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Psychological distress among parents with emigrant offspring: A mixed-methods study from Changunarayan Municipality, Nepal

Background The growing trend of international migration has significant socio-emotional implications for families left behind, particularly the left-behind parents. While much research focuses on the well-being of migrants, limited studies explore the psychological distress experienced by left-behind parents. This study assesses the prevalence and determinants of psychological distress among parents with emigrant offspring in Changunarayan Municipality, Nepal. Method A mixed-methods cross-sectional study was conducted among 218 parents whose children had emigrated for at least six months. The quantitative phase involved a structured survey, where psychological distress was assessed using the Kessler Psychological Distress Scale (K10). Pearson chi-square tests and multivariable logistic regression were performed to identify associated factors at a 5% level of significance. The qualitative phase included 16 in-depth interviews to explore emotional experiences and coping strategies. Thematic analysis, following Braun and Clarke’s six-step framework, was used to identify key qualitative insights. Results The prevalence of psychological distress was 18.8%, with 8.3% experiencing mild distress, 5.0% moderate distress, and 5.5% severe distress. Multivariable analysis revealed that parents with multiple morbidities (aOR: 4.032, 95% CI: 1.633–9.938), those whose children were employed in labor-intensive jobs (aOR: 9.215, 95% CI: 1.499–56.645), and those perceiving low support from emigrant children (aOR: 3.828, 95% CI: 1.178–12.442) had significantly higher odds of psychological distress. Qualitative findings highlighted loneliness, parental worries, and uncertainty regarding children’s return as key concerns. Social support, regular communication, and engagement in community activities were identified as coping strategies. Conclusion A significant proportion of parents with emigrant children experience psychological distress, influenced by health conditions, migrant employment status, and perceived social support. Strengthening intergenerational communication, enhancing mental health services, and developing targeted support programs for left-behind parents are crucial in mitigating their distress.

Autonomous Activation of a Gated Chemiluminescent Photosensitizer Enables Targeted Photodynamic Therapy in Tumor Cells

Human sounds and associated tonality disrupting perceived soundscapes in protected natural areas

Abstract In protected natural areas (PNAs), at popular scenic spots, visitors often contribute to noise pollution through their behaviour. The decibel-focused monitoring doesn’t capture the quality of an acoustic environment, human behaviour and perception. A mixed-methods framework, based on the ISO 12913 series, was tested in four European PNAs to address this gap. During five soundwalks (7–12 km long) organised by the Silenzi in Quota initiative, 443 questionnaires were gathered across 28 evaluation points, alongside corresponding binaural measurements. Acoustic environments as silent as L Aeq  = 31 dB and as loud as L Aeq  = 76 dB were observed, eliciting perceptions from very calm to chaotic. Psychophysical measures (loudness, sharpness, roughness, fluctuation strength and tonality) were calculated. The impact of the perceived sound source dominance, visual landscape quality and psychophysical and environmental acoustic features on the perceived soundscape pleasantness and eventfulness was analysed via Linear Mixed-Effects Models (LMMs). Perceived sound source type data- and psychophysical data-based models demonstrated higher predictive power than those based on sound pressure level metrics. Amongst the sounds of nature, water sounds demonstrated the strongest association with higher pleasantness and eventfulness. Unlike in urban context, presence of human sounds, associated with increased tonality, was the major factor driving the perception of chaotic soundscapes, revealing the detrimental effect of human behaviour on the experience of PNAs.

Editorial Note: Enhancing shipyard transportation efficiency through dynamic scheduling using digital twin technology

Designing Pb-Free High-Entropy Relaxor Ferroelectrics with Machine Learning Assistance for High Energy Storage

Enhanced anti-microbial properties of clear aligner resin containing zwitterionic material

Unveiling health disparities: Diagnostic prevalences in a transgender cohort versus matched controls

Importance Transgender and gender-diverse (TGD) individuals are at risk for discrimination and inequities across legal, social, and medical contexts. Population-level resources have rarely been used for TGD health research and, therefore, data is lacking about prevalences of a wide range of clinical conditions among TGD populations. Objective To leverage the Utah Population Database’s demographic, vital, and health records and examine population-level diagnostic prevalences in TGD individuals and an age-matched general cohort. Participants 6,664 TGD individuals were identified using ICD codes for gender incongruence between 1995 and 2021; 64,124 age-matched individuals comprised the control cohort. Design Using Phecodes to collapse ICD codes, this study examined differences in the prevalence of medical, mental health, and neurodevelopmental clinical phenotypes in TGD and control cohorts using modified Poisson regression models. Setting Affiliated healthcare systems within the state of Utah. Main outcome and measure We evaluated adjusted prevalence ratios of identified Phecodes. Results The TGD cohort showed broadly higher documented prevalences of medical, mental health, and neurodevelopmental conditions compared to controls. Medical diagnoses more common in the TGD cohort included sleep disorders and chronic pain. Disparities in diagnoses such as “other endocrine disorders” and “need for hormone replacement therapy” likely reflect gender-affirming treatments. Mental health conditions including mood, depression, anxiety, and personality disorders were significantly more prevalent in the TGD cohort. Conclusions and Relevance This study highlights diagnostic disparities for TGD individuals across multiple clinical categories. Our findings may be driven by: 1) discrimination and over-medicalization of TGD individuals, 2) differences in accessing and interacting with the healthcare system, and 3) variation in the true incidence of medical and mental health outcomes in the TGD vs control cohorts.

Testing the mediating role of self-esteem on the relationship between parenting styles and subjective well-being of adolescents

Quality of life in a family-centric applied behavior analysis model: A case series study

Autism spectrum disorder (ASD) is a condition with growing prevalence that results in significant healthcare spending, reduced parent income, high levels of family stress, and decreased quality of life (QoL). QoL is a measure for assessing overall wellness, and in the context of ASD is related to parent self-efficacy. Validated treatments, of which applied behavior analysis (ABA) is the gold standard, can mitigate some of the consequences that may be detrimental to parental QoL. We examined changes in parental QoL across multiple domains within three parent-child dyads in the context of a parent-led ABA model where the treatment was delivered by the parent. We hypothesized that parental QoL would be increased concurrently with ABA treatment lowering the frequency of interfering behaviors, which contribute to parental stress and limited self-efficacy. QoL components improved between the first and follow-up evaluations, though not all QoL component score changes achieved clinical significance. This study demonstrates a correlation between parental QoL and clinical treatment progress; with further validation, QoL assessment may serve as a tool to guide individualized treatment approaches that improve family outcomes.

Protein Recognition and Assembly by a Phosphocavitand

Activities of daily living mediate the association between balance and falls in middle aged and older adults

Can cognitive function tests discriminate between patients with glioma and healthy controls prior to treatment? A systematic review

Background Brain tumours affect 7 per 100,000 people in the UK, glioma being most prevalent, with only 12% five-year survival rates and devastating impacts. Primary care triage tools could facilitate earlier detection of glioma. One option for triage is cognitive function testing. The aim of this systematic review was to determine if cognitive function tests can discriminate between patients with glioma and healthy controls, and their potential suitability for primary care use. Methods Studies were included that conducted cognitive function tests with adult patients with glioma, prior to treatment, compared to healthy controls. Two independent researchers performed screening and data extraction. The primary outcome explored test discrimination between people with glioma and healthy controls. Results Seventeen studies were identified. Findings indicated multiple cognitive function and language function have potential discriminatory capacity between patients with glioma and healthy controls. Over half of cognitive function tests measuring multiple cognitive functions (59%, n = 17) and language function (54%, n = 30) found significant differences between patients with glioma and healthy controls with medium or large effect size. The Montreal Cognitive Assessment has short test duration, high feasibility and acceptability, suggesting potential primary care suitability. Further acceptability and feasibility studies are needed for other potential tests. Conclusions Acknowledging high heterogeneity of included studies, this review suggests tests of multiple cognitive functions or language could support primary care practitioners with decision-making for urgent neuroimaging referral. However, interpretations should be treated with caution and the applicability to primary care requires further exploration. Prospero registration number: CRD42023408671

Impact of precursor materials and activator interactions on the microstructural and mechanical properties of one part alkali activated concrete

Abstract The practical implementation of alkali activateds is frequently constrained by the complexities associated with preparing alkaline solutions. The advent of one-part alkali activated concrete presents substantial advantages over conventional two-part systems by negating the need for a separate activation process. This simplification not only enhances consistency, workability, and sustainability but also minimizes mixing errors, thereby facilitating broader adoption in construction applications. This study comprehensively examines the effects of various activators on the mechanical properties and microstructural characteristics of one-part alkali activated concrete. Utilizing Scanning Electron Microscopy (SEM) and Energy-Dispersive X-ray Spectroscopy (EDAX), we investigate the elemental compositions and microstructural features of the alkali activated samples. Our findings underscore the pivotal role of both precursor materials and activator selection in determining hydration products and overall material performance. Notably, the slag-only alkali activated exhibited a dense microstructure characterized by the formation of calcium–aluminum–silicate–hydrate (C–A–S–H) and sodium–aluminum–silicate–hydrate (N–A–S–H) gel phases. The addition of bentonite introduced a more heterogeneous microstructure, with elevated aluminum content indicative of a complex N–A–S–H structure. Furthermore, the choice of activator markedly influenced hydration reactions. The optimal ternary activator (6:3:1 Na-silicate: Na-hydroxide: Na-carbonate) achieved 47 MPa compressive strength, reducing CO₂ emissions by 80% compared to OPC [8]. This research provides critical insights for optimizing alkali activated concrete formulations, highlighting the significance of precursor materials and activator interactions. By advancing the understanding of one-part alkali activateds, this study establishes a foundation for innovative and sustainable solutions in building engineering, addressing practical challenges while enhancing the performance of construction materials.

Application of mechanical quantitative techniques in postoperative rehabilitation assessment of anterior cruciate ligament reconstruction: A study protocol

This study protocol aims to explore the application of mechanical quantitative techniques in the postoperative rehabilitation assessment following anterior cruciate ligament reconstruction (ACLR). Anterior cruciate ligament injuries are prevalent among athletes and pose a considerable threat to their careers. While ACLR remains the primary therapeutic intervention for such injuries, the assessment of postoperative rehabilitation still encounters significant challenges. Traditional assessment methods are limited by subjectivity and the absence of quantitative data. Mechanical quantitative techniques present a novel approach, offering objective and precise quantitative metrics for knee functional rehabilitation through the analysis of soft tissue mechanical properties. Methods: An observational methodology will be employed to gather clinical data from patients with ACL injuries. A soft tissue mechanical quantitative measurement device will be utilized for knee functional assessment. The anticipated sample size is 66 cases, with inclusion criteria encompassing specific age ranges, injury durations, and other pertinent factors. Exclusion criteria will exclude participants with other injuries or diseases that may impact rehabilitation. The assessment protocol will consist of traditional knee functional assessments, including knee muscle strength, range of motion, and Lysholm scores, as well as mechanical quantitative assessments of the quadriceps and hamstrings. Blinding: Due to the inherent challenges in clinical controlled trials, a strict double-blind design is infeasible. Therefore, participants will be aware of their group assignments, whereas assessors will remain blinded to the specific research objectives and group allocations. Data entry and statistical grouping will be managed by independent personnel. Statistical Analysis: Data analysis is conducted using SPSS 20.0 software. Categorical data are represented as frequencies (percentages), with intergroup comparisons made using chi-square tests or exact probability methods; continuous data are represented as means ± standard deviations, with intergroup comparisons made using t-tests, analysis of variance, or rank sum tests, and correlation analysis is performed using Spearman’s correlation coefficient. A P-value <0.05 is considered statistically significant. Expected Results: Firstly, It is anticipated that there will be a significant correlation between the assessment results of mechanical quantitative techniques and traditional functional assessment methods. This will validate the reliability of mechanical quantitative techniques and facilitate their complementary use alongside traditional assessment methods. Secondly. It is expected that this study will develop new scientific measurement tools and methods, mitigating errors associated with subjective judgments and ensuring the objectivity and accuracy of assessment results. By providing specific, quantifiable data, this study will offer physicians a more intuitive and precise basis for assessment.

Chiroptical Signal Amplification in Amorphous Siloxane Network by Asymmetric Ring Distortion

Life history of a new Paraceratheriid from the Early Oligocene of Northwest China

Abstract Understanding life history is crucial for elucidating mammalian evolution. Body size and tooth development have long been fundamental parameters in reconstructing the life histories of both fossil and extant species. The superfamily Rhinocerotoidea exhibits a protracted evolutionary history from the Eocene to the present, with its large body sizes and high-crowned teeth providing compelling evidence for such studies. In this research, we describe Turpanotherium qiui sp. nov., a new species within the family Paraceratheriidae, identified from a mandible recovered from the Early Oligocene of Northwest China. Analysis of elemental concentrations revealed insights into both longitudinal life history patterns and discrete developmental events. Significant variations in barium and strontium concentrations in the enamel were associated with neonatal development and breastfeeding phases, whereas zinc, strontium, and barium concentrations in the dentine displayed marked seasonal variability. Analysis of Retzius lines in enamel and annual lines in cementum from tooth histology reveals that this Paleogene species exhibited a life history pace comparable to its Quaternary relatives. The evolution of life history traits in Rhinocerotoidea has been relatively conservative since the Oligocene and does not consistently correlate with shifts in body size. This study establishes a foundation for understanding the evolution of life histories in this group.

An unexpected role of CLASP1 in radiation response and S-phase regulation of head and neck cancer cells

Radiotherapy is a mainstay of treatment for head and neck squamous cell carcinoma (HNSCC), either definitive or adjuvant to surgery. Biological factors known to affect radiation response are hypoxia and DNA repair capacity, but several lines of evidence indicate that other genes and pathways in the tumor cells might be involved that have not been elucidated. Here, we report the results of a genome-wide CRISPR-Cas9 functional genomics screen in HNSCC cells to identify radiosensitizing genes. Remarkably, microtubule organizing genes were identified with CLASP1 as most unexpected radiosensitizing hit. Clonogenic assay confirmed the radiosensitizing effect of CLASP1 knockout. Functional analysis showed that CLASP1 knockout has major impact during S-phase, and resulted in mitotic cells with broken chromosomes and cell death. CLASP1 and possibly the microtubule machinery in broader sense seem involved in protection of HNSCC cells against radiation–induced DNA damage. This newly identified mechanism provides an outlook for novel treatment approaches in HNSCC.

Cosolvent Electrolyte Design for High-Voltage Aqueous Zinc–Sulfur Batteries

LMF1 frameshift deletion in Franches-Montagnes horses with hypertriglyceridemia-induced pancreatitis

Abstract Hypertriglyceridemia (HTG) may be inherited and caused by variants in genes encoding enzymes of lipid metabolism. This study was prompted by the observation of eight Franches-Montagnes (FM) foals showing elevated plasma triglyceride levels and episodes of fatal acute pancreatitis. We termed this phenotype hypertriglyceridemia-induced pancreatitis (HIP). The affected foals were distantly related and inbred to a prominent stallion suggesting autosomal recessive inheritance. Whole genome sequencing of an affected foal identified a homozygous loss of function variant in LMF1 encoding lipase maturation factor 1. The variant, XM_023616679.1:c.369_373delinsTCT, leads to an early frameshift and is predicted to alter or truncate 78% of the LMF1 coding sequence. We genotyped the variant in a cohort of 2122 FM horses and identified 11 homozygous mutant animals including all eight foals that had initially been identified based on their clinical presentation. The three additional homozygous mutant animals had a comparable phenotype and were inbred to the same stallion. We concluded that all 11 had been affected by the same disease. Thus, we found perfect genotype-phenotype association in the tested cohort. The carrier frequency in the 2111 unaffected FM horses was 15.0%. Our findings enable genetic testing to prevent the unintentional breeding of further HIP-affected foals.

Precision medicine in rheumatoid arthritis: Evaluation of a new approach to predict clinical response to methotrexate in patients with early rheumatoid arthritis

Background International guidelines recommend methotrexate (MTX) as the first-choice treatment in rheumatoid arthritis (RA). Although most patients with recently diagnosed arthritis achieve low disease activity or remission with MTX, about 30–40% do not significantly decrease disease activity after 6-month treatment. Predicting response is essential for choosing the best therapeutic option during the window of opportunity. Objective This study aimed to evaluate the performance of two new tests measuring the in vitro response to MTX in MTX-naive patients with RA and the association of the test results with clinical remission after 6-month treatment with MTX. Methods This prospective 6-month study was conducted on 31 RA patients starting MTX treatment. Monocyte metabolic activity (Monocytes Test) and reactive oxygen species (ROS Test) in peripheral blood were measured in vitro before treatment, and response to MTX and remission was measured at 6 months. The area under the receiver operating characteristic curve (AUC) for predicting 6-month remission was calculated with 95% confidence intervals (CI) for each test. Results Patients in remission (71%) and not in remission (29%) at 6 months showed no statistically significant clinical differences at baseline. They only differed in test results: ROS levels were higher in patients who achieved 6-month remission than in those who did not (p < 0.001), and monocyte levels were lower in patients who achieved remission than in those who did not (p < 0.05). Prediction accuracy was high, with AUC values of 0.919 (95% CI [0.813–1.025]) and 0.826 (95% CI [0.664–0.989]), respectively, for ROS and monocyte levels. Conclusions In MTX-naive patients with RA, the pharmacological response to MTX can be adequately predicted in vitro by quantifying ROS production and total monocytes from peripheral blood mononuclear cells.