BACKGROUND The 2023 iteration of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) estimated prevalence, incidence, and health burden for 375 diseases and injuries, including 12 mental disorders. We assess past, current, and emerging trends in the prevalence and burden of mental disorders across sexes and age groups, for 21 regions, 204 countries and territories, and by Socio-demographic Index (SDI) quintile, from 1990 to 2023. METHODS Mental disorders included in GBD 2023 were anxiety disorders, major depressive disorder, dysthymia, bipolar disorder, schizophrenia, autism spectrum disorders, conduct disorder, attention-deficit hyperactivity disorder, anorexia nervosa, bulimia nervosa, idiopathic developmental intellectual disability, and a residual category of other mental disorders. A literature review identified epidemiological data for each disorder. These were analysed via a Bayesian meta-regression to estimate prevalence by disorder, sex, age, location, and year. Disorder-specific prevalence was multiplied by disability weights representing the severity of health loss associated with each disorder to estimate years lived with disability (YLDs). Deaths due to anorexia nervosa were assessed with a Cause of Death Ensemble modelling strategy to estimate deaths by sex, age, location, and year, and then multiplied by the standard life expectancy at age of death to estimate years of life lost (YLLs). YLDs equalled disability-adjusted life-years (DALYs) for all mental disorders except anorexia nervosa (the only mental disorder considered as an underlying cause of death in GBD), for which DALYs represented the sum of YLDs and YLLs. We presented prevalence, deaths, YLDs, YLLs, and DALYs as counts, age-specific rates per 100 000 population, and age-standardised rates per 100 000 population. FINDINGS We estimated 1·17 billion (95% uncertainty interval 1·06-1·31) prevalent cases of mental disorders globally in 2023, equivalent to an age-standardised prevalence rate of 14 210·7 cases (12 849·5-15 940·1) per 100 000 population. These estimates represented a 95·5% (75·0-121·2) increase in prevalent cases and 24·2% (11·4-41·4) increase in age-standardised prevalence rate between 1990 and 2023. All mental disorders showed increases in prevalent cases between 1990 and 2023, while notable increases were seen in age-standardised prevalence rates for anxiety disorders, major depressive disorder, dysthymia, anorexia nervosa, bulimia nervosa, schizophrenia, and conduct disorder. There were an estimated 171 million (127-228) DALYs due to mental disorders globally across sex and age in 2023, equivalent to an age-standardised DALY rate of 2070·5 DALYs (1519·1-2750·5) per 100 000 population. Mental disorders contributed to 6·1% (4·8-7·6) of all-cause DALYs in 2023, making them the fifth leading cause of global DALYs (up from 12th in 1990). DALYs were almost entirely composed of YLDs. Mental disorders were the leading cause of YLDs in 2023 (up from second in 1990), explaining 17·3% (14·8-20·6) of all-cause global YLDs. Leading causes of mental disorder DALYs were anxiety disorders (ranked 11th among the 304 diseases and injuries at Level 4 of the GBD cause hierarchy), major depressive disorder (15th), and schizophrenia (41st). Globally in 2023, mental disorder age-standardised DALY rates were higher among females (2239·6 [1643·7-3014·1] per 100 000) than among males (1900·2 [1399·8-2510·8] per 100 000), and peaked in the 15-19 years age group (2617·3 [1850·6-3696·8] per 100 000). All locations showed increased mental disorder DALY rates in 2023 compared with 1990, ranging across countries and territories from 1302·4 (952·7-1683·7) per 100 000 in Viet Nam to 3555·8 (2661·9-4715·0) per 100 000 in the Netherlands. Across SDI quintiles, DALY rates ranged from 1853·0 (1352·1-2469·3) per 100 000 for middle SDI to 2184·1 (1606·1-2890·3) per 100 000 for high SDI. INTERPRETATION A significant health burden was imposed by mental disorders in all countries and territories in 2023, irrespective of the health resources available. In some instances, this burden has increased over time and is unevenly distributed across populations. Stronger surveillance systems, particularly in low-income and middle-income countries, are required. Additionally, we need more coordinated and inclusive policies to reduce the burden through early treatment and prevention, tailored to sex and age differences across locations. Responding to the mental health needs of our global population, especially those most vulnerable, is an obligation, not a choice. FUNDING Gates Foundation, Queensland Health, and University of Queensland.

Background There are conflicting guidelines on whether patients with type 2 diabetes mellitus should withhold or continue glucose-lowering drugs before surgery, especially newer agents. We tested the hypothesis that continuing glucose-lowering drugs increases days alive at home and out of hospital at 30 days (DAH-30). Methods We performed a secondary analysis of a prospective, observational study in 21 European countries of patients with type 2 diabetes mellitus undergoing elective surgery. The primary outcome was DAH-30. The exposure of interest was the continuation or discontinuation of glucose-lowering drugs (metformin, sodium-glucose cotransporter 2 inhibitors [SGLT2i], glucagon-like peptide-1 receptor agonists [GLP-1 RA]). Median (interquartile [IQR]) values are shown. Results Between January 2021 and December 2024, 5767 participants with type 2 diabetes mellitus (age 64 [range: 22–89] yr; 43% female) were enrolled from 89 centres, with 4988 (87%) undergoing elective surgery. For 3623/5767 (73%) participants receiving metformin, DAH-30 was higher (28 days [24–29]) in 421/3623 (12%) participants who continued metformin on the day of surgery compared with 27 days (23–29) in 3202 of 5767 (88%) participants who had not taken metformin (P=0.001). After adjusting for prespecified covariates, continuing metformin on the day of surgery remained associated with higher DAH-30 (0.47 days [95% confidence interval:0.01–0.93]; P=0.044). No association was found for either stopping/continuing SGLT2i (n=836 participants) or GLP-1 RA (n=304 participants) with DAH-30. Conclusions Continuing metformin during surgery among patients with type 2 diabetes mellitus was associated with marginally shorter DAH-30, but the sample size for participants receiving SGLT2i and GLP-1 RA therapy precluded any meaningful estimates. Tracker ID ESA-IC_CTN_MOPED.

This study investigates early‐age carbonate mineralization in cementitious systems using in situ Raman microspectroscopy. In the presence of dissolved CO2, clinker phases undergo accelerated dissolution, decomposing to form various calcium carbonate polymorphs and a transient amorphous silica gel network. Once the available CO2 is consumed, clinker hydration resumes, leading to delayed calcium–silicate–hydrate (C–S–H) and portlandite (Ca(OH)2) formation. The precipitation of portlandite through the pore network triggers a localized pozzolanic reaction at the silica gel–portlandite interface, yielding a distinct calcium–silicate–hydrate (C–S–H*). This templated mechanism produces a homogeneous and highly polymerized binder, leading to improved 24‐h compressive strength compared to reference samples. Correlation function analysis confirms that the evolution of silica gel, portlandite, and C–S–H follows a three‐stage sequence—mineralization, transition, and stabilization—quantitatively demonstrating a strong spatial anticorrelation between silica gel dissolution and portlandite precipitation. These findings establish a new chemomechanical framework for CO2 mineralization in cement, highlighting transient silica gel as a critical intermediate for engineering sustainable, high‐performance concrete.

Abstract Objectives Clinical trial data are lacking for treatment of patients with juvenile systemic sclerosis (jSSc). Three published recommendations exist for jSSc but real-world data on treatment patterns are lacking. The aim of this study was to analyse treatments used in the jSSc inception cohort (jSSci) and compare to published recommendations on the treatment of jSSc. Methods Data was extracted for patients with 24 months follow-up visits in the jSSci up until June 2023. Medications used and their association with clinical characteristics were analysed. Logistic regression analyses were performed to compare treatments between limited and diffuse cutaneous jSSc subtypes, organ involvement and time of initiation of treatment. Multilevel mixed effects logistic regression analyses were used to evaluate the change in medication use in follow-up. Treatment patterns were compared against published recommendations. Results 93 patients had 24 months follow-up data. 77% of patients were receiving disease-modifying treatment (DMARD) at enrolment, which increased to 91% at 24 months (p<0.001). Patients with diffuse cutaneous jSSc subtype had significantly more frequently active ulcerations, skin involvement and received any kind of treatment more often compared with limited (97% vs 91%, p=0.047). Methotrexate was used in 52% of patients at enrolment which decreased to 37% at 24 months (p=0.001). Mycophenolate mofetil use increased from 24% to 46% (p<0.001). Biological DMARDs increased from 5% to 22% (p<0.001). The treatment pattern strongly overlapped with the published paediatric guidance. Conclusion This is the first report regarding the pattern of medication use in real life in the currently largest patient cohort of patients with jSSc. The observed pattern overlaps with the published recommendations.

Simple Summary Disease recurrence after allogeneic stem cell transplantation remains the principal cause of treatment failure in patients with myeloid malignancies. One possible explanation is the acquisition of additional genetic alterations by malignant cells over time. In this study, we investigated the emergence of cytogenetic changes at relapse and their association with prior treatment exposure and clinical outcomes. Nearly half of the patients developed cytogenetic changes at relapse. These alterations occurred more frequently in individuals with complex cytogenetic abnormalities at diagnosis, suggesting that an unstable genomic background may predispose further clonal diversification. In contrast, prior chemotherapy, conditioning regimen, and donor type were not associated with the emergence of new abnormalities. Although patients with cytogenetic changes showed a lower early response rate, long-term survival outcomes were not significantly affected. Overall, our findings suggest that cytogenetic alterations at relapse may primarily be driven by disease-intrinsic biological features rather than treatment-related genomic damage.

This paper presents a finite-time super-twisting sliding mode control (STWSMC) framework for robust three-dimensional (3D) trajectory tracking of a quadrotor unmanned aerial vehicle (UAV) operating under exogenous disturbances. The proposed approach ensures continuous control action while preserving finite-time convergence properties. A complete non-linear dynamic model of the quadrotor is considered, including translational-rotational couplings and gravitational effects. Separate STWSMC structures are developed for the altitude and attitude subsystems, guaranteeing robustness against bounded disturbances and model uncertainties without requiring explicit disturbance estimation. A Lyapunov-based stability analysis is carried out, proving finite-time convergence of the sliding variables and finite-time stability of the closed-loop tracking errors. Simulations demonstrate improved transient performance, reduced chattering amplitude, and enhanced robustness—particularly in yaw dynamics—when compared to a conventional second-order sliding mode control (SOSMC) scheme. The obtained results indicate that the proposed STWSMC strategy provides a theoretically sound and practically viable solution for high-performance quadrotor control.

This paper presents a concise, application-focused description of using EEZ Studio (Envox Experimental Zone) as a practical environment for system identification, data acquisition, and implementation of controllers on the programmable power supply EEZ BB3. The work demonstrates how EEZ Studio integrates SCPI control, MicroPython/JS scripting, and direct interaction with instruments (oscilloscopes and BB3) to perform identification and closed-loop control. The experimental implementation (water-level and DC-motor speed control tasks) used the EEZ BB3 as the actuator with an STM32 Nucleo micro-controller for signal acquisition and UART communication. The results show reliable acquisition, effective controller deployment in the BB3 and stable closed-loop behavior, indicating that EEZ Studio is a feasible tool for rapid prototyping and educational control experiments.

Large Language Models (LLMs) such as ChatGPT and Gemini are reshaping education through personalized learning and data-driven decision-making. This study evaluated LLM classroom feasibility by linking them with PISA student-level data. Using R-based processing, 1,000 structured profiles were submitted to ChatGPT and Gemini APIs to identify academic and socio-emotional strengths, risks, and improvement strategies. Unlike systems that rely on predictive modeling, this approach uses LLMs as interpretive assistants that generate context-aware feedback from standardized educational data without custom model training. Thematic analysis revealed strong cross-model agreement $(\mathbf{r}=\mathbf{0. 8 7})$ and alignment with teacher evaluations ($\mathbf{r}$ = 0.76). ChatGPT provided concise, action-oriented feedback; Gemini offered richer contextual explanations. High inter-rater reliability $\kappa=0.79-0.82)$ confirmed consistent content interpretation. However, the reliance on agreement-based validation introduces a circular reasoning risk that limits causal claims. Findings demonstrate LLMs' potential as real-time educational assistants for early detection and personalized guidance, though input data dependence, bias risks, and limited longitudinal validation remain key limitations.

Hydatidiform mole, the most common form of gestational trophoblastic disease, presents as complete or partial form. Complete hydatidiform mole (CHM) usually presents with prominent histological criteria, whereas partial hydatidiform mole (PHM) shows a wide spectrum of presentations depending on gestational age. Molecular markers enhance the understanding of the variation and heterogeneous presentation of molar pregnancies, as well as their biological potential and behavior. This retrospective study included 50 CHM and 50 PHM specimens, terminated in first trimester via suction curettage. A second histopathological review of slides stained with hematoxylin and eosin was conducted, as well as a selection of representative tissue slides for p53 immunostaining. This study aimed to determine the precise correlation between specific morphological criteria and the patterns of p53 immunoexpression. Semi-quantitative analysis of samples for both pathological criteria and p53 immunostaining was performed. p53 positivity was defined as follow: the percentage of positive cells/nuclei: + (10-40%); ++ (40-70%); +++ (>70%); and staining intensity was scored as: 1 – weak, 2 – moderate, and 3 – strong intensity. P53 expression was estimated on at least 200 nuclei of cytotrophoblasts per slide. Significant difference in p53 expression exist between CHM and PHM in staining intensity. CHM shows significant correlation of p53 positivity with hydrops, central cisterns and atypia. In PHM trophoblast pseudoinclusions demonstrate strong significant correlation with p53 positivity. The irregular pseudoinclusions demonstrate lower expression compared with round or oval, being consistent with benign behavior of PHM. Prominent morphological criteria strongly correlate with p53 immunoexpression for both CHM and PHM.

Covering: January 2005 to July 2025The interplay between Responsible Research and Innovation, the Nagoya and Cartagena Protocols and other legislative frameworks, ethical practices, and intellectual property protection plays a pivotal role in shaping the field of natural products R&D&I, and the bioeconomy. Together, these elements establish a holistic framework for the sustainable and equitable utilization of natural resources, while promoting innovation and supporting economic growth.

Countermovement jump (CMJ) performance is widely used to assess explosive lower-limb function in football players. Although knee isokinetic strength is frequently measured in elite sport environments, the extent to which it relates to CMJ performance remains unclear, particularly when CMJ is performed with free arm movement. Therefore, the aim of this study was to examine the relationship between knee isokinetic muscle strength characteristics and CMJ performance in elite male football players. Twenty-four elite male football players (age 23.83 ± 5.98 years) participated in this cross-sectional study. CMJ height was assessed using an optical measurement system (Optojump Next). Concentric knee extensor and flexor peak torque was measured using an isokinetic dynamometer at angular velocities of 60°/s and 180°/s and expressed as peak torque/body weight% (PT/BW,%). Pearson correlation and linear regression analyses were used to examine associations between isokinetic strength variables and CMJ performance. Bilateral differences, hamstring-to-quadriceps (H/Q) ratios, and inter-limb asymmetries were also analyzed. Significant positive correlations were observed between CMJ height and knee extensor peak torque expressed as PT/BW (%) at both angular velocities. Stronger relationships were found at 180°/s (r = 0.558–0.642, p ≤ 0.005) compared with 60°/s (r = 0.483–0.500, p < 0.05). Regression analyses showed that knee extensor strength at 180°/s explained up to 41.2% of the variance in CMJ height. Hamstring strength demonstrated weaker and less consistent associations with CMJ performance, while H/Q ratios and inter-limb asymmetries were not significantly related to jump height. Quadriceps isokinetic strength expressed as PT/BW (%) was significantly associated with CMJ performance in elite male football players, with stronger relationships observed at higher angular velocity. These findings suggest that knee extensor strength assessed at higher angular velocity is meaningfully associated with explosive lower-limb performance and may provide useful complementary information within routine neuromuscular monitoring in professional football.

Abstract This paper presents two offline, on-premise NLP proof-of-concept assistants built on a shared architecture for internal knowledge access in the Central Bank of Bosnia and Herzegovina: (i) a semantic document search tool for internal Word/PDF repositories and (ii) an HR chatbot that applies retrieval-augmented generation (RAG) over indexed HR policies and procedures. Rather than proposing a novel NLP method, the paper contributes by documenting a reusable offline architecture for institutional AI assistants in a security-constrained central banking environment and by providing pilot evidence on how established semantic retrieval and RAG techniques can be adapted to strict requirements of confidentiality, data sovereignty, and governance. The semantic search assistant combines exact phrase matching with embedding-based retrieval and hybrid re-ranking, while the HR chatbot generates source-grounded answers using locally hosted language models under explicit governance constraints, including B/H/S-only output, strict fallback behaviour, and transparent display of retrieved passages. Pilot results indicate that hybrid retrieval offers the most reliable performance across representative internal queries, while the HR chatbot demonstrates the feasibility of document-grounded employee support under offline institutional constraints. The findings provide preliminary evidence that offline NLP assistants can improve access to internal institutional knowledge while remaining compatible with the security and operational risk requirements typical of central banking environments.

This systematic review analyzed treatment strategies and outcomes for spinal low-grade gliomas, based on data from 63 studies encompassing 954 patients. Surgery was the primary treatment, with gross total or subtotal resection associated with improved survival. Subtotal resection followed by radiotherapy prolonged progression-free survival. Fractionated radiotherapy (45-50 Gy) showed disease stabilization and neurologic improvement, with some studies reporting a 5 year progression-free survival of 93% and an overall survival of 100%. Chemotherapy was mainly used in recurrent cases. Prognosis varied by histology; pilocytic astrocytomas showed excellent survival, while infiltrative gliomas were linked to poorer long-term outcomes.