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Anemia, micronutrient deficiency, and elevated biomarkers of inflammation among women and children in two districts in the Northern Region of Ghana: A pilot study
Introduction Previous data had shown a high prevalence of anemia and various micronutrient deficiencies (MNDs) in the Tolon and Kumbungu districts. We aimed to reassess these outcomes among lactating women (LW), women of reproductive age (WRA), and preschool children (PSC) to inform the design of a MN-fortified bouillon cubes trial, including the choice of micronutrients and selection of study sites; among WRA and PSC, we aimed to identify factors associated with anemia, MND, and inflammation, and to examine anemia co-occurring with MND and inflammation. Methods In this cross-sectional study (Nov 2020–Jan 2021), we randomly selected 7 urban and 7 rural clusters per district from those accessible at the time, recruited participants through a random walk-based search, and collected and analyzed breastmilk (LW) and venous blood (WRA and PSC). Ferritin (WRA and PSC), and retinol, retinol-binding protein, and zinc (PSC only) were adjusted for inflammation. Binary outcomes were defined using accepted cut-offs. Data analyses involved descriptive statistics, generalized linear mixed models (identify factors), and Rao-Scott chi-squared test (examine co-occurrence). Results Approximately 240 each of LW (average age, 30 y), WRA (30 y), and PSC (41 months) participated. Among LW, 41% had low breastmilk B-12; 8% had low breastmilk retinol. Among WRA, anemia was 31%; prevalences of MNDs were: iron, 45%; zinc, 79%; vitamin A, 1%; B-12, 12%; and folate, 12%; with 15% elevated α1‐acid glycoprotein (AGP) or C-reactive protein (CRP). Among PSC, anemia was 36%; prevalences of MNDs were: iron, 57%; zinc, 67%; vitamin A, 19%; and B-12, 19%; with 39% elevated AGP or CRP. Improved source of drinking water was associated with lower odds of anemia, iron deficiency, and vitamin A deficiency in WRA; rural or Kumbungu residence was linked to higher odds of vitamin B-12 or vitamin A deficiency in PSC. Anemia co-occurred with iron deficiency and inflammation in WRA and PSC. Conclusion Anemia and MNDs were common in this setting, suggesting the need for targeted interventions.
Ultra-massive fluid transfusion in adult liver transplant recipients: A single center observational study
Introduction Patients undergoing liver transplantation may require large volumes of fluid to maintain hemodynamic stability and treat coagulopathy. This study aimed to determine the prevalence of ultra-massive fluid transfusion and to examine its association with clinical outcomes. We defined an ultra-massive fluid transfusion a priori as a transfusion volume of >20 liters of crystalloids, colloids, blood and blood products administered intraoperatively and within the first 24 hours postoperatively. Methods This single-center retrospective observational study included all adult patients who underwent an orthotopic liver transplant and received an ultra-massive fluid transfusion. The primary aim was to determine the prevalence of ultra-massive fluid transfusion in patients undergoing liver transplantation. Secondary objectives included evaluating the effect of the total volume of fluid and packed red blood cell transfusions on postoperative complications, mechanical ventilation hours, intensive care unit and hospital length of stay, and mortality. Results Of the 844 liver transplantation procedures, 81 (9.6%) required an ultra-massive fluid transfusion with a median transfusion volume of 36.8 liters (IQR: 31.2–48.7). Each additional liter of fluid administered during surgery was associated with an additional stay of 0.47 days in intensive care (95%CI: 0.18–0.76, p = 0.003). Each additional unit of packed red blood cells administered during surgery was associated with an additional 12.8 hours of mechanical ventilation (95%CI: 3.12–22.43, p = 0.014) and 1.0 additional day in intensive care (95%CI: 0.27–1.79, p = 0.012). Neither ultra-massive fluid transfusion nor packed red blood cell transfusions were associated with increased complications. Conclusion Approximately one in ten liver transplantation patients required an ultra-massive fluid transfusion. While ultra-massive fluid transfusion was associated with prolonged recovery, it was not associated with an increased risk of complications or mortality.
Towards implementation of independent calculation-based dose verification in proton therapy
Background Proton therapy offers precision in targeting tumors while minimizing damage to surrounding healthy tissues. Independent dose calculation is a secondary dose validation tool for patient-specific quality assurance (PSQA) using Monte Carlo simulations. Purpose To implement independent dose calculation for PSQA in proton therapy and establish confidence limits, tolerance limits, and action limits. Methods and Materials The point dose validation of independent dose calculation was performed by ionization chamber. The dose distributions between independent dose calculation and treatment planning calculation were compared in single and multiple energy plans. Fifty clinical plans covering five regions (head and neck, breast, chest, abdomen, and pelvis) were evaluated using the gamma analysis criteria of 3%, 3 mm, and 5%, 3 mm. Confidence limits, tolerance limits, and action limits were determined. Results The dose differences between measurement and independent dose calculation for each energy level were within 1.0%. The results showing gamma passing rates of 99.4 ± 0.6% for single energy plans and over 98.0% for multiple energy plans. The average gamma passing rates for all treatment sites was 95.9 ± 2.7% with 3%/3 mm criteria, which increased to 97.9 ± 1.8% with 5%/3 mm criteria. The confidence limits, tolerance limits, and action limits showed 90.7%, 89.1%, and 85.4% with 3%/3 mm criteria and 94.3%, 93.2%, and 91.6% for 5%/3 mm criteria, respectively. Conclusions The independent dose calculation could potentially be implemented in PSQA. It is a secondary dose validation method for busy clinic. Particular attention should be paid to a confidence limit, tolerance limit, and action limit for reliable treatments.
Could calisthenic exercises improve maximal exercise capacity, peripheral muscle strength and quality of life in dyslipidemia?
Background Regular exercise improves cardiovascular health through regulating the plasma lipoprotein profile. But the effects of different exercise modalities on exercise capacity, muscle strength and quality-of-life in dyslipidemia is unclear. Objectives This study aimed to investigate the effects of calisthenic exercises on exercise capacity, muscle strength and quality-of-life in dyslipidemia. Methods Thirty-nine individuals were randomly divided into 3 groups: Aerobic + Calisthenic Exercise Group (ACG), Aerobic Exercise Group (AG) and Control Group (CG). Exercise capacity measured using cardiopulmonary exercise test, muscle strength using handheld dynamometer, quality-of-life using Short Form-36 Quality of Life Questionnaire (SF-36) at baseline and 8 weeks after. Results Peak oxygen uptake (VO2peak) (p < 0.001), metabolic equivalent (MET) (p < 0.001) and percentage of oxygen pulse increased significantly within ACG (p < 0.001). Peak heart rate (p = 0.006) and heart rate reserve improved significantly within AG (p = 0.004). Peak VO2 (p < 0.001), MET (p < 0.001), oxygen pulse (p = 0.006), knee extensor (p < 0.001) and handgrip strength decreased significantly within CG (p = 0.009). MET (p < 0.001) and %handgrip strength increased significantly in ACG compared to AG and CG (p = 0.021). Peak VO2 (p < 0.001), heart rate (p < 0.001), heart rate reserve (p < 0.001), and handgrip strength increased significantly in ACG compared to CG (p = 0.009). Peak heart rate (p < 0.001), heart rate reserve (p < 0.001) and shoulder abductor strength improved significantly in AG compared to CG (p = 0.019). Conclusions Aerobic exercises recommended for regulating blood biochemistry in dyslipidemia. But effects of calisthenic exercises in dyslipidemia are unclear. Our study showed that calisthenic exercises which combined with aerobic exercise training may improve cardiac and pulmonary response to exercise and handgrip strength in dyslipidemia. Additionally, aerobic exercise training may improve cardiac response to exercise in dyslipidemia. ClinicalTrials Number: NCT06008912.
Identification of Therapeutic Targets in Autism Spectrum Disorder through CHD8-Notch Pathway Interaction Analysis
Background Autism Spectrum Disorder (ASD) is a complex neurodevelopmental disorder with a rising global prevalence. Mutations in the CHD8 gene have been implicated in ASD, yet the underlying molecular mechanisms remain insufficiently understood. Methods We analyzed transcriptomic data from the CHD8A and CHD8B allelic deletion sample dataset GSE236993 to identify differentially expressed genes (DEGs). We intersected these DEGs with genes related to the Notch signaling pathway and performed functional enrichment analyses, including Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment, as well as protein-protein interaction (PPI) analyses, to identify key genes. These key genes were validated using the CHD8-deficient sample dataset GSE85417, resulting in the identification of seven common key genes. We then constructed drug-gene interaction networks and microRNA (miRNA) regulatory networks to further elucidate the mechanisms by which CHD8 impacts ASD. Results Seven hub genes—IGF2, FN1, CXCR4, COL11A1, ITGA6, LOX, and FBN2—were identified, all involved in the Notch signaling pathway and playing significant roles in neurodevelopment and extracellular matrix regulation. Among these, IGF2 and CXCR4 were particularly crucial in ASD pathogenesis, suggesting their potential as diagnostic biomarkers and therapeutic targets. MiRNA regulatory network analysis revealed several miRNAs that may modulate these hub genes, offering new insights into ASD pathogenesis. Drug-gene interaction analysis suggested possible therapeutic small-molecule compounds, such as AMD3100 and IGF-1R inhibitors. Conclusions Our multi-level bioinformatics analysis identified key genes and regulatory networks potentially involved in ASD associated with CHD8 deficiency. These findings enhance the understanding of ASD’s molecular mechanisms and highlight potential therapeutic targets, paving the way for future diagnostic and treatment strategies.
Efficacy of NAMPT inhibition in T-cell acute lymphoblastic leukemia
Novel agents targeting upregulated signaling pathways are needed to improve outcomes in T-cell acute lymphoblastic leukemia (T-ALL), since conventional cytotoxic chemotherapy regimens have reached the limits of tolerability. We identified upregulated, targetable signaling pathways common to both human T-ALL samples and a KrasLSL-G12D/+.Mb1Cre/+ murine model of T-ALL. We found the NAMPT inhibitor FK866 had the greatest cytotoxicity of a panel of small molecule inhibitors tested in human and mouse T-ALL cell lines, and in patient derived xenograft (PDX)-expanded T-ALL patient samples. We subsequently tested FK866 in vivo in PDX mouse models of T-ALL, and found that it significantly reduced the peripheral blood disease burden and prolonged the survival of leukemic mice (median survival of 60.5 vs 21 days, p = 0.0007). This screen for targetable pathways in T-ALL generated in vitro and in vivo preclinical data supporting NAMPT inhibition as a promising strategy for the treatment of T-ALL.
Inflammatory cells and remodeling in bronchial biopsies from COPD patients and controls
Background The understanding of inflammation and remodeling in the bronchial wall of COPD patients with varying disease severity remains incomplete. Methods 35 healthy controls and 47 volunteer COPD patients underwent bronchoscopy with bronchoalveolar lavage (BAL) and sampling by endobronchial biopsies in 2014–2015 as part of the MicroCOPD Study. Biopsies were embedded in glycol methyl acrylate (GMA) resin and examined by immunohistochemistry and staining for enumeration of CD3 + , CD4 + , CD8 + , CD20 + , CD68 + , EG2 + , and NE+ inflammatory cells, as well as endothelial cells (EN4) and smooth muscle actin (SMA). Mucus cells were stained by periodic acid-schiff (PAS), and toluidine blue to visualize the reticular basement membrane (RBM). Results The numbers of macrophages and eosinophils were higher, and vascularity increased in the submucosa in COPD patients compared with healthy controls. In healthy smokers there were lower numbers of lymphocytes (CD3 +, CD4 +, CD8 +, CD20+) than never smokers. However, COPD patients with GOLD I/II had higher numbers of eosinophils and larger smooth muscle area compared with GOLD III/IV. COPD exacerbations the last year, blood eosinophils, and use of inhaled corticosteroids did not affect levels of inflammation or remodeling. Conclusion Smoking alters inflammation in healthy controls, while specific patterns of macrophages, eosinophils, and vascularity distinguish COPD from non-COPD in bronchial biopsies.
Aspirations to study medicine, perceptions of a good doctor, and their influence on specialty choice among medical students
Background Specialty decision-making among medical students reflects a complex interplay of motivations, evolving perceptions, and experiences during medical training. This study explores how students’ initial motivations, views on what makes a good doctor, and academic progression influence their specialty preferences. Methods A mixed-methods study was conducted at VinUniversity, a not-for-profit medical school in Vietnam. Quantitative surveys were completed by 155 students across Years 1–4 (79.5% response rate), and 27 students participated in in-depth interviews. Quantitative data were analyzed using Wilcoxon rank-sum and Kruskal-Wallis tests. Qualitative responses underwent thematic analysis to explore identity formation and specialty choice. Results Altruism was the most cited factor influencing specialty choice, with “desire to help people” rated highest (4.08 ± 1.14). Students’ perceptions of essential doctor qualities evolved over time. Younger students valued creativity (p = 0.035) and innovation (p = 0.022) more than seniors, reflecting a shift toward practicality in later years. Specialty preferences aligned with professional values: students favoring surgery rated work ethic (p = 0.029), collaboration (p = 0.006), and adaptability (p = 0.044) higher than those preferring internal medicine. Students inclined toward pediatrics or psychiatry prioritized empathy and communication, while those choosing surgery emphasized technical skill and decisiveness. Female students rated prestige as more influential than male students (p = 0.049). Qualitative data revealed that clinical exposure and self-reflection helped students refine their specialty choices by aligning personal traits with perceived specialty demands. Conclusion Medical students’ specialty preferences are shaped by their initial motivations, developing perceptions of good doctor qualities, and experiences throughout training. These findings underscore the need for medical curricula and mentorship to address the evolving identity and values of students, supporting more informed and aligned specialty choices.
Abies sachalinensis naturally growing at a sedimentary site acquires iron tolerance via detoxicants production, elemental transfer adjustment, and root endophytic Phialocephala bamuru producing siderophores
Abies sachalinensis naturally growing in heavy metal-rich sedimentary sites exhibits heavy metal tolerance. Although root endophytes increase heavy metal tolerance in various plants, their effects on the tolerance in conifers are not focused on. The objective of our study was to clarify the heavy metal tolerance, considering root endophytes. We measured the heavy metal concentrations in root-zone soil, leaves, stems, fine roots along with heavy metal detoxicants. We also isolated root endophytes and identified the endophyte with the highest siderophore production activity for chelating heavy metals. Results showed high Fe accumulation in fine roots, where malic acid, catechin, and condensed tannins detoxify Fe. A lower Fe/Mn ratio in leaves than roots suggests that A. sachalinensis could regulate Fe and Mn transfer to mitigate Fe phytotoxicity in leaves. Among the isolated root endophytes, Phialocephala bamuru exhibited the highest siderophore production, which could detoxify Fe in A. sachalinensis. These results indicated that A. sachalinensis have multiple Fe tolerance: Fe detoxification production and Fe/Mn ratio adjustment. Moreover, interactions with root endophytes like Ph. bamuru producing siderophores could increase the Fe tolerance and facilitate revegetation on soil containing heavy metal like old mine sites by conifers including A. sachalinensis.
Lymphocyte immunophenotype in dogs with immune-mediated hematologic disease
Immune-mediated hematologic diseases (IMHD) including immune-mediated hemolytic anemia (IMHA) and immune thrombocytopenia (ITP) can cause severe disease in dogs. The underlying immune system abnormalities associated with these conditions is not known. The hypotheses of this study were that dogs with IMHD would have increased frequencies of CD4+ and CD8 + lymphocytes, decreased frequencies and numbers of T regulatory cells, and increased frequencies of interleukin (IL)-17 + lymphocytes. Fifteen dogs with newly diagnosed IMHA or ITP and 15 healthy control dogs were recruited for this prospective study. Flow cytometry was used to enumerate CD4 + lymphocytes, CD8 + lymphocytes, T regulatory (CD4 + CD25 + Foxp3+) cells, and lymphocytes secreting IL-17 in dogs with IMHD at diagnosis, then 2 and 4 days after starting immunosuppressive treatment. Median proportion of CD4+ (Day 0: 3.4%, Day 2: 3.3%) and CD8+ (Day 0: 1%, Day 2: 0.6%) cells was lower in dogs with IMHD compared to control dogs (CD4 + 22.8%, CD8 + : 13.6%; P < 0.0001 for each). Additionally, T regulatory cells were reduced in IMHD dogs at Day 0 (0.2% versus 0.6% of total lymphocytes, P = 0.0025). Dogs with IMHD had a higher proportion of lymphocytes positive for IL-17 at Day 2 (1.3%) compared to control dogs (0.4%, P = 0.0024). Dogs with IMHD have immune system alterations at diagnosis and during early treatment characterized by a deficiency in T regulatory cells and an increase in IL-17 + lymphocyte. These changes might contribute to the pathogenesis of IMHA and ITP.
Physical model of serum supplemented medium flow in organ-on-a-chip systems
Creating a physiologically relevant shear stress in organ-on-a-chip (OOC) devices requires careful tailoring of microfluidic flow parameters. Currently, it is fairly common to use a simple approximation assuming constant viscosity, even for serum-based media. Here, we show that a popular nutrient solution (Dulbecco’s Modified Eagle Medium supplemented with Fetal Bovine Serum) requires a more complex treatment (i.e., is a non-Newtonian fluid), with observed shear stress values significantly greater than reported in literature. We measure the rheology of the solutions and combine it with a 3-dimensional flow field measurement to derive shear stress at the channel surface. We verify the experiments with numerical simulations, finding good agreement and deriving flow properties. Finally, we provide relevant expressions for the shear stress approximation, suitable for development of OOC devices with various geometries.
Body image, obesity, and sexual coercion: Impacts on depression among students at a Nigerian university
Introduction University students face a variety of challenges, including mental health issues, which are often compounded by societal and individual factors such as body image concerns, obesity, and experiences of intimate partner violence. These factors may adversely affect their mental health and academic performance. Yet, limited research exists on studies evaluating the impact of these factors on depression in Nigerian institutions of higher learning. This study aims to address this gap by examining the impact of these factors on self-reported depression with a focus on the moderating role of sex. Objective To assess the associations between body image concerns, obesity, intimate partner violence, and sexual coercion with depression among university students in Nigeria and to explore how these relationships vary by sex. Methodology This cross-sectional study was conducted over a one-month period among university students in Nigeria. Data was collected through structured, self-administered questionnaires. The primary outcome variables were self-reported depression. Explanatory variables included body image concerns, BMI categories (obese vs. normal BMI), intimate partner violence, and sexual coercion. Sex was examined as a moderator. Inverse probability weighting was used to account for confounding variables, including age, sex, year in school, parental education, household income, smoking and alcohol consumption, and other comorbidities. Multivariable regression analyses were performed to evaluate the relationships between explanatory variables and outcomes, adjusting for potential confounders. Results The study included 501 participants, with 64.5% females and 35.6% males. Most respondents (83.4%) were aged 18–20 years. Obesity was observed in 18.6% of participants, higher in females (20.7%) than males (14.6%). Sexual coercion was reported by 10.8% (males: 5.6%; females: 13.6%), while 3.4% experienced intimate partner violence (IPV), with similar rates in both genders. Depression was reported by 33.5% of participants, more common in females (35.3%) than males (30.3%). Body image concerns increased the risk of depression by 35.3% (95% CI: 13.0%−57.7%, p = 0.002), particularly in males (26.3%, 95% CI: 16.4%−69.1%, p = 0.227). Obesity was linked to significantly higher depression rates in males (25.9%, 95% CI: 1.9%−50.0%, p = 0.035) but not in females. Sexual coercion strongly correlated with higher depression rates in both genders (males: 43.0%, 95% CI: 23.5%−62.6%, p < 0.001; females: 39.5%, 95% CI: 20.9%−58.1%, p < 0.001). IPV showed a weaker link to depression, with rates of 21.1% in males and 30.1% in females, though not statistically significant. Conclusion This study highlights the complex interplay between psychosocial factors and their impact on mental health outcomes among university students in Nigeria. Addressing these factors, particularly through gender-sensitive interventions, is crucial for improving student mental health. Policy implications The findings call for the integration of mental health and psychosocial support services in university settings, including counseling and educational programs on body image and intimate partner violence. Policymakers and university administrators should prioritize gender-sensitive approaches to address the unique challenges faced by male and female students. Additionally, strategies to promote healthy lifestyle behaviors and prevent obesity among students should be implemented to enhance their mental health and academic performance.
Optimizing solar drying efficiency: Effects of PCM, and IR on energy and exergy performance
This study investigates the drying behavior of potatoes using a hybrid solar dryer equipped with a Compound Parabolic Concentrator (CPC) collector, Phase Change Materials (PCM), and Infrared Radiation (IR). Drying experiments were conducted at 40°C, 50°C, and 60°C under different PCM and IR configurations to evaluate drying kinetics, energy consumption, and product color quality. Energy and exergy analyses, along with assessments of drying time and color change (ΔE), were performed to identify the most efficient drying conditions. This study introduces a novel integration of PCM and IR in a hybrid solar drying system, providing a unique approach to optimizing energy efficiency, and product quality. The results demonstrated that PCM significantly improved the drying process by reducing drying time by an average of 5.3%, stabilizing the thermal environment, and enhancing both energy and exergy efficiency. The lowest Specific Energy Consumption (SEC) and shortest drying time were recorded at 60°C with PCM and IR, demonstrating the efficiency of this setup in reducing energy consumption while ensuring high drying performance. IR alone reduced drying time by 40%, accelerating moisture removal considerably. However, while the combination of PCM and IR enhanced thermal stability, it slightly prolonged drying time due to PCM’s heat absorption characteristics. Among the tested conditions, 60°C with PCM and IR was identified as the optimal setting, achieving the lowest SEC while minimizing drying time and color degradation. This study highlights the importance of integrating PCM and IR into solar drying systems to enhance efficiency, reduce energy consumption, and improve product quality. Future research should explore additional drying techniques, such as microwave and ultrasound-assisted drying, to further optimize hybrid solar drying systems.
Towards a new perspective: Exploring the variability of conditional risk factors for multimorbidity susceptibility among older adults in India
Background There is a lack of substantive evidence on the epidemiology of multimorbidity in low and middle-income countries (LMICs). India is also undergoing through the major demographic shift marked by the rapidly aging population and followed by significantly elevated implications to multimorbidity risk. These implications include an increased risk of functional limitations, poor quality of life, and delayed mortality pattern but expanding morbidity burden among older adults. This study aimed to characterize the distribution, pattern and further provide an understanding of the conditional role of risk factors for multimorbidity susceptibility among older adults in India. Methods The study utilized data on 66,606 individuals form the national representative Longitudinal Ageing Study in India (LASI), Wave – 1, of individuals aged 45 years and above. To understands the distribution, prevalence and pattern of morbidities and multimorbidity we characterized and calculated the weighted frequency distribution, chi-square test for association and stacked area plot for relative burden of multimorbidity over age. Finally, we constructed the Classification and Regression Trees (CART) model to further identify the optimal leading covariates and their conditional role on multimorbidity susceptibility among older adults in India. Results Hypertension showed the highest prevalence (26.72%) and highest age-specific relative proportional share, followed by myopia (24.2%), hypermetropia (20.75%) and gastrointestinal condition (17.98%). Single morbidity prevalence was 23.78%, and multimorbidity was 50.94% and the relative prevalence share of multimorbidity over age expanded by 25.16% from the 45–49 to 85+ age group. The CART model identified that childhood health, place of residence, age, body mass index, caste category and education level were the leading risk factors for multimorbidity susceptibility among older adults in India. The highest susceptibility of multimorbidity with a risk of 0.57 was observed among individuals who had moderate to poor childhood health. Conversely, those adults who had good childhood health, resided in rural areas, underweighted or normal BMI and belonged to the Schedule tribe had the lowest risk of multimorbidity (0.19). Conclusion This study offers a comprehensive analysis of multimorbidity among older adults in India, revealing a risk burden driven by aging, poor childhood health, and socioeconomic disparities. By using an inclusive morbidity framework and CART modeling, it underscores the multifactorial nature of multimorbidity and highlights key interconnected determinants for future policy interventions.
Latent class analysis of depression among patients with non-small cell lung cancer after surgery: A cross-sectional study
Background Depression exhibits heterogeneity. However, limited research has explored this heterogeneity in patients with non-small cell lung cancer (NSCLC) after surgery from a person-centered perspective. This study aimed to identify classes of depression using latent class analysis (LCA) in patients with NSCLC after surgery and to explore the association between these classes and demographic and clinical characteristics, physical symptoms, distress disclosure, and relationship quality. Methods A cross-sectional study was conducted with 234 patients with NSCLC in China from March 17, 2024 to May 16, 2024. Participants provided written informed consent before participating in the study. LCA was performed to identify latent classes of depression. Binary logistic regression analysis was employed to examine the association between the identified classes and related factors. Result This study identified two distinct classes: the severe depression group (Class1, N = 162, 69%) and the mild depression group (Class2, N = 72, 31%). Binary logistic regression result demonstrated that, compared with the mild depression group, factors associated with the severe depression group included pain, fatigue, sleep quality, reluctance to distress disclosure and perceived low relationship quality. Conclusions The current study provides evidence of the heterogeneity of depression among Chinese patients with NSCLC after surgery. Healthcare providers can develop tailored interventions by identifying the unique characteristics of each depression class. For patients in the severe depression group, interventions should focus on symptom alleviation, encouraging self-disclosure, and enhancing the quality of family relationships to improve their depression. As this study is cross-sectional, future research should validate these depression classes in larger and more diverse populations, both in China and globally. Trial registration Chinese Clinical Trial Registry (ChiCTR, www.chictr.org.cn; registration no.: ChiCTR2400081943).
From detached to alarmed: How eco-emotion profiles predict concern and sacrifice for the planet
The rapid degradation of the environment is one of our greatest challenges in the 21st century. To avoid the worst consequences, human behavior change is required. The current study investigated how feelings about environmental problems (eco-emotions) predict concern for the natural environment and willingness to make sacrifices for it. Using a cross-sectional online sample of 286 New Zealand residents, latent profile analysis identified three profile groups with distinct patterns of eco-emotions: emotionally-detached (40%), emotionally-ambivalent (34%), and empathic-alarmed (26%). Validation analyses revealed that members of the empathic-alarmed segment reported significantly higher levels of environmental concern and willingness to make sacrifices for the environment than members of the emotionally-ambivalent segment, who in turn expressed greater concern and willingness to sacrifice than members of the emotionally-detached segment. Findings from this study suggest that inducing a combination of negative eco-emotions with compassion may be effective for promoting environmental concern and pro-environmental sacrifice.
Nurse educators’ challenges of problem-based learning implementation at Ethiopian public universities: A phenomenological qualitative study
Background Nursing students are the upcoming healthcare workforce who learn to face the reality of their roles and work in clinical practice, knowing all aspects of patient care and contributing their knowledge, attitude, and practice to the healthcare system in the future. Problem-based learning is one of the strategies to identify and encourage their theoretical, practical, and clinical thinking abilities. Still, its implementation is hindered by different shortcomings in developing countries, especially in Ethiopia. Objective To explore the nurse educators’ challenges with problem-based learning implementation at Ethiopian public universities, 2023. Method A phenomenological qualitative study design approach was used. Eighteen nurse educators were selected purposively from ten universities to explore the challenges they encountered while implementing problem-based learning. Data were collected using in-depth interviews, and field notes were organized from August 01–October 01, 2023. The data analysis was done by OpenCode software and conventional content analysis was carried out following Colaizzi’s 7-step approach. Results In the study, four major themes and eighteen subthemes emerged, covering challenges encountered by nurse educators in Ethiopian public universities: challenges about educators themselves, nursing students, institutions/universities, problem-based learning strategies. Some specific points raised include lack of materials, negative student perceptions of problem-based learning, absence of standardized cases, and subjective assessments. Conclusion Nurse educators at public universities in Ethiopia faced challenges related to themselves, nursing students, their respective universities, problem-based learning cases, and assessment methods during problem-based learning implementation. Understanding these points provide further insights into the specific difficulties encountered by nurse educators concerning problem-based learning implementation.
Obstetric and newborn outcomes of mothers with and without HIV infection in Anaka general hospital in Northern Uganda
Background Women of reproductive age constitute a significant proportion of the global HIV burden, with millions becoming pregnant while on lifelong antiretroviral therapy (ART). Although ART has dramatically improved maternal and child health outcomes, concerns persist regarding its safety in pregnancy. This study compares obstetric and neonatal outcomes between women with and without HIV infection at Anaka General Hospital, a rural hospital in northern Uganda. Methods A hospital-based retrospective cross-sectional study at Anaka General Hospital in northern Uganda was conducted from July 2020 to June 2023. A total of 914 delivery records were included, sampled using systematic random sampling from the hospital maternity register. Data were extracted from maternity and neonatal records using a structured tool. Associations between HIV status and obstetric or neonatal outcomes were assessed using Chi-square or Fisher’s exact tests for categorical variables and independent sample t-tests for continuous variables. Multivariable logistic regression was used to adjust for potential confounders and a p < 0.05 was considered statistically significant. Results Of the 914 participants included in the study 38 (4.2%) were HIV-positive. The odds of congenital anomalies were significantly higher among infants born to HIV-positive women compared with HIV-negative women (adjusted odds ratio = 9.76, 95% confidence interval: 1.72–55.48, p < 0.01). No significant differences were observed in maternal or neonatal outcomes between the two groups. Conclusion HIV infection was significantly associated with an increased risk of congenital anomalies, while other obstetric and neonatal outcomes were similar between HIV-positive and HIV-negative women. We recommend enhanced prenatal monitoring and early fetal screening among HIV-positive pregnant women on dolutegravir-based ART. Additionally, prospective studies are needed to better understand the contribution of dolutegravir and maternal factors to congenital anomalies in HIV-exposed pregnancies.
Prevalence of dengue in febrile patients in Peru: A systematic review and meta-analysis
Background Dengue is an acute febrile illness that is a significant public health problem. Peru is an endemic region for vector-borne diseases such as dengue, zika, and chikungunya, which initially manifest with febrile illness and can complicate differential diagnosis. Therefore, the present study aimed to determine the prevalence of positive results for dengue or dengue antibodies in Peruvian patients with febrile illness using diagnostic tools such as RT-PCR and ELISA NS1, IgM, and IgG. Methods A literature search was conducted in eight databases or search tools (PubMed, Scopus, Embase, Web of Science, ScienceDirect, Google Scholar, Virtual Health Library, and Scielo) until June 9, 2024. Medical Subject Headings (MeSH) terms such as “dengue” and “Peru” were used, together with the free term “febrile illness”, combined using the Boolean operators AND and OR. We included observational studies with a control group of patients with fever but no dengue infection and a non-control group of febrile patients who tested positive for dengue. Pooled estimates and 95% confidence intervals (CI) were calculated using random-effects models. Study quality and risk of bias were assessed using the Joanna Briggs Institute Statistical Meta-Analysis Assessment and Review Instrument. Heterogeneity was assessed using the I2 statistic, and statistical analysis was performed with R version 4.2.3. Results We included 15 observational studies that met the inclusion criteria developed in 10 regions of Peru and published between 2002 and 2022, with a total of 12,355 patients with febrile illness. The pooled prevalence of positive results for dengue or dengue antibodies in these patients was 21% (95% CI: 9%−36%; 2022 participants; 5 studies; I2 = 98%) for IgG ELISA, 16% (95% CI: 11%−21%; 10891 participants; 10 studies; I2 = 97%) for IgM ELISA, 19% (95% CI: 9%−31%; 2086 participants; 5 studies; I2 = 98%) for NS1 ELISA, and 20% (95% CI: 13%−28%; 3107 participants; 9 studies; I2 = 96%) for RNA PCR. Conclusion Our results suggest a high prevalence of positive results for dengue or dengue antibodies among febrile patients in Peru, which varies depending on the diagnostic method used. Despite this variability, the use of accurate diagnostic methods is essential for the early detection and prevention of serious complications. The findings underline the need to strengthen dengue control strategies, improve diagnostic capacity in health centers, and optimize epidemiological surveillance in high-incidence regions. It is recommended that public health policies focus on these key areas for better management of the disease.
Status and associated factors of psychological resilience of Chinese medical aid team members under public health emergencies in a cross-sectional study
Background Chinese medical aid team members (CMATMs) play an important role in the implementation of China’s foreign health aid strategy. However, there is no research on the status and influencing factors of their psychological resilience. Objective This study aims to investigate the current status and influencing factors of psychological resilience of CMATMs. Methods From 3rd December, 2024–25th December, 2024, a convenience sampling method was used. Demographic information questionnaire, Connor Davidson Resilience Scale, General Self-Efficacy Scale, Self-Rating Anxiety Scale and Self-Rating Depression Scale were used to measure the psychological status of aid members. The influencing factors of psychological resilience were investigated through T-test, ANOVA, pearson correlation analysis, Kruskal-Wallis test and multiple linear regression. Results A total of 89 questionnaires were analysed. The total score of psychological resilience was 72.53 ± 13.48, which was generally at a good level. Pearson correlation analysis showed that self-efficacy was positively correlated with psychological resilience, while anxiety and depression were negatively correlated with psychological resilience. Multiple linear regression analysis revealed that factors related to psychological resilience included professional title(B = 4.679, P = 0.001), loneliness(B = 4.973, P = 0.000), classification of hardship areas in recipient countries(B = 1.864, P = 0.004), family support(B = 3.110, P = 0.001), cultural and entertainment(B = 3.537, P = 0.001), and direct participation in public health emergency response missions in recipient countries(B = −3.775, P = 0.006). Conclusions In the context of public health emergencies, CMATMs are prone to great pressure, which has a negative impact on their psychological resilience. This study provides a theoretical basis for formulating psychological intervention measures for CMATMs. Policymakers or healthcare administrators should regular assess CMATMs ‘ mental health status, strengthen mental health training, mobilize family and social support networks, improve infrastructure and welfare security policies to help them establish a more adaptive defense mechanism and maintain good psychological resilience during foreign aid.