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Women and Pro-environmental Initiatives in Tourism: The Intersection of Gender Dynamics and Environment Issues
No full textWomen’s involvement, gender equality, and environmental challenges are critical concepts in tourism development, particularly in patriarchal systems where hierarchical value systems create challenges for both nature and women. However, the theoretical framework addressing these issues remains underexplored. This study examined how women interpret their motivations and challenges in these contexts while contributing to tourism-related environmental conservation and navigating patriarchal gender norms. It investigated the lived experiences of Iranian women actively engaged in tourism-related conservational initiatives. The findings revealed that their commitment to pro-environmental initiatives is driven by an intrinsic connection to nature and a desire to resist gender inequalities and challenge male-dominated structures. Despite facing challenges stemming from patriarchal structures, they demonstrate collective resilience against gender stereotypes. Additionally, their participation in tourism pro-environmental projects fosters trust and social recognition, driving incremental social change. This study makes a strong theoretical contribution by exploring gender issues through the lens of ecofeminism theory
Adipocytes in tumour microenvironment promote chemoresistance in triple negative breast 3 cancer through oxysterols
Full text linkObjective: Triple-negative breast cancer (TNBC) patients with excess adipose tissue experience poorer disease-free survival than those with a healthy body mass index.
Adipocytes store and release cholesterol, which can be hydroxylated to form oxysterols. These cholesterol derivatives activate the liver X receptor (LXR) pathway. This study tested the hypothesis that adipocytes contribute to an imbalanced tumour-microenvironment by exposing cancer cells to elevated oxysterols, mimicking chemotherapy-exposure conditions and priming for chemoresistance.
Methods: Tumour tissue microarray from 148 TNBC patients was assessed using immunohistochemistry for CH25H, CYP46A1, CYP27A1 and P-glycoprotein (Pgp), expression and survival outcomes assessed. Gene expression was compared between tumours from patients (GSE78958) and mouse models (GSE151866) with high versus low adiposity. In vitro, cell lines from lineages fount in the tumour-microenvironment were evaluated for oxysterol content, secretion, expression of relevant enzymes, and ability to induce Pgp expression and drug resistance in TNBC cells.
Results: In patients, stromal expression of oxysterol-synthesizing enzymes correlated with Pgp expression in cancer epithelial cells and was associated with shorter disease-free survival. Adipocytes conditioned media contained significantly higher oxysterols levels than that conditioned by other cell types and induced Pgp expression and drug resistance in MDA.MB.468 cells. Obese mice had elevated levels of Pgp in tumours compared to lean
counterparts.
Conclusions: Adipocytes secrete oxysterols that promote drug resistance in vitro and correlate with oxysterol:Pgp axis and survival in vivo.
Significance: This study reveals a mechanism by which adipose tissue contributes to drug resistance in ER-negative breast cancers, identifying the oxysterol-Pgp axis as potential therapeutic target
Experiences of bullying and harassment, including sexual harassment, amongst ENT trainees in the UK: survey findings
No full textObjectives
The Association of Otolaryngologists in Training (AOT) wanted to assess the experiences of bullying, harassment and raising concerns in their Ear, Nose and Throat (ENT) posts.
Methods
An online survey of ENT trainees, with 190 responses out of 350 targeted, included questions on bullying and harassment.
Results
Many respondents had experienced or witnessed a range of bullying, harassment and sexual harassment behaviours, including: unrealistic expectations about workload, responsibilities or level of competence; inadequate or absent supervision; and undervaluing someone’s contribution (in their presence or otherwise). However, very few (5% or less) had reported them. 21% would not feel confident in reporting bullying/harassment or sexual harassment problems and 40% do not feel safe raising concerns. Just 10% said the existing reporting mechanisms are sufficient.
Conclusions
A number of initiatives have been introduced recently in the UK to address bullying and harassment within the medical workplace, but there is still potential for further development
Enhancing Cardiovascular Disease Prediction: Optimised Feature Selection and Machine Learning Techniques for Improved Accuracy
No full textCardiovascular disorders (CVD) make a notable contribution to the global death toll, signifying the urgent need for precise prediction and proactive management tools. This study investigates the incorporation of advanced feature selection techniques with machine learning models to provide better predictions regarding cardiovascular disease in terms of accuracy and clarity. A merged healthcare dataset was used to address the common challenges such as small data size, incomplete or missing data and high dimensionality. Feature selection and dimensionality reduction through PCA and SHAP were used according to how much variance and importance they applied to features. The result demonstrates that SHAP-extracted features, which are fewer, obtained better performance compared to PCA and full-feature models. In addition, the fewer features from SHAP offered a more computationally efficient and interpretable solution. These results underscore the potential of incorporating explainable AI into clinical decision-making processes and the early diagnosis of cardiovascular disease
Mitigating Data Scarcity in Healthcare through Wasserstein Generative Adversarial Network- A Case Study in Medical Application
No full textBreast cancer represents a significant public health challenge, necessitating accurate predictive models for timely diagnosis and effective treatment. However, the scarcity and privacy constraints of medical datasets present substantial obstacles to developing robust predictive models. This study explores the application of Wasserstein Generative Adversarial Network (WGAN) to mitigate these challenges by generating synthetic breast cancer data. Using a comprehensive methodology that includes feature engineering, WGAN training, and model evaluation techniques, this research demonstrates the potential and effectiveness of integrating GAN-generated synthetic data into predictive modeling tasks. Evaluation metrics like Mean Squared Error (MSE) and Wasserstein distance (WD) are used to evaluate the quality of the generated data. Additionally, Random Forest is employed to evaluate model performance through accuracy scores and Area Under Curve (AUC) scores, which help assess the effectiveness of the predictive model for real, synthetic and combined data. The findings highlight the potential of WGAN to effectively enhance data availability and diversity, thereby improving predictive model performance in applications like breast cancer diagnosis and prognosis. In the future, ongoing advancements in GAN technology offer promising opportunities to refine data-driven methodologies in healthcare and advance patient care outcomes
Predictive models for immune checkpoint inhibitor response in cancer: A review of current approaches and future directions
Full text linkCheckpoint inhibitors have revolutionised cancer treatment, yet only 20–30 % of patients achieve durable responses, highlighting the critical need for predictive models. This review focuses on PD-1/PD-L1 pathway inhibitors as monotherapy, examining current prediction frameworks spanning biomarker-based approaches, multi-omics integration, mathematical modelling, and artificial intelligence applications. Recent advances include SCORPIO and LORIS machine learning systems demonstrating superior statistical performance compared to traditional biomarkers, with area under curve values of 0.763. However, critical analysis reveals significant limitations in external validation across diverse healthcare settings, with many promising models failing to maintain performance outside their development institutions. Traditional pathological assessment by expert pathologists, including standardised PD-L1 scoring and tumour-infiltrating lymphocyte quantification, continues to form the foundation of clinical decision-making and provides essential validation for emerging AI approaches. Despite extensive research, established biomarkers show limited predictive accuracy, with PD-L1 demonstrating predictive value in only 28.9 % of FDA approvals. Multi-feature models incorporating genomic and clinical data show improved accuracy but face substantial validation challenges. Integration of spatial biomarkers and digital pathology has enhanced capabilities, achieving area under curve values of 0.84 in select studies. The most critical challenge is the “validation gap”, many models show excellent single-institution performance but fail external validation, limiting clinical translation. Current obstacles include inadequate standardisation, interpretability concerns, and healthcare system integration difficulties. Future directions must prioritise rigorous multi-institutional validation studies, development of clinically implementable frameworks, and addressing practical deployment challenges to realise precision immunotherapy's potential
Perfectionism, School Burnout, and School Engagement in Gifted Students: The Role of Stress
Full text linkThere is evidence that many gifted students set unrealistically high personal standards and that such perfectionistic tendencies may lead to higher stress. To build on this evidence, we examined whether performance perfectionism and school stress influence school burnout and school engagement in gifted students. A sample of 342 gifted students (Mage = 16.27, SD = 0.49) completed the study measures. Using structural equation modelling, we found that dimensions of performance perfectionism indirectly predicted school burnout and engagement via school stress. When gifted students reported that they expected themselves to perform perfectly at school, or that others expected them to perform perfectly at school, they reported more school stress. In turn, higher levels of school stress were related to increased school burnout and decreased school engagement. The management of performance perfectionism and school stress is therefore important when it comes to supporting and safeguarding gifted students
Neurobiological and neuropsychological disturbance in EDS
Full text linkEhlers-Danlos Syndrome (EDS) is a collection of connective tissue disorders, defined by genetic defects in collagen and extracellular matrix proteins that lead to joint hypermobility, skin fragility, and vascular complications. However, recent studies point to a broader impact, revealing how EDS has both neurological and psychological effects. This review explores these neurological and neuropsychological dimensions of EDS across its 13 subtypes, drawing together evidence on brain structure changes such as Chiari malformations and craniocervical instability, alongside small fibre neuropathy, blood–brain barrier vulnerabilities, and cerebrovascular risks, particularly prevalent in the vascular EDS subtype. The review will also explore how these physical disruptions may act upon mental health, fueling anxiety, mood instability, and cognitive challenges. Mechanisms such as neuroinflammation, altered interoception, and chronic pain may contribute to these effects and drive emotional dysregulation. By reviewing clinical observations, neuroimaging findings, and emerging theories, this paper highlights the importance of understanding the involvement of the brain in EDS. The review highlights the need for a shift in approach to EDS, and an integrated effort across neurology, psychiatry, and genetics to better support those living EDS
User-Centered Assessment of MRI Equipment Flexibility, Workspace Adequacy, User Interface Usability, and Technical Proficiency
No full textThe effective operation of magnetic resonance imaging (MRI) systems relies on physical interactions with complex imaging environments, equipment, and user interfaces (UIs). However, there is limited empirical data evaluating how physical interactions with MRI equipment and accessories, workspace configuration, MRI UI design, and technical proficiency influence clinical workflow. In this study, a cross-sectional survey was conducted among MRI end-users, across public and private health facilities (n = 13), using a structured questionnaire to assess demographics, patient positioning and equipment handling, MRI workspace adequacy, interface usability (guided by Nielsen's heuristics), and self-reported MRI skill proficiency. The predominant field strength of scanners in current use was 1.5T. General Electric was the most frequently used MRI scanner brand. Most respondents received their MRI training from nonvendor sources—such as academic institutions or peer-based instruction—rather than directly from equipment manufacturers. High ease-of-use ratings were reported for patient positioning and equipment handling tasks. Workspace adequacy was mostly rated as very adequate to highly adequate. Computed Tomography-experienced users showed moderate-to-high proficiency in MRI pulse sequencing and image optimization. However, lower proficiency was noted in quality assurance and physiologic monitoring. Help documentation within the MRI interface received the lowest usability scores. No significant differences in usability or proficiency were found between those trained by vendors versus nonvendors (U = 8.5–15.0; p = 0.376–0.921). Opportunities exist to enhance clinical workflow and patient throughput by refining error-handling features, improving support documentation, reinforcing ongoing professional development, and re-evaluating training delivery by incorporating iterative, multimedia-based learning modules and regular postinstallation refresher sessions. End-user input in UI design and user feedback analysis should be prioritized to improve system usability and clinical efficiency
The Spectral West: Supenature and the Gothic in the Western Film
No full textThis book considers the presence of the supernatural and Gothic elements of the Western on screen. These dark and sinister undertones often exist in Western narratives to draw attention to the ever-present issue of death and its haunting resonance which characters encounter. This book examines this through key historic moments in Western film and its contemporary incarnations. The book detects imposing correlations in themes and currents between the Gothic and the Western relating to existential crisis and a loss of faith in ideologies and institutions. These themes represent the tensions between the old and the new, the deranged insistence on civility and order in a chaotic landscape, disillusionment and the shattering of faith in the natural order, and even nature and order themselves. The Western, just like the Gothic tale, reminds us that new frontiers are mired in the past, and optimism and survival are hunted down and haunted by guilt-ridden past and passed anxieties and traumas