Browse Articles

Multiple-family group intervention programming to improve mental health of adolescents living with HIV/AIDS in Ghana: An implementation science study protocol

Background Adolescents living with HIV/AIDS in sub-Saharan Africa face a disproportionate burden of mental health challenges and suboptimal antiretroviral therapy (ART) adherence, which can have significant consequences for their overall health and well-being. While multiple family group therapy (MFGT) has shown promise in improving outcomes for ALHIV in other settings, the intervention is yet to be wholly adapted and evaluated in the Ghanaian context. This study aims to adapt, pilot, and evaluate a multiple family group therapy (MFGT) intervention to improve mental health and ART adherence among adolescents living with HIV/AIDS in Ghana. Methods A total of 80 ALHIV (aged 10–19 years at enrollment) will be recruited from two HIV clinics and each clinic will be randomized to one of two study conditions (MFGT group and control group). The study will be conducted in three phases: 1) Adaptation Phase – Qualitative data collection through focus group discussions and in-depth interviews with key stakeholders (adolescents, caregivers, community leaders and healthcare providers) to inform the adaptation of the MFGT intervention for the Ghanaian context; 2) Pilot Implementation Phase – Quantitative assessments (PHQ-9, GAD-7, Wilson’s 3-item adherence scale, FAD, Berger HIV Stigma Scale) and qualitative data collection (focus groups, interviews) to evaluate the feasibility, acceptability, and preliminary effectiveness of the adapted MFGT intervention; and 3) Evaluation Phase – Continuation of the quantitative and qualitative data collection, as well as a cost-effectiveness analysis, to assess the long-term impact, sustainability, and scalability of the MFGT intervention. Expected Outcomes The study will provide valuable insights into the feasibility, acceptability, and effectiveness of the adapted MFGT intervention in improving mental health and ART adherence among adolescents living with HIV/AIDS in Ghana. The findings will inform the development of culturally relevant and sustainable strategies to support this vulnerable population, with potential implications for similar interventions in other sub-Saharan African contexts. Ethics and Dissemination The study has obtained necessary ethical approvals from the Ghana Health Service Ethics Review Committee and relevant health authorities, and will follow international research guidelines. Findings will be disseminated through peer-reviewed publications, conference presentations, and clinical trial registry, with an emphasis on open-access formats to maximize accessibility. Protocol Registration in Clinical Trials.gov (NCT06701942). Date of trial registration 24 November, 2024.

Greening nickel extraction requires institutional and financial support

Characteristics of traumatic brain injury-related healthcare visits across social determinants of health: A population-based birth cohort study

Background Traumatic brain injury is a major cause of death and disability worldwide, with almost half of new cases occurring in children, adolescents, and young adults. However, data on injury characteristics stratified by social determinants of health are scarce. This study explores severity, intent, and mechanism of traumatic brain injury sustained during childhood, adolescence, and young adulthood by social determinants of health. Methods This study utilizes a population-based birth cohort of births in publicly funded hospitals in Ontario, Canada, between April 1, 1992 and March 31, 2020 (n = 3,648,760). Individuals experiencing a traumatic brain injury requiring medical attention to the emergency department or acute care between April 1, 2002 and November 20, 2020 (n = 94,514) were identified using International Classification of Diseases Version 10 diagnosis codes. Social determinants of health variables included age, sex, rurality of residence, neighbourhood income quintile, and the following Ontario Marginalization Index variables: households and dwellings, material resources, and racialized and newcomer populations. The primary outcome was percentage of injuries falling under each mechanism, intent, and severity of injury category, stratified by social determinants of health variables. Results Approximately 50% of injuries were mild and 96.2% of injuries were unintentional. Injury severity and intent of injury significantly varied by social determinants of health; for example, the proportion of traumatic brain injury-related healthcare visits for moderate/severe and intentional injuries was highest in areas with the lowest income quintile (13.3% and 6.1%, respectively), lowest households and dwellings stability (12.2% and 5.7%, respectively), lowest material resources (12.8% and 6.0% respectively), and highest racialized and newcomer populations (13.5% and 4.5% respectively). The percentage of traumatic brain injury-related healthcare visits for a sports-related injury significantly varied by social determinants of health; for example, the proportion of traumatic brain injury-related healthcare visits for sports-related injuries was highest among males (45.5%), those living rural areas (44.0%), and those living in areas with the highest income (47.2%), highest households and dwellings stability (44.0%), highest material resources (45.8%), and lowest racialized and newcomer populations (43.4%). Conclusions Characteristics of traumatic brain injury-related healthcare visits vary based on social determinants of health. Targeted prevention of traumatic brain injury beyond the sports settings, including fall prevention among young children, are encouraged, and guidelines to identify and address traumatic brain injury outside of the sports setting must be developed to support early intervention of traumatic brain injury across social determinants of health.

The effects of charring on sunflower (Helianthus annuus L) achenes and kernels: Taphonomic and behavioral implications

Sunflower (Helianthus annuus L) is one of several seed-bearing annual plants that were domesticated in eastern North America 5000–3800 years ago. When found in the archaeological record the plant’s fruits (achenes) are generally charred. Charring causes changes in the lengths and widths of achenes and their enclosed kernels. Correction factors for these changes derived from controlled heating experiments have been proposed to estimate the original size of charred achenes. The resulting corrected sizes are used to distinguish achenes from domesticated and wild sunflowers. The current study aimed to assess the accuracy of these correction factors and explore morphological differences in hulled and unhulled kernels after heating in 20°C increments from 200 to 420°C. The results indicate the proposed correction factors are inaccurate, potentially leading to type 1 and type 2 errors in assessing domestication status of achenes; the use of correction factors to identify domesticated sunflower achenes is not warranted. Rather, size comparisons of charred archaeological to charred wild contemporary sunflower achenes reported in a previous experiment are less likely to result in assignment errors. Results also indicate it is possible to distinguish between kernels that were hulled before charring from those that were not hulled based on length:width ratios and the presence of longitudinal ridges on unhulled kernels.

Not all clinical data in the United States are fragmented

SA-UMamba: Spatial attention convolutional neural networks for medical image segmentation

Medical image segmentation plays an important role in medical diagnosis and treatment. Most recent medical image segmentation methods are based on a convolutional neural network (CNN) or Transformer model. However, CNN-based methods are limited by locality, whereas Transformer-based methods are constrained by the quadratic complexity of attention computations. Alternatively, the state-space model-based Mamba architecture has garnered widespread attention owing to its linear computational complexity for global modeling. However, Mamba and its variants are still limited in their ability to extract local receptive field features. To address this limitation, we propose a novel residual spatial state-space (RSSS) block that enhances spatial feature extraction by integrating global and local representations. The RSSS block combines the Mamba module for capturing global dependencies with a receptive field attention convolution (RFAC) module to extract location-sensitive local patterns. Furthermore, we introduce a residual adjust strategy to dynamically fuse global and local information, improving spatial expressiveness. Based on the RSSS block, we design a U-shaped SA-UMamba segmentation framework that effectively captures multi-scale spatial context across different stages. Experiments conducted on the Synapse, ISIC17, ISIC18 and CVC-ClinicDB datasets validate the segmentation performance of our proposed SA-UMamba framework.

Are metabolic abnormalities the missing link between complete blood count-derived inflammatory markers and diabetic foot? Evidence from a large population study

Background Diabetic foot is a serious complication of diabetes, and inflammation plays a key role in its pathogenesis. This population-based study investigates associations between complete blood count (CBC)-derived inflammatory markers and diabetic foot, while evaluating metabolic mediators in these relationships. Methods Data from 1,246 participants across three National Health and Nutrition Examination Survey (NHANES) cycles (1999–2004) were analyzed. Calculated inflammatory markers included monocyte-to-lymphocyte ratio (MLR), neutrophil-to-lymphocyte ratio (NLR), neutrophil-monocyte-to-lymphocyte ratio (NMLR), and systemic inflammatory response index (SIRI). Weighted logistic regression models assessed marker-diabetic foot associations, supplemented by subgroup and restricted cubic spline (RCS) analyses for nonlinearity. Mediation analysis quantified metabolic contributions. Results CBC-derived inflammatory markers demonstrated significant positive correlations with diabetic foot risk. Risk increased as quartiles for these markers increased. RCS analysis further revealed a significant nonlinear relationship between them. Serum creatinine (12.46%) and albumin (11.33%) mediated significant proportions of these associations. Conclusions CBC-derived inflammatory markers serve as accessible predictors of diabetic foot risk, with nonlinear patterns. The partial mediation by metabolic indicators highlights dual inflammatory-metabolic pathways in diabetic foot pathogenesis. Routine CBC-derived inflammatory markers monitoring could enable early risk stratification, while targeting metabolic abnormalities may amplify preventive strategies.

Reduced investment in universities has multifaceted effects

Global evolution of inflammatory bowel disease across epidemiologic stages

Immune-associated molecular classification and prognosis signature of sepsis

This study aims to explore the molecular subtypes of sepsis and the correlation between immune-related genes and the prognosis of patients with sepsis. Utilizing the Gene Expression Omnibus dataset (GSE65682) with 479 patients with sepsis as the training set and 164 patients treated at our hospital as the independent validation cohort. An unsupervised cluster analysis was used to identify potential molecular subtypes of sepsis, and a weighted gene co-expression network analysis was performed to identify gene modules. Gene Ontology, Kyoto Encyclopedia of Genes, and Genomes enrichment analyses were performed, and the immune status was also evaluated. Using LASSO regression and multivariate Cox regression, an immune-related gene prognostic model was developed, validated, and evaluated, followed by an individual risk scoring system. We identified two molecular subtypes of sepsis that are associated with distinct immune response patterns and clinical outcomes. Patients in Cluster A exhibited poorer survival and enrichment of pro-inflammatory pathways, while those in Cluster B had better outcomes and enrichment of immune regulatory pathways. A 10-gene prognostic model was constructed, stratifying patients into high- and low-risk groups using the estimated risk score that was confirmed to be an independent prognostic factor in both the training (hazard ratio [HR]: 1.126, 95% confidence interval [CI]: 1.096–1.156, P < 0.001) and validation datasets (HR: 1.149, 95% CI: 1.085–1.216, P < 0.001). A risk scoring system was developed based on the risk score and clinical parameters, with estimated mortality probabilities of 0.132 (7-day), 0.211 (14-day), and 0.258 (21-day). High-risk patients had significantly worse prognoses, and this was validated in the independent cohort. Distinct immune cell profiles were found between the two subtypes and risk groups, with B cells, CD8 + T cells, and NK cells elevated in Cluster B. This study identified immune-related molecular subtypes of sepsis and developed a prognostic model that accurately predicts sepsis mortality. These findings provide insights into the immune dysregulation in sepsis and can potentially be used for developing personalized treatment strategies and improving clinical decision-making in sepsis management.

Monitoring audience engagement using electrodermal activity during an inaugural lecture

Is an audience captured by a speech or lecture? At what times especially? Do different groups in an audience experience the same speech in different ways? Insight into attentional engagement of individuals can be valuable but difficult to quantify using self-report. Physiological synchrony, the degree to which physiological measurements such as electrodermal activity (EDA) of multiple people uniformly change, has been shown to covary with attentional engagement in lab settings. In this study, we moved out of the lab and monitored EDA of 30 individuals attending a real-life inaugural lecture. These individuals were labeled as belonging to either the personal or professional group, based on their relation with the speaker. We expected these groups to differ in their attentional engagement. We computed physiological synchrony between the participants and investigated how well this metric distinguished between the professional and personal groups, how well it marked predefined engaging events in the lecture, and its relation with levels of engagement as self-reported afterwards. Where possible, we compared physiological synchrony results to results based on individuals’ EDA. We found that physiological synchrony in EDA can distinguish between the two groups. Individuals’ EDA can also distinguish between the groups, if the occurrence and timing is known of an event that is expected to elicit different levels of engagement for the two groups. We further found that both synchrony and individuals’ EDA measures mark predefined engaging events with above-chance accuracies. Neither was reliably related to self-reported levels of attentional engagement, highlighting the complementary value of EDA. Our work shows the sensitivity of EDA measures in real-life conditions, where low-level sensory effects, movement and speech cannot be the explanatory factor. Ultimate applications may be in educational and entertainment domains, exploring potential differences in attentional engagement patterns between experts and novices, or different target groups in entertainment.

Titration-WB: A methodology for accurate quantitative protein determination overcoming reproducibility errors

Western blotting (WB) is a cornerstone technique for protein detection and quantification in molecular biology. However, its semi-quantitative nature, reliance on housekeeping protein normalization, and susceptibility to technical variability often undermine data accuracy and reproducibility. To address these limitations, we introduce titration-based Western blotting (t-WB), as innovative quantitative approach that uses serial dilutions of protein samples to generate regression curves for precise protein quantification. The method mitigates common errors, including loading inaccuracies and signal saturation, by leveraging the R² value as a quality control metric and calculating the regression line. Its slope is then used as a measure of protein concentration, expressed as signal intensity/total protein loaded. The advantage of t-WB is the removal of housekeeping protein normalization, eliminating thus the bias created by experimental conditions that may alter housekeeping protein levels. t-WB was validated across diverse setups, demonstrating its robustness in minimizing inter-experiment variability and improving accuracy by normalizing to a single internal control. By standardizing workflows, t-WB ensures reproducibility, uncovers subtle biological changes, and resolves biases inherent to classical WB protocols.

How to speak to a vaccine sceptic: research reveals what works

Pectoralis minor length index at 1 month postoperative can predict homolateral neuropathic pain 4 months after mastectomy with lymph node resection

The relationship between postoperative physical changes and the development of homolateral neuropathic pain (HLNP) following mastectomy and lymph node resection remains poorly understood. In this study, we aimed to investigate whether early postoperative physical and symptom-based assessments could predict HLNP occurrence at 4 months post-surgery. Fifty-seven breast cancer survivors were included, with HLNP defined as a painDETECT Questionnaire score ≥ 13 at 4 months. Independent variables included patient demographics, physical function metrics including pectoralis minor length index (PMI), and questionnaire-based evaluations at 1 month postoperatively. Multivariate logistic regression identified systemic therapy side effects (ST) (odds ratio [OR]: 1.056; 95% confidence interval [CI]: 1.015–1.098) and PMI (OR: 0.204; 95% CI: 0.043–0.977) as significant predictors of HLNP. Receiver operating characteristic curve analysis identified cutoff values of 23.81 for ST and 9.82 for PMI. Reconstruction type and adjuvant therapy influenced the correlation between PMI and the number of resected lymph nodes, unlike external rotation metrics. Early assessment of ST and PMI facilitates HLNP risk prediction following breast cancer surgery. Multimodal interventions, including targeted physical therapy, may mitigate HLNP risk, highlighting the importance of early postoperative care.

Mathematics in ancient Egypt

Feasibility trial protocol assessing the use of aerobic exercise to promote recovery from work-related concussion

Introduction Work-related concussion (WRC) is a common occupational injury that has received far less research attention compared to sport-related concussion (SRC). WRC results in prolonged lost time claims, adversely influences perceived life roles, and negatively impacts personal and family finances. WRC also affects workforce capacity in industries that are already facing worker shortages (e.g., construction, manufacturing, healthcare, etc.). Targeted heart rate aerobic exercise (THRAE) has emerged as an effective treatment for speeding recovery from SRC and for reducing the incidence of persisting post-concussive symptoms (PPCS). The aim of this proposed study is to explore the feasibility of THRAE in adults with WRC as there are very few interventions that have been rigorously studied in this population. Materials and Methods We describe a feasibility trial to implement THRAE in individuals with WRC. While this study will not test specific hypotheses related to effectiveness, it will provide key information related to adherence, safety, and psychosocial factors related to adherence and participation. Additionally, this study will provide mean and standard deviation values for the measures applied to this novel population to inform power analyses for larger-scale trials. Trial registration Clinicaltrials.gov NCT06263179

Dementia is deadly — the UN needs to take it more seriously

Training forecast to football athletes using Hopfield neural networks based on Markov matrix

This paper proposes a neural network based on the Markov probability transition matrix to predict the training performance of football athletes. Firstly, seven training indicators affecting the training performance are designed by the Event-group training theory. Then, a discrete Hopfield neural network is employed according to the seven training indicators. To improve the forecast ability of the discrete Hopfield neural network, the Markov probability transition matrix is used to calculate the activation probability of neurons. Finally, experimental results indicate that the proposed model defeats against the competitors in the forecast of training performance of football athletes. And the proposed model can find the major training indicators that have direct effects on the training performance, which can provide scientific suggestions for coaches to customize training plans. We demonstrate that the seven training indicators can sufficiently evaluate the effectiveness of training plans in the improvement in terms of training performance for football athletes.

Evaluation of Protein Cards: A nutrition education tool for metabolic bariatric surgery

Background Metabolic bariatric surgery (MBS) is a safe, effective treatment for severe obesity and its associated comorbidities. However, adherence to postoperative guidelines, particularly dietary protein intake remains a challenge. This study examined the suitability of the Protein Cards , a protein-focused nutrition education tool developed to support individuals meet their protein requirements during the postoperative diet stages: fluid, purée, soft, and regular. Methods An online adapted version of the Suitability Assessment of Materials questionnaire was administered from September 2020 to May 2021. Participants were recruited via convenience sampling and advertisement. Participants rated the rated as “superior”, “adequate” or “not suitable” on content, literacy demand, graphic illustrations, layout and typography, learning stimulation and motivation, and cultural appropriateness, with scores of 2, 1, and 0, respectively. Results A total of 437 individuals completed the online survey. Participants were identified as individuals who have undergone MBS (n = 263), caregivers of individuals who completed MBS (n = 68), and/or healthcare providers (including dietitians) specializing in MBS (n = 106). The Protein Cards received an overall “superior” rating of 73.00%. The tool had a high likelihood of use particularly for the soft diet stage (63.99 ± 20.70). Participants preferred the tool be available as a mobile application (63.41 ± 20.41) followed by paper book (59.40 ± 21.95) format. Conclusion Protein Cards have the potential of supporting individuals who have undergone MBS in adopting healthy dietary habits, particularly in meeting their protein requirements. Future studies are needed to refine the Protein Cards and evaluate its usability among individuals post-MBS.

Expansion of forest cover and coeval shifts in Later Stone Age land-use at Taforalt and Rhafas Caves, Morocco, as inferred from carbon isotopes in ungulate tooth enamel

Later Stone Age (Iberomaurusian) hunter-gatherer groups in northwestern Africa appear to have experienced a major reorganization of land-use strategies and settlement dynamics around 15–13 cal ka BP, which broadly corresponds to the globally recognized Greenland Interstadial 1 (Bølling-Allerød) climate interval. However, our understanding of the local impacts of this interval on environments in Morocco is incomplete, as is our understanding of the strength of the relationship, if any, between paleoenvironmental change and human behavior in the Moroccan Later Stone Age. This paper reconstructs changes through time in local forest canopy cover during the Later Stone Age around the archaeological cave sites of Taforalt and Rhafas (northeastern Morocco), using stable isotopes of carbon in ungulate tooth enamel. Results indicate a close link between tree cover expansion during Greenland Interstadial 1 and changes in land-use behaviors, which at Taforalt included the exploitation of storable oak and pine-derived plant foods and greater intensity of site occupation. High local productivity of nut-bearing trees paired with regional increases in human population densities likely contributed to greater intensity of occupations at Taforalt and Rhafas during Greenland Interstadial 1.