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Exploring the potential of blood and urine protein electrophoresis in predicting 1-year mortality in acute kidney injury

This retrospective cohort study aimed to assess the predictive value of protein fractions obtained from blood and urine protein electrophoresis, along with various clinical and laboratory parameters, for 1-year all-cause mortality in acute kidney injury (AKI) patients. Data were collected from hospitalized patients who had been diagnosed with AKI. Demographics, smoking status, blood and urine electrophoresis results, serum gamma globulin levels, monoclonal gammopathy status, immunofixation results, serum free kappa (κ) and lambda (λ), and urine κ and λ levels were measured in addition to routine biochemistry and complete blood counts. In addition, serum free κ-to-λ ratio and urine κ-to-λ ratio were calculated. The primary endpoint was 1-year all-cause mortality and its association with electrophoresis-obtained data. Among the 295 patients included in the analyses, 65 (22.03%) experienced mortality, with higher mean age (72.75 ± 13.51) compared to the survival group (62.58 ± 16.59) (p < 0.001). Sex distribution showed no significant difference between groups. No significant disparities were observed in electrophoresis parameters and other laboratory values. Multivariable logistic regression showed that high age (OR: 1.038, 95% CI: 1.016–1.062, p = 0.001) and low albumin (OR: 0.450, 95% CI: 0.263–0.770, p = 0.004) were independent predictors of mortality. We find that the evidence gathered in the present study is insufficient to recommend the use of blood and urine protein fractions for diagnostic or prognostic purposes in patients with AKI. Nonetheless, the current data showing some notable variations in urine κ and λ levels suggest that further studies are warranted to explore this relationship.

Telomere length as a biomarker for cumulative experience in broiler chickens

Cumulative experience can be defined as the sum of all positive and negative experiences during an animal’s lifetime. Telomere length shows promise as a biomarker of cumulative experience in humans and non-human animals but is not yet assessed for broiler chickens. Therefore, our objective was to determine telomere length changes due to positive and negative experiences in fast-growing broiler chickens. In three replicated experiments, male Ross 708 broilers were housed in a 2 × 2 factorial study investigating high environmental complexity as a positive environment (vs. low complexity; 6 pens/treatment) and high stocking density as a negative environment (vs. low density; 6 pens/treatment). Telomere length was quantified at day 48 of age via quantitative RT-PCR (qRT-PCR) from gonad and kidney samples (N = 9 samples/treatment/tissue/experiment). Prior to analysis, raw relative telomere length (rTL) values were z-transformed to allow comparison between experiments. Combined data from the three experiments were analyzed using mixed models with complexity, density, and their interactions as fixed factor and pen nested within experiment and qRT-PCR plate number as random factors. Over all three trials, birds housed in high complexity environments tended (P = 0.0503) to have longer telomeres from kidney tissue than birds housed in low complexity environments. Stocking density did not impact combined kidney telomere length and gonadal telomere length was not impacted by environmental complexity or stocking density. Longer telomeres (statistical trend) in response to positive experience (environmental complexity) when compared to low-complexity indicate that high-complexity environments elicited positive cumulative experience in broiler chickens, although effect size was small. Telomere length has the potential to be a valuable tool in the assessment of cumulative experience in production settings, and future works should replicate these findings and expand upon this work by comparing telomere length with other more traditional animal welfare markers.

Assessment of patient safety culture among healthcare employees in major Eswatini public hospitals

This primary study assessed the patient safety culture in five major public government hospitals in Eswatini. A cross-sectional survey was conducted among hospital employees using the validated Hospital Survey on Patient Safety Culture (HSOPSC) developed by the Agency for Healthcare Research and Quality (AHRQ). The average positive patient safety culture (PSC) score was 43%. The highest-rated composite was “teamwork within units” (75%), while the lowest-rated was “staffing” (25%). All 11 PSC composites scored below the 2018 AHRQ survey benchmarks. These findings underscore the need for significant improvements in PSC across Eswatini’s hospitals. Additionally, the study revealed a lack of robust patient safety reporting systems in the five hospitals, which hinders efforts to address safety issues and reduce medical errors.

Statin adherence improves with age and subsequent treatment sequences: A retrospective cohort study using Proportion of Days Covered (PDC)

Background Dyslipidaemia is a key risk factor for atherosclerotic cardiovascular disease (ASCVD), necessitating effective statin therapy. Despite statins’ proven safety and efficacy, adherence remains suboptimal, with significant gaps between clinical practice and guideline recommendations. Methods This retrospective cohort study analysed anonymized health administrative claims data from six employee health funds in the Czech Republic, covering approximately 40% of the insured population from January 1, 2017, to December 31, 2020. We identified statin-incident as well as prevalent cohort of patients. Adherence to statin therapy was assessed using the proportion of days covered (PDC) metric, with factors such as age, gender, sequence of use, and treatment intensity considered as modifiers. Results Among the statin-prevalent cohort (SP, n = 890,180), 83.5% achieved a PDC ≥ 50%, and 61.0% reached a PDC ≥ 80%. In the statin-incident cohort (SI, n = 287,871), a clear trend of increasing adherence with age and medication sequence was observed: in adults aged 18–39 median PDC rose from 84.1% (IQR: 57–100) in the first to 94.7% (IQR: 75.6–100) in the third sequence; in those aged 80 + median PDC rose from 95.0% (IQR: 68.9–100) in the first to 100% (IQR: 78.3–100) in the third sequence. Logistic regression identified age (OR=1.011 per year), female gender (OR=0.896), high-intensity treatment (OR=0.975), and second (OR=1.267) or later treatment sequences (OR=1.704) as significant predictors of adherence (all p < 0.001). Conclusion Adherence to statin therapy improves with subsequent treatment sequences and age. These findings highlight the need for targeted interventions to enhance adherence, particularly among younger patients. The PDC metric is recommended for integration into clinical practice to monitor and improve medication adherence.

Harnessing enzyme promiscuity of alditol-2-dehydrogenases for oxidation of alditols to enantiopure ketoses

Several alditol-2-dehydrogenase enzymes from the short chain dehydrogenase (SDR) family catalyze the production of enantiopure rare ketoses from alditols as substrates and are used in biotech industry. Clearly, the absolute configuration of the internal chiral carbons in the open-chain conformation of alditols provides the structural basis for the enzymatic operation. This also allows for substrate ambiguity that manifest as enzyme promiscuity due to partial stereoselectivity of the enzyme. The issue is to make the right choice of a promiscuous enzyme and access maximum product diversity. Based on the absolute configuration of a cohort of ten enantiopure hexitols, this study is a systematic exploration of the stereochemical foundation of enzyme promiscuity in alditol-2-dehydrogenases which does not involve any kinetic analysis. Using cell-free expressed galactitol-2-dehydrogenase (G2DH), D-sorbitol-2-dehydrogenase (D-S2DH), and D-altritol-5-dehydrogenase (D-A5DH), we confirmed chemoenzymatic synthesis of all enantiopure ketohexoses through characterization by GC/MS and NMR spectroscopy. However, we found that enzyme promiscuity is beyond the partial stereoselectivity for certain alditol-2-dehydrogenase enzymes that are reliably producing enantiopure ketoses from multiple alditols. For instance, G2DH oxidizes galactitol (2R 3S; 55% conversion), a meso-alditol with a plane of symmetry, as well as L-talitol (2S 3S; 2.1% conversion) to L-tagatose. The substrate bears different absolute/relative configurations and is an example among several promiscuous oxidations. Notably, their product yields are different under similar reaction conditions indicating stereochemical preference of the enzyme. This in vitro chemoenzymatic investigation of the underlying stereochemical interplay for the enantioselective oxidation of alditols explores the potential to harness enzyme promiscuity/substrate-adaptability as a tool for the predictive synthesis of multiple enantiopure ketoses. This study focuses on unconventional stereochemical investigation into enzyme stereospecificity and promiscuity which precludes kinetic analysis. Given the role of enzyme promiscuity in evolutionary processes, systematic stereochemical analysis may prove crucial in future.

Correction: Association of electronic learning devices and online learning properties with work-related musculoskeletal disorders (WMSDs): A cross-sectional study among Thai undergraduate students

High school science fair: What students say—mastery, performance, and self-determination theory

Most high school students indicate that participation in science and engineering fairs (SEFs) increased their interest in science and engineering (S&E). The underlying appeal of SEF participation is unknown. However, having this information will help to identify best practices leading to more effective student participation and successful outcomes. To learn more about the appeal of SEF participation, we incorporated into our national SEF surveys a free text Reason Why? question asking students the reasons why SEF participation increased or not their interest in S&E. In this paper, we report and analyze the positive and negative comments by 1191 students who participated in our surveys during 2021−22 and 2022−23 and provided free text reasons. The positive reasons that students mentioned most frequently were learned new things; experience doing research; enjoyed/fun experience; and career choice. The negative reasons most frequently mentioned were participation not fun/stressful/boring; not a good project; not interested in science; and required to participate. Overall, students who received coaching and help from scientists made the most positive comments, consistent with our finding that students who received these kinds of help achieved better SEF outcomes. Students who participated in school-only level SEFs made the most negative comments. Reasons students gave why SEF participation increased their interest in S&E aligned with mastery criteria. By contrast, reasons students gave in a previous study regarding why competitive SEFs should be required aligned with performance criteria. Mastery and performance orientations (learning vs. winning) integrate differently with the three elements of self-determination theory: motivation, competence and community engagement. Recognizing these differences in relation to science fair requirements and the S&E career interests of students who participate in SEFs has the potential to enhance the impact of SEF participation on student STEM interest and knowledge.

Inadequate lumbar protection with load weight limits based on body weight percentages: An experimental and simulation study of the weight limits set by the Japanese guidelines for preventing low back pain

Work-related low back pain is the most prevalent occupational disease in Japan, with 25% of cases resulting from manual handling of heavy loads. The Ministry of Health, Labor and Welfare of Japan has issued guidelines limiting load weights based on the worker’s body weight percentage: 40% of the body weight for males and 24% for females. This study aimed to evaluate the effectiveness of these weight limits in preventing excessive lower back strain and identify potential shortcomings. A total of 20 healthy participants (10 males and 10 females) were included in this study. The motions of the participants while holding loads at specific positions and lifting loads from the floor were recorded using a three-dimensional motion analysis system. The compressive force on the L5-S1 intervertebral disc (IVD-CF) was estimated by simulations using inverse dynamics analysis. The body weights for the musculoskeletal models were set at 50, 70, and 90 kg for males and 40, 55, and 70 kg for females, representing the light, average, and heavy body weights of Japanese workers. The load weights were set at 40% of the body weight for males and 24% for females. Increased body weight led to higher IVD-CF in males, exceeding the safe limit of 3400 N. Additionally, light-weight males experienced excessive strain when holding loads at shin height or lifting from the floor. The IVD-CF for females was lower than that for males because of their lighter body weight and load weight. However, heavy-weight females experienced excessive strain when holding loads at low and distant positions and during lifting. These findings indicate that weight limits based on body weight do not adequately prevent excessive lower back strain, and the nature of the task should be considered to avoid lower back strain.

AI, peer review and the human activity of science

A targeted approach for multiplex detection of respiratory viruses in cases with severe acute respiratory infections by nanopore sequencing

Severe acute respiratory infection (SARI) remains one of the leading causes of morbidity and mortality worldwide. Multiple viruses can cause this infection. Sequencing technologies hold great promise for detecting viral pathogens. This proof-of-concept study aimed to develop and validate a new method for multiplex detection and typing of SARI-related viruses (SARS-CoV-2, Influenza A (H1N1, H3N2), Influenza B, human respiratory syncytial virus, human adenoviruses, human enteroviruses, and human parainfluenza viruses) using a nanopore next-generation sequencing method. Following genome extraction from oropharyngeal swab samples and conventional RT-PCR assays, the libraries were barcoded and sequenced by the MinION device. The sensitivity and specificity were assessed using various serial dilutions of samples and different primer pools, respectively. Data analysis was carried out using bioinformatic tools. Finally, the protocol was validated with known positive samples. All participants provided written informed consent. During 12 hours of MinION sequencing, 711,000 reads passed the quality filters (Q-score>7). Eleven out of 12 target genes were successfully identified in clinical samples, with more than 90% coverage for most viruses. All viruses were detected by a Q30 value of more than 1%. The detection limit was measured for SARS-CoV-2, Influenza A (H1N1, H3N2), Influenza B, and human respiratory syncytial virus. The method showed 99.9% specificity in detection and was validated by 20 clinical samples. This study developed and validated a novel multiplex detection approach of Oxford Nanopore Technologies that allowed the identification of SARI-related respiratory viruses in a clinical laboratory setting.

“All I want is to be involved in my treatment”: Experiences of HIV treatment and viral load monitoring among adolescents, young adults and healthcare providers in Tanzania

Background Virologic response is the earliest indicator of HIV treatment, making it the gold standard in monitoring treatment response. This study explored experiences and challenges of HIV treatment and viral load (HVL) monitoring among adolescents and young adults (AYA), parents or guardians of young adolescents and healthcare providers (HCPs). Methods This was a qualitative study conducted between March and May 2022 in five health facilities in an urban setting of Tanzania. We performed 20 in-depth interviews (IDIs) with AYA who had full HIV-positive status disclosure, 8 IDIs with parents or guardians of young HIV-infected adolescents, and five focus group discussions (FGDs) with 30 HCPs. The IDIs and FGD transcripts were translated from Swahili into English, transcribed, coded, and performed thematic analysis using NVivo software. Results AYA demonstrated an understanding of HIV treatment as lifelong and, most knew the benefits of HIV viral load (HVL) monitoring. It was apparent that 60% of older adolescents (15–19 years), parents or guardians, and young adults (20–24 years) discussed HVL results with HCPs and, the majority desire to be involved in their HIV treatment. HCPs reported that missing clinic appointments among AYA attending boarding schools or college contribute to delays in HVL testing and initiation of enhanced adherence counselling (EAC). Notably, HCP faced challenges recalling AYA who received three to six multi-month anti-retroviral drug (ARV) refills when their HVL results were high (VL ≥ 1000 copies/ml). Conclusions More than half of AYA expressed ownership in their HIV treatment; they discussed the meaning of their HVL results with HCPs. Additionally, AYA reported non-frequent challenges in HVL testing however, HCPs described missing appointments for AYA on three to six multi-months dispensing of ARVs as major challenges for implementing HVL testing. Importantly multi-months ARV dispensing in AYA needs program evaluation to inform the best implementation modality to support viral suppression.

Correction: Forecasting outbound student mobility: A machine learning approach

A deep learning based approach for classifying the maturity of cashew apples

Over 95% of cashew apples are left to waste and rot on the ground. However, both cashew nuts and the often overlooked cashew apples possess significant nutritional and economic value. The cashew apple constitutes the major part (90%) of the cashew fruit, with the nut forming a modest portion (10%). Cashew nuts can be harvested and processed even after lying on the ground, but cashew apples are more delicate. Assessing the maturity status of these apples still requires human visual observation due to the challenges posed by their moisture content. Timely harvesting is crucial, as the pseudofruit is prone to microbial infections upon hitting the ground, making the process time- and labor-intensive. In this study, a Deep Learning based image classification model is presented, which can be used to automatically identify mature cashew apples. The model achieved an accuracy of 95.58% in classifying the cashew apples (immature vs. mature). Overall, the results highlight the potential of Deep Learning models for the classification of cashew apples and other fruits for precision agriculture purposes. This approach could enhance the harvesting process by enabling the utilization of the entire fruit and reducing the need for manual labor, thereby unlocking the full economic potential of the cashew tree.

Continuum of maternal health care utilisation in Sub-Saharan African countries: A positive deviance approach

Introduction Maternal health is a global priority for achieving Sustainable Development Goal 3.1. However, many mothers in Africa still lack access to the full continuum of care for maternal health (continuum of care). The lowest coverage is often observed among underserved mothers, particularly those who are uneducated and from poor households. Despite these disadvantages, some mothers in every community find effective ways to access a better continuum of care – these are known as positive deviants. However, there is limited evidence to support this concept. Therefore, this study examined the determinants of continuum of health care utilisation among underserved mothers in sub-Saharan African countries. Methods Data from the Demographic and Health Surveys of 15 Sub-Saharan African countries with high maternal mortality ratio were used. A positive deviance approach was applied to identify 32,778 underserved mothers using a two-stage stratified sampling technique for the final analysis. A multilevel mixed-effect binary logistic regression analysis was conducted to identify factors associated with being a positive deviant. Finally, an adjusted odds ratio (AOR) with a 95% confidence interval (CI) was used to declare statistically significant determinants. Results The overall continuum of care utilisation among underserved mothers was 13.8% (95% CI: 13.5–14.2%). Underserved mothers who were employed (AOR = 1.2; 95% CI: 1.1–1.3), those who had educated husband (AOR = 1.3; 95% CI:1.2–1.4), had one to three children (AOR = 1.2; 95%CI: 1.1–1.3), had a history of pregnancy termination (AOR = 1.3; 95%CI: 1.1–1.4), had the healthcare decision making autonomy (AOR = 1.2; 95% CI: 1.1–1.3), and faced no barriers to accessing health services (AOR = 1.2; 95% CI: 1.0–1.2) were significantly associated with being a positive deviant. Conclusion Despite socioeconomic disadvantage, a subset of underserved mothers in sub-Saharan Africa successfully utilised the full continuum of maternal healthcare. Key enabling factors included maternal employment, partner education, smaller family size, prior pregnancy termination, autonomy in healthcare decision-making, and absence of access barriers. These findings support the positive deviance approach as a valuable lens for identifying actionable pathways to improve maternal health coverage. Interventions that amplify these enabling factors could help close equity gaps and accelerate progress toward maternal health targets in high-burden settings.

Dinitrogen Activation and Cyanide Release by the Gas-Phase Cluster Anions InNbC₂^–: Synergistic Effects of the p-Block Indium and the d-Block Niobium

Assessment of the genetic diversity of Atlantic bottlenose dolphin (Tursiops truncatus) strandings in the Mississippi Sound (USA)

The common bottlenose dolphin ( Tursiops truncatus ) is a key marine mammal species in the Gulf of Mexico, playing an essential role as a top predator. This study investigates the genetic diversity and population structure of bottlenose dolphins stranded in the Mississippi Sound from 2010 to 2021. Tissue samples (muscle, liver, lung, kidney, and brain) were collected from 511 stranded dolphins, and mitochondrial DNAs (mtDNA) were extracted for analysis. A total of 417 samples were successfully amplified and sequenced using high throughput sequencing, yielding 386 complete mitogenomes. Genetic diversity metrics, such as nucleotide and haplotype diversity, were calculated, and population structure was inferred for both mitochondrial control region (mtCR) and whole mitogenome sequences. Using the whole mitogenome, the study identified four genetically distinct populations within the Mississippi Sound, demonstrating regional variation in dolphin populations. Notably, two stranded individuals likely originated from populations outside the sampled area. The use of whole mitogenomes allowed for improved resolution of genetic diversity and population differentiation compared to previous studies using partial mtDNA sequences. These findings enhance our understanding of bottlenose dolphin population structure in the region and underscore the value of stranded animals for population genetic studies.

Perceptions of women and their partners on postabortion intrauterine contraception: A qualitative study in central Uganda

Background The uptake of intrauterine devices (IUDs) has stalled below two percent among married Ugandan women. We explored the perceptions of women and their partners on the utilization of postabortion IUDs after medical management of incomplete abortions in central Uganda. Methods Between August 2022 and May 2023, using a semi-structured interview guide, fifteen in-depth interviews were conducted among Ugandan women and their partners at five public facilities on their perceptions in regards to postabortion IUDs. Using inductive content analysis, themes and subthemes were generated. Results Three themes emerged: 1) perceived women’s and their partners’ barriers in accessing postabortion IUDs such as myths and misconceptions on IUDs, spouse refusal, IUD related side effects. 2) women’s and their partners’ experiences while using postabortion IUDs such as increased lubrication, freedom from prior contraceptive side effects, assurance of early return to fertility after IUD removal, menstrual irregularities and abdominal pain following IUD insertion. 3) motivators and recommendations to the uptake of IUDs such as peer influence, client-healthcare provider relationship, spousal approval of IUDs and community sensitization on IUDs using social media platforms. Conclusion Understanding the socio-cultural context of women and their partners, is pivotal in the uptake of postabortion IUDs. Healthcare providers ought to provide evidence-based counselling to demystify individual and community misconceptions on IUD use. Male partner involvement, the assurance of early return to fertility after IUD removal, user champions, and social media platforms can enhance the uptake of postabortion IUDs.

Pressure-Induced Dome-Like Superconductivity and Unusual Charge-Density-Wave-Like Transition in Th₂Cu₄As₅

The opportunity to save a life: A qualitative study of a point-of-care overdose education and naloxone distribution intervention

Canada’s opioid crisis continues to escalate. Naloxone can effectively reverse the effects of opioid overdose. We planned a randomized trial on the effectiveness of a point-of-care overdose education and naloxone distribution (OEND) intervention on participants’ performance in a simulated opioid overdose scenario. In preparation for the trial, we conducted a feasibility study which included a qualitative process evaluation aimed at eliciting participants’ perspectives of the study’s OEND tool and procedures, and how their lived experiences of the opioid crisis intersected with their experiences of the study. Twenty-three participants were interviewed, including people with lived experiences of opioid use or overdose, and people living in neighbourhoods or working in services where they were likely to encounter overdose. Thematic analysis of interview transcripts was informed by stigma theory. Participants’ accounts depicted challenges faced by people who take opioids in their everyday lives, deep losses experienced, negative attitudes encountered, and systemic barriers to care. Participation in the study itself was portrayed as meaningful. We explored participants’ experiences through three key themes: (1) who were the participants – describing their experiences related to opioid overdose, opioid use and attendant stigma; (2) why did they participate – recounting their motivations to join the study; and (3) what they thought about study processes – reflecting on the OEND materials and study procedures. Accounts revealed a sense of agency as participants confronted the opioid crisis. Our results demonstrate that people experiencing opioid use and overdose and people who care about them are eager and willing to be approached about research at point of care; participants were eager to learn overdose prevention skills and to return for follow-up study sessions. They recounted a range of motivations for participating, the most important of which is the opportunity to actively intervene, save lives and raise awareness. Trial Registration: ClinicalTrials.gov registry (NCT03821649)

Temperature Variation of the Local Structure and Dihydrogen Bonds in Ammonia Borane