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Multi-stakeholder perspectives on reproductive and adolescent healthcare schemes in tribal regions of India: A qualitative study

Tribal populations, comprising 8.9% of India’s population, remain highly vulnerable to poor health outcomes due to socioeconomic deprivation, cultural barriers, and limited access to healthcare. Tribal women are disproportionately affected, facing high maternal mortality, poor reproductive health, and inadequate nutrition. Although government schemes such as Janani Suraksha Yojana (JSY) and Rashtriya Kishori Swasthya Karyakram (RKSK) aim to improve outcomes, utilization remains low. This study explored challenges and enablers in reproductive healthcare provision from multiple stakeholder perspectives in tribal Jharkhand. A descriptive qualitative study was conducted from December 2024 to June 2025 in two blocks of East Singhbhum district, Jharkhand. Using purposive sampling, 38 in-depth interviews were undertaken with stakeholders including tribal women, adolescent girls, Accredited Social Health Activists (ASHAs), Auxiliary Nurse Midwives (ANMs), Anganwadi Workers (AWWs), medical officers, and village heads. Interviews were conducted in Hindi, audio-recorded, translated, and transcribed into English. Thematic analysis was performed using Atlas.ti (version 8). Key challenges reported from the framed nine categories. Absenteeism of healthcare workers, inadequate infrastructure, cultural reliance on traditional medicine, weak governance, delayed incentive payments, financial and transport barriers, and limited awareness and use of health technology were the important themes developed. Enabling themes included supervision by higher authorities, quality service delivery, support from community leaders, and collaborations with NGOs. Significant barriers persist in delivering reproductive health schemes in tribal Jharkhand. Strengthening governance, ensuring workforce accountability, improving infrastructure, timely incentives, and implementing culturally tailored awareness interventions are essential to enhance reproductive health outcomes among tribal women and adolescents. Trial Registration: This study is registered at Clinical Trial Registry-India (CTRI) with CTRI No: CTRI/2024/03/063824 on March 8, 2024.

Publisher Correction: Zinc-oligoether carboxylate salts as electrolyte additives for aqueous Zn metal batteries

Borax-based gel electrophoresis: A novel approach for RNA integrity analysis

This study investigates the unexpected utility of borax-based agarose gel electrophoresis for RNA integrity assessment. Accurate RNA integrity analysis fundamentally requires denaturation to fully resolve RNA molecules from their complex secondary structures and prevent aggregation, a principle typically achieved with hazardous chemicals like formaldehyde. Through multiple independent experiments, this work demonstrates that borax, beyond its buffering properties, exhibits denaturing-like behavior, effectively separating RNA molecules with resolution comparable to formaldehyde-based methods. This finding is surprising and challenges conventional understanding. To validate the method's versatility, it was successfully applied to total RNA extracted from six diverse microbial species, including Gram-negative bacteria ( E. coli , Pseudomonas aeruginosa ), Gram-positive bacteria ( Staphylococcus aureus , Enterococcus faecalis ), and eukaryotic fungi ( Candida glabrata , Candida albicans ). This novel method offers a compelling and safer alternative to traditional formaldehyde-based approaches for RNA analysis in various research and clinical settings. It provides several advantages, including enhanced safety, simplified protocols, and reduced electrophoresis time. By eliminating the need for pre-treatment steps and utilizing borax as both a buffer and an apparent denaturant, this method significantly streamlines RNA analysis. While the precise mechanism underlying this denaturing-like effect requires further elucidation, this study highlights a promising, accessible, and universally applicable tool for robust RNA integrity assessment.

Author Correction: Phage therapy with nebulized cocktail BX004-A for chronic Pseudomonas aeruginosa infections in cystic fibrosis: a randomized first-in-human trial

Parents’ perspectives on a national child oral health promotion program: Sociodemographic influences and behavioral insights – A cross-sectional analysis

Background Iran’s Students’ Oral Health Promotion Program (SOHPP) aimed to improve primary school children’s oral health, but parental perceptions of this program, as key stakeholders, remain underexplored. This study explores parents’ perceptions of Iran’s SOHPP, the sociodemographic factors shaping them, and children’s post-program oral health behaviors. Methods Conducted at four randomly-selected comprehensive healthcare centers in Tehran (July–August 2020), this cross-sectional study phone-surveyed parents of primary school children who participated in Iran’s SOHPP. The questionnaire covered sociodemographics, children’s post-program oral health behaviors, and awareness and satisfaction with key SOHPP components: oral health education, fluoride therapy, electronic oral health profiling, and treatment need identification. ANOVA, chi-square, and regression models served for statistical analysis. Results The 354 surveyed parents (response rate: 67%), on average, scored 79% for SOHPP awareness and 74% for satisfaction. Awareness and satisfaction were lowest for treatment-related components (58.2% and 52.0% for oral health profiling; 70.9% and 53.7% for treatment need identification). Fluoride therapy acceptance was 76.6%, with refusals mainly due to poor notification and limited procedural understanding. While 61.6% of parents noted improved tooth-brushing in their child, post-program, only 38.7% reported twice-daily brushing, and 37.9% were unaware of their fluoride toothpaste use. Additionally, 41.5% reported sugary snacking at least once daily by their child, while 83.0% reported healthy school food intake. More educated fathers had greater program awareness (B = 0.18, p = 0.040), satisfaction (B = 0.17, p = 0.032), and fluoride therapy acceptance (OR = 1.37, p = 0.024), whereas government-employed household heads were less aware (B = –1.16, p = 0.004) and less likely to perceive tooth-brushing improvements (B = –1.48, p = 0.001). Conclusions To improve parents’ perceptions of Iran’s SOHPP, enhanced delivery of treatment-related components, improved fluoride therapy transparency, reinforced post-program oral health behaviors, and tailored outreach to fathers’ education and household heads’ government employment are recommended.

First-line modified FOLFOX plus/minus nivolumab and Ipilimumab or FLOT plus nivolumab in advanced gastroesophageal adenocarcinoma: a phase II multi-cohort IKF-AIO-MOONLIGHT trial

Abstract This multi-cohort study evaluates whether dual immune checkpoint inhibition with nivolumab and ipilimumab in parallel or sequentially, or triplet chemotherapy with nivolumab can enhance efficacy as first-line therapy for advanced or metastatic gastroesophageal adenocarcinoma. Patients are randomized 1:1 to Arm A (mFOLFOX + nivolumab 240 mg every two weeks + ipilimumab 1 mg/kg every six weeks in parallel or Arm B (mFOLFOX). Subsequently, patients are randomized 1:2 to Arm A1 (identical to Arm A) or Arm A2 (three cycles of mFOLFOX followed by nivolumab + ipilimumab). In Arm C all patients receive FLOT + nivolumab. Primary endpoint is progression-free survival. Secondary endpoints include overall survival and objective response rate. Median progression-free survival (months) is: Arm A/A1, 5.8; Arm A2, 4.0; Arm B, 6.6 and Arm C, 7.0.Toxicity is manageable across all arms, with higher rates in arms receiving dual checkpoint inhibition. Here we show that chemotherapy with dual checkpoint inhibition in parallel increases toxicity without improving efficacy, while FOLFOX followed by immunotherapy is insufficient. FLOT with nivolumab appears feasible and shows promising efficacy. ClinicalTrials.gov number NCT03647969

Reported adverse events following COVID-19 vaccination in gynecologic cancer patients in Thailand: A descriptive study

Objective Data on the safety of coronavirus disease 19 (COVID-19) vaccines in gynecologic cancer patients are scarce. The type of vaccine used in Thailand differs from what has been studied in other countries. This study evaluated the prevalence and characteristics of reported adverse events following COVID-19 vaccines in patients with gynecologic cancer patients. Method A retrospective, single-center descriptive study was performed in patients with gynecologic cancer who received at least one dose of the COVID-19 vaccine at King Chulalongkorn Memorial Hospital, Thailand, from January 2020 to August 2021. Adverse events were collected through structured telephone interviews using a standardized questionnaire. Descriptive statistics summarized patient characteristics and adverse events. Associations with any-grade adverse events were assessed using logistic regression and Fisher’s exact test for categorical variables. Results Of the 294 patients interviewed, 72.8% were in remission, under surveillance, or in palliative treatment at the time of vaccination, and 17.7% were undergoing treatment. The most common adverse effects were grade 1–2 injection site reactions. One patient developed grade 3 fever and seizures 10 days after the first dose of the AstraZeneca vaccine. Between the second and fourth doses of the vaccination, the most common adverse events were grade 1–2 injection site reactions. No severe allergic reactions or grade 4 adverse events were reported. The study concluded that patients under 60 years of age had more adverse events than older patients (adjusted odds ratio 1.99, 95% confidence interval 1.08–3.71 p = 0.029). The treatment status did not affect adverse events. Of 283 patients who received two doses, 27.6% were infected with COVID-19. Conclusion COVID-19 vaccination was generally well tolerated among gynecological cancer patients who received active anticancer therapy and those under surveillance. Younger patients frequently reported more adverse effects than older patients.

The dynamic distribution of genetic tandem amplifications in a heteroresistant Escherichia coli population revealed by ultra-deep long read sequencing

Abstract Antibiotic heteroresistance, characterized by rare resistant subpopulations of bacteria within a susceptible main population, is associated with treatment failure and often caused by tandem amplification of resistance genes. Here, we investigated how the distribution of tandem amplifications affects heteroresistance using an approach combining genetic engineering and ultra-deep Nanopore sequencing to accurately quantify the distribution of tandem amplification copy numbers on plasmids down to frequencies of 10 -5 . Using an Escherichia coli isolate, we describe the direct relation between the distribution of tandem amplifications increasing the copy number of a bla SHV gene and a heteroresistance phenotype to piperacillin-tazobactam, and reveal how this distribution expands under antibiotic pressure and partially reverts upon its removal. Mathematical modeling indicates that indirect resistance and fitness cost of amplifications influence the dynamic distribution of tandem amplifications. These findings provide insights into amplification-mediated phenotypes and enhance possibilities for the development of improved therapeutic and diagnostics strategies for heteroresistance.

Monitoring health and wellbeing in adolescent track and field (athletics) athletes: A co-creation study

Talent Development Environments, such as England Athletics’ Youth Talent Programme (YTP), aim to provide holistic support that promotes long-term athletic and personal development. There is a need for National Governing Bodies to understand athlete health and wellbeing (HWB) to increase athlete availability, wellbeing, and performance. Regarding the YTP, this study aimed to: (1) understand HWB concepts and current monitoring practices; (2) explore design preferences for athlete HWB monitoring; and (3) identify factors that influence the use and implementation of a HWB monitoring system. An online survey was completed by 53 YTP athletes (31 female) capturing demographics, HWB understanding, current monitoring behaviours, and design preferences. Six focus groups and one interview were subsequently conducted with YTP staff (n = 11) and athletes (n = 8). Staff discussions explored current data collection methods, factors that influence system adoption, and integration possibilities. Athlete discussions explored HWB attitudes, factors that influence system adoption, and design preferences. Survey findings indicated that athletes regard monitoring HWB as ‘important’ (36%) or ‘very important’ (26%). However, 62% of athletes do not keep a training diary and 45% do not monitor their HWB, confirming they lack tools and/or knowledge to monitor effectively. Sixty-six percent of athletes who do not monitor would like to improve HWB knowledge. Among those who monitor (55%), the most frequently recorded were training (n = 19) and sleep (n = 14) data. Reflexive thematic analysis generated four interrelated themes: (1) education as a pathway to athlete autonomy and wellbeing ; (2) holistic HWB perspectives ; (3) monitoring practices ; and (4) factors that influence adoption. Findings highlight the importance of HWB education and whole person development. Despite limited formal monitoring knowledge, athletes engage in self-monitoring and are willing to improve HWB knowledge. Preference for mobile accessibility, adaptability, and reminders, together with socio-environmental factors, will inform the design of an athlete HWB monitoring system for the YTP.

Reconstructing single-cell resolution from spatial transcriptomics with CellRefiner

Abstract Single-cell RNA sequencing technologies profile the transcriptome of individual cells but lack the spatial context necessary for dissecting cellular interactions like cell-cell communications. On the other hand, most current spatial transcriptomic technologies lack cellular resolution, limiting their capability for realistic downstream analysis. Here we present CellRefiner, a physical model-based method that integrates a single-cell dataset with a paired spatial dataset to generate single-cell resolution in the imputed spatial data. CellRefiner models cells as particles connected by forces, and then optimizes cell locations with spatial proximity constraints, gene expression similarity, and ligand-receptor interactions between cells. We systematically benchmark CellRefiner over a variety of simulated and real datasets using Visium, MERFISH, seqFISH, Slide-seqV2, and STARmap datasets to demonstrate its accuracy, robustness, and ability to recover spatial patterns of cells. We also demonstrate its utility for improving spatially dependent analysis over the original spatial data for the contact-based cell-cell communication on mouse cortex and lymph node tissues. Our results show CellRefiner is capable of reconstructing single-cell resolution from non-single-cell resolution spatial data, allowing downstream analysis that requires individual-cell resolution and spatial information.

Understanding diverse subjectivities of medical students in seeking composite role models: A Q-methodology study

Background Role modeling, an integral part of medical education, is a complex and multifaceted process. To unravel the hidden dimensions of role model selection, a comprehensive understanding of students’ subjectivities is crucial. This research aimed to elucidate the dominant subjectivities of medical students when selecting composite role models. Methods This study employed the Q-methodology to investigate individuals’ subjectivities and portray them. Initially, we formulated Q-statements based on semi-structured interviews with students and a literature review. In the second step, 31 undergraduate medical students were selected through purposive and snowball sampling. In the next step, data were collected using a questionnaire and a Q-grid. In the fourth step, we categorized individuals using KADE software and performed factor analysis. Finally, the research team utilized factor arrays and combined quantitative and qualitative data to interpret the dominant subjectivities in the selection of composite role models. Results This study identifies four dominant subjectivities among 31 undergraduate medical students, explaining 50% of total variance, including: 1) Relying on professional and skillful role models (n = 13, 34% variance): students emphasize professional behavior, responsibility, and strong teaching competence, 2) Relying on popular and famous role models (n = 4, 6% variance): students value fame at micro to macro levels, including clinical excellence and international engagement, 3) Relying on venerable and value-oriented role models (n = 6, 6% variance): students prioritize moral principles, ethical conduct, and alignment with personal values, 4) Relying on social and responsive role models (n = 5, 4% variance): students highlight social engagement, altruism, and a positive impact on society. Discussion Our research indicates that multiple factors significantly influence students’ selection of composite role models, with varying subjectivities across four domains. Teachers can use these subjectivities to reflect on the factors involved in role modeling. Medical schools can leverage these identified subjectivities to enhance role modeling and improve teaching and learning.

Inverse problems for dynamic patterns in coupled oscillator networks: when larger networks are simpler

Abstract Networks of coupled phase oscillators are one of the most studied dynamical systems with numerous applications in physics, chemistry, biology, and engineering. Their behaviour is often characterized by the emergence of various partially synchronized dynamic patterns, which in the case of large networks can be analysed using a variant of the mean-field approach. This method allows to predict what type of network dynamics can be observed for different system parameters. But it is less known that for different partially synchronized patterns it also allows to obtain statistical equilibrium relations that express the dependence of some time-averaged observable quantities of individual oscillators on the internal parameters of these oscillators and the interaction functions between them. In this paper, we show how such relations can be derived, what their typical accuracy is for finite-size networks, and how they can be used to reconstruct the parameters of the corresponding model. The proposed method is particularly effective for large networks, for unevenly sampled or noisy observables, and for partial observations. Its possibilities are demonstrated by application to chimera states in networks of phase oscillator with nonlocal coupling. The extension of the method to other systems with all-to-all and random network topologies is also described.

Explainable AI for gait speed analysis from multimodal data fusion

Gait speed analysis is vital for applications in healthcare, rehabilitation, human-robot interaction, and autonomous systems, necessitating robust methods to address its complexity. This study introduces an advanced framework for gait speed classification through multimodal data fusion and deep learning, optimized using Layer-wise Relevance Propagation (LRP). Utilizing a publicly available 4 datasets of 50 injury-free adults walking at varying speeds, we integrate data from full-body motion capture, electromyography (EMG), and force plates to capture detailed gait dynamics. We propose two novel architectures: a hybrid Convolutional Neural Network with Long Short-Term Memory (CNN+LSTM) and a Multi-stream CNN, benchmarked against Temporal Convolutional Networks (TCNs), Transformer neural networks, Gated Recurrent Units (GRU) and statistical classifiers (e.g., Linear Discriminant Analysis, Quadratic Discriminant Analysis, Support Vector Machines). All models in this study were trained, validated and tested using three distinct strategies: experiment 1 (sample-based splitting – 10-fold cross-validation), experiment 2 (10-fold cross-validation, subject-based splitting – 5 subjects for testing), and experiment 3 (5-fold cross-validation, subject-based splitting – 10 subjects for testing). Multi-stream Quads CNN is the best-performing model, achieving the highest F1 scores across all experiments (96.6% ± 1.4% experiment 1, 96.2% ± 1.6% experiment 2, 95.9% ± 0.9% experiment 3 with top performance for all experiments 98% ± 0.6%, outperforming traditional approaches. LRP is applied to evaluate feature relevance within the model, enabling the removal of critical features to verify robustness. Comprehensive assessments, including ROC curves, confusion matrices, t-test, and perturbation analyses, validate the model’s enhanced performance and durability. By combining multimodal fusion to overcome single-sensor constraints with LRP-driven feature optimization, this work provides a highly accurate and resilient tool for gait analysis, with significant potentials.

Rank signaling drives basal cell-lineage infidelity leading to mammary tumorigenesis

Paternal effects without paternity? Testing non-genetic male influence on offspring size and brood size in a gynogenetic vertebrate, the Amazon molly (Poecilia formosa)

Paternal effects, i.e., effects of fathers on the phenotype of their offspring that are not mediated by the transmission of alleles, are increasingly recognized as a potentially significant source of phenotypic variation across taxa – even in the absence of paternal care. Gynogenetic systems, which rely on sperm to trigger embryogenesis without incorporating male genetic material, provide a powerful way to experimentally isolate paternal effects from effects caused by the integration of male genetic material. Up to now, however, paternal effects remain largely unexplored in these systems. Here, we tested for non-genetic paternal effects in the gynogenetic Amazon molly ( Poecilia formosa ): a naturally clonal, all-female species with no parental care. Using a highly controlled breeding experiment involving 60 Atlantic molly males ( Poecilia mexicana ) and 54 Amazon molly females from a single clonal lineage, we generated 128 broods and 2,435 offspring. While males were drawn from a naturally variable stock population, females – next to being genetically identical – were standardized for age, size, descent, and developmental experience. We asked whether male identity or body size predicted offspring size – a key offspring phenotypic trait. We also asked whether male identity or body size predicted brood size. Male identity explained either no or only very small proportions of the variation in offspring or brood size. Larger males were weakly associated with larger offspring, but this effect was minimal (partial R 2  ~ 1.5%). However, these patterns did not hold consistently across all data exclusion criteria and analytical variants, underscoring their tentative nature and highlighting the need for further investigation. Our study offers one of the first empirical tests of male effects in a gynogenetic vertebrate, providing valuable quantitative benchmarks for the magnitude of such effects in gynogenetic systems.

Synthesis of 3-desoxycollinoketone B and its ability to reduce Alzheimer-associated misfolded proteins

Heterogeneous trajectories of exercise self-efficacy and its predictors in patients with multivessel coronary artery disease: A longitudinal study

Objective The developmental trajectory of exercise self-efficacy refers to the course of change in an individual’s belief in their capability to successfully perform exercise-related behaviors over time. This study aims to explore the developmental trajectory of exercise self-efficacy in patients with multivessel coronary artery disease, and analyze the predictors of various trajectory subgroups. Methods Between September 2023 to October 2024, 297 patients with multivessel coronary artery disease were recruited from three tertiary hospitals in Tangshan, China. Exercise self-efficacy was measured using the Multidimensional Self-Efficacy for Exercise Scale on the third day of admission (T1), one month after discharge (T2), three months after discharge (T3), and six months after discharge (T4). The latent class growth model was employed to identify the developmental trajectory of exercise self-efficacy in patients with multivessel coronary artery disease. Multinomial logistic regression was adopted to determine the predictors of trajectory subgroups. Results Three distinct trajectories of exercise self-efficacy were identified: the “Low-Efficacy Decline Group” (22%), the “High-Efficacy Ascending-Stable Group” (34%), and the “Moderate-Efficacy Continuous Increase Group” (44%). Multinomial logistic regression analysis revealed significant determinants of distinct exercise self-efficacy trajectories, when compared with the moderate-efficacy continuous increase group, the predictors for the low-efficacy decline group included having diabetes, a lack of exercise habits, low social support, and anxiety. In contrast, the predictors for the high-efficacy ascending-stable group were high average monthly household income, established exercise habits, and strong social support. Conclusion The study revealed heterogeneous trajectories of exercise self-efficacy among patients with multivessel coronary artery disease, highlighting the necessity for personalized intervention strategies. These findings offer a valuable opportunity for early prevention and targeted interventions aimed at enhancing exercise self-efficacy.

Polymorphism and evolutionary origins of accessory chromosomes in the basidiomycete Tremella fuciformis

Abstract Accessory chromosomes are non-essential for growth but poorly characterized in basidiomycetes, unlike in Ascomycota. Here, we report whole-genome sequencing of 16 strains of the basidiomycete Tremella fuciformis (silver ear fungus), generating 27 complete haplotypes (5 monokaryons and 11 dikaryons, each contributing two distinct haplotypes). Genome size varied by over one-third, driven by accessory chromosomes and repetitive sequences in core chromosomes (essential for basic biology). Each strain harbored 8-10 core chromosomes (polymorphic via fusion/fission) and 2-10 accessory chromosomes (total 108), whose distribution reflects phylogeny and symbiotic specificity with the ascomycete Annulohypoxylon stygium . Accessory chromosomes are small, transposon-rich, gene-poor, and exhibit higher sequence similarity but more diverse structural variations than core chromosomes, with few shared genes across phylogenetic branches. Both chromosome types show frequent copy number variation during cell type transformation. Most accessory chromosome genes lack homologs in core chromosomes or existing gene databases. Our study reveals basidiomycete accessory chromosome diversity, suggesting an origin from unexplored species pre-dating T. fuciformis speciation.

Widening East-West inequality in life expectancy in Europe during the COVID-19 pandemic: An international comparative study

For decades, life expectancy in Eastern Europe has lagged behind that in Western Europe, although the gap has narrowed since the mid-2000s. We examined the impact of the COVID-19 pandemic on these long-term trends by estimating and decomposing East-West differences in excess mortality and life expectancy losses. Regression models were used to explore the contribution of multiple factors to the observed differences. While excess mortality was initially low in Eastern Europe, partly due to lower air connectivity, by October 2020 and throughout 2021, the region experienced significantly higher life expectancy losses than Western Europe. These differences could not be attributed to greater frailty in the Eastern European populations. Rather, lower vaccination coverage and less trust in government in Eastern Europe explained about half of the gap in 2021. After the peak of the pandemic, the East-West gap in life expectancy began to narrow again. Our findings highlight that the factors behind the East-West differences in the timing and severity of pandemic-related mortality may have their ultimate origins in differences between societies that were established during the Cold War. Strengthening public health infrastructure and social trust should be considered to mitigate the unequal impact of future crises.

Weak localized electrons enhance electronic coherence for efficient photocatalytic uranium removal from nuclear wastewater

Abstract Photocatalytic uranium removal from nuclear wastewater is a promising strategy for radionuclide mitigation, yet its practical deployment is greatly hampered by inefficient charge separation of electron-hole pairs in photocatalytic systems, which critically limits the generation of reactive oxygen species essential for uranium precipitation. Herein, we propose a approach that leverages weakly localized electrons to enhance electronic coherence in fluorine-functionalized covalent organic frameworks, thereby strengthening charge separation and promoting directional electron transport for greatly boosting photocatalytic uranium removal from nuclear wastewater. We demonstrate that the partial fluorination in covalent organic frameworks induce weak electron localization and strong electronic coherence, which delivers a record-high solar-to-chemicals conversion efficiency of 1.52% and achieves 100% uranium removal efficiency within the pH range of 3-6, outperforming non-fluorinated (0.31%) and over-fluorinated (0.85%) counterparts. More importantly, a self-designed flow-type reactor achieves 99% uranium removal efficiency and superior U processing capacity of 281.3 g m -2 day -1 under natural sunlight, significantly surpassing reported photocatalytic systems and meeting World Health Organization discharge limits. Mechanism investigation reveal that the partial fluorination enhanced electronic coherence improves photogenerated carrier transport and reparation for accelerating reactive oxygen species synthesis, thereby promoting uranium removal from nuclear wastewater.