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Spectrum of glucose-6-phosphate dehydrogenase (G6PD) mutations and trends in hemoglobin levels among adult dengue patients in Thailand

Glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most common enzymopathy in humans that may exacerbate clinical outcomes during viral infections such as dengue, particularly in regions where both conditions are endemic. This study aimed to characterize the spectrum of G6PD mutations and explore trends in hemoglobin levels among adult dengue patients in Thailand. Samples from 231 adult patients diagnosed with dengue were analyzed. G6PD deficiency was identified in 24 individuals (10.4%), while G6PD mutations were detected in 111 patients (48.1%). The most frequently observed mutations include a combination of synonymous and intronic mutations (c.1311C > T and c.1365-13T > C), compound mutation of G6PD Viangchan (c. 871G > A, c.1311C > T and c.1365-13T > C), and a deletion variant (c.486−34delT). Additionally, a novel variant, c.1439T > C, was identified and named “G6PD Phaya Thai”. Patients carrying G6PD mutations exhibited different hemoglobin level trends compared to those without mutations. Specifically, while hemoglobin levels increased from the febrile to critical phase in patients without mutations, a significant decline was observed in mutation carriers. Median hemoglobin levels differed significantly between the two groups during both the febrile and critical phases (p = 0.02 and p < 0.001, respectively). Biochemical and structural analyses of uncharacterized variants, G6PD Phaya Thai and G6PD Viangchan+Chinese-5, suggested structural instability as a possible mechanism for the observed deficiency. These findings highlight the need for further investigation into the potential role of G6PD variants in dengue-related anemia. Routine G6PD screening and continuous hemoglobin monitoring may help identify individuals at risk of hemoglobin decline and guide supportive care strategies in dengue-endemic regions.

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The effect of lifestyle intervention and depression symptoms on binge eating and relation of binge eating to gestational weight gain and child birth weight in the UPBEAT cohort of pregnant women living with obesity

Binge eating is one of the most prevalent eating disorder behaviours in pregnancy, its risk factors and association with pregnancy-related outcomes has sparsely researched in this population. This study aimed to investigate: (hypothesis 1) the effectiveness of a lifestyle intervention in reducing binge eating; (hypothesis 2) the association between depressive symptoms and binge eating behaviours throughout the perinatal period; and (hypothesis 3) the association between binge eating, gestational weight gain and birthweight in a cohort of pregnant women with obesity. This is a planned secondary analysis of the UK Pregnancies Better Eating and Activity Trial (UPBEAT) randomized controlled trial. Exposures were trial arms (hypothesis 1); depressive symptoms (hypothesis 2); and number of weekly binge eating episodes and binge eating behaviours (hypothesis 3). Outcomes were number of weekly binge eating episodes and binge eating behaviours and cognitions (hypotheses 1 and 2), gestational weight gain and child’s birthweight (hypothesis 3). There was no evidence that the UPBEAT intervention was effective in reducing number of weekly binge eating behaviours (IRR .942; 95%CI .756, 1.174) or binge eating behaviours (IRR 1.005; 95%CI .861, 1.174). Increased levels of depressive symptoms were associated with a higher number of binge eating behaviours (IRR 1.031; 95%CI 1.015, 1.048) and its associated features (IRR 1.030; 95%CI 1.019, 1.041). There was evidence that more frequent binge eating behaviours lead to greater increase in gestational weight gain. (coefficient = .614; 95%CI .264, .964). There is a need for holistic interventions that promote maternal mental health and address binge eating behaviours. More work is required in the field to understand which interventions would prove efficacious.

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Exercise therapy to improve cervical proprioception in individuals with asymptomatic forward head posture: A systematic review of randomized controlled trials

Background Forward head posture (FHP) is a common musculoskeletal condition associated with impaired cervical proprioception, which compromises postural control and neuromuscular function. Exercise-based interventions have been proposed to address proprioceptive deficits in FHP, but their effectiveness remains unclear. This systematic review aimed to evaluate the impact of exercise programs on cervical proprioception in individuals with FHP. Methods A systematic search of PubMed, Scopus, and Web of Science was conducted up to April 20, 2025. Randomized controlled trials (RCTs) assessing exercise interventions on cervical proprioception in FHP were included. Risk of bias was assessed using the RoB-2 tool. Due to heterogeneity in outcome measures, a narrative synthesis was conducted, supported by effect size (ES) calculations. Results Nine RCTs involving 367 participants were included. Interventions ranged from cervical stabilization exercises (most common) to whole-body vibration, backward walking, and muscle energy techniques. ESs varied from trivial to nearly perfect, with trivial-to-very-large improvements observed in joint position sense and joint position error. While cervical stabilization exercises demonstrated positive outcomes in rotation and flexion tasks across some studies, the limited number and heterogeneity of studies on alternative interventions precluded a definitive comparison of consistency or effectiveness. Risk of bias was generally rated as “some concerns” due to lack of blinding and variability in outcome measures. Conclusion Current evidence suggests cervical stabilization exercises, the most studied intervention for FHP, may improve cervical proprioception. However, methodological heterogeneity and diagnostic inconsistencies, such as variations in craniovertebral angle thresholds used to define FHP, limit the ability to draw definitive conclusions. Future studies should standardize diagnostic criteria, outcome assessments, and investigate long-term effects across diverse populations.

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From CBC to clarity: Interpretable detection of beta-thalassemia carriers in imbalanced datasets

Thalassemia is an inherited blood disorder and is among the five most prevalent birth-related complications, especially in Southeast Asia. Thalassemia is classified into two main types—alpha-thalassemia and beta-thalassemia—based on the reduced or absent production of the corresponding globin chains. Over the past couple of decades, researchers have increasingly focused on the application of machine learning algorithms to medical data for identifying hidden patterns to assist in the prediction and classification of diseases and patients. To effectively analyze more complex medical data, more robust machine learning models have been developed to address various health issues. Many researchers have employed different artificial intelligence-based algorithms, i.e., Random Forest, Decision Tree, Support Vector Machine, ensemble-based classifiers, and deep neural networks to accurately detect carriers of beta-thalassemia by training on both diseased and normal test reports. While genetic testing is required by doctors for the most accurate diagnosis, a simple Complete Blood Count (CBC) report can be used to estimate the likelihood of being a beta-thalassemia carrier. Various models have successfully identified beta-thalassemia carriers using CBC data alone, but these models perform classification and prediction based on normalized data. They achieve high accuracy but at the cost of substantial changes to the dataset through class normalization. In this research, we have proposed a Dominance-based Rough Set Approach model to classify patients without balancing the classes (Normal, Abnormal), and the model achieved good performance (91% accuracy). In terms of generalization, the proposed model obtained 89% accuracy on unseen data, comparable to or better than existing approaches.

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CLIC1 down-regulates Nrf2/HO-1 signalling pathway promoting the apoptosis and pyroptosis in OGD/R-treated HT22 cells

Cerebral ischemia–reperfusion injury (CIRI) occurs during the treatment of ischemic stroke when the affected blood vessels are recanalized and the oxygen supply to the brain is restored. Chloride intracellular channel 1 (CLIC1) and the nuclear factor erythroid-related factor 2 (Nrf2)/heme oxygenase-1 (HO-1) pathway have been implicated in many neurological disorders. However, the exact mechanism by which CLIC1 contributes to CIRI remains unclear, and its potential role in modulating the Nrf2/HO-1 signaling pathway in CIRI has yet to be explored. We investigated the potential roles of CLIC1 in CIRI using an oxygen and glucose deprivation/reoxygenation (OGD/R) model in HT22 cells. The findings of our study indicated that CLIC1 was high-expressed after OGD/R and had an inhibitory effect on the Nrf2/HO-1 signalling pathway. This process led to an exacerbation of apoptosis due to oxidative stress and an increase in the activity of the nucleotide-binding oligomeriation domain-like receptor protein 3 (NLRP3) inflammasome and pyroptosis in OGD/R-treated HT22 cells. These effects were reversed when CLIC1 was silenced. Together, the results of this study confirm our hypothesis that CLIC1 promotes CIRI by suppressing the Nrf2/HO-1 signalling pathway. CLIC1 emerges as a promising therapeutic target to prevent neuronal cell injury in CIRI.

In vitro and in vivo approaches demonstrating the antiproliferative activity of pomegranate seed proteins and peptides on breast cancer

Pomegranate seed proteins and peptides exhibit high antioxidant capacity according to previous work carried out by our group. The present work aims to evaluate the antitumoral potential of pomegranate seed protein isolates (PIs), obtained using two different procedures, pressurized liquids (PLE) and high-intensity focused ultrasounds (HIFU), and their hydrolysates on breast cancer cells (HCC1806) and immunodeficient mice (Hsd:Athymic Nude-Foxn1nu). The treatment of HCC1806 cells with increasing concentrations of pomegranate seed PIs and the hydrolysates significantly reduced cell viability. At a concentration of 4 mg/mL (PLE PI), 2 mg/mL (HIFU PI), and 2.4 mg/mL (hydrolysates), all treatments significantly reduced breast cancer cell migration and metalloproteinase 9 (MMP-9) activity (active and pro form), and enhanced cell adhesion. Additionally, a reduction in the proliferation capacity of HCC1806 cells was observed, most likely due to cell cycle arrest and the apoptotic effect of PLE PI and its hydrolysate. In vivo experiments with pomegranate seed hydrolysates confirmed their antitumoral capacity, observing significant reductions in the tumor volume and weight after treating with pomegranate proteins and peptides, as well as in metalloproteinase (MMP) activity and vascular endothelial growth factor (VEGF) expression. In addition to proteins and peptides, the anticancer potential may also be related to the presence of phenolic compounds, especially abundant in the PLE extracts.

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Fetal malnutrition and associated factors among term newborn babies in Jimma Zone public hospitals, South West Ethiopia

Background Fetal malnutrition is a major public health burden affecting developing nations, potentially leading to cerebral and neurologic disabilities in later life. Despite its prevalence, little is known about its associated factors in the study area. Thus, this study aimed to assess prevalence and associated factors of fetal malnutrition among term newborn babies in Jimma Zone Public Hospitals. Method A cross-sectional study was carried out among 449-term newborns using systematic sampling techniques in Jimma Zone Public Hospitals from April 1, 2024, to July 30, 2024. Maternal data were collected using an interviewer-administered questionnaire and newborn data were collected using clinical assessment of fetal nutrition (CAN score) scoring system and entered into Epi-data version 4.6 and exported to SPSS version 26 for analysis. Bivariate logistic regression was performed and variables with a p-value ≤0.25 were entered into multivariable logistic regression analysis. P-value less than 0.05 were considered statistically significant and data were presented using text, figures, and tables. Result A total of 449 newborns with their mothers were involved in the study with the response rate of 100%. The prevalence of fetal malnutrition was 91/449 (20.3%) (95% CI, 16.5–24). Among delivered newborns 229/449 (51%) were females and the remaining are males. Maternal age less than nineteen was 60/449 (13.4%) (AOR = 2.930, 95% CI (2.518–13.967)), maternal MUAC ≤23 were 181/449 (40.3%) (AOR = 4.094, 95% CI (2.155–7.77)), infection during pregnancy 97/449 (21.6%) (AOR = 2.729, 95% CI (1.286–5.792)), malaria 99/449 (22%) (AOR = 2.125, 95% CI (1.002–4.510)), not taking Iron and Folic Acid 300/449 (66.8%) (AOR = 2.897, 95% CI (1.330–6.309)), complication during current pregnancy 116/449 (25.8%) (AOR = 4.629, 95% CI (2.444–8.767)), anemia 301/449 (67%) (AOR = 3.669, 95% CI (1.968–6.840)), low birth weight 77/449 (17.1%) (AOR = 5.363, 95% CI (2.760–10.420)), low placental weight 204/449 (45.4%) (AOR = 4.984, 95% CI (2.530–9.816)), antenatal depression 153/449 (34%) (AOR = 7.184, 95% CI (3.733–13.827)), and intimate partner violence 153/449 (34%) (AOR = 5.613, 95% CI (3.011–10.328)), were significantly associated with fetal malnutrition. Conclusion The prevalence of fetal malnutrition in this study indicates one in five delivered newborn. Newborns with low birth weight, low placental weight, and mothers having anemia, intimate partner violence (IPV), antenatal depression, teenage pregnancy, malaria, infection, and complications during pregnancy were a strong association with fetal malnutrition. Therefore, this study recommends that all concerned bodies, should prioritize efforts to reduce intimate partner violence, prevent infections during pregnancy, enhance maternal nutrition counseling, and address the issue of teenage pregnancy.

Gone with the wind: deciphering how dandelions drive seed dispersal

Inhibition of LncRNA Kcnq1ot1 suppresses hypoxia-induced pyroptosis of H9C2 cells by regulating miR-27b-3p

Background Heart failure (HF) is a major cardiovascular disease with high mortality worldwide, whose pathophysiology is multifaceted. Hypoxia has emerged as a critical factor contributing to the progression of heart failure. We aimed to examine the expression and functions of LncRNA Kcnq1ot1 in hypoxia-induced cardiomyocytes in the process of HF. Methods H9C2 cell model was simulated by hypoxia treatment. TUNEL, ELISA, Western Blot and qRT-PCR assay were carried out to evaluate cell pyroptosis, inflammation and dysfunction. Subsequently, we identified the direct downstream target of Kcnq1ot1 by bioinformatics analysis, RNA pull-down, double Luciferase reporter gene and other functional experiments. Results Firstly, Kcnq1ot1 levels was revealed to be upregulated in hypoxia cells than in control cells, and miR-27b-3p showed the opposite trend. And as expected, inhibition of Kcnq1ot1 and overexpression of miR-27b-3p both protected H9C2 against hypoxia-induced pyroptosis, inflammation and dysfunction. Moreover, miR-27b-3p was proved to bind with Kcnq1ot1 and participated in Kcnq1ot1-mediated H9C2 injury under hypoxia by regulating the Wnt3a/β-Catenin/NLRP3 signaling pathway. Conclusions Collectively, our study demonstrated that inhibition of Kcnq1ot1 protected cardiomyocyte against hypoxia-induced injury possibly via sponging miR-27b-3p, which could be useful as biomarkers and therapeutic targets for HF patients.

Time-on-task estimation for tasks lasting hours spread over multiple days

The ability of a human to retrospectively estimate the amount of time spent on a task is largely only understood when the period of time is seconds- or minutes-long. The lack of research into estimation of longer periods of time can be attributed, in part, to the difficulty of measuring ground truth durations when the task is broken up by other activities in a natural, day-to-day setting. An empirically based model of engagement was recently proposed that statistically estimates time-on-task for computer programming assignments in an introductory computer programming course. Computer programming assignments can be completed in many sessions across days or weeks and, based on recorded keystroke data, an objective ground truth of task duration can be measured. In this work, we take advantage of this new measurement method to explore duration estimation of tasks lasting hours that are spread out over multiple days in a natural setting. Subjects in our study overestimated time-on-task 78% of the time and reported a median of 1.45 hours worked for every actual hour spent on task. We find that self-reports are more accurate when students score higher on their assignments in our data, suggesting the accuracy of estimated time is correlated with task performance.

Validation of blue- and clear-native polyacrylamide gel electrophoresis protocols to characterize mitochondrial oxidative phosphorylation complexes

The mitochondrial oxidative phosphorylation (OXPHOS) system plays a pivotal role in the cell’s energy conversion. The enzymes involved in OXPHOS are arranged in five protein-lipid complexes. The first four complexes (I–IV) form the mitochondrial respiratory chain, while Complex V is an F1Fo-ATP synthase. Mutations in genes involved in the biosynthesis of the OXPHOS complexes are an important cause of metabolic diseases. Blue-native polyacrylamide gel electrophoresis (BN-PAGE), originally developed by Hermann Schägger in the 1990s, has become instrumental in gaining insights into structure/function relationships of the OXPHOS system, including: (1) the assembly pathways of the complexes, (2) the composition of higher-order respiratory chain supercomplexes and (3) pathologic mechanisms in patients with a monogenetic OXPHOS disorder. We have used BN-PAGE for >20 years and validate here our recently published step-by-step laboratory protocol. This protocol describes the manual casting of native mini-gels and sample preparation for the resolution of individual OXPHOS complexes or respiratory chain supercomplexes. In addition to BN-PAGE, we explain the closely related clear-native (CN)-PAGE and two-dimensional BN/denaturing-PAGE techniques. Downstream applications include western blot analysis and in-gel enzyme activity staining for Complexes I, II, IV and V. Limitations of the technique are the comparative insensitivity of in-gel Complex IV activity staining and the lack of in-gel Complex III activity staining. Compared to other published BN-PAGE protocols, our protocol contains a shortened sample extraction procedure, advises when to use BN-PAGE and when to use CN-PAGE, and suggests a simple enhancement step for in-gel Complex V activity staining that markedly improves sensitivity. Our protocol is adaptable and yields robust, semi-quantitative and reproducible results.

Prevalence of peripheral arterial disease and arterial calcification based on three ankle-brachial index calculation methods (highest, average, and lowest systolic ankle pressure): A cross-sectional study in Type 2 diabetes mellitus patients in Peru

Background Peripheral arterial disease (PAD) and arterial calcification (AC) are frequent yet underdiagnosed vascular complications in individuals with type 2 diabetes mellitus (T2DM). The ankle-brachial index (ABI) is a widely used, non-invasive too for detecting these conditions. However, differences in ABI calculation methos can impact diagnostic accuracy and prevalence estimates. Objective To determine the prevalence of PAD and AC based on three ABI calculation methods in patients with T2DM attending a public hospital in Peru. Methodology We conducted a cross-sectional study using data from the At-Risk Foot Program of the Endocrinology Department at Hospital María Auxiliadora (2015–2020). ABI was calculated for each lower limb using the highest, average or lowest systolic ankle pressure (SAP) from either the dorsalis pedis or posterior tibial artery as the numerator, divided by the highest brachial systolic pressure as the denominator. We applied a hierarchical classification: PAD was identified first (ABI < 0.9 in either limb), and among those without PAD, AC was identified (ABI > 1.3 in either limb); the rest were classified as normal. Prevalences estimates were calculated with 95% confidence intervals, and associations with clinical characteristics were explored using Poisson regression with robust variance. Results We included 643 subjects with a mean age of 61.4 years, 69.8% female. The prevalence of PAD was 7.8% (95% CI: 5.8–10.1), 15.4% (95% CI:12.7–18.4), and 28.2% (95% CI 24.7–31.7) using the highest, average, or lowest SAP as the numerator in the ABI, respectively. Conversely, the prevalence of AC was 18.2% (95% CI: 15.3–21.4), 11.0% (95% CI: 8.7–13.7), and 16.2% (95% CI:13.4–19.3). In all three methods, PAD was associated with older age (p < 0.05) and AC was associated with longer duration of diabetes (p < 0.01). Conclusions Among patients with T2DM, PAD prevalence varied substantially (7.8% − 28.2%) depending on the ABI calculation method, while AC was present in up to 18.2%. The lowest ankle pressure method increased sensitivity and may be preferred in high-risk populations where avoiding missed diagnoses is critical. The highest ankle pressure method, which maximizes specificity, may be more suitable for general screening and comparability with existing literature, whereas the average pressure approach could be useful in research or prognostic modeling. The hierarchical classification strategy allowed PAD and AC to coexist in the same individual, although this was rare. Given the variability in prevalence across methods, local validation studies are needed to determine which approach optimally balances sensitivity, specificity, and clinical applicability in Peruvian diabetic populations.

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The influence of teacher support on student engagement in physical education among college students: The mediating effects of autonomous motivation and self-efficacy

Student engagement is a malleable behavior shaped by instructional environments and widely regarded as a key component of higher education quality. Nevertheless, many college students have inadequate positive experiences with physical education classes, characterized by a lack of engagement. Therefore, framed within the self-determination theory and social cognitive theory, the present empirical research investigates how autonomy, relatedness, and competence support are associated with student engagement during physical education learning, focusing on the mediating variables of autonomous motivation and self-efficacy. Data collection involved a cross-sectional survey administered to undergraduates from four colleges located in Jiangxi Province, China. After excluding invalid questionnaires, 406 eligible responses were included in the data analysis. Structural equation modelling was then constructed through AMOS 26.0 for hypothesis testing. According to the findings, teacher autonomy and relatedness support were significantly related to student engagement, while competence support showed no significant correlation. Additionally, the pathways from autonomy and competence support to student engagement were both mediated by autonomous motivation. However, its mediating role was not supported in the link between relatedness support and student engagement. Furthermore, teacher autonomy, competence, and relatedness support all significantly influence student engagement via self-efficacy. The present study explores the relational mechanisms linking teacher support to student engagement in college physical education. These results contribute to refining teaching strategies to enhance student engagement while providing insights into optimally motivating instruction in higher education physical education teaching.

Assessment of glycemic control, health-related quality of life, and associated factors in type 2 diabetic patients attending a comprehensive specialized hospital in Northwest Ethiopia

Background Poor glycemic control in type 2 diabetes mellitus (T2DM) leads to serious complications that negatively impact health-related quality of life (HRQoL). This study aimed to assess glycemic control, HRQoL, and their associated factors in T2DM patients. Method This is a cross-sectional study and was conducted from May 1 to July 30, 2024. Systematic random sampling technique was used to recruit the study participants. The average fasting blood glucose (FBG) levels of three consecutive tests during follow-up visits were extracted from patient medical records while the data pertaining HRQoL were collected through interview using EQ-5D five-level (EQ-5D-5L) questionnaire and EQ visual analog scale (EQ VAS). EQ-5D-5L utility scores were determined using disutility values established for Ethiopian context. The FBG level was used to categorize patients by glycemic status (controlled or uncontrolled). Binary logistic regression analysis was performed to outline factors associated with glycemic control. Mann–Whitney U and Kruskal–Wallis tests were used to compare the median utility and VAS scores between subgroups. Furthermore, Tobit regression analysis was performed to determine factors associated with HRQoL. Results Nearly half (48.7%) of the patients were with uncontrolled glycemic levels (out of the target 4.4−72 mmol/L). In the multivariate logistic regression analysis, age, disease duration, comorbid conditions, diabetes complications, adherence to antidiabetic medications, and herbal medicine use were associated with glycemic control. Pain/discomfort, performing usual activities, and anxiety/depression were HRQoL dimensions in which the majority of participants reported problems; 85.8%, 76.2%, and 74.6% of participants, respectively, reported having problems in the dimensions. The overall median (interquartile range) EQ-5D-5L utility score was 0.86 (0.76–0.93) while EQ VAS score was 75.0 (65.0–80.0). The Tobit regression analysis showed that older age, diabetes duration, comorbid conditions, diabetic complications, and herbal medicine use were significantly negatively associated with HRQoL scores. On the other hand, engagement in physical exercise, controlled glycemic level, and adherence to antidiabetic treatments were found to be positively associated. Conclusion In conclusion, nearly half of the patients were with uncontrolled glycemic level. The majority of participants reported problems in pain/discomfort, usual activities, and anxiety/depression dimensions of HRQoL. Several factors were correlated with both glycemic control and HRQoL. Adherence to antidiabetic medications was positively associated with both glycemic control and HRQoL. In contrast, older age, longer duration of diabetes, presence of comorbidities, diabetic complications, and use of herbal medicine were all negatively associated with both outcomes. On the other hand, adherence to dietary recommendations was positively associated only with glycemic control, while engagement in physical exercise was positively associated only with HRQoL. Moreover, glycemic control was associated with improved HRQoL. The findings underscore the importance of interventions targeting modifiable factors, such as dietary modifications, physical activity, and adherence support, to improve overall glycemic control and HRQoL.