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Traumatic brain injury (TBI) in older adults is associated with high mortality and poor functional outcomes. However, optimal management remains uncertain, as evidence comparing surgical and medical strategies is limited, heterogeneous, and extrapolated from younger populations. We conducted a systematic review and meta-analysis to compare outcomes between surgical and medical management in this population. PubMed, Embase, and Web of Science were searched from database inception to 8 December 2025. Studies including adults aged&#x2009;&#x2265;&#x2009;60&#xa0;years with TBI comparing surgical versus medical management were included. The primary outcome was favorable neurological outcome, while secondary outcomes included hospital length of stay (LOS) and mortality. Pooled estimates were calculated as risk ratios (RR) and mean differences (MD) using random-effects models with restricted maximum likelihood and Hartung-Knapp adjustment. A total of 16 cohort studies comprising 132,823 patients were included. Surgical management was not associated with improved favorable neurological outcomes at discharge, 3, 6, or 12&#xa0;months. However, it was associated with longer LOS (MD&#x2009;=&#x2009;6.35&#xa0;days, 95% CI: 2.55 to 10.14; p&#x2009;<&#x2009;0.01). No differences were observed in in-hospital, 30-day, 3-month, 12-month, or 24-month mortality. Notably, surgical management was associated with a reduction in 6-month mortality (RR&#x2009;=&#x2009;0.68, 95% CI: 0.51-0.92; p&#x2009;=&#x2009;0.02). In older adults with TBI, surgical management was associated with reduced 6-month mortality and longer hospital LOS, but not with improved functional outcomes, highlighting a dissociation between survival and recovery. This dissociation has important implications for clinical decision-making and patient and family counseling. Although this study represents the best available comparative evidence to date on surgical versus nonsurgical management in older adults with TBI, the findings should be interpreted with caution due to substantial heterogeneity and the low to very low certainty of the evidence. High-quality randomized controlled trials are needed to better define the role of surgery in this population. Trial Registration This systematic review and meta-analysis was prospectively registered in PROSPERO on November 21, 2025 (CRD420251236960).

While the graphical user interface (GUI) is fundamental to computer-aided diagnosis (CAD) systems, a significant void exists in the technical literature regarding its design and integration into clinical workflows. Bridging this gap is essential, as a well-designed interface is the key driver of usability, interpretability, and the ultimate adoption of medical imaging tools. This scoping review aims to identify and analyze the primary approaches and emerging trends in GUI design for CAD systems developed for medical image analysis, with a specific focus on classification and segmentation tasks. We analyze not only the interaction patterns but also the specific clinical applications, datasets, AI algorithms, and evaluation protocols reported in the literature. A literature search was conducted across five major digital databases (ACM Digital Library, IEEE Xplore, PubMed, ScienceDirect, and SpringerLink) for scientific publications between 2020 and 2024. The search string ("medical image" AND ("computer-aided diagnosis" OR "CADx" OR "CAD") AND "user interface") was used. The search terms were strategically selected to specifically target visual diagnostic AI systems that integrate a clinician-facing interface. Initial screenings, followed by the application of predefined inclusion and exclusion criteria, were performed. Data was charted using eight research questions. From an initial pool of 1147 articles identified across two search phases, a total of 46 studies met the final inclusion criteria and composed the review set. The data extraction process revealed a growing trend towards the integration of interactive machine learning features, visualization of model uncertainty, and tools for explainable AI (XAI) directly within the user interface, moving beyond simple image display and result presentation. The design of GUIs for modern CAD systems is evolving from static displays to interactive and collaborative platforms. Many of them not only present the AI's prediction but also provide clinicians with tools to understand, question, and refine the automated analysis. A clear gap remains in the standardization of usability and human-computer interaction metrics for evaluating these systems, suggesting a critical direction for future research.

Chronic atypical neutrophilic dermatosis with lipodystrophy and elevated temperature (CANDLE) syndrome is a rare autosomal recessive autoinflammatory disorder caused by mutations affecting proteasome function. Given the absence of standard therapy, we reviewed the therapeutic potential of Janus kinase inhibitors (JAK-Is) in CANDLE syndrome. Following PRISMA guidelines, PubMed/MEDLINE, Scopus, Web of Science, and Embase were searched through September 2025. Eligible studies included patients with CANDLE or CANDLE-like disease treated with JAK-Is. Risk of bias was assessed using NHLBI and JBI tools, and findings were summarized descriptively. Sixteen articles including 46 patients were analyzed. The median age was 4.5 years, and all patients presented with skin rash. Common manifestations included fever (91.3%), lipodystrophy (73.9%), failure to thrive (56.5%), arthralgia/arthritis (43.4%), and panniculitis (39.1%). Multisystem involvement and elevated inflammatory markers were frequent. Corticosteroid use before JAK-I therapy was reported in 73.9% of patients. Baricitinib was the most commonly used JAK-I (73.9%), followed by tofacitinib (23.9%) and ruxolitinib (2.1%). Primary efficacy analysis in 26 patients of full-text publications showed complete response in 42.3%, significant response 11.5%, partial response in 38.5%, and no response in 7.6%. The most common adverse events were upper respiratory tract infections and BK virus infection. &#xa0;Available evidence suggests that JAK-Is may improve clinical and laboratory outcomes in patients with CANDLE syndrome, although these findings are based on a small number of patients and predominantly low-level evidence. Infections were the most commonly reported adverse events. Further prospective studies are needed to confirm these findings and establish the long-term efficacy and safety of JAK-Is in CANDLE syndrome. &#x2022; CANDLE syndrome is a rare autoinflammatory disease with limited treatment options and significant multisystem morbidity. &#x2022; JAK inhibitors have been increasingly used due to their role in interferon-mediated inflammation. &#x2022; This systematic review summarizes outcomes of 46 reported CANDLE patients treated with JAK inhibitors. &#x2022; Most patients showed clinical improvement, while infections were the most commonly reported adverse events.

Brainstem cavernous malformations (BCMs) are high-risk vascular lesions characterized by a significant tendency for recurrent hemorrhage and devastating neurological morbidity. While open microsurgery is the traditional gold standard, purely endoscopic approaches have emerged as minimally invasive alternatives. This study aims to systematically review the surgical effectiveness, safety, and clinical outcomes of purely endoscopic BCM resection. Following PRISMA guidelines, a systematic search was conducted across Web of Science, MEDLINE, Scopus, and Embase for all eligible studies published from database inception until October 21, 2025. Data on patient demographics, lesion characteristics, surgical corridors, extent of resection (EOR), and complications were extracted. Risk of bias was assessed using the Joanna Briggs Institute tool. Descriptive statistical pooling and data stratification by surgical approach corridors were performed using R software to calculate pooled clinical frequencies and symptom recovery rates. Twenty-six studies (22 case reports, 4 case series) involving 37 patients were included. The cohort was predominantly female (64%, n&#x2009;=&#x2009;23 of 36 with documented gender), with a mean age of 41 years. Lesions were primarily located in the pons (76%, n&#x2009;=&#x2009;28). The endoscopic endonasal transclival approach (EEA-TC) was the most frequent corridor (75.7%, n&#x2009;=&#x2009;28), followed by various transcranial endoscopic routes. Preoperative diffusion tensor imaging (DTI) was utilized in a subset of cases, consistently demonstrating corticospinal tract displacement. Gross total resection (GTR) was achieved in 89.2% of the cohort (n&#x2009;=&#x2009;33). Postoperative neurological improvement was documented in 91.9% of patients (n&#x2009;=&#x2009;34), with no instances of re-bleeding during follow-up. The most significant complication was postoperative cerebrospinal fluid (CSF) leakage, occurring in 16.2% of patients (n&#x2009;=&#x2009;6), with revision surgery required in 8.1% (n&#x2009;=&#x2009;3). Other complications included transient neurological worsening and aseptic meningitis. Purely endoscopic resection of BCMs is a technically feasible and effective treatment modality, particularly for ventral and ventromedial pontine lesions. It offers high GTR rates and favorable neurological recovery while avoiding the brain retraction associated with open microsurgery. However, the risk of CSF leakage remains a primary limitation of the endonasal corridor. Future prospective, multi-center registries are necessary to further define patient selection criteria and long-term comparative outcomes against traditional microsurgical standards.

Homelessness is widely regarded as one of the most severe forms of social exclusion and represents an urgent public health challenge. Notably, compassion has been proposed as a construct of social cognition closely linked to emotional well-being and as a facilitator of community integration. Although the importance of compassion within intervention teams and public attitudes toward people experiencing homelessness (PEH) has been emphasized, little is known about the processes of compassion and self-compassion among PEH. Hence, a systematic review was conducted with two main objectives: (a) to examine the processing of compassion and self-compassion in PEH, (b) to analyze the effects of compassion-based interventions on community integration and emotional well-being among PEH. Following PRISMA guidelines, quantitative and qualitative studies were included, identified through an unrestricted search of three major multidisciplinary databases: PubMed, PsycINFO, and Web of Science. Fourteen articles, comprising 1,591 participants, met the inclusion criteria. Depending on study characteristics, three risk-of-bias tools (ROBINS-E, RoB 2, and JBI) were applied, and all studies met the pre-established standards for their respective assessments. The findings highlight the multifaceted influence of compassion and social cognition in PEH. Higher levels of self-compassion and adaptive social-cognition skills were found to function as protective factors against psychological distress and depressive symptoms. With special relevance to the primary subgroups identified in the literature, these capacities were generally associated with better community integration, resilience, and overall emotional well-being. Furthermore, while the reviewed interventions suggest a potential to foster self-compassion in PEH, limited sample sizes and model heterogeneity prevent definitive conclusions regarding their impact on social exclusion. Overall, these results suggest a significant role for compassion and self-compassion within both the mental health and social domains of PEH, indicating that fostering these capacities may be key to building a more inclusive society and a more effective support system for this population.

In sub-Saharan Africa, approximately 85% of individuals use biomass fuels (e.g., charcoal, wood) for cooking. While replacing biomass fuels with cleaner cooking fuels (e.g., liquefied petroleum gas (LPG)) can benefit respiratory health, the difference in respiratory symptom prevalence between exclusive and partial LPG use is uncertain. Smart meter data from 621 households using pay-as-you-go (PAYG) LPG in an informal settlement in Nairobi, Kenya, was linked to survey data (September-October 2022) detailing weekly biomass cooking fuel use. Multivariable Poisson regression with robust error variance examined the association between the proportion of weekly cooking with PAYG LPG (100% PAYG LPG, PAYG LPG used for 50-99% or 0-49% of weekly cooking) and self-reported presence of at least one respiratory symptom (cough, wheezing, chest tightness, shortness of breath, flu-like symptoms) during the previous 6 months. The model was adjusted for sociodemographic and cooking environment characteristics. In the final model, a dose-response increase in odds of at least one respiratory symptom existed among those using PAYG LPG for 50-99% of weekly cooking (1.19; 95% CI, 0.94-1.52) and 0-49% of cooking time (1.30; 95% CI, 1.11-1.51) compared with exclusive PAYG LPG users. Participants not concerned about the health effects of smoke exposure from cooking had significantly higher odds (1.44; 95% CI, 1.25-1.65) of respiratory symptoms than those who reported being concerned. Transitioning from partial to exclusive LPG use may improve primary cooks' respiratory health in urban settings. Educating individuals about the risks of biomass smoke exposure may modify behaviors to subsequently reduce respiratory symptom risk; this pathway requires further investigation.

Direct oral anticoagulants (DOACs) reduce thromboembolism in atrial fibrillation (AF), but their effect on cardiac outcomes is less studied. Systematic review and network meta-analysis were performed on AF patients on DOACs/vitamin K antagonists (VKAs). Both observational studies and randomized clinical trials (RCTs) were included. Endpoints were myocardial infarction (MI) and major adverse cardiac events (MACE). Rankograms and SUCRA were performed. Sub-group analysis included age (</&#x2265;&#x2009;75&#xa0;years) and length of follow-up (</&#x2265;&#x2009;12&#xa0;months). 50 studies (3 RCTs, 4 post hoc analyses of RCTs and 43 observational studies) with 1,769,987 patients were included (59.9% on DOACs and 45.3% women). The MI risk (46 studies with 1,554,704 patients) was lower in all DOACs compared to VKA (apixaban: hazard ratio [HR] 0.83, 95% credible interval [95%CI 0.72-0.96], edoxaban: HR 0.68, 95%CI 0.53-0.86, rivaroxaban: HR 0.84, 95%CI 0.74-0.95, dabigatran: HR 0.85, 95%CI 0.75-0.97). SUCRA showed edoxaban as first choice for preventing MI overall. In patients aged&#x2009;<&#x2009;75&#xa0;years, a lower MI risk was found for edoxaban (HR 0.60, 95%CI 0.41-0.85), while in those aged&#x2009;&#x2265;&#x2009;75&#xa0;years, no significant difference was found among anticoagulants. Heterogeneity was low in all analyses. Network meta-analysis showed no differences among DOACs. Compared to VKA, apixaban (HR 0.77, 95%CI 0.63-0.97) was associated with lower MACE risk. Analysis of SUCRA showed apixaban as first choice for preventing MACE overall and in patients treated for&#x2009;<&#x2009;12&#xa0;months. DOACs were associated with a lower risk of MACE/MI in AF. The effect of DOACs on cardiovascular risk differs according to aging and follow-up length. However, our findings are based on indirect evidence, and further studies are needed. CRD42023407778.

Using a new restorer line for rapeseed Ogura cytoplasmic male sterility, with a shorter foreign DNA fragment, higher fertility stability, and seed color as a marker, established a fully mechanized hybrid seed production system that greatly reduces labor costs and improves hybrid seed purity.

To evaluate the effects of acceptance and commitment therapy (ACT) for insomnia compared with waitlist/standard control conditions and cognitive behavioral therapy for insomnia (CBT-I). A systematic review and meta-analysis of randomized controlled trials was conducted. We searched on PubMed, Embase, and the Cochrane Library for studies comparing ACT or ACT-based interventions with non-ACT conditions in patients with insomnia. Continuous outcomes were pooled using a restricted maximum likelihood random-effects model on R. ACT showed moderate-to-large improvement in insomnia symptom severity compared with waitlist/standard controls (SMD&#x2009;-&#x2009;0.67, 95% CI&#x2009;-&#x2009;1.08 to&#x2009;-&#x2009;0.25). We observed no significant difference in insomnia severity between ACT and CBT-I at posttreatment (SMD 0.21, 95% CI&#x2009;-&#x2009;0.02 to 0.43) or at 6-month follow-up (SMD 0.14, 95% CI&#x2009;-&#x2009;0.15 to 0.42). CBT-I showed significant improvement in remission (ISI&#x2009;<&#x2009;8 at posttreatment) compared to ACT at posttreatment (RR 0.81; 95% CI 0.67 to 0.98), but not at follow-up (RR 0.78; 95% CI 0.47 to 1.29). Treatment response rates (>&#x2009;7-point ISI reduction) did also not differ significantly. Compared with waitlist/standard control, ACT produced a small-to-moderate reduction in depression (SMD&#x2009;-&#x2009;0.34, 95% CI&#x2009;-&#x2009;0.57 to&#x2009;-&#x2009;0.12) and anxiety symptoms (SMD&#x2009;-&#x2009;0.42, 95% CI&#x2009;-&#x2009;0.67 to&#x2009;-&#x2009;0.17). ACT can be an efficacious treatment for insomnia with particularly strong outcomes for its psychological symptoms. Nevertheless, CBT-I remains the gold standard due to its more extensive and consistent evidence base.

Mucociliary transport (MCT) is the dominant mechanical host defense system in human airways. Although the importance of the peripheral airway in the pathophysiology of bronchial asthma has recently attracted attention, the characteristics of MCT in the peripheral airway during asthma remain unclear. This study aimed to investigate MCT velocity in the central and peripheral airways and the effects of thymic stromal lymphopoietin (TSLP) on MCT. Central and peripheral airways were isolated from freshly obtained porcine airways immediately after slaughter. The airway specimens were mounted in a custom-built fluorescence microscopy-based measurement system. MCT velocity and ciliary beat frequency (CBF) were measured under the following conditions: without stimulation, in the presence of a low concentration of acetylcholine (ACh), and after stimulation TSLP, which reflects the pathophysiological condition of bronchial asthma. MCT velocity in the peripheral airways was slower than that in the central airways at less than one tenth (median: 75.40&#xa0;&#x3bc;m/sec vs. 2.63&#xa0;&#x3bc;m/sec). Under physiologically low ACh concentrations, MCT velocity was increased in the peripheral airway but not in the central airway. TSLP addition partially inhibited MCT velocity in both the central and peripheral airways by approximately two-thirds to one-half. TSLP also partially inhibited the CBF in both the central and peripheral airways from approximately two-thirds to one-third. Furthermore, TSLP receptor (TSLPR) expression was confirmed in airway tissues by immunohistochemical staining. The inhibitory effects of TSLP on MCT velocity were completely abolished by pre-incubation with a Janus kinase (JAK) inhibitor. In conclusion, TSLP has the potential to reduce MCT velocity, especially in the peripheral airways, by inhibiting TSLPR signaling pathways, resulting in impaired CBF. The characteristics of MCT differ between the central and peripheral airways. Importantly, TSLP-induced MCT impairment may aggravate mucus plug formation in the peripheral airways in patients with bronchial asthma.

Alzheimer's disease (AD) classification from structural magnetic resonance imaging (MRI) remains challenging, particularly when distinguishing mild cognitive impairment (MCI) from both cognitively normal (CN) ageing and established AD. Multimodal approaches that combine imaging with clinical information are promising, but most confine the influence of clinical variables to the classifier head, so biomarkers cannot shape spatial feature extraction inside the imaging encoder. We propose a bimodal deep learning framework operating on two input sources: 3D T1-weighted structural MRI and tabular clinical assessment scores. A biomarker encoder maps the clinical scores into a conditioning representation that modulates vision transformer patch tokens through spatial rescaling and cross-attention throughout feature extraction. Within selected transformer layers, deformable biomarker attention (DBA) acts as an internal cross-modal modulation pathway rather than a third input modality, enabling sparse biomarker-guided spatial sampling from the 3D MRI feature grid. The framework was evaluated on ADNI data under strict subject-wise train, validation and test splits, so that repeated scans from the same individual never crossed partitions. On the held-out test set, the model achieved 95.68% accuracy, 95.39% macroprecision, 94.65% macrorecall and 95.01% macro F1 score, exceeding all comparison methods reproduced under the same protocol. Prediction uncertainty was higher for misclassified cases, and rejecting the most uncertain cases raised retained set accuracy to 98.31% at 85.03% coverage. Performance degraded gradually rather than catastrophically when clinical scores were with-held, falling to 93.20% accuracy with all five biomarkers imputed. These results indicate that within-encoder biomarker conditioning improves AD classification and yields uncertainty-aware predictions that may support decision-making in clinical research settings.

Health economic models, many of which rely on risk equations, often play an important role in informing local healthcare decision making for the management of obesity. Risk equations for predicting cardiovascular outcomes have previously been derived from SELECT trial data. Validation of risk equations in real-world populations can provide confidence in the accuracy and reliability of health economic models. The aim of this study was to validate the predicted outcomes of the novel, SELECT trial-derived cardiovascular risk equations in a real-world UK population with overweight or obesity and established CVD without diabetes using the Clinical Practice Research Datalink (CPRD) database. The SELECT risk equations for acute coronary syndrome (ACS) and stroke were externally validated in a CPRD cohort; records were assessed between 24 October 2008 and 29 March 2021 for patients aged &#x2265;&#x2009;45 years with body mass index (BMI) &#x2265;&#x2009;27&#xa0;kg/m2 and established CVD without diabetes. The risk equations were validated both in their original form, and after re-calibration to the CPRD analysis population. Discrimination and calibration were evaluated to assess the predictive performance of the risk equations. The SELECT risk equations, without recalibration, were also compared with published risk equations in terms of their discrimination and calibration. The discrimination C-indices at 4 years were 0.65 (95% confidence interval [CI] 0.64-0.65) for ACS and 0.71 (95% CI 0.71-0.71) for stroke. After re-calibration, at 4 years calibration, observed/expected ratio was 1.02 (95% CI 1.00-1.03) for ACS and 0.98 (95% CI 0.96-1.00) for stroke. Prediction accuracy was lower for those with a higher baseline risk of stroke, with over-prediction observed in these patients. For both ACS and stroke, the SELECT risk equations showed better discrimination than Framingham (ACS) (C-index 0.68 vs 0.54) and SMART-REACH (stroke) (C-index 0.74 vs 0.50). The recalibrated SELECT risk equations showed acceptable discrimination and good calibration when applied to a real-world population of patients with overweight or obesity and established CVD without diabetes from the CPRD database. These risk equations with calibration also demonstrated better predictive performance compared with published risk equations, supporting their use in health economic evaluations in this patient population.

Moderate-to-severe traumatic brain injury (msTBI) disproportionately affects populations in low- and middle-income countries. This study examines how initial care at a neurosurgery-capable facility (NCF) affects survival. This is a secondary analysis of data collected in the EpiC study from the Western Cape of South Africa. The study period was January 2022 to October 2024 and included adult patients with msTBI who survived to hospital arrival. The study compares in-hospital TBI-associated mortality among NCF and non-NCF groups using inverse probability of treatment weighted logistic regression models. A total of 620 patients with msTBI were included (210 NCF and 410 non-NCF, including 291 who were later transferred to the NCF), with mean age 34&#xa0;years, 89% male, and 78% blunt injury. NCF group had lower Glasgow Coma Scale (median 4 vs. 9, p&#x2009;<&#x2009;0.01), worse injury severity (median New Injury Severity Score [NISS] 34 vs. 27, p&#x2009;<&#x2009;0.01), and greater likelihood of ambulance transport (94% vs. 51%, p&#x2009;<&#x2009;0.01). NCF group received head computed tomography (CT) earlier (median 6&#xa0;h vs. 15&#xa0;h, p&#x2009;<&#x2009;0.01). Neurosurgical procedures occurred faster for NCF compared with non-NCF patients (median 12&#xa0;h vs. 23&#xa0;h, p&#x2009;=&#x2009;0.13). Almost one-third (29%) of the cohort experienced TBI-associated mortality (37% vs. 25%, p&#x2009;<&#x2009;0.01). After adjustment for confounders and effect modifiers such as age, sex, EMS arrival, intubation within 24&#xa0;h of injury, NISS, initial GCS, polytrauma, hypotension, and blood product administration, NCF was associated with lower odds of TBI-associated mortality (adjusted OR 0.51, CI 0.34-0.75, p&#x2009;<&#x2009;0.01). Direct transport to NCF was associated with improved survival for patients with msTBI in South Africa.

Spinal cord injury (SCI) is a complex medical condition and managing the multiple, co-occurring symptoms and functional and social limitations that follow SCI is a challenging task for clinical care providers. Understanding how the various post-SCI symptoms and limitations are interrelated or cluster together can inform patient care and improve clinical workflows. The purpose of this study was to determine the factor structure of the SCI-QOL measurement system and associated symptom clusters that affect health-related quality of life (HRQOL) in individuals with SCI. Participants were individuals with SCI living in the community (>&#x2009;1 year after injury) recruited from 8 rehabilitation hospitals in the U.S. who completed 18 Spinal Cord Injury - Quality of Life (SCI-QOL) outcomes measures representing domains of physical, medical, social, and emotional health. Two dimension-reduction techniques, confirmatory factor analysis and multidimensional scaling, were used to analyze the data. Factor analysis results suggest 7 common factors underlying the measures: Physical Symptoms, Physical Function, Negative Affect, Positive Affect, Social Health, Independence, and Pain Interference. The psychosocial factors of Negative Affect, Positive Affect, and Social Health were highly interrelated. Large correlations were also observed between Physical Function and Independence, and between Physical and Social Health. All other interrelations were small to moderate. Results from the multidimensional scaling analysis were largely consistent with those from the factor analysis. Study results will help inform the development of composite scores and symptom profiles in SCI, which will help researchers and clinicians better understand and manage symptoms following SCI.

This grounded theory study explores the cultural beliefs and perceptions that shape cancer-related health behaviors among Sub-Saharan African immigrant (SSAI) men in the United States. Despite growing awareness of poor health outcomes affecting immigrant communities, there remains a significant gap in understanding the cultural drivers that influence engagement with preventive care and early cancer detection among SSAI men. Guided by grounded theory, 36 SSAI men participated in in-depth interviews. Purposeful sampling was used to recruit eligible immigrants from SSAI men diagnosed with prostate cancer (12) and non-diagnosed men (24), capturing the rich diversity that exists among this population. Data were inductively analyzed following the key stages of open, axial, and selective coding, using constant comparison to enhance rigor. Data analysis culminated in the development of a conceptual framework, represented metaphorically as a tree that illustrates how core cultural beliefs (roots) give rise to intermediary thought patterns (stems), which ultimately manifest in specific health behaviors (leaves). Root factors represent deeply held beliefs that shape participants' worldviews and guide their subsequent actions. Three deeply held belief systems were identified as the perception of a strong link between poor diet and cancer, culturally embedded understandings of cancer from participants' countries of origin, and the low prioritization of preventive healthcare. These root beliefs informed a series of intermediary factors (the stem), which serve as a bridge linking root beliefs to observable behaviors by reinforcing and supporting the core ideas including participants' belief that the African diet is inherently healthy, the framing of cancer as a spiritual or religious affliction, and the view that medical care is necessary only when symptoms are present. These intermediary beliefs, in turn, lead to observable health behaviors (the leaves) which symbolize the outward, visible expressions in the form of health-related behaviors, including participants' reported avoidance of processed foods, reliance on religious healing over medical treatment, hesitancy to discuss cancer openly, and delays in seeking care until advanced stages of illness. The resulting grounded theory, Culturally Anchored Risk Engagement (CARE) Framework, explains how SSAI men make health decisions by interpreting cancer risk through culturally rooted lenses. The theory underscores the importance of culturally nuanced approaches in improving health equity and early detection in immigrant communities. By centering community voices and cultural context, this study contributes a nuanced understanding of how cultural frameworks influence health behavior and highlights opportunities for more responsive and equitable healthcare interventions targeting SSAI men.

In this study, we replicate a striking dissociation of consciousness from action. The dissociation comes from Vorberg et al. (2003) who explored whether metacontrast-masked stimuli still prime subsequent actions. In metacontrast masking, stimuli are rendered less visible by increasing the time between it and a subsequent mask (ISI). Vorberg et al.&#xa0;demonstrated that as stimuli were less visible with longer ISI, they nonetheless exerted a greater priming effect on motor responses to subsequent targets. This stunning dissociation is highly persuasive, as it obviates the usual critiques of subliminal priming effects. To our knowledge, it remains unreplicated. Here we report a successful replication: in metacontrast masking, prime visibility decreases initially with ISI while motor priming increases. Our replication study has almost 5x as many individuals and provides confirming evidence for the dissociation. We provide an interpretation within Mishkin et al. (1983) ventral-and-dorsal stream processing model, and we show that individual differences in the effect are qualitative in that different individuals exhibit qualitatively different patterns.

Despite sustained universal infant hepatitis B vaccination, chronic hepatitis B (CHB) remains an important cause of cirrhosis and hepatocellular carcinoma in Thailand, particularly among adults born before vaccine implementation. This article summarizes the 2026 National Guideline on Elimination of Viral Hepatitis B in Thailand and presents a health-system framework for addressing the remaining disease burden. The guideline was developed by a multidisciplinary expert panel using evidence from international recommendations, peer-reviewed literature, national epidemiological data, implementation studies, and health economic analyses. The recommendations were formulated using the GRADE framework and adapted for implementation within Thailand's Universal Health Coverage system. The national strategy prioritizes birth-cohort HBsAg screening for adults born before 1992, simplified evidence-based treatment eligibility incorporating non-invasive fibrosis assessment and virological criteria, and first-line use of high genetic-barrier nucleos(t)ide analogs. Prevention of mother-to-child transmission prioritizes HBV DNA-guided antiviral prophylaxis, with simplified implementation pathways reserved for settings with substantial diagnostic constraints. Long-term care emphasizes structured monitoring, appropriate specialist referral, conservative treatment discontinuation criteria, defined retreatment thresholds, and risk-based semiannual ultrasound surveillance for hepatocellular carcinoma. Integration with antenatal services, HIV programs, and primary care facilities supports decentralized delivery and continuity of care. Thailand's 2026 hepatitis B guideline operationalizes evidence-based CHB management within a publicly financed decentralized health system and provides a scalable model for expanding hepatitis B diagnosis and treatment in endemic settings.

Porcelain is a fundamental material in restorative dentistry due to its extensive use in full-coverage crowns, inlays, all-ceramic bridges, veneering systems, castable ceramics, and porcelain-fused-to-metal restorations. Its durability, glass-like structure, and close resemblance to natural tooth enamel make it a preferred choice for esthetic dental applications. The present study aims to develop an improved dental ceramic material that meets the increasing clinical demand for high-performance and esthetically reliable restorations. The physical, mechanical, thermal, and optical characteristics of newly formulated feldspathic porcelain made from locally produced Iraqi raw materials are examined in this work in relation to the impact of nano-additive integration. The high silica and alumina content and low impurity levels of the chosen feldspar, kaolin, and quartz allow for the manufacture of ceramic qualities similar to those of dental porcelains that are sold commercially. Additionally, there are benefits to using these locally accessible resources in terms of sustainability and cost-effectiveness. A mixture of 5% kaolin, 75% feldspar, and 20% quartz was made and then heated to 1100 degrees Celsius to improve its properties. Adding nano-sized alumina (AlO&#x2083;), titania (TiO&#x2082;), and bismuth oxide (BiO&#x2083;) to the composition with 0.75 weight% TiO&#x2082; and 0.75 weight% BiO&#x2083; made the material much less porous (from 0.83% to 0.45%) and less able to absorb water (from 0.76% to 0.33%). There was also an increase in apparent density (from 1.83 to 3.26&#xa0;g/cm&#xb3;) and diametrical strength (from 12 to 23.66&#xa0;MPa). The changed porcelain also had optical properties that were very similar to those of natural teeth. The composition with 0.75 weight% TiO&#x2082; and 0.75 weight% BiO&#x2083; showed better colour stability, which suggests that it might be good for aesthetic veneering applications.

Lymph nodes (LNs) in medical images often have fuzzy boundaries, vary in size and shape, and have intensities similar to those of neighboring tissues, making accurate segmentation challenging. To address this issue, we propose a multi-scale attention-enhanced network (MSA U-Net) that integrates channel-wise and spatial attention mechanisms for automatic segmentation of metastatic pelvic LNs associated with uterine malignancies from sagittal magnetic resonance imaging (MRI). This network integrates a U-Net backbone, fuses features from different encoder levels at skip connections, and feeds the fused features into the decoder at each layer. Different receptive fields are used at the bottleneck nodes to capture multiscale contextual information. A detection head is added to the bottom layer of the network and the detection results are used to assist in the final segmentation of the image. A lightweight design of the convolutional block attention module is also implemented to optimize feature representation. The experimental results demonstrate that the proposed network achieves better segmentation performance compared to the baseline model. The proposed network achieves a mean intersection over union of 0.76, an average pixel accuracy of 0.97, a precision of 0.78, a recall of 0.97, a Dice coefficient of 0.82, and a Hausdorff distance of 2.21. The proposed MSA U-Net segmentation network effectively segments LNs in uterine MRI images, outperforming existing segmentation methods. This study provides a reliable and automated method to help clinicians detect LN, thus improving clinical decision-making.