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Cohort-resolved excess mortality in Germany (2000-2024): Patterns and implications for the SARS-CoV-2 era

Understanding the impact of the SARS-CoV-2 pandemic on mortality requires more than aggregate statistics. While whole-population indicators have informed policy, they risk concealing subgroup-specific patterns. We analysed all-cause mortality in Germany from 2000 to 2024 using a weekly, cohort-resolved framework across 15 age groups to detect excess and under-mortality before, during, and after the pandemic. Expected mortality was modelled using exponential trends from two decades of pre-pandemic data. Deviations from expectation were quantified as normalised excess all-cause mortality rates (NEAMR), enabling the identification of significant, age-specific anomalies. We found sustained NEAMR in adults aged 75-79 and 35-49 from late 2021 through 2024—patterns absent in whole-population trends. Conversely, cohorts aged 30-34 and 55-59 showed persistent under-mortality. Earlier excess peaks in older cohorts (e.g., 85-89 in 2003, 95+ in 2013) suggest generational vulnerabilities potentially linked to early-life adversity. Cross-correlation analyses indicate that associations between NEAMR and SARS-CoV-2 mRNA injection rates diverge from expected protective patterns in most age cohorts, especially during the 2021 ‘alpha-to-delta’ transition. These findings highlight the need for further hypothesis-driven investigations as well as a high-resolution mortality surveillance. Cohort-resolved analysis reveals NEAMR signals that aggregate data obscure, offering a more accurate assessment of public health outcomes across demographic groups.

Consensus clustering-based undersampling for improved classification of transient events in time-domain astronomy surveys

Standardized protocol for laboratory rearing and breeding of the Lymnaeidae snail, Radix natalensis (Krauss, 1848)

Freshwater lymnaeid snails are involved in the transmission of fascioliasis in tropical and subtropical Africa, Asia, as well as in temperate regions. This study improved and standardized laboratory rearing and breeding of first-generation (F 1 ) R. natalensis using field-collected F 0 snails. Ninety field-collected R. natalensis adult snails with shell heights of 4–5 mm were divided into three experimental treatment groups: A, B, and C. Each experimental treatment group comprised of ten (10) 2L containers, with each containing 3 snails. Group A, the control, was fed Elodea sp. weed powder and Cyperus papyrus twigs from snail-sampling sites as oviposition material. Group A containers were filled with water from the snail sample sites. Spring-watered snails in experimental group B were fed with dried lettuce, fish flakes, and eggshells. In experimental group C, snails were fed with algal wafers and trout pellets in dechlorinated water. Groups B and C used polystyrene strips for oviposition. Daily snail mortality and egg mass counts were obtained. Experimental group B snails produced 69 egg masses and 500 F 1 offspring with the lowest snail mortality (13%). Group C produced 60 egg masses and 450 F 1 offspring. The mortality rate in this group was 20%. Group A control snails laid 10 eggs and 48 F 1 offspring. Also, mortality (66%) was higher in this group. Mean egg masses differed significantly between groups A and B (Group A: 0.85 ± 0.22 egg masses; Group B: 2.33 ± 0.53, p  = 0.034) and A and C (Group A: 0.85 ± 0.22 egg masses; Group C: 2.16 ± 0.48, p  = 0.041), but not between groups B and C. Treatment differences explained 11.4% (F 1, 25  = 4.36, p  = 0.047) of egg mass variability. The median snail survival in group B was 8.11 days versus 4.57 days in group A. Significant differences in median survival time were observed between experimental groups (Log Rank X² = 9.87, p  = 0.007). Group B had the highest fecundity and lowest mortality among the treatment groups. However, the use of spring water increased the costs of mass breeding of snails using this approach. On the other hand, experimental group C produced a comparable number of egg masses. Thus, for mass breeding of R. natalensis , the use of an experimental approach from group C would be recommended as it is cheaper.

Mechanical and microscale characterization of foamed concrete with Tianqi aluminosilicate binder

From theory to practice of designing for diversity: Applying intersectionality to improve HIV testing uptake

Introduction Given the critical perspective of intersectionality and its potential to identify the causes of inequalities, it has been employed increasingly in studies related to health. Despite the rich theoretical evidence about intersectionality, there is a need to consider this approach empirically. This study aimed to apply the intersectionality in practice for health policy makers and researchers seeking to reduce health inequalities. In this regard, we described the development of an intersectionality-based and context-specific intervention focusing on HIV testing uptake among Afghan immigrants in Iran. Methods This is an intervention development study. The intersectionality was used to design a peer-led intervention guided by the 2008 MRC framework. We undertook the following activities related to the three stages of the MRC framework: 1. Identifying the existing evidence (conducting a scoping review to investigate the application of intersectionality in designing and implementing health interventions; designing the checklist of applying the intersectionality in health interventions and programs); 2. Identifying and developing a program theory (conducting a realist review to identify why, how, and under what conditions peer interventions can improve HIV testing uptake among immigrants); and 3. Modeling process and outcomes (adapting the contextual factors identified by conducting a qualitative study and the realist review; extracting considerations regarding intersectionality principles using the checklist of applying the intersectionality in health interventions and programs; determining context specific, intersectionality-based and evidence-based intervention components for each of the intervention pathways). Results According to considerations regarding checklist of application of intersectionality principles, the intervention at the different individual, organizational, and policy levels with multiple strategies should be designed to respond to needs/conditions affecting HIV testing uptake among immigrants. We determined the peer-led intervention features to improve the use of HIV testing services in Afghan immigrants following the intersectionality principles, target group needs, and contextual conditions aiming to modify power structures. Intervention strategies included HIV information provision, support, community-based services, and structural interventions. Conclusion This study provides a practical framework for health planners and researchers seeking to reduce inequalities by presenting how intersectionality can influence the design of a health intervention. Accordingly, it is necessary to revisit the social relationships and power structures, determine the intervention components based on evidence tailored to the target group’s needs, and apply changes at different levels.

Community volunteer visitation frequency shows a U shaped relationship with family caregiver burden for disabled elderly in China

Effects of interferential stimulation on clinical symptom and urodynamic findings in women with voiding dysfunction: A protocol of randomized clinical trial

Background Voiding dysfunction, characterized by abnormally slow and/or incomplete micturition, is a clinical challenge that significantly impacts quality of life among women. Dysfunctional voiding, a subtype of voiding dysfunction is identified by intermittent and/or fluctuating urine flow caused by involuntary periurethral striated muscle contractions during voiding in individuals without neurological abnormalities. Interferential stimulation is a non-invasive surface electrical stimulation modality widely employed in physiotherapy. The current evidence supports its clinical efficacy in managing both urinary and fecal disorders. However, its role in treating dysfunctional voiding in women remains understudied. Thus, we present a study protocol to investigate the effects of interferential electrical stimulation on clinical symptoms and urodynamic findings in women with dysfunctional voiding. Methods This double-blind, randomized controlled trial will employ a parallel-group design and will be conducted at the Physiotherapy Clinic of Iran University of Rehabilitation Sciences, Tehran, Iran. The study population will comprise women aged 18–50 years diagnosed with dysfunctional voiding. This trial will enroll 28 participants, equally allocated to two parallel groups (n = 14 per group). Both groups will receive standard urotherapy and pelvic floor exercises as baseline interventions. The experimental group will additionally undergo 20-minute interferential stimulation twice weekly for 10 sessions under clinical supervision. Primary outcomes include maximum urine flow rate (Qmax) and severity of lower urinary tract symptoms, assessed at three times: before treatment, after treatment, and after a three-month follow-up. All statistical analyses will be conducted using SPSS software (version 26), with statistical significance set at p <0.05, Expected results It is hypothesized that using interferential stimulation will have a positive effect on clinical symptoms and urodynamic parameters in women with dysfunctional voiding. Trial registration This trial is registered in the Iranian Registry of Clinical Trials (IRCT) under the registration number IRCT20180611040061N2.

Alkaline pH and enhanced catalase activity improve the in vitro bio-remediation of crude-oil polluted soil

Correction: Spatial–temporal evolution and influencing factors of urban–rural economic circulation in China’s agricultural areas: A case study of Jianghan Plain

Predicting older adults smart healthcare adoption using an extended TAM

Weighted gene co-expression network analysis identifies functional modules related to bovine respiratory disease

Bovine respiratory disease (BRD) is a multifactorial disease of dairy and beef cattle that involves complex interactions with the host immune system. In the current study, a comprehensive meta-analysis was performed using a P-value combination approach. In the next step, the identified meta-genes were subjected to systems biology analysis using the weighted gene co-expression network analysis (WGCNA) method. Subsequently, the most functionally important modules and genes were validated using machine learning algorithms. Finally, the critical regulatory network associated with BRD was constructed. A total of 1,908 common meta-genes were identified through the combined analysis of differentially expressed genes (DEGs) using the Fisher and Invorm approaches. Co-expression network analysis confirmed six functional modules, among which the connectivity patterns of the blue, brown, green, and yellow modules were significantly altered in BRD- affected cattle compared with healthy controls. Functional enrichment analysis of the significant modules revealed that the ‘Salmonella infection,’ ‘NOD-like receptor signaling pathway,’ ‘Necroptosis,’ ‘Toll-like receptor signaling pathway,’ ‘TNF signaling pathway,’ ‘IL-17 signaling pathway,’ ‘Apoptosis,’ and ‘Influenza A’ pathways were the most significantly associated with BRD . The constructed regulatory network identified GABPA, TCF4, ELK1, NR2C2, and ARNT as key transcription factors (TFs) , each playing a central role in regulating immune and inflammatory pathways implicated in BRD . Finally, the constructed model revealed that differential expression of the CFB gene is significantly associated with susceptibility to BRD . In cattle, CFB expression correlates with clinical signs of respiratory disease, supporting its potential as a biomarker. Moreover, the involvement of CFB in modulating pro-inflammatory cytokines (e.g., TNF) and its integration with other immune-related pathways (e.g., NF- κ B signaling) further highlight its relevance as a biomarker. Overall, this integrative approach enhances our understanding of the molecular mechanisms underlying BRD and provides a foundation for developing diagnostic, therapeutic, and genetic selection strategies to improve cattle health and disease resistance.

Primary teachers’ acceptance and sustained adoption of AI powered learner corpora for writing instruction through TAM and ECM perspectives

Effects and mechanisms of engineered exosomes pretreated with Scutellaria baicalensis Georgi on osteoporosis

Osteoporosis (OP) is a common systemic bone disease characterized by reduced bone mineral density and the degeneration of the microstructure of bone tissue. Current therapeutic strategies for OP confront limitations including suboptimal efficacy and substantial adverse effects. This study investigates the therapeutic potential of exosomes derived from bone marrow mesenchymal stem cells (BMSCs) preconditioned with Scutellaria baicalensis Georgi (SBG) for osteoporosis management. Our findings demonstrate that SBG modulates the composition of BMSC-derived exosomes to potentiate osteogenesis. Furthermore, exosomes isolated from SBG-pretreated BMSCs (designated S-EXOs@BMSC) enhance osteogenic differentiation in MC3T3-E1 pre-osteoblasts, a process mediated by upregulating Semaphorin 3A (Sema3A). The efficacy of S-EXOs@BMSC in promoting bone regeneration was corroborated in a murine model of osteoporosis induced by ovariectomy (OVX). These results improve our understanding of how traditional Chinese medicine contributes to OP treatment and emphasize the potential of exosomes from BMSCs grown in SBG conditions as a novel therapeutic strategy for OP.

Geospatial analysis of diarrheal disease burden and associated health determinants among under-five children in Karnataka using NFHS data

Seismic performance evaluation of ancient Tibetan residential structures and energy dissipation of Mortise-Tenon Joints

Tibet, situated in western China, is renowned for its highland landscape, rich culture, and profound religious heritage. Tibetan-style ancient houses, typical dwellings in this region, reflect the Tibetan people’s adaptation to the plateau environment and hold significant cultural, historical, and ecological value. This study used theoretical and finite element analyses to compare the seismic performance of Tibetan houses under various conditions. It evaluated the effects of three types of seismic waves—with and without earth walls—having peak accelerations of 0.4 g and 0.6 g, focusing on interstory displacement angles and top accelerations. Finite element analyses were also conducted on through-tenon and straight-tenon joints to examine stress distributions and hysteresis curves for transverse and smooth grain orientations. Results showed that earth walls significantly enhanced the stiffness and seismic stability of the timber frame. Additionally, through-tenons exhibited fuller hysteresis curves than straight tenons, demonstrating superior energy dissipation.

Transfer learning on protein language models improves antimicrobial peptide classification

Abstract Antimicrobial peptides (AMPs) are essential components of the innate immune system in humans and other organisms, exhibiting potent activity against a broad spectrum of pathogens. Their potential therapeutic applications, particularly in combating antibiotic resistance, have rendered AMP classification a vital task in computational biology. However, the scarcity of labeled AMP sequences, coupled with the diversity and complexity of AMPs, poses significant challenges for the training of standalone AMP classifiers. Self-supervised learning has emerged as a powerful paradigm in addressing such challenges across various fields, leading to the development of Protein Language Models (PLMs). These models leverage vast amounts of unlabeled protein sequences to learn biologically relevant features, providing transferable protein sequence representations (embeddings), that can be fine-tuned for downstream tasks even with limited labeled data. This study evaluates the performance of several publicly-available PLMs in AMP classification utilizing transfer learning techniques and benchmarking them against state-of-the-art neural-based classifiers. Our key findings include: (a) Model scale is crucial, with classification performance consistently improving with increasing model size; (b) State-of-the-art results are achieved with minimal effort utilizing PLM embedding representations alongside shallow classifiers; and (c) Classification performance is further enhanced through efficient fine-tuning of PLMs’ parameters. Code showcasing our pipelines is available at https://github.com/EliasGeorg/PLM_AMP_Classification .

Antibody response to tetanus, diphtheria, poliomyelitis, hepatitis B, and H. influenzae b vaccines in allogeneic hematopoietic stem cell transplant adult recipients: A multicenter trial

Introduction National and international guidelines recommend vaccinating hematopoietic stem cell transplant (HSCT) recipients, although relatively few studies have evaluated immunogenicity in adults. We therefore aimed to assess the immune response in adult allogeneic HSCT recipients vaccinated against tetanus, diphtheria, poliomyelitis, hepatitis B, and H. influenzae b. Method We conducted a multicenter prospective study. HSCT recipients were included at least 6 months post-transplantation (maximum: 24 months) if blood CD19 + lymphocytes were ≥0.1 G/L and plasma immunoglobulin ≥ 4g/L, and if no immunosuppressive therapy was applied. They received the hexavalent pediatric combination vaccine for tetanus, diphtheria, poliomyelitis, hepatitis B, and H. influenzae b (and pertussis) at months 0, 1, 2, and 12 (in addition to other recommended vaccines). Plasma antibodies against the five valences were quantified at inclusion and 1 month after the third and fourth doses. Results We included 104 HSCT recipients (median age: 58 years [IQR:48–64]). Study vaccination was initiated a median of 11 months [IQR:9–14] after transplantation. Median [IQR] values for CD19 and plasma gammaglobulin at inclusion were 0.3 [0.2–0.6] G/L and 7.9 [6.4–11.1] g/L, respectively. Seroprotection after three doses and after the M12 booster was achieved for 97.2% and 97.5% of participants for tetanus, 100% and 97.5% for diphtheria, 96.6% and 92.7% for poliomyelitis, 78.3% and 84.1% for hepatitis B, and 94.6% and 95.0% for H. influenzae b. Adverse effects were benign. Conclusion Vaccination against these five infections initiated during the first year post-allograft is immunogenic and should be performed in every recipient not undergoing immunosuppressive therapy. Trial registration ClinicalTrials.gov NCT03402776

Mirror invariance dies hard during letter processing by dyslexic college students

Abstract Reversal errors (e.g., confusing b with d, or R with Я) are common in beginning readers and often persist in individuals with developmental dyslexia due to mirror invariance —an evolutionary-old perceptual tendency of processing mirror images as equivalent. This study investigated whether dyslexic adults still struggle with mirror-image discrimination when processing reversible letters (i.e., differing only by orientation; e.g., d, b, p) and nonreversible letters (i.e., differing also in shape; e.g., f, t, r). In a masked priming lexical decision task, one letter of the prime was manipulated by letter-type (reversible, nonreversible) and prime-condition : identity (e.g., judo, zero), control (judo, zero), mirrored-letter (jubo, zero), or rotated-letter (jupo, zero). Both dyslexic and neurotypical readers showed identity priming effects: faster recognition of target-words preceded by identity than control primes. Neurotypical readers also showed mirror and rotation costs , regardless of letter-type: slower word recognition after mirrored- or rotated-letter primes than an identity prime. In contrast, and for nonreversible letters only, dyslexics were as fast in recognizing target-words preceded by identity as by mirrored-letter primes (qualified by Bayesian statistics). These findings suggest that, despite extensive reading experience, orthographic processing by dyslexic college students remains residually sensitive to mirror invariance.

Fixational saccade inhibition and pupil dilation during self-paced limb movement preparation

Fixational saccades are modulated in anticipation of several kinds of stimuli and motor actions, suggesting that they can form an overt marker of preparatory state. However, no existing work has studied fixational saccades ahead of spontaneous limb movements in the absence of sensory stimuli, in order to isolate motor preparation from other anticipatory processes (e.g., those related to stimulus processing). Here we examined fixational saccades while participants made self-paced hand and foot movements. We observed that fixational saccade rate steadily dropped prior to either kind of motor action, and recovered immediately after. To examine the relation between this fixational saccade rate signal and other known signals that precede volitional action, we analyzed how this signal related to anticipatory pupil size changes in the same dataset. Replicating previous work, we found steady pupil dilation ahead of limb movements, followed by rapid re-constriction. The amplitude of this pupil signal covaried across individual limb movements with that of the fixational saccade rate signal. The pupil modulations, moreover, followed too shortly after the accompanying fixational saccade rate modulations to be caused by saccade-induced changes in visual input. Together, these observations suggest a joint neural factor influencing both fixational saccade rate and pupil size ahead of limb movements. We discuss possible interpretations of our findings, both specific ones that center on processes of motor planning or temporal expectation, and more general ones that are in terms effort.

Biochemical evaluations of Ethiopian sweet sorghum [Sorghum bicolor (L.) Moench] accessions for sugar production