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The arginine/gallic acid-based deep eutectic solvent as a capable catalyst for the green synthesis of pyrano[2,3-d]pyrimidines

Global, regional, and national burden of cardiomyopathy (including alcoholic cardiomyopathy and others) from 1990 to 2021: An analysis of data from the global burden of disease study 2021 and forecast to 2040

Background Cardiomyopathy is a disease that can lead to severe cardiac symptoms and has seen an increasing number of cases in recent years. This study aims to analyze the incidence, mortality, and disability-adjusted life years of cardiomyopathy (including alcoholic cardiomyopathy and other cardiomyopathy) globally, as well as in different regions and countries, from 1990 to 2021, at different gender, age, and socio-demographic index levels. Methods All data relevant to the burden of disease analysis in this study were obtained from the 2021 Global Burden of Diseases, Injuries, and Risk Factors Study (GBD), encompassing alcoholic cardiomyopathy (AC) and other cardiomyopathy (OC). The overall burden of total cardiomyopathy (TC) was evaluated by integrating data about AC and OC, with 95% confidence intervals calculated based on the 95% uncertainty interval (UI) width divided by the standardized error value, determined by 1.96 × 2. Temporal patterns and trends in age-standardized prevalence rates (ASPR), mortality rates (ASDR), and disability-adjusted life years (ASR_DALYs) for global TC, as well as for AC and OC burden calculations, their estimated annual percentage changes (EAPCs) were calculated, assessed, and visualized. The analysis was categorized by gender, 20 age groups, 21 GBD regions, 204 countries/regions, and 5 socio-demographic index (SDI) regions. The burden of disease prediction model was subjected to Bayesian age-period-cohort (BAPC) modeling to derive predictions for the period from 2022 to 2040. All statistical analyses and mappings were conducted using the R statistical package version 4.4.3. Results In 2021, the global burden of TC remains considerable, with a total of 4752361.3, including AC: 528429 and OC: 4223932.2; the ASPRs (per 100,000 persons) were 59.5, 6.2 and 53.3; the ASDR (per 100,000 persons) were 4.5, 0.7 and 3.7; the age-standardized DALYs were 129.8, 25.3 and 104.5. In the aspect of AC, a considerable disparity in age-standardized prevalence, mortality, and DALYs was observed between the regional, national, and gender levels. The predictive results indicated that from 2021 to 2040, the ASPR of TC and OC showed a general increasing trend, while that of AC showed a decreasing trend. The ASDR and ASR_DALYs of TC, OC, and AC showed a general decreasing trend. Conclusions Globally, there has been an observed increase in the ASPR of TC and OC, while AC presented a decreasing trend, with significant regional, age, and gender variations in future trends. Although future projections in this study suggested a decline in ASDR and ASR_DALYs of TC, AC, and OC, there is a need to continue controlling the burden of disease in TC, AC, and OC studies to respond to the corresponding epidemiological trends and reduce the burden of them to some extent.

Correction: Aerobic exercise alleviates cognitive impairment in T2DM mice through gut microbiota

Mental health help-seeking among individuals with breast cancer: A qualitative exploration of women’s and healthcare practitioners’ perspectives

Individuals with breast cancer (BC) experience significant psychological distress, yet their utilization of mental health services remains low. This study identified key factors influencing help-seeking behavior through integrated Theory of Planned Behavior (TPB) and Health Belief Model (HBM) frameworks. We conducted in-depth interviews (IDIs) with eight BC patients and nominal group technique (NGT) with six health professionals, followed by Fuzzy Delphi Method (FDM) to assess expert consensus. The IDIs revealed that the individuals with BC recognized the value of professional psychological support but were reluctant to engage with these services personally. The participants identified emotional thresholds for help-seeking, expressed preference for informal support networks, and demonstrated varied understanding of mental health professional roles. The FDM evaluation demonstrated strong expert consensus across all assessed elements, particularly those related to emotional support mechanisms. Three barrier categories emerged: individual factors (mental health literacy, autonomy preferences), social factors (family support, cultural stigma), and systemic factors (healthcare integration gaps). Expert consensus exceeded 80% agreement across all domains.This study identified a complex interplay between individual psychological barriers and systemic factors affecting mental health help-seeking among individuals with BC. Effective interventions must address psychological barriers and healthcare delivery factors while respecting individual autonomy in coping choices. A multi-level approach targeting individual education, family support systems, and healthcare integration is recommended to improve mental health service utilization among individuals with BC.

Three dimensional palatal morphology and dentoalveolar differences after extraction and non extraction treatment in class II malocclusion

Abstract Digital technologies have transformed orthodontics by enabling precise three-dimensional (3D) assessment of treatment outcomes; however, the effects of extraction versus non-extraction strategies on palatal morphology in Class II malocclusions remain underexplored. This study quantified segmental palatal volume and surface changes, along with skeletal–dentoalveolar outcomes, using digital model analysis integrated with cephalometrics. Records of 69 post-pubertal patients treated with fixed appliances (Class II, n = 34; Class I controls, n = 35) were retrospectively analyzed, each subdivided into extraction and non-extraction protocols. Maxillary casts were scanned with Sirona inEos X5 and segmented in Materialise 3-Matic to compute palatal volume and surface area, while cephalometric variables were derived from lateral radiographs (Dolphin Imaging). Group comparisons were performed using non-parametric tests ( p  < 0.05). Multivariable regression analyses were conducted to identify dentoalveolar predictors of palatal remodeling. Intra-examiner repeatability was excellent, as indicated by a high intraclass correlation coefficient (ICC ≥ 0.90). Skeletal changes were minimal and comparable across groups. Dentoalveolar findings demonstrated significant maxillary incisor protrusion in non-extraction protocols and retrusion in extraction protocols ( p  < 0.05). Anterior palatal volume and surface area increased across all groups. Overall, measurable differences in total palatal volume and surface area were observed between extraction and non-extraction treatment strategies. Regression analyses indicated that sagittal dentoalveolar displacement was associated with palatal remodeling, whereas angular and vertical dental variables showed limited independent influence. Extraction and non-extraction treatment protocols were associated with measurable differences in three-dimensional palatal volume and surface area, reflecting distinct dentoalveolar and palatal remodeling patterns between treatment strategies.

Novel approaches in linkage of data sources to explore the associations between purchase of opioid prescriptions during pregnancy and adverse neonatal outcomes

Objective To evaluate patterns of opioid purchases by payment source among pregnant women in Arkansas and examine their associations with adverse neonatal outcomes. Methods Liveborn singleton infants born in Arkansas between 2014 and 2016 were identified from the Birth Certificate Records and linked to the All-Payer Claims Database (APCD), capturing public and private insurance claims; the Prescription Drug Monitoring Program (PDMP), recording controlled substance dispensations regardless of payment source; and the Social Determinants of Health Database, providing neighborhood socioeconomic indicators. Pregnancies were categorized as opioid non-buyers or buyers (insurance-only or self-paid). Adjusted odds ratios (AORs) for neonatal outcomes were estimated using Generalized Estimating Equations. Trimester-specific opioid exposure, expressed per 100 morphine milligram equivalents (MME), was analyzed to assess time-related effects. Results This longitudinal retrospective cohort analysis included 27,441 pregnancies; 21% (5,841) involved opioid purchases, with 15% (880) including at least one self-paid transaction. Opioid prescription counts during pregnancy were 3,434 (PDMP), 2,161 (APCD), and 8,579 (both). Compared with non-buyers, opioid buyers had higher adjusted odds of preterm (PT) birth (AOR 1.14, 95% CI 1.02–1.27) and neonatal opioid withdrawal syndrome (NOWS) (AOR 2.10, 95% CI 1.42–3.11), with no significant associations observed for low birth weight, NICU admission, or birth-weight z-score. Increasing MME was associated with higher odds of NOWS in first (AOR 1.0045, 95% CI 1.0011–1.0080), second (AOR 1.0064, 95% CI 1.0025–1.0103), and third (AOR 1.0206, 95% CI 1.0122–1.0291) trimester. No significant differences were found between insurance-only and self-paid buyers for any neonatal outcome. Conclusions Linking APCD and PDMP enabled a comprehensive assessment of prescribed opioid exposure. Opioid purchases were associated with increased risk of NOWS and modestly higher odds of PT birth. The dose and timing of opioid purchase were key determinants of NOWS. Payment source was not associated with differences in neonatal risk.

Research on inter-well connectivity in CO2 flooding based on long short-term memory graph attention network

Molecular remodeling of the myocardium in mice with melanocortin-4 receptor deletion before cardiac function impairment

The melanocortin-4 receptor (MC4R) is highly expressed in the hypothalamus, and mutations in this gene are closely associated with the development of hereditary obesity and early-onset severe obesity in humans. Mc4r has been shown to be involved in the development of dilated cardiomyopathy. However, the current system for the early diagnosis and treatment of heart disease is not well established. In this study, we analyzed the effects of Mc4r knockout on cardiac function, cardiomyocyte morphology, fibrosis, and apoptosis in mice. Moreover, we explored the possible early molecular mechanisms by which Mc4r affects cardiac dysfunction via transcriptome sequencing of cardiac cells combined with bioinformatics analysis. Although the overall heart does not show organic changes, our study suggested that cardiomyocytes already show early abnormal changes at the molecular level. The sequencing results revealed that the genes that were differentially expressed between the two groups of mice were enriched mainly in the p53 signaling pathway and the hypoxia-inducible factor 1 (HIF-1) signaling pathway. We screened 10 key target genes via a protein–protein interaction (PPI) network and module analysis. Drugs targeting key genes were subsequently screened, and angiotensinogen ( Agt ) and Kit were identified as potential drug targets. We analyze relevant data through bioinformatics to screen for signaling pathways and key hub genes that are enriched in differentially expressed genes (DEGs), as well as molecules targeting the hub genes, in order to provide ideas for early prevention of heart disease caused by Mc4r gene defects or related obesity.

Nano packaging with carbon quantum dots and essential oil nanocapsules prolongs shelf life of fresh cut Kale

Inclusion of 8% alfalfa silage advances feeding time and improves late-finishing feed efficiency in pigs

Feed is the largest cost in pig production, driving interest in alternative ingredients that maintain performance at lower expense. Alfalfa, a nutrient-rich and widely available forage legume, shows promise as a partial feed substitute. However, it remains unclear how partial replacement with alfalfa affects growth dynamics, feed efficiency, and feeding behavior across fattening stages in pigs. This study investigated the effects of substitution with 8% alfalfa or alfalfa silage on growth performance and feeding behavior in growing-finishing pigs over a 60-day fattening period (60–130 kg). A total of 24 pigs were randomly assigned to three diet treatments: commercial feed, 8% alfalfa substitution, or 8% alfalfa silage substitution. Weight, feed intake, feed conversion ratio (FCR), and feeding hour were measured and analyzed using linear mixed-effects models and generalized additive mixed models. Results showed no significant effects of alfalfa on overall weight, feed intake or FCR. However, Pigs fed commercial feed showed superior FCR during mid-fattening (weeks 2.8–5.2, P < 0.05) but worse FCR than alfalfa-fed groups during late-finishing phase (weeks 6.6–8, P < 0.05). Moreover, alfalfa silage altered animal behavior by shifting feeding hour by roughly three hours earlier (P < 0.05). In summary, substitution with 8% alfalfa or alfalfa silage can be incorporated without compromising overall pig performance. While, integrating alfalfa in later fattening stages could further improve feed efficiency and reduce costs. This supports the use of phase-specific feeding strategies and adoption of such practices could enhance both economic and environmental sustainability in commercial pig farming.

Emotional intelligence training improves stress regulation and performance in high-stress occupations

Wearable technology to characterize and treat mild traumatic brain injury subtypes: Study protocol for a randomized controlled trial on biofeedback-based precision rehabilitation (SuBTyPE)

Background Rehabilitation of persistent imbalance in people with mild traumatic brain injury (mTBI) is challenging, and responsiveness to rehabilitation is often suboptimal. One reason for suboptimal outcomes may be patient heterogeneity within rehabilitation referrals. Specifically, people with greater vestibular and/or ocular-motor (V/O) symptoms may respond better to vestibular rehabilitation therapy (VRT) compared to those with greater mood or cognition symptoms. Poor performance of exercises may also explain suboptimal outcomes. This study aims to 1) assess if a wearable sensor-based multidimensional biofeedback system could enhance rehabilitation, 2) examine responsiveness to rehabilitation depending on the severity of V/O deficits, 3) characterize the impact of V/O deficits on gait and turning during seven days of unsupervised daily living and establish normative mobility data from active-duty service members. Methods This study is a single-blinded randomized controlled trial involving 100 individuals experiencing persistent symptoms from subacute and chronic mTBI. Participants will be randomized into VRT with or without sensor-based biofeedback. Both groups will receive a 6-week VRT. All participants will be tested for balance, gait, turning, and V/O performance before and after VRT. We will compare the efficacy of VRT with or without biofeedback, stratified by the severity of V/O symptoms. Additionally, a subset of 50 participants with mTBI and 40 healthy active-duty service members will wear inertial sensors for seven days to quantify daily mobility. We will use the data to examine if the severity of V/O deficits following mTBI impacts daily mobility and to establish normative data for daily living mobility from military service members. Discussion This study will be the first clinical trial to investigate whether wearable technology can improve rehabilitation outcomes for those with V/O symptoms by providing real-time biofeedback during rehabilitation. This work will also help to identify individuals with sensorimotor deficits associated with V/O subtypes. These results will enhance the assessment and rehabilitative care following mTBI by integrating objective measures to identify and address V/O subtypes. Furthermore, establishing normative data for daily living mobility from service members will aid in return-to-duty decision making following mTBI. Trial registration This protocol is registered on ClinicalTrials.gov under the number NCT06381674. Registered on April 04, 2024. Recruited period from June 2024 to September 2028. https://clinicaltrials.gov/study/NCT06381674 . Trial Protocol v1 (Dated November 14, 2023)

Bullying plays a moderated mediation role in the association between emotional intelligence and school engagement through self-esteem

Reinforcement Operator Learning (ROL): A hybrid DeepONet-guided reinforcement learning framework for stabilizing the Kuramoto–Sivashinsky equation

This study presents Reinforcement Operator Learning (ROL)—a hybrid control paradigm that marries Deep Operator Networks (DeepONet) for offline acquisition of a generalized control law with a Twin-Delayed Deep Deterministic Policy Gradient (TD3) residual for online adaptation. The framework is assessed on the one-dimensional Kuramoto–Sivashinsky equation, a benchmark for spatio-temporal chaos. Starting from an uncontrolled energy of 42.8, ROL drives the system to a steady-state energy of 0.40  ± 0.14, achieving a 99.1% reduction relative to a linear–quadratic regulator (LQR) and a 64.3% reduction compared with a pure TD3 agent. DeepONet attains a training loss of 7.8 × 10 −6 after only 200 epochs, enabling the RL phase to reach its reward plateau 2.5 × sooner and with 65% lower variance than the baseline. Spatio-temporal analysis confirms that ROL restricts state amplitudes to ± 1.8 —three-fold tighter than pure TD3 and an order of magnitude below LQR—while halving the energy in 0.19 simulation units (33% faster than pure TD3). These results demonstrate that combining operator learning with residual policy optimisation delivers state-of-the-art, sample-efficient stabilisation of chaotic partial differential equations and offers a scalable template for turbulence suppression, combustion control, and other high-dimensional nonlinear systems.

Correction: A practical approach to replenishment optimization with extended (R, s, Q) policy and probabilistic models

Adaptive laboratory evolution and transcriptomic profiling reveal carbon–nitrogen metabolic reprogramming enabling aerobic co-fermentation of glucose and xylose in Saccharomyces cerevisiae

The efficient conversion of lignocellulosic sugars into bioethanol is constrained by the inability of Saccharomyces cerevisiae to metabolize xylose and by its preference for glucose when both sugars are available. Although recombinant strains have been developed to improve xylose utilization, further optimization is needed to achieve robust co-fermentation performance. In this study, three parental strains were used: a wild-type S. cerevisiae strain (GF16), a genetically engineered S. cerevisiae strain capable of metabolizing xylose (TMB3001), and a reference strain of Scheffersomyces stipitis (ATCC 58376). From these, we obtained an evolved S. cerevisiae strain (F2C7A) through a combination of UV mutagenesis, protoplast fusion, and adaptive laboratory evolution. In synthetic medium containing only xylose, F2C7A consumed 87.9% of the sugar after 72 h, compared with only 52.3% by its parental hybrid strain, although, its biomass yield was lower (0.20 g/g vs. 0.35 g/g). Under mixed-sugar conditions, F2C7A consumed all available glucose and 33% of xylose within 48 h, producing ethanol at 0.45 g/g yield with minimal xylitol accumulation. In culture medium containing only xylose, it reached a biomass yield of 0.86 g/g and a xylitol yield of 0.11 g/g. Transcriptomic analysis revealed strong induction of XYL1 , XYL2 , tricarboxylic acid cycle genes, and oxidative phosphorylation components under xylose, consistent with a respiratory phenotype. Mixed-sugar cultures displayed a respirofermentative profile and reduced xylitol formation, suggesting improved redox balance in the presence of glucose. Several nonspecific sugar transporters ( HXT8 , HGT1 , STL1 ) were overexpressed under xylose, indicating potential compensatory uptake mechanisms. Changes in nitrogen metabolism included upregulation of GLT1 and repression of GDH1 , suggesting a shift toward NADH-dependent glutamate synthesis. These findings demonstrate that combining classical and evolutionary strategies can enhance xylose metabolism in S. cerevisiae , providing a foundation for further improvement of strains intended for lignocellulosic bioethanol production.

Caregiver acceptability, and uptake of voluntary medical circumcision among male children under 5 years in Gulu city, Northern Uganda

Factors associated with unmet healthcare needs in patients using Primary Care Access Points for unattached patients in Quebec (Canada)

Background Access to primary care is an important component of health systems. Given the barriers experienced by unattached patients to accessing primary care in Quebec (Canada), the Ministry of Health mandated the province-wide implementation of Primary care access points for unattached patients ( Guichet d’accès première ligne ; GAP), an organizational innovation designed to orient patients to the most appropriate professional or service. This study aims to 1) document the factors associated with unmet healthcare needs after receiving GAP services and 2) assess whether those factors vary by GAP orientation. Methods This cross-sectional study builds on data collected between April and July 2024 using an online patient questionnaire. All patients with a valid email address registered on the centralized waiting list for unattached patients in three local health territories (LHTs) received an email invitation to participate in the survey. The total sample included 20,282 participants who responded to the questionnaire and used the GAP. Results The findings showed that younger age, self-reporting poor/fair physical and mental health, receiving services in LHT 3 and reporting an emergency room visit were associated with increased likelihood of reporting unmet needs. Stratified analyses suggested that some characteristics (age, use of emergency room) were associated with unmet needs across orientations, while others (self-reported physical and mental health) were associated with specific orientations. Conclusion This study serves as a first step in deepening our understanding from a patient perspective of how to better plan primary care services and improve unattached patients’ experiences using the GAP. The findings showed that patients oriented to other professionals than a medical appointment with a family physician had the highest percentage of unmet needs. The next step involves an in-depth exploration of the reasons for patients’ unmet needs, enabling the development of more precise and effective strategies to address them.

Efficient workflow scheduling in fog-cloud collaboration using a hybrid IPSO-GWO algorithm

Abstract With the rapid advancement of fog-cloud computing, task offloading and workflow scheduling have become pivotal in determining system performance and cost efficiency. To address the inherent complexity of this heterogeneous environment, a novel hybrid optimization strategy is introduced, integrating the Improved Particle Swarm Optimization (IPSO) algorithm, enhanced by a linearly decreasing inertia weight, with the Grey Wolf Optimization (GWO) algorithm. This hybridization is not merely a combination but a synergistic fusion, wherein the inertia weight adapts dynamically throughout the optimization process. Such adaptation ensures a balanced trade-off between exploration and exploitation, thereby mitigating the risk of premature convergence commonly observed in standard PSO. To assess the effectiveness of the proposed IPSO-GWO algorithm, extensive simulations were carried out using the FogWorkflowSim framework—an environment specifically developed to capture the complexities of workflow execution within fog-cloud architectures. Our evaluation encompasses a range of real-world scientific workflows, scaling up to 1000 tasks, and benchmarks the performance against PSO, GWO, IPSO, and the Gravitational Search Algorithm (GSA). The Analysis of Variance (ANOVA) is employed to substantiate the results. The experimental results reveal that the proposed IPSO-GWO approach consistently outperforms existing baseline methods across key performance metrics, including total cost, average energy consumption, and overall workflow execution time (makespan) in most scenarios, with average reductions of up to 26.14% in makespan, 37.73% in energy consumption, and 12.52% in total cost Beyond algorithmic innovation, this study contributes to a deeper understanding of workflow optimization dynamics in distributed fog-cloud systems, paving the way for more intelligent and adaptive task scheduling mechanisms in future computing paradigms.

Lethal means safety for Asian American, Native Hawaiian, and Pacific Islander Veterans: Insights from key informants

Aims Asian American, Native Hawaiian, and Pacific Islander (AANHPI) Veterans are more likely to use suffocation and less likely use firearms in suicide deaths, relative to Veterans overall. Information to inform tailoring of lethal means safety (LMS) interventions for AANHPI Veterans is limited. We elicited subject matter experts’ perspectives regarding LMS among AANHPI Veterans, including awareness of differences in suicide methods and insights regarding LMS considerations. Method Qualitative interviews were conducted with forty-three key informants in the Continental U.S. (CONUS), Hawaii, and Guam in 2022–2024. Interview transcripts were examined via deductive content analysis for this secondary analysis. Results Key informants noted an increased use of hanging among AANHPI Veterans and in specific regions (e.g., Pacific Islands), though mention of hanging/suffocation was specific to key informants in Hawaii and Guam. Key informants noted that LMS efforts do not address hanging, emphasizing the need for resources that address hanging and that are tailored to local contexts. Some key informants also noted the lower use of firearms as a suicide method among AANHPI Veterans, sharing potential explanations for this, while expressing concerns that recent increases in firearm access in this population could lead to increases in firearm suicide deaths. Accordingly, key informants expressed a need to understand how cultural considerations could be incorporated into firearm LMS efforts for AANHPI Veterans. Discussion Some subject matter experts, particularly those in the U.S. Pacific Islands, have awareness of the differences in suicide methods among AANHPI Veterans; however, increasing CONUS practitioners’ awareness of the increased use of hanging/suffocation as a suicide method among AANHPI Veterans may be warranted. Developing strategies to prevent suicide by hanging is crucial to preventing suicide among AANHPI Veterans. Considering potentially increased rates of firearm access among AANHPI Veterans, development of culturally responsive firearm suicide prevention efforts for this population is also warranted.