Abstract: Background/Objectives Atrial fibrillation/flutter (AF) and liver cirrhosis both present a large disease burden internationally, with millions of adults afflicted. There is evidence of a link between these two diseases; however, the prevalence and impact of liver cirrhosis in patients with and without AF have not been extensively detailed. With the utilization of a large national database, we examined the relationship between liver cirrhosis and AF and the effects on hospital outcomes. Methods We conducted a nationwide review from 2016 to 2020 utilizing the Nationwide Inpatient Sample (NIS) database. Patients ≥ 18 years old with newly diagnosed atrial fibrillation or atrial flutter were identified. They were then further stratified into patients with and without liver cirrhosis. Characteristics and comorbidities were identified, evaluating in-hospital mortality as the primary outcome. Results A total of 3,866,486 patients with a primary diagnosis of AF were included. Patients with liver cirrhosis were younger in age (mean age 68.32 vs 74.36 years old), the majority were White (74.1%), followed by Black (10.2%), and Hispanic (10.5%). They had more comorbidities, such as diabetes (45.1% vs 37.3%, p<0.001), hypertension (78.5% vs 83.6%, p<0.01), and chronic kidney disease (22.1% vs 19.5%, p<0.001) when compared to patients without liver cirrhosis. Patients with liver cirrhosis had a higher risk of in-hospital mortality (OR=1.84, p<0.001), hypovolemic shock (OR=2.17, p<0.001), gastrointestinal bleed (OR=2.42, p<0.001), requiring blood transfusions (OR=1.84, p<0.001), and requiring ICU-level of care with intubation (OR=1.214, p<0.001), central line (OR=1.33, p<0.001), arterial line (OR=1.32, p<0.001) and vasopressors (OR=1.61, p<0.001). Moreover, patients with liver cirrhosis had a lower risk of having an acute cerebrovascular accident (OR=0.431), transient ischemic attack (OR=0.475), or pulmonary embolism (OR=0.68) while hospitalized (p<0.001). Conclusion Our results have demonstrated a remarkable relationship between AF and liver cirrhosis, with significantly increased morbidity and mortality reported in individuals with both conditions compared to AF without liver cirrhosis.

Abstract: Dielectric engineered plasmonic nano-hole arrays (NHAs) provide an effective approach for controlling subwavelength light confinement. Here, we investigate wavelength compression in aluminum NHAs filled with three different dielectric materials such as Al₂O₃, MoO₃, and TiO₂ under illumination by a 1.5 µm lightwave. The hole radius varies from 300 nm to 500 nm to analyze the combined effects of geometry and dielectric environment on the plasmonic response. The NHAs filled with Al₂O₃ exhibit a pronounced and monotonic increase of the compressed wavelength with decreasing hole radius, indicating strong geometric tunability of the dominant plasmonic mode. Meanwhile, the structures filled with MoO₃ or TiO₂ show weak wavelength variations over the same radius range. Spatially resolved analysis at these nano-holes reveals nearly position-independent wavelength squeezing for Al₂O₃, whereas noticeable spatial variations appear for MoO₃ and TiO₂ at hole radii of 450 nm and 400 nm, respectively. The observed wavelength compression is attributed to hybrid plasmonic modes originating from the interplay between in-hole–like compressed cavity modes and localized surface plasmon polaritons. Our findings demonstrate how dielectric composition tunes wavelength compression in plasmonic NHAs, offering practical guidelines for designing the near-infrared plasmonic devices.

Abstract: Background/Aim: Hepatitis D virus (HDV) infection is the most severe form of viral hepatitis but is under-recognized. We evaluated HDV screening frequency and clinical characteristics of HDV-positive patients in our liver center in the United States. Method: Patients with chronic hepatitis B (CHB) evaluated between January 2021 and December 2023 were included. For those tested anti-HDV(+), HDV RNA was performed and clinical data were recorded. Results: Among 1,337 (M=716, F=621) CHB patients, 93.3% were foreign-born. The cohort included 74.9% Asians, 12.3% Blacks, 9.1% Whites and 1.3% Hispanics. HDV screening significantly increased after 2011 reflecting an increase in HDV awareness. Patients aged 18-40 years had the highest screening rate of 58%. Overall, 13 (1.95%) were tested HDV positive and 11 were repeatedly HDV RNA(+). PWID was noted in 5 of 11. Despite low HBV DNA levels, all had ≥stage 2 fibrosis, and 7 had advanced stage 3-4 disease. After a median follow-up of 8.75 years, 8 (73%) developed hepatic decompensation and 4 had hepatocellular carcinoma. Conclusion: HDV screening reached 51.3% among our predominantly foreign-born CHB patients. The high prevalence of advanced fibrosis at diagnosis underscores the importance of HDV screening. Early diagnosis and effective therapy are urgently needed for this challenging disease.

Abstract: Background/Objectives: Autism spectrum disorder (ASD) is biologically heterogeneous, and immune-linked variation may coincide with differences in tryptophan–kynurenine pathway (KP) metabolism. Here, we report a targeted urinary profile of KP metabolites, NAD (nicotinamide adenine dinucleotide), and neopterin in a Bulgarian pediatric ASD cohort to describe within-cohort patterns and associations. Methods: Second-morning, acid-stabilized spot urine was collected from 73 children with ASD in Bulgaria (3–13 years; 57 males; 16 females). No contemporaneous neurotypical control group was enrolled; therefore, laboratory-provided reference limits are reported only as contextual benchmarks and are not interpreted as ASD-specific abnormalities. Tryptophan (TRP), kynurenine (KYN), kynurenic acid (KYNA), 3-hydroxykynurenine (3-HK), quinolinic acid (QUIN), NAD, and neopterin were quantified and derived indices were computed (KYN/TRP × 1000; QUIN/KYNA). Non-parametric statistics, Benjamini–Hochberg false discovery rate (FDR) correction, and Spearman correlation analyses were applied. Results: Neopterin was strongly associated with QUIN and KYN in creatinine-normalized data (QUIN: ρ = 0.59, q36 = 2.64 × 10-7; KYN: ρ = 0.54, q36 = 3.69 × 10-6); these associations persisted when reconstructed as absolute concentrations (e.g., QUIN_abs: ρ = 0.68, q36 = 2.69 × 10-10) and after partial Spearman correlation controlling for spot creatinine (partial ρ = 0.46, q = 2.52 × 10-4). One NAD value was &lt;LOQ and was imputed as ½LOQ; sensitivity analyses did not materially change inference. Conclusions: In this ASD-only cross-sectional dataset, urinary neopterin levels co-varied with urinary KYN and QUIN and with KP indices. Clinical interpretation and causal inference require controlled and longitudinal studies with richer covariate capture.

Abstract: Objective collapse models are often implemented so that collapse acts only on the fermionic (matter) sector, while bosonic fields do not undergo fundamental collapse. In generalized trace dynamics (GTD), spontaneous localization is expected to arise when the trace Hamiltonian has a significant anti-self-adjoint component. In this note we show, starting from the STM-atom (spacetime-matter atom) trace Lagrangian written in terms of two inequivalent matrix velocities Q̇₁ and Q̇₂, that the purely bosonic subsector admits a self-adjoint Hamiltonian, whereas the fermionic sector carries an intrinsic anti-self-adjoint contribution. The key structural input is that making the trace Lagrangian bosonic requires insertion of two unequal odd-grade Grassmann elements β₁ ≠ β₂. Assuming natural adjoint properties for these elements, we compute the trace Hamiltonian explicitly via trace-derivative canonical momenta (with bosonic and fermionic variations treated separately) and isolate the resulting anti-self-adjoint term. This provides a first-principles mechanism, within GTD, for why only fermionic degrees of freedom act as collapse channels.

Abstract: The hypothesis that antibiotics evolved from or co-opted bacterial intercellular signaling molecules predicts that signaling-active compounds should exhibit physicochemical properties favorable for drug development. We explored this prediction through a comparative cheminformatics analysis of 74 bacterial signaling molecules — comprising 48 small-molecule diffusible signals, 17 peptide autoinducers and intracellular messengers, and 9 antibiotics with documented signaling activity — against 71 randomly selected drug-like molecules. Small-molecule signaling molecules showed significantly higher Lipinski Rule-of-5 compliance than random drugs (95.8% vs. 73.2%; Odds Ratio = 8.40, 95% CI: 1.86–38.1, p = 0.001; Bonferroni-adjusted p = 0.009), while peptide autoinducers and intracellular messengers showed near-zero compliance (5.9%), confirming that the enrichment is specific to small-molecule diffusible signals. Predicted membrane permeability was over 2-fold higher for small-molecule signals (72.9% vs. 32.4% classified as “Good”), and enrichment was observed across six of seven drug-likeness filters (Enrichment Factors 1.12–1.31). We identified 10 signaling-active molecules with favorable profiles whose direct antibiotic activity has not been systematically tested; six are free of PAINS alerts. This analysis was conducted with substantial AI assistance, molecular properties were compiled from databases rather than computed de novo, and results require independent verification with validated cheminformatics tools. We present these findings as a hypothesis-generating study to stimulate experimental testing of the signaling-first triage concept for antibiotic discovery. For all abbreviations and acronyms used throughout this manuscript, please refer to the Glossary section.

Abstract: Hypnosis and hypnotherapy have emerged as powerful, evidence-based therapeutic modalities with demonstrated efficacy across a broad spectrum of mental and somatic health conditions. This comprehensive review synthesizes the latest research from 2018 to 2026, examining the neurobiological mechanisms, clinical applications, and therapeutic outcomes of hypnotic interventions. Recent meta-analytic evidence reveals effect sizes ranging from medium to large (d = 0.5 to 2.72) for various conditions, with particularly robust evidence for chronic pain management, depression, anxiety disorders, and perioperative care. Neuroimaging studies have elucidated the neural substrates of hypnotic analgesia and emotional regulation, demonstrating modulation of the anterior cingulate cortex, default mode network, and pain matrix. Randomized controlled trials consistently show that hypnotherapy achieves outcomes comparable to or exceeding cognitive behavioral therapy for depression, with sustained benefits extending up to 3.5 years post-treatment. Importantly, hypnotic interventions demonstrate excellent safety profiles with no significant adverse events reported across studies. This review establishes hypnosis as a credible, hope-inspiring healing modality that warrants broader integration into mainstream clinical practice for patients seeking effective, non-pharmacological treatment options.

Abstract:

Background: Lassa fever remains a major public health challenge in West Africa, particularly in Nigeria where recurrent outbreaks continue to place pressure on health systems. Facility-based analyses are important for understanding morbidity and mortality trends in endemic regions. Objective: To assess morbidity and mortality trends of Lassa fever among patients managed at Irrua Specialist Teaching Hospital over a five-year period. Methods: A retrospective hospital-based cross-sectional study was conducted at Irrua Specialist Teaching Hospital, Edo State, Nigeria. Case records of all patients with confirmed Lassa fever managed between January 2018 and August 2022 were reviewed. Data were extracted using a structured checklist and analysed using SPSS version 23. Descriptive statistics were used to summarise socio-demographic, clinical and outcome variables. Results: A total of 191 Lassa fever case records met the eligibility criteria. The estimated mean age was 26.0 ± 18.8 years, with most patients younger than 30 years. There was a slight male predominance (52.4%). Admissions peaked in 2018 (47.1%) and declined thereafter. Most patients presented within five days of symptom onset (46.1%), although 17.8% presented after more than 11 days. The most common symptoms were fever (91.1%), vomiting (50.3%), headache (46.6%), and anorexia (46.1%), while haemorrhagic manifestations were uncommon (4.7%). The overall case fatality rate was 13.6%. Most hospital admissions lasted 6–15 days. Conclusion: Lassa fever remains an important cause of hospital admission and mortality in Edo State. Although mortality in this cohort was within previously reported hospital-based ranges, delayed presentation and non-specific clinical features remain challenges for early diagnosis. Strengthening surveillance systems, improving early detection, and enhancing infection prevention practices are essential to reducing Lassa fever morbidity and mortality in endemic settings.

Abstract:

Background and Objectives: The thoracolumbar fascia (TLF) has been implicated in low back pain, but imaging-based characterization in specific degenerative lumbar pathologies—particularly in surgical cohorts—remains limited. To evaluate TLF thickness on Magnetic resonance imaging (MRI) and Ultrasound (US) across common lumbar pathologies, examine associations with age, body mass index, disability, and assess MRI–US agreement for TLF thickness. Materials and Methods: In this prospective single-centre cohort, adults scheduled for elective lumbar surgery underwent preoperative US (short- and long-axis at L3) and review of routine lumbar MRI (axial and sagittal T1-weighted measurements at L3) using standardized protocols. Disability was assessed using the Oswestry Disability Index (ODI). Group comparisons, correlation analyses, and intraclass correlation coefficients were used to evaluate between-diagnosis differences, patient-factor associations, and MRI–US agreement. Results: Thirty-seven patients were eligible (15 lumbar spinal stenosis, 5 discs herniations, 4 spondylolisthesis, 2 scoliosis, 9 revision surgeries, 2 trauma comparators). Median TLF thickness was 0.86 mm (0.16–1.40) on axial MRI, 1.12 mm (0.47–2.33) on sagittal MRI, 2.38 mm (1.01–5.91) on US short-axis, and 2.87 mm (1.12–5.74) on US long-axis. Axial MRI thickness differed across groups (p=0.010), driven by thinner measurements in trauma versus disc herniation (p=0.031); no significant group effects were observed on sagittal MRI or US. Age correlated positively with axial MRI thickness (p=0.021). No significant correlations were detected between ODI and TLF thickness on MRI or US. MRI–US agreement was poor, indicating the modalities are not interchangeable for TLF thickness measurement. Conclusions: TLF thickness measured on MRI and US did not consistently differentiate diagnostic groups and was not associated with disability. Thickness estimates differed substantially by modality, with poor MRI–US agreement. Larger studies with standardized acquisition and reliability testing are needed to clarify the clinical and mechanistic relevance of TLF imaging in degenerative lumbar disease and to determine whether it can support phenotype-based stratification within degenerative spine disease.

Abstract: Emergency evacuation in complex and dynamic building environments requires robust and adaptive routing strategies capable of responding to evolving hazards, blocked passages, and changing crowd behaviour. Most existing evacuation planners rely on static geometric representations and lack semantic awareness of the environment, limiting their ability to perform informed re-planning and backtracking when routes become unsafe. This paper proposes a neuro-symbolic evacuation planning framework that integrates Lifelong Planning A* (LPA*) with ontology-driven semantic reasoning and a Bidirectional Long Short-Term Memory (BiLSTM) prediction model. The building’s spatial and semantic knowledge is represented using the Web Ontology Language (OWL) and Resource Description Framework (RDF), enabling automated inference of implicit connections and enforcement of safety policies. The BiLSTM model learns temporal patterns from ontology-consistent evacuation trajectories and provides guidance for remaining-cost estimation and early prediction of routes likely to require backtracking, which is combined with a bounded semantic heuristic to preserve admissibility and optimality guarantees. Simulation results in a multi-floor academic building show that the proposed BiLSTM-guided semantic LPA* framework reduces average evacuation time by up to 9.6%, decreases node expansions by up to 32%, and increases evacuation success rates to 96.2% compared with a purely semantic baseline. The BiLSTM model also achieves strong predictive performance, with a test AUC of 0.92 for backtracking prediction and a next-state accuracy of 87.1%. The proposed framework provides a scalable, explainable, and real-time solution for personalised and policy-compliant evacuation guidance under rapidly evolving emergency conditions.

Abstract: This study examines the causal mechanisms through which the effectiveness of public policy influences the economic welfare of tobacco farmers in Madura, Indonesia. Using survey data from tobacco farmers and applying structural equation modelling partial least squares (SEM-PLS), the study analyses the direct effects of policy effectiveness on innovation adoption, farmer productivity and economic welfare, as well as the mediating and serial mediating roles of innovation adoption and productivity. The findings demonstrate that public policy effectiveness significantly enhances innovation adoption, productivity and economic welfare. Innovation adoption improves productivity and welfare, while productivity directly strengthens welfare outcomes. Mediation analysis confirms that innovation adoption and productivity function as both individual and sequential mediators. This indicates that welfare gains are primarily achieved through policy-driven innovation uptake and productivity improvements, rather than through the direct effects of policy alone. Despite limitations relating to the cross-sectional nature of the data and the focus on economic welfare, the study provides valuable insights for the design of innovation-oriented agricultural interventions aimed at promoting sustainable welfare among smallholder farmers.

Abstract:

Background: Seasonal influenza remains a major public health challenge worldwide, causing significant morbidity each year and imposing substantial burdens on individuals, healthcare systems and national economies. Vaccination is considered the most effective available strategy for prevention; however, uptake rates vary considerably across countries, with many failing to achieve the recommended coverage levels. The aim of this review is to examine the beliefs, attitudes and behaviors of healthcare professionals worldwide regarding seasonal influenza vaccination. Methods: This is an umbrella review, according to the PRISMA Statement 2020, searching PubMed, Cochrane Library and Google Scholar. The following search terms were used: beliefs, attitudes, behaviors, influenza vaccination, flu vaccine, health professionals, primary health care. Selection criteria were the following: 1) Reviews, 2) Published after 1/1/2000, 3) English language 4) Healthcare professionals as target-population. Results: Twenty-five studies met the selection criteria and were included in this review. Twelve out of 25 studies were systematic reviews. Globally, vaccination uptake among healthcare professionals remains below recommended national and international targets. North America demonstrates the highest vaccination coverage, while the lowest coverage is reported in Africa and South America. Overall, low- and middle-income countries show significantly lower vaccination behavior compared with high-income countries. Attitudes and beliefs appear to shape vaccination behavior in high-income countries. The main driver of acceptance is perceived protection of oneself and family, whereas hesitancy is mainly driven by concerns about side effects and vaccine safety. Across studies, non-physician healthcare professionals consistently demonstrated lower influenza vaccine acceptance compared with physicians while pediatricians and general practitioners were found to receive the influenza vaccine more frequently. In addition, younger physicians and those with fewer years of professional experience showed higher vaccination coverage and a greater likelihood of recommending influenza vaccination to patients. Conclusions: Vaccination coverage, worldwide, is lower than what is recommended by the World Health Organization. Healthcare professionals, working in hospital settings, tend to be vaccinated at a higher rate and are more likely to recommend the vaccine to their patients. The recommendations that health professionals give are influenced by whether they accept influenza vaccines themselves. Beliefs and attitudes seem to influence behavior in countries where structural barriers, such as limited access to primary healthcare and socio-economic status are absent.

Abstract: The modern prosthetic foot market is characterized by a pronounced polarization between affordable but low-function devices and high-performance yet costly composite prosthe-ses. The aim of this study was to develop and comprehensively evaluate cost-effective, functional prosthetic feet manufactured by fused deposition modeling (FDM). An iterative design methodology was employed, combining finite element analysis to optimize the biomechanical response of the device, incorporation of user-specific requirements and ex-perimental validation. Two TPU 95A-based 3D-printed prosthetic foot designs were de-signed and developed, and their strength and functional characteristics were assessed numerically under the ISO 22675:2024 normative loading cycle. Bench-top mechanical tests were conducted on the fabricated prototypes. Functional performance was evaluated by a transtibial amputee using an inertial motion capture system to analyze gait kinemat-ics. The results demonstrated that both designs operate predominantly within the elastic range with an adequate safety margin. The pilot gait assessment indicated biomechani-cally acceptable walking kinematics for both prototypes, with a subjective preference for the smoother rollover provided by Model 2.

Abstract: Background Malawi remains endemic for some preventive chemotherapy-neglected tropical diseases requiring mass drug administration. Challenges persist in controlling schistosomiasis and soil-transmitted helminths, particularly in rural schools, despite efforts in the mass treatment with drugs such as praziquantel and albendazole. School feeding programs improve child health, education, and social stability, yet they have not been fully scaled nationwide, leaving gaps in coverage. Despite government efforts, overall drug treatment uptake is notably lower in non-feeding schools, with potential barriers linked to social, economic, and logistical factors. This study explored the challenges affecting the uptake of drugs in schools without a feeding program and identified key factors that may hinder treatment coverage and program effectiveness. Methods The study was nested in Malawi within the Deworm3 clinical trial (Clinicaltrials.gov number: NCT03014167), a multi-country cluster randomized study designed to assess the feasibility of interrupting the transmission of soil-transmitted helminths. Data were collected from key players in the implementation of school-based deworming programs, using semi-structured qualitative interviews, transcribed, translated, and analyzed using N-vivo 11. Results Several barriers affected uptake drug uptake. Only 40% of community health workers and teachers reported effectively educating communities about the program and the usefulness of taking the drugs, leading to misinformation, including fears of infertility (30%) and witchcraft (20%). Food scarcity (67%) in schools prevented children from taking the drugs, as they required food beforehand. Some families opposed drugs due to cultural and religious beliefs. Logistical challenges such as delayed drug supply (45%), lack of transport (38%), and no financial incentives (55%), further hindered implementation. Conclusion The study highlighted low treatment coverage in non-feeding schools is due to knowledge gaps, food insecurity, religious and cultural influences, logistical constraints, and financial barriers. Addressing these issues requires enhanced community engagement, improved drug distribution logistics, better incentives for implementers, and consideration of religious and cultural practices when scheduling drug distribution.

Abstract: Background/Objectives: Incidental gallbladder cancer (IGBC) is an uncommon but clinically important malignancy, typically diagnosed unexpectedly after cholecystectomy performed for benign indications. Despite its incidental nature, IGBC may present with advanced pathological features and unfavorable outcomes. This study aimed to evaluate the incidence, clinicopathological characteristics, surgical management, and prognostic factors of IGBC in a large cholecystectomy cohort from a tertiary referral center. Methods: A retrospective analysis was performed on 19,798 cholecystectomy procedures conducted between January 2010 and December 2025. Patients with a preoperative diagnosis of gallbladder cancer or incomplete clinical or pathological data were excluded. Only cases with invasive incidental gallbladder cancer (IGBC) were included, whereas dysplasia and carcinoma in situ were excluded. Demographic, clinical, surgical, pathological, and survival data were systematically collected. Results: Incidental gallbladder cancer was identified in 43 patients (0.22%). The mean age was 71.4 ± 9.9 years, and 74.4% were female. Gallstones were present in 88.4% of patients. Adenocarcinoma was the predominant histology (90.7%), and pT2 disease was the most common stage (41.9%), while 25.6% had advanced-stage tumors (pT3–T4). Median OS was 26.0 months, and median DFS was 25.5 months in non-metastatic patients. Pathological T stage was significantly associated with both OS and DFS. Advanced T stage, positive surgical margins, perineural invasion, lymphovascular invasion, and increasing tumor size were significantly associated with worse DFS. Re-resection rates were limited, mainly due to advanced age and comorbidities. Conclusion: Although incidental gallbladder cancer is rare, it leads to clinically and oncologically significant outcomes. In this study, pathological T stage emerged as a key prognostic factor influencing both overall survival and disease-free survival. In addition, perineural invasion, lymphovascular invasion, and positive surgical margins were identified as the main pathological factors adversely affecting disease-free survival.

Abstract: Motivated by the work of Matsas et al. (2024), which demonstrates that time can serve as the fundamental unit for physical quantities—obviating the need for traditional Length-Mass-Time (LMT) dimensions—this research evaluates the operational resolution of velocity within relativistic frameworks. Utilizing a Lorentz transformation matrix approach, we first validate the Matsas three-clock protocol, confirming the derivation of distance as a function of three proper clock times in Minkowski spacetime and uncovering two novel velocity expressions derived solely from these temporal intervals. The investigation was extended to Tangherlini’s 4D spacetime framework (1958) to test the hypothesis that absolute velocity could be resolved through subluminal signaling. While the initial three-clock scenario resulted in the systematic cancellation of the Base system's absolute velocity, a breakthrough was achieved by applying the Relativistic Doppler Effect within the Tangherlini metric. This approach effectively circumvents the mathematical cancellations prevalent in standard relativistic "null" experiments. The findings reveal that the Tangherlini and Minkowski frameworks are intimately related; the former serves as a necessary complement to the Special Theory of Relativity (STR) rather than an antagonist. This theoretical advancement suggests a plausible methodology for the measurement of absolute velocity without the requirement of instantaneous signals. By resolving the longitudinal Doppler shift within a preferred-frame geometry, this research provides fresh impetus for the historical debate on absolute motion initiated by Poincaré and Einstein.

Abstract: Background: Bovine milk protein-based human milk fortifiers (HMFs) are routinely used in preterm infants in low- and middle-income countries (LMICs) but are associated with potential adverse effects. Plant-derived amino-acid based HMFs are a promising alternative, but comparative data from randomized controlled trials (RCTs) are lacking. This pilot RCT aimed to evaluate the feasibility, safety, and growth outcomes of a novel plant-derived amino-acid based HMF compared to a bovine-derived whole protein based HMF in preterm infants <34 weeks’ gestation. Methods: In this open-label, parallel pilot RCT, preterm infants <34 weeks’ gestation were randomized to a plant-derived amino-acid based HMF (n=66) or a bovine-derived whole protein based HMF (n=70). Primary outcomes were time to reach 180 mL/Kg/day enteral feeds and growth velocities to discharge and 40 weeks’ postmenstrual age (PMA). Feasibility and safety were also assessed. Analysis followed intention-to-treat approach. The trial was registered (CTRI/2025/06/089133). Results: Baseline characteristics were comparable between groups. Time to reach enteral feeds of 180 mL/Kg/day did not differ (adjusted Hazard Ratio 0.93, 95% CI 0.65–1.33; p=0.70). In-hospital weight gain was significantly higher in the plant-derived HMF group (adjusted mean difference 3.20 g/Kg/day, 95% CI 0.46–5.95; p=0.02). This benefit was most evident in exploratory subgroup analyses of infants with birth weight ≥1500g. Length, head circumference growth, and all safety outcomes were similar between groups. Conclusions: The plant-derived amino-acid based HMF was well-tolerated, with a comparable safety profile. Its use was associated with better in-hospital weight gain, indicating it is a potential alternative to bovine-derived whole protein based HMF. These data support the feasibility of definitive trials powered for critical clinical outcomes.

Abstract: Dredging activities regularly occurring in near-shore and coastal waters generate turbid waters within the surface layer with high concentrations of suspended particulate matter collected in bottom sediments. The potential impact of these dredge plumes on natural ecosystems must be monitored using cost-effective methods and observations. Here, we investigate the biogeochemical and optical properties of dredge plumes selected mainly in European and African coastal waters. Laboratory analyses realized on numerous water samples collected in dredge plumes reveal (extremely) high water turbidity and high concentrations of mineral-rich particles in suspension, sometimes mixed to high concentrations of phytoplankton particles. The most peculiar optical property of these particles is a spectral light absorption coefficient significantly flatter than that of suspended particles in natural turbid waters (e.g., river plumes or estuarine maximum turbidity zones). This peculiar optical property is also detected on ocean color satellite data corrected for atmospheric effects, with a water reflectance signal higher than natural turbid waters at short visible wavebands (400-550 nm). Such an atypical spectral signature, that can be detected and mapped from space, makes the operational monitoring of dredge plumes in coastal waters using high spatial resolution (e.g., Sentinel2-MSI) satellite data possible.

Abstract: Constrained Object Hierarchies (COH) offer a unified theoretical foundation for artificial general intelligence (AGI), rooted in neuroscience principles and developed with full mathematical rigor. This paper presents the complete formalization of COH theory, showing how intelligence emerges from hierarchically composed structures governed by adaptive optimization constraints. We introduce precise definitions, establish core properties of soundness and completeness, and situate COH within established mathematical frameworks including category theory, dynamical systems, and information theory. Building on this foundation, we prove three central theorems that demonstrate COH’s practical significance for AGI: guaranteeing high‑fidelity world modeling, preventing jagged or non-smooth intelligence behaviors, and enabling the construction of coherent agentic systems. These results provide quantitative bounds on representational accuracy, generalization performance, and decision-making complexity. Collectively, the findings show that COH delivers a mathematically rigorous, interpretable, and scalable basis for modeling intelligent systems across six heterogeneous domains, while preserving the flexibility required for general intelligence and ensuring explicit guarantees for safety and transparency.

Abstract: Invasive conjunctival squamous cell carcinoma (CSCC) is an aggressive, ocular surface malignancy. The mean annual age-standardised incidence rate of 0.45 cases per million per year is increasing with an average annual percent rise of 4.5% and occurs mainly in over 65-year-olds in temperate climates but in a younger demographic in the tropics. Invasive CSCC can lead to vision loss either from the destructive effects of the tumour or side effects of therapy, facial disfigurement from radical surgery, and death from metastases. There is no standardised treatment and not all cases are referred to a specialist ocular oncology centre. Recent progress in cancer immunology and genetics has revolutionised the treatment of cutaneous and head and neck SCCs, which share some similarities to invasive CSCC. A better understanding of invasive CSCC and its preinvasive intraepithelial lesions is required to lead to the development of novel targeted and immunotherapies both for local tumour control, globe sparing alternatives and to prevent disseminated disease. This review aims to provide a comprehensive clinical overview of the current knowledge regarding CSSC, its epidemiology, pathogenesis, presentation, diagnosis, management, recent advances in targeted and immunotherapies for personalised treatment of this disease, and early diagnosis strategies to improve patient outcomes.