Browse Articles
Discover research articles across all indexed journals
US healthcare professionals’ knowledge, attitudes, and practices regarding RSV disease and vaccination in adults during the 2024–2025 RSV season
Background Adults aged ≥60 years and adults with certain chronic medical conditions are at increased risk for severe respiratory syncytial virus (RSV) disease. However, RSV vaccine uptake in the United States (US) remains low, with limited awareness of RSV among adults and potential knowledge gaps among healthcare professionals (HCPs). This study assessed US HCP knowledge, attitudes, and practices (KAP) related to RSV disease and vaccination. Methods A cross-sectional, web-based survey was administered among 700 HCPs, including primary care physicians (PCPs), specialist physicians, nurse practitioners (NPs) and physician assistants (PAs), and pharmacists, between December 2024–January 2025. Survey questions assessed RSV disease- and vaccination-related KAP, with descriptive statistics calculated overall and by HCP type. Characteristics associated with RSV-related KAP were identified through multivariable logistic regression modeling. Results Among the 700 respondents (199 PCPs, 153 specialist physicians, 148 NPs and PAs, and 200 pharmacists), 72.3% reported being very familiar with RSV disease. However, potential knowledge gaps were identified (e.g., related to approved indications for RSV vaccines and Advisory Committee on Immunization Practices [ACIP] recommendations). HCPs commonly cited patients’ refusal or hesitation (62.3%) and patients’ lack of awareness of RSV (58.0%) as barriers to recommending and administering RSV vaccines. Although only 36.4% of HCPs reported that their workplace stocked RSV vaccine(s), 84.1% reported recommending RSV vaccines to eligible adult patients. However, RSV vaccination recommendations were not consistently implemented among all eligible adult patients. In multivariable modeling, characteristics that were significantly associated with RSV vaccination practices included familiarity with RSV disease, knowledge of ACIP recommendations, RSV vaccine stocking, and use of clinical decision supports, among other characteristics. Conclusions Potential knowledge- and practice-related gaps remain regarding adult RSV disease and vaccination among US HCPs. Continued efforts are needed to enhance RSV-related education among HCPs and ensure eligible patients are able to access RSV vaccination.
CVD‑engineered silver nanoparticle substrates for matrix‑free LDI‑MS analysis of diesel fuel components
Abstract Rapid screening of diesel‑fuel composition remains challenging because the hydrocarbon matrix is chemically complex and conventional chromatographic workflows are labor‑intensive. Here, we systematically examined how chemical vapor deposition (CVD) parameters influence the morphology and analytical performance of silver nanoparticle (AgNPs) substrates for nanostructure‑assisted laser desorption/ionization mass spectrometry of diesel‑fuel components. Stainless‑steel plates were coated with AgNPs layers using a volatile silver precursor while varying deposition time, precursor‑evaporation temperature (T s ), deposition temperature (T d ), and argon flow rate. The resulting surfaces were characterized by SEM and AFM, and their performance was evaluated by LDI‑MS for a certified diesel standard and three real diesel samples, in parallel with conventional MALDI‑MS using DHB and HCCA matrices. Within the investigated dataset, substrates prepared at T s = 240 °C, T d = 290 °C, 60 min, and intermediate Ar flow formed continuous fine‑grained AgNPs films that were among the best‑performing surfaces in terms of signal richness and spectral coverage. For the real diesel samples analyzed here, AgNPs‑assisted NALDI generally produced cleaner, analyte‑centered spectra than MALDI‑MS, whereas for the diesel reference standard the MALDI datasets contained a broader overall set of detected m/z features. These findings support CVD‑prepared AgNPs substrates as promising matrix‑free platforms for rapid diesel profiling, although the present conclusions should be regarded as exploratory until validated with independently prepared replicate substrates.
LNC297 promotes BMSCs differentiation and alleviates BHBA-induced inhibition through the miR-145/GAS7 axis
Ketosis in dairy cows is characterized by elevated circulating β-hydroxybutyrate (BHBA) and profound alterations in whole-body energy metabolism. As a major peripheral tissue responsible for energy consumption and substrate utilization, skeletal muscle is continuously exposed to increased BHBA during ketosis and may use BHBA as an alternative energy substrate. However, the regulatory mechanism by which BHBA affects skeletal muscle differentiation remains unclear.This study used bovine skeletal muscle satellite cells (BMSCs) to investigate the effects of BHBA on the differentiation of BMSCs and to explore the regulatory roles of LNC297, miR-145, and GAS7 in this process. The results of dual-luciferase reporter gene assays and miRNA pull-down experiments verified the targeting relationship between LNC297, miR-145, and GAS7. BHBA inhibits the differentiation of BMSCs in a dose-dependent manner. Both LNC297 and GAS7 promote the differentiation of BMSCs and attenuate the inhibitory effect of BHBA. In contrast, miR-145 inhibits BMSCs differentiation and enhances the inhibitory effect of BHBA. Mechanistically, LNC297 acts as a competing endogenous RNA (ceRNA) or molecular sponge for miR-145, thereby upregulating GAS7 expression and promoting its differentiation function. LNC297 may promote muscle differentiation through the miR-145/GAS7 axis, thereby alleviating muscle damage in cows with ketosis, providing a new perspective for investigating the mechanisms of muscle development disorders.
Mancozeb induces cytotoxicity and functional impairment in bovine mammary epithelial cells through ER stress, oxidative stress, and inflammatory responses
Association of triglyceride-glucose index (TyG) and a body shape index (ABSI) with cognitive decline and dementia risk
Background Longitudinal evidence linking the body shape index (ABSI) to dementia and its subtypes remains scarce. Furthermore, the use of ABSI and TyG-ABSI as predictors of cognitive decline and dementia is infrequent. Therefore, this study aimed to examine the relationships between the triglyceride-glucose (TyG) index, ABSI, and TyG-ABSI indices and their predictive value for cognitive decline and dementia risk. Methods This study included 370,744 participants from the UK Biobank. The TyG and ABSI indices were calculated using their respective formulas, while the TyG-ABSI index was derived by multiplying TyG and ABSI. Cognitive decline was defined as scoring in the bottom 25% on cognitive tests, while dementia was diagnosed from first-recorded incidents and algorithmically-defined outcomes. Logistic regressions were employed to assess the associations of TyG, ABSI and TyG-ABSI indices with cognitive decline; Cox regressions were used to analyze the associations of these indices with the risk of all-cause dementia (ACD) and its subtypes. Result The TyG, ABSI, and TyG-ABSI indices were all significantly associated with cognitive decline. Additionally, compared with the lowest quartiles, the highest quartiles of TyG, ABSI and TyG-ABSI indices were associated with a significantly increased risk of ACD by 33% (HR = 1.33, 95% CI: 1.13–1.57), 79% (HR = 1.79, 95% CI: 1.65–1.94) and 67% (HR = 1.67, 95% CI: 1.54–1.82), respectively. These indices were also significantly associated with the risk of Alzheimer’s disease (AD) and vascular dementia (VD) (all P < 0.05). Conclusion The TyG, ABSI, and TyG-ABSI indices are significantly and positively linked to the risk of cognitive decline and dementia.
Perception and utilization of artificial intelligence in healthcare research among professionals in India: a cross-sectional study
Characterization of aortic endothelial dysfunction in ovariectomized allergic asthmatic mice
Clinical observations suggest that sex hormones may have a role in female asthma-related cardiovascular diseases (CVD), however, the mechanism by which sex hormones may influence CVD in asthmatics is unknown. The goal of this study was to determine if ovariectomized (OVX) mice with asthma alter asthma severity biomarkers and vascular reactivity. Female C57/BL6 mice were assigned to 4 groups: 1) sham vehicle control (VC), 2) OVX VC, 3) sham asthma, and 4) OVX asthma. Asthmatic groups were sensitized with 30 μg ovalbumin suspended in Imject alum by i.p. injections followed by 5% ovalbumin in saline for aerosol challenges. Vehicle groups received an identical treatment without ovalbumin. In the lungs, the eosinophil population was significantly higher in OVX asthma mice than in sham asthma mice (58 ± 9 vs. 76 ± 5%). Similarly, the OVX asthma group had significantly higher plasma anti-IgE (8.98 ± 1.66 vs. 27.5 ± 2.07 ng/mL) and elevated cytokines in bronchoalveolar lavage fluids. Isometric tension experiments demonstrated that maximal acetylcholine-induced aortic relaxation was significantly reduced by approximately 24% in both asthmatic mice groups compared with respective vehicle control mice. Similarly, the nitric oxide component of Ach-induced relaxation was significantly reduced in both asthma groups, but there were no differences between sham and OVX asthmatic mice. Our data demonstrated that OVX asthmatic mice developed exacerbated allergic lung responses, and lung-initiated inflammation can extend to impair endothelial function in the aorta.
Trade-offs and synergies of ecosystem services in the yellow river basin: spatial dynamics and driving factors
Early community reactions and acceptance of the Sliding-Scale Community Based Health Insurance Scheme in Ethiopia: Qualitative Findings from the treatment arm
Background Ethiopia’s Community-Based Health Insurance (CBHI) launched in 2011, has significantly improved access to healthcare. However, the program has faced several challenges, including concerns about equity, financial sustainability, and limited resource mobilization stemming from its flat-rate premium contribution system. To address these issues, a new sliding-scale premium scheme—based on households’ socio-economic status—has been piloted in 13 districts across Oromia and Sidama regions in Ethiopia. However, empirical evidence on community responses to sliding-scale CBHI models remains unexplored. Objective To generate early empirical evidence on community responses to Ethiopia’s new sliding-scale CBHI policy (socio-economic-based premium differentiation), focusing on acceptability, perceived concerns, and community perceptions of relevance, appropriateness, affordability, equity and fairness. Methods The study was conducted between March and May 2024 in 13 pilot districts across Oromia and Sidama regions where the sliding-scale CBHI pilot was implemented. Using a qualitative design, data were collected through 10 focus group discussions and 16 key informant interviews with community members, local leaders, and health officials, who were purposely selected to capture diverse perspectives. Discussions explored community acceptance, affordability, and experiences with the new scheme. Transcripts were translated and analyzed thematically using ATLAS.ti 7.5, following open coding and triangulation to identify key themes on barriers, facilitators, and overall community response. Results The study found generally positive community reception of the sliding-scale CBHI scheme, which was widely perceived as acceptable, more equitable, inclusive, and better aligned with households’ economic capacity. However, this acceptance was conditional, as it depended on sustained improvements in service quality, consistent availability of medicines, and transparent management of scheme funds. Moreover, operational challenges were also reported, including household misclassification, perceived favoritism, inconsistent application of eligibility criteria, and inadequate communication of the scheme’s procedures and decisions. While stakeholders viewed the reform as a promising step toward a more equitable and inclusive system, sustaining support will require strengthened trust and consistent service delivery. Conclusion The early implementation of Ethiopia’s Sliding-scale CBHI premium system was generally well received by community members and implementers, who viewed it as fair, contextually appropriate, and aligned with households’ ability to pay. The participatory, asset-based classification process enhanced legitimacy, ownership, and trust. However, operational and ethical challenges such as misclassification, favoritism, inconsistent criteria, and limited communication were reported. Participants highlighted the need for improved transparency, grievance handling mechanisms, and consideration of broader livelihood factors to sustain trust and ensure long-term acceptance and equity in the scheme.
In vitro fertilization and the risk of placenta accreta spectrum: a systematic review and meta-analysis
Abstract Placenta accreta spectrum (PAS) is an increasingly common obstetric complication, characterised by the abnormal attachment of placental villous tissue to the uterine wall. Medline, Embase, Scopus, and Google Scholar were searched to identify observational studies that provided data on IVF pregnancies and PAS at birth between September 1980 and April 2025. The methodological quality of studies was assessed using the Newcastle–Ottawa Scale. Data were combined using a random-effects, generic inverse-variance approach, which allows the inclusion of diverse relative risk estimates in a single meta-analysis. The primary measures were the incidence of nulliparity, placenta previa, previous cesarean deliveries, and the type of IVF techniques used. The risk of both PAS and placenta previa was significantly increased in IVF compared to spontaneous conception (SC) pregnancies ( p = 0.002 and p = 0.005, respectively), and the risk of PAS was significantly ( p = 0.002) increased in patients undergoing frozen embryo transfer (FET) compared to those undergoing fresh embryo transfer. A significantly ( p = 0.001) higher number of patients with IVF pregnancies were nulliparous compared to SC pregnancies. Due to the heterogeneity and poor quality of the included studies, the evidence that IVF is an independent factor in the development of PAS during pregnancy remains scant and limited. Any association between IVF and PAS is likely indirect, mediated through higher rates of placenta previa and prior uterine surgery, rather than a direct biological effect of IVF itself.
Structure-guided identification of a potential inhibitor targeting the VacA toxin of Helicobacter pylori
Various human diseases including gastric inflammation, ulcers, stomach malignancies, and even coronary heart disease are significantly influenced by the infection of the gram-negative bacterium Helicobacter pylori. While antibiotics are commonly used to treat H. pylori infection, their effectiveness is compromised by the development of antibiotic resistance. Therefore, the development of novel therapeutics against this pathogen is imperative. The virulence factor “vacuolating cytotoxin autotransporter (VacA)” was annotated from H. pylori genome by using the RAST server. All strains of H. pylori contain VacA toxin. Phyre2 and SWISS-MODEL servers were used for modeling and evaluating the structure of the active site containing p55 domain of VacA toxin (PDB: 2QV3) which shows the Ramachandran plot (98.68%), MolProbity Score (1.32), Bad Bonds (0), and Clash Score (5.78) of the refined model of VacA toxin. Autodock Vina was used to dock 3000 ligand molecules obtained from the ZINC15 database which identified only 178 ligands bind to VacA’s active site. Molecular docking and ADMET studies predicted ZINC4004291 ((3As,4R,9bS)-4-pyridin-4-yl-8-(trifluoromethyl)-3a,4,5,9b-tetrahydro-3H-cyclopenta[c]quinolone) as the best inhibitor of VacA toxin based on its strong binding affinity (−6.9 kcal/mol) and low toxicity. Molecular dynamics simulation indicated favourable levels of RMSD, RMSF, Rg, SASA and Hbonds exploring the stable dynamics of the docking complex between the p55 domain of VacA toxin and ZINC4004291 ligand. Moreover, principal component analysis and Gibbs free energy landscape studies indicate the favourable thermodynamic stability of the complex during 100 ns simulation period. Thus, the ligand ZINC4004291 is a computationally identified in silico hit for a possible drug to treat H. pylori infection, while additional experimental validation required.
Sequential removal of oppositely charged multi pollutants from wastewater using sugarcane bagasse
Abstract Efficient removal of organic pollutants from water remains a major challenge. In this work, a circular economy strategy is adopted to address critical challenges associated with excessive waste generation, resource limitations, and economic sustainability. Sugarcane bagasse (SCB), an abundant lignocellulosic agricultural waste, was utilized as a sustainable adsorbent for the sequential removal of oppositely charged dyes from aqueous solutions. Pristine SCB was first employed for the adsorption of the anionic dye Alizarin Red S (ARS), and the resulting spent adsorbent (SCB@ARS) was subsequently reused without regeneration for the removal of the cationic dyes Crystal Violet (CV) and Methyl Green (MG). The adsorbents were characterized using point of zero charge (pH PZC ), Fourier-transform infrared spectroscopy (FTIR), Thermogravimetric analysis (TGA), Scanning electron microscopy (SEM), and Energy-dispersive X-ray spectroscopy (EDX). The effects of adsorption parameters, including shaking time, pH, dye concentration, and adsorbent dose, were studied. The maximum adsorption capacities of SCB for ARS and SCB@ARS for CV and MG were 99.38, 136.84, and 452.26 mg/g, respectively. Kinetic, isotherm, and thermodynamic studies indicated that the adsorption process was best described by the linear pseudo-2nd-order and nonlinear pseudo-1st-order kinetic models and the Langmuir isotherm model, and was thermodynamically feasible and spontaneous. The adsorption mechanism was further elucidated using pH PZC and FTIR analyses. Recovery studies in pharmaceutical and real water samples demonstrated removal efficiencies exceeding 90%. A one-way ANOVA statistical analysis was used to evaluate the effect of pH on adsorption. These findings highlight the potential of sequential adsorption using renewable agricultural waste as an effective and sustainable wastewater treatment strategy.
Digital transformation of spiritual care education: A scoping review protocol of technology-enhanced learning for nursing students and professionals
Background Spiritual care is a fundamental yet often under-addressed component of holistic nursing, with nurses and nursing students globally reporting limited competency. Traditional education models face challenges in accessibility, scalability, and pedagogical depth. While digital technologies offer transformative potential for learning, the evidence regarding their application and effectiveness in spiritual care education remains fragmented and insufficiently synthesized. Objective This scoping review aims to systematically map the existing literature on the use of digital technologies in spiritual care education and training specifically for nurses and nursing students. Methods The review will be conducted following the Joanna Briggs Institute (JBI) methodology for scoping reviews and reported per the PRISMA-ScR guidelines. A comprehensive search will be performed across multiple databases (e.g., MEDLINE, CINAHL, PsycINFO, Web of Science, Scopus, CNKI, WanFang) from inception, supplemented by grey literature searches. Two independent reviewers will screen records, select studies, and extract data using a standardized form. We will include empirical studies focusing on digital interventions (e.g., online courses, mobile apps, virtual simulations) designed to develop spiritual care competency in the target population. Data will be analyzed using descriptive statistics and thematic analysis. Anticipated results The review will generate a comprehensive map and classification of existing digital spiritual education interventions, detailing their technological characteristics, pedagogical strategies, outcome measures, and implementation facilitators and barriers. It is expected to identify key evidence gaps and inconsistencies in the field. For example, we anticipate identifying virtual simulation, online modules, and mobile apps as the most common categories. Significance This will be the first scoping review to systematically consolidate evidence on digital spiritual education for nurses. The findings will provide a foundational resource to inform the future design, implementation, and evaluation of theoretically grounded, effective, and scalable digital training models, ultimately aiming to enhance spiritual care competence in nursing practice. Systematic review registration OSF registration number: https://doi.org/10.17605/OSF.IO/7VNHF .
Quantitative segmental organization of spinal motoneuron projections to terminal brachial plexus nerves in the rat
The 2024–2025 Pertussis outbreak in children in Chengdu: A large-scale retrospective cross-sectional study
Objective To characterize the epidemiological features of pertussis among pediatric patients tested by polymerase chain reaction (PCR) at a tertiary children's hospital in Chengdu from May 2024 to April 2025, with particular emphasis on temporal variation and age distribution, to inform regional prevention strategies. Methods This retrospective cross-sectional study included 19,084 pediatric patients who underwent PCR testing for Bordetella pertussis . Multivariable logistic regression and subgroup analyses were used to examine associations between PCR positivity and season, age group, sex, and visit type. Results The overall PCR positivity rate was 20.47% (3,905/19,084). Summer had the highest positivity rate (25.62%) and accounted for the majority of positive cases (67.12%, 2,621/3,905), followed by spring (21.50%; 23.58% of cases, 921/3,905). The monthly number of positive cases peaked in June 2024 (n = 1,078). School-aged children (6 to <12 years) represented the largest proportion of positive cases (56.72%, 2,215/3,905) and had significantly higher PCR positivity than other age groups (χ² = 1098.21, df = 4, P < 0.001). In multivariable analysis, school-aged children had higher odds of PCR positivity than adolescents (adjusted OR = 1.55, 95% CI 1.23–1.95). No significant association with sex was observed. Outpatients showed higher PCR positivity than inpatients (21.41% vs. 13.66%; crude OR = 1.72, 95% CI 1.52–1.95, P < 0.001). The outpatient advantage was most pronounced in spring (crude OR = 1.95) and summer (crude OR = 1.44), with a significant interaction by season ( P = 0.013). Conclusion This hospital-based study identified a substantial burden of PCR-confirmed pertussis among symptomatic children in Chengdu during the study period, with a prominent peak from May to July 2024 and the highest positivity among school-aged children. These findings may partly reflect waning vaccine-induced immunity and increased social contact in school settings, and support strengthened surveillance, timely PCR testing, and targeted pertussis prevention strategies for school-aged children.
Group normative data and arbitrary asymmetry thresholds fail to represent individual players in weekly hip strength monitoring
Abstract Hip and groin injuries account for 10–18% of all time-loss injuries in elite football, yet return-to-play decisions can rely on group normative data or arbitrary asymmetry thresholds (10–15%) with limited empirical support. We characterised the longitudinal behaviour of isometric hip adduction and abduction strength across a full Premier League season at weekly resolution, evaluated whether group normative data can adequately represent individual players, and assessed the clinical utility of standard asymmetry thresholds. Seventeen male Premier League players (age: 25.0 ± 5.7 years, height: 181.7 ± 7.9 cm, body mass: 75.7 ± 7.3 kg) underwent weekly bilateral isometric hip strength testing using a fixed-frame dynamometer across 35 weeks (589 player-week observations). Linear mixed-effects models, intraclass correlation coefficients, and three clinically used reference strategies (pre-season baseline, contralateral limb, 4-week rolling average) were employed. Normalised adduction strength increased significantly across the season ( p < 0.001), but players changed at significantly different rates ( p < 0.001), meaning no single group trajectory could represent all individuals. Between-player variance accounted for 64–78% of total variance in normalised hip strength, causing group normative bands to be too wide to reliably detect meaningful within-player change. Despite all 17 players remaining injury-free, 37% of sessions exceeded the 10% interlimb adduction asymmetry threshold. Ipsilateral adduction: abduction ratios averaged 0.75–0.85, rendering the 10% interlimb threshold inappropriate. The three reference strategies agreed on approximately half of flagging decisions, and weekly monitoring revealed clinically meaningful fluctuations entirely invisible to traditional pre-mid-post designs. Group normative data, static baselines, and arbitrary thresholds may be inadequate for individual clinical decision-making. Individualised longitudinal monitoring is recommended; the three reference strategies answer different clinical questions and are best used in combination, with rolling averages as the primary within-season tracking tool alongside pre-season baselines and contralateral comparisons as complementary reference points.
Protein intake and injury outcomes among fallers in the Women’s Health Initiative’s Objective Physical Activity and Cardiovascular Health in Older Women Study
Background Falls among older adults are associated with increased morbidity, mortality, and healthcare costs; therefore, it is critical to assess modifiable risk factors. This study aimed to determine if low protein intake among older women was associated with injuries among fallers. Methods The Women’s Health Initiative ancillary studies, Live Long Study (LLS), Food Intake (FI), and Objective Physical Activity and Cardiovascular Health in Older Women study (OPACH) were combined for analyses (n = 6,580; n = 1,285 fallers). Protein intake was assessed by food frequency questionnaires at LLS/FI/OPACH baseline. Participants completed fall calendars for 13 months and self-reported injuries in interviews. Logistic regression determined odds ratios (OR) and 95% confidence intervals (CI) for risk of injurious falls and falls with fracture. Diabetes medication use had a significant interaction between protein density and fall with any injury; thus, models were stratified. Results Of the participants who fell, 841 (65.4%) fell without injury, 444 (34.6%) fell with injury, and 70 (7.7%) fell with fracture. Lower protein density (<15% calories from protein) increased risk of fracture from falling (OR: 1.73; 95% CI: 1.02–2.92) compared to those with higher protein density (≥15% calories from protein). Among participants with diabetes medication use and lower protein density, the OR for any injury from falling was 5.54 (95% CI: 1.79–17.19) compared to those with higher protein density though based on a small subgroup. Conclusion Lower protein density increased risk of injurious falls. Dietary and medication screening may facilitate selection and tailoring for behavioral falls prevention to reduce injurious falls and fractures.