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Listen to Gen Z when it comes to AI in education
Reversibly Stacked Monolithic 3D Integrated Circuits
Family planning service receipt during facility visits in Ethiopia: Evidence from the 2021–2022 service provision assessment survey
Background Family planning is a central component of reproductive health and contributes to reductions in maternal and child mortality. While most evidence in Ethiopia is derived from household surveys, limited attention has been given to service delivery at the point of care. This study examines determinants of receipt of family planning services during facility visits using nationally sampled Service Provision Assessment (SPA) survey data. Methods A facility-based cross-sectional analysis was conducted using nationally implemented SPA survey data. The survey employed a stratified multistage sampling design, in which health facilities were selected within strata defined by region, managing authority, and facility type, followed by systematic sampling of clients within facilities for exit interviews. The study included 2,588 women aged 15–49 years who attended sampled facilities and completed client exit interviews. The outcome was receipt of any family planning service during the visit, defined as provision of counseling and/or a contraceptive method, reflecting service delivery at the point of care rather than contraceptive use. Multivariable logistic regression was used to assess associations between client characteristics, provider attributes, and facility-level factors. Exploratory interaction analyses were conducted but not retained in the final model due to instability and sparse data structures. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were reported, and statistical significance was defined at a two-sided p-value < 0.05. All analyses were conducted using R (version 4.5.3). Results Overall, 64.2% of clients received a family planning service during their visit. After adjustment, clients without prior contact with a provider had higher odds of receiving a service compared with those reporting prior contact (AOR = 2.25; 95% CI: 1.86–2.72; p < 0.001). Married women had lower odds of receiving a service than single women (AOR = 0.69; 95% CI: 0.49–0.98; p = 0.030). Substantial regional variation was observed, with lower odds in Amhara (AOR = 0.29; 95% CI: 0.17–0.49) and Addis Ababa (AOR = 0.41; 95% CI: 0.23–0.73), and higher odds in Benishangul-Gumuz, Gambella, and Dire Dawa. Other covariates were not statistically significant after adjustment, and observed associations should be interpreted as reflecting service delivery processes at the point of care rather than underlying contraceptive demand. Conclusions Family planning service receipt during facility visits in Ethiopia is associated with prior client–provider contact, marital status, and regional context. The persistence of regional differences after adjustment indicates that contextual factors related to health system performance and service delivery environments play a role in shaping service delivery during clinical encounters. The findings indicate heterogeneity in service delivery at the point of care, suggesting the need for context-specific strategies to improve the consistency and quality of family planning services within health facilities.
Decoding cancer circulating transcriptomic signatures with language models
Knowledge, attitude, and practices towards rabies: A community survey in selected areas of KwaZulu-Natal Province, South Africa
Knowledge, attitude, and practices (KAP) studies have been widely used to assess gaps in KAP towards rabies. However, there is no evidence of baseline studies that have assessed KAP towards rabies among selected communities in KwaZulu-Natal Province, South Africa. A cross-sectional, questionnaire-based study design was adopted. Participants (n = 768) were selected using systematic random sampling. Data from respondents (≥18 years of age) were collected using a validated questionnaire and analysed using descriptive and inferential statistics. Overall, 26.95% (207/768) of the respondents could name the cause of rabies, while 53.52% (411/768) indicated that they would adhere to post-exposure prophylaxis (PEP), which can include, depending on the category of the bite wound, wound washing, and receiving a dose of human rabies immune globulin (HRIG) and rabies vaccine at the time of the first medical visit. Most respondents (90.10%, 692/768) would seek medical attention following a dog bite. Most dog owners (82.11%, 459/559) owned a vaccination certificate for their pet. Allowing dogs to roam without supervision was widely reported by the respondents. Dog ownership was the only factor significantly associated (p = 0.0001) with knowledge of rabies. Gaps in some aspects of knowledge about rabies were observed, which require awareness creation among residents of the study area, irrespective of whether they own pets.
Author Correction: A generalizable approach for programming protease-responsive conformationally inhibited artificial transcriptional factors
Performance of four scoring systems in predicting the need for massive transfusion in Iranian trauma patients
Background Post-traumatic hemorrhage is a leading cause of death if not promptly identified and treated. This study aimed to compare the performance of four scoring systems in predicting the need for massive transfusion (MT) in trauma patients. Methods This retrospective cohort study analyzed data from trauma patients admitted to Sina Hospital in Tehran between July 2021 and December 2024. All trauma patients who received at least one unit of packed red blood cells were included in the study. Patients were evaluated for the need for MT, and four scoring systems were compared between those who did and did not receive MT. The discriminative ability of the Shock Index (SI), Assessment of Blood Consumption (ABC), Revised Assessment of Bleeding and Transfusion (RABT), and Trauma-Associated Severe Hemorrhage (TASH) was evaluated using the concordance index (C-index) and logistic regression models. Results A total of 329 trauma patients were included, with a mean age of 49.2 (SD = 20.8) years; 244 (74.2%) were male. MT occurred in 36 patients (10.9%). All four scoring systems were significantly associated with the need for MT (p < 0.001) and showed comparable discriminative performance (C-index range: 0.81–0.84). At predefined cutoff values, sensitivity ranged from 63.9% to 94.4%, specificity from 60.0% to 94.2%, PPV from 22.4% to 59.5%, and NPV from 95.5% to 98.9%. In univariable logistic regression, an ABC score ≥ 2 was significantly associated with MT (OR: 36.9; 95% CI: 15.6–87.3), followed by an RABT score ≥ 2 (OR: 25.5, 95% CI: 11.2–58.1) and a TASH score ≥ 6 (OR: 25.2, 95% CI: 5.9–106.9). Conclusion All four scoring systems showed significant associations with the need for MT. These tools may assist clinicians in the early risk stratification of trauma patients; however, given the moderate positive predictive values in this low-prevalence setting, they should be used as adjuncts to clinical judgment rather than as standalone triggers for massive transfusion activation.
How to avoid dementia — what the science really says
Propagation effects in high harmonic generation media driven by bright squeezed vacuum light
Multi-method, longitudinal study on behavioral, emotional, and developmental factors of children in residential care in Lower Austria: A study protocol
Background In Austria, there is a significant research gap concerning the quality of out-of-home care (OoHC) provisions and their capacity to promote children’s well-being and development. Given the intrusive nature of such interventions, thorough evaluation is essential. This study protocol outlines a multi-method, long-term, and multi-perspective study that investigates: 1) the circumstances leading to full-time residential care placements; 2) the development of behavioral, emotional, and social factors over time; 3) key factors influencing children’s outcomes in residential care 4) the structure and everyday reality of residential care in Lower Austria, a federal state of Austria and 5) that generates knowledge that will inform improvements in child welfare practice and policy. Methods The first three research questions will be addressed through a longitudinal quantitative study involving children and adolescents (aged 11–21 years), their parents, and professionals working in residential care settings. Standardized surveys will be administered at multiple time points to track developmental changes and identify influencing factors. In addition, to gain a deeper understanding of the implicit mechanisms, and everyday practices of residential care, we plan to implement accompanying qualitative methods adapted to the particular circumstances of the field of research. Finally, a communicative validation process will be used to discuss and reflect on preliminary findings with professionals in the field. This step ensures the relevance of the results and supports the development of practice-oriented knowledge for quality improvement and safeguarding in child welfare services. Discussion This first-of-its-kind study in Austria combines quantitative and qualitative methods to generate evidence for child welfare practice and policy. An innovative element is the potential development of a standardized documentation tool to support research and quality assurance. Challenges include the field’s complexity, participant recruitment, and risk of participation fatigue, which require close collaboration with practitioners and flexible survey strategies to ensure relevant results.
How long can humans live? All evidence points to a maximum of 125 years
Author Correction: Electrostatic potentials of atomic nanostructures at metal surfaces quantified by scanning quantum dot microscopy
Interpretable machine learning with Bayesian optimization for bond strength prediction of steel reinforcement in geopolymer concrete
Accurate estimation of bond strength between steel reinforcement and geopolymer concrete is essential for the reliable design of sustainable reinforced concrete structures. However, the highly nonlinear interactions reduce the applicability and accuracy of conventional empirical models. This study proposes a Bayesian-optimized interpretable machine learning framework to predict the ultimate bond strength of reinforced geopolymer concrete using a comprehensive experimental database compiled from published studies. A dataset of 238 samples with 20 influential input variables was assembled to represent material properties, geopolymer chemistry, and specimen geometry. Six advanced machine learning algorithms, including Support Vector Regression (SVR), Random Forest (RF), Extra Trees Regressor (ETR), Gradient Boosting Machine (GBM), XGBoost, and CatBoost, were developed and systematically compared. Hyperparameter tuning was performed using Bayesian optimization to improve model performance. The results indicate that all models achieved strong predictive capability, while the optimized CatBoost model (BO-CatBoost) provided the best performance with testing metrics of R² = 0.950, MAE = 1.173, MAPE = 11.608%, and RMSE = 1.669. A comparative evaluation with existing empirical equations further demonstrated the superior accuracy and lower prediction variability of the proposed model. To enhance model transparency, SHAP-based explainability analysis was conducted to quantify the contribution of each input parameter. The global importance analysis revealed that compressive strength, the embedment length-to-bar diameter ratio, and the cover-to-bar diameter ratio are the most influential factors governing bond strength. Additional mixture-related parameters, including the alkaline solution-to-binder ratio, curing temperature, CaO content in the binder, and the SiO₂/Al₂O₃ ratio, also contribute to the bond mechanism by influencing geopolymerization and matrix densification. The proposed framework provides both high predictive accuracy and interpretable insights, demonstrating the potential of Bayesian-optimized interpretable machine learning to support the design and optimization of sustainable reinforced geopolymer concrete structures.
AI can cause harm: safeguards must catch up
Neural mechanisms of time-forward predictions for naturalistic auditory tone sequences
Factors associated with women’s choice for mode of cervical sampling in future cervical cancer screening
Background Cervical cancer (CC), primarily caused by persistent high-risk human papillomavirus (HR-HPV) infection, remains a major public health challenge, with Latvia experiencing substantially higher incidence and mortality rates than the European average. HR-HPV self-sampling is an effective and acceptable screening method, yet some women continue to prefer clinician-collected sampling. Evidence on factors associated with reluctance to adopt self-sampling in the Baltic region is limited. This study examined demographic, socioeconomic, behavioral, and health-related characteristics linked to women’s preferences for future cervical cancer screening modalities. Materials and methods This cross-sectional study was conducted in Latvia between February 2021 and April 2022. Women attending general practitioners or the Colposcopy Unit of Riga East University Hospital were invited to perform unsupervised HR-HPV self-sampling using written and visual instructions, followed by a structured questionnaire. Collected data included demographic and socioeconomic characteristics, health status, health behaviours, emotional responses to self-sampling, and preferred sampling modality for the next screening round. Descriptive statistics and Chi-square tests were used to assess differences in emotional responses and preferences. Factors associated with preferred sampling modality were identified through univariate and multivariate multinomial logistic regression. Statistical significance was set at p < 0.05. Results A total of 1,217 women were included. Overall, 45.9% preferred clinician-collected cervical sampling, 42.6% preferred self-sampling, and 11.5% expressed no clear preference. Women who preferred self-sampling reported significantly lower embarrassment and discomfort during the procedure (p < 0.001). Most participants expressed positive emotional responses. The main reason for preferring clinician-collected sampling (81.0%) was a lack of confidence in performing self-sampling correctly. Multivariate analysis showed a higher preference for clinician-collection among women recruited from colposcopy settings and those with more recent gynecological visits, whereas former or occasional smokers were less likely to prefer clinician collection. Higher BMI (≥25) and non-Latvian nationality were associated with indecision regarding future sampling preference. Conclusion HR-HPV self-sampling was generally well accepted and may help engage women less likely to attend traditional screening. Preference for clinician-collection was shaped mainly by medical history and nationality. Emotional factors may also influence screening choices and should be considered in future implementation strategies.
How to widen access to the critical minerals that the world needs
Author Correction: Coupled sulfur-silicon isotopes reveal supracrustal origin of Archean continents
Effectiveness and safety of intra-articular hyaluronic acid SEMICAL GEL-B CROSS therapy in knee osteoarthritis (SEM-ART1): Study protocol for a randomized, placebo controlled, double-blind, cross-over clinical trial
Objective This study aims to evaluate the effectiveness and safety of a single intra-articular injection of high-dose cross-linked hyaluronic acid on pain, physical function, muscle strength, and quality of life in patients with knee osteoarthritis. Methods This randomized, double-blind, placebo-controlled, cross-over clinical trial includes 102 adults with symptomatic knee osteoarthritis (Kellgren–Lawrence grade II–III). Participants will be allocated using stratified randomization based on radiographic severity and laterality. Patients will receive either intra-articular hyaluronic acid (Semical Gel-B Cross, 90 mg/3 mL) or isotonic saline (3 mL of 0.9% NaCl), followed by cross-over at the 3-month evaluation. Outcomes will be assessed at baseline and at 3, 6, 9, and 12 months. The primary efficacy endpoint is the between-group difference in WOMAC pain score at the 3-month assessment prior to cross-over. Secondary outcomes include VAS pain, WOMAC physical function and stiffness scores, isometric quadriceps and hamstring strength, quality of life (SF-36), the 6-minute walk test, the 5-times sit-to-stand test, analgesic use, and adverse events. Treatment response will additionally be categorized as “absolute responders” (≥50% and ≥20-point improvement in VAS) and “responders” (≥20% and ≥10-point improvement). Sample size was calculated using G*Power (effect size 0.5, 80% power), yielding 102 participants. Statistical analyses will include both intention-to-treat and per-protocol approaches. Expected results and conclusions This study will provide 3-month efficacy data and long-term (3–12 months) safety outcomes for high-dose intra-articular hyaluronic acid compared with placebo. Findings are expected to inform clinical decision-making regarding symptom relief, functional improvement, and the safety profile of cross-linked HA formulations in knee osteoarthritis. Trial registration ClinicalTrials.gov: NCT06141018