Browse Articles

The acquisition of personal pronouns’ comprehension and production in French-speaking children: Toward the ability to embody characters’ perspectives in various pictured speech interactions

Language acquisition involves the ability to switch perspectives according to the partners’ roles in the speech context. This ability, involving morphosyntactic and pragmatic aspects, is fundamental in the acquisition process of personal pronouns (PersP). Our aim is to analyze, in spoken French, the acquisition of comprehension and production of PersP according to different perspectives (1p, 2p, 3p) and functions [subject (S); direct object (DO) and indirect object (IO) clitics]. 110 children aged from 6 to 13 participated. Comprehension and production of PersP were evaluated through an experimental protocol consisting of various ecological situations of the children’s daily life, in a comic strip format. Sentences had two levels of difficulty: D1, involving S and DO; and D2 involving S, DO and IO PersP. We found an age effect on the scores for the two tasks. Scores for expected answers were higher in the comprehension (1) than in the production task (2). We identified a significant increase in the mean scores, after an estimated breakpoint of 8 years for (1), and after the two estimated breakpoints of 8 and 10 years for (2). In (2) we found significantly better performances for D1 than for D2 sentences. In D1, unexpected answers occur more significantly on the DO than on the S, and in D2 they occur first on the DO, then on the IO and finally on the S. In D1 sentences, the DO is pronominalized but challenging for gender; in D2 sentences it is mainly omitted, like for IO. After the age of 6, children’s performances in the acquisition of PersP’s comprehension and production increase with age. At the age of 8 for the comprehension task, and at the ages of 8 and 10 for the production task we identified a significant increase in the children’s performances. In this last task, the difficulties could be explained by its computational complexity in terms of morphosyntactic and pragmatic constraints The difficulties were focused on the use of object pronouns and mainly DO. We suggest that, in D2 sentences, children focus primarily on the partners of the interaction involved in the speech context (designated by S and IO), rather than on the object of the interaction (DO).

Research on UAV dynamic frame rate adaptation and multi-feature fusion network optimization in intelligent monitoring of animal husbandry

Precision livestock farming, particularly the collective rearing of animals, remains a pivotal area of focus within agricultural research. However, tracking group-raised animals under conditions of poor lighting, occlusion, and complex outdoor environments continues to pose significant challenges. Due to the intricacies of these conditions, existing methodologies frequently encounter reduced tracking accuracy, decelerated processing rates, and recurrent failures amid occlusion and drift. In response to these challenges, this study introduces SiamCMR, a sophisticated RGB-Thermal (RGBT) object tracking framework tailored for the prolonged observation of group-raised Holstein cows. Constructed upon a dual-stream Siamese network architecture, SiamCMR incorporates innovative feature fusion techniques to deliver robust, real-time tracking capabilities. The framework utilizes a Complementary Coupled Feature Fusion (CCFF) module that merges semi-shared convolutional filters with adaptive sigmoid weighting to efficaciously amalgamate modality-specific features derived from RGB and thermal inputs. To further refine the fusion quality under diverse illumination conditions, we have developed a Multimodal Weight Penalty Module (MWPM), which selectively emphasizes informative channels via batch normalization scaling and feature variance analysis. The framework’s resilience to occlusions and drift is enhanced through the integration of reinforcement learning. In experimental evaluations using our proprietary dataset, SiamCMR maintained real-time processing at 135 frames per second (FPS), achieving 81.3% precision (PR) and 58.2% success rate (SR). When compared to the baseline Siamese tracker, SiamFT, which recorded 76.5% PR, 56.2% SR, and 45 FPS, our approach exhibited improvements of 4.8% in PR, 2.0% in SR, and a threefold increase in processing speed, thereby enhancing both tracking accuracy and robustness. Moreover, the system’s efficacy has been corroborated through successful implementations on a UAV platform in real-world ranch settings. Results from ablation studies under severe occlusions, light interference, low illumination, and low temperatures validate the effectiveness of the primary components. This research delineates an innovative real-time cattle-tracking solution that augments pasture management by facilitating precise monitoring of cow positions, behaviors, and health, ultimately optimizing feeding strategies and enhancing milk quality and safety.

Active electroceutical treatment of Pseudomonas aeruginosa infected murine wounds

Chronic, infected dermal wounds have a high burden of cost and remain a persistent hurdle within healthcare. Electroceutical dressings that deliver antimicrobial agents directly to the wound site have emerged as an alternative solution to current standards of care. Here, through a systematic evaluation in an infected murine wound model we report on an actively powered electroceutical dressing that generates hypochlorous acid in situ as an antimicrobial agent to clear infection. In a significant new discovery, we also report that the treatment of these infected wounds with the actively powered electroceutical promotes the closure of wounds better than other test conditions. In a 10-day murine study, mice were wounded, and the dermal injury was infected with Pseudomonas aeruginosa. Four treatment plans were administered to these wounds: no treatment, a commercially available electroceutical dressing, and our electroceutical dressing both powered and unpowered. The mice were subsequently sacrificed 8 days post infection. The powered electroceutical dressing demonstrated significantly reduced bacterial burden compared to untreated wounds. The powered electroceutical dressing also showed the highest wound closure with nearly 60% wound area reduction and approximately 36% percent re-epithelization of the wound bed in contrast to the no-treatment case. When compared against the other treatments, the powered electroceutical dressing demonstrated an improved capability in promoting wound area reduction while lowering infection burden.

The groove hypothesis—music and dance reimagined: A sensory motor synchronization study

Perfect synchronization, although essential in ensembles, has not been objectively evaluated. Further, the closely associated backbeat feel has not been adequately explained in the literature. This study introduces the groove hypothesis as a novel strategy for achieving perfect synchronization in musical ensembles, particularly in tasks involving backbeat feel. In ensemble playing, musicians must begin their movements before hearing the sounds of others to achieve synchronization. Conversely, in professional music settings, it is believed that target times are shared with an error of ±5ms based on experience, and this is considered perfect synchronization. Furthermore, while the word “groove” is used in various ways, here, it introduces the perspective of those who play groove. By examining the performance of participants using electronic drums with a 65-ms response delay, I identified two distinct synchronization strategies, shedding new light on how musicians and dancers manage rhythmic coordination. Based on the experimental results, the participants (ten university students and four dancers) were divided into Group A, which included six participants who could synchronize, and Group B, which included eight participants whose synchronization was delayed. Their p-values indicated that Group A used different strategies for the two plays. While the metrical swing theory explains why we can match a rhythm, I propose the groove hypothesis as a synchronization strategy for musicians: achieving perfect synchronization facilitated by imagining walking or running. The hypothesis suggests that we are aware of the motion of the center of gravity and that this awareness can be linguistically represented as a quiet inner “singing” in the brain. This idea is a new approach to music and dance performances and is also a proposal for cognitive science that suggests the possibility of linguistic imagery being involved in the perception of musical rhythms and synchronized movement of the body.

The impact of thermal and auditory unpleasant stimulus on explicit motor imagery in healthy individuals: An experimental study

Motor imagery is the ability to mentally simulate a motor task without actually performing it. Furthermore, pain is an unpleasant sensory experience that involves different dimensions – sensory-discriminative, motivational-affective, and cognitive-evaluative – that are known to interfere with motor imagery. However, it remains unclear which specific pain dimension most significantly impairs motor imagery vividness. This study aims to compare the effects of unpleasant auditory (primarily affective and cognitive) and thermal (primarily sensory) stimuli, which can be assimilated to pain, on discrete and continuous explicit motor imagery sessions. Eighteen healthy participants were exposed to these unpleasant stimuli in addition to a control condition. Participants rated the vividness of their explicit motor imagery after performing full back-and-forth flexion and extension of their wrists in discrete and continuous sessions. Results showed that during discrete explicit motor imagery, only the aversive auditory stimulus significantly reduced motor imagery vividness, whereas thermal pain had no effect. In contrast, motor imagery vividness was preserved during the continuous session. These findings suggest that explicit motor imagery may be more affected by the affective dimension of pain induced by aversive auditory stimuli. The preservation of motor imagery vividness in the continuous session provides insight into the optimization of rehabilitation programs.

Retraction: Improved support vector machine based on CNN-SVD for vision-threatening diabetic retinopathy detection and classification

Detecting LLM-generated peer reviews

The integrity of peer review is fundamental to scientific progress, but the rise of large language models (LLMs) has introduced concerns that some reviewers may rely on these tools to generate reviews rather than writing them independently. Although some venues have banned LLM-assisted reviewing, enforcement remains difficult as existing detection tools cannot reliably distinguish between fully generated reviews and those merely polished with AI assistance. In this work, we address the challenge of detecting LLM-generated reviews. We consider the approach of performing indirect prompt injection via the paper’s PDF, prompting the LLM to embed a covert watermark in the generated review, and subsequently testing for presence of the watermark in the review. We identify and address several pitfalls in naïve implementations of this approach. Our primary contribution is a rigorous watermarking and detection framework that offers strong statistical guarantees. Specifically, we introduce watermarking schemes and hypothesis tests that control the family-wise error rate across multiple reviews, achieving higher statistical power than standard corrections such as Bonferroni, while making no assumptions about the nature of human-written reviews. We explore multiple indirect prompt injection strategies–including font-based embedding and obfuscated prompts–and evaluate their effectiveness under various reviewer defense scenarios. Our experiments find high success rates in watermark embedding across various LLMs. We also empirically find that our approach is resilient to common reviewer defenses, and that the bounds on error rates in our statistical tests hold in practice. In contrast, we find that Bonferroni-style corrections are too conservative to be useful in this setting.

Modeling treatment of osteoarthritis with standard therapy and senolytic drugs

Osteoarthritis (OA), the most common form of joint disease, involves the progressive degradation of articular cartilage and is a major cause of chronic disability in aging populations. Since OA is associated with severe deficiency of collagen type II, clinical trials considered treatment of OA by injection with undenatured collagen type II (UC-II). Recent studies consider also injection of senolytic drugs, like fisetin, that eliminates senescent chondrocytes in aging patients, to reduce the negative effect of these senescent cells on cartilage structure. In this paper we develop a mathematical model of OA for men and, separately, for women, and use the model to assess the efficacy of treatment by UC-II and by fisetin, alone or in combination. Our computations show the benefits of starting treatment early. They also show that although the effect of treatment by fisetin on slowing the progression of OA is much smaller compared to UC-II treatment, its effect in combination with UC-II is significantly increased.

Field DCP testing, MSEW analysis, and monitoring-based investigation of a reinforced earth retaining wall collapse

Reinforced retaining walls are critical components of urban infrastructure, yet failures continue to occur due to complex geotechnical and environmental factors. This study investigates a collapse case, focusing on the influence of water infiltration from a damaged sewage pipe near a manhole. Photo documentation and portable dynamic cone penetration (DCP) testing were conducted to evaluate subgrade strength and identify localized weaknesses. Results revealed significant variability in ground rigidity, with particularly low resistance values near the manhole, indicating deterioration caused by seepage and soil softening. Stability analysis using MSEW software, under both static and seismic conditions, confirmed that affected wall sections did not meet safety requirements. Based on these findings, targeted remediation measures are proposed, including soil nailing, low-pressure grouting, and embankment reinforcement, complemented by continuous monitoring using displacement targets and inclinometers. This integrated approach offers both diagnostic insight and practical strategies to improve the design, maintenance, and resilience of MSE retaining walls, providing valuable guidance for engineers and decision-makers in preventing similar failures in densely built urban environments.

Early postoperative complications following laparoscopic-assisted modified Soave procedure for Hirschsprung’s disease: Incidence, Clavien-Dindo classification, and risk factor analysis

Objective To investigate the incidence and severity of early postoperative complications (within 30 days post-surgery) following laparoscopic-assisted modified Soave procedure for Hirschsprung’s disease (HSCR), and to analyze the factors influencing these complications. Methods A retrospective analysis was performed on the clinical data of patients who underwent laparoscopic-assisted modified Soave procedure for HSCR from January 2010 to December 2020 at our institution. Data including gender, age at surgery, clinical type, occurrence of Hirschsprung-associated enterocolitis (HAEC), presence of stoma, anemia, hypoalbuminemia, and surgery duration were collected. Patients were categorized into complication and non-complication groups based on the occurrence of early postoperative complications. The Clavien-Dindo (CD) classification system was used to grade the severity of postoperative complications, and univariate analysis was performed to identify potential factors influencing complications. Statistically significant variables were further analyzed by multivariate logistic regression. Results A total of 112 patients were included in the study, comprising 83 males (74.1%) and 29 females (25.9%). Nineteen patients (17.0%) experienced complications, including three with two types of complications. The non-complication group included 93 patients (83.0%). The complications included perianal skin erosion (2 cases, 9.1%), abdominal wound infection (1 case, 4.6%), abdominal cavity infection (1 case, 4.6%), HAEC (10 cases, 45.5%), HAEC with intestinal perforation (2 cases, 9.1%), umbilical wound dehiscence with omental exposure (1 case, 4.6%), adhesive bowel obstruction (3 cases, 13.6%), rectal retraction (1 case, 4.5%), and acute respiratory failure with laryngeal edema (1 case, 4.6%). The CD classification for postoperative complications was as follows: Grade I (3 cases, 13.6%), Grade II (11 cases, 50.0%), Grade IIIb (7 cases, 31.8%), and Grade IVa (1 case, 4.6%). Univariate analysis indicated that preoperative stoma (P = 0.029), preoperative anemia (P = 0.025), and hypoalbuminemia (P < 0.001) were significant factors influencing early postoperative complications. Multivariate logistic regression revealed that preoperative stoma (OR=4.826, 95% CI = 1.187–20.162, P = 0.028) and hypoalbuminemia (OR=9.14, 95% CI = 2.678–30.972, P < 0.001) were independent risk factors for postoperative complications. Conclusion Early postoperative complications following laparoscopic-assisted modified Soave procedure are not uncommon, with approximately one-third of cases requiring surgical reintervention. The most frequent complication was Hirschsprung-associated enterocolitis (HAEC), and most were classified as Clavien-Dindo grade II. Preoperative hypoalbuminemia and stoma creation were identified as independent risk factors, suggesting that perioperative nutritional intervention and risk stratification may help reduce the incidence of complications.

Impact of fear on pediatric pain assessment: A retrospective study

Background Fear and pain are intimately linked in the experience of caring for a child. The advent of a self-assessment tool for fear makes it possible to study the link between these two emotions. Objectives The primary objective was to determine whether self-assessment of fear (with the Trouillomètre®) affects self-assessment of pain. The three secondary objectives were to search for a correlation between fear and pain scores, and to analyze the effect on analgesic consumption and tool satisfaction. Methods A retrospective study was carried out in a French university hospital comparing the VAS (visual analogue scale) values of children aged 7–12 presenting to pediatric ED before and after the introduction of a fear assessment by Trouillomètre®. Selected pain scores were measured using the VAS. Analgesic consumption was compared between the exposed and unexposed periods. Satisfaction was assessed using a questionnaire distributed to the paramedical team. Results 154 patients in the Trouillomètre® group and 154 in the unexposed group were included in the analysis. There was no significant difference between the 2 groups in terms of pain assessment, but there was a significant correlation between fear and pain (rho = 0.18, p-Value = 0.002). Following the implementation of the tool, there was an increase in level 1 analgesic use and a corresponding decrease in level 2 analgesic use. The paramedical teams were satisfied with the tool. Conclusion This study did not show any impact of fear assessment on pain assessment, but secondary analyses suggest that there is an effect of fear management on pain already described in the literature, and that Trouillomètre® can be used to highlight this fear for its better management.

Association of albumin to globulin ratio with mortality in patients with aneurysmal subarachnoid hemorrhage

Background The albumin to globulin ratio (AGR) has been associated with poor outcomes in various diseases, but the association with mortality in aneurysmal subarachnoid hemorrhage (aSAH) is still unclear. Our study aimed to explore the relationship between AGR and short-term case fatality in patients with aSAH. Methods This retrospective study included 3,421 patients with aSAH at West China Hospital, Sichuan University. All Serum AGRs were obtained within 2 days of admission, and patients were categorized into four groups based on their AGR. Cox regression analyses were conducted to assess the relations between AGR and both 30-day and 90-day mortality. Results In 3,421 participants, 339 patients (9.9%) with 30-day mortality, and 407 patients (13.3%) with 90-day mortality. The patients were categorized into four quartiles based on their AGR levels: Q1 (AGR ≤ 1.33), Q2 (AGR: 1.33–1.50), Q3 (AGR: 1.50–1.70), and Q4 (AGR > 1.70). The HR after adjusted for confounders showed significant associations with 30-day mortality, Q2 group (HR 0.72, 95% CI 0.53–0.97), Q3 group (HR 0.72, 95% CI 0.54–0.96), Q4 group (0.53, 95% CI (0.39–0.72)) compared to Q1 group. The association was still significant for 90-day mortality, Q2 group (HR 0.77, 95% CI 0.59–1.01), Q3 group (HR 0.75, 95% CI 0.58–0.98), Q4 group (0.53, 95% CI (0.40–0.71) compared to Q1 group. Conclusions A lower admission AGR was significantly associated with an increased risk for short-term case fatality and poor functional outcomes in patients with aSAH. Further prospective research is essential to confirm our findings and explore the mechanisms behind this association.

Accuracy of estimating total-tract fibre and protein fractions digestibilities using uNDF, uNDFom, and AIA markers, and their NIRS prediction potential in dairy sheep and goats

This study investigated the use of uNDF, uNDFom, and acid insoluble ash (AIA) markers for estimating the total-tract and total-tract apparent digestibility (ttD and ttaD) of nutrients in dairy sheep and goats fed alfalfa hay and concentrate separately, and the potential of Near-Infrared Spectroscopy (NIRS) in predicting the estimated digestibility. A total of 180 faecal samples were collected from animals fed alfalfa hay and concentrate at varying ratios (F:C – 60:40, 50:50, 40:60). The samples underwent wet chemistry markers and nutrients analysis, to evaluate the digestibility of dry matter (DM), crude protein (CP), soluble CP, ash, neutral detergent fibre (NDF), acid detergent fibre (ADF), hemicellulose, cellulose, neutral detergent insoluble CP (NDICP), acid detergent insoluble CP (ADICP), and potentially degradable NDF (pdNDF). NIRS spectra acquisition was performed on the same samples and predictive models developed and tested. Compared to digestibility determined by total collection, results indicate that all the considered markers, namely uNDF, uNDFom and AIA tend to underestimate ttaD and ttD. Among the three makers, AIA resulted in the lowest recovery. Using uNDF as marker, NIRS predictive models showed almost adequate screening performance for ttADICPD and ttAshD, with a R²ExV values of 0.63 and 0.59, and RPDExV of 1.56 and 1.45, respectively. The uNDFom marker showed better performance for ttaDMD and ttADICPD preliminary screening, with R2ExV values of 0.55 and 0.62, and RPDExV values of 1.42 and 1.61, respectively. The study highlights that all the considered markers underestimate the nutrients digestibility, while uNDFom performed better concerning the NIRS calibration. Despite the encouraging results obtained, the NIRS accuracy in predicting digestibility traits in small ruminants remains poor, and further research are needed to explore its potential for nutrients ttD and ttaD measurement in sheep and goats.

Development and validation of a depression risk prediction model for middle-aged and elderly adults with sensory impairment: Evidence from the China health and retirement longitudinal study

Objective Compared with those without such impairment, middle-aged and older adults with sensory impairment (SI) demonstrate a greater prevalence and severity of depressive symptoms, significantly affecting their mental health. We aimed to develop and validate a depression risk prediction model for middle-aged and elderly individuals with SI. Methods Data from the 2018 China Health and Retirement Longitudinal Study were randomly partitioned into training and validation sets at a 7:3 ratio. Within the training set, least absolute shrinkage and selection operator (LASSO) regression analysis and binary logistic regression were used to identify predictor variables, and a risk prediction column‒line graph was subsequently developed, with depression status among middle-aged and elderly individuals with SI as the dependent variable. Predictive performance of the training and validation sets was assessed via receiver operating characteristic (ROC) curves, calibration plots, and decision curve analysis. Results In total, 5308 middle-aged and older adults with SI were included, with 50.1% (n = 2657) developing depression. Multifactorial logistic regression analysis identified several depression predictors, including sex, education level, place of residence, marital status, self-rated health, life satisfaction, pension insurance status, nighttime sleep duration, functional impairment status, and pain (all P < 0.05), which were incorporated into a column–line graph that demonstrated good consistency and accuracy. The areas under the ROC curves for the predictive models in the training and validation sets were 0.797 (95% CI = 0.783–0.811) and 0.778 (95% CI = 0.755–0.800), respectively. The Hosmer–Lemeshow values were P = 0.176 and P = 0.606 (P > 0.05), and the calibration curves revealed significant agreement between the model and actual observations. ROC and DCA curves indicated good predictive performance for the column‒line graph. Conclusion This study presents a reliable, validated, and acceptable predictive model for depression risk in middle-aged and elderly individuals with SI, and the identified predictors have potential applications in public health policy and clinical practice.

Combined application of BNLF2b antibody with VCA-IgA, Rta-IgG, and Zta-IgA in nasopharyngeal carcinoma screening in the Guangxi region

Background This study aims to assess the diagnostic value of the Epstein-Barr virus (EBV) BNLF2b antibody(P85-Ab), alone or in combination with VCA-IgA, Rta-IgG, and Zta-IgA antibodies, in the context of nasopharyngeal carcinoma (NPC). Methods The study included 100 NPC patients and 100 healthy controls. Chemiluminescent microparticle immunoassay was utilized to measure P85-Ab levels in the serum samples of both NPC patients and healthy controls. Additionally, the ELISA method was employed to detect serum levels of VCA-IgA, Rta-IgG, and Zta-IgA antibodies. The study analyzed the roles of serum P85-Ab in conjunction with VCA-IgA, Rta-IgG, and Zta-IgA antibodies in the diagnosis of NPC. Results Serum levels of P85-Ab, VCA-IgA, Rta-IgG, and Zta-IgA antibodies in NPC patients were significantly higher than those in the normal control group (P < 0.05). The area under the receiver operating characteristic curve (AUC) for individual diagnosis of NPC using serum P85-Ab, VCA-IgA, Rta-IgG, and Zta-IgA antibodies were 0.964, 0.916, 0.838, and 0.840, respectively. The AUC for the combined detection of the four markers in diagnosing NPC was 0.996, indicating the optimal diagnostic value of the combined detection. Conclusion The combined detection of P85-Ab with VCA-IgA, Rta-IgG, and Zta-IgA antibodies demonstrates high diagnostic value for nasopharyngeal carcinoma. Serum P85-Ab may serve as a potential marker for the diagnosis of NPC.

Correction: Evaluation of the therapeutic efficiency and efficacy of blood purification in the treatment of severe acute pancreatitis

Stratifying atherosclerotic cardiovascular disease by SMuRF burden in a Middle-Eastern country: A multiregistry study of demographics, comorbidities, and therapeutic trends

Background Atherosclerotic cardiovascular disease (ASCVD) is a growing public health challenge in the Middle East, driven by increasing rates of obesity, diabetes, and hypertension. However, limited region-specific data exist on the distribution and impact of Standard Modifiable Risk Factors (SMuRFs) among affected individuals. Most available evidence is derived from Western populations, which may not reflect the unique demographic, cultural, and epidemiological profiles of Middle Eastern communities. Objective This study aims to compare demographic profiles, clinical presentations, comorbidities, and pharmacologic management among Middle Eastern patients with ASCVD, stratified by SMuRF burden: SMuRF-less (no risk factors), 1–2 SMuRFs, and 3–4 SMuRFs. The goal is to identify clinically relevant differences across these groups and address the significant gap in region-specific data on ASCVD risk factors and outcomes. Methods Data were pooled from six established cardiovascular registries and the Jordan SMuRF-less patient study. Baseline characteristics, cardiovascular risk profiles, comorbidities, use of secondary prevention therapies, and one-year outcomes were analyzed across the three SMuRF categories. Results Among 5,540 patients, the group with 3–4 SMuRFs exhibited the highest prevalence of hypertension (88.9%), diabetes (35.4%), smoking (54.0%), and a family history of cardiovascular disease (39.3%). This group also showed increased rates of chronic kidney disease (7.3%) and heart failure (15.1%). Statin, aspirin, and beta-blocker use increased in parallel with SMuRF burden. Key lipid profiles deteriorated with increasing SMuRFs, with the highest LDL cholesterol observed in patients with 1–2 SMuRFs. Conclusions This study provides valuable insight into the clinical characteristics and management patterns of Middle Eastern patients with atherosclerotic cardiovascular disease (ASCVD), stratified according to the burden of standard modifiable risk factors (SMuRFs). An increased SMuRF burden was associated with a higher prevalence of comorbid conditions, including hypertension, diabetes mellitus, dyslipidemia, chronic kidney disease, and heart failure. Utilizing data from six regional registries, this study represents the first comprehensive, region-specific analysis of the role of modifiable risk factors in this population. The findings underscore the critical need for individualized, risk-based prevention and management strategies to mitigate the rising burden of ASCVD across the Middle East.

A Delphi process to build consensus on revised Emergency Obstetric and Newborn Care (EmONC) signal functions and levels of care

The emergency obstetric care (EmOC) monitoring framework has been used for decades to monitor the availability and use of EmOC services in low- and middle-income countries (LMICs). EmOC monitoring is based around eight signal functions, a shortlist of key clinical interventions capable of averting deaths from the main direct causes of maternal mortality, categorised between two levels of care: basic and comprehensive, with a newborn resuscitation signal function added in 2009. The Re-Visioning Emergency Obstetric and Newborn Care (EmONC) Project (2020–2024) aimed to update the EmOC approach to reflect new knowledge in maternal and newborn health (MNH), and to expand the scope of the original EmOC monitoring framework. The project used technical workstreams and workshops to arrive at new proposals. This paper reports on the approach used to build consensus on a revised set of EmONC signal functions and levels of care. Using a three-round online Delphi approach, consensus (≥85%) was sought from a diverse panel of global MNH experts on EmONC signal functions and their placement at different levels of care, based on existing evidence-based guidelines. The process was iterative, each round building on the previous, and embedded in the wider Re-Visioning EmONC project; the output from each round involved coordination of inputs from multiple tiers of technical experts, including UN agencies, via technical expert groups, workstreams and workshops. The Delphi study recruited 113 experts in MNH from a range of geographic and economic settings, specialities and professions, including clinical, academic and programme expertise. The output from the three rounds included substantial convergence, resulting in set of 25 signal functions (11 obstetric, 13 neonatal and 1 referral) that reflect the spectrum of EmONC required for women and newborns. The revised EmONC signal functions are intended as a simple approach to allow health system managers to visualise their EmONC services, and as a means to hold health systems accountable to provide the main interventions to avert preventable maternal and newborn morbidity and mortality, and stillbirths.

Identification and 3D modeling of bioactive peptides from Lactobacillus brevis RAMULAB49 protein hydrolysate with in silico ERK1 phosphorylation inhibition activity targeting diabetic nephropathy

Diabetic nephropathy (DN) poses a significant health challenge, necessitating novel therapeutic approaches. In this study, we isolated proteins from cell-free supernatant (CFS) from the culture of the lactic acid bacteria Lactobacillus brevis RAMULAB49 strain. The proteins were subjected to simulated in vitro gastrointestinal digestion using gut enzymes – pepsin, pancreatin, and trypsin. The hydrolysates were filtered using 3kDa threshold ultra-centrifugal filters and were desalted using C18 disks. This was followed by nLC-ESI MS/MS tandem mass spectrometry-based identification of peptides, leading in the identification of a of 258 unique peptides across three enzyme combinations. The resultant sequences were made into peptide library construction based on their, bioactivity scores, allergenicity, toxicity, and antidiabetic potential, a total of 10 peptides was constructed and modeled in 3D. On the other hand, 266 DN associated genes were identified using a network pharmacology approach. The resultant protein-protein (PPI) network was analysed using the gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment approaches, resulting in identification of critical pathways, ERK1, PI3K-Akt, EGRF and TNF signaling as significantly involved in DN, where, ERK1 emerging as a key node due to its involvement in cell proliferation, inflammation, and fibrosis associated with DN. Top two 3D-modelled bioactive peptides were selected for interaction study with the target protein ERK1. Peptide TNEDPYTIDVES showed a strong binding energy of −9.9 kcal/mol, at the ATP-binding site and dynamics simulations confirmed the structural stability of this complex over 100 ns, showing consistent hydrogen bond interactions and RMSD values below 2.5 Å. These findings suggest that TNEDPYTIDVES may act as a competitive ERK1 inhibitor by occupying the adenine-mimicking ATP-binding cleft, thereby interfering with phosphorylation activity. This integrative approach highlights L. brevis RAMULAB49 strain derived peptides as promising candidates for the development of peptide-based therapeutics target and could pave the way for new drug development treating diabetic nephropathy.

Vehicle avoidance: The hierarchy of visual attention towards animals, plants, and vehicles

The biophilia hypothesis posits that humans have an innate affinity for nature, with natural landscapes effortlessly capturing their attention, and a tendency to seek nature. The animate monitoring hypothesis suggests that humans have evolved to quickly detect and respond to animals for survival. The plant awareness disparity hypothesis argues that people notice plants less than animals due to perceptual biases and preferences. Based on these hypotheses, it was predicted that people’s visual attention would be superior towards animals, plants, and manufactured objects, in that order. This study investigated the hierarchy of visual attention towards animals (birds, mammals and humans), plants (fruit), and manufactured objects (vehicles) using a dot-probe task framework. The findings revealed no significant differences in reaction time or attentional bias for animal or plant stimuli. In contrast, perceptual processing was inhibited when viewing a vehicle and attentional avoidance occurred, resulting in slower reactions than to animals or plants. These findings offer partial support for the proposed hierarchy of visual attention, suggesting that while natural stimuli such as animals and plants receive comparable attention, some manufactured objects may elicit perceptual avoidance.