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Adolescent sexual and reproductive health literacy in Saudi Arabia: The roles of school type and maternal education
Background Adolescent sexual and reproductive health (SRH) literacy remains uneven in conservative settings. We assessed SRH knowledge among female secondary-school students in Al-Madinah Al-Monawara and examined socio-demographic correlates and parent–daughter communication. Methods Cross-sectional survey of 389 students (grades 10–12) selected via stratified cluster sampling from government and private schools (20 June–20 July 2024). A validated Arabic questionnaire measured domain-specific SRH knowledge (menstruation, reproductive anatomy, contraception, sexual relationships), sexually transmitted disease (STD) awareness, and parent–daughter communication. Analyses included t -tests/ANOVA, Pearson correlations, and multivariable OLS with HC3-robust SEs. Results Knowledge gaps were concentrated in contraception and sexual relationships; 61 students incorrectly endorsed casual contact as a transmission route for STDs. Private-school students had higher composite SRH scores than government-school peers ( t -test, p < 0.01 ). Maternal education correlated with SRH knowledge ( r = 0.38, p < 0.001 ). Scores varied by age (ANOVA F = 4.67, p = 0.009 ), but age was not an independent predictor in regression. In multivariable models, private-school attendance ( β = 0.212, p = 0.018 ) and higher maternal education ( β = 0.043, p = 0.019 ) independently predicted higher SRH knowledge; paternal education, age, and family size were non-significant. Parent–daughter discussions were infrequent; 72% of students supported school-based SRH education. Conclusions SRH literacy among Saudi adolescent girls is uneven, with prominent misconceptions in contraception and transmission. School type and maternal education are actionable levers. Culturally attuned, standardized curricula—especially in government schools—combined with parent-focused communication supports are warranted to close knowledge gaps and reduce stigma.
Anti-interference framework for weakly supervised thermal defect segmentation on high-rise building facades
Priming iTBS for lower limb rehabilitation after stroke: Protocol for a randomized controlled trial on efficacy and neuroplasticity
Introduction Repetitive transcranial magnetic stimulation (rTMS) is widely applied in treating motor dysfunction after stroke. Building on metaplasticity principle, continuous theta burst stimulation (cTBS) preconditioning enhances subsequent excitatory effects of intermittent theta burst stimulation (iTBS). This phenomenon is well-established for upper limbs in healthy populations, yet its application to the lower limbs remains underexplored, especially in stroke survivors. Guided by “central-peripheral-central” theory, this protocol investigates the synergistic effects of cTBS-preconditioned iTBS combined with lower limb robotic exoskeleton training for functional recovery and neuroplasticity after stroke. Methods and analysis This single-blind, three-arm randomized controlled trial will assess the effects of priming iTBS combined with REX exoskeleton training in subacute stroke patients. Participants (n = 60) will be randomly assigned 1:1:1 to: (1) priming (cTBS + iTBS), (2) non-priming (sham cTBS + iTBS), or (3) sham stimulation (sham cTBS + sham iTBS). Stimulation targets lower-limb primary motor cortex (M1) using a double-cone coil (80% active motor threshold). All groups will receive REX exoskeleton training as conventional therapy to facilitate sensorimotor loop integration through proprioceptive feedback. The intervention lasts for 4 weeks, with assessments at baseline, mid-intervention, post-intervention, and 6-week follow-up. Primary outcome is the Fugl-Meyer Assessment of Lower Extremity (FMA-LE) score. Secondary outcomes include the Postural Assessment Scale for Stroke (PASS), Modified Barthel Index (MBI), and three-dimensional gait analysis, complemented by surface electromyography (sEMG) to assess muscle activation patterns and coordination during functional movements. The functional near-infrared spectroscopy (fNIRS) functional connectivity, motor evoked potential (MEP) indices, and electroencephalography (EEG) signals will be analyzed to explore the neural plasticity underlying the treatment effects. Data will be analyzed using mixed-design analysis of variance (ANOVA), and the study achieves 90% power to detect FMA-LE differences with 20 participants per group.
Right vagus nerve stimulation promotes motor cortical plasticity
Time-dependent changes in stepping performance and velocity following partial dopaminergic lesions in the SNc of male and female rats
Parkinson’s disease (PD) is a neurodegenerative disorder in which gait disturbances are a major source of disability, yet their early manifestations remain difficult to characterize because prodromal PD is challenging to identify in humans. Rodent models may help address this gap by approximating partial dopaminergic loss and enabling investigation of motor changes that precede overt symptoms. Here, we examined stepping performance and velocity in Wistar rats following unilateral low-dose 6-hydroxydopamine (6-OHDA) lesions in the substantia nigra pars compacta (SNc). Animals were assessed weekly for six weeks in the horizontal ladder, where velocity and footfall errors were quantified using markerless pose estimation with DeepLabCut (DLC). Lesioned animals showed greater tyrosine hydroxylase (TH) asymmetry than controls, accompanied by persistent but gradually attenuating impairments in stepping accuracy. Footfall errors peaked around week three and remained elevated thereafter, whereas velocity showed more heterogeneous changes across time. Although sex effects were not uniformly robust, control females showed an increase in velocity across weeks, whereas lesioned females exhibited a less pronounced and more variable pattern. These findings indicate that partial SNc lesions can reveal subtle and time-dependent alterations in locomotor skills relevant to the study of early dopaminergic dysfunction. Combined with DLC-based tracking, this framework provides a practical approach for detecting early behavioral changes and refining the study of preclinical motor features of PD.
A detailed DFT inspection on the trapping of aspirin from drinking water using B12N12 nanocage
USMLE Step 2 Clinical Knowledge performance by disability, race, and ethnicity in U.S. medical students: A multi-site study
Importance With the transition of USMLE Step 1 to pass/fail, USMLE Step 2 Clinical Knowledge (CK) has become a high-stakes component of residency selection. This shift raises concerns that increased reliance on Step 2 CK may exacerbate existing inequities, particularly for medical students with disabilities and those with intersecting marginalized identities. Objective To examine differences in USMLE Step 2 CK performance by disability status, race, ethnicity, and their intersections among U.S. medical students. Methods We conducted a cross-sectional analysis of the Pathways II dataset, comprising deidentified student-level data from nine U.S. MD-granting medical schools. Graduated students from the 2020–2023 cohorts were included. Medical students with disabilities were defined as those formally registered with institutional disability resource offices and were matched 1:2 with nondisabled peers by institution, gender, graduation cohort, and MCAT score. Race and ethnicity were categorized as White, Asian, underrepresented in medicine (URiM, including American Indian/Alaska Native, Black/African American, Hispanic/Latino, and Native Hawaiian/Pacific Islander), or Other. Disability categories included ADHD, learning, psychological, mobility/sensory, chronic health, or other. Multivariable linear regression models estimated adjusted Step 2 CK score differences by disability status, race, ethnicity, and their interactions, adjusting for MCAT score and clustering standard errors at the school level. Results Among 1,350 students, 448 (33.2%) had a registered disability. The mean Step 2 CK score was 244.3 (SD, 15.1). Students with disabilities scored lower than nondisabled peers (mean 239.6 vs 246.7; adjusted β, −7.02; 95% CI, −8.76 to −5.28). Students with ADHD, learning, or psychological disabilities scored 9–11 points lower than nondisabled peers (P < .001). URiM students scored lower than White students overall (adjusted β, −8.50; 95% CI, −10.74 to −6.25). Intersectional analysis demonstrated that disparities were largest among URiM and Asian students with disabilities. Conclusions Medical students with disabilities experience significant disparities in Step 2 CK performance, particularly those with cognitive-based disabilities and intersecting marginalized identities. As Step 2 CK plays a larger role in residency selection, addressing structural barriers in assessment and accommodation processes is critical to advancing equity.
Synergistic enhancement of zinc anode stability via bismuth alloying and CO2 exposure in 1 M KOH for alkaline battery applications
Abstract This study systematically investigates the electrochemical performance of pure zinc and zinc-0.5 wt% bismuth electrodes employed as anodes in alkaline battery systems using a 1 M KOH electrolyte, under both CO₂-free and CO₂-saturated environments. Electrochemical behavior was evaluated through potentiodynamic polarization, electrochemical impedance spectroscopy (EIS), and galvanostatic charge–discharge cycling. Surface morphology, elemental composition, and phase structure were analyzed using scanning electron microscopy coupled with energy-dispersive X-ray spectroscopy (SEM-EDX) and X-ray diffraction (XRD). The introduction of CO₂ markedly reduced the corrosion current density ( i corr ) of both electrodes, indicating a significant mitigation of corrosion processes. Notably, the zinc–bismuth alloy exhibited superior electrochemical performance compared to pure zinc. Under CO₂-containing conditions at 25 °C, the Zn-Bi electrode achieved a maximum corrosion inhibition efficiency of 87.615%. Galvanostatic cycling results further demonstrated enhanced charge–discharge behavior, improved capacity retention, and greater electrochemical stability in the presence of CO₂. These results highlight the strong potential of Zn-Bi alloys as durable and high-performance anode materials for advanced alkaline battery applications.
The importance of baseline health in linking life purpose to longevity
The well-established inverse relation between purpose in life and mortality risk is widely interpreted in the literature as evidence that higher purpose causes greater longevity. This study assesses the role of baseline health in linking purpose and longevity. Based on a prospective cohort sample of 5,953 US adults aged ≥ 50 drawn from the Health and Retirement Study (2006–2018), we replicate a recent high-quality study that documents the correlation between purpose and longevity and then examine the sensitivity of the results to varying the amount of baseline health measurement error and limiting the sample to individuals with more homogeneous levels of baseline health. The relation between life purpose and longevity strongly attenuates when using more robust measures of baseline health and excluding individuals who are already seriously ill. For instance, in a model that uses the coarse measures of baseline health typically used in this literature, individuals with low purpose exhibit a hazard ratio for the subsequent 4-year period of 2.59 (95% CI = 1.43, 4.68). Once adjusting for more robust objective measures of baseline health, the hazard ratio falls to 1.77 (95% CI = 0.97, 3.22). After adjusting for objective measures of baseline health and excluding already ill individuals, the associated hazard ratio falls to 1.20 (95% CI = 0.66, 2.20) for survival over years 5–8 and 0.75 (95% CI = 0.42, 1.32) for survival over years 9–12. The results suggest that baseline health confounding or mediation explains much of the apparent relation between life purpose and longevity, and that the strong associations reported in the literature may largely reflect inadequate measurement of baseline health rather than a causal effect of purpose on longevity.
Stochastic human exposure-risk modelling and environmental health implications of potentially toxic elements in the Mubuku irrigation scheme, Uganda
Comprehensive quantum chemical analysis, vibrational spectroscopy, molecular docking, ADMET, and in vitro validation studies of hydroxychloroquine-MRGPRX2 complex in IDH-wildtype glioblastoma
Glioblastoma is an aggressive astrocytic neoplasm characterized by significant intratumoral heterogeneity and resistance to standard therapies. Despite advances such as the Stupp protocol, the prognosis remains poor, with a median survival of 12–15 months. Mast cells in the tumor microenvironment (TME) release pro-inflammatory mediators, promoting tumor progression and therapeutic resistance. The Mas-related G protein-coupled receptor X2 (MRGPRX2), expressed on mast cells, is implicated in neuroinflammatory regulation. This study evaluates hydroxychloroquine (HCQ), a 4-aminoquinoline derivative, as a potential MRGPRX2 inhibitor using a comprehensive multidisciplinary approach. Density Functional Theory (DFT) at the B3LYP/6–31 + G(d,p) level was employed to analyze the structural and electronic properties of HCQ, validated by FTIR and Raman spectroscopy. To ensure statistical robustness and address receptor specificity, 100 independent blind docking simulations were performed using the high-resolution MRGPRX2 structure (PDB ID: 7S8L). The docking protocol was rigorously validated through a cross-docking study using the 7S8N reference ligand, yielding a high spatial consensus with an RMSD of 3.06 Å. The results revealed that HCQ possesses a superior binding affinity of −7.0 kcal/mol, while comparative docking with the standard therapeutic Temozolomide (TMZ) yielded a lower affinity of −5.6 kcal/mol. Detailed residue-level analysis highlighted a distinct binding fingerprint for HCQ, involving specific interactions with residues such as Tyr137, Ser130, and Phe64, which were notably different from the TMZ-receptor complex. ADMET profiling confirmed HCQ’s favorable pharmacokinetic properties and its potential to cross the blood-brain barrier. In vitro validation on U87-MG glioblastoma cells demonstrated a time-dependent cytotoxic effect, where HCQ significantly reduced cell viability to approximately 70% at 72 hours (p < 0.01). This biological activity directly correlates with the strong binding profile and high affinity observed in the 100-run docking analysis . Our findings suggest that HCQ is predicted to interact with MRGPRX2 with a high binding affinity, supporting further functional validation and providing a novel structural basis for targeting mast cell-mediated neuroinflammation in glioblastoma treatment. These results advocate for the repositioning of HCQ as a targeted adjuvant therapy to overcome conventional treatment limitations.
A study on physicians’ perceptions of privacy in the context of the e-Nabiz (e-Pulse) in the Turkish healthcare system
Heavy metal footprints in landfill-proximate soils of Jashore, Bangladesh: An index-based risk assessment
Disposal of the household originated and industrial hazardous materials with municipal solid waste (MSW) into the open dumping sites is the usual practice in Bangladesh which raises concerns regarding the pollution of the regions adjacent to these landfill sites. The study evaluated the impact of landfill techniques and environmental factors on soil contamination by potentially toxic elements and the corresponding environmental hazards. This study assessed the potential ecological hazards linked to a landfill s ite in southwestern Bangladesh. ICPMS and AAS were used to detect eleven heavy metals in soils from the landfill. This analysis aimed to uncover the origin, degree of contamination, geographical representation, and the environmental and human health hazards connected with these metals. Mean levels of the metals in mg/kg were As (12.02 ± 4.40); Hg (0.611 ± 0.441); Cd (0.606 ± 0.487); Pb (37.5 ± 14.08); Cr (46.9 ± 10.06); Zn (260.7 ± 201.0); Co (16.03 ± 3.02); Ni (39.5 ± 11.6); Cu (260.7 ± 55.79); Mn (613.2 ± 189.6); Fe (26087 ± 4396). This investigation discovered significant amounts of As, Hg, Cd, Pb, Zn, Cu, and Mn relative to established standards. The ecological risk assessment index revealed that Cd exhibited the most significant level of danger, whereas Cu and As demonstrated a moderate level of danger. The health index values indicate that the levels of As and Zn in adults and children exceeded the acceptable limit, while the levels of Pb, Cr, Fe, Cu, Ni, and Co among children came close to the borderline. The TCR values of Ni for children are beyond the permissible level. PCA revealed that the majority of heavy metals are derived from human activity. Consequently, administration strategies for remediating these open dumps nationwide should include continuous monitoring and surveillance of neutralized dumpsites to avert further contamination.