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Ameliorative effects of strigolactone on tolerance to lead stress on lettuce (Lactuca sativa L.) plants
Assessing COVID-19 lockdown effects on coastal water quality in a strongly impacted tourist destination using Sentinel-2 multispectral data
Remote sensing data from satellite platforms were the only available source of information for environmental studies during the COVID-19 lockdown in many regions of the world. We analyzed the spatial variability of representative water indices derived from the Sentinel-2 sensor across six coastal land cover classes along a tourist destination on the North Pacific coast of Mexico. A comparative assessment was conducted between the 2020 lockdown period and the same holiday season in 2019, 2020, and 2022, evaluating the spatial distribution of water indices per coastal class. Principal coordinate analysis of organic content matter (CDOM), Chlorophyll-a (CHLA), and total suspended matter (TSMC2 and TSM_Clear) indices demonstrated clear distinctions in water quality among pre-pandemic (2019), pandemic (2020), and post-pandemic (2021−2022) periods. Canonical analysis of principal coordinates during the lockdown year revealed two key patterns: (1) sewage and harbor areas displayed a significant decrease in CHLA levels alongside elevated TSMC2, while (2) mangrove forest exhibited markedly reduced CDOM in post-pandemic years. Distance-based redundancy analysis further showed interannual variability across coastal zones, while the pandemic year (2020) was particularly distinguished by diminished CDOM in tourist and industrial areas. The high-resolution (10 m/pixel) and revisit time (5 days) of Sentinel-2 data was invaluable for monitoring water quality dynamics during the COVID-19 lockdown.
Noninvasive Assessment of Liver Fibrosis
Machine learning identifies environmental drivers of pulmonary tuberculosis in Xinjiang a typical arid region of China
Headwaters to valley: Water quality in rivers transitioning from forest to agricultural bottomland
Many waterways flow out of forestlands, which tend to maintain higher water quality, into agricultural lands, which tend to degrade water quality. The roles of land cover in impacting key water quality parameters (phosphorus, nitrogen, total suspended solids, bacteria, and conductivity) were investigated for the watershed of the North and South Fork of the Shenandoah River, Virginia. This area has a particularly sharp boundary between heavily forested and heavily agricultural regions. Two datasets were analyzed: 1) a large number of datapoints spanning a 20-year range in the Water Quality Portal (WQP) database, and 2) transects along three representative rivers systems over the span of a 4-year period. All parameters trended better in forested regions than agricultural regions. This was particularly true for nitrogen and conductivity; phosphorus, TSS and bacteria showed more local variability, especially in the agricultural region. Periods of high flow increased phosphorus, sediment and bacteria concentrations, and decreased conductivity, but not when drainage basin forest cover was less than 80%. Transects showed that waterways flowing out of forestland maintained higher water quality for approximately the first 8 km in agricultural land. Both transect and WQP data indicated higher water quality when the percent of forested land cover in a drainage basin was about 70–80%. Thus, forestland does mitigate the impacts of agriculture on water quality to some degree, but this effect rapidly diminishes as forest cover of the watershed lessens. Furthermore, forests themselves have degraded water quality at certain times and places; for instance, nutrients level were in the medium to high stress level for aquatic life in approximately 15% of samples. This study illustrates general trends of land cover effects on water quality, while also highlighting both site-specific variability, and the dynamics of water quality as water flows out of forested areas into agricultural areas.
Automating WIC Screening and Enrollment in Pediatric Primary Care
Developing ecolabels to encourage sustainable eating in restaurants: A randomized experiment
Restaurants are increasingly adopting ecolabels to highlight environmentally friendly menu offerings. However, it remains unclear which ecolabel design is the most effective at encouraging consumers to select these items. This study aimed to determine which of 4 common ecolabel formats are perceived as most effective at encouraging selection of environmentally sustainable foods. We conducted an online experiment with 2,169 US adults in August 2023. Participants were randomized to 1 of 5 label formats, including a control format (e.g., QR code) and 4 ecolabel formats: text-plus-icon, text-only, icon-only, or numeric ecolabels. Participants viewed 3 label variations of their randomly assigned label format. Participants rated each label variation on perceived effectiveness for encouraging environmentally sustainable food choices (primary outcome) and other label reactions (e.g., thinking about environmental impacts; secondary outcomes) on 5-point scales. All ecolabels were perceived as more effective at encouraging environmentally sustainable food choices than the control labels (range of average differential effects [ADEs]=.26 to .82, p s < .001). Among ecolabels, the text-plus-icon ecolabels were perceived as the most effective (mean = 3.17), followed by icon-only (mean = 2.95), text-only (mean = 2.93), and numeric (mean = 2.62) ecolabels. A relatively similar pattern emerged for secondary outcomes. Text-plus-icon ecolabels may be the most promising ecolabel format to encourage selection of sustainable foods. Restaurants, third-party certification systems, and policymakers interested in encouraging sustainable food choices in restaurants could consider adopting text-plus-icon ecolabels on restaurant menus, though further testing is needed to determine effects on behavior.
As-Needed Albuterol–Budesonide in Mild Asthma
Early- and late-diagnosed autism are genetically distinct
Risk factors for aggravated COVID-19 despite medical care after admission among Japanese patients: A Japanese association for infectious diseases COVID registry study
Background Limited data are available on COVID-19 outcomes in the Japanese population. During the Wuhan strain–dominant period, we investigated factors associated with clinical deterioration of COVID-19 despite inpatient medical care in Japan. Materials and methods This retrospective, multicenter cohort study used data from the Japanese Association for Infectious Diseases (JAID) COVID registry to identify risk factors for progression to severe disease after hospital admission. The study population included Japanese patients with a confirmed diagnosis of COVID-19 between January 2020 and March 2021. Baseline data included demographics, symptoms at disease onset and admission, and laboratory findings. Univariate and multivariate logistic regression models were used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for each explanatory variable associated with disease aggravation. Multiple imputation was used to handle missing data. The predictive performance of two multivariate models—Model I (based on measurable clinical findings) and Model II (based on interview data)—was assessed using the area under the receiver operating characteristic curve (AUC). Results A total of 2,884 patients were enrolled across 36 institutions in Japan. After excluding 25 ineligible cases and 45 protocol deviations, 2,814 patients were included in the analysis. Multivariate analysis identified several independent risk factors for disease aggravation despite inpatient care, including admission early in the pandemic, older age, impaired consciousness, respiratory distress, elevated BMI, high body temperature, anemia, cholestasis, dehydration, and elevated γ-GTP and LDH levels. The AUCs were 0.8928 for Model I and 0.8862 for Model II, indicating strong discriminatory power. Conclusion This study identified key risk factors for COVID-19 progression despite inpatient medical care among Japanese patients. These findings underscore the importance of early risk stratification for patients at high risk of deterioration despite treatment and may inform preparedness strategies for future respiratory pandemics.
Herpes Simplex Virus Blepharitis
Video‐rate tunable colour electronic paper with human resolution
Abstract As demand for immersive experiences grows, displays with smaller sizes and higher resolutions are being viewed increasingly closer to the human eye 1 . As the size of emitting pixels shrinks, the intensity and uniformity of their emission are degraded while colour cross-talk and fabrication complexity increase, making ultra-high-resolution imaging challenging 2–4 . By contrast, electronic paper, which uses ambient light for visibility, can maintain high optical contrast regardless of pixel size, but cannot achieve high resolution 5,6 . Here we demonstrate electronic paper with electrically tunable metapixels down to ~560 nm in size (>25,000 pixels per inch) consisting of WO 3 nanodisks, which undergo a reversible insulator-to-metal transition on electrochemical reduction. This transition enables dynamic modulation of the refractive index and optical absorption, allowing precise control over reflectance and contrast at the nanoscale. By using this effect, the metapixels can achieve pixel densities approaching the visual resolution limit when the display size matches the pupil diameter, which we refer to as retina electronic paper. Our technology also demonstrates full-colour video capability (>25 Hz), high reflectance (~80%), strong optical contrast (~50%), low energy consumption (~0.5–1.7 mW cm – 2 ) and support for anaglyph 3D display, highlighting its potential as a next-generation solution for immersive virtual reality systems.
Psychosocial interventions for improving marital intimacy, sexual satisfaction, and quality of life of women and couples with infertility problems in low and middle-income countries: Systematic review protocol
Introduction Psychosocial interventions can be effective in improving health outcomes and quality of life of persons with infertility problems. This systematic review aims to document available psychosocial interventions for infertility-related problems in Low- and Middle-Income Countries (LMICs) and to assess their effectiveness for marital intimacy, sexual satisfaction, and quality of life (QoL) in people with infertility problems. Methods Studies will be considered eligible if they are randomized controlled trials (RCTs), quasi-experimental studies, and Observational studies (cohort, case-control, cross-sectional studies) involving women and couples with infertility problems and living in a LMIC who received a psychosocial intervention to improve marital intimacy, sexual satisfaction, and QoL. We will search PubMed, SCOPUS, CINAHL, LILACS, CENTRAL, and PsycINFO (EBSCO) from inception to 31 st March 2025, without language restriction, using all the relevant search terms and their synonyms, singular and plural forms and British and American spellings, together with the individual countries according to the Sheffield Centre for Health and Related Research (ScHARR) 2022 classification of LMICs. We will also search conference proceedings, preprint repositories, dissertation databases, the World Health Organisation, and government databases for additional studies. We will contact trial registries and experts for unpublished trials and hand-search reference lists of retrieved papers for studies missed by our searches. The retrieved studies will be exported to Rayyan for de-duplication and study selection using a pre-tested study selection flowchart developed from the study eligibility criteria. At least two reviewers will independently select studies, extract data with pretested data extraction sheet, and assess the quality of the included studies using validated tools. Dichotomous data will be assessed and reported as odds ratio (OR) or risk ratio (RR), and for continuous outcomes, mean difference (MD) will be used; all will be reported with their 95% confidence interval (CI). Heterogeneity will be assessed graphically by inspecting overlapping CIs and quantitatively using the I 2 statistic. Sensitivity analysis will be performed to test the robustness of the pooled estimates if the data permit, and the overall quality of the evidence will be assessed using the GRADE approach. Expected outcomes This systematic review and meta-analysis will identify effective psychological interventions and elaborate on the specific components to optimize and improve the psychosocial well-being of persons with infertility experiencing problems with sexual satisfaction and intimate relationships. The review will also uncover previously misclassified effective interventions due to limited data and small sample sizes from underpowered primary studies. Highlighting the existing evidence on available psychosocial interventions will inform clinical application, public education, and counselling services to optimize QoL of infertile couples and, importantly, inform the design of further studies to interrogate the region-specific application of these interventions. Dissemination and protocol registration The findings of this study will be disseminated through stakeholder forums, conferences, and peer-reviewed publications. The review protocol has been registered in the International Prospective Register for Systematic Reviews (PROSPERO)- CRD CRD42023480729.
Case 31-2025: A 56-Year-Old Man with Left Lower Abdominal Pain and Anemia
Health systems performance in health outcomes, health financing and COVID-19 pandemic: Lessons from 31 countries
Background ssssHealth system performance is a multifaceted concept that encompasses various dimensions of a nation’s healthcare infrastructure. This study aims to assess and rank the performance of health systems across different regions of the world. Methodology We employed the Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) method in 2023 to evaluate and rank the health system performance of 31 countries across six geographical regions. Our evaluation included six general categories and twelve indicators related to health, finance, and the COVID-19 pandemic. The final weights for these indicators were determined using the Three-scale method and the Entropy-weighting method. Additionally, we categorized health system performance into three groups: high, moderate, and low. Hierarchical clustering of health system performance scores was conducted using SPSS software (version 26). Results Luxembourg emerged as the only high-performing health system, while Qatar and the Netherlands fell into the moderate-performance group. Other countries exhibited low-performing health systems. Notably, within the low-performance group, the United States of America, Australia, Singapore, Canada, England, and Germany achieved relatively better rankings. Conversely, Yemen, Egypt, Afghanistan, and Bolivia ranked lowest in terms of health system performance. Conclusion Contrary to the assumption that higher health spending guarantees improved performance, the experience of COVID-19 among high-income countries revealed mixed results. Strengthening resilience, investing in public health systems, and ensuring sustainable financial resources are crucial for enhancing health system performance.
Safety, Efficacy, and Immunogenicity of a Salmonella Paratyphi A Vaccine
Artificial intelligence (AI)-Enabled behavioral health application for college students: Pilot study protocol
Given the prevalence of depression among young adults, particularly those aged 18–25, this study aims to address a critical need in higher education institutions for proactive, private, automated mental health self-awareness. This study protocol outlines how a mobile phone application will leverage sensor signal and survey data to develop an automated screening tool for depressive behaviors. By analyzing sensor-based behavioral data through deep learning techniques, the proposed study seeks to identify students exhibiting depressive symptoms and their specific behaviors. Approximately 1,000 first-year undergraduate students (age 18 and above) will be recruited from two public US universities, one in the Midwest and one in the Southwest. For the midwestern university, there will be 11 surveys (baseline, nine follow-ups, and an endline) collected throughout a single academic year (2024–2025). However, at the southwestern university, only nine surveys will be administered during a semester. Simultaneously, sensor-based behavioral data on behaviors such as physical activity, social interactions, and sleep will be continuously collected passively. The main analysis will focus on understanding the relationships between human behaviors captured by sensor-based behavioral data and self-reported mental health surveys. Machine learning and deep learning algorithms will be used to uncover key behavioral patterns most indicative of mental disorders such as depression.
Overall Survival with Amivantamab–Lazertinib in <i>EGFR</i> -Mutated Advanced NSCLC
Effective coverage of antenatal care services in post war Tigray, Northern Ethiopia: An analysis of community and health facility–based surveys
Background Although promoting high–quality care is particularly important in post–conflict settings, little is known about the effective coverage of antenatal care (ANC) services in post war Tigray. Thus, our study was aimed to assess the effective coverage of ANC services in post war Tigray, Northern Ethiopia. Methods A combined community and health facility–based cross–sectional study design was conducted in 24 randomly selected districts of Tigray, Northern Ethiopia from 29/01/2024–26/02/2024. Using multi–stage cluster sampling method, 2340 mothers of children under one year, 32 health facilities and 250 antenatal care (ANC) clients from the selected health facilities were included in the study. A pre–tested and structured questionnaire was used to collect the households’ data. Additionally, checklists were used to collect data on facility readiness and process quality. Data were collected by Open Data Kit (ODK) and analyzed using SPSS version 27. The effective coverage of antenatal care (ANC) services was analyzed among the target group of women by computing the proportion who received four or more ANC visits multiplied by the average facility readiness score, received iron–folate supplementation, and the average process quality score. Results In this study, 87.4% (95% Confidence Interval (CI): 86.1–88.8%) of women received their first antenatal care visit. However, only 10.7% (95% CI: 9.5–12.0%) of the women had their first visit before 12 weeks of gestation and the coverage of fourth and more ANC visits was 15.7% (95% CI: 14.2–17.2%). The overall ANC service readiness mean score was 55.6% (95%CI: 45.8–65.4%). Input–and intervention–adjusted ANC coverage was 8.7% and 7.1% respectively. The mean process quality score was 53.8% (95%CI: 51.0–56.6%), and the overall effective ANC coverage was 3.8%. Conclusions The effective coverage of ANC services in post war Tigray is very low. To improve ANC uptake and ensure that pregnant women complete the recommended number of visits, it is crucial to enhance facility readiness by equipping essential ANC tracer items in conflict–affected Tigray region. Additionally, on-the-job training for healthcare providers working in maternal and neonatal departments is crucial to reinforce the basic components of ANC services and ensure adherence to standard protocols for delivering high quality of ANC services. Promoting early ANC initiation at health posts and encouraging pregnant women to maintain continuity in their ANC visits at nearest health centers/hospital are also vital for improving ANC4 + coverage and overall effective coverage of ANC services.