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Frugal engineering of a jaw crusher using the factor-of-frugality, a modern version of the safety-factor

Businesses are increasingly keen on going frugal due to increasing demand for sustainable and low-cost products that do not sacrifice quality. However, there is a dearth of tools for the systematic design and engineering of frugal products from scratch in the industry. Accordingly, a new approach has been applied in this paper for the formal design of a frugal jaw crusher for the mining industry. Consequently, this paper uses the factor of frugality (F of FN) which is a composite number that combines the safety factor (N) with fractions of material saved in various stages of product-development. In doing so, this work has iteratively applied the factor of frugality to the relevant components of a jaw crusher. And rigorous design procedures are adopted, for maintaining quality, due to the use of lower safety factors in making the product frugal. Contemporary concepts like generative design, design for manufacturing and biomimetics have been explored to achieve frugality in the relevant “bulky” components of a jaw crusher. Accordingly, factors of frugality of 1.871.79, 1.761.68 and 1.631.33 have been obtained for the flywheel, the Pitman and the rear wall, respectively, based on the frugal approach. Therefore, use of the new frugal design approach has resulted in material savings of 8%, 7% and 30% and increases in factor of safety of 35%, 71% and 18% in the flywheel, the Pitman and the rear wall, respectively, over their base values. Such savings in materials have been accompanied by moderate cost reductions with improvement in functionality and this trio of features is typical of an advanced frugal product.

Probiotic bacteria vs. yeast for gastrointestinal diseases treatment: Protocol for a systematic review and meta-analysis

Background Disruption of the gut microbiota, an essential ecosystem of microorganisms inhabiting the gastrointestinal tract (GIT), has been linked to the development and progression of various gastrointestinal disorders. Probiotics have received considerable attention for their role in gastrointestinal diseases. However, there is a need to synthesise existing evidence to determine the optimal probiotic approach for managing complications of GIT disorders. By conducting a systematic review of randomised controlled trials (RCTs) comparing the effects of probiotic bacteria and yeast in patients with gastrointestinal diseases, we aim to provide a comprehensive and evidence-based analysis of the benefits and limitations of these interventions, which could inform clinical decision-making and improve patient outcomes in this population. Methods Different databases, including PubMed, Web of Science, and Scopus will be searched to identify randomized controlled trials (RCTs). The titles and abstracts will be screened using Rayyan, and data will be extracted from eligible studies using Microsoft Excel. Critical appraisal and quality assessment will be performed using the ROB 2 tool, while GradePro will be used to assess the certainty of outcomes. All steps will be independently performed by two reviewers. This study will assess the effectiveness of yeast and bacterial probiotics in treating GIT disorders by evaluating inflammation markers, diarrhoeal score and disease severity, stool frequency, length of hospital stay, and adverse effects. By comparing the efficacy of probiotic bacteria and yeast, this review will identify the most effective type of probiotics for different gastrointestinal disorders, potentially enhancing treatment outcomes and reducing healthcare costs. Systematic review registration: PROSPERO (CRD42023384070).

The Healthy Brain 9 (HB9): A new instrument to characterize subjective cognitive decline, and detect anosognosia in mild cognitive impairment

Objectives Subjective cognitive decline (SCD) affects 10% of older adults and may be a risk factor for future mild cognitive impairment (MCI) and dementia. Some individuals with MCI have anosognosia, the denial or lack of awareness of their cognitive deficits. We developed and tested the Healthy Brain 9 (HB9), a self-reported assessment of cognitive performance and everyday functioning, in a diverse community-based cohort of older adults in South Florida. Design Cross-sectional study. Setting Community-based longitudinal study of brain health. Participants A total of 344 participants (mean age of 68.5±9.3y, 70% were female, 62% with 16 or less years of education, 39% ethnoracial minorities) completed the study. The sample included 42% normal cognition, 27% SCD and 30% MCI. Within the MCI group, 62% demonstrated awareness of cognitive deficits and 38% had MCI with anosognosia. Measurements The psychometric properties of the HB9 were examined and the performance of the HB9 was compared to Gold Standard comprehensive clinical-cognitive-functional-behavioral evaluations and biomarkers evaluations from the Healthy Brain Initiative at the University of Miami. Results The HB9 had strong psychometric properties with a Cronbach α of 0.898 (95%CI: 0.882-0.913) and low floor and ceiling effects. The HB9 performed well across different sociodemographic groups. Lower HB9 scores were associated with greater resilience, better physical performance, and less physical frailty. Higher HB9 scores were associated with more comorbid medical conditions, more mood symptoms, lower resilience, and more functional impairment. A cut-off score of 4 on the HB9 provided a 15-fold ability to detect SCD in cognitively normal individuals, and a 14-fold ability to detect anosognosia in MCI. Conclusions The use of the HB9 as an assessment of subjective cognitive complaints may help identify SCD for potential interventions and enrollment into clinical trials. The HB9 may also identify anosognosia which could lead to worse outcomes in MCI.

Future direction of digital textbooks in undergraduate nursing education: A scoping review

Digital natives have emerged, and nursing educator must develop digital textbook(DT)s the meet their information processing methods. But literature reviews on DTs remain insufficient. This scoping review aims to guide nursing educators on the future direction of DTs in undergraduate nursing education. This study includes research on DTs published in English after 2016, targeting undergraduate nursing students. Two reviewers independently screened titles, abstracts, and full texts for inclusion and extracted data from Medline (PubMed), Embase (Elsevier), Cochrane Library, Cumulative Index to Nursing and Allied Health (CINAHL), and IEEE Xplore up to May 27, 2024. Of the 3,978 articles identified, 7 met the inclusion criteria. The most common study design was experimental (n = 5), and the most frequent intervention type was interactive (n = 5). The most common nursing field was caring for medically complex/special needs patients (n = 5). However, no DTs were developed for social determinants of health or mental health or for working in underserved communities. Information was provided via mobile devices (n = 2) and QR codes, applications, or links (n = 2). Six studies measured all three outcome variables: knowledge, skills, and attitudes. The technology aspects included feedback, display functions, and other technical and educational features. The findings highlight the importance of usability, integration with the nursing education curriculum, and the development of clinically based DTs for future undergraduate nursing education. Thus, DTs in undergraduate nursing education, designed for the digital native generation, should be developed based on interactive intervention-type content that facilitates easy access to personalized information and timely learning. In addition, to comprehensively cover the educational domains essential for future nurses, DTs should not only address caring for medically complex/special needs patients but also include content on social determinants of health, mental health, and nursing in underserved communities.

The in cellular and in vivo melanogenesis inhibitory activity of safflospermidines from Helianthus annuus L. bee pollen in B16F10 murine melanoma cells and zebrafish embryos

Melanin, synthesized by tyrosinase (TYR), is a natural pigment essential for skin protection and pigmentation. However, excessive melanin production can cause dermatological disorders. Safflospermidines, comprised of safflospermidine A and B isomers isolated from sunflower (Helianthus annuus L.) bee pollen, were shown to exhibit a strong in vitro TYR inhibitory activity against mushroom TYR. However, their anti-melanogenesis activity in cellular and in vivo models remains unexplored. This study firstly evaluated the effects of these safflospermidines on melanogenesis in α-melanocyte stimulating hormone-stimulated B16F10 cells, using kojic acid as a positive control. Cytotoxicity was evaluated using the MTT assay, while TYR activity and melanin content were measured to assess melanogenesis inhibition. The expression of key melanogenesis-related genes was analyzed through quantitative real-time reverse transcription (RT-q)PCR to elucidate the molecular mechanisms involved. Secondly, the melanogenic activity and potential toxicity of the compounds were confirmed in zebrafish embryos, with phenylthiourea (PTU) as a reference. The results revealed that a mixture of these two safflospermidines exhibited no cytotoxicity across the treated concentration range (0–500 µg/mL). At 62.5 µg/mL, safflospermidines significantly reduced the intracellular melanin content by 21.78 ± 4.01% and the TYR activity by 25.71 ± 3.08% in B16F10 cells through downregulation of TYR, TYR-related protein 1 (TRP-1), and TRP-2 gene expression. Additionally, the safflospermidines induced a noticeable reduction in dendritic cell structures, which likely contributed to the marked decrease in extracellular melanin levels. Kojic acid (250 μg/mL) significantly reduced the melanin content and TYR activity by suppressing all three melanogenesis-related genes. In zebrafish embryos, safflospermidines showed no toxicity or morphological abnormalities within a concentration range of 0–62.5 µg/mL, and at a concentration of 15.63 µg/mL the melanin production in zebrafish embryos was significantly reduced by 28.43 ± 9.17%. In comparison, 0.0015% (v/v) PTU decreased melanin production by 53.20 ± 3.75%. These findings suggest that safflospermidines are safe, effective melanin inhibitors with potential applications in pharmaceuticals and cosmetics for managing hyperpigmentation.

Systematic mediation and interaction analyses of kidney function genetic loci in a general population study

Chronic kidney disease (CKD) is a complex disease affecting >10% of the global population, with large between- and within-continent variability reflecting major environmental determinants. To identify molecular targets for treatment and prevention, genome-wide association study meta-analyses (GWAMAs) of CKD-defining traits have identified hundreds of genetic loci in aggregated population samples. However, while GWAMAs estimate the average allelic effect across studies, single population studies may be relevant to unravel specific mechanisms. To assess whether a study sample from a specific population could extend existing knowledge on kidney function genetics, we selected 147 kidney function relevant loci identified by a large GWAMA, assessing their association with the glomerular filtration rate estimated from serum creatinine (eGFRcrea) in 10,146 participants to the Cooperative Health Research In South Tyrol (CHRIS) study, conducted in an Alpine region where thyroid dysfunction is common. We identified associations with single nucleotide polymorphisms (SNPs) at 11 loci, showing up-to-5.4 times larger effect sizes than in the corresponding GWAMA, not explainable by allele frequency differences. Systematic mediation analysis across 70 quantitative traits identified serum magnesium and the activated partial thromboplastin time as partial mediators of the eGFRcrea associations at SHROOM3 and SLC34A1 , respectively. Given that free triiodothyronine and thyroxine acted as effect modifiers across all loci, we conducted SNP-by-thyroid stimulating hormone (TSH) interaction analyses, identifying significant interactions at STC1 : SNPs had larger effects on eGFRcrea at higher TSH levels, possibly reflecting stanniocalcin-1 autocrine and paracrine role. Individual population studies can help characterize genetic associations. The interplay between phenotypes at SHROOM3 and SLC34A1 and the role of thyroid function as a genetic effect modifier warrant further investigations.

Non-invasive tape sampling of tryptophan and kynurenine in relation to phenylalanine and tyrosine from melanoma and adjacent non-lesional skin: A pilot study

Purpose To evade immunosurveillance many cancers convert tryptophan (Trp) into kynurenine (Kyn), which induces immunotolerance and suppresses immune responses. Elevated Kyn amounts have been found in blood from patients with cutaneous melanoma. This study aimed to investigate whether higher Kyn abundance and lower Trp abundance can be detected on the surface of cutaneous melanoma lesions compared with adjacent non-lesional skin. Methods Sixteen patients with suspected melanomas were enrolled in this study. All lesions were excised and histopathologically diagnosed: 7 lesions were diagnosed as invasive malignant melanomas (MM), 6 as melanomas in situ (MIS), and 3 as benign lesions (BL). Non-invasive metabolite sampling was performed by tape stripping of suspected skin lesions and adjacent healthy non-lesional (NL) skin. Trp, Kyn, tyrosine (Tyr), and phenylalanine (Phe) were quantified by liquid chromatography-tandem mass spectrometry (LC-MS/MS). Electrical impedance spectroscopy (EIS) measurements were conducted to assess skin barrier integrity. Results Levels of all metabolites, Tyr (x6), Phe (x6), Trp (x5), and Kyn (x3), were significantly higher in MM lesions compared with adjacent NL skin, resulting in an elevated Trp/Kyn ratio. Trp levels increased less than Phe and Tyr levels, suggesting a potential increase in Trp depletion. Skin resistance in MM lesions was half that of NL skin. No differences were observed between MIS or BL and NL skin. Conclusions Non-invasive skin sampling revealed elevated Tyr, Phe, Trp and Kyn levels in MM skin, which is likely the result of compromised skin barrier at this stage of cutaneous melanoma.

Understanding the changes in endogenous GA3 in relation to developmental transitions in cauliflower (Brassica oleracea var. botrytis L.)

Cauliflower is a crop with intricate developmental transitions influenced by both external and internal cues. Plant growth regulators (PGRs) play a key role in developmental transitions and plant responses to environmental factors. The present study aimed to investigate the endogenous levels of gibberellins (GAs) (i) at six different developmental stages and (ii) at four time points in four varieties of cauliflower using high-performance liquid chromatography (HPLC). The Pusa Ashwini, Pusa Sharad, Pusa Shukti, and Pusa Snowball Kt-25 varieties represent all four thermosensory-based maturity groups: early (20–27 °C), mid-early (15–20 °C), mid-late (12–16 °C), and late or snowball (10–16 °C), respectively. GA3 content was highest in Pusa Shukti (4.020 ppm) and lowest in Pusa Ashwini (3.091 ppm). A higher endogenous GA3 concentration was recorded at the bolting stage (4.118 ppm), seedling stage (4.057 ppm), and curd initiation stage (3.722 ppm), suggesting its role in stalk elongation. The difference in GA3 content was significant between curd (3.613 ppm) and leaf tissues (2.947 ppm) at the full curd stage and nonsignificant between stalk (3.948 ppm) and leaf tissues (4.118 ppm) at the bolting stage. Regarding the time points, the GA3 content was highest in Pusa Sharad (4.311 ppm) and lowest in Pusa Ashwini (2.990 ppm). GA3 content showed a significant positive correlation with duration to crucial developmental transitions, namely the curd initiation stage, the full curd stage, and the bolting stage. The study highlights the role of endogenous gibberellins in plant development and suggests their potential for benefiting seed production.

Association between serum zinc and serum neurofilament light chains: A population-based analysis

Background While serum zinc levels are strongly associated with various neurological disorders, the relationship between serum zinc and axonal damage remains largely unexplored. Consequently, the objective of this study was to investigate whether an association exists between serum zinc levels and serum neurofilament light chain (sNfL) concentrations in the general population. Methods Data from the National Health and Nutrition Examination Survey (NHANES) conducted during 2013–2014 were utilized for this study. We applied multiple linear regression and smoothed curve fitting methods to explore the connection between serum zinc levels and sNfL. Furthermore, subgroup analyses and interaction tests were performed to assess the consistency of this association among various populations. Results This analysis included a total of 585 adults. After controlling for various confounding variables, we identified a significant negative association between serum zinc levels and sNfL (β = −0.62, 95% CI: −1.18, −0.05, p = 0.0321). Stratified analyses revealed that this negative association was significant only among individuals who were divorced, widowed, or separated, with no such association observed in other subgroups. This finding suggests that serum zinc levels may have a more pronounced impact on neurological health within these specific populations. Additionally, we identified an L-shaped association between serum zinc and sNfL, with an inflection point at 10.21 nmol/L. Conclusion Our findings demonstrate an inverse association between serum zinc levels and sNfL concentrations among adults in the United States. This relationship is particularly pronounced in individuals who are divorced, widowed, or separated.

Analysis of global stock market development—Integration of clustering, classification, and shapley values

This study aims to analyze the development of global stock exchanges by integrating clustering, classification, and Shapley Values to identify growth patterns and understand the differences in market characteristics and dynamics. The research applies the K-means algorithm for clustering, which enables the segmentation of exchanges based on their similarities. This is followed by using the random forest algorithm to classify these clusters and evaluate the importance of various features. Shapley Values are employed to interpret the contribution of individual variables to the model’s predictions, considering all possible combinations of features. The empirical analysis is based on data from 82 stock exchanges worldwide, sourced from organizations such as the World Federation of Exchanges and the International Monetary Fund. Key variables used include market capitalization, trading value, the number of listed companies, and share turnover velocity. The results highlight the significant heterogeneity among exchanges, with major markets like those in China and the United States forming distinct clusters due to their size, capitalization, and high trading activity. This distinction underscores their dominant position in the global financial landscape. Moreover, exchanges that have emerged from mergers, such as Euronext and NASDAQ Nordic, demonstrate superior characteristics compared to their peers, indicating that consolidation can be an effective strategy for competing with larger markets and enhancing global competitiveness. The study’s findings show that integrating clustering, classification, and Shapley Values is a robust approach for uncovering complex structures within financial markets. This approach provides deeper insights for market participants and policymakers into the growth patterns and strategic positioning of stock exchanges, offering valuable implications for future market development and competition strategies.

Evaluation of subretinally delivered Cas9 ribonucleoproteins in murine and porcine animal models highlights key considerations for therapeutic translation of genetic medicines

Genetic medicines, including CRISPR/Cas technologies, extend tremendous promise for addressing unmet medical need in inherited retinal disorders and other indications; however, there remain challenges for the development of therapeutics. Herein, we evaluate genome editing by engineered Cas9 ribonucleoproteins (eRNP) in vivo via subretinal administration using mouse and pig animal models. Subretinal administration of adenine base editor and double strand break-inducing Cas9 nuclease eRNPs mediate genome editing in both species. Editing occurs in retinal pigmented epithelium (RPE) and photoreceptor cells, with favorable tolerability in both species. Using transgenic reporter strains, we determine that editing primarily occurs close to the site of administration, within the bleb region associated with subretinal injection. Our results show that subretinal administration of BE-eRNPs in mice mediates base editing of up to 12% of the total neural retina, with an average rate of 7% observed at the highest dose tested. In contrast, a substantially lower editing efficiency was observed in minipigs; even with direct quantification of only the treated region, a maximum base editing rate of 1.5%, with an average rate of <1%, was observed. Our data highlight the importance of species consideration in preclinical studies for the development of genetic medicines targeting the eye and provide an example of a lack of translation between small and larger animal models in the context of subretinal administration of Cas9 eRNPs.

Conscientious objection in euthanasia and assisted suicide: A systematic review

Introduction As euthanasia and assisted suicide (EAS) become legal in more countries, conscientious objection (CO) of healthcare professionals is gaining increasing attention. While some argue that CO safeguards professionals’ moral integrity, others view it as a barrier to patients’ access to desired healthcare. This review provides a comprehensive synthesis of the ethical literature regarding CO to EAS and answers three key questions: What is the meaning of CO and how is it used in EAS? What ethical positions support or challenge it? What underlying presuppositions shape the debate?. Methods We used the PRISMA guidelines, RESERVE standards, and TARCiS statement to conduct a systematic review of argument-based publications retrieved from 13 major databases covering biomedical, philosophical, and theological literature. No date or language restrictions were applied. Titles and abstracts were independently screened by the two authors, and complete articles were selected based on predefined inclusion and exclusion criteria. Results We identified 58 pertinent articles that were included in our review. Of these, 51 were published in the last decade, from 2015 through 2024. Our findings highlight three key dimensions. First, while there is general agreement on the definition of CO, its interpretation and application in EAS remain highly contested. Second, the ethical debate revolves around three main positions: conscience absolutism, the compromise approach, and the incompatibility thesis. Each of these is supported by distinct ethical arguments. Third, the debate is shaped by several underlying presuppositions, including divergent views on conscience, morality, religion, medicine, and end-of-life care. Conclusions Our results highlight the risk of polarization in the debate on CO in EAS. It emphasizes the importance of dialogue between theoretical and context-sensitive perspectives to support more effective implementation of CO. Clearer guidelines are needed to balance respect for conscience, patient rights, and professional responsibilities in this complex issue.

Sox9 in the epicardium: Implications for cell invasion, differentiation, and coronary vascular development

The epicardium is the mesothelial lining of the heart and is a source of progenitor cells during heart development, giving rise to an invasive population of mesenchymal cells which differentiate into cardiac fibroblasts, mural cells, and other cell types essential for heart structure and function. Previously, we showed that epicardial-specific deletion of the gene encoding SRY-box transcription factor 9 (SOX9) impairs epicardial-derived cell invasion and reduces their contribution to the atrioventricular valve mesenchyme. In this study, we use single-cell RNA-sequencing to investigate broader roles of Sox9 in the epicardium as it relates to epicardial invasion, differentiation, and vascular development. We identified transcriptional changes indicative of decreased epicardial-to-mesenchymal transformation consistent with histological observations. Immunofluorescence analyses revealed defective epicardial attachment and decreased epicardial-derived cell invasion into the ventricular myocardium associated with delayed coronary plexus formation. Sox9-deficient epicardial cells exhibited elevated expression of vascular smooth muscle cell genes, suggesting that Sox9 may influence epicardial cell fate decisions. This study expands our understanding of the role of Sox9 in epicardial biology, demonstrating an important function in regulating epicardial cell invasion, differentiation, and coronary vasculature development. These insights provide a foundation for further investigations into epicardial-mediated mechanisms underlying congenital heart abnormalities.

Effects of pressure garments of varying designs on upper extremity sensorimotor functions and quality of life after stroke: Study protocol for a multicenter, double-blind, prospective randomized controlled trial

Rationale Stroke often results in extensive neurological damage, leading to a wide range of rehabilitation needs and challenges, with upper extremity dysfunction being particularly prevalent. Although pressure garments have been used in the rehabilitation of children with cerebral palsy to reduce muscle tone, their therapeutic effects have not been thoroughly investigated in the field of stroke. Aims To determine the effects of pressure garments with varying designs on stroke patients’ sensorimotor function and quality of life. Sample size estimate A total of 165 participants is required (55/group) with an effect size of 0.125, power of 0.80, alpha level of 0.05, and adjusted for a dropout rate of 20%. Methods and design This is a multicenter, double-blind, prospective randomized controlled, three-group trial. At three hospitals in Shandong, China, 165 patients within 1−12 months of stroke are randomly assigned (1:1:1) to receive Dorsal-Double-layered 10% circumferential reduction (DD-10, intervention), Single-layered 10% circumferential reduction (S-10, intervention), or Single-layered 0% circumferential reduction (S-0, placebo) pressure garments. Pressure garments are worn for 3 hours in the morning, 3 hours in the afternoon, and 8 hours at night daily for 8 weeks. During the first 4 weeks, patients also receive 30-min occupational therapy sessions. Study outcomes The primary outcome is the Fugl-Meyer Assessment of Upper Extremity to assess motor control. Secondary outcomes are the Box and Block Test (BBT) for assessing dexterity, Modified Ashworth Scale (MAS) for assessing muscle tone, Visual Analogue Scale for assessing pain, Disabilities of Arm, Shoulder, and Hand (DASH) for assessing self-perceived upper extremity function, and 36 Item Short Health Survey (SF-36) for assessing quality of life. Measurements are taken at Time 1(Baseline), Time 2 (Week 4), and Time 3 (Week 8). Discussion The expected outcome of this study is that it can determine the design of pressure garments best suited to improve sensorimotor function and the quality of life of stroke patients. It can also extend the clinical value of pressure garments and help healthcare professionals make more targeted treatment choices for stroke patients. Trial registration ClinicalTrials.gov Identifier: NCT06587308.

The effect of adding neuromuscular electrical stimulation to exercise therapy on patellofemoral pain: A systematic review and meta-analysis

Background This study investigated the effects of adding neuromuscular electrical stimulation (NMES) to exercise therapy on pain, knee function, quadriceps strength, and the ratio of activation of the Vastus Medialis Oblique (VMO) to Vastus Lateralis (VL) muscles in people with Patellofemoral pain (PFP). Methods A rigorous search for randomized controlled trials (RCTs) spanning database inception to July 1, 2024, was executed across PubMed, Embase, Web of Science, Cochrane Library, and Scopus. Two researchers independently screened the literature and extracted data. The Cochrane Risk of Bias Tool was used for included studies to assess risk of bias and the GRADE system was used to assess the certainty of evidence for outcomes. Result Nine randomized controlled trials, encompassing 337 participants (171 intervention, 166 control), were included in the analysis. The meta-analysis findings indicated that compared to exercise therapy alone, NMES combined with exercise therapy significantly reduces pain intensity (MD: −0.37; 95% CI: −0.64 to −0.10; P = 0.007), notable improvements in knee function (MD: 4.76; 95% CI: 2.08 to 6.84; P = 0.0002), and significantly increased quadriceps muscle strength (SMD: 0.55; 95% CI: 0.24 to 0.87; P = 0.0006). However, there was no significant impact observed on the VMO/VL ratio (SMD: 0.8; 95% CI: −0.33 to 1.93; P = 0.16). Subgroup analyses superimposed that incorporating NMES did not result in a meaningful reduction in pain intensity (MD: −0.85; 95% CI: −1.76 to 0.07; P = 0.07) or a significant improvement in quadriceps muscle strength (SMD: 0.27; 95% CI: −0.24 to 0.78; P = 0.30) when the treatment period was less than or equal to 4 weeks. Conclusion The study’s findings revealed that adding NMES to exercise therapy offers further improvement in pain intensity, knee function, and quadriceps strength in people with PFP compared with exercise therapy alone, but did not significantly improve VMO/VL ratio, and it recommended that the duration of the intervention lasts more than4 weeks for better therapeutic outcomes.

Editorial Note: Knowledge and practice of clients on preventive measures of COVID-19 pandemic among governmental health facilities in South Wollo, Ethiopia: A facility-based cross-sectional study

Correction: Trends in lifetime risk and years of potential life lost from diabetes in the United States, 1997–2018

Barriers experienced by and educational needs of clinicians who provide care for transgender, nonbinary, and gender-diverse young adults in the Mid-Atlantic and Southern United States

Purpose The purpose of this study is to identify and explore the educational needs of and broader barriers experienced by clinicians who provide care to transgender, nonbinary, and gender diverse (TGD) young adults (aged 18–24), with a focus on unique healthcare needs and challenges. Methods Between April 2022 – July 2022, we conducted qualitative interviews with 13 clinicians (n = 9 medical and n = 4 mental health) about perceived needs and barriers relating to the care of TGD young adults. Clinicians were recruited throughout the Southeastern and Mid-Atlantic United States and were a mix of general practitioners and specialists. Using a hybrid deductive and inductive thematic analysis approach, the interview transcripts were analyzed and key themes identified. Results Thematic analyses of these interviews identified three main themes: the need for knowledgeable clinicians, the need and desire for reliable training resources and mentorship, and concerns surrounding the impact of the sociopolitical environment. Many participants noted a lack of access to local educational opportunities and mentorship but expressed willingness to seek these out if centralized resources, such as national platforms or accessible training modules, were available. Conclusion This study identifies both gaps in clinician education and broader barriers – such as local politics and access to mentorship – that hinder the ability to provide effective care to TGD young adults. These findings will help to inform the development of clinician education and support programs.

Development and accuracy assessment of molecular markers associated with crown rust resistance genes in oat

Crown rust caused by Puccinia coronata Cda. f. sp. avenae P. Syd. (Pca) is considered the most destructive disease of oat, causing yield and grain quality losses. Over a hundred crown rust race-specific resistance genes have been identified, but the history of cultivar development has left the identity of Pc resistance genes elusive. Closely linked molecular markers may be used to identify the carrier status of a particular Pc resistance allele in any given oat line. However, elevated false positive rates could lead to misidentifying carriers, potentially excluding valuable genetic material from breeding programs. There are very few studies that examine the reliability of gene molecular markers in a diverse genetic background. In this study, molecular markers with genotype data from the T3/Oat database and map data from GrainGenes, which indicated linkage to Pc genes, were evaluated for their predictive potential. A panel of non-carrier lines for Pc genes was identified using phenotype data downloaded from T3/Oat database and pedigree records from Pedigrees of Oat Lines database. The false positive rate of the markers was calculated as the percentage of non-carriers possessing the allele associated with the Pc gene. Using the available map information, thirty SNPs associated with 15 Pc genes were selected and assessed for their predictive capabilities. Eight out of the thirty markers, linked to seven Pc genes, showed potential in predicting carrier status with a false positive rate of ≤25% in non-carrier lines. Particularly, markers for Pc38 and Pc68 perfectly corresponded to carrier status across all lines. Furthermore, validation of published predictive markers for four Pc genes in this non-carrier panel demonstrated consistency with published data, with only a 6–17% genotyping error observed for three markers. Such markers have potential to identify Pc genes present in germplasm with resistance of unknown derivation, thereby enhancing the marker assisted selection process for oat breeding.

Global, regional, and national burden of cataract: A comprehensive analysis and projections from 1990 to 2021

Objective Cataract is the most prevalent cause of blindness. Surgery remains the only effective and widely accepted treatment; early diagnosis and intervention can significantly prevent blindness. Hence,Understanding the current epidemiological status of cataract is crucial for formulating better healthcare policies and effectively preventing blindness due to cataract. Design This study utilizes Global burden of Disease (GBD) 2021 data to conduct an in-depth analysis of the burden of cataract from 1990 to 2021, including gender disparities, risk factors, and the relationship between Socio-Demographic index (SDI) and disease burden. Additionally, we performed a frontier analysis of Disability-Adjusted Life Years (DALYs) due to cataract from 1990 to 2021. Finally, we used the BAPC model to project the burden of cataract by gender from 2022 to 2030. Results The study revealed that the global burden of cataract remains significant. Worldwide, the Estimate Annual Percentage Change (EAPC) for cataract prevalence was 0.2117([95% CI] 0.1172–0.3063); the EAPC for cataract DALYs is −0.4798([95%CI] −0.5766--0.3828). Predominantly affecting females, individuals aged 50 and older, and those in medium-low and low SDI regions. Furthermore, the Bayesian Age-Period-Cohort (BAPC) model forecast a gradual decline in the global burden of cataract over the next nine years. Conclusion This study utilized GBD 2021 to provide an in-depth analysis of the current global disease burden of cataracts. The results showed that although the Age-Standardized Rate (ASR) of DALYs decreased, the overall cataract Number still showed an increasing trend from 1990 to 2021 and 2022–2030.