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Lactic acid photosynthesis via C–C cross-coupling over atomically dispersed Ba
Abstract Photocatalytic carbon–carbon coupling offers a route for converting plastic-derived chemicals into valuable multi-carbon products, yet uncontrolled coupling of intermediate limits efficiency and selectivity. Here, we report atomically dispersed barium species on titanium dioxide that act as frustrated Lewis pairs, enabling efficient and selective generation intermediates during the co-oxidation of ethylene glycol and methanol toward lactic acid. The barium species create interstitial states near the Fermi level, enhancing charge separation and surface redox activity. Meanwhile, barium sites promote the formation of transient •CHOHCH 2 OH radicals from ethylene glycol, while lattice O generates stable *CH 3 intermediates from methanol. Their directed cross-coupling yields lactic acid at rate of 2.04 ± 0.08 mmol g –1 h –1 with 81.8 ± 2.4 % carbon selectivity, alongside H 2 evolution at 5.85 ± 0.23 mmol g –1 h –1 . In this work, we show an alkaline-earth frustrated Lewis pairs for selective solar-driven cross-coupling reaction.
Patients’ preference for receiving healthcare services from out-of-area hospitals based on the Analytic Hierarchy Process (AHP): A mixed-methods study
Introduction Meeting patients’ needs and expectations is one of the core responsibilities of healthcare delivery organizations in any region. Patients have two options for receiving services; either they go to hospitals outside their area of residence to receive medical services or they are referred by physicians to receive these services. Objective The present study aimed to identify and prioritize the factors influencing patients’ preference for obtaining healthcare services from out-of-area hospitals (Ilam Province). Methods This mixed study was conducted in two qualitative and quantitative phases in hospitals in Ilam city, 2024. In the qualitative phase, 15 experts and specialists were interviewed; data were collected using an In-depth interview guide and analyzed through a conventional content analysis approach. In the quantitative phase, 25 participants were assessed using a pairwise comparison questionnaire, and data were analyzed using the Analytical Hierarchy Process (AHP) with Expert Choice version 11. In the qualitative phase, Data analysis was conducted through employing the software MAXQDA-12. Results In the qualitative phase, the 41 identified subthemes were categorized into four main themes: physician-related factors, patient and family-related factors, service-providing organization–related factors, and sociocultural factors. Findings indicated that delayed payment of physicians’ claims, shortage of medical specialists, insufficient medical infrastructure and equipment, and promotional activities by healthcare centers in neighboring provinces played a key role in patient referral and preference for receiving healthcare services outside the province. According to the AHP results, physician-related factors were the most influential criteria, whereas sociocultural factors were the least significant in shaping patients’ preference for out-of-province hospitals. Conclusion Given the high annual referral rates and the substantial number of patients traveling outside the province to obtain medical services, health policymakers and provincial senior managers need to implement effective planning and corrective measures to reduce these referrals. Such measures may include recruiting the required specialists and subspecialists, developing practical strategies to improve retention of experienced physicians, enhancing medical equipment and infrastructure, and applying effective marketing strategies in the healthcare sector.
Imperatorin restores behavioral and recognition memory deficits induced by REM sleep deprivation in male rats
Native long-read RNA sequencing of human monocytes reveals activation-induced alternative splicing toward functional isoforms
Challenges and opportunities in hydroxyurea access and adherence for sickle cell disease patients at Komfo Anokye Teaching Hospital: Insights from healthcare providers
Hydroxyurea is a vital medication for managing Sickle cell disease, yet access and adherence remain significant challenges in low-resource settings. This qualitative study explored challenges and opportunities in hydroxyurea access and adherence among Sickle cell disease patients at the Komfo Anokye Teaching Hospital in Ghana. Alongside, the utility of the Ahodwo CommCare mobile App in enhancing Sickle cell disease management was explored. Semi-structured interviews were conducted with six healthcare providers, including doctors, nurses, and pharmacists from May 12 to August 15, 2022. This study found that the key barriers to hydroxyurea access and adherence include financial constraints, medication stock-outs, administrative inefficiencies, bureaucratic delays, patient-related factors such as forgetfulness and concerns about side effects, and practical challenges in administering the medication especially to children. The healthcare workers indicated that reconstituting the medication into suspension added both cost and time constraints to children who cannot take capsules hence affecting access to hydroxyurea. Facilitators to access and adherence identified included patient education, streamlined procurement processes, and government support for medication subsidies. This study found that patient education sessions should emphasize the benefits of hydroxyurea treatment and the importance of adherence to prescribed regimens. The study also revealed limited awareness and utilization of the Ahodwo CommCare app among healthcare personnel, highlighting the need for targeted training and integration into clinical workflows. These findings underscore the importance of multifaceted interventions involving healthcare workers, hospital management, and government stakeholders to improve hydroxyurea access and adherence, ultimately enhancing Sickle cell disease patient outcomes.
Evolution characteristics and driving factors of water use structure in typical urban agglomerations in China
Beyond the Numbers: Quantitative and qualitative analysis of quality of life after deep brain stimulation for OCD
Purpose Obsessive-Compulsive Disorder (OCD) severely impairs quality of life (QoL) in many sufferers. Deep Brain Stimulation (DBS) can be effective therapy for OCD that is refractory to standard treatment options, which include medications and cognitive behavioral therapy/exposure and response prevention therapy. The purpose of this study was to acquire qualitative data about the impact of DBS on QoL for people who have treatment refractory OCD. Methods Ten subjects who received DBS surgery and are receiving ongoing DBS programming participated in this study. Pre- and post-surgery assessments (Q-LES-Q-SF and Y-BOCS) were analyzed for 8 of the 10 participants, and narratives from all 10 subjects were coded for themes. To assess individual correlations, analyses were completed within each participant, using solely their data points. Results In six out of 8 subjects, improved QoL scores correlated with a decrease in Y-BOCS score, although this was only found to be significant in 2 of the 6 subjects. Qualitative data revealed that pre-DBS QoL was generally poor, with patients experiencing impairment in at least one domain. Post-DBS, most patients described improvements in overall QoL, particularly in the areas of mood and general functioning. However, many continued to experience difficulties in the social/relationship domain, including difficulty with social skills and transition to independent living. Conclusions These findings suggest that focused interventions addressing social skills and independent living may enhance post-DBS quality of life.
Digital disconnection as a self-regulatory strategy against procrastination
Abstract Digital media are pervasive and offer various short-term rewards, yet they may undermine the achievement of long-term goals by fostering procrastination —the irrational delay of intended tasks. Research documents that media users try to avoid procrastination through digital disconnection , the voluntary and temporary reduction of digital media use. Combining theoretical perspectives on psychological processes of self-regulation and digital disconnection, our study investigates whether goal conflicts and trait self-control make engaging in disconnection more likely and whether disconnection is in turn associated with less procrastination. In an experience sampling study with N = 237 young adult participants and T = 12,408 observations, we find that in situations in which participants experienced stronger goal conflicts they were more likely to engage in digital disconnection and that individuals who generally experience higher goal conflict were more likely to disconnect. Additionally, those with higher trait self-control disconnected more. Most notably, disconnection was associated with lower procrastination on the within-person level: In situations with more disconnection, procrastination was lower. Exploratory analyses find that this effect persisted to the following situation. Our results show that engaging in digital disconnection could be a promising self-control strategy to reduce procrastination.
What did the dove sing to Pope Gregory? Ancestral melody reconstruction in Gregorian chant using Bayesian phylogenetics
An attractive goal in the study of Gregorian chant melodies is reconstructing unobserved melodies as they may have been transmitted along their history, especially as early chant notation does not capture pitch exactly. We propose doing this computationally using Ancestral State Reconstruction over phylogenetic trees. Bayesian phylogenetic trees have shown promise as a tool to study the evolution of chant melodies, by inferring a plausible topology of chant transmission. However, the inferred trees cannot be used as Ancestral State Reconstruction inputs directly, because they are undirected, and their branch lengths conflate time and evolutionary rate. We therefore first apply Divergence Time Estimation to separate them and represent the tree in a directed form on the time dimension. Using Ancestral State Reconstruction, we then obtain reconstructions of melodies for each of the ancestral nodes, in addition to their distribution in time obtained from Divergence Time Estimation, and thus recover a phylogeny of chant melody with a music-historical interpretation. We applied this method to the Christmas Vespers dataset, and compare the results against musicological knowledge and melodies reconstructed at Solesmes using methods of contemporary philology, which shows potential for reconstructing cultural transmission through time.
Large language model empowered explainable and interpretable mental health analysis
A comparative analysis of co-contraction indices using synthetic EMG data: Implications for selection and interpretation
Co-contraction—the simultaneous activation of opposing muscles—influences movement efficiency, joint stability, and motor learning. While consensus exists for EMG acquisition and processing, comparable guidance for quantifying co-contraction is lacking. This study evaluated the behavior and interrelationships of six commonly used co-contraction indices (CCIs) to develop practical recommendations for their selection, calculation, and interpretation. Synthetic EMG-like signals were generated and used to evaluate CCI behavior across a range of conditions that would be difficult to achieve experimentally. Based on their formulas and observed behavior, CCIs were sorted into three categories: shape-based, amplitude-driven, and temporal indices. Shape-based CCIs increase when two EMG signals have similar shapes, regardless of amplitudes. Amplitude-driven CCIs increase when activation is high in both muscles. Temporal CCIs increase as the duration of EMG overlap increases, regardless of signal shape or amplitude. Correlation analyses showed stronger associations within-category than between-category, supporting the proposed classification scheme. CCI behavior yielded three principal findings, each paired with a practical recommendation. First, EMG amplitude normalization techniques altered co-contraction estimates, and the effect varied by index. Researchers should therefore test whether their conclusions hold across normalization methods. Second, because CCIs differ in scale and theoretical maxima, their values are not directly comparable across indices. Comparisons should instead focus on relative trends interpreted within each index’s bounds. Third, each CCI category was sensitive to different EMG features (e.g., amplitude versus shape). The choice of CCI should therefore align with hypothesized differences in EMG signals—use shape-based CCIs when waveform similarity is of interest, and amplitude-driven CCIs when differences in activation magnitude are expected. These results provide initial guidance for selecting, calculating, and interpretating CCIs, and they establish a framework for testing the robustness of these theoretical findings using experimental EMG from diverse tasks, muscle pairs, and populations.
O²RDL-net for joint risk classification and delay forecasting in logistics systems using interaction amplified deep
The influence of coach leadership behavior on athletes’ prosocial behavior in sports: The mediating effect of goal orientation and moral disengagement in sports
To investigate the impact of coach leadership behavior on athletes’ prosocial behavior in sports, as well as the mediating role of goal orientation and moral disengagement in it, a questionnaire survey was conducted on 1239 athletes. The results showed that democratic leadership behavior has significant positive and negative effects on athletes’ prosocial behavior and antisocial behavior in sports, respectively; Authoritarian leadership behavior has significant negative and positive impact on athletes’ prosocial behavior and anti social behavior in sports, respectively; Both democratic leadership behavior and authoritarian leadership behavior can have a significant indirect impact on prosocial behavior and antisocial behavior in sports through the mediating effect of goal orientation and moral disengagement. Specific mediating paths include independent mediating paths of self-orientation, task orientation, and moral disengagement in sports, and chain mediating paths of self-orientation and moral disengagement in sports. In the future, coaches can enhance democratic leadership, reduce authoritarian leadership behavior, adjust athletes’ goal orientations, and lower moral disengagement levels, thereby suppressing antisocial behavior and promoting prosocial behavior in sports.
The microRNA (miRNA) signatures in different phases of the natural history of chronic hepatitis B virus infection
Abstract Chronic hepatitis B virus (HBV) infection (CHB) progresses through distinct clinical phases characterized by dynamic immune responses and changes in intrahepatic gene expression. While hepatic transcriptomes have been studied, hepatic microRNA (miRNA) profiles across the natural history of CHB remain poorly defined. In this study, we aimed to characterize hepatic miRNA expression and its association with liver cell composition across CHB phases. Liver biopsies from 43 treatment-naïve CHB patients across four clinical phases, immune tolerance (IT), immune active (IA), inactive carrier (IC), and HBeAg-negative hepatitis (ENH), were analyzed using miRNA microarrays and mRNA sequencing. Hepatic cell composition was inferred using CIBERSORT and expression of 92 cell-type marker genes. Differentially expressed miRNAs were identified by Mann–Whitney U test, and clustering and correlation analyses were performed to assess associations with immune and liver cell markers. Consistent with previous studies, immune cell infiltration varied by phase, peaking in IA and ENH phases. Sixty-five miRNAs were significantly differentially expressed (|log₂FC| > 0.585), including immune-associated miRNAs such as miR-155-5p, miR-150-5p, and miR-142-5p. Twenty-two miRNAs elevated in IA phase were associated with macrophage and T cell markers. Hepatocyte-enriched miRNAs (e.g., miR-122-5p, miR-192-5p) remained highly expressed across all phases. Clustering analysis identified five miRNA expression patterns, with immune-associated clusters upregulated in IA and ENH phases. Correlation analysis confirmed strong associations between immune-phase miRNAs and αβ T cell markers. Overall, these findings indicate that hepatic miRNA profiles are largely stable across CHB phases, with immune cell infiltration associated with selective miRNA changes, particularly in IA and ENH phases.
Thinking Ability and Creativity Quotient in the landscape of basic education: A contextual and demographic perspective
Thinking Ability (THI) and Creativity Quotient (CQ) equips students to navigate a complex, fast-changing world. These cognitive functions drive problem-solving, innovation, and adaptability, essential for academic and personal success. In the basic education landscape (elementary and secondary levels), schools worldwide are focusing on promoting core competencies among students. The comparison for THI and CQ based on students’ demographic characteristics is little known. This study examines the levels and demographic variations of THI and CQ among basic education students in Thailand, using a learning-sufficiency framework and key of cognitive and creative developmental theories to explain their development across diverse contexts. A multi-stage random sampling method was employed, involving a total of 1,494 students from schools across various regions. Participants completed a demographic characteristics questionnaire as well as the THI and CQ scales. The results show that the level of THI and CQ among the participants were low to moderate in total and had a statistically significant difference (p < 0.05) when compared based on the demographic characteristics. The study advances theory by providing evidence of distinct patterns across demographic groups. Key implications include adopting stage-appropriate instruction, integrating inquiry- and creativity-based pedagogies, and promoting equity-focused policies to reduce demographic disparities in cognitive and creative development. These findings provide guidance for teachers, educational psychologists, curriculum developers, school leaders, and administrators in strengthening students’ THI and CQ in accordance with their demographic characteristics.
Clinical risk factors and prediction model for gonadal impairment in pediatric patients following hematopoietic stem cell transplantation
Correction: Public attitudes to potential synthetic cells applications: Pragmatic support and ethical acceptance
Association between HALP score and in-hospital outcomes in patients with acute kidney injury: a retrospective cohort study
Older age and sex differences in the proportion of vital signs flagged as abnormal
Background The variability of vital signs thresholds has not been well described in relation to older age and sex assigned at birth. Significant variations may influence clinical interpretation of vital signs, most notably the thresholds at which investigations or treatments are initiated. Our objective was to compare, in stable health status, the percentage of abnormal values (flagging percentage) of standard vital signs thresholds of adults aged 45 years and older and to determine centile-based thresholds by age and sex. Methods A retrospective observational study was conducted using data from the Centre for the Integration and Analysis of Medical Data (CITADEL) at the Centre hospitalier de l’Université de Montréal (CHUM), a tertiary care hospital. All inpatients and outpatients, from January 2012 to December 2021, were included. For individuals with multiple visits, a single hospitalization or a single outpatient visit was selected at random for inclusion. To reflect a stable health status, the last vital signs recorded before hospital discharge were selected and in-hospital deaths were excluded. Flagging percentages were identified using a quantile-based approach. Age and sex specific centile-based thresholds were determined by identifying values at the 2.5 th and 97.5 th centiles. Flagging percentages and centile values for systolic and diastolic blood pressure, heart rate, and temperature were analyzed by age group (45–54, 55–64, 65–74, 75–84, and 85 + years) and sex. Results The sample comprised 123,420 individuals, including 90,813 inpatients. Flagging percentages for the standard threshold of upper systolic blood pressure (140 mmHg) ranged from 13.3 (12.7–13.9) % (45-54y assigned female at birth (AFAB)) to 39.8 (38.6–41.0) % (85y+ AFAB). Flagging percentages for standard thresholds ranged between 0.1 (0.1–0.2) to 1.2 (1.0–1.4) % for upper temperature (37.8°C), lower temperature (35.0°C), and lower systolic blood pressure (90 mmHg). Across subgroups, the 97.5 th centile-based adapted thresholds varied between 158 (156−159) – 178 (177−180) mmHg for upper systolic blood pressure and between 37.2 (37.1–37.2) – 37.3 (37.3–37.3) °C for upper temperature. Conclusions Important differences in vital signs flagging percentages may affect their comparability by vital sign, age, and sex. Standard thresholds may need to be reassessed using clinical outcomes to factor age and sex differences.