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A comprehensive outline of antimicrobial resistance, antibiotic prescribing, and antimicrobial stewardship in South Africa: A scoping review protocol

Introduction The global prevalence of antimicrobial resistance transcends geographical and economic boundaries, affecting populations worldwide. Excessive and incorrect use of antibiotics encourages antimicrobial resistance which leads to complex treatment strategies for infectious diseases and possible failure of treatment. The incorrect and unnecessary prescribing of antibiotics places a burden on healthcare costs and thus, antimicrobial resistance is evident globally as a major public health concern. The impact is particularly pronounced in low to middle-income countries, where limited access to healthcare exacerbates the crisis. This scoping review aims to comprehensively map the evidence of antimicrobial resistance in healthcare settings, encompassing the exploration of antibiotic prescribing practices and the implementation of antimicrobial stewardship initiatives in South Africa. Methodology This protocol has been registered in the Open Science Framework (https://doi.org/10.17605/OSF.IO/PWMFB). This review will consider all types of study designs, conducted within South Africa. Studies that are published in English for the period 2019–2024, and that explore antimicrobial resistance (AMR) evidence in healthcare in South Africa, including antibiotic prescribing trends and antimicrobial stewardship and surveillance initiatives will be included. Non-English publications, studies outside of South Africa, animal and environmental studies will be excluded. The criteria for the scoping review will be set by two reviewers. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews (PRISMA-ScR) tool will be used. Studies will be identified through an extensive search of peer-reviewed and grey literature databases. The results of the review will be tabulated and include a narrative synthesis of the findings.

Unraveling the interactive effect of opaque2 and waxy1 genes on kernel nutritional qualities and physical properties in maize (Zea mays L.)

Generalized functional varying-index coefficient model for dynamic synergistic gene-environment interactions with binary longitudinal traits

The genetic basis of complex traits involves the function of many genes with small effects as well as complex gene-gene and gene-environment interactions. As one of the major players in complex diseases, the role of gene-environment interactions has been increasingly recognized. Motivated by epidemiology studies to evaluate the joint effect of environmental mixtures, we developed a functional varying-index coefficient model (FVICM) to assess the combined effect of environmental mixtures and their interactions with genes, under a longitudinal design with quantitative traits. Built upon the previous work, we extend the FVICM model to accommodate binary longitudinal traits through the development of a generalized functional varying-index coefficient model (gFVICM). This model examines how the genetic effects on a disease trait are nonlinearly influenced by a combination of environmental factors. We derive an estimation procedure for the varying-index coefficient functions using quadratic inference functions combined with penalized splines. A hypothesis testing procedure is proposed to evaluate the significance of the nonparametric index functions. Extensive Monte Carlo simulations are conducted to evaluate the performance of the method under finite samples. The utility of the method is further demonstrated through a case study with a pain sensitivity dataset. SNPs were found to have their effects on blood pressure nonlinearly influenced by a combination of environmental factors.

Publisher Correction: The disappearing COVID-Naïve Population and comparative Roche vs. Abbott Test sensitivity: evidence from antibody seroprevalence in Milwaukee County, Wisconsin

Patterns of self-harm presentations at a Tertiary Urban Hospital in Kenya: A retrospective 5-year study (2018–2022)

Introduction Self-harm represents a complex and multifaceted public health issue of global significance, exerting profound effects on individuals and communities alike. It involves intentional self-poisoning or self-injury with or without the motivation to die. Although self-harm is highly prevalent, limited research has focused on the patterns and trends of self-harm among hospital populations in low- and middle-income countries, particularly within Africa. This study aims to explore the socio-demographic and clinical profile of patients presenting with self-harm and determine the common self-harm patterns at a tertiary facility in Kenya. Methodology We carried out a descriptive retrospective study and included patients from inpatient units and outpatient settings within the Secion of Psychiatry at the Aga Khan University Hospital, Nairobi from January 1st 2018 to December 31st 2022. A data abstraction tool was used to collect data from eligible files sourced from the medical records department for all patients who met the study criteria. Summary statistics were reported as frequencies and percentages for categorical data and as means and standard deviations for continuous data. Results A total of 507 files were reviewed in the given timeframe and 497 patients were included in the analysis. Of these patients, 28.1% (n = 144) presented with self-harm. The mean age of the self-harm patients was 26.5 years (SD = 10.5) and a majority (74.3%) were female. The first point-of-contact was at the emergency department in 72.9% of the cases. A majority of them, i.e. 89.6%, reported a past psychiatric diagnosis. Based on the psychiatric diagnosis evaluation of the patients- depression was the most common diagnosis at 88.2%, followed by anxiety disorder at 27.8% and bipolar mood disorder at 17.4%. The majority of reported self-harm cases involved overdose incidents (68.8%), with self-injury accounting for 56.3% of cases. Analgesics were the most frequently reported type of overdose, followed by tricyclic antidepressants. In context of self-injury, cutting emerged as the predominant form of self-harm. Family conflict was reported to be the most common reason for self-harm at 39.6%. Conclusion This study shows a high rate of self-harm among patients with mental illness in this facility, necessitating the development of self-harm prevention and management protocols. A national registry of self-harm behavior would also help further elucidate the occurrence and mechanisms of self-harm in the population, improving the possibility for early interventions and prevention.

State switch control of magnetically suspended flywheel energy storage system in uninterrupted power supply system

Identification and validation of key autophagy-related genes in lupus nephritis by bioinformatics and machine learning

Introduction Lupus nephritis (LN) is one of the most frequent and serious organic manifestations of systemic lupus erythematosus (SLE). Autophagy, a new form of programmed cell death, has been implicated in a variety of renal diseases, but the relationship between autophagy and LN remains unelucidated. Methods We analyzed differentially expressed genes (DEGs) in kidney tissues from 14 LN patients and 7 normal controls using the GSE112943 dataset. Key modules and their contained genes were identified utilizing weighted gene co-expression network analysis (WGCNA). Differentially expressed autophagy-related genes (DE-ARGs) among DEGs, key module genes and autophagy-related genes (ARGs) were obtained by venn plot, and subjected to protein-protein interaction network construction. Two machine learning methods were applied to identify signature genes. The area under the receiver operating characteristic (ROC) curves was used to assess the accuracy of the signature genes. We also analyzed immune cell infiltration in LN. Additionally, the association between key genes and kidney diseases was predicted. Finally, key genes expression in kidney was verified by clinical samples and animal experiments. Results A total of 10304 DEGs were identified in GSE1129943 and 29 modules were identified in WGCNA. Among them, the brown module and coral 2 module exhibited significant correlation with LN (cor = 0.86, -0.84, p<0.001). Machine learning techniques identified 5 signature genes, but only 2 were validated in the external dataset GSE32591, namely MAP1LC3B (AUC = 0.920) and TNFSF10 (AUC = 0.937), which are involved in autophagy and apoptosis. Immune infiltration analysis suggested that these key genes may be associated with immune cell infiltration in LN. In addition, these genes have been linked to a variety of renal diseases, and their expression was verified in kidney tissues in LN patients and lupus mice. Conclusion MAP1LC3B and TNFSF10 may be key autophagy-related genes in LN. These key genes have the potential to provide new insights into the molecular diagnosis and treatment of LN.

Alleviating symptoms of paediatric acute rhinosinusitis and acute otitis media with otorrhea using nasal-spraying Bacillus probiotics: a randomized controlled trial

Abstract Acute rhinosinusitis (ARS) in children may be accompanied by acute otitis media (AOM) which is often associated with bacterial co-infections. These conditions are among the primary reasons that children visit hospitals and require antibiotic treatment. This study evaluated the efficacy of the nasal-spraying probiotics (LiveSpo Navax containing 5 billion Bacillus subtilis and B. clausii spores/5 mL) as a supportive treatment for dual ARS and AOM with otorrhea in a randomized, single-blind, controlled clinical trial. Eighty-two patients (41 per group), aged 1 month to 12 years, received standard care along with nasal spraying of either physiological saline (Control group) or LiveSpo Navax (Navax group), administered three times daily over a 7-day follow-up period. A total of sixty-one patients (30–31 per group) completed the trial. The Navax group experienced 68.00% and 96.77% reductions in nasal congestion (by day 3) and rhinorrhea (by day 7), respectively, which were 2.04 and 1.94-fold higher than the Control group, with odds ratios (OR) of 4.31 and 30.00 (p < 0.05). Endoscopic results indicated 8% and 11% higher reductions in nasal mucopurulent discharge and tympanic membrane hyperemia in the Navax group compared to the Control group. By day 3, compared to day 0, the Navax group exhibited > 1200-fold reduction in Streptococcus pneumoniae and ≥ 4-fold reduction in Haemophilus influenzae concentrations (p < 0.05) in both nasopharyngeal and middle ear fluid samples, whereas the Control group showed no significant reductions. Navax treatment reduced IL-6 by 1.35- to 1.74-fold and TNF-α by 1.17- to 1.45-fold, more effectively than the Control group (p < 0.05). These results suggest that nasal-spray Bacillus spore probiotics, with their ability to reduce bacterial load and modulate immune responses, provide a cost-effective and safe solution for alleviating symptoms of both ARS and AOM in children. Trial registration: ClinicalTrials.gov, Identifier NCT05804123 on April 7, 2023.

Enhanced silk production and pupal weight in Bombyx mori through CRISPR/Cas9-mediated circadian Clock gene disruption

The domesticated silkworm, Bombyx mori, is crucial for global silk production, which is a significant economic activity supporting millions of livelihoods worldwide. Beyond traditional silk production, the growing demand for insect larvae in cosmetics, biomedical products, and animal feed underscores the need to enhance B. mori productivity. This study investigates the role of the circadian clock gene Clock in B. mori using CRISPR/Cas9-mediated mutagenesis to establish the ClkΔ29 knock-out mutant strain. Dysregulation of the circadian clock in ClkΔ29 was demonstrated by altered temporal transcriptional profiles of core circadian clock genes in adult heads and disrupted circadian-controlled behaviors, including adult eclosion and egg hatching rhythms under constant darkness. By analysing larval development timing, as well as the weights of late instar larvae, pupae, and cocoon components in ClkΔ29 mutants and in ClkΔ1922 silkworms (carrying an independently generated Clk- null allele), we showed that CLK contributes to physiological processes regulating B. mori development and growth. Importantly, ClkΔ29 mutants reared on a standard sericulture diet exhibited significant increases in key economic traits, with silk production increasing by up to 7%, and pupal weight increasing by up to 25% compared to wild-type controls. This study highlights the potential of circadian clock gene manipulation to significantly enhance sericultural productivity. Future research should focus on elucidating the molecular mechanisms driving these phenotypes and determining whether they result from circadian clock functions or pleiotropic effects of B. mori Clk. These findings provide a foundation for advancing sustainable sericulture and developing new commercial applications for silkworm-derived products.

Metacognitive strategies improve self-regulation skills in expert sports coaches

A study of Chinese enterprises’ business models to determine the impact of dynamic capabilities on innovation and performance

Small and medium-sized enterprises (SMEs) can gain a competitive advantage by implementing business model innovation (BMI), which is characterized as irreversible changes to a company’s business model. However, BMI is often associated with high risk, uncertainty, and ambiguity. In this study, the effectiveness of BMI on improving SME performance is examined using structural equation modeling (SEM) based on data collected from 330 Chinese SMEs. The purpose of this paper is to examine how enterprise risk management (ERM), organizational agility (OA), and entrepreneurial orientation (EO) affect SME performance. The results reveal that ERM, OA, and EO all have a positive impact on efficiency-centered BMI and SME performance; efficiency-centered BMI mediates this pathway. Building on dynamic capabilities theory, this paper combines ERM, OA, and EO into one framework to assess their impact on SME performance. Additionally, a case study is presented to provide suggestions for making decisions about BMI implementation.

Multi task opinion enhanced hybrid BERT model for mental health analysis

Comparative analysis of developmental outcomes in very preterm infants: BSID-II versus Bayley-III German norms

Introduction After the release of the Bayley Scales of Infant and Toddler Development, third edition (Bayley-III), US norms, an overestimation of outcome was observed. But, the conformity between the Bayley Scales of Infant Development, second edition (BSID-II), and the Bayley-III German norms is unknown. This retrospective analysis aimed to compare outcomes of very preterm infants tested with BSID-II and Bayley-III German norms. Methods Infants born from November 2007 to July 2018 were included. Exclusion criteria were death or missing outcome. Infants underwent testing with either BSID-II until December 2013 or Bayley-III from January 2014 onward, at 12 and/or 24 months. BSID-II Mental Developmental Index (MDI) was compared to Bayley-III cognitive score and a combined Bayley-Score (CB-III) consisting of the cognitive and language composite score. BSID-II Psychomotor Developmental Index (PDI) was compared to Bayley-III motor composite score. Abnormal outcomes were defined as scores <85 (delay) or <70 (impairment). Results 649 infants were included. At 12 months, the Bayley-III cohort achieved higher scores in all domains compared to the BSID-II cohort (all p<0.05), with lower rates of motor delay in the Bayley-III cohort (p<0.001). At 24 months, only Bayley-III motor composite scores were higher than the BSID-II PDI (p<0.001). Rates of cognitive impairment were higher in the Bayley-III cohort (p = 0.013). Interpretation Our findings indicate that the Bayley-III German norms effectively identify children needing interventions, particularly at 24 months corrected age. This supports both clinical application and scientific comparability with the BSID-II.

Orbital angular momentum light interacted with double quantum dot-metal nanoparticle hybrid structure under spontaneous coherence

Abstract This work studies the generation of the orbital angular momentum (OAM) beam in the double quantum dot-metal nanoparticle (DQD-MNP) system under the application of the OAM beam. First, an analytical model is derived to attain the relations of probe and generated fields as a distance function in the DQD-MNP system under OAM applied field and spontaneously generated coherence (SGC) components. The calculation here is of material property; it differs from others by calculating energy states of the DQDs and the computation of the transition momenta between quantum dot (QD)-QD and QD-wetting layer (WL) transitions. The orthogonalized plane wave (OPW) calculates QD-WL transitions and their momenta. The momentum calculation is essential to specify the Rabi frequency of the input field. Such characteristics are not used in earlier models. The results show that SGC is vital in increasing the generated field. The signal field generated in the DQD-MNP system doubles that from the DQD system alone. So, the DQD-MNP system is preferred to the DQD system. The generated field in the DQD-MNP for the strong coupling DQD-MNP system is higher than that for the weak coupling. Increasing the distance separating the DQD-MNP reduces the generated field. Higher OAM number reduce the generated field at a long distance in the device. The model is then extended to study the effect of incoherent pumping ( $$\:{R}_{inc}$$ ) and the relations are modified to cover this part. The results show that $$\:{R}_{inc}$$ reduces the generated field. While the results that compare the weak and strong coupling appear for the first, others compare well to the literature.

Measuring self-reliance and wellbeing among forcibly displaced women enrolled in a gender-focused economic empowerment program: A protocol for a pilot randomized controlled trial in Colombia

Colombia currently hosts nearly three million Venezuelan refugees and migrants and is home to seven million internally displaced Colombians. For forcibly displaced populations in Colombia, and especially for women, gender-based violence (GBV) poses a threat during transit and in their new homes where xenophobia, lack of accessible and adequate services, limited safe economic opportunities, and lack of information on access to services, further increase risk. The dearth of livelihood opportunities also affects forcibly displaced populations, especially women. This study will conduct a randomized-controlled trial (RCT) of HIAS’ Entrepreneurship School with Gender Lens (ESGL), a program that targets forcibly displaced GBV survivors and women at-risk to help them develop business ideas, access needed support for the prevention of and response to GBV, and improve overall self-reliance. The RCT will be conducted within three cities in Colombia; approximately 80 eligible participants will be enrolled in each city and randomized to a treatment or control arm. Survey questionnaires will be administered to participants at baseline, eight months following baseline (endline), and 3–4 months after endline. Outcomes of interest include household self-reliance, mental health, resilience, empowerment, utilization of GBV services, and social support.

Petrophysical assessment of the Hammam Faraun, Matulla and Nubia Reservoirs in the Ashrafi Oil Field, Gulf of Suez

Abstract The Hammam Faraun, Matulla, and Nubia formations in the Ashrafi oil field, in the southern Gulf of Suez, Egypt, are key hydrocarbon reservoirs with significant economic importance. These formations, characterized by their favorable reservoir properties and structural settings, play a crucial role in oil and gas accumulation. Their study provides valuable insights into regional petroleum systems and guides exploration and production activities. The Ashrafi Oil Field is one of the most complex and important areas due to its intricate geological framework, which closely resembles that of the Red Sea. Its proximity to the Red Sea further emphasizes its significance. Therefore, the findings from this study can serve as a valuable analogy for understanding the geology of the Red Sea. This study presents a comprehensive structural interpretation and petrophysical evaluation of the Hammam Faraun, Matulla, and Nubia formations by examining well log data and seismic lines, the research quantifies essential petrophysical parameters that characterize the reservoir properties and hydrocarbon potential of these formations. The Hammam Faraun Member exhibits effective porosity values ranging from 0.15 to 0.25 and water saturation levels between 0.23 and 0.67, indicating a significant capacity for hydrocarbon storage, especially in the northern region where net pay thickness can reach up to 60 ft. The Matulla Formation shows effective porosity values between 0.10 and 0.20, with water saturation levels ranging from 0.31 to 0.41 and net pay thickness varying from 51 to 269 ft, highlighting its substantial hydrocarbon reserves. In contrast, the Nubia Formation, characterized by its uniform sandstone composition, has an effective porosity of approximately 0.18 and a consistent water saturation level of about 0.24, with net pay thicknesses between 72 and 155 ft, marking it as an important target for hydrocarbon exploration. Also, the resulting structural interpretation reveals a series of normal faulted structures, including horsts, half-grabens, and step faults. These faults extend across the area, primarily trending northeast-southwest (clysmic trend), with minor northwest-southeast faults perpendicular to the major faults, creating a complex fault network. Integrating this structures with petrophysical parameters such as shale volume, effective porosity, and hydrocarbon saturation provides critical insights into reservoir quality, informing future exploration and production strategies. The study further underscores the lateral variations in water saturation and net pay thickness across the formations, which are closely linked to facies changes. This thorough analysis enhances our understanding of the geological framework and serves as a vital resource for optimizing hydrocarbon recovery and guiding exploration initiatives in the Ashrafi Oil Field. The findings underline the potential of these formations as significant contributors to the region’s hydrocarbon resources, emphasizing the necessity for ongoing exploration and development efforts. Additionally, the insights gained from this research can facilitate the implementation of advanced recovery techniques, ensuring the efficient utilization of hydrocarbon resources while addressing the challenges associated with reservoir management in the Gulf of Suez region and the Red sea.

The cellular response of lipopolysaccharide-induced inflammation in keratoconus human corneal fibroblasts to RB-PDT: Insights into cytokines, chemokines and related signaling pathways

Purpose Rose Bengal Photodynamic Therapy (RB-PDT) offers dual therapeutic benefits by enhancing corneal stiffness and providing antibacterial activity, presenting significant potential for patients with keratoconus complicated by keratitis. Our purpose was to assess the effect of rose bengal photodynamic therapy (RB-PDT) on the expression of pro-inflammatory cytokines and chemokines, as well as on extracellular matrix (ECM)-related molecules, in lipopolysaccharide (LPS)-induced inflammation of keratoconus human corneal fibroblasts (KC-HCFs). Additionally, the involvement of the mitogen-activated protein kinase (MAPK) and nuclear factor kappa B (NF-κB) signaling pathways which are downstream of the Toll-like receptor 4 (TLR4) pathway were examined. Methods KC-HCFs were stimulated with varying concentrations of LPS (0–10 μg/ml), which was followed by RB-PDT. The expression levels of interleukin-1β (IL-1β), IL-6, IL-8, interferon alpha 2 (IFNA2), IFNB1, intercellular adhesion molecule 1 (ICAM-1), chemokine (C-C motif) ligand 4 (CCL-4), collagen I, collagen V, lysyl oxidase (LOX), transforming growth factor β 1(TGF-β1) were measured using qPCR, ELISA, or western blot. The activation of the NF-κB and MAPK pathways was assessed using qPCR and western blot. Results In LPS-induced inflammation of KC-HCFs, the expression of IL-6 was further amplified by the treatment with RB-PDT (p = 0.001). However, the activation of the MAPK and NF-κB pathways did not increase following RB-PDT. Additionally, RB-PDT reduced the transcription of collagen I and collagen V (p≤0.03), while the transcription of LOX and TGF-β1 secretion remained unchanged in KC-HCFs exposed to LPS. Conclusion In LPS-induced inflammation of KC-HCFs treated with RB-PDT, despite the increased expression of pro-inflammatory cytokines, the activation of the TLR4 signaling pathways is lacking. RB-PDT may have no adverse effects on corneal scar formation of keratoconus corneas in the short term.

Epigenetic modulation of social cognition: exploring the impact of methylation in brain-derived neurotrophic factor and oxytocin receptor genes across sex

Impact of Chlorella vulgaris and probiotic supplementation on performance, immunity and intestinal microbiota of broiler chickens

Chlorella vulgaris has antioxidant, antimicrobial, and anti-inflammatory properties, as well as the probiotic that is important for keeping the intestinal microbiota balanced. The objective was to test the impact of supplementation with microalgae and/or probiotics on broiler chickens’ performance, immunity, and intestinal microbiota. The experimental design was in randomized blocks in a 4x2 factorial scheme, with four levels of inclusion of C. vulgaris (0; 0.25; 0.50 and 1%) associated or not with a commercial probiotic with five replications of 26 chickens per experimental unit. The results showed that probiotics improved feed conversion. Probiotics increased the productivity index only at 0.25% C. vulgaris supplementation. There was a reduction in spleen weight at 42 days of age in chickens fed with probiotics, but the different treatments did not alter serum antibodies. Sampling age had a significant impact on richness addressed by the number of observed genera and diversity addressed by the Shannon index. The most abundant phylum in the chicken intestinal tract was Firmicutes followed by Bacteroidetes and Proteobacteria. Bifidobacterium spp. was found in animals receiving 1% microalgae and probiotics on day 42, suggesting that this genus has benefited from microalgae supplementation. It is concluded that the probiotic and C. vulgaris have the potential to improve performance without causing major changes in the immunity and cecal microbiota.

A new method for assessing the health status of aerospace equipment based on a belief rule base with balanced accuracy and complexity