were completely effaced by neoplastic infiltration, including similar neoplastic changes in distal femur and proximal tibia epiphyses, metaphyses and diaphyses. Tumor cells were immunopositive for either vimentin or cytokeratin. Based on the 2020 World Health Organization (WHO) classification, the tumor was diagnosed as a malignant synovial and perisynovial neoplasm. The cat died 3 months after surgery; at the owner's request, no post-mortem examination was conducted.  To the authors' knowledge, this is the first reported case of malignant synovial and perisynovial neoplasia diagnosed in a juvenile cat in accordance with the 2020 WHO classification. This case provides new insights into the histopathological findings of this rare tumor type in feline patients. Rare joint cancer in a young cat A 1-year-old domestic cat was examined because of lameness and progressive swelling of the right stifle joint that had been present for about 1 month. The cat was unable to bear weight on the limb and showed muscle loss, tremors and pain when the joint was moved. Imaging showed bone destruction around the joint. Examination of cells collected from the joint indicated the presence of a tumor. The affected limb was surgically removed, and the mass measured 3 × 5 × 3 cm. Microscopic examination showed an invasive cancer made up of two different types of tumor cells that had destroyed the normal structures of the joint and extended into the surrounding bones. Additional tests confirmed that the tumor was a malignant synovial and perisynovial neoplasm, according to the 2020 World Health Organization classification. The cat died 3 months after surgery. To the authors’ knowledge, this is the first reported case of this type of joint cancer in a young cat diagnosed using the current classification system.
In June 2023, the Kakhovka Hydroelectric Power Plant's dam was destroyed by Russian troops, leaving large areas downstream flooded and an area upstream dried-up. Therefore, the objectives of this screening-level study were (i) to determine the content of organic pollutants in the alluvial soils that have dried-up and soils that are above the old water level, and (ii) to determine the pattern of accumulation of organic pollutants in the dried-up zone. The alluvial soils within the city of Zaporizhzhia were sampled from the superficial, 30 cm, layer in six areas in the dried-up zone, drained after the dam's breach, and also in six areas in the floodplain above the former water level. The composition of organic pollutants was determined using the method of gas chromatography-mass spectrometry. The distribution of organic pollutants in the soils was analyzed based on the hygrophilicity index that we proposed, which was calculated as a ratio of the amount of compound in the soils of the dried-up zone to its amount in the dried-up zone and in unflooded areas together. We identified 155 organic compounds, 24 of which are hazardous toxicants that contaminate the environment. Those compounds were represented by polycyclic aromatic hydrocarbons, acid esters, aromatic heterocycles, and other compounds. This ecological pollution jeopardizes the urban landscapes of Zaporizhzhia and other setllemens on the banks of the former Kahovka Reservoir and the health of people in southern Ukraine.
Native consumers can behave maladaptively towards invasive species, with evolution of behavioural or physiological traits thought to be the main way out of these 'evolutionary traps'. However, shorter term ecological processes resulting from biological invasions could provide other ways to escape evolutionary traps. Asobara cf. rufescens, a resident (i.e. possibly native or previously introduced) parasitoid of drosophilid fly larvae in North America, can rarely produce offspring on the invasive fruit pest Drosophila suzukii in the laboratory, but often emerges from field-collected D. suzukii. We hypothesized that the successful development of the resident parasitoid in the invasive host in the field is made possible by Leptopilina japonica, a recently introduced parasitoid of D. suzukii. In laboratory experiments, we found that the resident parasitoid had more than 30-fold higher offspring emergence in the invasive host when the recently introduced parasitoid was also present. The resident parasitoid was only able to develop when it parasitized the host after the introduced parasitoid, possibly because the introduced parasitoid destroyed the hosts' cellular immunity. The introduced consumer thus enabled a resident consumer to expand its host range to include the invasive host species, rescuing it from an evolutionary trap.
The UFO procedure is an established surgical technique to treat extensive endocarditis of the aortic or mitral valve with involvement of the intervalvular fibrous body (IVFB). This technique can be used for radical resection of the whole infected tissue. Independently of the size of the infected region it is unavoidable to replace both valves. In this high-risk re-do case we performed a modified so-called hemi-UFO procedure with preservation of the mitral valve. We present a 71-year-old male patient initially diagnosed with severe stenosis of the aortic valve. An aortic valve replacement with a 23-mm prosthesis was performed via partial upper mini-sternotomy. Eight weeks after surgery an echocardiogram revealed a large vegetation and severe regurgitation of the aortic valve prosthesis. The risk of death following reintervention heart surgery (EuroSCORE II) was calculated as 50.64%. We performed a re-do with full sternotomy. Intraoperatively it was observed that the aortic prosthesis was partially torn out. The aortic annulus exhibited circular infection with an abscess connecting to the left atrium. The tissue of the left atrial roof was partially destroyed, similar to a phlegmonous infection. We opened the left atrial roof and radically resected the infected tissue up to the IVFB. We prepared a custom-made conduit prosthesis of bovine pericardium with a 25-mm valve prosthesis. We replaced two thirds of the ascending aorta with re-implantation of the coronary arteries using the Bentall-de Bono technique. We were able to stabilise and implant the new aortic valve prosthesis with sutures through the opened left atrial roof. The stitches began close to the anterior mitral leaflet region and ended in the direction of the left ventricle outflow tract. All sutures were pericardium-pledgeted and were passed through a bovine pericardial patch. This patch formed a new mitral annulus and was used for the closure of the left atrial roof. We had to reconstruct the IVFB, the roof of the left atrium and the mitral annulus in the anterior (A1), middle (A2) and posterior (A3) segments. The patient was transferred to the intensive care unit with no inotropes and in sinus rhythm. The 3-year follow-up was uneventful. We showed a successful surgical treatment of aortic prosthesis endocarditis with involvement of the IVFB. We were able to perform a radical resection of the infected tissue, reconstruct and replaced all sacrificed tissue with biological tissue and preserved the native mitral valve in a modified hemi-UFO procedure.
Living systems operate far from thermodynamic equilibrium while maintaining a high degree of internal order, raising the long-standing question of how fragile quantum coherence can persist in warm, noisy biological environments. While several biological processes exhibit signatures of quantum coherence, the physical mechanisms responsible for stabilizing such coherence remain an active area of debate. In this work, we present a phenomenological model demonstrating that quantum coherence in open spin systems can be stabilized through entropy-dependent feedback with a weakly coupled coherent field. We consider an open quantum spin ensemble subject to environmental decoherence, augmented by (i) entropy-sensitive suppression of decoherence and (ii) a coherence-inducing interaction that favors low-entropy, collectively coherent configurations. Using multipartite Greenberger-Horne-Zeilinger (GHZ) states as representative low-entropy coherent states, numerical simulations reveal nonlinear threshold behavior, entropy collapse, and long-lived coherence despite strong environmental noise. These features provide clear signatures of a positive feedback loop, wherein coherence suppresses decoherence, reduced decoherence enhances coherence, and the resulting self-reinforcement stabilizes the system. Importantly, the model is agnostic to the physical origin of the coherent field and is compatible with a wide range of candidates, including internally generated biological oscillations, collective electromagnetic or redox dynamics, oxygen-mediated spin correlations, and other structured cellular fields. As an illustrative example, we discuss the potential role of an ultralight dark matter (ULDM) background field, whose predicted macroscopic coherence and oscillation frequencies could, in principle, participate in the same feedback mechanism. By separating the general principle of feedback-stabilized coherence from any specific physical realization, this work provides a unifying theoretical framework for understanding how quantum coherence may persist in open, noisy systems relevant to biological physics. The results suggest that coherence in living matter may arise not from isolation from the environment, but from structured coupling to coherent fields that dynamically regulate decoherence through entropy-sensitive feedback. Living cells are warm and noisy environments, yet growing experimental evidence shows that some biological processes are sensitive to very weak electromagnetic influences, including extremely low-frequency (ELF) magnetic fields. Such fields are already used or explored in medicine—for example in bone repair, neuromodulation, and cancer research—although the physical mechanisms underlying their biological effects remain unclear.In this study, we investigate a general physical principle that could explain how weak oscillating influences affect biological systems. We show that if a quantum system is weakly coupled to a coherent background influence—such as an ELF magnetic field—and if this coupling becomes more effective as the system becomes more ordered, a positive feedback loop can emerge. In this loop, quantum coherence reduces the rate at which it is destroyed by environmental noise, and the resulting stability further strengthens coherence. Using computer simulations of interacting quantum spins, we demonstrate that this feedback can produce sudden transitions from disordered behavior to long-lived, highly coherent states, even when noise is strong. The model does not depend on the specific origin of the oscillating influence and is compatible with known biological rhythms, chemical oscillations, and externally applied ELF fields.As a physically motivated example, we also discuss ultralight dark matter—hypothesized to form a weak, coherently oscillating background field throughout space—as a possible contributor to the same stabilization mechanism. Overall, the results suggest that weak oscillating fields may influence biology and medicine not through direct energy transfer, but by stabilizing quantum coherence through feedback. This framework offers a unified, testable perspective for understanding biological sensitivity to ELF fields and, more broadly, how coherence may persist in living systems.
Chronic obstructive pulmonary disease (COPD) presents with obstructive ventilation disorders. Because no drugs can regenerate destroyed alveoli, there is an urgent need for new treatments that repair alveolar damage. We previously reported revealed that 1α,25-dihydroxyvitamin D3 (1,25(OH)2D3) showed emphysema-improving effects in COPD model mice. However, because 1,25(OH)2D3 carries a risk of serious adverse effects such as hypercalcemia, strategies to reduce the risk are needed to allow further dose reduction. To solve this problem and achieve efficient intracellular drug delivery, we focused on SS-cleavable proton-activated lipid-like material O-Phentyl-P4C2 (COATSOMEⓇSS-OP; hereafter "SS-OP") and helper lipid as the components of lipid nanoparticles. In this study, we investigated intracellular drug delivery, emphysema-improving effect, and reduction of adverse effect risk by 1,25(OH)2D3-encapsulated SS-OP lipid nanoparticle (SLPs) prepared using either of two helper lipids: 1,2-dioleoyl-sn-glycero-3-phosphocholine (DOPC) or 1,2-dioleoyl-sn-glycero-3-phosphoethanolamine (DOPE). Only 1,25(OH)2D3-encapsulated SLPs prepared using DOPE achieved efficient drug delivery, increased nuclear translocation relative to Free 1,25(OH)2D3, and successfully induced lung cell differentiation and improvement of the respiratory function at a lower dose. Moreover, the use of DOPE-based 1,25(OH)2D3-encapsulated SLPs, reduced elevated serum Ca2+ levels, and these formulations are expected to be a therapeutic candidate for COPD.
A universal healthcare system historically recognised for medical humanism is undergoing systematic defunding through a fiscal threshold of 6.2% of GDP. This analysis examines how New Public Management (NPM) has orchestrated an ontological displacement of clinical practice, transforming medicine from a patient-centred healing art into a managerially-controlled process of data extraction and fiscal optimisation. This paper employs critical philosophical analysis grounded in hermeneutical phenomenology and contemporary social theory, drawing on the work of Martin Heidegger, Hans-Georg Gadamer, Emmanuel Levinas, Achille Mbembe, and Giorgio Agamben. The analysis interrogates how NPM-driven austerity in healthcare constitutes a form of ontological violence that simultaneously instrumentalizes patients and strips physicians of clinical autonomy and practical wisdom. We identify five mechanisms through which managerializaton destroys authentic clinical encounter: (1) ontological reduction of patients to 'standing-reserve' (Bestand); (2) destruction of meditative thinking in favour of calculative efficiency; (3) elimination of practical wisdo'm (Phronesis); (4) violation of ethical infinity through fiscal totalisation; and (5) creation of necropolitical zones through waiting-list abandonment. A Constitutional Court judgement has declared that 'irreducible rights must affect the budget, not vice versa'-a principle routinely violated through systematic underfunding. Reclaiming authentic clinical practice requires both material correction (funding floor of 7.5% GDP) and philosophical resistance. Narrative medicine and temporally-protected clinical encounters represent acts of political resistance against managerial logic. This case study warns that even robust universal systems can be destroyed through bureaucratic defunding masquerading as fiscal responsibility.
Early childhood caries can cause extensive coronal destruction in preschool children, often requiring complex rehabilitation at an age when cooperation is limited. This case report describes a behavior-adapted digital workflow used to complete full-mouth rehabilitation in a four-year-old boy with severe early childhood caries and very limited cooperation. Clinical and radiographic assessment showed advanced multi-tooth carious involvement, with marked destruction of the maxillary anterior segment. Differential diagnostic reasoning supported severe early childhood caries as the most consistent diagnosis. Because conventional impression-taking was not tolerated, a two-step intraoral scanning workflow was used to support treatment planning and definitive anterior rehabilitation. Management included disease control, caregiver education, sealants, restorative procedures, pulpectomies where indicated, post-and-core reconstruction, and full-coverage restorations. In the maxillary anterior segment, biologic posts were used for severely destroyed primary incisors, followed by computer-aided design and computer-aided manufacturing fabrication of polymethyl methacrylate crowns. The crowns were tried in, adjusted, and cemented under controlled isolation. No pain or immediate complications were observed. At the six-month follow-up, the restorations remained intact, gingival tissues were healthy, occlusion was clinically acceptable, and periapical findings were unremarkable, with no radiographic signs suggestive of pathological resorption. This case suggests that intraoral scanning and digital restorative workflows may provide a practical pathway for completing definitive rehabilitation in selected non-cooperative pediatric patients, provided that disease control, isolation, fit verification, cementation quality, and structured follow-up are maintained.
Aberrant and excess proteins are destroyed by compartment-specific protein quality control mechanisms. In Saccharomyces cerevisiae , endoplasmic reticulum (ER)-associated degradation (ERAD) and inner nuclear membrane (INM)-associated degradation (INMAD) require the Ubc6 and Ubc7 ubiquitin-conjugating enzymes. Ubc6 is an integral membrane protein. By contrast, Ubc7 is a soluble protein tethered to the ER and INM membranes by the transmembrane protein Cue1. Here, we assessed the requirement of Cue1 in resisting proteotoxic stress. CUE1 loss sensitized cells to hygromycin B to a similar extent as UBC7 deletion, consistent with a shared role for Cue1 and Ubc7 in ER and INM protein quality control.
This study revealed the effects and underlying mechanisms of key amino acids in marinade on A. parasiticus growth and aflatoxin B1 (AFB1) biosynthesis. Six key amino acids (with a concentration gradient of 0.5-8 g/L) from the marinade were selected and cultured them synchronously with A. parasiticus in this study. Solid/liquid culture combined with LC-MS/MS technology was used to analyse the effects of amino acids on colony growth, spore production, mycelial dry weight, and AFB1 biosynthesis in A. parasiticus, and metabolomics was employed to elucidate the regulatory mechanisms of key amino acids. Results demonstrated that arginine, glycine, and lysine exhibited varying degrees of inhibitory effects. Specifically, 8 g/L lysine completely inhibited AFB1 biosynthesis and significantly suppressed the mycelial growth. Proline, phenylalanine, and leucine remarkably promoted both the growth of A. parasiticus and AFB1 production, with AFB1 content reaching 324.50 ng/mL in the 8 g/L proline group, 3.45 times higher than in the control group. Metabolomic analysis indicated that proline synergistically enhanced AFB1 biosynthesis by activating metabolic pathways, including the tricarboxylic acid (TCA) cycle and gibberellin metabolism. In contrast, lysine disrupted glucose metabolism and the TCA cycle, destroyed cell membrane integrity and inhibited A. parasiticus growth and toxin production at multiple levels. This study clarified the bidirectional regulatory effects and mechanisms of key amino acids in marinade, providing crucial technical references and theoretical foundations for controlling AFB1 contamination in the production of marinated products by regulating marinade amino acid composition.
The present study aimed to investigate the epidemiology of rabies in camels by collecting and analyzing data on its occurrence and applying laboratory confirmation. During 2010-2022, data on the occurrence of rabies in camels, reported outbreaks, the number affected, seasonal occurrence, and outbreak management were collected and statistically analyzed. Data was collected from the Ministry of Animal Resources and Fisheries in Sudan. During the study period, 11 outbreaks resulted in 24 clinically suspected cases of rabies in camels. The highest percentage (29.2%) was in 2021. Within localities, the highest occurrence rate (58.3%) was observed in Darfur State in Western Sudan. The majority of rabies outbreaks (62.5%) were reported during July-September. The logistic regression model revealed a 25.1% annual decline in rabies infection risk, with a notable increase in 2021, while increases of 137.4% linked to seasonal effects and 69% linked to geographical location were observed. Most of the affected camels (71%) died, the rest were destroyed, and vaccination covered the vast majority of in-contact animals. Rabies in camels was found to occur across different localities, with the highest figures in 2021 and peaks during July-September.
Acute pharyngitis is a common upper respiratory tract infectious disease worldwide. The increasing prevalence of multidrug‑resistant pathogens, particularly methicillin‑resistant Staphylococcus aureus (MRSA), greatly hinders clinical treatment and predisposes patients to recurrent and persistent inflammation. Consequently, there is an urgent need for safe and effective alternative therapeutic agents. This research focused on examining the protective effects of a traditional sore‑throat composite phytoextract (TSCP) formulated from edible medicinal natural ingredients, while also investigating its underlying mechanisms. An ammonia‑induced acute pharyngitis murine model was employed. Network pharmacology was used to screen potential bioactive components and key therapeutic targets, followed by the molecular biological validation. In vitro assays assessed the antibacterial and anti‑biofilm activities of TSCP. TSCP dose‑dependently ameliorated abnormal behavioral manifestations, alleviated pharyngeal histopathological injury, and reduced inflammatory cell infiltration in the model mice. Network pharmacology identified 22 potential bioactive components and 174 key therapeutic targets, which were mainly enriched in the PI3K/AKT and NF‑κB signaling pathways. Subsequent molecular validation confirmed that TSCP modulated the PI3K/AKT/NF‑κB signaling axis and significantly downregulated the downstream inflammatory mediators iNOS, COX‑2, and IL‑6. Hematological results showed that TSCP decreased peripheral leukocyte, lymphocyte, and neutrophil levels, indicating a favorable systemic anti‑inflammatory effect. In vitro antimicrobial assays demonstrated that TSCP exhibited broad‑spectrum activity against S. aureus, MRSA, and E. coli with minimum inhibitory concentration (MIC) values of 32, 64, and 256 μg/mL, respectively; and the minimum bactericidal concentration (MBC) for each strain was twice its corresponding MIC. TSCP also concentration‑dependently inhibited bacterial adhesion, disrupted cell membrane integrity, and destroyed biofilm microstructure. Collectively, TSCP exerts prominent protective effects against acute pharyngitis through dual mechanisms: suppression of the inflammatory response via the PI3K/AKT/NF‑κB pathway, and direct broad‑spectrum antibacterial and anti‑biofilm activities in vitro. This study provides solid experimental evidence supporting the modern application of the compound herbal preparation TSCP, suggesting that TSCP is a promising candidate for the prevention and adjunctive treatment of drug‑resistant bacteria‑associated acute pharyngitis.
Aortic dissection is life-threatening due to continued loss of medial integrity that may culminate in secondary rupture within hours to days. While pre-existing defects or hemodynamic loads compound structural deterioration of the aorta, pathological progression from symptomatic dissection channel to lethal transmural tear is poorly understood. We examined the structure of referent and acutely dissected ascending aortas by microscopy. Elastic, collagen, and cellular components of non-dissected media were intricately interconnected. Medial damage in dissection lesions was traced from ingress to central to peripheral areas. Entry tears broke cleanly through successive laminae leading to cavernous false lumens in which medial structure was destroyed. Nearby laminae with widening between flanking elastic lamellae (termed minor delaminations) were filled with blood and showed severe medial damage. Farther laminae without delamination but containing red blood cells (termed blood extravasation) displayed moderate medial damage. More distant, non-delaminated laminae with accumulation of albumin but not red blood cells (termed plasma extravasation) exhibited mild medial damage. Varying medial hemorrhage with scattered sloughing of laminae was observed along the entire false lumen. We conclude that hydraulic fracturing of residual dissected media by pressurized blood via communications from the false lumen contributes to further structural weakening of the aortic wall.
Starch microspheres with uniform morphology and controllable particle size show significant application value. In this work, micrometer-sized natural starch microspheres (SMs) were prepared via membrane emulsification for the first time. Transmembrane pressure and the dispersed phase concentration significantly affect the morphology of SMs. The average particle size decreased with an increase in the transmembrane pressure, while a higher dispersed phase concentration yielded a more uniform particle size distribution. Under optimized membrane emulsification conditions (0.2 MPa and 10% dispersed phase concentration), debranched corn starch microspheres (CSM, 7.93 ± 0.12 μm) and debranched amaranth starch microspheres (ASM, 0.95 ± 0.01 μm) were successfully prepared. Gel permeation chromatography (GPC) analysis showed that the SMs had a lower molecular weight dispersity (D̅) than that of debranched starch (from 2.18 to 1.36 for CSM and from 2.04 to 1.59 for ASM), indicating a narrower molecular weight distribution and more densely arranged molecular chains. The crystallinity of conventional starch microspheres was generally lower than that of native starch because the ordered structure of starch molecules was destroyed during the microsphere formation process. Whereas, the SMs prepared in this work exhibited a significant increase in crystallinity compared with native starch (from 18.7 to 58.52% for CSM and from 25.8 to 69.67% for ASM), which was significantly higher than that of starch microspheres reported in previous papers. DSC proved that the gelatinization temperatures of SMs were higher than 90 °C, indicating that our SMs were difficult to gelatinize under conventional conditions. Because of the controllable particle sizes, the SMs prepared in this study had a narrow molecular weight distribution, extremely high crystallinity, and resistance to gelatinization, thus having broad application prospects in food, medicine, and other material fields.
Surgical specialties continue to be dominated by men, even though women make up more than 50% of medical school graduates. Female surgeons' self-esteem, career paths, and well-being are destroyed by overt discrimination and microaggressions, which also have an impact on team dynamics and patient safety. Women in surgery report widespread bias, from being mistaken as nurses to receiving fewer highly complex cases, which contributes to emotional burnout, obstructed skill-learning, and premature career termination. The hidden "time taxes" of additional planning and self-monitoring, which go beyond the typical obstacles, reduce output and limit creativity. We support structured mentorship programs, clear criteria for case allocation and promotion, clear leadership commitment to gender parity in the operating room, and institution-wide implicit bias training as ways to break these long-standing trends.
As climate change increases the frequency and severity of disasters, proactive planning for post-disaster housing recovery is essential to mitigate long-term social and economic disruption. Computational models can support this planning by simulating potential recovery trajectories, yet many existing approaches are limited by overwhelming data requirements or narrow applicability to past events. Here, we introduce RAAbIT (Recovery Assessment using Agent-based Tools), a novel agent-based model designed to simulate housing recovery using data available within weeks of a disaster. RAAbIT models individual households, insurers, and contractors as agents governed by empirical behavior rules, and incorporates modifiable system-level constraints, such as contractor availability, to reflect context-specific recovery dynamics. We demonstrate the model's utility by hindcasting two California wildfires-the 2017 Tubbs Fire in Santa Rosa and the 2018 Camp Fire in Paradise-and capturing their divergent recovery trajectories. Despite similar hazards, the two communities experienced significantly different reconstruction outcomes, with Santa Rosa rebuilding 57% of destroyed homes and Paradise only 9% within five years. RAAbIT can reproduce temporal and spatial patterns of recovery observed in building permit and construction data. By balancing generalizability with data realism, RAAbIT provides a flexible and transferable tool for post-disaster recovery planning, supporting more effective decision-making under uncertainty and enhancing community resilience in the face of escalating climate risks.