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First evidence of bronze production in the Iron Age I southern Levant: A direct link to the Arabah copper polity

This study presents new analytical data from the site of el-Ahwat, a short-lived Iron Age I settlement located at the northern edge of the Central Hill Country in Israel. The site’s substantial metal assemblage, including copper and bronze spills and slag, provides direct evidence for on-site bronze production. Microstructural features indicate that primary alloying of copper and tin—rather than the re-melting of scrap—was practiced at the site. Lead isotope analysis, chemical composition, and microstructure link some of the metal specifically to the Faynan ores, and other finds to the Timna ores, suggesting that both ores, possibly controlled by a joint polity, supplied copper to el-Ahwat. These findings challenge long-standing assumptions about the localization of bronzeworking in urban lowland centers, and open new perspectives on the inland trade routes and social organization of the early Iron Age southern Levant. We propose that el-Ahwat was part of a broader and more complex network of copper distribution and bronze production, extending from the Arabah to the coast, including also peripheral highland communities.

Impact of the WellCheck smartphone app linked to electronic health records on clinical outcomes in patients with type 2 diabetes: Study protocol for primary care-based, prospective, multicenter, cluster-randomized, pragmatic clinical trials

Diabetes, obesity, and dyslipidemia are significant contributors to cardiovascular diseases, necessitating effective strategies to manage blood glucose, blood pressure, and lipid levels through lifestyle interventions and pharmacotherapy. This study aims to assess the glycemic control and metabolic health outcomes achieved over 24 weeks with the use of the “WellCheck” digital healthcare application in patients diagnosed with type 2 diabetes mellitus (T2D) within real-world primary care settings. This is a primary care-based, prospective, multicenter, cluster-randomized pragmatic trial. Eligible participants include adults aged 19–80 with T2D who are treated with or planning to be treated with Envlo (enavogliflozin) or Envlomet (enavogliflozin/metformin). WellCheck links a mobile application for patients with a web platform for physicians and integrates with electronic health records to support the management of diabetes and hypertension. The primary outcome is the change in glycated hemoglobin levels at 24 weeks from baseline. We will conduct cluster randomization by grouping 24 participating primary care centers according to basic characteristics, such as the treating physician’s age (above or below 45 years) and the clinic’s location (metropolitan or non-metropolitan areas). The “App+Physician Support” group will use the WellCheck app for comprehensive digital monitoring and receive feedback supported by an investigator (primary care physician), and the “App-Only” group will rely on the WellCheck app for independent self-management without direct physician assistance. This study aims to explore the effectiveness of WellCheck app in improving glycemic control and metabolic outcomes, providing valuable insights into its potential as a digital tool for managing T2D. The wide age range of participants and cluster randomization of primary care centers into the intervention and control groups enhance the generalizability and robustness of the study, reducing bias and enabling a meaningful comparison of outcomes in diverse healthcare settings. Trial registration ClinicalTrials.gov NCT06419816. Registered on 14 May 2024.

‘The Sun had fallen to Earth’ — a survivor’s recollection of the Hiroshima bombing

Behavioural rhythms of two amphipod species Marinogammarus marinus and Gammarus pulex under increasing levels of light at night

Artificial light at night (ALAN) is proliferating at an alarming rate across the globe, particularly around aquatic habitats. Natural and predictable light cycles dictate much of an individual organism’s life by acting as a major signal for their circadian clock, driving rhythmic behaviours and physiological changes throughout the body. Light cycles also help populations coordinate group behaviour and greatly impact the interspecies dynamics of a community. Research into the ecological impacts of ALAN has highlighted numerous effects on these biological processes, including higher predation rates, impaired growth and development, and diminished reproductive success. Invertebrates play an undeniable role in ecosystem functioning and show robust daily rhythms. As such, it is vital to understand how ALAN may disrupt their behavioural patterns. The aim of this study was to monitor the impacts of increasing levels of light at night (0 lux – 80 lux), as well as constant light and constant darkness, on the behavioural rhythms of the intertidal amphipod, Marinogammarus marinus, and the freshwater species, Gammarus pulex. Gammarus pulex activity was not strongly synchronised to any of the light at night treatments. Marinogammarus marinus, however, exhibited strong behavioural rhythmicity in diurnal cycles with dark night periods. All the ALAN treatments resulted in a significant decrease in M. marinus rhythmicity and overall activity. Moreover, ALAN between 1–50 lux disrupted nocturnality in this species. These results indicate that while some amphipods show some adaptive plasticity when it comes to light pollution, others may experience strong direct impacts on their activity. This may be relevant to individual and population level fitness of vulnerable species in more heavily urbanised areas.

Tackle fake citations generated by AI

Early detection of cardiotoxicity in children receiving adriamycin: A comparison of tissue Doppler and standard echocardiography with Troponin I as an early marker

Background Adriamycin (doxorubicin hydrochloride) is a widely used chemotherapeutic agent for treating various malignancies. However, its most significant adverse effect is cardiac toxicity. Early detection of Adriamycin-induced cardiac dysfunction is crucial in preventing heart failure through interventions such as angiotensin-converting enzyme inhibitors and beta-blockers. Adriamycin-induced cardiotoxicity is classified into Type I (irreversible, involving cardiomyocyte necrosis) and Type II (potentially reversible, involving cardiomyocyte dysfunction). Type I toxicity is more common, leading to long-term heart cell necrosis. Monitoring cardiac function in children receiving Adriamycin is essential. Non-invasive imaging techniques like transthoracic echocardiography, cardiac magnetic resonance imaging, and computed tomography are used to evaluate left ventricular (LV) systolic and diastolic functions. However, the role of cardiac Troponin I for early detection of anthracycline-induced cardiomyopathy remains debated. Methods This prospective study included 50 children (26 males, 24 females) with a median age of 8 years (range: 2–14) receiving Adriamycin. Troponin I levels were measured before and 24 hours after Adriamycin administration. Standard Doppler Echocardiography and Tissue Doppler Imaging (TDI) were performed at baseline, one month, and six months’ post-treatment to assess LV function. Results Out of 50 patients, two showed a decrease in left ventricular ejection fraction (LVEF) below the normal range (<55%) one month post-treatment, along with significant increases in Troponin I levels. No significant decline in LVEF was observed at one or six months’ post-treatment using Standard Doppler Echocardiography. However, TDI revealed a decrease in LV systolic and diastolic function in all patients one month after Adriamycin administration. Conclusion TDI is more sensitive than Standard Doppler Echocardiography in detecting Adriamycin-induced cardiotoxicity. Elevated cardiac Troponin I levels correlate with a decline in LVEF, but subclinical cardiac dysfunction is better detected with TDI.

Conserve marine migratory species to protect ecological links between land and sea

Efficacy of the power centering for seniors intervention on physical functional performance in older community-dwelling adults: a secondary analysis of a randomised controlled trial

Categorized and individualized behavioral phenotyping approaches for control and triple-hit schizophrenia-like model rats in acute and chronic reward-based systems: A pilot study

A wide variety of acute test procedures are used for the behavioral characterization of schizophrenia rodent models, but prolonged observation in home-cage systems remains underexplored. This study aimed to profile the behavior of control (Wistar) and triple-hit schizophrenia-like (Wisket) model rats under two reward-based test conditions: the acute Ambitus test, a simple reward-collection task, and the delay-discounting paradigm in the HomeManner system, designed for extended observation periods. Wisket rats exhibited significant behavioral impairments compared to Wistar rats in the Ambitus test. However, in the HomeManner system, no significant group differences were observed at the cohort level due to heterogeneous individual behavioral patterns. Specifically, only half of the rats explored both food-providing trays, while others focused on one or ignored both. Subgroup analysis, based on tray activity patterns, revealed that Wisket rats displayed impaired cognitive processes and greater intolerance to delayed food rewards. Furthermore, personalized analysis indicated lower behavioral variability within the Wisket group compared to controls. The absence of a strong correlation between performance in the Ambitus and HomeManner tests suggests that these assessments capture distinct behavioral characteristics. This pilot study provides an extended behavioral phenotyping of rat substrains under both acute and chronic conditions. The automated HomeManner system demonstrates potential as a valuable tool for prolonged behavioral assessments. Importantly, this study underscores the value of categorized and personalized analyses in revealing behavioral differences that may not be apparent in group-level comparisons, thereby enhancing the translational relevance of preclinical research.

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Straightlining prevalence across domains of social media use and impact on internal consistency and mental health associations in the LifeOnSoMe study

Abstract Straightlining (uniform responses across items), poses a risk in surveys. Among adolescents, previous studies have investigated the prevalence and impact of straightlining in shorter questionnaires within larger surveys. A typical finding is that straightlining is more common among younger respondents, and particularly among boys. A better understanding of straightlining is important for improving data quality. The present study aims to estimate the prevalence of straightlining among adolescents filling out a survey covering different aspects of social media use across 64 items. Additionally, it seeks to assess the impact of straightlining on internal consistency and the associations between six domains of social media use and symptoms of anxiety and depression. Data from the «LifeOnSoMe»-study (N = 3,285), collected from adolescents (aged 16+) in Bergen, Norway. Descriptive and inferential statistics. In total, 5.4% of participants were straightliners, (8.6% of the boys vs. 2.9% of the girls (p < 0.001)). There were no differences in age between straightliners and the remainder of the sample. Overall, the prevalence and impact of straightlining was limited in the present sample. However, there were large discrepancies in terms of both internal consistency, correlations between domains of social media use, and associations with symptoms of anxiety and depression between straightliners and the remainder of the sample. Straightlining behavior had minimal effects on this sample’s analytical epidemiological conclusions. While boys were more prone to straightlining than girls, overall prevalence was low. However, significant discrepancies between straightliners and other respondents suggest potential risks in samples with higher straightlining prevalence.

Behavioral risk factors in oncology patients: A matched case control study from Yemen

Background Cancer is a significant public health challenge globally, marked by the uncontrolled growth of abnormal cells that can lead to severe morbidity and mortality. Modifiable lifestyle factors significantly influence cancer risk. The study aimed to investigate the behavioral risk factors of cancer among Yemeni adults, highlighting the critical need for targeted prevention strategies. Methods A matched case-control study design was used. It carried out at the National Center of Oncology in Sana’a, Yemen, and the largest referral center for cancer patients in Yemen. The study included 680 participants, consisting of 340 newly diagnosed cancer cases and 340 matched controls. Controls matched cases on age, sex, and place of resident. All subjects volunteered to participate and were personally interviewed using a structured questionnaire that covered socio-demographic, behaviors and dietary intake data. Crude odd ratios (COR) and adjusted odds ratios (AOR) were estimated using conditional logistic regression and the level of significance was set at p-value < 0.05. Results Our analysis found that those who have any family member with a history of cancer (AOR = 2.84; 95% confidence interval (CI): 1.59–5.06), consuming bread or food made from white flour more than once a day (AOR = 2.21; 95% CI: 1.03–4.73), frequently consuming animal oil three to seven times per week (AOR = 3.43; 95% CI: 1.76–6.70), and consuming soft drinks three to seven times per week (AOR = 2.08; 95% CI: 1.08–4.01) were at higher risk of cancer. However, those who had no formal work but supporting family activities (AOR = 0.35; 95% CI: 0.15–0.79), consuming fruit frequently during its seasons (AOR = 0.25; 95% CI: 0.09–0.67), consuming coffee three to seven times (AOR = 0.36; 95% CI: 0.21–0.62) or one to two times per week (AOR = 0.44; 95% CI: 0.23–0.81) were less likely to have cancer. Additionally, no significant differences found between cases and controls regarding education level, smoking, chewing shamma, and frequent consumption of other food and beverages. Conclusion Frequent consumption of bread or products made from white flour, animal fats, and soft drinks were statistically associated with cancer. On the contrary, moderate coffee consumption and frequent intake of seasonal fruits showed to be protected from cancer. Additionally, a family history of cancer was identified as a significant risk factor for developing the disease. To mitigate cancer risk in Yemen, implementing health education campaigns through media to promote awareness of these dietary influences are needed. Additionally, community initiatives should encourage healthier eating habits, emphasizing the importance of fresh fruits and moderate consumption of coffee, and reducing the intake of food made from white flour, animal fat and sugary beverages.

Scientists can help stop a slide to nuclear war — don’t shut them out again

Troponin, NT-proBNP and postoperative atrial fibrillation in a prospective cohort undergoing coronary artery bypass surgery

Abstract Troponin and N-terminal pro B-type natriuretic peptide (NT-proBNP) are biomarkers of cardiac damage and myocyte stretch. The existing evidence on the predictive value of preoperative high-sensitive Troponin and NT-proBNP concentration for the onset of postoperative atrial fibrillation (POAF) is inconsistent. Therefore, we aimed to assess these biomarkers as predictors for POAF in a prospective observational cohort study of patients without atrial fibrillation undergoing coronary artery bypass graft surgery (CABG). We analysed 423 patients with a median age of 66.3 years, 15.1% were women. About a third of these patients (N = 135, 32.4%) developed POAF. The median concentration of (25th, 75th percentile) high-sensitive Troponin at baseline was 11.8 (5.6, 42.7) ng/l in the POAF group and 11.4 (5.2, 37.0) ng/l in the group without POAF, median NT-proBNP was 255 (131, 621) ng/l in the POAF group and 184 (91, 497) in the group without POAF. In uni- and multivariable analyses neither biomarker showed statistically significant associations with POAF. These findings add further neutral data to the inconsistent results found in the current literature and mandate the search for better clinical or biomarker information to assess the risk of this common complication of CABG surgery.

Barriers to access to care in the implementation of telemedicine in public hospitals in Southern Ethiopia: A phenomenological qualitative study

Background Technological advancement has had a beneficial impact on enhancing healthcare globally. The adoption of telemedicine is a crucial component of digital health, but various obstacles have impeded its adoption in developing nations like Ethiopia. Hence, identifying these influencing factors will aid in fostering its implementation in Ethiopia. Objective To explore challenges in the implementation of telemedicine in public hospitals in southern Ethiopia. Methods This study employed a phenomenological qualitative research design and twelve healthcare professionals and six patients were purposively chosen from sixteen public hospitals in Southern Ethiopia to explore the influencing factors of the implementation of telemedicine. Data were gathered through in-depth interviews and field notes between September 10 and October 10, 2024. The data analysis was conducted using OpenCode 4.02 software, and a content thematic analysis was executed following Colaizzi’s 7-step method. Results During this study, four themes emerged, encompassing eighteen subthemes of challenges to care faced by healthcare professionals and patients during the implementation of telemedicine. These themes were administrative and managerial-related challenges, healthcare professionals-related challenges, patient-related challenges, and technology-related challenges. The most commonly raised subthemes were language and cultural barriers, adaptability, and complexity, privacy and cybersecurity, a lack of clear policies and an implementation climate, a lack of necessary resources, a lack of experience and skills, inadequate knowledge and unfavorable attitudes, poor awareness and understanding of technologies, and the high cost of devices and services. Conclusion and recommendations Healthcare professionals and patients in public hospitals in southern Ethiopia encountered challenges related to technology use, patient-related challenges, management and administrative obstacles, and issues unique to healthcare workers. These considerations shed more light on the unique challenges that healthcare providers and patients face while implementing telemedicine.

Neuronavigation accuracy of the VOSTARS wearable AR platform vs traditional infrared navigation in a comparative study

Pre-training heart rate variability as a predictor of Air Force Academy completion

Introduction Operational pilots are required to perform complex tasks under high stress and uncertainty. One of the major challenges of aviation medicine is the selection of suitable candidates to serve as pilots. The vagal nerve is a crucial moderator of stress responses, and its activity (indexed by heart rate variability, HRV) reflects psycho-physiological resilience and has been shown to predict performance in various settings. However, its predictive value in pilot training has not been examined. This study examined the relationship between HRV and success in an intensive and long pilot course. Methods In a historical prospective study, we derived an HRV parameter (RMSSD) from a 10-second ECG of 169 male and 16 female candidates attending a 3-year pilots’ course. The ECGs were performed 2–3 months before the courses. The predictive validity of other routinely obtained measures was also considered. Data were analyzed in two ways. First, we analyzed the entire sample using t-tests. Then, significant predictors of success and HRV were entered in a multivariate logistic regression. Second, we focused on a smaller sample of paired candidates (passed vs. failed), matched on significant predictors, and then examined differences in HRV between these groups using a paired t-test. Results High RMSSD significantly predicted the completion of the pilot course in a multivariate logistic regression. RMSSD and the selection test formula score were the only significant predictors. In the paired matched sample, candidates who passed the course had significantly higher initial HRV (M = 121.30ms) compared to those who failed (M = 84.31ms; t(25)= 1.78, p < 0.05). Conclusion The current study supports the predictive value of HRV for aviation selection. Given the high cost of training operational pilots and the physical and mental burdens they undergo, improved accuracy of the selection processes may be crucial.

How I’m electrifying transportation in Tanzania

Gut microbiota maturation and early behavioral and cognitive development

In-depth insight into the short-term effect of floor management practice on young apple trees development and soil microbial biodiversity and activity

Living mulches can be considered a practice providing multi-level benefits and several ecosystem services in orchards. Two multifunctional living mulches (Mix1 – Trifolium repens (20%) and Festuca ovina (80%), Mix2 – a mixture of 10 different species suitable as flowering strip) sown during the establishment of an apple orchard, were evaluated in relation to the impact on the soil nutrient content and bacterial microbiome, as well as the growth and yield potential of the apple trees. Notwithstanding the increase of N-nitrate and N-ammonia forms induced in the soil, both living mulches mixtures limited the growth and yield potential of the apple trees during the first two growing seasons. The two mixtures induced divergent effects on the biodiversity, activity and metabolic potential of the soil bacterial microbiome, not always increasing them compared to natural cover (control). Such effects could be related to modifications that both mixtures induced in the bacterial community capacity of metabolizing some classes of C-sources compared to control. This was particularly evident for Mix2 and in summer, when all classes of C-sources utilised by the bacterial community for its metabolism resulted to be significantly more exploited than in other seasons. In conclusion, the impact of very diverse living mulch mixtures on the growth, yield potential and overall nutrient status of the young apple trees could be related to modification of the tree physiological status, indirectly derived from the modifications observed on the soil bacterial communities’ composition and metabolic capacity during the whole vegetative season. These results could provide hints for the correct soil management of the orchard to foster the exploitation of soil microbiome suitable for the apple trees development and production.