Financial hardship is common in cancer care and may extend beyond medical costs to threaten basic needs such as housing and utilities. Nationally representative data comparing inability to pay mortgage, rent, or utility bills and threatened utility shutoff among adults with gastrointestinal (GI) cancer versus adults without GI cancer are limited. We analyzed 2022-2023 Behavioral Risk Factor Surveillance System data for adults aged >=18 years. GI cancer history and treatment status were identified using Cancer Survivorship Module items and categorized as no GI cancer, current treatment, or treatment completed. Outcomes were inability to pay mortgage, rent, or utility bills and threatened utility shutoff in the prior 12 months. Survey-weighted multivariable models adjusted for demographic and socioeconomic factors and were stratified by employment status and housing tenure. Among 63,753 adults, 1,870 (3.0%) reported GI cancer, including 420 (0.7%) undergoing current treatment and 1,450 (2.3%) with completed treatment. Inability to pay mortgage, rent, or utility bills was reported by 21.0% (n=88) of those undergoing current treatment and 14.8% (n=215) of those with completed treatment compared with 8.2% (n=5,100) of adults without GI cancer (p=0.01). Threatened utility shutoff was reported by 13.1% (n=55) and 10.0% (n=145), respectively, versus 5.8% (n=3,600) among adults without GI cancer (p=0.02). Among renters who were not employed, current GI cancer treatment was associated with higher odds of inability to pay mortgage, rent, or utility bills (aOR 3.40; 95% CI 2.20-5.40) and threatened utility shutoff (aOR 3.30; 95% CI 2.30-4.90) compared with renters without GI cancer. Self-reported GI cancer, particularly current treatment, was associated with elevated inability to pay mortgage, rent, or utility bills and threatened utility shutoff, with the highest burden among renters who were not employed.
This study evaluated the combined effects of red ginger extract and a cooling perch system on thermoregulation and performance of broiler chickens under chronic heat stress in tropical semi-open housing. A total of 198 broiler chicks were allocated to 18 floor pens in a completely randomized design with three treatments: control, red ginger supplementation, and red ginger combined with a cooling perch. Birds were exposed to daily ambient temperatures exceeding the thermoneutral range. The combined treatment significantly reduced cloacal temperature, water intake, and the heterophil/lymphocyte ratio compared with the control group, indicating improved thermal status and reduced physiological stress. Growth performance did not differ significantly among treatments, while the feed conversion ratio was numerically lower, suggesting a trend toward improved feed utilization under heat stress conditions. These findings suggest that combining phytogenic antioxidant supplementation with conductive cooling may provide a practical strategy to improve thermoregulation and production efficiency in broilers raised under tropical conditions.
Due to legacy leaded products, soil Pb is generally higher in older urban centers triggering substantial implications for environmental equity. By integrating a gridded soil Pb analysis of about 150 samples each in two historically industrial cities (Hartford, CT and Springfield, MA) with block-level census data, we tested the hypotheses that (a) high soil Pb areas correlate spatially with older housing, (b) historical processes of discrimination have caused long-lasting environmental injustices with respect to Pb exposure, and (c) multiple social, demographic and geographic factors intersect in determining areas in need of targeted remediation efforts. Our data and geospatial analysis showed higher Pb concentrations in Hartford than Springfield and confirmed the prevalence of elevated (>200 ppm) Pb in soils closer to older homes in both cities. Using a decision tree statistical partition, we show that exposure to elevated soil Pb was most prevalent in communities with children population higher than the city median, who live in multi-family housing. In Springfield, ethnicity was a significant factor in exposure as census blocks populated by non-Hispanic Whites were least likely to contain lead in soils above 200 ppm. Our analysis highlights that historical discriminatory practices, including redlining, have anchored environmental injustices in the studied communities, creating an invisible legacy challenge recorded in the land and carried across decades. The use of decision trees in the context of soil lead contamination provides a new method to help identify vulnerabilities of marginalized populations, providing quantitative tools to advocate for targeted mitigation and remediation. Our analysis of soils in Hartford, CT and Springfield, MA reveals elevated soil lead levels that are associated with older houses. Using recent census data we show that Hispanic households and communities of color, particularly those living in multi‐family housing, are most at risk of soil lead exposure in these two cities. We argue that these vulnerabilities are remnants of past discriminatory practices in urban contexts, including redlining policies.
The global population is aging, and with this development, frailty prevalence is increasing as well. Age-related preparation activities could benefit the prevention or delay of frailty. Local stakeholders such as municipalities, welfare organizations, and community health services should understand how to support (future) older adults in old-age preparations in their local context. This study aims to describe and understand middle-aged and older adults' focus points, needs, and wishes in preparation for older age. A mixed-methods study was conducted in the Oosterpark neighborhood in Groningen, a city in northern Netherlands, in 2023. Questionnaires regarding age-related preparations were collected both digitally and on paper. The questionnaire addressed nine themes: financial situation, emergencies, mental and physical fitness, housing, looks and appearance, personal relationships, health, leisure activities, professional activities. Additionally, focus group discussions were organized in the community center. Data were analyzed separately in SPSS and ATLAS.ti, and integrated analysis was conducted following the Pillar Integration Process. In total, 134 questionnaires were completed (mean age 59 ± 12 years), six focus groups and two individual interviews were conducted. While respondents scored high on preparation for themes as physical and mental fitness or personal relationships, scores for themes as housing and leisure activities were lower. Participants identified a tenth theme, neighborhood, and several subthemes were added to existing themes of health and personal relationships. Although many were concerned with age-related preparation, few engaged in active preparation. People also indicated not knowing how to prepare or where to request help. The study identified that middle-aged and older adults think about age-related preparation often, but hardly prepare actively for themes such as housing or financial situation. Local stakeholders, e.g., municipalities, social welfare organizations and community health organizations, should stimulate, facilitate and support citizens to prepare for later life by offering practical support, e.g. easily accessible information points. Taking into account the physical and social living environment of older adults is crucial. Better age-related preparedness could help to prevent or delay frailty, prolong independence and increase quality of life.
To analyze therapeutic relationships in psychosocial care and their role in addressing the vulnerability of people involved in the revolving door phenomenon. A qualitative case study, grounded in historical-dialectical materialism, was conducted in health and social assistance services in southern Brazil between March and August 2023. Participants included eight patients over 18 years of age, all with at least two psychiatric hospitalizations between 2021 and 2023. Data collection included guided discursive interviews, information from the hospitalization system, and field notes. Data were analyzed, supported by NVivo® 14, in stages: segmentation, qualification, and individuation. The narratives revealed multiple vulnerabilities: individual (severe mental disorders, problematic substance use, low therapeutic adherence), social (unemployment, family breakdown, precarious housing), and programmatic (weaknesses in the care network, limited access to social assistance). It was evident that experiences of integration between Psychosocial Care Centers and social assistance services provide concrete alternatives to rehospitalization, such as access to benefits, housing support, rights mediation, and community strengthening. Therapeutic relationships, guided by acceptance, shared responsibility, community support, and the guarantee of rights, constitute essential technology for the continuity of care in freedom and the confrontation of vulnerability.
The objective of this study is to evaluate adherence to seven Canadian Lower-Risk Cannabis Use Guideline (LRCUG) recommendations among Canadian university students and identify subgroups of high-risk users. We analyzed survey data collected across four Canadian universities under the World Mental Health-International College Student (WMH-ICS) initiative. Seven of the ten 2017 LRCUG recommendations were evaluated. Zero-inflated Poisson models were employed to examine the sociodemographic correlates of (1) any lifetime cannabis use; and (2) the number of unmet LRCUG recommendations, conditional on lifetime use. Additionally, multivariable binary logistic regression models examined the sociodemographic correlates of adherence to individual recommendations. Among the 27 236 respondents, the prevalence of lifetime cannabis use was 33.8%. Of the seven recommendations evaluated, "choosing lower-strength cannabis products" had the lowest adherence rate (29.0%), followed by "not smoking cannabis" (36.7%). "Not using synthetic cannabis" had the highest adherence rate (96.1%), followed by "delaying cannabis use until age 16" (91.2%). Men, non-heterosexual students, students living in shared housing, and domestic students were more likely to use cannabis and, among users, reported risky use. While White students were more likely to use cannabis, among users, many non-White student groups reported riskier use. Although most students did not use cannabis and many of the LRCUG recommendations had high rates of adherence, there were low rates of choosing lower-strength cannabis products and avoiding smoking cannabis among users. Study findings highlight specific recommendations and subpopulations to inform tailoring of future interventions targeting university students. L’objectif de cette étude est d’évaluer le respect de sept recommandations canadiennes pour l’usage du cannabis à moindre risque (RUCMR) chez des étudiants universitaires canadiens et déterminer des sous-groupes de consommateurs à risque élevé. Nous avons analysé les données d’enquête recueillies dans quatre universités canadiennes dans le cadre de l’initiative World Mental Health-International College Student (WMH-ICS). Sept des dix RUCMR de 2017 ont été évaluées. Des modèles de Poisson à inflation nulle ont été utilisés pour étudier les corrélations sociodémographiques entre 1) toute consommation de cannabis à vie et 2) le nombre de RUCMR non respectées, en fonction de la consommation à vie. De plus, des modèles de régression logistique binaire multivariés ont permis de mesurer les corrélations sociodémographiques du respect des recommandations individuelles. Parmi les 27 236 répondants, la prévalence de la consommation de cannabis à vie était de 33,8 %. Sur les sept recommandations évaluées, « choisir des produits de cannabis moins puissants » affichait le taux d’observance le plus bas (29,0 %), suivi par « ne pas fumer le cannabis » (36,7 %). « Ne pas consommer de cannabis synthétique » affichait le taux d’observance le plus élevé (96,1 %), suivi de « retarder la consommation de cannabis jusqu’à l’âge de 16 ans » (91,2 %). Les hommes, les étudiants non hétérosexuels, les étudiants vivant dans un logement en colocation et les étudiants canadiens étaient plus susceptibles de consommer du cannabis et, parmi les consommateurs, ce sont eux qui ont fait état d’une consommation plus risquée. Bien que les étudiants blancs aient été plus susceptibles de consommer du cannabis, parmi les consommateurs, de nombreux groupes d’étudiants non blancs ont fait état d’une consommation plus risquée. Bien que la plupart des étudiants ne consomment pas de cannabis et que de nombreuses RUCMR aient un taux d’observance élevé, les taux des recommandations « choisir des produits de cannabis moins puissants » et « éviter de fumer le cannabis » étaient faibles chez les consommateurs. Les résultats de l’étude mettent en évidence des recommandations et des sous-groupes de population précis, ce qui permet de mieux cibler la création d’interventions futures destinées aux étudiants universitaires. One third of Canadian university students surveyed reported using cannabis in their lifetime. Optimistically, 91.2% of users reported delaying cannabis use until age 16 and 96.1% of users reported avoiding synthetic cannabis. Among users, the most commonly reported risky cannabis use behaviours were not choosing lower-strength cannabis products (71.0%) and smoking cannabis (63.3%). Riskier cannabis use was more common among men, non-heterosexual students, students living in shared housing, and domestic students. Further efforts are needed to promote literacy about lower-risk cannabis use among university students and increase the availability of lower-potency cannabis products. The adoption of a THC standard unit on labels should also be considered. Un tiers des étudiants universitaires canadiens interrogés ont déclaré avoir consommé du cannabis au cours de leur vie. De manière optimiste, 91,2 % des consommateurs ont déclaré avoir retardé leur consommation de cannabis jusqu’à l’âge de 16 ans et 96,1 % ont déclaré éviter le cannabis synthétique. Chez les consommateurs à vie, les comportements à risque les plus fréquemment signalés ont été le fait de ne pas choisir de produits de cannabis moins puissants (71,0 %) et de fumer le cannabis (63,3 %). Une consommation de cannabis plus risquée était plus fréquente chez les hommes, les étudiants non hétérosexuels, les étudiants vivant dans un logement en colocation et les étudiants canadiens. D’autres efforts sont nécessaires pour promouvoir la littératie sur la consommation de cannabis à moindre risque chez les étudiants universitaires et accroître la disponibilité des produits de cannabis moins puissants. L’adoption d’une unité standard de THC sur les étiquettes devrait également être envisagée.
To quantify continuity of care in general practice in the Australian population, including variation according to patient characteristics and over time, to support ongoing policy reforms directed towards improving general practice care. Repeated cross-sectional analyses of linked whole-of-population data from the Medicare Benefits Schedule, the Medicare Consumer Directory and the Census of Population and Housing (2021). Continuity was assessed in people with at least four general practitioner visits in a 2-year period (about 80% of the population). Relational continuity of care in general practice, measured with the Usual Provider Index, for eight overlapping 2-year periods (2016-2017 to 2022-2023). High continuity was defined as having ≥ 70% of visits with one provider. About one-third of the population had high continuity of care (range: 31.3% in 2018-2019 to 37.2% in 2020-2021). After adjustment for age, sex and remoteness, high continuity was more common among those with greater care needs, including those who were older (≥ 70 years vs. 0-14 years: adjusted prevalence ratio [aPR], 1.88) or with health conditions (e.g., ≥ 3 vs. none: aPR, 1.14) and those who were living in more disadvantaged areas (e.g., most vs. least disadvantaged: aPR, 1.22), born overseas (e.g., born in Southern or Eastern Europe vs. born in Australia or New Zealand: aPR, 1.20) or not proficient in English (aPR, 1.29). However, it was less common for females compared with males (aPR, 0.90) and those living remotely (e.g., very remote vs. major cities: aPR, 0.43). While most people in Australia do not receive continuous care in general practice with a specific provider, those with greater healthcare needs are more likely to. With ongoing policy reforms, monitoring continuity of care may provide insights into the consequences for quality of care. Continuity of care is central to quality primary care, but data for the general Australian population are lacking. Among the approximately 80% of Australians with at least four general practitioner visits in a 2‐year period, around one‐third had high continuity (≥ 70% of visits with their usual general practitioner), with small increases since 2020. Proportions were higher among those with greater healthcare needs (e.g., older age, more socioeconomically disadvantaged, with health conditions), but lower in remote areas. Monitoring continuity may provide insights into consequences of health policy reforms, both intended and unintended, to optimise primary care in Australia.
It is challenging and time-intensive to assess fidelity to complex evidence-based interventions in the homeless service sector. We describe a multi-component procedure to assess fidelity to Critical Time Intervention (CTI)-an evidence-based, time-limited case management practice for homeless-experienced persons undergoing housing transitions-developed for a large-scale pragmatic trial conducted with homeless-experienced Veterans. Using literature review, expert consultation, and pilot testing, we developed a pragmatic, scalable CTI fidelity assessment procedure. We integrated data from: a CTI implementation self-assessment designed to enhance provider practice; 90-minute videoconferences with case managers to collaboratively review charts from ≥2 randomly selected "exemplar cases" assessed for CTI's core components; and field notes from case manager narratives during these videoconferences. At 12- and 18-month timepoints after CTI implementation began with 17 case managers across 15 homeless service agencies, we employed this procedure to assess fidelity to CTI. We used field notes to contextualize differences between self-assessment and expert-rated findings. All case managers self-assessed their CTI practice as well- or ideally-implemented. Expert-rated assessments suggested that all case managers had limited fidelity to at least one of CTI's core components; 4 agencies had inadequate fidelity to the overall practice. Field notes provided explanations for disparate results between the self- and expert-rated assessments, including skill deficits, staff turnover (resulting in limited understanding of CTI's core components), and agency mandates (e.g. for case management visit frequency that were misaligned with CTI). The effectiveness of CTI is contingent on adherence to its core components. Streamlined approaches to fidelity assessment across EBPs in the homeless service sector is important for pragmatic, large-scale implementation efforts. The integration of self-assessment and expert-rated assessments can be applied to other multifaceted EBPs in the homeless service sector. Supplementing fidelity assessments with field notes may be useful to contextualize disparate findings between self- and expert-rated assessments, and to shape feedback to providers that enhances practice fidelity and improves housing outcomes. This project was registered with ClinicalTrials.gov as "Implementing and sustaining Critical Time Intervention in case management programs for homeless-experienced Veterans." Trial registration NCT05312229, registered 4/4/2022.
The ISO 4037:2019 standard is the reference standard for dosimetry laboratories who wish to realize dosimetric operational quantities for radiation protection calibrations. In implementing the ISO 4037:2019 standard, the X-ray radiation qualities need to be defined according to strict requirements on the material and thickness of the additional filtration, and according to metrologically traceable high voltage bias applied to the X-ray tube. This enables usage of standardized conversion coefficient from air kerma to operational quantities. However, the tube potential may vary as a function of tube current if a protective resistor is built into the protective tube housing, which, if not corrected, alters the energy distributions of the reference field and thus the value of the appropriate conversion coefficients. Particularly at low energies, the energy dependence of the conversion coefficients can be sharp and, depending on the specific realization of a radiation quality, the conversion coefficient from air kerma to dose equivalent can vary substantially. We have investigated the correspondence between the tube voltage measurements of a X-ray system based on calibrated voltage dividers and that of an X-ray spectrometer system based on a Cadmium Telluride (CdTe) detector in order to obtain an estimation of the resistance of the protective resistor that is usually unknown. A method based on X-ray spectrometry for calibration of the tube potential even in the presence of tube with protective resistor is presented. Finally, conversion coefficients were calculated using simulated spectra to study the influence of the protective resistor on the determination of these coefficients. The simulated spectra obtained from X-ray tube with and without a protective resistor resulted in differences in conversion coefficients mostly ˂2% but 5.6% for the radiation quality considered at the lowest energy.
Hikikomori is a condition characterized by remaining predominantly at home for at least 6 months, with marked social withdrawal and functional impairment. In prolonged cases, reduced self-care and physical comorbidities are common; however, access to necessary medical care is often limited. When a distrust of medical services and the refusal of psychiatric care are pronounced, psychiatric interventions alone may be insufficient. In such cases, it is important to use general medical care as an entry point to subsequent psychiatric and community-based support. We herein report a case of hikikomori for more than 15 years in a man in his 50s. He first presented to general medical services after developing wound myiasis. Thereafter, while receiving physical treatment, he received stepwise support in a psychiatric ward, including support for hygiene behaviors, family support, and discharge planning. His resistance to bathing and grooming gradually decreased. After discharge, he moved into supported housing and began attending a supported employment program. During the 3-month follow-up, no recurrence of hikikomori was observed. This case shows that in patients with long-term hikikomori for whom psychiatric interventions alone are difficult, a structured support process that links general medical, psychiatric, and community care in a stepwise manner may facilitate social reintegration. The process may be conceptualized in terms of the entry point, transition phase, and outcome.
Objectives. To describe a data-mapping blueprint for identifying US locations at high risk for childhood lead exposure and to apply this approach to inform targeted public health interventions. Methods. We developed a stepwise, flexible blueprint integrating environmental and housing data, blood lead level data, and geospatial mapping to identify potential lead exposure hotspots, characterize contributing sources, and guide intervention prioritization. We applied the blueprint in multiple federal and state case studies through interagency collaboration. Results. Application of the blueprint identified high-risk locations for childhood lead exposure and informed targeted actions across diverse contexts. In data-rich settings, integration of blood lead level and environmental data enabled identification of exposure hotspots and prioritization of outreach, enforcement, and remediation. In data-limited settings, lead exposure indices and environmental indicators supported targeted surveillance and resource allocation. Across applications, the blueprint facilitated coordination among agencies, improved lead-based paint and infrastructure intervention targeting, and supported expansion of screening and prevention efforts. Conclusions. A coordinated, data-driven mapping approach can improve identification of lead exposure hotspots and support prioritization of impactful interventions. Public Health Implications. Broader implementation of the blueprint, along with enhanced data integration and interagency collaboration, may strengthen efforts to reduce childhood lead exposures and improve public health outcomes. (Am J Public Health. 2026;116(7):1030-1037. https://doi.org/10.2105/AJPH.2026.308440).
Environmental fluctuations challenge juvenile hibernators to efficiently balance growth, fattening, and energy conservation prior to their first winter. This study investigates how social thermoregulation (huddling) and food availability affect the use of torpor, growth, fat accumulation, and hibernation in late-born juvenile garden dormice. Juveniles exhibited flexible energy-saving strategies, with huddling influencing torpor patterns and food intake during pre-hibernation. Despite these behavioral differences, individuals reached similar body mass and size at the onset and end of hibernation, regardless of housing or feeding conditions. During hibernation, food availability modulated total energy expenditure, particularly in males, likely due to changes in reproductive investment. These findings suggest that the combined use of torpor and huddling provides developmental flexibility, enabling juvenile dormice to meet the energetic demands of early life. This plasticity may be critical for survival in the face of environmental unpredictability, and future studies should investigate how early-life energy strategies influence long-term fitness and reproduction success.
Oxidative protein modifications have been linked to several diseases, but the variety and diversity of modifications are less studied. We used the chicken egg protein ovalbumin and gas plasma technology, a potent source of various reactive species, for protein oxidation. Using high-resolution mass spectrometry and an in-house workflow, over 80 distinct oxidative protein modifications were mapped at per-amino-acid resolution. To examine how modification profiles depend on changes in reactive species types and concentrations, we generated 12 distinct argon gas plasmas by systematically varying molecular gas admixtures (water, ethanol, oxygen, and nitrogen). Optical emission spectroscopy (OES) and photometric determination of deposited long-lived species (hydrogen peroxide, nitrite, and nitrate) were applied to profile gas plasma conditions, revealing the admixture-dependent impact on the reactive oxygen/nitrogen species (ROS/RNS) fingerprint. Correlation analysis with mass spectrometry data revealed the significant involvement of atomic oxygen and hydrogen peroxide in protein oxidation. The enrichment of specific reactive species created by a defined gas plasma composition generated specific ovalbumin oxidation profiles resolved per amino acid. Feed gas-dependent oxidation hotspots, such as Trp149 for dry argon gas or Met274 for hydroxyl radical-rich humidified argon gas, were identified. This first-of-its-kind study reveals intricate relationships between dynamic reactive species environments and protein oxidation profiles using ovalbumin as a model system.
Gender bias continues to shape the experiences of healthcare professionals, including those in dentistry. Although more women are joining the dental workforce, unequal opportunities, differences in patient perceptions, and subtle workplace discrimination still exist. This study explored dental clinicians' perceptions and experiences concerning gender-bias in clinical opportunities and patient preferences. A cross-sectional survey was conducted among 110 dental clinicians at CMH Lahore Medical College & Institute of Dentistry from April-August 2025. Data was collected using a validated questionnaire (Cronbach's α = 0.739) and analyzed through descriptive statistics and chi-square tests using SPSS version 26. Out of 110 respondents, 70% were female and 30% male. Significantly more females than males (57.1% vs. 3%, p<0.001) felt that the opposite gender was more confident clinically, felt males were generally more favored in dentistry (75.3% vs. 24.2%, p<0.001), reported facing some form of gender-based discrimination in terms of clinical opportunities or recognition of their skills(61.0% vs. 12.1%, p<0.001), and experienced patients requesting to be treated by the opposite gender (68.8% vs. 42.4%, p=0.009). The study highlights that gender bias in dentistry remains a subtle but influential factor in shaping clinical experiences and confidence levels. Although many patients say that they have no gender preferences upfront but gender biases are still evident. Although patient education can help but cultural mindsets are not easy to change. However, encouraging mentorship, promoting gender-sensitive training, and ensuring fair institutional policies can help create a more balanced and supportive professional environment for all dental practitioners and reduce interpersonal bias.
Throughout the female reproductive lifespan, the ovary undergoes hundreds of cycles of follicle development, ovulation and tissue regeneration. How aging disrupts the coordination of such precise, multicellular interactions across time and space is not well understood. Using Slide-seq, a near-cellular spatial transcriptomics method, here we profile 22 mouse ovaries across the reproductive cycle and chronological ages, capturing 610,620 spots across 69 spatial profiles. We develop a novel segmentation pipeline to examine the multicellular dynamics of 358 oocytes, 668 follicles and 236 corpora lutea to find that aging impairs the spatial and temporal coordination required for folliculogenesis even before reproductive cycles cease. These disruptions are characterized by altered immune cell dynamics, inflammatory signaling and global tissue disorganization, which impair the cyclic remodeling required for ovarian function. Our findings reveal how multicellular niches orchestrate ovarian function and demonstrate that age-related breakdown in tissue organization precedes the end of fertility.
This paper presents a combined numerical and experimental study on the transient thermo-mechanical response of layered perlite concrete beams subjected to unilateral heating. The motivation arises from the growing application of lightweight, thermally efficient materials in structural elements exposed to temperature gradients, where time-dependent thermal effects may significantly influence deformation behavior. An in-house computational framework is developed that explicitly couples transient heat transfer through the beam thickness with a shear-deformable Timoshenko beam model extended by an axial degree of freedom. The temperature field is reduced to section-level thermomechanical quantities, namely effective axial thermal strain and thermal curvature, which are introduced into the mechanical problem in a transparent and physically interpretable manner. Spatially nonuniform thermal loading along the beam length is accounted for through position-dependent boundary conditions. The numerical model is validated against laboratory experiments conducted on a layered concrete-perlite-concrete beam subjected to controlled top-surface heating up to 35 °C. Measured time-dependent midspan deflections show good agreement with numerical predictions, indicating that the model is able to capture delayed thermal response and thermally induced bending governed by transient heat conduction and material heterogeneity. In addition, a small illustrative nonlinear extension is presented in a purely numerical setting by introducing temperature-dependent stiffness degradation within the same framework. This additional example is not experimentally validated and is included solely to demonstrate the extensibility of the proposed formulation beyond the linear thermoelastic regime. The study should therefore be interpreted as a benchmark linear validation case, complemented by a concise numerical proof-of-concept for extensibility toward nonlinear thermo-mechanical analysis.
A completely randomized experiment with a 2 × 2 × 2 factorial arrangement of treatments was used to evaluate the effect of stocking density (low, 840 cm2/hen vs. high, 420 cm2/hen) and addition of 200 ppm gamma-oryzanol (GO), 200 ppm vitamin E tocotrienols (VE), or both on productivity, egg quality, and immune- and health-related mRNA abundance. Compared with laying hens housed at low stocking density, high stocking density during 54-62 weeks of age resulted in a significantly lower average daily feed intake and hen-day egg production. The supplementation of VE in the diet increased average egg weight and egg mass significantly (p < 0.05). However, improved feed conversion ratio and higher egg mass were detected in laying hens fed dietary GO (p < 0.05). A significant interaction of VE by GO supplementation on feed conversion ratio (p < 0.05) was observed. This was accompanied by an improved feed conversion ratio in laying hens reared under high stocking density. Except for eggshell breaking strength (p < 0.05), there was no main effect of dietary VE, GO and stocking density on any other egg quality parameters examined. This was associated with decreased eggshell breaking strength in laying hens reared under high stocking density, while eggshell hardness improved in hens fed dietary VE and GO. Among hens kept on a high stocking density, there was a decrease in 3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMGCR) mRNA abundance in the VE group, while the highest interferon gamma (IFN-γ) mRNA abundance was detected in hens fed the GO diet (p < 0.05). Thus, the data suggested that dietary GO or VE at a level of 200 ppm, either individually or in combination, can improve egg productivity and eggshell hardness as well as regulate mRNA abundance of immune- and stress-related genes. We conclude that these dietary antioxidants should be part of a nutritional strategy to mitigate the negative impacts on laying hens reared under high stocking density conditions.
The prevalence of dementia is currently set to rise to 1.7 million by 2040, with associated costs estimated at £90 billion. Given its substantial impact on quality of life (QoL) and the growing societal and financial burden, identifying efficient approaches to dementia support is a key policy priority. Current policy direction emphasises a shift toward community-based models of care; however, economic evidence is required to determine whether such approaches can improve outcomes while representing cost-effective use of limited healthcare resources. This study presents a cost-effectiveness analysis of the Sage House Model, a community-based dementia support intervention integrating NHS diagnostic services, third-sector provision, and local partnerships within a single hub. A preliminary cost-effectiveness analysis was conducted using a natural experimental design comparing individuals with dementia accessing the Sage House Model (n = 65) to those receiving usual care (n = 153). Health-Related Quality of Life (HRQoL) and health and social care utilisation were collected over a three-month period and valued from a health and social care perspective. Incremental costs and outcomes were estimated to assess cost-effectiveness. The Sage House Model was associated with lower incremental costs and higher incremental QALYs compared to usual care over the three-month time horizon and was likely to be cost-effective, with a 72.2% probability at a £20,000 willingness-to-pay threshold and 74.7% at £30,000 per QALY. These findings provide preliminary evidence that community-based dementia support approaches, such as the Sage House Model, may represent a promising strategy for improving outcomes alongside more efficient use of health and social care resources, and therefore warrants larger scale investigation.
Inhibitory control is frequently impaired under anxiety, yet the temporal dynamics through which oxytocin (OXT) modulates this process remain poorly understood. This randomized, double-blind, placebo-controlled pharmacological event-related potential (ERP) study investigated how intranasal OXT (24 IU) influences neural and behavioral correlates of inhibitory control under threat-of-shock (anxiety) and safe conditions in 100 healthy male university students. Participants performed an interference-inhibition working memory task requiring attention to either emotional faces (social) or house scenes (non-social) while ignoring superimposed task-irrelevant stimuli. ERPs across distinct processing stages (N1, P2, N2, N450) were analyzed. OXT did not significantly affect behavioral performance. However, it produced stage-specific, context-dependent neuromodulatory effects. Specifically, OXT (1) modulated early perceptual processing of social stimuli under anxiety, as indicated by a reduced P2 amplitude to faces; (2) influenced conflict-monitoring, as reflected by an anxiety-dependent attenuation of the N2 response during the non-social task; and (3) modulated later conflict resolution processes, evidenced by a double dissociation in the N450 component: OXT prevented the anxiety-induced increase in N450 for houses while enhancing the N450 response to faces under threat. This study provides temporal insights into the neurophysiological effects of OXT, indicating that OXT modulates inhibitory control through multi-stage neural processes rather than a general anxiolytic effect.
The investigation focused on differences in the overall network structures of depressive symptoms between patients with bipolar depression (BD) and those with unipolar depression (UD), emphasizing their unique symptom dynamics and centralities. Data from the Research on Asian Psychotropic Prescription Patterns for Antidepressants, Phase 3 (REAP-AD3), were used to estimate depressive symptom networks for 240 patients with BD and 2905 patients with UD. A Network Comparison Test (NCT) was conducted to evaluate differences in global strength, edge weights, and node centralities between the two networks. An additional NCT was performed using the same sample size in both groups. Anhedonia emerged as the most central symptom in BD, while persistent sadness was the most central symptom in UD. Global strength was higher in the BD network in the full-sample NCT (p = 0.04), but not in the equal sample-size analysis (p = 0.20). However, no significant differences were identified in overall network structure invariance. These findings underscore distinct depressive symptom networks in BD and UD. Anhedonia and energy dysregulation were prominent in BD, whereas persistent sadness and self-rumination were more pronounced in UD. Despite the non-significance of other NCT results, the full-sample pairwise network comparison suggested that BD patients exhibit a more integrated symptom structure than UD patients, with stronger overall connectivity between symptoms, which may be linked to neurobiological distinctions such as widespread abnormalities in white matter connectivity and increased within-network connectivity in BD.