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Simulation of fusion neutron spectra from D-D and D-T thermonuclear fusion

Frontal brain activity assessment during basic life support skill acquisition and transfer in serious game based learning environments

Basic Life Support (BLS) is a crucial life-saving skill, and the effectiveness of different training methods for acquiring and transferring BLS knowledge and skills remains an important area of investigation. Traditional methods, such as lectures, may be less engaging and lack the practical application necessary for optimal skill transfer. New training modalities, including serious games on tablets and in virtual reality (VR) environments, offer interactive experiences, enable personalized feedback, and repetitive practice, potentially enhancing the learning process. However, the effectiveness of these newer training delivery methods on skill acquisition, transfer, and the underlying neurophysiological mechanisms needs further investigation. Hence, this study explores the effectiveness of various BLS training modalities, including traditional lecture-based instruction, tablet-based serious gaming, and VR-based serious gaming. A wearable functional near-infrared spectroscopy (fNIRS) sensory system is used to monitor prefrontal cortex (PFC) activity during training and subsequent hands-on testing. A total of 51 participants, who were randomly assigned to one of three training groups (lecture, tablet, VR), were analyzed. These participants underwent fNIRS monitoring during the training sessions and a final hands-on exam. Our findings revealed that while all three training modalities led to comparable hands-on exam performance, there were notable differences in neural activation patterns. VR-based training appeared to elicit neural responses indicative of more efficient use of cognitive resources during the hands-on test, suggesting its potential effectiveness as a practice mode for skill acquisition and transfer. These findings highlight the importance of considering both behavioral and neurophysiological metrics when assessing the efficacy of educational interventions.

A contact lens delivering a combination of PDRN and DMPC enhances corneal wound healing and alleviates dry eye in a rabbit model

Abstract Corneal epithelial defects and dry eye disease are leading causes of ocular morbidity, characterized by epithelial damage, inflammation, and tear film instability that current monotherapies rarely address simultaneously. Polydeoxyribonucleotide (PDRN) promotes tissue regeneration and suppresses inflammation, while 1,2-dimyristoyl-sn-glycero-3-phosphocholine (DMPC) reduces tear evaporation. We evaluated a contact lens co-delivering PDRN and DMPC (PDRN+DMPC) in two rabbit models: a corneal epithelial wound healing model and a meibomian gland dysfunction–induced dry eye model. In each animal, one eye received a control lens and the contralateral eye a PDRN+DMPC lens worn six hours daily. Outcomes included epithelial defect area, tear break-up time, histology, and gene expression. In the wound model, the PDRN+DMPC lens accelerated re-epithelialization and produced greater epithelial thickness. In the dry eye model, tear break-up time was prolonged, tear osmolarity reduced, and epithelial desquamation decreased. Pro-inflammatory cytokines were selectively suppressed, and membrane-associated mucins (MUC1 and MUC16) were downregulated, whereas the secreted gel-forming mucin MUC5AC, goblet cells, epithelial differentiation markers, and tight junction genes were preserved. Thus, the PDRN+DMPC lens accelerates corneal wound healing, restores tear film homeostasis, and limits inflammation while maintaining protective mucin and barrier components, supporting its potential as a multifunctional therapeutic platform for ocular surface disease.

Implementation, enforcement, and monitoring of tobacco advertising, promotion, and sponsorship (TAPS) laws in Ethiopia: Insights from a qualitative study

Background Tobacco advertising and promotion remain major drivers of tobacco use, particularly at points of sale (PoS). Ethiopia has enacted comprehensive tobacco control laws, including bans on TAPS at PoS. However, little is known about how these laws are implemented, monitored, and enforced in practice. This study explored the facilitators and barriers to implementing, monitoring compliance with, and enforcing TAPS laws at PoS in Ethiopia. Methods Qualitative interviews with 41 key informants were conducted between December 2022 and January 2023 across 10 purposively selected cities. Participants included policy implementers and stakeholders from government agencies, civil society organizations (CSOs), and international partners. Participants were purposively selected from national and sub-national actors involved in tobacco control, including government agencies (MoH, EFDA, Ministry of Trade, regional health and trade authorities, regulatory bodies, and research institutions) and non-governmental stakeholders (WHO Ethiopia, professional associations, and CSOs). Semi-structured interview guides were developed and administered in local languages. Interviews were audio-recorded, transcribed verbatim, translated into English, and analyzed thematically using ATLAS.ti software. Results Key facilitators included strong tobacco control laws (Proclamation No. 1112/2019), federal-level political commitment, and the national tobacco control committee (NTCC). Barriers included the absence of EFDA structures at lower administrative levels, a lack of regionally adapted tobacco control laws, limited dedicated tobacco control departments, unclear enforcement mandates, advertisement of illicit tobacco products, not being a prioritized agenda, low awareness among non-health departments and retailers, tobacco industry interference, and, in some areas, a culture that normalizes tobacco smoking. Conclusions Strong legislation banning 100% of TAPS and the presence of a national tobacco control committee support implementation; however, enforcement remains limited by structural, operational, and socio-cultural challenges. Enhancing compliance requires strengthening regional regulations, establishing clear institutional frameworks, raising stakeholder awareness about the tactics of the tobacco industry, and ensuring adequate allocation of human and financial resources, particularly in regions with a high prevalence of illicit tobacco products, to achieve the intended public health impact of TAPS laws in Ethiopia.

The impact of parental emotional warmth on online gaming addiction among adolescents and young adults: a moderation-mediation model

Abstract Parental emotional warmth is widely recognized a protective factor against internet gaming disorder (IGD), however, the precise mechanisms underlying this protective effect remain poorly understood. Notably, the potential mediating role impulsivity and moderating role of belief in a just world, which have not been systematically examined. This study aims to explore the effects of parental emotional warmth on internet gaming disorder in adolescents and young adults, and to test the mediating role of impulsivity and the moderating role of belief in a just world. Using a cross-sectional survey design, 550 college and high school students from Anhui Province were selected via convenience sampling between July and October 2022, yielding 513 valid questionnaires (valid response rate: 93.27%). Participants ranged in age from 15 to 22 years (M = 18.28, SD = 1.75), including 232 males (45.2%) and 281 females (54.8%). Assessments were conducted using the Parental Emotional Warmth Scale, the Just-World Beliefs Scale, the Barratt Impulsiveness Scale (BIS-11), and the Internet Gaming Disorder Scale (IGD-20). SPSS 22.0 was used for descriptive statistics, correlation analysis, and regression analysis. The PROCESS macro (Models 4 and 7) was used to test for mediation effects and moderated mediation effects, and confidence intervals were estimated using 5,000 Bootstrap resampling iterations. (1) The screening rate of IGD was 2.90%. (2) IGD was negatively correlated with parental emotional warmth ( r  = − 0.177, p  < 0.01) and belief in a just world ( r  = -0.093, p  < 0.05), but positively correlated with impulsivity ( r  = 0.353, p  < 0.001). (3) Impulsivity fully mediated the relationship between parental emotional warmth and IGD (indirect effect = − 2.19, 95% CI [− 3.10, − 1.37]), accounting for 68.18% of the total effect. (4) Belief in a just world moderated the first-stage path (parental emotional warmth → impulsivity; interaction B = − 1.87, p  < 0.05); the indirect effect was stronger at higher levels of belief in a just world (95% CI [− 3.51, − 1.43]) than at lower levels (95% CI [− 2.32, − 0.34]). Parental emotional warmth is a protective factor for the IGD of adolescents and young adults, and impulsivity is an important mediating mechanism, which is regulated by a belief in a world of just.

The quality of care for type 2 diabetes mellitus management in Malaysian primary health care settings: A scoping review of ABC (glycated haemoglobin A1c, blood pressure, and LDL-cholesterol)

Background Diabetes is a major health concern in Malaysia, yet no comprehensive review has assessed the quality of care for these patients. This study aims to systematically review published evidence on type 2 diabetes mellitus (T2DM) management in Malaysian primary health care (PHC), focusing on the achievement of glycated haemoglobin (HbA1c), blood pressure (BP), and LDL-cholesterol (LDL-C) targets (ABC control). Methods A scoping review was conducted, involving a comprehensive search of four databases (PubMed, Embase, Scopus, and MyMedR) and grey literature for publications up to December 2024. Studies were included if they reported on at least one ABC indicator among the general adult T2DM population in Malaysian PHC settings. The scoping review followed the Joanna Briggs Institute (JBI) methodology and PRISMA-ScR guidelines. EndNote was used for deduplication, and Rayyan was utilised for the screening process. Data were extracted and synthesised narratively. Results A total of 109 publications were included. Publications increased post-2010 but remained geographically concentrated in urban states. Large-scale studies heavily relied on the National Diabetes Registry. HbA1c was the most reported indicator. Findings revealed no evidence of improvement in HbA1c and BP control over two decades; achievement rates were 30–45% for HbA1c (<7.0%) and 20–50% for combined BP target (<130/80 mmHg). Conversely, LDL-C control (≤2.6 mmol/L) showed a modest improvement, with achievement rates rising from approximately 30% to 50% over a decade. Conclusion Despite a substantial increase in research, the HbA1c and BP control for T2DM in Malaysian PHC has remained static and suboptimal, highlighting a persistent gap between clinical guidelines and real-world outcomes. The modest improvement in LDL-C suggests that progress is achievable. These findings underscore the need for a balanced policy focus on all three ABC indicators, strategies to overcome systemic barriers, and continued investment in the national registry to guide evidence-based improvements in diabetes care.

Spatial organization and environmental niche modeling of Goguryeo archaeological sites in Northeast China: integrating GIS and machine learning approaches

From theory to practice: A case study on estimating the costs of improving animal welfare on Simmental alpine dairy farms

This case study estimates the economic implications of enhancing animal welfare (AW) in Alpine dairy farming, specifically focusing on Simmental cattle in both conventional (CON) and organic (ORG) farms. Given the increasing demand for higher welfare standards from consumers and policymakers, it is important to assess the economic feasibility of implementing these practices. The primary aim of this study is to develop a proof of concept for estimating the costs involved in meeting specific AW standards. Data were collected from 30 dairy farms (15 CON and 15 ORG), and AW scores were evaluated using both resource-based and animal-based indicators (total score of 90 points). Additionally, AW costs were assessed by calculating the cumulative additional costs, offset by potential benefits. Results show ORG farms achieve higher AW scores (73.99) compared to CON farms (70.28) but incur significantly higher production costs (€1.263/kg ECM for ORG vs. €0.977/kg ECM for CON), primarily due to the dilution effect caused by lower milk production on ORG farms. A nonlinear relationship between AW scores and AW costs was also observed, indicating that higher AW scores in initial farm conditions could, in some cases, lead to cost savings, particularly in larger and more efficient farms. The study emphasizes the need for clearly defined AW standards and a corresponding scoring system that reflects both the welfare impacts on animals and the economic feasibility for farmers. Further, we argue that the aggregation of AW scores should not merely categorize welfare on a simple best-to-worst continuum. Rather, it should account for the specific targets and conditions that policymakers and consumers are willing to support financially.

Using a cooperative board game to examine One Health teamwork functions under pressure

Abstract Health threats at the human–animal–environment interface demand joint decisions across public health, veterinary, and environmental agencies, yet institutional mandates and siloed data systems frequently hinder effective coordination. While One Health frameworks identify enabling functions such as communication, collaboration, coordination, and capacity building, these routines are often managed implicitly during stable periods but become fragile during crisis. Educational curricula often rely on broad competency domains that provide limited guidance on the observable behaviors required to maintain these functions as conditions shift from routine to emergency response. To address this gap, this study uses a cooperative board game as a time‑limited activity that creates interdependence and moments of escalating pressure to expose how stable teamwork functions, degrades, or adapts under threat. The seminar was refined across four annual cohorts of the programme between 2020 and 2023. The analyzed dataset comes from the 2023 cohort of 13 multidisciplinary practitioners, studied across three consecutive play sessions. A hybrid deductive–inductive thematic analysis of gameplay and structured debrief discussions describes how learners enact and articulate specific routines. These descriptions include how they resequenced steps, checked rule requirements, and paused briefly to regain a shared understanding of the evolving situation. The findings show how time‑limited tasks draw attention to tensions between immediate containment actions and longer‑term progress toward shared objectives. The study proposes that structured game activities offer a reproducible environment for learners to notice and describe teamwork behaviors relevant to One Health training and assessment.

Molecular analysis and computational modeling reveal temporally separable responses triggered by DENV-induced soluble factors in endothelial cells

Dengue virus (DENV) represents a growing global health challenge with billions of people at risk. Severe Dengue (SD), a complication of DENV infection that involves generalized hemorrhage, is driven, at least in part, by endothelial dysfunction. Endothelial dysfunction refers to increased permeability due to inflammation, mechanical injury and/or modification of the genetic program of endothelial cells. Previous work showed that exposure of endothelial cells to conditioned media from DENV-infected cells (CMDV) increased permeability and cellular stiffness, repressed endothelial markers and induced mesenchymal genes. However, the generality, extent, mechanism and ultimate impact of these events in the onset of SD remain elusive. Here, we integrate analysis from in vitro treatment of endothelial cells with media containing UV-inactivated DENV with computational modeling to investigate the key features of CMDV-induced endothelial alterations and their potential impact on endothelial dysfunction. We found that CMDV increased SNA1 and CDH2 expression, while suppressing endothelial genes OCLN and CDH5 . Global transcriptomics analysis revealed that CMDV triggered a transient pro-inflammatory response, followed by induction of selected tissue repair genes and matrix remodeling. A non-directed asynchronous network model (NDAM-CMDV) identified IL6 and FN1 as central nodes of DENV-induced endothelial trans-differentiation, providing new molecular insights that predict the evolution of the disease and identify potential therapeutic targets.

Optimizing construction risk management through BIM integration and strategic planning

Isolation and characterization of Candida metapsilosis from foci of chronic pododermatitis in captive steppe eagles in Kazakhstan

Pododermatitis (bumblefoot) is a chronic, debilitating disease of the plantar surface of the foot that affects birds of prey kept in captivity worldwide. Although bacterial pathogens, especially Staphylococcus aureus , are most commonly considered as causative agents, the contribution of opportunistic yeasts to chronic, non-healing footpad lesions remains poorly characterized. Keratinophilic yeasts may sustain the disease process by degrading keratin in superficial tissues, impairing wound healing and, owing to their thermotolerance and minimal nutritional requirements, persisting in the environment of the bird’s enclosure. In this study, three captive steppe eagles ( Aquila nipalensis ) from a single aviary in Kazakhstan, all presenting with chronic pododermatitis unresponsive to antibacterial treatment, were investigated by integrated mycological, biochemical and molecular approaches. The yeast isolates were recovered from the deep footpad lesions and identified to species level by sequencing of the ITS1-5.8S-ITS2 rDNA region. All these isolates were assigned to Candida metapsilosis , and phylogenetic analysis confirmed their close clustering with reference C. metapsilosis sequences. Phenotypic characterization showed that all isolates were thermotolerant (growth at 8–37 °C), expressed strong urease and keratinolytic activity (the latter confirmed in vitro by the hair perforation test), high saccharolytic activity and selective, weak proteolytic activity. Disk diffusion screening showed susceptibility to azoles (ketoconazole, clotrimazole, fluconazole) and reduced susceptibility to polyenes (nystatin, amphotericin B). To our knowledge, this is the first report of C. metapsilosis isolated from chronic pododermatitis lesions in captive steppe eagles. Combined with the documented in vitro virulence-associated traits and the resolution of the lesions following targeted antifungal therapy, our findings support a contributory etiological role of C. metapsilosis as an opportunistic pathogen in raptor pododermatitis in immunocompromised birds maintained under suboptimal husbandry. Mycological work-up, including molecular identification, is therefore warranted in cases of chronic, non-resolving pododermatitis in captive birds of prey.

The perceptions and concerns of parents about vaccination of their children against COVID-19: a cross-sectional study

Integrated transcriptomic analysis of LMB2-induced podocyte injury identifies conserved inflammatory and adaptive stress responses

Podocyte injury is a central driver of progressive glomerular diseases, yet the temporal organization of podocyte-intrinsic responses remains incompletely defined. In this study, we performed an integrated re-analysis of two publicly available mouse transcriptomic datasets (GSE108629 and GSE151869) to identify conserved molecular responses to LMB2-induced podocyte injury across comparable post-injury time points. Differential expression analysis was conducted independently at Day 4 and Day 7 in each dataset, followed by cross-dataset integration at each time point by identifying shared differentially expressed genes (DEGs) with consistent directionality. The resulting Day 4 and Day 7 shared gene sets were subsequently combined to define a final pooled shared DEG set. Functional enrichment, network analysis, upstream regulator prediction, and gene set enrichment analysis (GSEA) were used to characterize conserved biological processes and regulatory features. We identified 1,418 and 1,401 shared DEGs at Day 4 and Day 7, respectively, with 725 genes defining the final pooled shared DEGs set. At Day 4, the transcriptional response was characterized by inflammatory signaling and adaptive stress-related pathways, including endoplasmic reticulum stress. By Day 7, this response expanded to include extracellular matrix remodeling, focal adhesion reorganization, sustained inflammatory signaling, and downregulation of autophagy–lysosome pathways, together with disruption of ER-to-Golgi trafficking. Network analysis highlighted RELA-centered regulatory modules alongside epigenetic- and kinase-associated regulators. Collectively, these findings support a conserved, cross-dataset biphasic transcriptional response to podocyte injury, characterized by an early adaptive inflammatory phase followed by a later maladaptive state involving extracellular remodeling and impaired proteostasis. This framework provides a reproducible, temporally organized injury signature and is consistent with stage-specific pathways as potential targets for future mechanistic and therapeutic studies.

Fluid shear stress inhibits vascular endothelial cells proliferation via EGR1/Grem1 axis

Testing standards for AI-based scores in automated essay scoring

Recent developments in the field of artificial intelligence and machine learning allow the wide application of large language models for the evaluation of written text and other non-numerical data. When applied in the context of psychological and educational assessments, such models can be used for assigning scores to essays and other types of responses. In contrast to classical tests, essays do not consist of test items, which leads to specific challenges in the evaluation of testing standards for scores obtained from AI models that differ from those observed for classical ability tests and personality questionnaires. To address these challenges, we discuss the evaluation of validity, fairness, and reliability for scores obtained from models of artificial intelligence in the context of automated essay scoring. We review existing methods, propose new methods, and further illustrate the reviewed methods with an empirical example based on the Hewlett Foundation data set on automated essay scoring. By applying the proposed framework to an evaluation based on a DistilBERT model, we find the model to be robust with sufficiently high internal consistency (Spearman-Brown coefficients in the range from .77 to .92). We further found empirical evidence for the validity of the evaluation model, but also indications for violations of fairness when comparing the human and AI scores across different topics. This study provides a standardized, replicable toolkit for researchers and practitioners to evaluate the psychometric quality of AI-based assessments.

Overexpression of FEN1 promotes cervical cancer progression via upregulating PCNA expression

Barriers and levers to using an app for motor function assessment by therapists in hospitals: A qualitative study of the MFM-Play app

Background The Motor Function Measure (MFM) is an important evaluation tool used to monitor the progression of most neuromuscular diseases. However, the MFM is subject to inter-rater variability, and patients must produce their best effort, which can be difficult for children. In response to these issues, we developed a digital app named MFM-Play, designed to optimise completion of the MFM in a fun manner. The objective of this study was to explore barriers and levers to the MFM-Play’s use by therapists. Method We conducted a qualitative study with rehabilitation professionals who had tested the app in a previous reliability study. Individual interviews based on the Technology Acceptance Model were followed by a focus group based on the interview results. Thematic analysis was performed on transcripts. Results Seven therapists participated in the interviews and seven others in the focus group. The results revealed the multi-dimensional features related to adopting the MFM-Play app. Barriers related to ease of use, training and organisational constraints were identified, and were partly due to the additional mental burden of learning to use the technology. However, therapists who were at ease with the digital tool found it useful for their practice. The app also modified patient-therapist dynamics, fostering greater patient autonomy, but sometimes disrupted therapists’ habits, by calling into question assessment methods. Conclusion The MFM-Play app offers considerable practical and efficiency benefits; however, its successful adoption depends on overcoming technical, organisational, and user-specific barriers. This involves providing support for the change in the therapist’s stance within the triadic patient-therapist-tablet relationship.

Physics-guided deep representation learning for SEM-based pollen classification via morphology-aware hybrid feature integration

Herbal medicine use disclosure, database-flagged potential herb-drug interactions, and inter – interaction database concordance among patients with non-communicable diseases in Vietnam: A multicenter cross-sectional study

Background The widespread use of herbal medicines in clinical practice, particularly in Southeast Asia, presents significant challenges for medication safety management, notably regarding interactions between herbs and conventional drugs. Current drug interaction screening tools demonstrate substantial gaps in documenting herb-drug interactions, especially for regionally specific medicinal plants, creating potential risks for patients receiving concurrent therapies. Aim (1) to identify the prevalence of potential herb–drug and herb–herb interactions and the disclosure rate of HM use in patients with NCDs; and (2) to assess the consistency of interaction information across commonly used drug interaction databases. Methods An observational study enrolled 658 patients with non-communicable diseases from two Vietnamese tertiary care facilities. Structured interviews captured herbal medicine utilization patterns, disclosure practices, and specific botanical preparations used. Potential herb-drug and herb-herb interactions were systematically evaluated using four databases: Micromedex®, UpToDate Lexicomp Drug Interactions, Medscape Drug Interaction Checker, and Stockley’s Herbal Medicines Interactions. Inter-database agreement was assessed using Fleiss’ kappa statistics. Results 48.6% of participants reported active herbal medicines use, with 96% failing to disclose this to their healthcare providers. Potential interactions were identified in 31.3% of herbal medicine users, representing 15.2% of the total cohort. Database concordance was remarkably poor, with only 0.7% of interactions consistently documented across all four resources (Fleiss’ κ = –0.0653; p < 0.001). Multiple indigenous medicinal plants commonly used by patients were absent from all evaluated databases. Conclusion The substantial prevalence of undisclosed herbal medicine use, alongside inadequate representation in drug interaction databases, represents a critical gap in medication safety infrastructure. These findings demonstrated the necessity for integrating herbal medicine assessment into routine care, enhanced provider training, and expansion of clinical decision support systems to include region-specific botanical data for populations using concurrent traditional and conventional therapies.