Multimorbidity refers to the presence of multiple co-existing conditions, but is often underappreciated in the context of severe asthma (SA) management. We sought to identify differences in approaches to multimorbidity management in SA, variability in access to multidisciplinary team (MDT) resources, and whether physician perspectives on multimorbidity differ between SA specialists and general respiratory physicians. The Severe Heterogeneous Asthma Registry, Patient-centred (SHARP) Clinical Research Collaboration circulated an online physician survey via European national respiratory societies to assess a) available resources to address multimorbidity and b) physician perspectives on multimorbidity in SA. 495 responses from 25 European countries included 48% SA specialists and 52% general respiratory physicians. SA specialists had more experience with SA patients (20% seeing>60 patients/month) compared to general respiratory physicians. SA specialists had greater access to multidisciplinary care – including better access to MDT, allied health professionals and referrals to external specialists and therefore more routinely assessed comorbidities and considered them greater influences on their practice. They also considered multimorbidity to a greater degree, and rated its impact on their patients’ asthma outcomes (and general health outcomes) as more substantial. Alongside more experience of treating SA, SA specialists have increased awareness of multimorbidity and better resources to manage it. However, access to MDTs remains a significant gap for both SA specialists and general respiratory physicians. Furthermore, both groups identified a high need for further education and training about multimorbidity. These findings highlight key areas for improvement in clinical practice, resources and training.

This translational synthesis highlights the potential role of obesity-induced low-grade chronic inflammation in modulating clinical outcomes among patients with spondyloarthritis (SpA). Obesity transforms adipose tissue into a pro-inflammatory endocrine organ, where hypertrophic adipocytes release adipokines such as leptin alongside cytokines including TNF-α and IL-6, potentially contributing to macrophage polarization toward an M1 phenotype and activating NF-κB signaling pathways. This systemic immunometabolic priming may lower activation thresholds at the enthesis—the primary pathological site in SpA—potentially amplifying IL-23/IL-17 axis activity via Th17 bias, innate-like lymphocyte responses, and stromal–immune crosstalk under mechanical stress. Clinically, patients with SpA and obesity have been reported to demonstrate heightened disease activity (BASDAI, ASDAS), impaired function (BASFI), accelerated radiographic progression (syndesmophytes, enthesophytes), and diminished biologic response rates, potentially attributable to pharmacokinetic alterations (e.g., subtherapeutic TNF inhibitor levels) and pharmacodynamic resistance. Multisystem comorbidities, including non-alcoholic fatty liver disease, cardiovascular events, metabolic syndrome, sleep disturbances, and depression, further exacerbate morbidity and diminish quality of life. Therapeutic implications emphasize obesity as a modifiable disease modifier. Weight loss interventions, including hypocaloric diets, anti-inflammatory regimens (e.g., Mediterranean diet), multicomponent exercise, GLP-1 receptor agonists, and bariatric surgery, have been associated with reductions in inflammatory biomarkers, improved remission rates (MDA, DAPSA), and prolonged drug survival by restoring adipokine balance and disrupting mechano-inflammatory loops. Future randomized controlled trials should prioritize long-term evaluations of integrated multidisciplinary strategies that combine metabolic optimization with immunomodulatory therapies, addressing adherence challenges through psychological support and patient-tailored protocols, while elucidating dose–response relationships for GLP-1RAs and exercise in diverse SpA subtypes to establish precision management paradigms that mitigate cardiometabolic burden and improve holistic outcomes.

The semiconductor industry is foundational to modern technology, yet its complex global multi-relational firm network remains poorly understood, posing challenges to scientists, firms, and policymakers. Traditional analysis relies on proprietary databases that are often expensive, incomplete, and slowly updated, limiting their ability to capture rapidly evolving dependencies. Here, we demonstrate that a novel, generalizable methodology combining Large Language Models (LLMs) with open web data can reconstruct this network and its structural dynamics at scale. We identify and classify supply-chain, partnership, and ownership links from 170 million semiconductor firm webpages, yielding a temporal network of over 1,300 linked firms. We validate link-extraction quality (Precision: 0.884; F1-score: 0.784), network overlap and complementarity with a proprietary database, and consistency with aggregate economic data. Our network reveals a temporary 9% decline in edges during the 2022 chip shortage, rapid increases in the centrality of AI supply-chain bottleneck firms such as NVIDIA, and geographic realignment of interfirm relations amid geopolitical turbulence. This generalizable framework overcomes barriers to transparency and provides essential, up-to-date maps for assessing resilience and informing policy across strategically relevant sectors.

This study aimed to provide a more in-depth analysis of the fruit quality of three table grape varieties: 'Moldova', 'Lasta', and 'Italia', cultivated in the Žepče area (Bosnia and Herzegovina). The findings from the comparative analysis indicated substantial variations in grape quality among the studied varieties. 'Moldova' grapes exhibited significantly higher total soluble solids and pH values than those of the other table grape varieties. 'Moldova' also had higher total phenolic and flavonoid contents in the grape skin relative to 'Italia' and 'Lasta'. On the other hand, 'Italia' variety showed the highest titratable acidity, followed by 'Lasta' and 'Moldova'. Total phenolic and flavonoid contents were highly positively correlated with the antioxidant capacities of all analyzed grape samples, suggesting that phenolic compounds contribute significantly to the antioxidant properties of grapes. Study results also indicated that all heavy metal levels tested in grapes were below the threshold limits, which was expected considering that the experimental soil was not contaminated with the heavy metals being assessed. Overall, the results from the study have shown that all grape varieties studied hereby displayed a satisfactory level of quality based on key chemical parameters, and that the experimental area is quite favorable for their cultivation.

We develop a framework in which Yukawa hierarchies arise from powers of fully anarchic spurions transforming in higher representations of the flavor symmetry group $SU(2)^{n_2}\times SU(3)^{n_3}$. The core mechanism is the progressive lifting of Yukawa ranks through successive outer products of composite doublets and triplets. We formulate the general construction in detail and build explicit models realizing it. We then investigate whether renormalizable scalar potentials for higher $SU(2)$ representations can dynamically generate anarchic spurions with non-vanishing composites. The framework predicts distinctive patterns in flavor-changing neutral currents and potentially observable stochastic gravitational-wave backgrounds.

In this paper, we study a discrete-time host–parasitoid model in which the host survival probability is governed by a general escape function that satisfies natural biological constraints. The host population follows a Beverton–Holt growth model, while a constant number of individuals remains in a refuge each generation. Both host availability and current parasitoid density influence parasitoid population dynamics. We show that the system admits three possible equilibrium outcomes: no equilibrium, a parasitoid-free equilibrium, or a unique interior equilibrium where both species coexist. Conditions are established under which the parasitoid-free equilibrium is globally asymptotically stable. In certain parameter ranges, we prove the occurrence of transcritical bifurcation at the boundary equilibrium and Neimark–Sacker bifurcation at the interior equilibrium. Despite the possibility of complex behavior, we prove that, within specific parameter ranges, the system is uniformly persistent and permanent, ensuring the long-term survival of both populations. Numerical simulations are included to support and illustrate the theoretical results.

The dark web hosts a dynamic ecosystem of cybercrime forums and marketplaces that adapt to law enforcement pressure, technological change, and economic incentives. Prior research has extracted cyber threat intelligence from these platforms using static snapshots, with limited attention to how discussions evolve over time. In this study, we conduct a longitudinal analysis of 25,065 websites in the dark web using 11,403,638 HTML snapshots (approximately 1245.38 GB) collected over six years. We develop a longitudinal topic-modeling framework combining domain-specific embeddings, density-based clustering and temporal aggregation to measure topic prevalence and lifecycle at the website level. Our analysis identifies 55 thematic clusters. We find that approximately 75% of total discussion volume is concentrated in a small set of persistent core topics, while short-lived themes account for approximately 3% of activity. The median topic lifespan is 75 months, indicating gradual thematic evolution rather than abrupt replacement.

Global reporting of obesity is commonly based on comparisons over multiple decades1 and lacks a granular and systematic analysis of its dynamics. We used 4,050 population-based studies with measured height and weight data on 232 million participants to assess the worldwide dynamics of obesity from 1980 to 2024. The rise in obesity decelerated in school-aged children and adolescents throughout the 1990s in many high-income countries, and subsequently plateaued in most at age-standardized prevalences spanning 20 percentage points, from 3–4% for girls in Japan, Denmark and France to 23% for boys in the USA. There were indications of a small decline in obesity in children and adolescents in some high-income western countries (for example, Italy, Portugal and France) since the 2000s. Similar trends were seen in some countries in Central and Eastern Europe. In adults, the rise in obesity slowed down in high-income western countries about a decade after children, followed by a plateau or possibly a small reversal of the rise in some countries (for example, Spain). In most low-income and middle-income countries, the annual absolute change in prevalence has remained stable or increased over time, even though prevalence has surpassed that of high-income countries. These highly varied dynamics suggest that the social, economic and technological trends that influence the availability, affordability and use of different foods may have helped control the rise in obesity in high-income countries, but require policy interventions in low-income and middle-income countries.

Primary hypothermia arises from prolonged exposure to low environmental temperatures without underlying pathology, whereas secondary hypothermia is triggered by impaired thermoregulation due to factors such as disease, trauma, or substance use. This study aimed to investigate core temperature changes in rats exposed to specific water temperatures over time, with a focus on differentiating primary and secondary hypothermia induced by alcohol and benzodiazepines.Survival analysis was performed using Kaplan–Meier survival curves to compare the time to event (in minutes) among three experimental groups: Control, ethanol, and Diazepam. Core temperatures were recorded at five key points: baseline (normal temperature), post-ketamine anesthesia, during immersion, at hypothermia onset, and at the time of death. Survival times were also recorded and statistically analyzed. Median survival times were highest in the control group (35 minutes), followed by Diazepam (29 minutes) and ethanol (28 minutes). Pairwise comparisons using the log-rank test, adjusted for multiple comparisons via the Benjamini-Hochberg method, revealed a statistically significant difference between the control and diazepam groups (p = 0.018), with the control group demonstrating longer survival time. A significant interaction between Diazepam and time was observed (β = -0.23, 95% CI: -0.35 to -0.12, p < 0.001), indicating that the rate of temperature decline over time was significantly greater in the Diazepam group compared to the control group. Our results indicate that Diazepam accelerates the decrease in body temperature over time, which may contribute to its observed effect on survival, and that Diazepam administration is associated with a significant reduction in survival time compared with untreated controls. Ethanol did not significantly alter the measured thermoregulatory or survival outcomes in this pilot study. Any potential forensic relevance of ethanol-induced hypothermia remains speculative and requires further investigation in larger, adequately powered studies. Our results could have potential forensic implications in differentiating between primary and drug-induced as secondary hypothermia in medico-legal investigations.