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Examining women’s choice between home and institutional births: Insights from the Salud Mesoamérica Initiative (SMI)
This study examines women’s childbirth choices between home and institutional settings in the context of the Salud Mesoamérica Initiative, a results-based financing program focused on disadvantaged populations. This study characterizes the childbirth experience using the World Health Organization’s Positive Childbirth Experience framework, identifies factors influencing women’s decisions for home versus institutional births, and describes reasons for transitions between these settings, especially for women with multiple pregnancies. A retrospective observational study was carried out using secondary data from household surveys carried out in Guatemala, Chiapas (Mexico), Nicaragua, and Honduras. A two-stage random sample of women (15–49 years) who had a live birth within five years preceding the surveys was analyzed. Quality of institutional care and reasons for home birth were categorized into specific domains and data across three follow-up points were analyzed using design-adjusted chi-squared tests (Rao-Scott correction). Finally, for the second follow-up, a sub-analysis explored setting transitions for women with multiple pregnancies. The main results indicate that Guatemala had the highest rate of home births (83.8%), while institutional deliveries were more common in Honduras and Nicaragua. Over time, institutional births increased across the board, notably in Honduras, where they surged from 72.3% to 92.7%. The primary factors influencing birth setting choices were accessibility and cultural preferences, with the latter being particularly significant in Guatemala and Chiapas. The results underscore the critical need for culturally sensitive strategies to boost institutional birth rates. While enhanced accessibility has contributed to more institutional deliveries, deep-seated cultural preferences remain a considerable hurdle. Interventions that respect local beliefs while simultaneously improving the quality of care in institutional settings are essential to ensure safe childbirth for all women.
Novel photonic crystal fibre for low-noise coherent supercontinuum generation
Abstract We present a polarisation-maintaining all-normal dispersion photonic crystal fibre designed for 1030 nm femtosecond pumping, enabling ultra-stable and coherent supercontinuum (SC) generation spanning 650–1300 nm. The fibre’s polarisation-maintaining properties are achieved through two larger central holes in the structure, which is an alternative approach to using conventional stress rods. The fibre is specifically engineered to achieve minimum dispersion near 1030 nm, making it ideal for ultrafast comb-based metrology, and widely tunable optical parametric amplifier (OPA) systems. We further investigate the influence of input pulse contrast on supercontinuum generation through both numerical simulations and experiments. Relative intensity noise (RIN) and phase noise (PN) are characterized using three complementary techniques: dispersive Fourier transform (DFT), the Bellini–Hänsch interferometric method, and the dual-reference oscillator cross-correlation technique. The results demonstrate excellent stability, with pulse-to-pulse RIN below 0.5%, an optical phase deviation under 15 mrad, and phase noise levels down to − 150 dBc/Hz at 10 kHz from the carrier, confirming the fibre’s suitability for demanding ultrafast applications.
Comparable performance of 3D and 2D anterior segment optical coherence tomography in predicting intraocular pressure reduction following cataract surgery
Purpose To develop predictive models using three-dimensional (3D) and conventional two-dimensional (2D) anterior-segment optical coherence tomography (AS-OCT) parameters for intraocular pressure (IOP) reduction following phacoemulsification in glaucoma and non-glaucoma cohorts. Methods This prospective study included patients with and without glaucoma who underwent phacoemulsification. Preoperative predictors of 1-month IOP reduction, including clinical, ocular biometry, and AS-OCT (CASIA2) parameters, were analyzed. 3D AS-OCT measurements were assessed in two approaches: (1) averaging 360-degree values and (2) estimating circumferential areas or volumes. 2D variables were obtained from horizontal cross-sectional images. Model selection with least absolute shrinkage and selection operator (LASSO) for 2D and 3D variables was performed separately. R-squared (R²) used to represent model accuracy. The performance was validated by bootstrap resampling. Results A total of 130 eyes (64 glaucoma, 66 non-glaucoma) from 103 patients were included. The average IOP change was −1.20 ± 3.29 mmHg. Preoperative IOP (preIOP) was the strongest single predictor across all models. In the entire cohort, the final models showed moderate predictability (R² 38% for 3D and 36% for 2D; optimism-corrected R² 31% for both). In glaucoma eyes, models incorporating AS-OCT angle status and anterior chamber width achieved R² values of 36% (3D) and 38% (2D), with optimism-corrected R² of 27% (3D) and 28% (2D). In non-glaucoma eyes, both 3D and 2D models showed higher predictability (R² 53%, optimism-corrected R² 45%), with final predictors incorporating AS-OCT anterior chamber area and iris thickness. Both 3D and 2D models significantly outperformed the reference preIOP models across all cohorts (all p > 0.05). Conclusions AS-OCT parameters improved the predictability of IOP reduction after phacoemulsification, with notably better performance in non-glaucoma eyes. 2D and 3D models showed comparable predictive ability.
An improved air-gap flux control method of a bearingless induction motor based on the optimized mutual inductance
Birth-related characteristics predict vision-related quality of life in adults: A population-based study
Background Individuals with an abnormal birth are at risk of having ophthalmic complications and visual impairment. The aim of this study was to understand the relationship between birth-related characteristics and vision-related quality of life (VR-QoL) in adults in the general population. Methods We used data from Lifelines, a population-based cohort study from the North of Netherlands (n = 167,000). We included individuals with National Eye Institute Visual Function Questionnaire 25 (NEI-VFQ-25) data (n = 29,840; 18–55 years). Included birth-related characteristics were gestation length, birth weight, mode of delivery, and the presence of birth defects. We used ordinal regression with the NEI-VFQ-25 items as dependent variable and the birth-related characteristics as independent variables. Analyses were adjusted for age and gender, and corrected for multiple hypothesis testing using false discovery rate (FDR). Results Participants with birth defects directly related to eye or brain development showed a poor VR-QoL in 9/10 subscales (FDR-corrected P value q < 0.001 to 0.05) with the most pronounced effect for difficulties performing peripheral vision-related activities. Individuals with birth defects not directly related to eye or brain development showed a poor VR-QoL in 4/10 subscales (q = 0.02 to 0.05). Early preterm birth was related to the general vision (q = 0.02) and vision specific social functioning (q = 0.05) subscales. High birth weight (>4500 g) contributed to general vision problems (q = 0.05), and vacuum or forceps mode of delivery was associated with difficulties performing activities under low luminance conditions (q = 0.02). Conclusion At the level of the general population, birth-related characteristics are related to VR-QoL. To elucidate the underlying mechanisms, future studies could add visual function to the questionnaire outcomes.
Self-Organizing Dual-Buffer Adaptive Clustering Experience Replay (SODACER) for safe reinforcement learning in optimal control
Synergistic antifungal activity of antiretrovirals with amphotericin B against Aspergillus species
Aspergillosis is a life-threatening fungal infection that primarily affects the lungs of immunocompromised individuals, including those living with human immunodeficiency virus (HIV), and is associated with mortality rates exceeding 50%. The infection is predominantly caused by Aspergillus fumigatus , a pathogen that has become increasingly difficult to treat due to the emergence of azole-resistant strains. Although azoles have traditionally served as first-line antifungals, the rise in resistance has necessitated broader use of amphotericin B (AmB), a polyene agent whose clinical utility is limited by its considerable toxicity. To address this therapeutic challenge, we screened a library of 618 antiviral compounds to identify agents that could synergize with AmB and enhance its antifungal efficacy. An initial screen identified 18 compounds that enhanced the antifungal activity of AmB. From this hit set, we prioritized the two FDA-approved HIV drugs, cobicistat and elvitegravir, as promising lead candidates. When combined with AmB, both compounds exhibited potent synergistic activity against A. fumigatus and other clinically relevant Aspergillus species, with FICI values <0.5 in over 90% of isolates tested. To further evaluate the breadth of this synergy, the assay was extended to include A. brasiliensis, A. flavus, A. niger , and A. terreus . Synergistic interactions were observed in three of the four species tested, while the combination displayed indifference against A. flavus . In time-kill assays, both combinations demonstrated sustained fungistatic effects over 48 hours and significantly impaired hyphal development as early as 16 hours, indicating early disruption of fungal growth. Additionally, both cobicistat and elvitegravir significantly enhanced the antibiofilm activity of AmB, reducing biofilm biomass by over 60% when combined with sub-inhibitory AmB concentrations. These combinations also disrupted mature biofilms, achieving up to 80% eradication, a substantial improvement over AmB alone. These findings highlight the potential of these drug combinations as promising treatment options for aspergillosis, leveraging already approved therapies.
Association of prognostic nutritional index with all-cause and CVD mortality in hypertensive individuals
Inhibition of transient receptor potential vanilloid 1 (TRPV1) by a novel selective antagonist for anti-nociceptive effect on inflammatory pain without hyperthermia
Nowadays, chronic pain remains a major clinical challenge because of the unsatisfactory efficacy and nonnegligible side effects of current treatments. Pharmacological antagonists of the transient receptor potential vanilloid-1 (TRPV1) channel for chronic pain relief have been confirmed in numerous preclinical studies. However, no TRPV1 antagonist has been approved in clinical, indicating an urgent need to develop effective TRPV1 antagonists with analgesic properties. In this study, we reported a TRPV1 antagonist 1-(1 H -indazol-4-yl)-3-((2-(4-methylpiperidin-1-yl)-6-(trifluoromethyl)pyridin-3-yl)methyl)urea named IMTU. According to the whole-cell patch clamp recording assay, we identified that IMTU was a potent and selective TRPV1 antagonist with an IC 50 value of 128.34 ± 9.49 nM and exciting no inhibition of cardiotoxicity-related channels. Further single-channel recording assay revealed that IMTU (300 nM) reduced the channel open probability from 80.8 ± 2.1% to 14.9 ± 2.8% with the presence of capsaicin (100 nM). In addition, does-dependent administration of oral IMTU alleviated nociceptive reactions on mouse models of formalin and inflammatory pain induced by complete Freund’s adjuvant (CFA) without hyperthermia. Finally, studies on molecular docking combined with site-directed mutagenesis suggested that residue Thr550 was critical for the TRPV1 antagonist by IMTU. Taken together, we identified a novel and selective TRPV1 antagonist IMTU exhibiting analgesic properties in mice, which provide a useful lead for the development of analgesia in the future.
Combining graphlets and random walks for capturing complex network topology
Residual metric learning with class-specific consistency for multiclass classification
Least squares regression (LSR) has been widely used in pattern recognition due to its concise form and ease of solution. However, inadequate exploration of inter-class margin and intra-class similarity limits its discriminative ability. To this end, we present a novel method called residual metric learning with class-specific consistency for multiclass classification (RMLCC). Specifically, RMLCC jointly learns a projection matrix and a metric matrix for the regression residuals in a compact framework. This joint learning mechanism makes the inter-class margin of the projected instances as large as possible in the learned metric space, prompting the instances of different classes to be separated. To further improve the generalization, the class-specific consistency constraint that stimulate intra-class similarity is cleverly embedded into the joint learning framework. To solve the proposed model, we propose an alternative optimization algorithm which guarantees weak convergence. With the interactive optimization of the projection matrix and metric matrix, RMLCC can fully exploit the structure and supervised information of the data and thus has the potential to outperform other methods. Extensive experiments on several benchmark datasets demonstrate the validity of the proposed method.
Brain-derived microvesicles induce activation of aspirin-treated platelets via the PLC/PKC pathway
Lived experiences of female second-cycle students with abnormal menstrual cycle in a selected municipality of Ghana: A phenomenological qualitative study
Background Menstruation can be accompanied by stressful experiences and one such experience is the abnormal menstrual cycle, which could include menstrual irregularity and painful menstruation. Menstrual irregularity is defined as deviations in cycle length, frequency, or flow and can occur at any age, but it is most common among young women, often school-going children. Lack of understanding of abnormal menstruation often exposes young girls to adverse health outcomes. There is limited qualitative evidence on the lived experiences, beliefs, and coping strategies of secondary-school girls experiencing irregular menstrual cycles, particularly in rural settings. Objective We explored the lived experiences of female second-cycle students with irregular menstrual cycles in a selected district in Ghana to inform policy on menstrual health education. Methods We employed a phenomenological qualitative research approach to purposely interview 28 students using an in-depth interview guide. A thematic approach was used to analyze the data using ATLAS.ti v 7.5. Result For lived experiences, patterns of menstrual flow characterized by inconsistent menstrual blood flow were a major reason they considered their menstrual cycle irregular. The challenges faced were physical and emotional. The students have personal beliefs that an irregular menstrual cycle is a sickness and a sign of infertility, which is caused by food and diet (unhealthy diet and sugary foods). The main coping mechanisms adopted were resting, hot water therapy, and medication and support from friends and family. Conclusion The study provides an in-depth understanding of irregular menstrual cycles and their significant impact on the well-being of secondary school girls.
Study on floor large deformation and failure mechanism of water-rich soft rock roadway
Prevalence and risk factors of disordered eating risk among Yemeni medical students: A national multicenter cross-sectional study
Background Disordered eating behaviors represent an important mental health concern among medical students, who are exposed to substantial academic and psychological stressors. Data on disordered eating risk in Yemen remain limited. This study aimed to estimate the prevalence of disordered eating risk among Yemeni medical students and to examine associated sociodemographic, lifestyle, medical, and psychological factors. Methods A national multicenter cross-sectional study was conducted between June and July 2025 across fifteen Yemeni medical colleges. Undergraduate students completed a structured, self-administered online questionnaire using a convenience sampling approach. Disordered eating risk was assessed using the Eating Attitudes Test (EAT-26), with a cutoff score of ≥20. Additional items assessed sociodemographic characteristics, lifestyle factors, chronic medical conditions, and self-reported psychiatric diagnoses. Multivariable logistic regression was performed to examine factors associated with disordered eating risk. Results A total of 3,540 students participated. Overall, 30.4% screened positive for disordered eating risk. Disordered eating risk was associated with food insecurity, parental perception of being overweight, weight dissatisfaction, type 1 diabetes mellitus, past suicide attempts, and several self-reported psychiatric conditions, including post-traumatic stress disorder, obsessive compulsive disorder, social anxiety disorder, bipolar disorder, schizophrenia, and major depressive disorder. Weight satisfaction was associated with lower odds of risk. Additionally, 31.6% of participants reported a prior self-reported diagnosis of an eating disorder, which was not independently verified. Conclusion Disordered eating risk was common among Yemeni medical students and was associated with multiple sociodemographic, medical, and psychological factors. Given the cross-sectional design and reliance on self-reported data, causal relationships cannot be established. The findings suggest that consideration may be given to screening and supportive mental health resources within medical training institutions.
Edelfosine induces cell cycle arrest and apoptosis in vascular smooth muscle cells to suppress neointimal hyperplasia
Association between local food policy council coverage and longitudinal household food insufficiency during COVID-19, stratified by race, ethnicity, and income
Many local food policy councils (FPCs) worked to increase food access during the COVID-19 pandemic. Our objective was to determine whether households living in states with higher FPC coverage were less likely to experience food insufficiency during COVID-19 compared to households in states with lower local FPC coverage, and to analyze associations by race, ethnicity, and household income. We used a modified Poisson regression approach to estimate the prevalence of household food insufficiency in states with high and low FPC coverage as of 2020, adjusting for age and gender of the survey respondent, and percent of the state’s population living in a rural area (N = 1,909,647). Longitudinal food insufficiency was measured via the US Census Household Pulse Survey (May 2020 – May 2023). Lower income households in states with low FPC coverage were more likely to experience food insufficiency during the pandemic than households in states with high FPC coverage (food insufficiency prevalence ratio: 1.05, 95% CI 1.04–1.07, p < 0.001). Lower FPC coverage was associated with significantly more food insufficiency among lower-income non-Hispanic Black (1.05, 95% CI 1.02–1.09, p = 0.003) and white households (1.02, 95% CI 1.00–1.04, p = 0.01). Presence of FPCs may have been a protective factor against food insufficiency for low-income Black and white households during the COVID-19 pandemic. Local FPCs may have potential for promoting resilience and racial equity within food systems.
A cross sectional study of the autonomic function at different recovery phases in SARS-CoV-2 patients without orthostatic symptoms
A standardised protocol for measuring farmland biodiversity outcomes across European Farmer Cluster landscapes
Farmland biodiversity has declined, with agricultural intensification cited as a major contributing factor. Therefore, monitoring farmland biodiversity in a consistent manner is a crucial aspect of determining if conservation efforts are aiding in its recovery. “Farmer Clusters” comprise groups of neighbouring farmers who have identified and instigated their own biodiversity targets as a collective. These provide an opportunity to assess the impact of collaborative conservation efforts on farmland biodiversity at the landscape-scale. Through the FRAMEwork project (Farmer clusters for Realising Agrobiodiversity Management across Ecosystem), an EU Horizon 2020 project, eleven Farmer Clusters were established across Europe, and their biodiversity monitored in a Before-After-Control-Impact (BACI) experiment. The aim of this paper is to describe and critically evaluate the methods applied to monitor biodiversity across these landscapes. Once relevant landscape-scale biodiversity indicators were identified, the protocol was assembled. Guidance to select appropriate survey squares and transects in different farming systems and European landscapes that are representative of the different farmland habitats are provided. The monitoring protocol also describes how to conduct biodiversity surveys of birds, pollinators (bumblebees, butterflies, solitary bees, and hoverflies), and vegetation within these survey squares. The methods comprise of a combination of well-documented procedures, presented as a single, standardised protocol that can be replicated in different farming systems and landscapes throughout Europe. Anticipated results are also presented, demonstrating how the methods might contribute towards the BACI analysis, as well as multi-taxa, community-level biodiversity analysis. Finally, an evaluation of the biodiversity indicators and survey methods used is also given. Through FRAMEwork, these methods will be used to assess the effectiveness of Farmer Clusters at improving landscape-scale biodiversity.