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The Firefighter problem with dynamic defence costs
The Firefighter Problem is a single-player game modelling the spread of a contagion (e.g. rumours, diseases) on a graph. The player’s objective is to defend vertices to protect at least a given number. This problem is computationally hard, but it can be solved efficiently on certain restricted classes of graph, such as complete graphs (in constant time) and graphs with path length at most ℓ − 1 (in 𝒪 ( ( n + m ) n ℓ − 2 ) -time). We define The Cost Function Firefighter Problem, the first variant of the Firefighter problem that introduces vertex defence costs depending on time and game state. We show the Cost Function problem is computationally hard even for classes of trees on which the classic problem is tractable, but tractable on some very restricted graph classes (complete graphs, graphs of fixed bounded path length and trees under certain conditions). By expressing our variant in monadic second-order logic, we prove it is fixed-parameter tractable with respect to treewidth, budget, and maximum time step. To complement theoretical findings, we undertake empirical investigation to compare performance of cost, threat and degree-based heuristics under various cost functions. We find that the relative effectiveness of these heuristics depends heavily on graph structure, with degree-based heuristics generally performing worse than state-based strategies. We show how these heuristics play out on both random and real-world interaction graphs.
Spirulina-coenzyme Q10 nanoemulsion regulating growth, antioxidant, immune capacity, histopathological alterations in Nile tilapia exposed to heat stress
Abstract Variation in water temperature has a big impact on fish physiology, behavior, growth, and other biological processes. The current perspective aimed to assess the ameliorative effects of Spirulina-co-enzyme Q10 nanoemulsion (SCN) dietary inclusion on reared Nile tilapia ( Oreochromis niloticus ) health aspects under heat stress conditions (32 °C). A random design was used to establish 5 groups of Nile tilapia ( n = 225), each consisting of 15 fish in triplicates. After being given a baseline diet, the 1st (C25) and 2nd (SCN0) groups were raised at 25 °C and 32 °C respectively and supplemented by a basal diet. Diets supplemented with a10, 20, and 40 mg/kg diet were given to groups 3 (SCN10), 4 (SCN20), and 5 (SCN40), respectively, which were raised at 32 °C for 60 days. At the termination of the 60-day session, growth metrics, and immunological biomarkers were assessed. Tissue specimens were also obtained for further assessment of the antioxidant status and histopathological alterations. A subsequent bacterial challenge with Streptococcus agalactiae was performed, where mortalities, clinical symptoms, and postmortem lesions were investigated. As per the results of the investigation, dietary incorporation with SCN40 followed by SCN20 significantly promoted growth metrics and immunological biomarkers, where the lowest records were noted in SCN0. Tissue antioxidants (SOD, GST, and CAT) showed notable improvement in SCN40, which also expressed the lowest MDA value compared to SCN0. Nonetheless, oxidative stress mediators and lipid peroxidation markers revealed a marked decline in SCN-fortified groups in a concentration-associated pattern compared with the SCN0 group. Histopathological evaluation of liver, intestine, and spleen tissues revealed a noticeable improvement and almost restoration of the normal tissue architecture in the SCN20 and SCN40 groups. Following the Streptococcus agalactiae challenge, Nile tilapia survivability was significantly higher in SCN40 (80%) than in SCN20 (74%). Taken together, SCN, especially at 20 and 40 mg levels, demonstrated its valuable impact on mitigating heat stress in the Nile tilapia.
Antiviral and anti-inflammatory evaluation of herbal extracts: Implications for the management of calf diarrheal diseases
Traditional herbal extracts are attracting attention in the context of animal disease control because of their low side effects, diverse bioactive compounds, and low antimicrobial resistance risk. However, the underlying mechanisms remain inadequately understood. To characterize the multifaceted biological activities that underlie their therapeutic potential, this study systematically evaluated the antiviral and complex immunomodulatory properties of three distinct herbal combinations (designated Extracts A, B, and C) in vitro . The antiviral activities of the extracts were tested against bovine rotavirus and bovine coronavirus, two major pathogens of neonatal calf diarrhea, and their regulation of inflammatory mediators was assessed in a murine macrophage model (RAW 264.7 cells) stimulated with lipopolysaccharide from Escherichia coli by measuring nitric oxide production and the gene expression of inflammation related enzymes. Immunomodulatory effects were investigated by analyzing the gene expression of T helper cell-associated cytokines in both RAW 264.7 cells and bovine peripheral blood mononuclear cells (PBMCs). All three extracts exhibited inhibitory activity against both viruses and reduced the expression of specific inflammatory mediators. Furthermore, the extracts demonstrated complex immunomodulatory effects in bovine PBMCs, with Extract C promoting T helper 1 and T helper 17 responses while suppressing the regulatory T-cell transcription factor Forkhead Box P3. In conclusion, this in vitro study demonstrates that these herbal extracts possess antiviral and immunomodulatory potential, providing a basis for future studies to determine their relevance in viral infections associated with calf diarrhea.
Time trends in psychosomatic symptoms among Hungarian youth using repeated cross sectional HBSC data from 2002 to 2022
Abstract Psychosomatic symptoms have become increasingly prevalent among adolescents; however, trends covering a longer period remain underexplored in Hungary. This study examines changes in psychosomatic symptoms among school-aged children using nationally representative data from the Hungarian Health Behaviour in School-aged Children (HBSC) survey, collected in 2002, 2006, 2010, 2014, 2018, and 2022 (N = 37,930; M age = 14.88 years, SD age = 2.36 years; boys = 49.3%). Descriptive statistics, logistic regression analyses, and ANCOVAs were conducted to assess trends from 2002 to 2022. Girls and older adolescents reported more symptoms overall, with 2022 showing the highest prevalence across all symptom categories in both genders. The proportion of adolescents reporting multiple health complaints (MHC) (excluding fatigue) became considerably more common between 2010 and 2022, increasing from 40.6 to 65.6% among girls, and from 30.2 to 42% among boys. Fatigue emerged as the most reported frequent symptom across all survey waves among both genders, peaking in 2022 at 47.5% among boys and 67.6% among girls. The findings point to a trajectory—particularly in recent years—highlighting the urgent need for targeted interventions and policy actions to support adolescent health.
Post-discharge healthcare utilization and costs in musculoskeletal surgery patients: A cohort study in Korea
Background Musculoskeletal surgery imposes extended recovery periods and significant financial burdens that can undermine individual and system-level health security. Patients undergoing musculoskeletal surgery often face prolonged recovery and substantial post-discharge costs, yet longitudinal evidence on their healthcare use remains limited. Methods This study quantified two-year post-discharge utilization and identified predictors of high expenditure among Korean musculoskeletal surgery patients. A retrospective cohort was constructed from the 2019–2021 Korea Health Panel. Adults (n = 182) hospitalized for spinal, knee, shoulder or other musculoskeletal disorders between July 2019 and June 2020 were followed for 24 months. Outcomes were total healthcare expenditure (log-transformed) and in the top 25% cost group (“high-expenditure”) in the second post-discharge year. Results Among 182 adults hospitalized for musculoskeletal surgery, first-year post-discharge spending averaged US $848 but fell to US $487 in the second year. Readmission fell from 19.2% to 7.1%, and Western-medicine outpatient visits declined from 18.3 ± 25.9 to 13.6 ± 22.9 per person. By contrast, Traditional Korean Medicine (TKM) visits rose from 2.3 ± 6.5 to 3.3 ± 10.0. In multivariable models, metropolitan residence, obesity, additional chronic conditions, and heavier first-year inpatient and outpatient use independently predicted higher second-year costs. Lower household income was associated with lower spending. Index diagnoses were pivotal: spinal disorders and shoulder disorders markedly increased the odds of falling into the top-cost quartile. Among the first-year TKM, frequent chuna/manual therapy sessions were marginally associated with higher costs, suggesting these rehabilitative modalities may serve as proxies for underlying health complexity during the stabilization phase. Conclusions Spinal and shoulder disorders, metropolitan residence, obesity, multimorbidity, heavy inpatient and outpatient use during the first post-discharge year, and frequent TKM sessions, albeit marginally, jointly predicted the highest second-year expenditures. These findings highlight the value of early risk stratification and tightly coordinated Western-and-traditional care pathways that facilitate the shift from structural repair to functional restoration. From a policy perspective, these results suggest the need for integrated post-discharge care models and targeted financial support strategies to reduce avoidable costs and enhance equity in musculoskeletal rehabilitation.
A frequency restoration control scheme of series-parallel-type microgrids with local low bandwidth communication
Abstract Series-parallel-type microgrids include several distributed generators (DGs) connected in series to form a string, with multiple such strings then connected in parallel. The existing centralized frequency restoration control needs global communications. To reduce the communication requirements of frequency restoration control for series-parallel-type microgrids, this paper proposes a frequency restoration control scheme that relies solely on local low bandwidth communication (LBC). Specifically, the first DG in each string utilizes the local LBC network to achieve consensus control, while the remaining DGs operate without any communications. In a series-connected system, the line current serves as a common information. Global frequency restoration can be achieved by enabling only the first DG’s line current in each string to perform frequency recovery control. Compared to existing global communication-based methods, the proposed method ensures frequency restoration using only the local LBC for the first DG in each string, significantly reducing the need for communication. Meanwhile, the system’s computational complexity is reduced. Further, the stability of the proposed controller is validated based on the root locus method. Finally, simulation results with the proposed method validated the frequency restoration performance, applicability to RL and RC loads, robustness under certain communication failures, and proportional active power allocations.
Efficacy evaluation of the S-adenosylhomocysteine hydrolase inhibitor MSD-914 in rhesus macaques (Macaca Mulatta) challenged with Ebola virus by the intramuscular route
Ebola virus (EBOV) causes a severe and often fatal hemorrhagic fever in humans for which effective postexposure countermeasures are lacking. Herein, we describe the evaluation of an S-adenosylhomocysteine hydrolase inhibitor, MSD-914, using mouse and nonhuman primate (NHP) models of lethal EBOV. Mice were completely protected from severe disease and death at doses as low as 0.31 mg/kg/day administered orally. From the pharmacological data and a toxicokinetic study, a predicted protective dose was selected for rhesus macaques (RMs). Surprisingly, orally administered MSD-914 was unable to protect RMs at doses as high as 0.8 mg/kg/day despite providing similar exposure of the drug to the efficacious dose observed in the mouse model.
Estimating cognitive workload in robot assisted surgery using time and frequency features from EEG epochs with random forest regression
Abstract Cognitive workload (CW) refers to the mental effort required to perform a task and is critical to monitor in high-stakes environments such as robot-assisted surgery (RAS), where excessive demand can impair decision-making and performance. This study proposes a machine learning framework to estimate CW using electroencephalography (EEG) signals, focusing on four cortical regions: frontal, temporal, parietal, and occipital. EEG epochs were processed to extract both time-domain features (mean, variance, skewness, kurtosis, RMS, zero-crossings) and frequency-domain features (power spectral density across delta, theta, alpha, beta, and gamma bands). To enhance computational efficiency, data were downsampled from 500 to 128 Hz, with minimal signal degradation confirmed via topographic and spectrogram-based comparisons. Random Forest Regressor (RFR) was trained to predict region-specific EEG-derived CW scores, achieving high accuracy with R 2 (coefficient of determination) values of 0.9947 (temporal), 0.9692 (parietal), 0.9635 (occipital), and 0.9329 (frontal), alongside low RMSE scores. Feature importance analysis identified kurtosis, RMS, and select power bands as key predictors. Model robustness was validated using tenfold cross-validation and statistical significance testing (p < 0.0001). Comparative evaluation with SVR, Linear Regression, and XGBoost confirmed the superior generalizability of the RFR model. Topographic EEG maps and time–frequency spectrograms visually supported region-specific activation patterns, reinforcing the effectiveness of spatially localized workload modeling. These findings demonstrate a promising, interpretable, and high-performing pipeline for EEG-based cognitive workload estimation, with broad implications for adaptive neuroergonomic systems in surgical and clinical settings.
Adoption and validation of the European Association for the Study of the Liver algorithm for the noninvasive diagnosis of advanced fibrosis in metabolic dysfunction-associated steatotic liver disease in low-resource South Asian settings
Introduction Patients with significant liver fibrosis (SF) are likely to progress to advanced chronic liver disease (ACLD). Therefore, liver-directed therapy is indicated. The European Association for the Study of the Liver-2024 (EASL) recommends annual screening of patients with diabetes for SF/ACLD using the FIB-4 score, followed by vibration-controlled transient elastography (VCTE) in patients with FIB-4 ≥ 1.3 in ≤65-year-olds and ≥2.0 in > 65-year-olds. Because VCTE is not freely available in resource-limited settings, we revised the EASL algorithm to prioritise referrals for VCTE in such settings and validated it in an external cohort. Methods We conducted a cross-sectional study of adults with type 2 diabetes (T2DM) and ultrasonographic evidence of steatotic liver disease (SDL) attending three outpatient medical clinics in the Gampaha District, Sri Lanka. FIB-4 scores were calculated, and those with scores ≥1.3 underwent VCTE. SF was defined as liver stiffness measure (LSM) ≥ 8.0 kPa. Factors significantly associated with SF/ACLD were identified using multiple logistic regression (LR). We then developed a new criterion for VCTE referral and compared the number of referrals for VCTE when using the new criterion-based algorithm with the EASL algorithm. We validated the new criterion-based algorithm in an external cohort of 372 patients with MASLD. Results We studied 363 patients, and 128 had an FIB-4 score of≥1.3. Of them,121 underwent VCTE, and 76 had an LSM ≥ 8.0 kPa. On multivariable LR, VCTE-diagnosed SF/ACLD was independently associated with diabetes of ≥ 5 years duration (OR 3.8, p = 0.035), micro/macrovascular complications (OR 19.4, p = 0.016), and BMI of ≥ 25 kg/m2(OR 6.2, p = 0.003). We revised the VCTE referral criterion as “patients having EASL FIB-4 criterion plus one or more of the three other factors: diabetes of ≥ 5 years duration, presence of micro/macrovascular complications or BMI≥25 kg/m2,”. The number of VCTE referrals indicated using the EASL algorithm was 96, compared to 83 with the new criterion, resulting in a 13.5% reduction. In the external validation cohort, the new algorithm reduced the number requiring VCTE referral by 15.5%. Conclusions Adopting the new criterion for VCTE referral in patients with MASLD appears more cost-effective for detecting SF/ACLD in low-resource settings in South Asia.
Bioequivalence assessment between two formulations of a film-coated fixed-dose combination of metformin and vildagliptin (850/50mg) in healthy Tunisian subjects under fed conditions
Abstract In Tunisia, bioequivalence studies have been required for generic drug approval since 2008. This study aimed to assess the bioequivalence of vildagliptin and metformin fixed-dose combination (FDC) 850/50 mg for a tested (Bi-Galvine) versus the approved reference products (Galvumet). A randomized, two-way, two-period, single oral dose, open-label, crossover, bioequivalence study with a washout period of 7 days to compare metformin/vildagliptin film-coated tablets in 18 healthy Tunisian subjects aged between 18 and 50 years under fed conditions was conducted at the National Center Chalbi Belkahia of Pharmacovigilance. During each period, 20 blood samples were collected from each subject at pre-dosing (0.00) and between 0.25 and 24.00 h after dosing. The bioequivalence between the test (T) and reference (R) products required 90% confidence intervals (CIs) for the geometric least square (LS) mean T/R ratio to be within 80–125% for the pharmacokinetic parameters, maximum plasma concentration (C max ), and Area Under the Curve from zero to 24 h (AUC 0–24 h ). The 90% CIs of the geometric means of the T/R ratios for C max and AUC 0–24 h for metformin were 92.01–102.66% and 93.55–101.80%, respectively; the corresponding results for vildagliptin were 96.03–107.09% and 94.46–101.92%, respectively. Other parameters, such as AUC 0-∞ , time to maximum concentration (T max ), and terminal half-life (t 1/2 ), were comparable between the test and reference products. Adverse events (AEs), mainly hypoglycemia and loose stools events, were reported without relevant differences between the test and reference products. AEs were generally mild and transient. No severe or serious AEs occurred. The new generic drug product of metformin/vildagliptin FDC 850/50 mg demonstrated bioequivalence to the approved product and is therefore expected to provide similar therapeutic effects.
Retraction: Boosting happiness in left-behind children: Unveiling the power of physical activity through cognitive reappraisal and psychological resilience
In vitro comparative evaluation of the flexural strength of acrylic denture bases reinforced with nano-PEEK and PEEK–zirconia composites
Abstract Poly(methyl methacrylate) (PMMA) is the most widely used denture base material but exhibits limited fracture resistance under functional loads. This study investigates the effect of incorporating zirconia (ZrO 2 ) and polyether ether ketone (PEEK) nanoparticles on the structural and mechanical properties of PMMA. Thirty rectangular heat-cured PMMA specimens (65 × 10 × 2.5 mm) were divided into three groups: Group C (control): unmodified PMMA; Group P: PMMA with 5% PEEK nanoparticles; and Group ZP: PMMA with a hybrid of 2.5% ZrO 2 and 2.5% PEEK nanoparticles. Nanoparticle morphology was analyzed by field emission scanning electron microscopy (FESEM), showing PEEK sizes between 26 and 100 nm and spherical ZrO 2 with a mean diameter of 47 nm. Energy-dispersive X-ray spectrometry (EDXS) was performed on ZrO 2 only. FTIR analysis confirmed interfacial bonding in the hybrid composite. Flexural strength was measured via a three-point bending test. The ZP group exhibited the highest flexural strength (mean: 139.78 MPa), significantly outperforming both P and C groups ( p < 0.05), with no significant difference between P and C. The synergistic addition of ZrO 2 and PEEK nanoparticles significantly improved the mechanical and structural behavior of PMMA, offering a promising strategy to enhance durability and clinical performance of denture base materials in prosthodontics.
Genetic diversity and phylogenetic relationships of the rock ptarmigan (Lagopus muta) in Japan based on mitochondrial genome analysis of museum specimens
Relict species are important targets for biodiversity conservation and biogeographical research. The rock ptarmigan, Lagopus muta , which is distributed across the circumpolar region, is also found as relict populations in high mountain areas of mid-latitude regions worldwide. In Japan, isolated populations occur in the high mountain areas of Honshu Island. The Japanese L. muta japonica is threatened with extinction due to its fragmentation into multiple distribution areas, including regions where populations have already become extinct. To clarify the phylogenetic origin of the Japanese population, we conducted a mitochondrial genome-based phylogenetic analysis using museum specimens, including samples that are over 100 years old. A literature survey of the distribution areas near Japan suggested that the northern Kuril Islands represent the closest distribution area, although an alternative theory proposes that Primorsky Krai, on the eastern edge of the Eurasian continent, is nearest. Although the extracted DNA fragments were very short, we successfully determined the complete mitochondrial genome for all 18 individuals. Among the various mitochondrial regions, the control region and ND5 exhibited the greatest diversity. Network analysis of the control region from 209 individuals across all distribution areas worldwide indicated that the Japanese population is endemic, whereas no clear regional differentiation within Japan was observed in either the control region or the entire mitochondrial genome. Divergence time estimation suggests that the Japanese population diverged approximately 80,000–120,000 years ago, before the Last Glacial Maximum. This study demonstrates that useful genetic information can be recovered from degraded DNA even from specimens stored under high-temperature and high-humidity conditions in Japan, and provides a basis for re-evaluating the evolutionary history and regional genetic independence of L. muta .
Efficient and sustainable nanocatalyst based on dithiocarbamate ionic liquid functionalized magnetic graphene oxide for green synthesis of 1,4-dihydropyridins
‘I gotta Feeling’: Exploring the effects of a smartphone app (Feelee) to enhance adolescents’ emotion regulation in forensic outpatient settings: A multiple single-case experimental design
Adolescents in forensic outpatient care often face a complex interplay of emotional and cognitive challenges, which is also reflected in current challenges within treatment approaches. Mobile health (mHealth) interventions have shown increasing value in forensic settings, although empirical evidence remains limited. One particular mHealth app that may address current challenges in forensic outpatient care is Feelee, which provides daily emotion regulation practice through self-reported emotional check-ins and passively collected smartphone sensor data. Given the potential but still limited evidence for mHealth apps in forensic settings, this study aimed to provide first thorough evaluation of the Feelee app as an addition to treatment as usual to enhance emotion regulation skills among adolescents in forensic outpatient care. A multiple single-case experimental ABA design was applied, consisting of a 2-week baseline (phase A 1 ), 4-week intervention (phase B), and 2-week follow-up (phase A 2 ), combining quantitative and qualitative methods. Twenty-two adolescents (aged 12–23) completed daily assessments of emotion regulation. Secondary outcomes focused on emotional developmental mechanisms and treatment-related factors, measured at pre-, post-, and follow-up. Semi-structured interviews with adolescents and clinicians explored experiences with Feelee and its integration into treatment. Results showed a significant improvement in the emotional recognition during the intervention phase. No improvements were found in emotion suppression and impulse control, while reflection and distraction showed reversed outcomes. At follow-up, secondary outcomes indicated increases in positive emotion differentiation, emotional awareness, and self-reflection. Treatment motivation remained stable, while therapeutic alliance improved. Qualitative findings highlighted increased emotional insight, a alongside technical difficulties and limited discussion of Feelee data during sessions. These findings suggest that Feelee may particularly be valuable in the early stages of emotion regulation by enhancing emotional recognition. Future research should explore longer-term use and actively involve clinicians in the integration of app data to maximize therapeutic relevance and impact. Trial registration Central Committee on Research Involving Human Subjects NL-OMON54390 and ClinicalTrials.gov NCT06509360
Combined effect of triglyceride-glucose index and glucose disposal rate on cardio-cerebrovascular disease
Objective The triglyceride-glucose index and estimated glucose disposal rate serve as notable surrogate markers of insulin resistance, demonstrating established links to cardio-cerebrovascular disease. However, their combined prognostic value in predicting cardio-cerebrovascular disease outcomes remains unexplored. The current investigation examined the interaction between the TyG (triglyceride–glucose index) index and eGDR (estimated glucose disposal rate) concerning the danger of cardiovascular disease within a clinical population. Methods This investigation employed data sourced from the China Health and Retirement Longitudinal Study (CHARLS). The median TyG index and eGDR scores were used to stratify the participants into 4 categories: low TyG/high eGDR, high TyG/high eGDR, low TyG/low eGDR, and high TyG/low eGDR. Clinical characteristics across groups were systematically compared. Cox proportional hazards regression models evaluated the distinct and interconnected associations of the TyG index and eGDR with the risk of cardio-cerebrovascular disease, with multiplicative and additive interaction effects subsequently assessed through formal interaction analysis. Results The final study cohort comprised 7,330 participants, with 1,336 individuals (18.2%) developing cardio-cerebrovascular disease during the 9-year follow-up. Stratification using median thresholds (TyG: 8.59; eGDR: 10.55 mg/kg/min) yielded four groups: low TyG/high eGDR (n = 2,991), high TyG/high eGDR (n = 1,375), low TyG/low eGDR (n = 1,372), and high TyG/low eGDR (n = 2,292). Multivariable-adjusted Cox regression analyses revealed markedly increased risks of cardio-cerebrovascular disease among the various exposure groups when contrasted with the low TyG/high eGDR reference: high TyG/high eGDR (HR: 1.31, 95%CI: 1.10–1.57, p < 0.05), low TyG/low eGDR (HR: 1.54, 95%CI: 1.29–1.84, p < 0.05), and high TyG/low eGDR (HR: 1.55, 95%CI: 1.31–1.82, p < 0.05). Interaction analysis revealed significant multiplicative effects between TyG and eGDR but no evidence of additive interaction. Conclusion The TyG index and eGDR demonstrate independent associations with cardio-cerebrovascular disease risk, while their combined assessment reveals synergistic predictive capacity. Combined assessment of the two allows for further accurate stratification of the population based on insulin resistance and improved prediction of cardio-cerebrovascular disease.
Extracts from Cordyceps cicadae and Hericium erinaceus promote the neurite outgrowth of retinal ganglion cells
The regenerative capacity of mammalian RGC neurites after damage, such as glaucoma, is limited. Numerous studies have utilized herbal extracts to promote neural regeneration and exert neuroprotective effects in the hope of mitigating glaucoma. In the present study, we investigated the effect of extracts from the cicada fungus ( Cordyceps cicadae ) and the Lion’s mane mushroom ( Hericium erinaceus ) on neurite outgrowth of retinal explants and isolated RGCs. We also examined whether these extracts affect the number of apoptotic cells and neurite outgrowth activity of RGCs. The results showed that an aqueous extract of Cordyceps cicadae , an ethanol extract of Hericium erinaceus , and the purified compound Erinacine Sare able to promote neurite outgrowth in retinal explants. Given its role as a key bioactive compound, Erinacine S was further investigated on isolated RGCs, where it also significantly enhanced neurite outgrowth, demonstrating a direct effect on RGC regeneration. In addition, these extracts have no significant drawbacks in terms of cell apoptosis and RGC neurite outgrowth activity at specific concentrations. The present study thus demonstrates that while excessively high concentrations of these extracts may inhibit neurite growth, at moderate concentrations some extracts from Cordyceps cicadae and Hericium erinaceus have the potential of promoting neurite regeneration in the mammalian retina. Further research targeting the molecular mechanisms behind these effects may shed light on their potential application as a medicine or nutraceutical for facilitating neural regeneration.
HIV pre-exposure prophylaxis practices in Florida, USA: Clinicians’ perceptions of initiation, risk identification, barriers, and facilitators
This qualitative exploratory study aimed to learn clinicians’ perspectives on Pre-exposure Prophylaxis (PrEP) initiation, the HIV risk assessment process, perceived barriers to PrEP implementation, and how a potential electronic health record (EHR)-based PrEP clinical decision support tool can help improve their practices. Using purposive sampling, we recruited 15 clinicians with experience in PrEP practices for the three remote focus groups held between October 2021 and November 2021 using a semi-structured discussion guide. The focus groups were audio-recorded, transcribed, and analyzed in NVivo using thematic analysis. Five themes emerged from the qualitative analysis: (1) PrEP initiation is a joint effort between patients and clinicians; (2) Patient-clinician conversations are key for identifying PrEP candidates; (3) EHRs are helpful but insufficient for identifying PrEP candidates; (4) Patient, clinician, and system-level barriers deter PrEP implementation; and (5) Adopting technological innovations in health care can improve PrEP prescribing. Our analysis suggests that implementing effective communication strategies and behavioral interventions can improve PrEP awareness and reduce barriers in patient-clinician discussions of sexual history and substance use.