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Perspectives of health workers on malaria case referral among pregnant women attending antenatal care in Savelugu Municipality, Ghana: A qualitative descriptive study
Background Malaria remains endemic in Africa, with pregnant women exposed to the dangers of complications, which require emergency referral for lifesaving interventions. This study explored the perspectives of health workers on malaria case referral among pregnant women attending antenatal care (ANC) at health facilities in Savelugu Municipality, northern Ghana. Methods The study employed a qualitative descriptive design with a constructivist grounded theory perspective. A semi-structured interview guide was used to collect information from thirteen health workers on face-to-face. The participants were purposefully sampled and interviewed. The data were transcribed verbatim. Content analysis was performed and the results were presented as themes and sub-themes. Results After the analysis, two main themes and six sub-themes emerged from the data: a robust referral system (patient awareness and consent, documentation, referral coordination, and post-referral feedback) and a referral mechanism (ambulance/nurse accompaniment, and transportation shortfalls/patients left to their fate). Participants described the referral system as robust but reported transport challenges as the main obstacle to its operation. The study also revealed that health workers do not accompany all referral cases. Conclusion A referral system exists in the Savelugu Municipality with transportation lapses causing delays. Health workers often failed to accompany referred cases to the referral facilities. Though an inter-sectoral approach is needed to tackle the referral transport challenges, facility managers need to ensure that all referred cases are accompanied by a designated health worker.
Molecular insights into supercritical water gasification process of polyoxymethylene plastics
Abstract Effective plastic management is crucial in addressing the growing environmental challenges posed by plastic pollution. Among various plastics, polyoxymethylene (POM) stands out as a widely used engineering thermoplastic with significant applications in industries . Innovative recycling solutions are essential to mitigate its environmental impact. This study investigates the supercritical water gasification (SCWG) of POM plastics at a molecular level using reactive molecular dynamics simulations. The research aims to provide insights into the factors influencing the SCWG process. Key findings reveal that temperature significantly affects reaction mechanisms, while the primary syngas products include hydrogen , carbon monoxide, and carbon dioxide. A notable trend observed is the increase in activation energy as water content increases, highlighting the importance of optimizing hydration levels for efficient conversion. The calculated activation energies range from 106 to 135 kJ/mol, aligning well with experimental findings (160 kJ/mol). The study validates the computational approach by demonstrating excellent agreement between simulation results and experimental findings on the molar fraction of gas and activation energy, underscoring its reliability as a predictive tool for process design and optimization. Furthermore, the research contributes to sustainable waste management by offering strategies to enhance SCWG efficiency.
iPSCs engrafted in allogeneic hosts without immunosuppression induce donor-specific tolerance to secondary allografts
Currently, most cell or tissue transplantations using induced pluripotent stem cells (iPSCs) are anticipated to involve allogeneic iPSCs. However, the immunological properties of iPSCs in an allogeneic setting are not well understood. We previously established a mouse transplantation model of MHC-compatible/minor antigen-mismatched combinations, assuming a hypoimmunogenic iPSC-setting. Here, we found that iPSCs subcutaneously inoculated into MHC-compatible allogeneic host mice resisted rejection and formed teratomas without immunosuppressant administration. Notably, when skin grafts were transplanted onto hosts more than 40 d after the initial iPSCs inoculation, only the skin of the same strain as the initial iPSCs was engrafted. Therefore, donor-specific immune tolerance was induced by a single iPSC inoculation. Diverse analyses, including single-cell RNA-sequencing after transplantation, revealed an increase in regulatory T cell (Treg) population, particularly CD25 + CD103 + effector Tregs within the teratoma and skin grafts. The removal of CD25 + or Foxp3 + cells suppressed the increase in effector Tregs and disrupted graft acceptance, indicating the importance of these cells in the establishment of immune tolerance. Within the teratoma, we observed an increase in TGF-β2 levels, suggesting an association with the increase in effector Tregs. Our results provide important insights for future applications of allogeneic iPSC-based cell or tissue transplantation.
Smart IoT-driven precision agriculture: Land mapping, crop prediction, and irrigation system
As the world population is increasing day by day, so is the need for more advanced automated precision agriculture to meet the increasing demands for food while decreasing labor work and saving water for crops. Recently, there have been many studies done in this field, but very few discuss implementing smart technologies to present a combined sustainable farming system. In this article, we present a complete integrated design of a smart IoT-based suitable agricultural land and crop selection, along with an irrigation system using agricultural mapping, machine learning, and fuzzy logic for precision agriculture. Multi-spectral band images from Landsat-8 satellite images of a chosen land are employed from USGS Earth Resources Observation and Science (EROS) Center for extracting indices that are used for agricultural analysis, determining the vegetation index, water index, and salinity index of that land using K-means. Furthermore, crop yield is predicted using Linear Regression and Random Forest, achieving accuracies of 93.49% and 95.87%, respectively, while using RMSE (Root Mean Squared Error) as the loss function. The LSTM model is used for healthy vegetation area forecasting highlighting the changes of the vegetation area over time. Such analysis helps to decide whether that land is suitable for farming or not. Multiple soil-parameter measuring sensors are used to identify suitable crop and fertilizer requirements for that land using IoT and machine learning. The ML model-based crop prediction showed 97.35% accuracy utilizing random forest algorithm. Finally, a fuzzy logic-based solar-powered irrigation system is used to monitor the water requirements of those crops and irrigate them according to their needs. The experimental results demonstrated that fuzzy logic has faster calibration rate of 66.23% and helps to save around 61% water in comparison to average logic algorithm. The implementation of a fuzzy logic algorithm significantly optimized water usage compared to traditional manual irrigation methods. These findings highlight the effectiveness of advanced computational techniques in enhancing agricultural practices and resource management.
Predictors of optimal angiographic lesion outcomes in drug-coated balloon treatment for de novo coronary artery disease
<i>N</i> 6-methyladnosine of vRNA facilitates influenza A virus replication by promoting the interaction of vRNA with polymerase proteins
N 6-methyladnosine (m 6 A) modification is present in both positive- and negative-strand RNA of influenza A virus (IAV) and affects the replication and pathogenicity of IAV. However, little is known about the regulatory mechanism of m 6 A in IAV RNA. In the present study, we identified the m 6 A methylation of the viral RNA of different IAV subtypes and confirmed that m 6 A modification promotes the polymerase activity and replication of IAV. By mutating m 6 A motifs on the multiple viral RNAs (vRNAs) of IAV, we revealed that m 6 A deficiency in vRNA suppresses the expression of viral genes and the replication of the virus in vitro. In addition, m 6 A deficiency in vRNA reduced the pathogenicity of IAV in a mouse model. Mechanistically, m 6 A deficiency in vRNA suppresses the assembly of the viral ribonucleoprotein (vRNP) complex by impairing the interaction between vRNA and vRNP proteins in an m 6 A methyltransferase-dependent manner, but not the m 6 A reader proteins. Together, our findings reveal an important role for m 6 A on viral RNAs in facilitating the activity of the polymerase complex and the replication and pathogenicity of IAV, which provides insights for the development of novel anti-influenza strategies.
Sarcopenic obesity in predialysis chronic kidney disease: Muscle strength is a predictor of mortality and disease progression in a six-year prospective cohort
Introduction Sarcopenic obesity (SO) is a poorly defined physiological condition that is associated with increased morbimortality in the general population. The prevalence of SO has increased, making it an important public health issue; however, its effects when associated with other chronic conditions are still unclear. Therefore, it is necessary to comprehend the potential outcomes in chronic kidney disease (CKD) patients. Objective To assess the associations of predialysis CKD patients with SO and its components with death and disease progression to renal replacement therapy (RRT). Methods Prospective six-year cohort with 100 patients with predialysis CKD (stages one through five). Participants were older than 18 years and signed an informed consent form. The data were collected in an outpatient clinic specializing in predialysis care, and demographic, clinical, laboratory and inflammatory variable data were collected. A descriptive analysis was performed, and the SO and non-SO groups were compared with Student’s t test, Mann‒Whitney U test and Cox regression, taking into consideration all relevant confounding variables. Body composition variables utilized to diagnose SO were separately analyzed along with the outcomes. Results Sixteen percent of our sample were diagnosed with SO, but this was not associated with death or RRT, while lower BMI values were negatively associated with these outcomes. However, in an isolated analysis, handgrip strength was correlated with both RRT (p = 0.029) and death (p = 0.003). We recommend that health professionals pay greater attention to muscle strength, striving for earlier assessment, in an effort to better counsel patients and implement actions to increase or preserve strength through nonpharmacological treatment, such as resistance training.
Influence of dietary protein levels on nano-encapsulated Yucca schidigera extract and its effects on in vitro ruminal greenhouse gas production and fermentation dynamics
Abstract The influence of nano-encapsulated Yucca schidigera extract (YSE) on total gas (GP), ruminal methane (CH4), carbon monoxide (CO), hydrogen sulphide (H2S) production, and fermentation activities of diets based on two different protein levels were investigated. A completely randomized experimental design with a factorial arrangement (2 × 4 × 4) with three replications was used. Factor 1 was the dietary protein levels (14%and 18%), factor 2 was the types of extracts used (TE; negative control (without extract), positive control (empty chitosan nano-capsules), Y. schidigera extract nano-capsules, and crude Y. schidigera extract), and factor 3 the doses of each type of extract (ED; 0-, 0.25-, 0.5-, and 1.0- mL extract/g DM). Nano-chitosan reduced the GP production with a higher protein level by 24.9% after 48 h while the crude extract elevated it. At both crude protein levels, the interaction of crude extract at an ED of 0.25 mL extract/g DM generated a higher volume of CH4 at 6 h (p = 0.001 and 0.001 respectively) compared to the volume generated by the negative control. The 0.25 mL extract/g DM extract for both the crude extract and nano-extract elicited higher and lower CO production at 6 h (p < 0.0001), respectively. Nano-chitosan at 0.25 mL extract/g DM resulted in less H2S produced at 6 h than when crude extract was used at the same dose and a higher protein level (p = 0.027). The ED did not significantly affect any of the parameters under consideration as used under lower protein levels. However, TE affected pH and dry matter degradability (p < 0.0001) while the interaction of both TE and ED impacted both CH4:SCFA and CH4:ME (p = 0.045) with higher and lower values obtained for nano-chitosan and the negative control, respectively. In conclusion, nano-chitosan at a higher protein level proved its antimicrobial property, and although the production of CO increased at 14% protein, in vitro fermentation indicated its ability to minimize the production of GP, methane and hydrogen sulphide in the rumen, and to boost the degradability of DM and methane conversion efficiency.
Real-life intense fear is communicated through context, not facial expressions
Central emotion theories assume that during threatening and dangerous events the human face signals a prototypical, distinct, and universally recognized expression of fear which can be accurately decoded by conspecific perceivers. Due to the importance of fear expressions, an unusually large body of research has been dedicated to exploring their evolutionary origins, neurobiological mechanisms, and clinical significance. However, these studies typically utilize highly recognizable posed actor portrayals presumed to closely resemble the diagnostic physical appearance of real-life fearful faces. Here, we challenge this diagnosticity assumption. Following context-dependent frameworks (Barrett, 2017), we hypothesized that extrafacial context (e.g., situational information, body posture, etc.) plays a far greater role in fear communication than the signal of the isolated face. In 12 preregistered experiments (N = 4,180), we examined the perception of authentic, real-life videos documenting a diverse range of intense fear-inducing situations (e.g., height jumping, physical attacks, exposure to phobia triggers). Participants viewed the face alone, the context with no face, or the full video while various response methods of emotion perception were tested (forced choice, open-ended, multiple emotion scales, valence-arousal ratings). Across experiments, videos of the faces alone failed to communicate fear in a reliable manner. In sharp contrast, context with no faces, and faces with context were clearly and robustly perceived as fearful, with medium to large effect sizes. These findings suggest that despite the undisputed importance of perceiving fear reactions, facial expressions alone bear minimal diagnostic value, while context plays a critical role in real-life fear perception.
Predictors of internalised stigma among people with mental illness attending a psychiatry outpatient clinic in Ethiopia: Institution based cross sectional study
Background Despite initiatives to increase access to mental health care and improve the quality of life for individuals living with mental illness, there is limited information on internalized stigma and its impact on these individuals. This study aimed to determine the prevalence of internalised stigma and identify associated factors (sociodemographic, clinical, and substance use) among people with mental illness attending an outpatient clinic in Ethiopia. Method Institution-based cross-sectional study was conducted with patients with mental illness at the University of Gondar Hospital clinic. We recruited 638 participants from the clinic using systematic random sampling with an interval of three applied. Internalised stigma was measured using the nine-item (ISMI-9) Internalised stigma of Mental Illness Scale. Variables were coded and entered into SPSS-28 software for further analysis. To analyze the data, we used descriptive and multivariate logistic regression analysis. Adjusted odds ratio (AOR) with 95% confidence interval (CI) and p-value less than 0.05 were considered significant. Results Prevalence of internalised stigma among study participants was 49.1% (95% CI: 45, 52). The following attributes were associated with a greater likelihood of high internalised stigma, participants with no formal education (AOR=2.19, 95% CI:1.33, 3.61); patients with fair self-reported health (AOR=3.12, 95% CI:1.28, 7.59), patients with poor self-reported health (AOR= 9.11, 95% CI: 2.89, 28.73), patients with suicidal ideation (AOR=1.95, 95% CI:1.37, 2.79), alcohol users (AOR= 1.89, 95% CI:1.24,2.91), patient with low self-esteem (AOR=1.55, 95% CI:1.09, 2.21), patient with poor drug adherence (AOR=2.2, 95% CI:1.30,3.71), patients with family history of substance use (AOR= 2.46, 95% CI:1.54,3.93). Conclusions The prevalence of high internalised stigma among patients with mental illness in was high. Therefore, anti-stigma activities, early outpatient support, drug adherence information, and reduction of suicidal behaviors are all necessary to reduce stigma in patients with mental illnesses.
Theoretical modeling and fault diagnosis of pantograph–catenary arc under high-speed airflow
The decade-long growth of government-authored news media in China under Xi Jinping
Autocratic governments around the world use clandestine propaganda campaigns to influence the media. We document a decade-long trend in China toward the planting of government-authored articles in party and commercial newspapers. To examine this phenomenon, we develop an approach to identifying scripted propaganda—the coerced reprinting of lightly adapted government-authored articles in newspapers—that leverages the footprints left by the government when making media interventions. We show that in China, scripted propaganda is a daily phenomenon—on 90% of days from 2012 to 2022, the vast majority of party newspapers include at least some scripted propaganda at the direction of a central directive. On particular sensitive days, the amount of scripted propaganda can spike to 30% of the articles appearing in major newspapers. We show that scripted propaganda has strengthened under President Xi Jinping. In the last decade, the front page of party newspapers has evolved from 5% scripted articles to approximately 20% scripted. This government-authored content throughout the paper is increasingly homogeneous—fewer and fewer adaptations are done by individual newspapers. In contrast to popular speculation, we show that scripted content is not only on ideological topics (although it is increasingly ideological) and is also very prevalent in commercial papers. Using a case study of domestic coverage of COVID-19, we demonstrate how the regime uses scripting to shape, constrain, and delay information during crises. Our findings reveal the wide-ranging influence of government-authored propaganda in China’s media ecosystem.
Sexual dimorphism does not translate into foraging or trophic niche partitioning in Peruvian boobies (Sula variegata)
Intraspecific competition can lead to sexual segregation of diets or foraging behaviors in seabirds, and in some species the resulting niche partitioning is facilitated by sexual dimorphism. However, environmental stochasticity can mediate intraspecific competition and thus the extent of sex-based partitioning. The Peruvian booby (Sula variegata) is a sexually dimorphic seabird endemic to the Humboldt Current System (HCS), a highly variable environment due to El Niño Southern Oscillation. To determine the extent of sexual partitioning in this species, we quantified the foraging and trophic niches of breeding Peruvian boobies at Isla Guañape Norte, Peru in two years with different oceanographic conditions and nesting propensity. Morphometrics, GPS-tracked foraging behaviors, diets via regurgitates, and isotopic niches were compared between sexes and years where sample sizes permitted. Although females were larger and in better body condition than males, breeding Peruvian boobies in our study did not exhibit sex-specific foraging or isotopic niche partitioning and had few differences in diet. Anchoveta (Engraulis ringens) dominated diets in both years, reflecting Peruvian boobies’ dependence on this prey. Overall, while oceanographic conditions in 2016 were unfavorable enough to reduce nesting propensity, these effects did not qualitatively translate to foraging or dietary niche partitioning between the sexes for those individuals who opted to breed. In combination, our results suggest weak intraspecific competition during our study period, and highlight how the foraging strategies of Peruvian boobies have adapted to the variable environmental conditions found in the HCS.
Machine learning predicts spinal cord stimulation surgery outcomes and reveals novel neural markers for chronic pain
Epitope-directed selection of GPCR nanobody ligands with evolvable function
Antibodies have the potential to target G protein–coupled receptors (GPCRs) with high receptor, cellular, and tissue selectivity; however, few antibody ligands for GPCRs exist. Here, we describe a generalizable selection method to enrich for GPCR ligands from a synthetic camelid antibody fragment (nanobody) library. Our strategy yielded multiple nanobody ligands for the angiotensin II type I receptor (AT1R), a prototypical GPCR and important drug target. We found that nanobodies readily act as allosteric modulators, encoding selectivity for both the receptor and chemical features of GPCR ligands. We then used structure-guided design to convert two nanobodies from allosteric ligands to competitive AT1R inhibitors through simple mutations. This work demonstrates that nanobodies can encode multiple pharmacological behaviors and have great potential as evolvable scaffolds for the development of next-generation GPCR therapeutics.
Parents’ work–family conflict and parent‒child relationship: The mediating role of parenting burnout and the moderating role of self-compassion
In today’s fast-paced society, balancing work and family has become a key challenge affecting individual well-being, particularly for working parents. The conflict between these roles not only impacts personal mental health but also strains family dynamics, especially the parent‒child relationship. The main objective of this study is to explore the impact of work‒family conflict on the parent‒child relationship, with a focus on the mediating role of parenting burnout and the moderating role of self-compassion. The findings of a sample of 818 working parents revealed that work–family conflict negatively affects parent–child relationships and increases parenting burnout, thus further damaging these relationships. However, self-compassion significantly mitigates these negative effects, reducing the risk of parenting burnout. This study highlights the importance of fostering self-compassion as a potential intervention to protect the parent‒child relationship in the context of the work‒family relationship.
Exploring the relationship between the tourist behavior and the spatial characteristics for rural tourism
Abstract With global urbanization, rural tourism has become a thriving trend for urban-rural sustainable development in addition to the urban landscape. However, research on rural landscape planning is still lacking. The topography of the rural areas is complex, with mountains and buildings arranged in accordance with the terrain, and pedestrian data is difficult to collect. Therefore, this study adopts mixed methods to obtain high-precision data. This study aims to investigate the relationships between tourist behavior and spatial characteristics. The results indicated that (1) Different rural spaces formed an uneven distribution of tourists’ spatial-temporal behavior characteristics, which could be attributed to three potential factors: easy space accessibility, good visual permeability, and herd mentality; (2) Visual space had a strong influence on guiding tourists compared to the passable space; (3) Historical trees, heritage buildings and cultural legacy are the positive influencing cultural factors for tourist attraction in spaces. Furthermore, these findings provided rationales to mobilize the utilization of the rural landscape resources and enhance the sustainable urban-rural development. These findings and methods improve our understanding of the temporal–spatial tourist behavior in rural tourism, which is of great significance for rural tourism planning and cultural legacy protection.
Large increases in public R&D investment are needed to avoid declines of US agricultural productivity
Increasing agricultural productivity is a gradual process with significant time lags between research and development (R&D) investment and the resulting gains. We estimate the response of US agricultural Total Factor Productivity to both R&D investment and weather and quantify the public R&D spending required to offset the emerging impacts of climate change. We find that offsetting the climate-induced productivity slowdown by 2050 will require R&D spending over 2021 to 2050 to grow at 5.2 to 7.8% per year under a fixed spending growth scenario or by an additional $2.2 to $3.8B per year under a fixed supplement spending scenario (in addition to the current spending of ~$5B per year). This amounts to an additional $208 to $434B or $65 to $113B over the period, respectively, and would be comparable in ambition to the public R&D spending growth that followed the two World Wars.
Revisiting the determinants of CO2 emissions: The role of higher education under the extended STIRPAT model
This study directly aligns with Sustainable Development Goals (SDGs), i.e., SDG-13 and SDG-4. Carbon emissions (CO2e) are primarily addressed under SDG-13: Climate Action, which aims to combat climate change and its impacts. CO2e reduction efforts contribute to achieving this goal by mitigating greenhouse gas emissions. SDG 4: Quality Education aims to ensure inclusive and equitable quality education for all. It emphasizes explicitly lifelong learning opportunities and targets higher education (HE) access to improve skills for sustainable development. Therefore, the current study aims to examine the determinants of CO2e in China and the role of HE under the extended STIRPAT model. This study utilizes the Fully Modified Ordinary Least Squares (FMOLS) and Dynamic Ordinary Least Squares (DOLS) methods using the time series data from 1985 to 2023. The finding shows that total population, GDP, and industry positively affect CO2e, while technological innovation and higher education negatively affect CO2e in China.