Browse Articles
Discover research articles across all indexed journals
Hyperbaric oxygen therapy in alleviating cerebral ischemia-reperfusion injury via the BMP6/Smad-hepcidin pathway
Cerebral ischemia-reperfusion injury (CCI) is a cause of neurological damage. Hyperbaric oxygen therapy (HBOT) can improve recovery in CCI in relation to iron metabolism and ferroptosis, but the precise mechanisms remain unclear. This study aims to explore the neuroprotective effects of HBOT in CCI and its regulator of iron homeostasis via BMP6/Smad-Hepcidin signaling pathway. Male Wistar rats were divided into Control (CT), Ischemia-Reperfusion (GM), Ischemia-Reperfusion + Normobaric Hyperoxia (NH), and Ischemia-Reperfusion + HBOT (HO) groups. The CCI model was induced by four-vessel occlusion. HBOT was administered at 2.5 ATA for 120 minutes daily for 5 days. Neurological function was assessed using the modified neurological severity score, light-dark box, and Morris Water Maze test. Histopathological analysis, transmission electron microscopy, Nissl and TUNEL staining, oxidative stress markers, Western blotting and qPCR were used to assess neuronal damage, mitochondrial integrity, necrosis, apoptosis, oxidative stress, iron metabolism and BMP6/Smad-Hepcidin mRNA expression and protein concentrations. HBOT significantly improved neurological function, reduced neuronal damage, and preserved mitochondrial integrity compared to untreated animals. Oxidative stress markers, including malondialdehyde and antioxidant enzyme activities were significantly restored. HBOT also downregulated the BMP6/Smad-Hepcidin pathway, leading to decreased hepcidin levels. Western blot and qPCR analysis confirmed the suppression of ferroptosis-related markers in the HBOT group. HBOT significantly reduces neurological deficits, neuronal damage, and oxidative stress in CCI injury. Its neuroprotective effects are likely mediated by the regulation of the BMP6/Smad-Hepcidin pathway and the suppression of ferroptosis. These findings suggest that HBOT is a promising therapeutic strategy for treating CCI.
Opioid dispensing prior to opioid toxicity hospitalizations and emergency department visits in Canada, 2018–2022
Background Both pharmaceutical and non-pharmaceutical opioids contribute to overdoses and other drug-related harms in Canada; however, the role of these sources of opioids have been dynamic over the past two decades and vary geographically. Therefore, we sought to examine trends in the prevalence of prescription opioid exposure at the time of opioid toxicity hospitalizations and emergency department (ED) visits across Canada over the past 5 years. Methods We conducted a population-based repeated cross-sectional study of yearly opioid toxicities treated in an inpatient hospital setting in 6 Canadian provinces―British Columbia, Alberta, Saskatchewan, Manitoba, Ontario, and Quebec―between January 2018 and December 2022. We linked hospitalization records with community pharmacy dispensing data to determine active exposure to prescribed opioids at the time of opioid toxicity, annually and stratified by patient characteristics and type of opioid dispensed. In a secondary analysis, we replicated these methods among opioid toxicities treated in EDs in 5 provinces where data were available. Results We identified 23,876 opioid toxicity hospital admissions over the study period. Active opioid exposure at the time of hospital admission declined across provinces over time, apart from British Columbia (range, 20.0% in British Columbia to 47.5% in Quebec in 2018; 19.7% in British Columbia to 36.5% in Quebec in 2022). Generally, people ≥65 and females were proportionally more likely to have an active opioid exposure. When stratified by opioid type, we observed a shift towards active exposure to opioid agonist treatment (OAT), while active exposure to opioids for pain declined over time. Active opioid exposure was less common at the time of opioid toxicity ED visit but was more stable over time (range, 11.0% in British Columbia to 28.5% in Quebec in 2018; 14.9% in Alberta to 26.0% in Quebec in 2022), with only small declines in most provinces (Alberta, Ontario, and Quebec), and an increase in British Columbia (from 11.0% in 2018 to 16.8% in 2022), which was driven by a large increase in active OAT exposure. Conclusions Our findings highlight the increasing role of the potent unregulated drug supply in opioid toxicities across Canada, as well as important differences in the role of prescription opioids in harms across demographic groups, geography, and opioid indication.
Prevalence, demographic factors, co-morbidities, and treatment types associated with acanthosis nigricans in a large cross-section of 900+ transmasculine patients: Data from a single academic center 2016–2023
Background Acanthosis nigricans (AN) is a highly visible cutaneous condition that has been associated with cardiometabolic factors, drugs, or malignancy in various populations. AN can be challenging to treat. Transmasculine patients are a special population, but their AN prevalence, and whether AN associates with demographic factors, co-morbidities and gender affirming care (GAC) treatment types have not been well-studied. Our study explores whether GAC treatment type is associated with AN while controlling for confounders in a large group of transmasculine patients at an academic center. Methods Following Institutional Review Board approval, the Stanford Research Repository (01/01/2016–21/09/2023) was searched to identify transmasculine patients for individual chart review. The primary outcome was AN and its association with demographic factors, co-morbidities, and gender-affirming care (GAC) treatment type by multivariate logistic regression (presented as Odds Ratio (OR) and 95% Confidence Interval (CI)). Results Out of 945 transmasculine patients, AN prevalence was 4.55%, an elevated rate compared to the overall database prevalence of 0.3% for the same period. Prevalence of AN in transmasculine patients never exposed to GAC was 4.02% (7/174). Median age was 20.1 years (interquartile range (IQR) 17.2–25.4). On multivariate logistic regression, AN was associated with obesity (OR 9.31, 95% CI 4.40–20.33), metabolic syndrome (OR 4.04, 95% CI 1.09–15.23), prediabetes (OR 3.17, 95% CI 1.10–8.54), hypertension (OR 2.74, 95% CI 0.96–7.18), and Hispanic ethnicity (OR 2.46, 95% CI 1.12–5.25). GAC type (including exogenous testosterone usage) was not associated with AN, despite >99% power to detect a 10% difference in AN prevalence. Conclusions Because AN is enriched in transmasculine patients, and precedes co-morbidities in a majority of cases, dermatologists and other physicians should consider examination of common areas for AN in in transmasculine patients, as screening and diagnosis of co-morbidities could lead to improved health outcomes.
Prioritizing areas for post-fire restoration in Greece using mixed-methods spatial analysis
The Mediterranean region will likely face an increase in the frequency and intensity of wildfires due to climate change. Despite being fire-prone, Greece lacks a developed standardized system for identifying and prioritizing burned areas in relation to their restoration needs. Prioritization of areas for post-fire restoration efforts using Geographic Information System and Remote Sensing is a powerful decision-making tool, which, however, can be insufficient in effectively integrating socio-ecological criteria and perspectives from multiple stakeholders. Combining qualitative methods such as interviews with remotely sensed data can enhance the understanding of nuances in a local context. We designed an approach to identify high-priority areas for post-fire vegetation restoration. The identification was based on stakeholder interviews and the subsequent integration of their responses with subsequent multi-criteria overlay analysis. We selected criteria to rank the areas by interviewing 15 stakeholders working on post-fire issues. The expert interviews revealed the key characteristics respondents consider essential for prioritizing burned areas for restoration. Areas covering 77.25 km² were selected for restoration depending on the fire history, slope, and designation as part of the protected areas. Outcomes of the analysis helped to highlight three locations that potentially need special attention, with the total area of 31 km². We propose a prioritization system that is flexible, scalable, and can help government agencies, local foresters, private consultancies, and NGOs plan restoration actions and optimize the effectiveness of restoration programs in various ecosystems.
Time to treatment failure and its predictors among children receiving first-line antiretroviral therapy in Tigray Region public general hospitals, North Ethiopia, 2024: Retrospective cohort study
Background Pediatric human immunodeficiency virus (HIV) remains a significant public health challenge, with an estimated 1.5 million children living with HIV globally. In addition, first-line antiretroviral therapy (ART) treatment failure has remained high, as studies and reports showed. Furthermore, time to treatment failure and its predictors on first-line ART among HIV-infected children are less researched in the study area after the test-and-treat strategy is implemented. Hence, this study was conducted to assess time to treatment failure and its predictors among children receiving first-line antiretroviral therapy in Tigray Region public general hospitals, North Ethiopia, 2024. Methods A hospital-based retrospective cohort study was conducted among children who started ART from January 2014 to March 2020 and from February 2023 to August 2023 in Tigray Region public general hospitals. Epi Data version 3.1 and Stata version 14 were used for data entry and analysis, respectively. Kaplan-Meier and log-rank tests were computed. Bivariable analysis variables with p-value < 0.2 were taken to multivariable Cox regression analysis to identify predictors. Finally, 95% CI and p-value <0.05 were considered for statistical significance. Results From 410 records of children, 55 (13.4%) (95% CI, 10.43–17.08) had treatment failure, with an incidence rate of 3.3 (95% CI, 2.6–4.3) per 1000 child-month observation. The median time to treatment failure was greater than or equal to 75 months. Poor adherence (AHR = 3.6, 95% CI: 1.7–7.5), baseline CD4 count <200 cells/mm 3 (AHR = 3.8, 95% CI: 1.8–8.4), baseline CD4 count 201–350 cells/mm 3 (AHR = 2.7, 95% CI: 1.2–6.2), and initial Nevirapine-based regimen (AHR = 4, 95% CI: 1.8–8.8) were predictors of time to treatment failure. Conclusion and recommendation The incidence of treatment failure among children receiving first-line ART was found to be high according to the UNAIDS virological suppression targets. Poor adherence, baseline CD4 count, and initial NVP-based regimen were predictors of time to treatment failure of ART. Hence, all children on ART should be closely monitored, mainly on these identified predictors.
Rally and recover: Physiological demands between tennis drills
This study examined physiological recovery between repeated tennis drills in elite adolescent tennis players. Ten tennis players (5 males, 5 females; age 17 ± 2 years) underwent treadmill testing to establish maximal physiological characteristics. Several days later participants completed three standardized on-court tennis drills with fixed rest intervals, during which physiological parameters were monitored. A one-way repeated-measures ANOVA was used to compare physiological responses across the three drills. V ˙ O 2max utilization stayed above 75% in all drills, peaking during the first drill (p = 0.003). During recovery, V ˙ O 2max utilization decreased from 58 ± 8% in the first recovery to 50 ± 9% (p = 0.018) and 47 ± 12% (p = 0.022) in the second and third recovery, respectively. The respiratory exchange ratio (RER) stayed below 1.0 during drills, while increasing during recovery periods, (1.07 ± 0.08, 1.00 ± 0.01, 1.04 ± 0.05; p = 0.014). Ventilatory equivalents for oxygen ( V ˙ E / V ˙ O 2 ) were stable (p = 0.054), while those for carbon dioxide ( V ˙ E / V ˙ CO 2 ) increased progressively for each recovery period (29.5 ± 3.6, 31.5 ± 3.8, 32.3 ± 4.3; p < 0.001). Blood lactate concentration differed significantly across recovery periods (p = 0.035) with the lowest value in recovery period two (5.9 ± 2.0, 4.9 ± 1.9 and 5.6 ± 2.0 mmol·l -1 ). These findings highlight a sustained metabolic demand extending into the recovery phase during standardized tennis drills, characterized by substantial V ˙ O 2max utilization and elevated respiratory compensation. This suggests a significant anaerobic contribution and underscores the intensity of the physiological load imposed even after exercise cessation.
Higher fibrinogen-to-albumin ratio is associated with the severity of toxin associated acute kidney injury in high-altitude (3650 m) population: A retrospective analysis
Background Few reports used acute kidney injury concept in the area of toxic kidney damage, especially in highland areas. Recent evidence suggests that the fibrinogen-to-albumin ratio is significantly associated with the incidence and severity of acute kidney injury, highlighting its potential clinical utility for risk stratification and prognostication in high-risk populations. We investigated the clinical characteristics and risk factors of toxic kidney injury in highland areas using the acute kidney injury criteria defined by the kidney disease improving global outcomes work group, with focus on the significance of the fibrinogen- to- albumin ratio. Methods Clinical data of poisoned patients who had electronic inpatient medical records during the past ten years were retrospectively analyzed, and risk factors affecting renal function were investigated. Results Sixty-five inpatients fulfill the criteria with the median age of 36.7 years old, including 40 females (61.5%). Thirty-four patients (52.3%) underwent blood purification, mainly hemoperfusion (n = 33). Medicine poisoning accounts for 53.8% (n = 35), including antipsychotic sedatives (n = 14) and Tibetan medicine (n = 9). Pesticide poisoning ranks the second (27.7%, n = 18). And the last was toxic substances eaten as food (n = 12). Among them, 39 cases (60.0%) were attributed to intentional self-poisoning. Multivariate linear regression analysis revealed that the serum creatinine concentration was positively related to the fibrinogen-to-albumin ratio, and to the concentrations of uric acid and serum phosphate: The reciprocal of the highest serum creatinine concentration (µmol/L) = 0.032–0.002 * uric acid concentration (µmol/L)/ 100 - 0.005 * serum phosphate concentration (mmol/L) −0.078 * the fibrinogen-to-albumin ratio + ε. The study demonstrated a dose-dependent association between elevated fibrinogen-to-albumin ratio and increased serum creatinine levels. Conclusions The public needs to be well informed to minimize the chance of exposure to excessive medicine, wild vegetables, toxic mushrooms, and pesticides. Traditional Tibetan medicine, unique to this plateau region, requires professional guidance for its identification, processing, and dosage. Mental well-being in plateau areas must be prioritized, and regulatory oversight of pesticides and antipsychotic sedatives need to be strengthened to mitigate the risks of overdose and toxic exposure. The serum creatinine concentration in poisoned patients in plateau regions may be affected by the fibrinogen-to-albumin ratio. Therapy against microinflammation, higher uric acid and phosphate levels may prevent further kidney injury.
Automated, stress-free, and precise measurement of songbird weight in neuroscience experiments
Monitoring the health and well-being of research animals is essential for both ethical and scientific purposes. In songbirds, body weight is one of the main indicators of their overall condition, yet traditional weighing methods can be intrusive and stress-inducing, which could decrease their song rate. We developed an automated system for monitoring the weight of multiple birds in longitudinal neuroscience experiments, which often include birds tethered to data acquisition systems. Building on previous models that were mostly designed for weighing birds outdoors and in large housing cages, our design serves as a perch for the bird to stand on (a perch-scale ) and meets the needs of neuroscience experiments by (i) minimizing cable entanglement to safely accommodate tethered birds, (ii) supporting long-term monitoring of individually-housed birds, and (iii) linking multiple devices into a unified control unit that oversees setup, calibration, and data acquisition. We deployed the system in the cages of six canaries for ten days and validated its accuracy against daily manual weighing. The precision and continuous monitoring of the perch-scale allowed observing physiological patterns such as overnight weight loss. Our system detected 22 sequences of overnight perching in five different birds, showing an average decrease of ≈ 4% of the bird’s body-weight overnight. We also found that daily weight estimates, derived from perch-scale data, were within the range of daily weight fluctuations (5–10%), as they deviated by less than 5% on average when compared to the manual weights. These results validate the device’s sensitivity for detecting subtle and health-related changes. By eliminating the need for manual handling of birds, this system offers a non-invasive, hands-free approach that reduces stress and improves the accuracy of health assessments. Future applications could integrate additional health metrics to provide a more comprehensive understanding of animal welfare in neurophysiology and behavioral studies.
Calibrated-Two Optional Randomized Response Techniques (C-TORRT) for the estimation of quantitative sensitive variable information
Accurate estimation of sensitive quantitative variables remains a challenge in survey research due to respondents’ reluctance to disclose truthful information. While existing randomized response techniques (RRT) offer privacy protection, many suffer from inefficiencies and limited robustness. This study addresses this critical gap by proposing new classes of Calibrated-Two Optional Randomized Response Techniques (C-TORRT) , developed through calibration methods that incorporate auxiliary information to enhance estimation accuracy and respondent privacy. The theoretical framework of the proposed models demonstrates unbiasedness, reduced variance, higher privacy protection, and a superior combined metric of efficiency and privacy. Empirical studies based on real-life and simulated data showed that the proposed C-TORRT models consistently outperformed existing RRT models. For instance, under Population I, the proposed model achieved a variance of 21.76704, privacy level of 222.4369, and a percentage relative efficiency (PRE) of 608.93, compared to the Azeem et al. model with variance 142.4927 and PRE 93.02. Similarly, under Population II, the C-TORRT model reduced the variance to 4.3098 and raised the PRE to 499.60, a significant improvement over Gjestvang and Singh’s variance of 21.5316 and PRE of 100. Real-life data application using academic records confirmed these findings, where the C-TORRT estimators yielded lower variance (0.8084), higher privacy levels (817.28), and smaller combined efficiency-privacy metrics (0.000991) compared to existing models. These results underscore the superior efficiency, precision, and privacy protection of the proposed C-TORRT models, making them robust alternatives for sensitive quantitative data collection.
Effectiveness of clinical decision support in fall prevention among older adults: A systematic review and meta-analysis
Background Systematic use of Clinical Decision Support (CDS), which provides timely information to assist healthcare practitioners in decision-making, is recommended in the implementation of fall prevention among older adults. This systematic review aimed to evaluate the effects of CDS for fall prevention on healthcare practitioners’ adherence to recommended practice, medication outcomes, and patient outcomes. Methods We searched Medline, EMBASE, CINAHL, Cochrane Library, Web of Science, AMED, PEDro, and Google Scholar from the earliest available dates through January 2025. We included randomised and non-randomised studies that directly compared interventions consisting of CDS presented on-screen or on paper to healthcare practitioners aiming to prevent falls in persons aged 65 years or older. We analysed healthcare practitioner performance, medication review and prescribing, fall risk, fall rate, and fall injury rate as primary outcomes. Two reviewers independently screened studies and assessed for risk of bias. We synthesised results using meta-analyses and vote-counting based on direction of effect, when possible, otherwise narratively, and we rated the certainty of the evidence using the GRADE approach. Results Of 25 included studies, 20 were randomised and five were non-randomised. Most CDS tools supported healthcare practitioners in performing multifactorial fall risk assessments and follow-up interventions based on identified risks (60%) and most were delivered electronically (60%). CDS may improve healthcare practitioners’ adherence to recommended practice (all eight comparisons favouring CDS; 95% confidence interval [CI] 68% to 100%; low certainty) and likely improve medication review and prescribing (all nine comparisons favouring CDS; 95% CI 70% to 100%; moderate certainty), although the effect sizes are uncertain. CDS may reduce fall risk, but the effect may be small (odds ratio 0.93; 95% CI 0.81 to 1.01; low certainty). CDS likely reduces fall rates in hospitals or residential care (rate ratio [RaR] 0.74; 95% CI 0.63 to 0.88; moderate certainty) and in patients aged 80 years or older (RaR 0.72; 95% CI 0.61 to 0.86; moderate certainty). CDS may reduce fall rates in community-dwelling older adults (RaR 0.97; 95% CI 0.93 to 1.00; moderate certainty) and in patients aged between 65 and 80 years (RaR 0.92; 95% CI 0.84 to 1.01; low certainty), though the effects in both of these subgroups may be small. CDS may reduce fall injury rates in older adults aged between 65 and 80 years (RaR 0.80; 95% CI 0.59 to 1.09; low certainty). The evidence on fall injury rates in patients aged 80 years or older was very uncertain. Conclusion CDS likely enhances healthcare practitioners’ performance in fall prevention among older adults; however, the effect sizes remain unknown. Although CDS may improve patient outcomes in fall prevention, both the effect sizes and the certainty of evidence vary. Results from this study may inform the planning and implementation of CDS in fall prevention. Future studies should strive for clearer reporting of CDS design factors to allow for an evaluation of which factors may influence the success of CDS interventions in fall prevention. Trial registration Registration: PROSPERO, CRD42021250500.
ACMTF-R: Supervised multi-omics data integration uncovering shared and distinct outcome-associated variation
The rapid growth of high-dimensional biological data has necessitated advanced data fusion techniques to integrate and interpret complex multi-omics and longitudinal datasets. Shared and unshared structure across such datasets can be identified in an unsupervised manner with Advanced Coupled Matrix and Tensor Factorization (ACMTF), but this cannot be related to an outcome. Conversely, N-way Partial Least Squares (NPLS) is supervised and captures outcome-associated variation but cannot identify shared and unshared structure. To bridge the gap between data exploration and prediction, we introduce ACMTF-Regression (ACMTF-R), an extension of ACMTF that incorporates a regression step, allowing for the simultaneous decomposition of multi-way data while explicitly capturing variation associated with a dependent variable. We present a detailed mathematical formulation of ACMTF-R, including its optimisation algorithm and implementation. Through extensive simulations, we systematically evaluate its ability to recover a small y - related component shared between multiple blocks, its robustness to noise, and the impact of the tuning parameter ( π ) which controls the balance between data exploration and outcome prediction. Our results demonstrate that ACMTF-R can robustly identify the y -related component, correctly identifying outcome-associated shared and distinct variation, distinguishing it from existing approaches such as NPLS and ACMTF. The development of ACMTF-R was motivated by a real-world dataset investigating how maternal pre-pregnancy BMI affects the human milk microbiome, human milk metabolome, and infant faecal microbiome. Emerging evidence suggests that inter-generational transfer of maternal obesity may affect multiple omics layers, highlighting the need to identify outcome-associated variation. The applicability of ACMTF-R is therefore validated by applying it to this multi-omics dataset. ACMTF-R successfully identifies novel mother-infant relationships associated with maternal pre-pregnancy BMI, underscoring its utility in multi-omics research. Our findings establish ACMTF-R as a versatile tool for multi-way data fusion, offering new insights into complex biological systems by integrating common, local, and distinct variation in the context of a dependent variable.
Feasibility trial of a transdiagnostic individual lifestyle evaluation and intervention (Lev-i) for health behavior change
Purpose Individuals with disabilities face challenges in adopting and maintaining healthy behaviors. Existing interventions are often diagnosis-specific, profession-bound, and limited to single health behaviors, restricting a broader applicability. This study evaluated the feasibility and acceptability of Lev-individual (Lev-i), a transdiagnostic and interprofessional intervention designed to promote health behaviors among individuals with disabilities. Method This feasibility study was conducted in an outpatient disability healthcare setting, involving 25 adult participants with long-term disabilities. Lev-i consists of three structured sessions focusing on goal setting, motivational strategies, and behavior change techniques that can be used across ten health domains. Data on treatment completion, acceptability and secondary outcomes was collected through self-reports for participants and professionals before, during, and after the intervention. Results The treatment completion rate was 23 out of 25 (92%), with high treatment satisfaction (M = 3.61 out of maximum 4). Participants reported significant increases in treatment credibility and expectancy of change (6.93 pre, 8.27 post, p < .01), as well as high treatment satisfaction. Professionals rated the intervention as relevant and feasible, though many comments indicated a need for simplification of the study protocol and clearer intervention materials. No serious adverse events were reported. For secondary outcomes, goal attainment scores indicated that participants on average reached their goals. Also, there was a significant improvement in dietary habits ( p < .05, d = 0.55), and a non-significant trend toward increased physical activity ( d = 0.39). Conclusion Findings suggest that Lev-i is a feasible and acceptable intervention for promoting health behaviors among individuals with disabilities. However, further refinements may enhance feasibility for both patients and professionals before conducting a randomized controlled trial. ClinicalTrials.gov (NCT05889936).
Cohort profile: The Bristol IVF Study- A longitudinal study of women, their partners and treatment outcomes following assisted reproductive technologies
Background The Bristol IVF Study (BRIST-IVF) is a longitudinal clinical cohort, established to determine factors related to successful live birth and other outcomes following conception by assisted reproductive technologies (ART). This cohort profile describes recruitment, data collection and planned research. Methods The study gathered comprehensive sociodemographic, lifestyle, anthropometric, and clinical data from women and their partners before and during treatment, as well as during pregnancy and after birth. Biological samples, including blood, urine, and saliva, were collected at initial recruitment and at pregnancy clinics, with cord blood and placental tissue obtained at birth. Participants consented to NHS record linkage, allowing access to pregnancy and birth outcomes from obstetric notes. Data collection during pregnancy and after birth followed the same protocols as a naturally conceived cohort, the second generation of the Avon Longitudinal Study of Parents and Children (ALSPAC-G2). Results Between 3rd September 2019 and 30th June 2023, 502 couples or single women were recruited (967 individuals in total). Of these, 490 women underwent 1,055 ART treatment cycles during the study follow-up (up to 31st March 2024). Recruited women had a mean age of 35.8 years (SD = 4.4) and a mean BMI of 25.1 (SD = 4.4). At the time of recruitment, 251 women (50%) had never been pregnant, and 374 (75%) had not had a previous live birth. Women and their partners with a confirmed viable pregnancy at a scan performed at 7 weeks of gestation were invited to participate in the pregnancy follow-up study, with 305 women (for 324 pregnancies) invited. Data were collected from pregnancy questionnaires (n = 246, 76%), pregnancy clinic data (n = 119, 37%), and birth questionnaires (n = 223, 69%). Collection of obstetric data from health records is ongoing. Conclusion The BRIST-IVF cohort enables novel research into the predictors and consequences of ART conception, with comparison to ALSPAC-G2.
Air pollution macro-regions identification using machine learning and spatio-temporal analysis
Air pollution caused by suspended particulate matter (PM) remains one of the key environmental challenges in Poland, particularly in the context of public health and spatial planning. This study presents a spatio-temporal analysis based on data from 173 air quality monitoring stations collected between 2015 and 2023. Advanced unsupervised clustering methods based on the Dynamic Time Warping (DTW) metric were applied to identify spatial patterns of pollution at both daily and annual timescales. Based on over 13 million observations, four macroregions were delineated, along with a set of sixteen clusters allowing for assessment of local anomalies. A significant variation in median PM 10 concentrations has been observed across macroregions, ranging from 19.7 to 27.18 μ g / m 3 . The results revealed the significant role of topographic, urban, and microclimatic factors in shaping the spatial distribution of particulate matter. Urbanized areas in southern Poland (Silesia, Lesser Poland) formed distinctly isolated clusters with high PM levels, in contrast to the stable, low-emission northern lowlands. The analysis further demonstrated that regional policies may be ineffective without supra-regional coordination. These findings show the need of including the high-resolution data analyses into environmental and public health planning to effectively limit the impacts of air pollution.
ViSQA: A benchmark dataset and baseline models for Vietnamese spoken question answering
Spoken Question Answering (SQA) extends machine reading comprehension to spoken content and requires models to handle both automatic speech recognition (ASR) errors and downstream language understanding. Although large-scale SQA benchmarks exist for high-resource languages, Vietnamese remains underexplored due to the lack of standardized datasets. This paper introduces ViSQA, the first benchmark for Vietnamese Spoken Question Answering. ViSQA extends the UIT-ViQuAD corpus using a reproducible text-to-speech and ASR pipeline, resulting in over 13,000 question–answer pairs aligned with spoken inputs. The dataset includes clean and noise-degraded audio variants to enable systematic evaluation under varying transcription quality. Experiments with five transformer-based models show that ASR errors substantially degrade performance (e.g., ViT5 EM: 62.04% → 36.30%), while training on spoken transcriptions improves robustness (ViT5 EM: 36.30% → 50.70%). ViSQA provides a rigorous benchmark for evaluating Vietnamese SQA systems and enables systematic analysis of the impact of ASR errors on downstream reasoning.
Adverse events following Synflorix vaccination reported to the Vaccine Adverse Event Reporting System (VAERS), 2010–2024
Background Synflorix is a conjugate vaccine targeting Streptococcus pneumoniae, effectively reducing pneumonia and invasive pneumococcal disease in children under five. To evaluate its safety profile, this study analyzed adverse event (AE) reports associated with Synflorix vaccination submitted to the Vaccine Adverse Event Reporting System (VAERS) from 2010 to 2024. Methods We conducted a retrospective analysis of 1,704 VAERS reports from January 1, 2010, to December 30, 2024. Data processing and statistical analysis were performed using R software. Reporting Odds Ratios (ROR) with 95% confidence intervals (CI) were calculated to identify potential safety signals. Symptom types, onset times, and severity differences across age groups were examined. To facilitate comparison with other vaccines in the VAERS database, certain Preferred Terms (PTs) were normalized per 100,000 reports. Results The most common adverse reactions included crying, pyrexia, hypotonic-hyporesponsive episodes (HHE), pallor, and diarrhea. Newly detected signals not previously listed in the product insert were HHE, hypotonia, pallor, and bronchiolitis. Severe reactions such as pyrexia, crying, vomiting, and pallor showed delayed onset compared to non-severe cases. Infants and toddlers demonstrated stronger systemic reactions within one day post-vaccination, while children aged 2–10 years mostly developed injection site nodules. Adults predominantly experienced localized reactions within 10 days. Reports for elderly individuals (≥55 years) were limited and primarily described mild symptoms like erythema and pyrexia. When compared to other pneumococcal vaccines (PCV7, PCV13, PCV15, PCV20, PPSV23), Synflorix showed the third-highest frequency of mortality and significantly higher RORs for HHE, hypotonia, pallor, and bronchiolitis. Additionally, in terms of the timing of AEs, Synflorix exhibited a similar trend to these vaccines, with reactions primarily occurring in the short-term post-vaccination period. Conclusion Age-specific patterns of adverse events following Synflorix vaccination were observed, with infants and toddlers showing higher intensities of systemic reactions. Compared to other pneumococcal vaccines, Synflorix exhibited a relative higher mortality reporting frequency, along with higher frequencies and RORs for specific PTs, including HHE, hypotonia, pallor, and bronchiolitis. Enhanced post-vaccination monitoring is recommended for younger populations due to their immature immune systems. Age-stratified surveillance can help optimize vaccine safety and management.
Sex differences in cachexia outcomes and branched-chain amino acid metabolism following chemotherapy in aged mice
Cachexia is a complex muscle wasting syndrome that affects the majority of hospitalized cancer patients receiving chemotherapy. It is often unresponsive to nutritional interventions, including provision of branched-chain amino acids (BCAAs: leucine, isoleucine and valine). BCAAs are anabolic for skeletal muscle. We wondered whether their ineffectiveness in managing cachexia might be related to altered metabolism of these amino acids, a subject that has received minimal attention. Because estrogen limits BCAA catabolism, we hypothesized that the effects of chemotherapy on cachexia in old mice would be worse in males compared to females, and that this would be related to greater tissue release of the BCAAs in males. To better reflect the age population for which cachexia is an issue, we treated aged male and female mice (18 ± 2 months) with the chemotherapy drug cocktail FOLFIRI (50 mg/kg 5-fluorouracil (5FU), 90 mg/kg Leucovorin, and 24 mg/kg CPT11) or vehicle twice per week for 6 weeks. This cocktail is used in treating colon cancer. Metabolism and concentrations of the BCAAs and their metabolites were measured in plasma and tissues. There was a main effect of chemotherapy, reflected in reduced body weight, skeletal muscle, myofibrillar protein content, anabolic signalling and protein synthesis. In response to chemotherapy, males showed worsened outcomes for skeletal muscle weight and ubiquitinated proteins; they also had higher total plasma BCAAs but reduced muscle BCAAs. There was a main effect of chemotherapy in reducing the expression of the BCAA transporter LAT1. In response to chemotherapy, gastrocnemius muscle of males but not females had reduced inhibitory phosphorylation of BCKD-E1α ser293 , corresponding with increased activity of this enzyme. Chemotherapy reduced muscle and liver ketoacids of the BCAAs only in females. These data suggest that sex differences in BCAA catabolism may be linked to the severity of chemotherapy-induced muscle damage and interventions against cachexia need to take this into account.
Data management for distributed computational workflows: An iRODS-based setup and its performance
Modern data-management frameworks promise a flexible and efficient management of data and metadata across storage backends. However, such claims need to be put to a meaningful test in daily practice. We conjecture that such frameworks should be fit to construct a data backend for workflows which use geographically distributed high-performance and cloud computing systems. Cross-site data transfers within such a backend should largely saturate network bandwidth, in particular when parameters such as buffer sizes are optimized. To explore this further, we evaluate the “integrated Rule-Oriented Data System” iRODS with EUDAT’s B2SAFE module as data backend for the “Distributed Data Infrastructure” within the LEXIS Platform for complex computing workflow orchestration and distributed data management. The focus of our study is on testing our conjectures—i.e., on construction and assessment of the data infrastructure and on measurements of data-transfer performance over the wide-area network between two selected supercomputing sites connected to LEXIS. We analyze limitations and identify optimization opportunities. Efficient utilization of the available network bandwidth is possible and depends on suitable client configuration and file size. Our work shows that systems such as iRODS nowadays fit the requirements for integration in federated computing infrastructures involving web-based authentication flows with OpenID Connect and rich on-line services. We are continuing to exploit these properties in the EXA4MIND project, where we aim at optimizing data-heavy workflows, integrating various systems for managing structured and unstructured data.
Synergistic antifungal effects of botanical extracts against Candida albicans
Antifungal resistance is growing increasingly more common due to the widespread use of limited number of antifungal compounds classes. Plant extracts have been used and studied for thousands of years as antifungal therapeutics alone or in combination with other natural products. This study investigated the synergistic effects of combining ethanolic extracts from nine plants with documented antifungal activity to identify natural and more powerful antifungal treatments against Candida albicans . Using checkerboard microdilution assays, 11 out of 15 combinations exhibited additive or synergistic interactions (fractional inhibitory concentration index, FICI < 1). The strongest synergy was observed between Alpinia officinarum and Hydrastis canadensis with MIC 90 FICI = 0.08 and MIC 50 FICI = 0.05. Combinations involving H. canadensis , Eucalyptus globulus, and Punica granatum produced the most synergistic effects with other tested extracts and with each other. Combining putative active compounds from each of these three extracts demonstrated synergistic antifungal activity, with the strongest synergy observed with berberine (from H. canadensis ) and punicalagin (from P. granatum) with MIC 90 FICI = 0.31 and MIC 50 FICI = 0.13. Eucalyptol did not produce any significant antifungal activity so E. globulus extract was fractionated to identify its main antifungal compounds. UPLC-MS analysis determined that the most active fractions were primarily made up of hydrolysable tannins which produced strong synergy when combined to berberine with MIC 90 FICI = 0.31 and MIC 50 FICI = 0.25. The combinations of berberine with punicalagin and berberine with the E. globulus high tannin fraction F5 displayed antifungal activity against C. albicans with MIC 90 concentrations of 2–16 µg/mL, which are comparable to MIC 90 concentration for econazole of 0.5–8 µg/mL. These results suggest that phytochemical mixtures containing different classes of antifungal compounds can approach the efficacy of commercial antifungals and may serve as effective alternatives.
Isothermal real-time RT-RPA for Machupo virus detection: Field-adaptable sensitivity comparable with laboratory PCR
Isothermal nucleic acid amplification methods, such as recombinase polymerase amplification (RPA), are becoming increasingly vital as diagnostic platforms for neglected tropical diseases by enabling rapid and accurate detection in under-resourced regions. We developed a real-time RT-RPA assay for Machupo virus (MACV), the causative agent of Bolivian hemorrhagic fever, and directly compared it to a real-time RT-PCR assay targeting the same viral sequence fragment. The methods were evaluated across critical parameters: limit of detection (LOD), tolerance to single-nucleotide substitutions, multiplexing capability, and adaptability to multiple MACV genetic variants. The LOD was identical for both assays: 5 × 10 3 copies/ml of armored RNA particles. They differed in terms of input RNA (copies/reaction): 100 (PCR) versus 20 (RPA). The real-time RT-RPA assay was further validated on a portable device, demonstrating its potential for field-deployability for point-of-care applications.