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Coverage of insecticide-treated mosquito nets in preschool consultations and factors associated with non-use of insecticide-treated mosquito nets among children in the Democratic Republic of Congo: A base population cross-sectional study
Insecticide-treated nets (ITNs) are among the most effective malaria prevention interventions, yet their actual use among children remains below national targets. This study assesses ITN coverage and utilization among children attending preschool consultations (PSC) and identifies factors associated with non-use. A cross-sectional study was conducted in 2025 in 156 health facilities across six provinces of the Democratic Republic of the Congo (DRC). Children aged 6–59 months accompanied by a parent or guardian were included. Data were collected during a household survey through face-to-face interviews using a structured questionnaire programmed in ODK Collect. Data on ITN ownership and use, as well as sociodemographic characteristics, were collected. Factors associated with non-use were analyzed using multivariate logistic regression. Among the 1,247 children included in preschool consultations, the mean age was 15.0 ± 4.3 months. The population showed marked socioeconomic vulnerability: 81.5% of guardians had a low educational level, 82.4% of households had low monthly income, and 48.2% lived in rudimentary housing. Community awareness through community health workers (CHWs) was high (78.7%). Overall, 62.5% of households owned at least one ITN, and 95.9% of children used it. The main factors associated with non-use were lack of community sensitization (aOR = 4.75), parental marital status (aOR = 4.57), rainy season (aOR = 3.41), rudimentary housing (aOR = 2.59), and a high number of children in the household (aOR = 1.80). Adherence to ITN use was ≥ 80% of individuals reporting sleeping under an ITNs the previous night, a predefined threshold based on WHO recommendations. Community-based interventions and context-adapted planning that account for seasonal and socioeconomic factors are essential to maximize the impact of malaria reduction among preschool children in the DRC.
Fold bifurcations in shearing radiative collapse
OracleTrust: A dual-layer provenance-based signature verification scheme for preventing transaction malleability in blockchain
Decentralized oracle networks pose significant security risks to blockchain systems due to transaction malleability, which can lead to double-spending and integrity issues. While existing solutions such as DAON, SegWit, and SecPLF improve specific aspects of security, they do not address Oracle-driven transaction malleability on a transaction level. DAON focuses on decentralized oracle consensus and reputation mechanisms, but it does not support the cryptographic binding of Oracle metadata to transactions. SegWit reduces signature malleability at the Bitcoin protocol level, but it does not protect the integrity of Oracle-fed data or require validation before transactions are added to the blockchain. SecPLF protects loanable-fund protocols from Oracle manipulation, but it lacks a comprehensive transaction-level solution to prevent Oracle-driven malleability. OracleTrust, on the other hand, uses a dual-layer scheme to bind Oracle metadata and signatures to transactions via provenance tracking and a smart contract validation layer. The first layer encodes transactions into verifiable provenance records, and the second layer dynamically verifies these records with salted Keccak hashing and ECDSA recovery to bind the Oracle signature. A time-constrained commit-reveal mechanism with penalty enforcement ensures that the data is tamper-resistant. OracleTrust outperforms existing solutions in detecting malleable transactions, reducing latency, and memory consumption. This demonstrates its superior robustness and efficiency in blockchain.
Web questionnaire survey of physicians and patients on the side effects of trifluridine/tipiracil
Abstract Trifluridine/tipiracil (FTD/TPI) is effective for advanced colorectal and gastric cancers; however, limited real-world data exist on physician and patient experiences with non-hematologic toxicities such as nausea, anorexia, and fatigue. We investigated the real-world incidence and management of these side effects from both perspectives. A web-based questionnaire survey was conducted among physicians experienced in prescribing FTD/TPI and patients with colorectal or gastric cancer who were receiving or had received these medications. Patients reported non-hematologic toxicities‒fatigue, anorexia, nausea, diarrhea, and vomiting‒more frequently and earlier than physicians anticipated. Fatigue and anorexia were the most distressing side effects for patients and the most challenging for physicians to manage. Discrepancies existed between physicians and patients regarding communication and side-effect management strategies. Although nausea and vomiting were manageable with antiemetics, clear management methods for fatigue and anorexia have not been established. Patients valued detailed explanations about medication administration, non-hematologic side effects, and costs more than physicians recognized. In FTD/TPI therapy, a discrepancy exists between physicians’ and patients’ perceptions of non-hematologic toxicities, which may pose challenges in effective symptom management. Symptoms such as fatigue and anorexia appear to be less adequately addressed, highlighting the need for continued efforts to improve management strategies.
Correction: Impact of skin tone, environmental, and technical factors on thermal imaging
Enhanced geometry control powered by AI for UAVS with a robotic arm for compensating for disturbances
Abstract Unmanned Aerial Vehicles (UAVs) equipped with robotic manipulators have emerged as a powerful paradigm for advanced aerial manipulation tasks, including infrastructure inspection, emergency response, and precise object handling in hazardous or inaccessible environments. Despite their potential, integrating robotic arms introduces significant challenges due to strong dynamic coupling, time-varying payloads, and external disturbances such as wind and aerodynamic turbulence, which can severely compromise flight stability and control performance. Conventional linear and nonlinear contrDistributed Control Architecture strategies often struggle to cope with these highly nonlinear dynamics, particularly during aggressive manipulator motions. This paper proposes an AI-enhanced geometric control framework for stabilising UAV–manipulator systems under high-manoeuvrability conditions. By operating directly on the nonlinear configuration space, geometric control provides robust attitude and position stabilization while avoiding singularities and ensuring global stability. To overcome the limited adaptability of purely geometric controllers, artificial intelligence algorithms are integrated to predict and compensate for manipulator-induced disturbances, optimize thrust distribution, and dynamically adjust BLDC motor currents in real time. The integration of robotic manipulators with Unmanned Aerial Vehicles (UAVs) offers a transformative approach to aerial manipulation in hazardous environments. However, the shifting center of mass and aerodynamic coupling during arm movement present significant stabilization challenges. This paper proposes a hybrid control framework that combines Geometric Control on the SO(3) manifold with a Long Short-Term Memory (LSTM) neural network. The LSTM is specifically designed to predict and compensate for non-linear disturbances and dynamic coupling effects in real-time. Experimental results demonstrate that this AI-enhanced geometric approach provides superior attitude tracking and disturbance rejection compared to traditional PID and sliding mode control, significantly reducing oscillation during complex maneuvers. A quadrotor UAV equipped with a Cartesian robotic arm employs the proposed framework for compensation of disturbances affecting both position and orientation. Simulation results obtained using a high-fidelity CoppeliaSim–MATLAB environment demonstrate the effectiveness of the proposed approach. The UAV maintains stable flight and accurate attitude regulation while carrying relatively high payloads and executing rapid robotic arm maneuvers.
Timely Integration of specialist palliative care into oncology care for patients receiving radiotherapy for bone metastases: A study procotol for the TIPZO-RT Randomized Controlled Trial
Background Patients living with advanced cancer often benefit from palliative care. Timely referral to specialist palliative care improves quality of life and reduces potentially inappropriate end-of-life care. Despite these benefits, specialist palliative care is frequently introduced late and inconsistently. This study evaluates whether systematically offering a consultation with the hospital palliative care consultation team (PCCT) to all patients referred for radiotherapy for symptomatic bone metastases improves satisfaction with care. Patients and Methods The Timely Integration of Palliative Care in Oncology care for patients referred for palliative RadioTherapy (TIPZO-RT) trial follows the Trials within Cohorts design and is embedded within the PRospective Evaluation of interventional StudiEs on boNe meTastases (PRESENT+) cohort. Following cohort enrollment, 246 patients will be randomized (1:1) to either the intervention or control group. Patients in the intervention group are offered a PCCT consultation, which they may accept or refrain from. Patients in the control group are not informed about the trial and continue to receive usual care. After four weeks, patient satisfaction with care (affective behavior, EORTC Satisfaction with Cancer Care core questionnaire (EORTC PATSAT-C33)) will be compared between the groups. Secondary outcomes include symptom burden, quality of life, overall survival, and palliative care utilization. Additionally, in the intervention group, patients’ experiences with the consultation are evaluated. Discussion Integrating palliative care into oncological care for patients with advanced cancer is essential to deliver comprehensive, patient-centered care that addresses physical, psychosocial and spiritual needs. This pragmatic study may provide evidence to support timely integration of specialist palliative care for all patients with bone metastases who may benefit from specialist palliative care. Using the Trials within Cohorts design, this study generates real-world evidence on the acceptance or need for a consultation with the PCCT, while minimizing disappointment or response bias, as patients in the control group are not informed. Trial registration ClinicalTrials.gov ID NCT06805396 . Registered on 25-03-2025.
Market sentiment of electric vehicles in Malaysia
Association between different atherogenic and insulin resistance indices and infertility in polycystic ovary syndrome patients
Background This study aimed to assess the association between multiple atherogenic and insulin resistance indices—including TyG, TyG-BMI, AIP, TG-HDL, and METS-IR—and infertility in women with PCOS, and to evaluate their clinical utility. Methods In this cross-sectional study, we analyzed data from 669 sexually active women aged 18–45 with PCOS treated at a tertiary center in Iran (2021–2023). We compared infertile women with PCOS (≥12 months unsuccessful conception, n = 274) to fertile women with PCOS (n = 395). Logistic regression, restricted cubic spline, and receiver operating characteristic (ROC) analysis were used to assess associations and predictive performance. Results Infertile women had significantly worse metabolic profiles across all indices (P < 0.001). AIP showed the largest point estimate of association (adjusted OR = 9.065, 95% CI: 1.722–47.721). TG-HDL showed a significant non-linear relationship, with ORs rising steeply up to a ratio of ~2.5. Predictive ability was modest, with AUCs ranging from 0.598 (TyG-BMI) to 0.625 (AIP, TG-HDL). Conclusion Several metabolic indices, particularly AIP, are associated with infertility in women with PCOS, though their standalone predictive utility remains limited.
External radiation exposure via car-borne survey among returnees in former restricted regions in Fukushima a decade after the nuclear accident
Correction: Pahon Cave, Gabon: New insights into the Later Stone Age in the African rainforest
Metagenomic survey of pathogen prevalence in the infant gut
Prevalence and determinants of workplace violence among nurses in public tertiary hospitals in Enugu state, Nigeria
Background Despite its impact on nurses’ well-being, hospital efficiency, and patients’ quality of care, published studies on workplace violence against nurses in sub-Saharan Africa are scarce. This study assessed the prevalence, characteristics, and determinants of workplace violence among nurses in public tertiary hospitals in Enugu State, Nigeria. Methods The study was a cross-sectional survey among nurses in the four (4) public tertiary hospitals (n = 450) in Enugu State Nigeria. The nurses were selected from the hospitals using proportional stratified random sampling technique. Data were collected using a self-administered, workplace violence questionnaire for nurses. The outcome variable was nurses’ experiences of workplace violence in the past 12 months, scoring as yes or no. Workplace violence included verbal, physical, and sexual violence. Additionally, we collected socio-demographic and organizational characteristics of the nurses. Nurses’ socio-demographic factors, organizational characteristics and prevalence of workplace violence were summarized using descriptive statistics. We identified the predictors of workplace violence using bivariate analysis and binary regression. The significance level for all inferential analyses was p-value less than 0.05. Results Overall, the prevalence of any workplace violence was 92.4%. The prevalence of verbal violence, physical violence, and sexual violence are 91.1%, 13.3%, and 2.0% correspondingly. Relatives of patients perpetrated most workplace violence among nurses in this study. Female nurses were more likely to experience verbal abuse than male nurses (COR = 2.84, 95%CI: 1.09–7.42, p = 0.002). Being a registered nurse (AOR = 2.06, 95%CI: 1.13–3.78, p = 0.019), direct contact with patients (AOR = 21.04, 95%CI: 3.17–139.82, p = 0.002), working in accident and emergency units (AOR = 6.91, 95%CI: 2.82–16.93, p < 0.001) increased the likelihood of physical violence against nurses. Direct contact with patients (AOR = 20.71, 95%CI: 3.54–121.12, p = 0.001) increased the likelihood of sexual violence. Conclusion Workplace violence among nurses in public hospitals need to improve. Decision-makers and practitioners can incorporate these findings into safeguarding policies and strategies to improve nurses’ safety and monitor interventions to eliminate workplace violence against nurses in Nigeria.
Room-temperature memristive switching between charge density wave states
Abstract Control over charge density wave (CDW) states is technologically promising for the development of ultra-efficient memory devices. However, using electrical pulses for non-volatile resistance switching involving CDW states has so far been limited to cryogenic temperatures. In this work, we investigate a recently discovered layered semiconductor EuTe 4, which exhibits the coexistence of distinct CDW orders. We report that electrical pulses can be used for excitation to non-equilibrium, yet stable electronic states across a broad temperature range from 6 K to 400 K. We find that switching occurs through a non-thermal pathway and is reversible via a thermal erase procedure. The resistance of the new electronic state is tunable by the pulse voltage, so the device acts as a memristor. Calculations show fixed bilayer CDW, whereas CDW in single layers shows bistability due to weak Eu-Te links. Low-voltage, fast, and energy-efficient CDW switching holds potential for memristor applications.
DNA damage burden causes selective CUX2 neuron loss in neuroinflammation
Abstract Neurodegeneration shows regional and cell-type-specific patterns in ageing and disease 1 , but the underlying mechanisms for cell-type-specific neuronal losses remain poorly understood. Previous studies have shown that upper cortical layer thinning occurs in progressive human multiple sclerosis (MS) and that cortical layer 2 and layer 3 (L2/3) excitatory neurons (L2/3ENs) that express CUT-like homeobox 2 ( CUX2 ) are selectively vulnerable to degeneration 2 . Here we report that L2/3ENs within MS cortical lesions have an elevated DNA damage burden. DNA damage and selective loss of L2/3ENs were recapitulated in diverse mouse models of demyelination and pan-cortical inflammation, confirming their intrinsic vulnerability. Functions of Cux2 and activating transcription factor 4 ( Atf4 ) were essential for resilience of L2/3ENs during postnatal neuroinflammation, acting in neurons to enhance DNA double-strand break repair. Interferon-γ, a cytokine implicated in MS pathogenesis 3,4 , was sufficient to elevate levels of reactive oxygen species, leading to DNA damage-mediated neuronal death in vitro, and caused selective depletion of L2/3 neurons in mice. These findings indicate that DNA damage burden and inadequate repair in CUX2 + L2/3ENs contributes to selective vulnerability in neuroinflammatory injury.
Co-occurring clonal hematopoiesis exhibits strong selection and high leukemia risk
Abstract Clonal hematopoiesis of indeterminate potential (CHIP) and mosaic chromosomal alterations (mCAs) are two types of clonal hematopoiesis (CH) associated with hematological parameters and malignancy risk. Here we show, in genomic data from 546,090 biobank participants, that co-occurring CH (≥2 CH mutations detected) is present in 1.6% of cancer-free individuals and shows strong evidence for selection (up to 804x enrichment). Co-occurrence is more frequent in those with a prior cancer (3.6%), suggesting treatment-induced selection. Acquisition of CHIP usually precedes mCAs with co-occurrences manifesting stronger phenotypic disruptions in telomere attrition and hematologic parameters than component CH events. Individuals with co-occurring CH have pronounced elevations in risk of myeloid and lymphoid malignancies (HRs>40), particularly when CHIP and mCAs overlap genomically. Our findings indicate CH co-occurrences are selected for in the aging population and identify CH clones with notable implications for future malignancy risk.