Browse Articles

Boomerang and bones: Refining the chronology of the Early Upper Paleolithic at Obłazowa Cave, Poland

Beginning with the Early Aurignacian, Homo sapiens demonstrated an enhanced symbolic capacity, expanding artistic expressions from body decoration to portable art and aesthetically refined tools. These artistic endeavors, often intertwined with utilitarian purposes, have sparked debates regarding their symbolic versus functional roles. Among these remarkable artifacts is a complete mammoth tusk boomerang from Layer VIII of Obłazowa Cave, Poland, found in association with a human phalanx. Determining its precise chronology and cultural context is critical for understanding the emergence and variability of symbolic behaviors among early Homo sapiens groups in Europe. This study refines the chronology of the Early Upper Paleolithic occupation of Layer VIII at Obłazowa Cave through radiocarbon dating of several bones and the human fossil found near the ivory boomerang. Bayesian modeling places the site’s main occupation phase between 42,810−38,550 cal BP (95,4% probability). The mammoth-ivory boomerang, calibrated to 42,290−39,280 cal BP with a 95.4% probability, emerges as one of Europe’s oldest known examples of this complex tool, exemplifying technological and symbolic innovation at Obłazowa Cave. This multi-disciplinary research underscores the importance of integrating advanced methodologies to explore cultural practices during the Upper Paleolithic. The findings not only deepen our understanding of Homo sapiens’ adaptive strategies but also highlight the nuanced interplay of technology, symbolism, and environmental interaction during the earliest phases of human dispersals in Central Europe.

Association of microtubule destabilization with platelet yields in terminally differentiating hiPSC-derived megakaryocyte lines

Millions of platelet units are needed each year to manage thrombocytopenia and other conditions linked to excessive bleeding. These life-saving treatments still depend entirely on donated platelets, despite the numerous shortcomings associated with them, such as limited shelf life, supply shortages, unpredictable functionality, potential for infection, as well as immune-incompatibility issues. These challenges could be overcome with universal donor platelets generated from human induced pluripotent stem cell (hiPSC)-derived megakaryocytes (MKs). We recently developed expandable hiPSC-derived megakaryocytic cell lines (imMKCLs) as a potentially unlimited source for platelet production. imMKCL-derived platelets are functional and have already been tested in patients. In this study, we demonstrate through single-cell time-course imaging that imMKCL maturation is heterogeneous and asynchronous, with only a few imMKCLs generating platelets at any given time under static culture conditions. Using a chemical screen, we identify microtubule (MT) destabilizing agents, including vincristine (VCR), as promising hits, with a larger proportion of VCR-exposed imMKCLs developing proplatelet extensions and more platelets being produced per imMKCL. VCR use reduces the MT content of imMKCLs and results in the production of platelets with a diminished peripheral MT ring structure. Nevertheless, these platelets are functional, as evidenced by their normal response to agonists, their ability to attach to and spread on fibrinogen-coated surfaces, and their capacity to restore hemostasis in vivo. Interestingly, we also observed a negative correlation between the MT content of imMKCLs and platelet yields when we compared imMKCLs differentiated under static conditions (MThigh, low yield) to our turbulence-optimized VerMES™ bioreactor (MTlow, high yield). Taken together, our findings highlight the importance of MT dynamics in megakaryocyte biology, provide a possible explanation for the still poorly understood link between vinca alkaloid in vivo use and thrombocytosis, and bring us closer to realizing the clinical potential of affordable, off-the-shelf hiPSC-derived platelets.

Atomic-Scale Dynamics of Five-Fold Twin Mediated Coalescence: Pathway-Dependent and Defect-Governed Nonclassical Growth Mechanisms

Altiplano agricultural origins was a process of economic resilience, not hardship: Isotope chemistry, zooarchaeology, and archaeobotany in the Titicaca Basin, 5.5-3.0 ka

Prevailing models of agricultural origins tend to envision that economic hardship drove the transition from foraging to farming economies. Growing human populations and the depletion of high-ranked animal resources forced humans into increasingly intensive and dependent relationships with plant foods. Current evidence from the Andean Altiplano (High Plateau, 3800 masl) identifies the Terminal Archaic Period (5.0–3.5 cal. ka) as the period of economic transition from Archaic foraging economies to Formative Period agro-pastoral economies. Consistent with models of agricultural origins, isotope chemistry (δ13Ccollagen, δ13Capatite, δ15Ncollagen) of human bone samples from 16 individuals from the Terminal Archaic sites of Kaillachuro and Jiskairumoko (5.3–3.0 cal. ka) indicates that C3 plants comprised approximately 84% of the dietary protein. Archaeobotanical data show that chenopods may have been the most important subsistence resource, and zooarchaeological remains indicate that protein was derived from camelid meat. Inconsistent with the working model of plant intensification, the Terminal Archaic diets reported here are statistically indistinguishable from previously published values of Early—Late Archaic (9.0–6.5 cal. ka) individuals in the same region, which also show approximately 84% of protein coming from plants. Rather than being a process of dramatic dietary change and economic hardship, the agricultural transition on the Altiplano appears to have been one of remarkable resilience in which plant:meat ratios remained relatively stable over six millennia, spanning the transition from Archaic foraging and hunting to Formative farming and herding economies. Plant and animal domestication on the Altiplano thus represents a process of economic sustainability rather than one of food insecurity and hardship, as many prevalent agricultural origins models would suggest.

How does mindfulness training affect attention and penalty kick performance in university football player

Athletes often struggle to maintain attentional focus and performance consistency under pressure, particularly during high-stakes tasks like penalty kicks. This study examined the effects of brief mindfulness training on visual attention behaviors and penalty kick performance among university football players under non-pressure and pressure conditions. The study comprises two experiments: Experiment 1 was conducted in non-pressure conditions, whereas Experiment 2 involved pressure condition. Each experiment involved 40 participants, who were randomly assigned to either the intervention group or the control group. The intervention group underwent 15 minutes of brief mindfulness training, while the control group engaged in 15 minutes of quiet sitting. Eye-tracking technology was used to measure fixation count and fixation duration during the penalty kick tasks. In non-stress conditions, the mindfulness group showed a significant increase in fixation duration and fixation count, with no change in penalty kick performance. In pressure conditions, the mindfulness group again showed significant gains in fixation duration and fixation count, but penalty kick scores did not significantly improve. Comparisons across stress conditions revealed that fixation duration improvements were larger under pressure, suggesting mindfulness may enhance attentional stability when athletes are under stress. In conclusion, brief mindfulness training can enhance visual attention behaviors in university football players, especially under pressure, by promoting sustained focus on task-relevant visual targets.

Assessment of testicular self-examination awareness and practice among adult males in Ajman, United Arab Emirates: A cross-sectional study

Introduction Testicular cancer (TC) is one of the most common cancers affecting men between the ages of 15 and 40 years. Testicular self-examination (TSE) is an effective tool for the early detection of TC, significantly improving survival rates. This study aimed to assess the level of awareness and practice of TSE among adult males in Ajman, United Arab Emirates (UAE). Methods A descriptive cross-sectional study was conducted among 1031 adult men residing in Ajman, UAE, using a structured self-administered and interviewer-administered questionnaire. Descriptive statistics were used to summarize the data, and Chi-square tests were applied to assess associations between awareness and practice of TSE with socio-demographic variables. Results The mean age of participants was 34.9 ± 9.8 years. Overall, 212 participants (20.6%) reported being aware of TSE. Among those who were aware, 106 individuals (50%) reported practicing TSE. Conclusion The findings highlight a low level of awareness and practice of TSE among men in Ajman. There is a critical need for targeted health campaigns and educational interventions to promote knowledge and practice of TSE. Healthcare providers should play a proactive role in raising awareness about TC and the importance of regular self-examination for early detection.

Seasonal and periodic patterns of PM2.5 in Manhattan using the variable bandpass periodic block bootstrap

Air quality is a critical component of environmental health. Monitoring and analysis of particulate matter with a diameter of 2.5 micrometers or smaller (PM2.5) plays a pivotal role in understanding air quality changes. This study focuses on the application of a new bandpass bootstrap approach, termed the Variable Bandpass Periodic Block Bootstrap (VBPBB), for analyzing time series data which provides modeled predictions of daily mean PM2.5 concentrations over 16 years in Manhattan, New York, the United States. The VBPBB can be used to explore periodically correlated (PC) principal components for this daily mean PM2.5 dataset. This method uses bandpass filters to isolate distinct PC components from datasets, removing unwanted interference including noise, and bootstraps the PC components. This preserves the PC structure and permits a better understanding of the periodic characteristics of time series data. The results of the VBPBB are compared against outcomes from alternative block bootstrapping techniques. The findings of this research indicate potential trends of elevated PM2.5 levels, providing evidence of significant semi-annual, tri-annual, and weekly patterns missed by other methods.

Gender differences in trunk appearance perception and health-related quality of life (HRQoL) in the patients with moderate adolescent idiopathic scoliosis (AIS) undergoing orthotic treatment: An observational study

Background Orthotic treatment is commonly used as a non-surgical intervention for managing moderate adolescent idiopathic scoliosis (AIS). Although prior studies have evaluated various factors influencing health-related quality of life (HRQoL) in the patients with AIS, the association between trunk appearance perception and HRQoL, including potential gender differences, remains insufficiently defined. This study investigated gender differences in trunk appearance perception and its relationship with QoL among the patients with moderate AIS undergoing orthotic treatment. Methods Patients with moderate AIS undergoing orthotic treatment were included, and HRQoL evaluations were conducted before treatment, as well as one and seven months after the initiation of orthotic treatment. The evaluation tools included the Trunk Appearance Perception Scale (TAPS), Scoliosis Research Society-22r (SRS-22r), and Brace Questionnaire (BrQ). The study time points were selected to capture baseline conditions, initial adaptation, and longer-term treatment effects. Results A total of 34 females and 11 males participated in the study. No significant gender differences were observed in global HRQoL, with both groups consistently reporting low self-image and self-esteem. In females, increasing age was negatively correlated with TAPS scores, whereas in males, it showed a positive correlation. For females, higher compliance was associated with higher bodily pain scores on the BrQ (ρ = 0.417), indicating reduced pain levels. In contrast, among males, greater compliance was associated with poor trunk appearance perception after seven months (ρ = −0.619). While TAPS was unrelated to SRS-22r and BrQ in females, a more favorable trunk appearance in males was strongly related to better function and self-image scores on the SRS-22r after seven months (ρ = 0.614 and 0.703, respectively). Conclusion Trunk appearance perception and overall HRQoL were similar between females and males in this study. However, the score related to self-image was lower than other HRQoL domains.

Crossing chasms: A PLS approach to EU public sector performance assessment

This paper examines the dynamics of public sector performance across European Union (EU) countries through a comprehensive methodological framework. This study introduces the European Public Sector Performance Index, a novel approach that employs Partial Least Squares (PLS) econometric modelling and cluster analysis to evaluate public sector performance from 2007 to 2021. By assessing performance across governance, social, and economic dimensions, the research captures the multifaceted nature of public sector efficiency in the EU. Our investigation reveals significant determinants of performance, including governance factors like Control of Corruption, Rule of Law, and Government Effectiveness, as well as economic indicators such as Inflation and social factors like Equity of access to healthcare services and Education Spending. These findings underscore the critical role of transparent governance, economic stability, and equitable social policies in enhancing public sector efficiency. Despite its reliance on secondary data and the PLS method, the study provides new methodological insights and empirical evidence on public sector performance, contributing to the literature with a holistic analysis that integrates digitalisation and well-being. This study’s holistic approach offers actionable insights for policymakers and stakeholders, emphasising the need for robust governance and equitable policies to improve public sector performance across the EU. The omission of certain societal components—such as economic conditions, demographic changes, or cultural factors—may result in a skewed representation of how digital transformation and governance interact. These external factors can significantly influence the effectiveness of digital initiatives and the overall performance of public institutions.

Experiences of Indigenous and ethnic minority women with culturally safe healthcare in Europe: A scoping review

Worldwide, Indigenous and ethnic minority women encounter discrimination in access to high quality healthcare and other advantageous social determinants of health. Cultural safety is the concept of proactively considering social, economic, and political situations, and power relationships in healthcare. By identifying ways in which culturally unsafe healthcare practices can intensify institutional discrimination and replicate traumatic experiences in historically oppressed populations, interventions may be crafted to improve patient experiences and outcomes. The purpose of this paper is to conduct a scoping review of research on experiences with culturally safe healthcare among adult Indigenous and ethnic minority women in Europe. All research articles within Europe, without set date parameters, addressing the experiences of individuals who self-identify as adult women or gender non-normative individuals who are members of Indigenous or ethnic minority communities were included. A total of four peer reviewed articles were identified for this scoping review. Participants in four studies described healthcare providers’ lack of knowledge of their culture and healthcare needs. The studies suggest that this lack of knowledge may lead to patient sentiments of inferiority, prejudice, increased barriers to access care, inadequate healthcare intervention and ineffective healthcare service. The articles propose the implementation of cultural safety to close the gap of health disparities in Indigenous and ethnic minority populations. There are limited data on the implementation of cultural safety in Europe, potentially indicating a lack of awareness regarding the concept of cultural safety or its core tenets, as well as regarding the importance of culture, racism and biases in healthcare related to ethnic minority populations. Overall, this scoping review reiterates the gap in research and knowledge in the implementation of culturally safe healthcare in Europe.

Deciphering the Nexus: Analysing Social Dynamics in Cybercrime Investigations through Interpretive Structural Modeling in Forensic Science

Cybercrime has evolved into a pervasive and multifaceted challenge, inÁuenced by an array of social factors that often confound traditional forensicmethodologies. This paper endeavors to identify and analyze key social factors contributing to cybercrime investigations within the domain of forensic science. Employing Interpretive Structural Modeling (ISM), this study delves into the intricate interrelationships among these social factors to provide a comprehensive understanding of their impact on cybercrime investigations. Through an exhaustive literature review, signi𿿿cant social factors inÁuencing cybercrime forensics areidenti𿿿ed and analyzed. Drawing upon empirical evidence and expert insights, an ISM model is constructed to visualize the complex network of interactions among these factors. The model serves as a valuable tool for elucidating the dynamics of cybercrime investigations and identifying areas for intervention and improvement. The 𿿿ndings of this study underscore the profound nÁuence of social factors on cybercrime investigations, shedding light on the complexities inherent in forensic analysis of digital crimes. By recognizing and understanding these social dynamics, forensic practitioners and law enforcement agencies can develop more effective strategies and methodologies for combating cyber threats and prosecuting cybercriminals.

Efficient preconditioning strategies for accelerating GMRES in block-structured nonlinear systems for image deblurring

We propose an efficient preconditioning strategy to accelerate the convergence of Krylov subspace methods, specifically for solving complex nonlinear systems with a block five-by-five structure, commonly found in cell-centered finite difference discretizations for image deblurring using mean curvature techniques. Our method introduces two innovative preconditioned matrices, analyzed spectrally to show a favorable eigenvalue distribution that accelerates convergence in the Generalized Minimal Residual (GMRES) method. This technique significantly improves image quality, as measured by peak signal-to-noise ratio (PSNR), and demonstrates faster convergence compared to traditional GMRES, requiring minimal CPU time and few iterations for exceptional deblurring performance. The preconditioned matrices’ eigenvalues cluster around 1, indicating a beneficial spectral distribution. The source code is available at https://github.com/shahbaz1982/Precondition-Matrix.

Advancing Artificial Intelligence in Criminal Investigation: AComprehensive Review and Future Directions

The willingness enables an electronic device or technology to accomplish projects that a human can do but faster and with fewer errors, like speech recognition, visual perception, cognitive thinking, decision-making, and experiential education, it is known as machine learning or Arti𿿿cial Intelligence (AI). The many recent areaof development that is utilized to improve the application of arti𿿿cial intelligence(AI) in the domains of scienti𿿿c investigation and the judicial system. Experts inScience of Crime and criminal investigation face many challenges today, including the deluge of data, the minute elements of testimony in the complex and chaotic conditions, the usual scienti𿿿c setups, and occasionally the ignorance that couldlead to a miscarriage of justice or an unsuccessful investigation. AI is the weapon of choice for overcoming various deep learning and machine learning-related problems. And to achieve such without error, impartial, and repeatable leads to in numerous forensics𿿿elds, neural networks have produced and ase-based easoning are utilized. These days, arti𿿿cial intelligence (AI) is helping ractically very well-known𿿿eld in forensic science and criminal investigation. It does this rough a variety of methods that include data extraction, statistical evaluation and probable techniques, machine learning, detection of patterns, image processing, machine learning, analysis of information, analytical and numerical methods, and pictorial modelling. Arti𿿿cial intelligence is assisting frensic ecialists and investigators by creating rational proof, creating three-dimensional reconstructions of scene of crime, ef𿿿ciently managing evidence, and asessing i to draw reasonable inferences at different stages of an examination. In addition to

Validating self-administration as an agile modality for high-frequency diet quality data collection

Data collection of diet quality is important to estimate global dietary transitions affecting public health. Mobile-phone based tools can provide a low-cost and rapidly deployable modality to complement enumerator-collected data. This study validated self-administration of the Diet Quality Questionnaire using mobile phones, comparing accuracy against enumerator administration, measuring both against an observed benchmark. Quantitative dietary intake data were gathered from 308 participants in northwest Rwanda, using a weighed food record. Intake data were used to calculated ‘observed’ responses to the questionnaire, half the participants responding to enumerators, and the other half using a mobile-administered version of the questionnaire. After filtering for low quality data, agreement in observed and reported responses, for all questionnaire questions, were statistically compared. Agreement rates (observed-reported) of self-administered and enumerated responses were high (91% vs 95%, p = 0.05), respectively. Agreement was significantly lower for the mobile-administered modality among older and lower income respondents (by about 5 percentage points), with no significant differences by gender or time of response. Mobile-administration cost approximately USD 0.70 per response, versus the marginal cost of USD 0.79 for the enumerator-administered. Our results confirm self-administered reporting by mobile-phone as a valid, low-cost method for collecting dietary data, with only marginal (yet significant for some subgroups) differences in agreement rates, compared to enumerated data. Data collection by mobile phone represents an agile complement to enumerated collection, administrable in the absence of existing survey platforms; and provides a useful option for high-frequency data collection to monitor dietary dynamics in target sub-populations.

Identification of Diatoms in the Different Water Bodies of Gorakhpur

In both forensic and medical-legal investigations, diatoms are an essential component of the evidence. The discovery of diatoms can shed light on whether the individual drowned before they passed away, or not. The purpose of this research was to determine which species of Diatom are present in the various bodies of water that are located in and around the Gorakhpur district of Uttar Pradesh, India. For the purpose of this study, water samples were gathered from three distinct categories of water bodies located in Gorakhpur. These categories include running rivers, still rivers, and drained rivers. The samples were stored in sterilized water bottles with tops that had a snug𿿿t. The procedure of Lugols iodine method s used o identify the diatoms from the water sample. Under a microscope with a camera in hand, each species of diatom is examined and photographed at the same time. 13 different diatom species were identi𿿿ed and their names are Pseudo-Nietzsche p, Epithemia sorex sp, Nitzschia linearis sp, Craticula sp, Bacillaria paxillifer sp, Cyclotella sp, Cembella sp., achnanthidium- minutissimum sp, Detonula sp, and many more sp. The results of this experiment will be useful in further research on diatoms, as well as in determining the locations of areas where crimes have been committed.

Elucidating the functions of gut microbiota from two edible dung beetle species: Implications for waste management and food industry

Dung beetle larvae are consumed globally, yet their gut microbiota across different geographical locations remains largely unexplored. This study examined the diversity and composition of the gut microbiota of two edible dung beetle species, Cetonia aurata and Rhinoceros beetle (Oryctes sp.), from three sites in Kenya. Using advanced molecular techniques, bacterial and fungal communities were sequenced. The most abundant bacterial phyla in C. aurata were Firmicutes (42.10%) and Bacteroidota (32.50%), while Oryctes sp. had higher levels of Proteobacteria (35.00%), Actinobacteriota (11.40%) and Desulfobacterota (7.40%). Fungal communities were dominated by Lecanoromycetes (92.60%) in Oryctes sp. and Saccharomycetes (92.60%) in C. aurata. Beta diversity analysis revealed that neither species phylogeny nor larval location significantly influenced the presence of specific microbes. Pathways related to nitrogen and carbon degradation were predicted in bacteria like Bacillus, Pseudomonas mosselii, and Proteiniphilum. This implies that bacteria and fungi from the gut of dung beetle larvae could be ideal targets for potential bio‐resource to eliminate waste pollution and opened an important window of opportunity for bio-based economy solutions. This work offers very practical solutions that have great business potential that can create a gigantic market ranging from functional foods to dietary supplements and therapeutic applications.

AI-Driven Forensic Palynology Advancements in Investigative Technology

Forensic palynology applies pollen grains and spores as trace evidence in scenes of crime. Identi𿿿cation by hand is labor intensive and subject to observer bias anderror. Major objective is to highlight a conceptual model for automating the analysis of pollen grains with imaging and arti𿿿cial intelligence (AI). Alab-basedsimulationstudy created from online available datasets and microscopic images of pollen grains. This study presents a conceptual model for automating pollen analysis through imaging and arti𿿿cial intelligence (AI). A lab-based simulationutilizedpublicly available microscopy datasets of 25 pollen species to develop a theoretical framework. The morphology of pollen grains and spores were assessed. The workÁow that was proposed consisted of: data acquisition, image pre-processing, image analysis, and dataset generation; and classi𿿿ed pollen grains andsporesusing arti𿿿cial intelligence models (Arti𿿿cial Neural Networks, Convolutional Neural Networks (CNN) and support vector machine (SVM). AI and automation present a signi𿿿cant number of possibilities to enhance the effectiveness andspeedof forensic palynology. There is a requirement for a properly curated dataset in the development for effective automated tools.

Land use and climate change-based multi-scenario simulation of ecosystem service trade-offs/synergies: A case study of the central Yunnan urban agglomeration, China

Exploring Land use and climate change-based multi-scenario simulation of ecosystem service trade-offs/synergies is of great importance to regional ecological security and sustainable development. Taking the Central Yunnan Urban Agglomeration (CYUA) as a case study, six different scenarios of LULC-RCP were established to quantitatively assess four key ecosystem services(ESs) of water yield (WY), carbon stock (CS), soil conservation (SR) and habitat quality (HQ) with multiple objective programming and patch-generating land use simulation(MOP-PLUS) and integrated valuation of ecosystem services and tradeoffs (InVEST) models. The ESs were revealed regarding spatio-temporal trade-offs/synergies using Spearman correlation and geographically weighted regression (GWR). It was found that: (1)the ESs in CYUA is characterized with high spatial heterogeneity in 2030; specifically, the distribution of WY and SR was low in the northwestern region and high in the southeastern region, while the distribution of HQ and CS was high in the western region and the periphery, and low in the eastern and central regions; (2) the trade-offs between WY-HQ, and WY-CS, and the synergies between WY-SR, HQ-SR, HQ-CS, HQ-CS, and HQ-SR; (3) under the six different scenarios, the spatial distribution of trade-offs/synergies between the four ESs was consistent: the SR-HQ, SR-CS, and WY-CS showed an overall weak synergistic relationship; the HQ-CS showed an overall weak trade-offs; the HQ-WY, CS-WY showed an overall weak synergistic relationship in the northern and southern areas and an overall weak trade-off relationship in the center. The findings of this study may provide a theoretical foundation for ecosystem management in CYUA and offer technical support for the evaluation of national land space.

Role of Titanium Dioxide Nanoparticles in Forensic Science

The use of science in the criminal justice system is known as forensic science. Justice is upheld through a proper analysis and assessment of the evidence. Due to factors like𿿿re, explosion, environmental changes, water, dirt, and any thers, crime scenes are usually damaged. The most reliable method of identifying a person is by their𿿿ngerprints, which is also one of the evidence types that are mst frequently found at crime scenes. The perpetrator frequently makes a concerted effort to destroy a𿿿ngerprint that contains crucial evidence. Due to their extreme ssitivity, nanoparticles are used to improve latent𿿿ngerprints on porous, semiporous, and nonporous surfaces. The problem wit the traditional 𿿿ngerprint development technique is that it is not that durable for a longer period of time. The particle size of the black powder and the other nano traditional powders are much more as compared to the size of the particles. In addition to adhesives, titanium dioxide (TiO2 ), a common paint pigment, can be suspended in a surfactant and utilized as a powder suspension to remove latent impressions from a variety of surfaces. It is a tiny, non-Áammable, non-toxic powder that is white in colo and smaer than one micron in diameter. AÁatoxin genes can be identi𿿿ed usin forsic genetics by adding silver and titanium dioxide nanoparticles to real-time PCR. It can also be used to detect explosives. Similarly, there are other applications as well. Therefore, this review paper will discuss the use of titanium dioxide nanoparticles in forensic research.

Cardiovascular health knowledge, attitude and practice among school-going adolescents and the availability of digital prerequisites for health education in Bhaktapur, Nepal

Background In Nepal, the proportion of annual deaths from cardiovascular disease (CVD) increased from 12% in 1990 to 22% in 2021. Although CVD manifests in adulthood, exposure to risk factors begins early in life. In Nepal, a high prevalence of risk factors combined with limited knowledge about cardiovascular health warrants a life course approach. One strategy could be a digitalized health education targeted at adolescents to prevent future CVDs. Methods We conducted a cross-sectional survey to assess adolescents’ knowledge, attitude and practice (KAP) regarding cardiovascular health and explored possibilities for digital education. In total, 649 adolescents in grades 8–10 from two public and seven private schools in a semi-urban community of Nepal were surveyed. A self-administered questionnaire assessed KAP, digital prerequisites such as mobile phone use and internet availability at home, and gaming behaviors. Quantile regression was performed to assess the relationship among the variables. Results The median scores were 69.1% (Interquartile range/IQR 63.1%–74.4%) for knowledge about cardiovascular health, 77.9% (73.3%–82.3%) for attitude and 76.7% (72.2%–81.1%) for practice. Quantile regression showed that the knowledge score for grade 9 adolescents was 4.2 percentage point (pp) higher (p < 0.001) and grade 10 adolescents was 4.0pp higher (p < 0.001) than those in grade 8. Knowledge was 4.9pp higher (p < 0.001) for private than for public school adolescents. Attitude scores were 2.0pp higher (p = 0.001) for girls than for boys and 1.7pp higher (p = 0.008) for private than for public school adolescents. For practice, boys scored 2.2pp higher (p < 0.001) than girls and private school adolescents scored 2.5pp higher (p < 0.001) than public. Furthermore, 98.6% of adolescents had smartphone access, 91.5% had internet access and 68.0% played mobile games. Conclusion Adolescents have lower knowledge than attitude and practice regarding cardiovascular health. This combined with high digital access provides opportunities for digital health education, especially in public schools.