Browse Articles
Discover research articles across all indexed journals
Longitudinal association between self-rated health and psychological well-being in a sample of Spanish university graduates
Purpose Previous research has shown that psychological well-being (PWB) is associated with self-rated health (SRH) over time, but limited research has explored the reciprocal association. This study examined the longitudinal association between self-rated health and subsequent psychological well-being in a Spanish cohort. Methods Data were collected from participants of the “Seguimiento Universidad de Navarra” (SUN) Project, a dynamic university graduate cohort study. Psychological well-being was measured using the Ryff scale. Multivariable linear regressions analyse assessed the relationships between self-rated health, measured at study’s baseline and after 4 years, and psychological well-being measured after a mean follow-up of 14.6 years. The association with Ryff’s six dimensions (self-acceptance, positive relations with others, autonomy, environmental mastery, purpose in life, and personal growth) was also assessed. Results A total of 2,927 participants, mean age 38.7 years (SD = 11.2) at pre-baseline, 55.5% women, were followed-up for a mean of 14.6 years (SD 0.7). Compared to participants reporting poor/fair health, those with excellent self-rated health at baseline showed substantially higher subsequent psychological well-being scores (ajusted β = 15.1, 95% CI: 11.4–20.3) and were three times more likely to have above-median psychological well-being (adjusted OR=3.0, 95% CI: 1.8–4.8). A dose-response relationship was observed across self-rated health categories, with significant associations for all PWB dimensions. Additionally, self-rated health improvements during the first 4 years were associated with higher subsequent psychological well-being scores. Conclusions Self-rated health showed a direct, long-term association with subsequent PWB among Spanish university graduates, suggesting that perceived health status may be an important determinant of future PWB. However, our findings are limited by the single measurement of PWB and the use of self-reported measures. Further studies in more diverse populations are warranted to confirm these results.
Pseudomonas syringae pv. tomato and the fall armyworm modulate the morpho-physiology and the metabolome of potato plants
Potato seedlings were challenged with two parasites, namely, the fall armyworm and Pseudomonas syringae pv. tomato , in combination and individually. Growth (plant height, stem diameter, total number of tubers and total tuber weight) and physiological function (photosynthesis rate, stomatal conductance, transpiration efficiency, the ratio of intercellular CO 2 concentration to ambient CO 2 concentration (Ci/Ca) and water use efficiency) were measured to assess the effects of the parasites on the plants. A correlation analysis of the measured growth and physiology parameters was done to understand the co-ordination of the parasite-attacked plant processes. Finally, plant metabolomic profiles were determined to assess the effects of the parasites on the metabolomes of the treated plants. Individually and in combination, the parasites had varied effects on the growth and physiology of the plants. The correlation analysis also revealed key associations between the growth and physiology aspects, and the parasites caused metabolomic reprogramming in the treated plants. Some of the results were expected but there were also unexpected outcomes. Surprisingly, the pest drastically reduced plant height when administered alone, but its ability to reduce height lessened when it was co-administered with the bacterium. The lessened ability of the pest to reduce plant height in the presence of the bacterium hints at parasite-to-parasite antagonism. This same pattern extended to stem diameter and total tuber weight. The pest individually reduced stem diameter and total tuber weight, but not when co-administered. This also hints at parasite-to-parasite antagonism. However, this matter warrants further investigation. In conclusion, the pest and the pathogenic bacterium induce morpho-physiological and metabolomic changes in potato seedlings, their effects on the measured parameters vary, and there is a possible parasite-to-parasite antagonism.
Validation of anthropometric-based weight prediction equations among Ugandan adults: A Cross-sectional study
Introduction Effective patient management often requires accurate weight estimation. However, the appropriate weight-measuring equipment is not always available in emergencies and low-resource settings. Hence, emergency clinicians resort to less reliable methods of weight estimation, often with negative consequences. In this study, we assess the accuracy of anthropometric-based weight prediction equations in Ugandan adults. Methods A cross-sectional study was conducted at Kira Health Center IV. Recruitment was done between 05-01-2022 and 21-02-2022. A sample of 240 adults, 18 years and above, was selected by quota sampling, stratified by sex and nutritional status. Anthropometric measurements, including weight, height, knee height, subscapular skin fold thickness, and circumference measurements, were taken. The predicted weight was computed using the proposed equations, and their accuracy was assessed using Bland-Altman analysis, and the percentage of weight estimates within 10% and 20% of the actual weight. Results Out of 240 participants, 50% were females. The median (interquartile range) was 29 (24 –38 ) years for age, 64.5 (54−76) kg, and 162.5 (156.5–170.1) cm, for weight and height, respectively. Rabito equation 3 (Weight = (0.5759x(Mid Arm Circumference)) + (0.5263x(Abdominal Circumference)) + (1.2452x(Calf Circumference)) – (4.8689xSex)-32.9241) was the most accurate, with a percentage of estimates with 10% of the actual weight of 77.08%. Conclusion In emergency settings with an absent patient-reported weight or an appropriate weighing scale, using Rabito equation 3 for weight prediction can be used as an accurate alternative. However, fine-tuning will be required before its recommendation for general use.
Impact of Chinese national centralized volume-based drug procurement policy on health costs and utilization: An interrupted time series analysis using panel data (2009–2022)
Introduction Chinese volume-based procurement (VBP) policy, implemented nationally in 2019, represents a cornerstone of healthcare reform aiming to reduce drug prices through centralized drug procurement. While existing studies have demonstrated the success of the VBP policy in lowering drug costs, comprehensive assessments of system-wide impacts on healthcare expenditures and service utilization remain underexplored. This study evaluates its effects on outpatient and inpatient service costs and volumes. Materials and methods We conducted an interrupted time series analysis using panel data (2009–2022) from the China Health Statistical Yearbook and the China Statistical Yearbook . Primary outcomes included CPI(Consumer Price Index)-adjusted per-visit outpatient(OP)/inpatient(IP) expenditures, hospital OP rates, hospital IP rates, and length of stay. Segmented regression models quantified immediate and long-term policy effects, with two-stage meta-analysis evaluating regional heterogeneity. Results and discussion When the VBP implementation occurred, per-visit outpatient costs (β 2 = 21.400, P < 0.001) and inpatient costs (β 2 = 693.749, P = 0.006) showed an instantaneous increasing trend. The post-policy long-term trend was decreasing annually by 5.702 Chinese Yuan (CNY) (P < 0.001) for per-visit outpatient costs and 270.670 CNY (P = 0.012) for per-visit inpatient costs compared to the pre-policy period. Hospital OP rates immediately decreased by 0.510 visits (P < 0.001) while hospital IP rates dropped by 3.775 percentage points (P < 0.001), with length of stay increasing by 0.522 days (P < 0.001) immediately after the policy was implemented. Hospital OP rates had a modest increasing trend (β 3 = 0.069, P = 0.046). Marked regional heterogeneity was observed (I² = 64.6–88.3%), with municipalities showing the most pronounced variations. Conclusions Chinese national centralized volume-based drug procurement policy has significantly reduced drug prices but initially increased non-drug costs. Regional disparities linked to aging demographics and complementary reforms (e.g., Diagnosis Related Group) shaped outcomes, while COVID-19 temporarily suppressed utilization. Future policy optimization should integrate Diagnosis Related Group payment reforms with regionally tailored strategies to balance cost containment and service quality. We recommend enhancing temporal resolution and extending observation periods to enable more precise policy evaluation.
In-silico core proteome analysis for chimeric vaccine development against tick-borne tularemia
Tularemia is an extremely contagious zoonotic illness resulting from infection with the intracellular bacterium Francisella tularensis . It is transmitted primarily via vector bites particularly from ticks, flies, and mosquitoes and is a severe public health threat. Because of its high virulence, low infective dose, aerosol transmissibility, and potential for mass casualties, F. tularensis is also considered a potential biological warfare agent. Despite its severity, there is presently no licensed vaccine against this pathogen. In the present work, a subtractive proteomics pipeline was implemented to identify potential antigenic targets to prepare a multi-epitope vaccine. Five vaccine constructs were generated through the combination of B-cell, HTL, and CTL epitopes with suitable adjuvants and linkers. Among these, two constructs V1 and V2 were extremely non-allergenic and antigenic. To assess immune receptor engagement, molecular docking was conducted with TLR4 and TLR5, followed by 200 ns molecular dynamics simulations. Vaccine-receptor complexes were analyzed using RMSD, RMSF, radius of gyration (Rg), Dynamic Cross-Correlation Matrix (DCCM), SASA, PCA, H-bond analysis and MMPBSA binding energy calculations, all confirming structural stability and strong binding affinity. In-silico cloning revealed a GC content of 50% and 1.0 codon adaptation index (CAI), suggesting high expression potential in E. coli . Immune simulation further supported the construct`s ability to elicit a robust and long-lasting immunity. These computational findings highlight the potential of the constructed vaccines as effective candidates against F. tularensis , though experimental substantiation is requisite.
Perceptions and practices on substandard and falsified medicines in humans and animals in Wakiso district, Uganda: A qualitative study
Background Few studies have taken a broad perspective on substandard and falsified medicines (SFMs) in community settings in Uganda. We therefore qualitatively assessed the perceptions and practices on SFMs for humans and animals in Wakiso District, Uganda. Methods This qualitative study employed 12 focus group discussions among community health workers and farmers, as well as 11 key informant interviews among health professionals, local leaders, veterinary and human drug shop operators, and Ministry of Health and Ministry of Agriculture, Animal Industry and Fisheries officials. Data was analysed thematically using NVivo (2020). Results Findings are presented under four themes: definition of SFMs; identification of SFMs; drivers of SFMs; and challenges in reporting SFMs. Although participants felt that the term SFMs was too broad to define, many explained it in relation to consequences (such as side effects, disabilities, and death), and the different methods that may be employed to identify SFMs. SFMs were said to be identified through changes in appearance such as colour, texture and packaging. However, the most reported way of identifying SFMs was based on negative effects on humans and animals after use. Customer drivers of SFMs included inadequate knowledge, lack of finances, and lack of access to licensed drug shops/ pharmacies. Supplier drivers of SFMs included limited regulation and enforcement, and the business orientation of drug shops/ pharmacies. Lack of knowledge of how to report suspected cases of SFMs, lack of proof of purchase of SFMs, fear of reporting, and lack of trust in government procedures were the challenges identified to reporting SFMs. Conclusion Several drivers of SFMs in the community were established related to individuals, sources of medicine, and regulatory frameworks. Increased awareness on SFMs, improved traceability of purchases and reporting, and better enforcement of regulations are needed to reduce the use and risks associated with SFMs to protect public health.
Failure to replicate the Aubert-Fleischl effect
For many years the accepted wisdom in vision science has been that humans tend to underestimate the speed of an object when they pursue it with their gaze in comparison to when they fixate a spot in the visual scene and the object moves across the retina, an effect that is referred to as the Aubert-Fleischl phenomenon. However, experiments on the Aubert-Fleischl effect have generally employed a target moving in front of a blank background. For objects moving in the real world, relative motion between the object and the background provides additional cues, potentially allowing the visual system to compensate for the Aubert-Fleischl phenomenon. To test this hypothesis, we asked 50 participants to compare the speed of a single sphere to the speed of a sphere-cloud in a two-interval forced-choice task while they either followed the single sphere with their gaze or kept their eyes on a fixation cross. Stimuli were presented in virtual reality and the sphere’s movement could occur either in a completely black environment with no relative motion cues present, or against a visible, textured background behind the moving sphere. The probe sphere-cloud always moved in front of the same background as the target. We found no evidence for an Aubert-Fleischl effect, i.e., no evidence for an underestimation of speed during pursuit relative to fixation, in either of the environments. Our results challenge the prevailing notion that object speed is underestimated when the object is pursued versus when fixation is maintained and highlights the necessity to take into account characteristics of the visual scene when it comes to the Aubert-Fleischl effect.
Short-term simulation training course improves basic obstetric ultrasound operational skills of residents: A multi-center study
Objectives To evaluate effectiveness of a short-term simulation-based obstetric ultrasound training course. Methods 21 inexperienced trainees and 44 experienced trainees participated in a short-term course about obstetric ultrasound operational skills, which was designed into four task modules. Participants deliberately practiced on simulators for one hour at each module. Their pre-training and post-training operational skill levels were assessed using Obstetric ultrasound competency assessment tool. Likert scale was used to learn about trainees’ confidence before and after training, and their satisfaction with the simulated training course. Results Scores of inexperienced and experienced trainees after training were significantly higher than those before training (inexperienced trainees 20.48 ± 10.64 vs 61.80 ± 15.40, P < 0.001; experienced trainees 39.83 ± 15.00 vs 76.26 ± 12.16, P < 0.001). The passing rate increased from 0% to 90.5% for inexperienced trainees, and from 31.8% to 97.7% for experienced trainees (all P < 0.001). The mastery learning rate increased from 0% to 23.8% for inexperienced trainees, and from 0% to 70.5% for experienced trainees (all P < 0.001). Trainees’ confidence in obstetric ultrasound examination also significantly improved compared to pre-training (2.66 ± 1.12 vs 3.98 ± 0.50, P < 0.001). Most trainees believed that simulation training could help them acquire standardized ultrasound planes (58/60), form organized thinking of scanning (59/60) and improve their competence in following clinical practice (54/60). Conclusions Both inexperienced and experienced trainees can benefit from the short-term simulation training course. Trainees demonstrated strong training satisfaction with the simulation training course.
Retraction: Can artificial intelligence and face recognition using deep learning detect emotions in children with autism?
Study on fold formation mechanism and process optimization in multi-directional die forged valve bodies
Fold defects represent a prevalent and detrimental issue in the multi-directional die forging of complex valve bodies, often resulting in product rejection and increased manufacturing costs. In this study, a three-dimensional thermo-mechanical coupled finite element (FE) model was developed using Forge ® software to simulate the multi-directional die forging process. The “marking grid” and “sensors” functionalities were employed to visualize and track the formation and evolution of fold defects throughout the entire forming process, thereby elucidating the underlying fold formation mechanism. The effects of three key process parameters—initial billet temperature, main punch speed, and friction coefficient between the billet and die—on fold depth and damage value were systematically analyzed. Orthogonal experiments combined with analysis of variance (ANOVA) were conducted to identify the optimal parameter combination. Results indicated that the friction coefficient had the most significant influence on fold formation and damage accumulation, followed by billet temperature, while punch speed had the least impact. The optimal parameters were determined to be a friction coefficient of 0.1, an initial billet temperature of 1200 °C, and a main punch speed of 30 mm/s. Production trials and fluorescent magnetic particle inspection confirmed the absence of fold and crack defects, and the final forged product closely matched the simulation predictions, validating the effectiveness of the optimized process.
Trade policy uncertainty and stock price crash risk in China: The moderating role of marketization and digital transformation
This paper investigates the link between trade policy uncertainty (TPU) and stock price crash risk in Chinese listed firms. Using a novel firm-level TPU index derived from annual reports between 2001 and 2023, we show that heightened TPU significantly elevates crash risk, robust across multiple specifications and measures. The effect is particularly pronounced in private firms, those with CEO duality, internationalized firms, and those audited by non-Big Four auditors. Mechanism tests reveal that TPU exacerbates crash risk through discretionary accruals, suppressed exports, investor sentiment distortions, analyst forecast bias, and information asymmetry. Importantly, market liberalization and digital transformation act as effective buffers. Our findings highlight TPU as a key determinant of firm-level fragility and extend the literature on uncertainty by uncovering the micro-level channels through which trade policy shocks destabilize capital markets, offering actionable insights for policymakers and investors.
Clinical decision support system impact on diagnostic imaging appropriateness and value-driven outcomes in a Singapore emergency department: Protocol of a pragmatic controlled before-after study
Modern medicine relies heavily on diagnostic imaging because of its beneficial role in the healthcare chain. Imaging rates are increasing globally and are expected to continue to rise in the future. In tandem with this phenomenon is the increase in inappropriate imaging that adversely affects the provision of healthcare and increases the risks to patients. To date, effective interventions to reduce inappropriate imaging have shown conflicting results due to various underlying implementation designs and strategies. The aim of this controlled before-after study is to assess the impact of a clinical decision support system (CDSS) on appropriateness rates of X-ray cervical and lumbar spine in the emergency department (ED) compared to the existing practice without one, while also exploring associated outcomes. In this study, a CDSS will be carried out using implementation science principles to enhance evidence uptake with institutional medical board-approved imaging referral guidelines embedded. Recruited ED physicians will be allocated into control and intervention groups. The control group will continue the routine practice of “do nothing” for four months, while the intervention group will have a two-month CDSS intervention after an initial two-month routine practice of “do nothing”. The difference between the baseline and post-implementation appropriateness rate of imaging will be compared. This study will also evaluate the impact of CDSS on clinical effectiveness, cost avoidance, radiation doses, and sustainability. Findings from this before-after study will provide a rigorous, pragmatic test of the impact and effect of radiological CDSS as an evidence-based intervention to reduce inappropriate imaging in the ED.
Unraveling participant motivation dynamics in local-centric secondhand digital sharing platforms
This study investigates the motivational and attitudinal drivers of user engagement in local-centric digital sharing platforms (LDSPs), with a focus on secondhand consumption through Karrot Market in South Korea. Grounded in Self-Determination Theory and the Theory of Reasoned Action, we examine how economic, environmental, interaction, and reputation motivations, together with attitudes and socioeconomic characteristics, influence individuals’ behavioral intentions to purchase secondhand goods. Using structural equation modeling (SEM) on survey data from 449 Seoul residents with prior Karrot use experience, we found that economic motivations were the strongest direct predictor of both attitudes (i.e., positive stance toward buying secondhand on Karrot) and behavioral intentions (i.e., intention to buy secondhand on Karrot). Reputation motivation also exhibited a direct effect on behavioral intention, while environmental and interaction motivations showed influences on behavior only indirectly through attitudes. Multigroup SEM further revealed that these pathways vary by age and marital status, indicating heterogeneous motivational patterns across user segments. Environmental motivation was more salient among users in their 20s and 50s, while reputation held greater importance for older users. Our findings highlight the central role of attitudes as mediators in translating relatively more intrinsic motivations, particularly for environmental and social drivers, into behaviors. Taken together, we offer practical insights for platform design and policy interventions, including strategies to visualize environmental impact, incentivize sustainable behaviors, and tailor engagement approaches by user characteristics. By decoding the multidimensional motivations behind LDSP participation, this research contributes to emerging scholarship on local-centric secondhand commerce and informs efforts to advance community-based circular consumption.
Barriers Broken: Genetic swamping in restored Brook Trout populations
Scientists use reintroductions to restore native species to their historical ranges but sometimes overlook effects of dispersal on genetic structure of restored populations. Unidirectional or biased gene flow can result in genetic swamping, where unique variation in a recipient population is replaced by genotypes from the source population. In theory, this can result in loss of advantageous alleles and adaptive capacity. In Great Smoky Mountains National Park native Brook Trout ( Salvelinus fontinalis) are being restored to streams from which they had been extirpated. Multiple source lineages are mixed in restoration sites to maximize genetic diversity. However, in our study system, translocated fish were released unevenly along a rugged mountain stream, resulting in an upstream population coming from only one source stock and a downstream population that was a mixture of three source stocks. A natural cascade allows downstream dispersal but prevents or constrains upstream movement. Theory predicts that such biased movement will lead to genetic swamping, i.e., reduction or loss of representation of ancestral lineages released only in the downstream population. However, the rate of gene flow and degree of asymmetry were unknown. Here, we used genetic and population density data to confirm the directionality of dispersal, estimate the rate of genetic swamping, and assess alternative mitigation strategies. Our results indicate that the downstream population has already become dominated by ancestry from the upstream source and translocation from within the restored stream will not achieve the intended genetic diversity. Instead, introducing additional fish from the original source stocks above the natural barrier would be necessary to equalize the contribution of all three source populations. Our results emphasize the importance of understanding the interplay between dispersal and genetic structure for conservation planning.
The impact of farmers’ digital literacy on farmers’ enthusiasm for grain cultivation: Findings from the “Double Hundred and Thousand” farmers in Jiangxi province
Enhancing farmers’ enthusiasm for grain cultivation is crucial for ensuring national food security. Based on survey data from the “Double Hundred and Double Thousand” farmers in Jiangxi Province, this study measures farmers’ enthusiasm for grain cultivation through their double-cropping rice cultivation behavior and employs Probit and Tobit models to empirically analyze the impact of farmers’ digital literacy on their enthusiasm for grain cultivation in traditional double-cropping rice production areas of Jiangxi, as well as its underlying mechanisms. The findings reveal: (1) Improving farmers’ digital literacy exerts a significantly positive influence on their enthusiasm for grain cultivation, promoting double-cropping rice adoption and expanding cultivation areas in traditional production regions. This conclusion remains robust after rigorous testing. (2) Mechanism analysis identifies three pathways: accelerating farmland transfer-in, facilitating the utilization of agricultural machinery socialization services, and promoting the adoption of green grain production technologies, through which enhanced digital literacy drives double-cropping rice cultivation and elevates cultivation enthusiasm. (3) Heterogeneity analysis demonstrates that the positive effect of digital literacy on double-cropping rice cultivation is more pronounced among farmers with higher educational attainment and the level of household part-time farming. Therefore, policies should prioritize elevating farmers’ overall digital literacy, narrowing digital capability gaps, refining land transfer procedures and mechanisms, leveraging the advantages of farmers’ cooperatives, and advancing the dissemination of agricultural machinery socialization services and green grain production technologies.
Individual-level surrogacy of MRI lesions for disease severity in RRMS: Methods to quantify predictive power and their application to longitudinal data from recent trials
Background Individual-level surrogacy (ILS) assesses how well a surrogate endpoint predicts treatment effect at the individual level. The paper discusses mutual information (MI) and the likelihood reduction factor (LRF) as ways to quantify ILS. It also reassesses ILS statements for people with relapsing-remitting multiple sclerosis (RRMS) by using T2 MRI lesions (T2L) as surrogates for disability and disease activity. ILS is often reported using inadequate concepts, e.g. subgroup analysis, correlation, odds ratios, sensitivity/specificity, or metrics based on Prentice’s criteria. Methods LRF assesses ILS quality by determining prediction quality through shared information (MI) between surrogate(s) and clinical endpoint(s). A simulation study validates LRF as a measure of ILS quality. Individual-level data from ten randomized controlled trials (n = 5673) provided longitudinal information on T2L, T2 MRI lesion volumes (T2V), future disability progression (EDSS), and relapses. LRFs for different scenarios were calculated. Results were compared to those obtained by methods commonly applied in RRMS literature. Results Simulations confirmed the robustness of LRF as a reliable ILS quality measure. Two of ten trials showed weak ILS between T2V and EDSS (LRF = 0.21, CI95%: 0.16–0.26; LRF = 0.28, CI95%: 0.23–0.34). Other LRFs were below 0.2. A method commonly used in the MS literature also showed no strong ILS. Conclusion LRF is an important measure to quantify ILS and prediction quality. But it is rarely applied in RRMS research. LRF did not reveal robust surrogacy patterns when applied to data of ten clinical trials. Existing surrogacy claims should be reassessed since ILS assessments in the MS literature may have major limitations.
Fabrication and characterization of n-type Ge1−xSnx- and Si1–x–yGeySnx-on-SOI junctionless transistors
Abstract Ge 1−x Sn x and Si 1−x−y Ge y Sn x alloys are promising materials for future nanoelectronic applications owing to their high carrier mobilities and CMOS compatibility. However, ternary Si 1−x−y Ge y Sn x transistors have only theoretically been discussed, and there are only a few reports on lateral n-type Ge 1−x Sn x transistors to benchmark their material performance. The low equilibrium solid solubility of Sn in Si 1−x Ge x (less than 1 at%) requires device fabrication processes at temperatures below the growth temperature of Si 1−x−y Ge y Sn x (x > equilibrium solubility) or at non-equilibrium conditions. Therefore, Si-based processes need to be adjusted according to the materials requirements. A relatively easy-to-fabricate device concept are junctionless field effect transistors, which operate as a gated resistor. In this work, we use Ge 0.94 Sn 0.06 and Si 0.14 Ge 0.80 Sn 0.06 grown on silicon-on-insulator substrates to fabricate and characterize lateral n-type Ge 1−x Sn x and Si y Ge 1−x−y Sn x junctionless field effect transistors. The transistors were structurally characterized by top-view scanning electron microscopy and cross-sectional transmission electron microscopy. Electrical characterizations by transfer characteristics show the first working n-type Ge 1−x Sn x and Si 1−x−y Ge y Sn x hetero-nanowire transistors, achieving on/off-current ratios of up to eight orders of magnitude.