Chronic non-communicable diseases are highly prevalent in older women and are associated with unfavorable changes in body composition (BC). Physical literacy (PL) and physical activity (PA) are key determinants of healthy aging but it remains unclear whether chronic illness modifies not only their levels but also the structural relationships among PL, PA, and BC. This study aimed to examine differences in PL, PA, and BC between older women with- and without-chronic-illness and to compare the structural organization of associations among these variables in two observed groups. The sample included 60 women aged 66.1±9.6 years, categorized in two groups, those with- (n=36) and without-chronic-illness (n=24). PL, and PA were assessed using the validated questionnaires (Perceived Physical Literacy Questionnaire for South Eastern Europe, and Nordic Physical Activity Questionnaire – short version), and BC via bioelectrical impedance analysis. Between-group differences were examined using Welch’s t-tests with Cohen’s d effect size (ES). Pearson correlations were calculated separately by group, and Fisher’s z-tests with FDR correction were applied (91 comparisons). Correlation networks (|r|≥0.25) were constructed to assess cross-domain integration. Women with chronic illness demonstrated lower PL-competence (moderate ES) and higher PL-confidence and PL-knowledge, as well as higher moderate-to-vigorous PA (all moderate ES). No significant differences were observed in BMI, fat mass, skeletal muscle mass, or visceral fat. Prior to correction, PA showed stronger negative associations with fat mass (r=−0.54 vs. 0.11) and visceral fat (r=−0.55 vs. 0.04) in women without-, compared to women with-chronic-illness. Network analysis indicated reduced cross-domain integration between PA and BC in the chronic-illness group. Chronic illness in older women appears to modify the structural relationships among PL, PA, and BC rather than uniformly reducing their levels. The attenuated coupling between PA and BC suggests partial behavioral–physiological decoupling in the presence of chronic disease.

Extubation is a crucial component of anesthesia practice, requiring clinical expertise and effective communication among anesthesia personnel to ensure patient safety. In situations of insufficient spontaneous respiration, the anesthesia personnel assume control of ventilation using appropriate airway management techniques and anesthetic equipment. To explore the experiences of nurse anesthetists and anesthesiologists regarding extubation. A systematic literature review with an integrative approach was conducted in PubMed, MEDLINE, CINAHL, Embase, and the Cochrane Library, including both qualitative and quantitative studies. Literature searches were performed in electronic databases and via web-based sources. Thirteen articles published between 2006 and 2022 were included. Experience was identified as a key factor in optimizing extubation outcomes. Challenges such as poor communication, time constraints, and lack of mutual respect were detrimental to the performance of the anesthesia personnel during extubation. Furthermore, adequate planning and preparation were highlighted as essential components for improving the management of extubation. Experience, effective communication, and structured planning are fundamental to safe extubation practices. Addressing interpersonal and organizational barriers may enhance both health care professionals’ performance and patient safety.

Evidence suggests that age-associated differences in body composition-bone/muscle/adipose tissue-are nonlinear, but their timing, sex-specific features, and relation to osteosarcopenic adiposity (OSA) phenotype remain poorly defined. OSA is characterized by the coexistence of osteopenia/osteoporosis, sarcopenia, and excess or redistributed adiposity. We examined sex- and age-specific patterns and inflection points for bone, muscle, fat, and intramuscular adipose tissue (IMAT) in cross-sectional data from 9717 Caucasian adults aged 20-90 years. Body composition was assessed using BIA-ACC, a nonionizing bioelectrical impedance analysis that estimates total body bone, skeletal muscle, fat mass, and IMAT. Prespecified operational thresholds for the BIA-ACC-derived bone and muscle mass scores and sex-specific fat mass percentages were used to define reduced bone and muscle mass, adiposity, and the BIA-ACC-based OSA phenotype. LOESS nonparametric regression was used to model age-related body composition patterns without assuming a predefined functional relationship between age and each outcome and to identify inflection points. For sensitivity analyses, all LOESS curves were fitted with stiffness/span parameter (f) and confidence intervals were calculated. Men showed earlier peaks and relative midlife stability in bone and muscle, followed by lower later life values than women. Women showed lower baseline values, multiple early-life inflection points, and sharper midlife downturns, particularly around menopause. Fat mass increased steadily in men but followed multiphasic patterns in women, whereas IMAT increased progressively with age in both sexes. Adults meeting the operational BIA-ACC criteria for OSA (identified even in the youngest participants) demonstrated less stable trajectories, earlier downturns in bone and muscle components, and more complex fat and IMAT patterns. Distinct sex-specific patterns and adverse association between BIA-ACC-defined OSA and body composition patterns were identified. Early identification of this phenotype may support preventive assessment of accelerated musculoskeletal decline and increasing adiposity.

<p style="text-align: justify;"><span class="a_GcMg font-feature-liga-off font-feature-clig-off font-feature-calt-off text-decoration-none text-strikethrough-none">Dysautonomia, reflecting autonomic nervous system dysfunction, is frequently observed in patients with syncope, particularly those with orthostatic hypotension. </span><em><span class="a_GcMg font-feature-liga-off font-feature-clig-off font-feature-calt-off text-decoration-none text-strikethrough-none">Thymus serpyllum </span></em><span class="a_GcMg font-feature-liga-off font-feature-clig-off font-feature-calt-off text-decoration-none text-strikethrough-none">L. (wild thyme) has demonstrated antioxidant, anti-inflammatory, and cardiometabolic properties in preclinical studies. This study aimed to evaluate the effects of </span><em><span class="a_GcMg font-feature-liga-off font-feature-clig-off font-feature-calt-off text-decoration-none text-strikethrough-none">T. serpyllum </span></em><span class="a_GcMg font-feature-liga-off font-feature-clig-off font-feature-calt-off text-decoration-none text-strikethrough-none">essential oil on autonomic function and selected biochemical markers in patients with syncope. This prospective, single-center study included 15 patients with a history of syncope who received a capsule formulation of </span><em><span class="a_GcMg font-feature-liga-off font-feature-clig-off font-feature-calt-off text-decoration-none text-strikethrough-none">T. serpyllum</span></em><span class="a_GcMg font-feature-liga-off font-feature-clig-off font-feature-calt-off text-decoration-none text-strikethrough-none"><em> </em>essential oil for three months. Autonomic function was assessed using beat-to-beat heart rate and blood pressure variability analysis, 24-hour Holter ECG monitoring, and ambulatory blood pressure monitoring. Biochemical parameters were evaluated at baseline and after treatment. After three months, the beat-to-beat analysis showed increased LFnu values and a higher LF/HF ratio, along with decreased HF values, indicating a shift toward sympathetic predominance. No significant changes were observed in 24-hour heart rate or blood pressure parameters. Biochemical analyses revealed significant reductions in AST and C-reactive protein levels after treatment. In this pilot study, three-month supplementation with </span><em><span class="a_GcMg font-feature-liga-off font-feature-clig-off font-feature-calt-off text-decoration-none text-strikethrough-none">T. serpyllum </span></em><span class="a_GcMg font-feature-liga-off font-feature-clig-off font-feature-calt-off text-decoration-none text-strikethrough-none">essential oil was associated with changes in autonomic balance and favorable reductions in selected inflammatory and biochemical markers in patients with syncope. Further and larger placebo-controlled studies are required to confirm these findings and clarify their clinical significance.</span></p>

<p style="text-align: justify;"><span class="a_GcMg font-feature-liga-off font-feature-clig-off font-feature-calt-off text-decoration-none text-strikethrough-none">The COVID-19 pandemic has led to the development of several types of vaccines, among which messenger RNA (mRNA)-based vaccines have represented a significant breakthrough. This study aimed to evaluate attitudes towards COVID-19 and seasonal influenza vaccination among the general population and individuals with a medical background. A questionnaire was developed to collect sociodemographic data, personal health information, vaccination status, and information on participants&rsquo; attitudes towards and knowledge of vaccines. The profile of the typical participant was an employed woman with tertiary education, living with another person in an urban area and reporting generally good health. The typical participant had received at least two doses of the Sputnik V vaccine. Participants generally expressed favourable attitudes towards regular COVID-19 vaccination. The results showed no apparent differences between participants with and without a medical background regarding vaccine choice, the decision to receive a third dose, or seasonal influenza vaccination. Similarly, no apparent differences were observed in attitudes towards the AstraZeneca vaccine or mandatory COVID-19 vaccination between respondents with and without a medical background.</span></p>

<p style="text-align: justify;"><span class="a_GcMg font-feature-liga-off font-feature-clig-off font-feature-calt-off text-decoration-none text-strikethrough-none">Halogenated boroxine is an important enzyme inhibitor with potential applications in cancer therapy. This study aimed to evaluate its effects on hematological parameters in rats</span><span class="a_GcMg font-feature-liga-off font-feature-clig-off font-feature-calt-off text-decoration-none text-strikethrough-none"> <em>in vivo</em></span><span class="a_GcMg font-feature-liga-off font-feature-clig-off font-feature-calt-off text-decoration-none text-strikethrough-none"><em> </em>and creatine kinase activity </span><em><span class="a_GcMg font-feature-liga-off font-feature-clig-off font-feature-calt-off text-decoration-none text-strikethrough-none">in vitro</span></em><span class="a_GcMg font-feature-liga-off font-feature-clig-off font-feature-calt-off text-decoration-none text-strikethrough-none">. Halogenated boroxine, administered either intraperitoneally (IP) or orally, induced route-dependent changes in hematological parameters compared with controls. IP administration significantly increased neutrophils, mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC), while decreasing hematocrit (HCT). In contrast, oral administration significantly decreased lymphocytes and increased basophils, while other hematological parameters remained unchanged. These effects were more pronounced following IP administration. </span><em><span class="a_GcMg font-feature-liga-off font-feature-clig-off font-feature-calt-off text-decoration-none text-strikethrough-none">In vitro</span></em><span class="a_GcMg font-feature-liga-off font-feature-clig-off font-feature-calt-off text-decoration-none text-strikethrough-none">, halogenated boroxine exhibited competitive inhibition of creatine kinase without pre-incubation, whereas after a 30-minute pre-incubation, the inhibition pattern indicated a non-competitive mechanism. Further analysis showed a time-dependent shift in creatine kinase inhibition mechanism following pre-incubation, characterized by a decrease in maximum reaction velocity (V</span><span class="a_GcMg font-feature-liga-off font-feature-clig-off font-feature-calt-off text-decoration-none text-strikethrough-none font-size-modifier vertical-align">max</span><span class="a_GcMg font-feature-liga-off font-feature-clig-off font-feature-calt-off text-decoration-none text-strikethrough-none">), while the Michaelis constant (K</span><span class="a_GcMg font-feature-liga-off font-feature-clig-off font-feature-calt-off text-decoration-none text-strikethrough-none font-size-modifier vertical-align">m</span><span class="a_GcMg font-feature-liga-off font-feature-clig-off font-feature-calt-off text-decoration-none text-strikethrough-none">) remained unaltered. These findings show that halogenated boroxine modulates specific hematological parameters and inhibits creatine kinase activity, with effects depending on the route of administration and experimental conditions.</span></p>

Background/aim: Hemodialysis patients face a high burden of cardiovascular diseases, which account for over 40% of mortality in this population. In these patients, approximately two-thirds of cardiovascular deaths are due to arrhythmia. The aim of this study was to determine whether the ultrafiltration rate is associated with morphological and functional parameters of the left heart and arrhythmias. Methods: This work was a cross-sectional observational clinical study, with 75 hemodialysis patients. Patients were divided into two groups based on ultrafiltration rate (UFR): higher-UFR group, ultrafiltration rate ≥ 10 mL/kg/h (n = 37); lower-UFR group, ultrafiltration rate < 10 mL/kg/h (n = 38). All patients were analyzed for myocardial morphological and functional parameters and arrhythmias. Results: Statistically significant higher values were observed for the left atrium diameter (LAD) (47.56 ± 4.82 vs. 44.75 ± 2.33 mm, p = 0.0019), the left atrial volume index (LAVI) (43.28 ± 7.13 vs. 36.43 ± 8.52 mL/m2, p = 0.0003), and the left ventricular mass index (LVMI) (138.47 ± 29.32 vs. 116.04 ± 31.64 g/m2, p = 0.0021) in the higher-UFR group. UFR was associated with LAD (OR: 3.6000, 95% CI: 1.3780–9.4053, p = 0.0089), LAVI (OR: 4.1067, 95% CI: 1.5478–10.8956, p = 0.0045), and LVMI (OR: 4.7619, 95% CI: 1.6825–13.4774, p = 0.0033). The frequency of ventricular and supraventricular arrhythmias was similar between the analyzed patient groups. Conclusions: Higher UFR was associated with structural changes in the left heart (LAVI, LAD, and LVMI), but not with other echocardiographic parameters or arrhythmias in hemodialysis patients.

KV cache memory and bandwidth costs grow with context length and batch size, which limits efficient long-context inference. To address this bottleneck, we introduce WUSH-KV for low-bit KV-cache quantization. It adapts WUSH, which constructs a data-aware transform from the second-order statistics of both factors in a matrix product to reduce quantization error. WUSH-KV uses calibration data to construct separate key and value transforms, with the value transform folded into the model weights and the key transform applied after RoPE. The transforms can be paired with clipped quantizers. For one such quantizer, QuEST INT, we show that, under mild assumptions, the WUSH transform is near-optimal. With this quantizer, WUSH-KV reduces layerwise reconstruction error and achieves the lowest end-to-end perplexity among other tested transforms. For end-to-end evaluation, we integrate WUSH-KV into SGLang using OSCAR-style percentile-clipped affine quantization. At 2-bit, WUSH-KV performs comparably to or outperforms the OSCAR transform across all evaluated models and downstream tasks.

The present study investigated whether script type (Latin vs. Cyrillic) differentially influences the temporal characteristics of handwriting in children with dyslexia, chronological age-matched controls (CA), and spelling-level matched controls (SL). Four tasks varying in cognitive and linguistic demands were administered: name and surname writing, an alphabet task, a dictation task including real words, pseudowords, and nonwords, and a text composition task. Temporal handwriting measures were obtained using Eye and Pen software. Writing in Cyrillic generally required longer total task duration than writing in Latin. Across groups, total task duration was longer in Cyrillic during the name and surname, alphabet, real word, and composition tasks. Significant Group × Script interactions for total task duration were observed only in the pseudoword and nonword tasks, indicating that the CA and SL groups required more time to write in Cyrillic than in Latin, whereas no significant script-related difference was observed in the children with dyslexia. A significant Group × Script interaction for pen speed was observed only in the pseudoword task, where children with dyslexia wrote faster in Cyrillic than in Latin. In the composition task, Cyrillic was associated with longer writing duration, longer pause duration, and a greater percentage of pause time across groups, whereas a significant Group × Script interaction was observed only for between-word pauses. The findings suggest that script-specific visual-orthographic characteristics contribute to handwriting performance, while differences between children with dyslexia and typically developing peers emerge for selected handwriting measures under specific task demands.

PURPOSE/BACKGROUND Tumors with microsatellite instability high/mismatch repair-deficient (MSI-H/dMMR) exhibit distinct biological features and are associated with Lynch syndrome. Current approaches for detecting MSI-H/dMMR status rely on immunohistochemistry or molecular assays. Recent advances in digital pathology have enabled the extraction of clinically relevant molecular tumor features from routine hematoxylin and eosin (H&E)-stained diagnostic slides. Image-based deep learning approaches have the potential to screen for MSI-H/dMMR at scale in tumor types such as localized prostate cancer, in which MSI-H/dMMR is so rare that traditional testing is not routinely performed. EXPERIMENTAL DESIGN We developed and validated PathStage-MSI, a multi-stage transfer learning framework to predict MSI-H/dMMR status from H&E-stained slides. The model was trained and validated on 984 standard-of-care whole slide images (n = 906 patients) from three international clinical prostate cancer cohorts with matched H&E images and genomic data. To assess model generalizability and stability, we additionally evaluated PathStage-MSI in an independent metastatic prostate cancer cohort comprising 85 WSIs from 29 patients. RESULTS PathStage-MSI achieved the area under the receiver operating characteristic curve (AUROC) of 0.89 [0.79 - 0.96] and 0.91 [0.81 - 0.98] in two internal hold-out validation cohorts, 0.75 [0.57 - 0.88] and 0.81 [0.66 - 0.94] in two independent external validation cohorts. CONCLUSIONS PathStage-MSI is a deep learning-based image analysis framework for detecting MSI-H/dMMR prostate cancer directly from routine histopathology. By enabling efficient pre-screening for this rare molecular subtype, it has the potential to improve patient identification for precision therapies and appropriate germline genetic testing.