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Leveraging transcriptome-wide association studies identifies the relationship between upper respiratory flora and cell type-specific gene expression in severe respiratory disease

ObjectivesThe upper respiratory tract flora may influence host immunity and modulate susceptibility to viral respiratory infections. This study aimed to investigate the associations between upper respiratory tract flora and immune cells in severe ILI, identify specific microbial taxa and immune response pathways contributing to disease severity, and elucidate how flora influences ILI progression by modulating immune cell functions.MethodsHeritability of GWAS summary data was estimated using LDSC (v1.0.1). Gene-level genetic associations were analyzed with MAGMA. scRNA-seq data were integrated with genetic association data using scDRS. FUSION was used to construct cell type-specific expression quantitative trait locus models based on genotypes and scRNA-seq data from the onek1k project, which were combined with flora abundance-related GWAS data for a transcriptome-wide association study.ResultsFrom the LDSC analysis, data from 1195 severe ILI-associated GWASs with upper respiratory flora(h2 > 0.1) were included in subsequent analysis. TWAS identified 19 significant association pairs (Padj < 0.05), and 1226 differentially expressed genes between mild and severe ILI patients (Padj < 0.05 and | log2FC|>0.25). Functional enrichment analyses using GO, KEGG, and Reactome databases revealed that immune cells,such as CD4 + T effector memory cells, cDCs, NK cells, were enriched in multiple biological processes or pathways.ConclusionsThis study identified associations between severe ILI-related upper respiratory tract flora and cell type-specific gene expression, potentially explaining how differential flora influences ILI progression. CD16 + monocytes exhibited the most differentially expressed genes, followed by proliferating cells and cDCs, highlighting the significant role of immune cell-enriched pathways in ILI progression.

Active trachoma among children aged 1–9 years in Ethiopia: A meta-analysis from 2019 to 2024

Background Trachoma is a leading infectious cause of blindness and of significant public health concern targeted for elimination. This study aimed to systematically summarize the magnitude of active trachoma among children aged 1–9 in Ethiopia from 2019–2024. Methods The review was prospectively registered on PROSPERO (Registration number: CRD42024514026). Database searches were conducted on Google Scholar, SCOPUS, PubMed, EMBASE, and Africans Journals Online (AJOL) for studies published between January 2019–31-March-2024 and with restriction to articles published only in English. Data extraction was done using a pre-prepared Excel sheet. STATA version 17 was used to perform the analysis. Heterogeneity between studies was assessed using I 2 statistics and Cochrane Q. Qualitative synthesis was done to summarize the studies and random effect model was used to estimate the Pooled magnitude of active trachoma with a corresponding 95% confidence interval. Results A total of 17 studies with 19793 subjects were included in the meta-analysis. The pooled magnitude of active trachoma among children aged 1–9 years was found to be 18.4% (95% CI: 13.88, 22.91). We found a statistically significant heterogeneity between studies. Among the regions, Southwest region was found to have the highest magnitude (44.1%) (95%CI: 41.8%, 46.4%) and Dire Dawa was found to have the lowest (4.3%) (95%CI: 2.9%, 5.7%). Conclusion The magnitude of active trachoma is still higher than the World Health Organization (WHO) target for elimination. There was significant interregional difference in magnitude of active trachoma. Strengthening surgical treatment for trichiasis, antibiotic therapy, facial hygiene, and environmental improvement (SAFE) strategy and health education and promotion is recommended.

Ecological functional zoning for mineral resource development in Xizang, China

Xizang is an important base of mineral resources, hosting abundant deposits. However, its unique and fragile ecological environment has long constrained resource development and utilization. Achieving a balance between ecological protection and mineral resource exploitation has become a pressing issue. This study proposes a novel approach for ecological functional zoning to provide scientific evidence for mineral resource development in Xizang. The study employs remote sensing image interpretation and single-factor ecological indicators analysis to construct a comprehensive ecological environment assessment system, scientifically delineating ecological function zoning for mineral resource development in Xizang. The results indicate that Xizang can be divided into five functional zones: (I) Northern Plateau Desert Zone, (II) Plateau Grassland Zone, (III) Plateau Mountain Zone, (IV) High Mountain-Forest Zone, and (V) Eastern Canyon Zone. Zone I and Zone III exhibit relatively favorable conditions for development but also face significant ecological vulnerability. Therefore, development activities in these areas must be rigorously controlled to minimize environmental disturbances. Zone II and Zone IV impose substantial constraints on resource development due to the heightened sensitivity of their ecosystems, necessitating stringent conservation measures. While Zone V demonstrates strong ecological restoration capabilities, it remains highly susceptible to water resource contamination and soil erosion risks. The innovative outcomes of this study lie in integrating comprehensive regional zoning and quantitative ecological environment assessments, providing an actionable framework for the coordinated development of mineral resources and ecological protection, thus advancing the scientific and refined management of resources and the environment.

Vegetation extraction through UAV RGB imagery and efficient feature selection

Accurate identification of vegetation in mining areas is crucial for conducting pre-mining ecological assessments and post-mining ecological monitoring. However, the vegetation in the mining area is always highly heterogeneous including both field crops and naturally scattered growing vegetation, which brings great challenges for fine vegetation mapping. Feature combinations are an important factor to influence the vegetation mapping. Thus, to effectively identify the vegetation, this study utilized an unmanned aerial vehicle (UAV) RGB image to extract vegetation indexes and textures, and then selected features based on standard deviation and difference coefficient. By integrating selected optimal features with RGB images, different combinations were constructed and classified using Support Vector Machine (SVM). The results demonstrated that the combination of RGB and all selected features yielded the highest accuracy, followed by the combination of RGB and a single type of texture, and then the combination of RGB and VIs, which indicated that texture features were more important than VIs for vegetation identification. The OA and Kappa for the best combination were 87.76% and 0.8351 for study area A, and 88.74% and 0.8505 for study area B, indicating the effectiveness of the adopted method. Besides, compared with the commonly used random forest (RF) feature selection method, the adopted method avoided complex parameter settings and constructed a superior optimal combination, which further proved the simplicity and effectiveness of difference coefficient-based feature selection methods for vegetation classification in highly heterogeneous environments, contributing to more accurate ecological assessments and monitoring.

The Tibial Plateau fracture—Current incidence and treatment in Germany

Purpose This study aims to analyze the epidemiology, incidence, and treatment of tibial plateau fractures in Germany from 2019 to 2022. The focus is on understanding demographic trends, clinical presentations, and surgical management strategies for this severe injury. Methods A retrospective cohort study was conducted using data from the German Institute for the Hospital Remuneration System (InEK) from 2019 to 2022. Cases were identified using the International Classification of Diseases 10th Revision (ICD-10) codes related to tibial plateau fractures, and documented surgical procedures were categorized using OPS codes. The Patient Clinical Complexity Level (PCCL) was used to assess the severity of cases. Results A total of 79,158 cases of tibial plateau fractures were recorded during the study period, with an incidence of 22.4–25.3 per 100,000 inhabitants. Women were more frequently affected, accounting for 61.5% ± 1.1% of cases annually. The average hospital stay was 9.2 ± 0.1 days, and 76.5% ± 0.5% of patients were categorized at PCCL 0. Most fractures were multifragmentary 68.8% ± 1.3%, and the predominant documented treatment method was open reduction and internal fixation with plate osteosynthesis 63.5% ± 2.8%. 23.6% ± 2.2% of cases required bone grafting, with a preference for allografts. Conclusions Tibial plateau fractures represent a significant and stable burden in Germany, with an incidence ranging from 22.4 to 25.3 per 100,000 inhabitants. Women accounted for 61.5% ± 1.1% of cases, highlighting a gender-related predisposition. The mean hospital stay remained stable at 9.2 ± 0.1 days. The study underscores the need for tailored treatment strategies and highlights the importance of preventive measures, particularly for the elderly population, in order to reduce the incidence of these fractures. Future research should focus on improving surgical techniques and postoperative care to enhance patient outcomes and potentially reduce hospital stay durations.

DC vs. AC distribution: Revealing the efficiency advantage of DC in today’s energy landscape

The new millennium witnessed an unanticipated escalation in the installation of rooftop solar panels, particularly due to the development of highly efficient power electronic converters (PECs). The ‘battle of currents’ between AC and DC, which settled in the favor of AC in the nineteenth century, reignited as DC is striking back due to this technological augmentation. The shifting trend towards DC is more pronounced in the residential sector, which necessitates a comparative analysis of AC and DC at distribution scale on realistic grounds. Modern home data extracted from the energy information administration (EIA) has been utilized to devise a mathematical model based on bottom-up approach. The comparative analysis has been performed encompassing scenarios of varying PEC efficiencies as a result of daily load variation. Moreover, the scenarios of multiple PEC efficiencies and rooftop solar capacities are also considered. The comparative analysis revealed efficiency advantage of 1.966%, 1.41% and 1.17% in favor of DC as compared to AC for the scenarios considered. In the end future recommendations are presented to further enhance the efficiency of DC, thereby providing a concrete standing for power industry decision of adopting DC at distribution scale.

Computerized neuropsychological assessment in post-COVID condition

Background Attention/ processing speed deficits with or without executive function and episodic memory deficits have been suggested as a relatively characteristic cognitive profile of people with post-COVID condition (PCC). Most studies have been performed using standardized paper and pencil neuropsychological assessment. Sensitive and applicable tests are needed to improve the diagnostic capacity of patients with PCC. Objectives In this study, we aimed to investigate the dimensions of a comprehensive computerized neuropsychological battery and to characterize the cognitive characteristics of patients with PCC. Materials and methods Five hundred and eight participants were enrolled in the study (PCC = 227, Healthy Controls, HC = 281) and underwent cognitive assessment focused on attention, concentration, executive functions, and episodic memory. We conducted a multi-group confirmatory factor analysis. Factor scores were obtained to compare the PCC and HC groups and partial invariance analysis was performed to identify relevant cognitive processes that differentiate the two groups. Results The proposed four-factor model showed adequate fit indices. There were differences in attention, concentration, and executive functions factor scores with small to moderate effect sizes and with a particular implication of attention processes based on measurement invariance analysis. Impairments in reaction times and divided attention were especially relevant in patients with PCC. Conclusions The battery revealed four factors representing attention, concentration, executive functions, and episodic memory. The PCC group performed worse than the HC group in attention, concentration, and executive functions. These findings suggest the validity of computerized neuropsychological assessment, which could be particularly useful in PCC.

Predicting breast cancer prognosis based on a novel pathomics model through CHEK1 expression analysis using machine learning algorithms

Background Checkpoint kinase 1 (CHEK1) is often overexpressed in solid tumors. Nonetheless, the prognostic significance of CHEK1 in breast cancer (BrC) remains unclear. This study used pathomics leverages machine learning to predict BrC prognosis based on CHEK1 gene expression.. Methods Initially, hematoxylin-eosin (H&E)-stained images obtained from The Cancer Genome Atlas Breast Invasive Carcinoma (TCGA-BRCA) were segmented using Otsu’s method. Further, the sub-image features were extracted using machine learning algorithms based on PyRadiomics, mRMRe, and Gradient Boosting Machine (GBM). The predicted CHEK1 expression levels were represented as the pathomics score (PS) and validated using the corresponding RNA-seq data. The prognostic significance of both CHEK1 and PS was evaluated using Kaplan-Meier (KM), and univariate and multivariate Cox regression. The model was assessed by comparing CHEK1 expression by immunohistochemistry (IHC) with PS in BrC tissue microarray (TMA). Results A 633 × 10 sub-image set was eligible for training and a 158 × 10 set for validation. 1,488 features were extracted and 8 recursive feature elimination (RFE)-screened features were used to generate the model. A high PS was associated with CHEK1 overexpression, significantly correlating with survival outcomes, especially within 96 months post-diagnosis. Further, patients with high PS responded to anti-programmed cell death protein 1 (anti-PD-1) and anti-cytotoxic T lymphocyte antigen-4 (anti-CTLA4) treatments. In TMA validation, the IHC analysis estimated that high PS similarly predicted poorer prognosis and correlated with higher CHEK1 expression. Conclusions The novel pathomics model reliably predicted CHEK1 expression using machine learning algorithms, which might provide potential clinical utility for prognosis and treatment guidance.

Retraction: The C2238/αANP Variant Is a Negative Modulator of Both Viability and Function of Coronary Artery Smooth Muscle Cells

Investigating the biochemical variations in onion leaves due to purple blotch disease and its management through induced resistance

Purple blotch (PB), caused by Alternaria porri (Ellis) ciferri, poses a significant threat to onion crop, resulting in major economic losses in both bulb and seed production globally. The incidence of this disease underscores the critical need for an effective management. In the present study, screening of onion genotypes for PB under field conditions revealed that the genotypes like Phulkara and Ceylon expressed resistant, response with 8.21 and 8.91% disease severity index (DSI) respectively, whereas Desi Black and Red Imposta were highly susceptible, with DSI of 67.38 - 79.41%. Furthermore, resistant and susceptible genotypes were also evaluated for biochemical variation analysis. Significant variations (p ≤ 0.05) in antioxidant enzymes were observed across reaction groups (inoculated and un-inoculated), types (resistant and susceptible), and onion varieties in response to A. porri infection. The analysis of variance showed significant changes in antioxidant enzymes level of onion leaves, including catalase (CAT), peroxidase (POD), and super dismutase (SOD). Results indicated that the concentration of SOD (55.37%), POD (41.87%) and CAT (37.92), respectively, in resistant plant leaves, whereas susceptible varieties showed SOD (43.71%), POD (28.3%) and CAT (26.59%). Furthermore, the amount of antioxidant enzymes was reduced in both resistant as well as susceptible varieties of onion after inoculation. Amount of SOD (68.04%), POD (57.45%) and CAT (50.87%) were recorded in un-inoculated group of onion plants that reduced to 31.05, 12.98 and 13.64% in inoculated group respectively. For the management of A. porri four different plant activators (salicylic acid, benzoic acid, citric acid and di-potassium hydrogen phosphate) at three different concentrations (0.5, 0.75 and 1%) were evaluated under greenhouse and field conditions. Among all salicylic acid was found to be most effective in controlling this disease under greenhouse and field conditions. The present study revealed that purple blotch affects the biochemical mechanism of the plants, which helps in activating the resistance process against pathogens through various enzymes. Additionally, salicylic acid demonstrated significant efficacy in controlling purple blotch in onions.

The effect of peer relationships on college students’ behavioral intentions to be physically active: The chain-mediated role of social support and exercise self-efficacy

Purpose Physical activity behavioral intentions have a positive impact on individuals’ physical and mental health, social adjustment, and academic work. This study explored the effects of peer relationships on college students’ behavioral intentions for physical activity and analyzed the mediating role of social support and exercise self-efficacy. Methods The Peer Relationship Inventory, the Physical Activity Rating Scale-Intentions to Physical Activity Behavior subscale, the Social Support Scale, and the Exercise Self-Efficacy Scale were used to psychometrically measure 514 college students (age = 19.00 ± 1.27) from June 3, 2024, to June 7, 2024, and the Bootstrap method was used to mediate the relationship between social support and exercise self-efficacy. Results (1) Peer relationships, social support, exercise self-efficacy and intention to engage in physical activity behaviors were positively correlated (all p < 0.01); (2) gender differences in exercise self-efficacy and intention to engage in physical activity behaviors existed (p < 0.001), and male students scored higher than female students (M ± SD: 3.18 ± 0.55 > 2.98 ± 0.59; 3.23 ± 0.62 > 2.95 ± 0.61); (3) the mediating effect size of social support (peer relationship→social support→behavioral intention to exercise) was 0.078, which accounted for 8.83% of the total effect, and that of exercise self-efficacy (peer relationship→exercise self-efficacy→behavioral intention to exercise) was 0.314, which accounted for 35.56% of the total effect, the chained mediation effect of social support and exercise The chain mediation effect size of self-efficacy (peer relationship→social support→exercise self-efficacy→behavioral intention to exercise) was 0.057, accounting for 6.46% of the total effect, and none of the confidence intervals contained 0. Conclusions (1) College students’ peer relationships can significantly and positively predict behavioral intention to exercise; (2) college students’ peer relationships can have a simple influence on the behavioral intention to exercise through social support and exercise self-efficacy, respectively; (3) College student peer relationships can also influence intention to engage in physical activity through social support and exercise self-efficacy in a chained manner.

An exploration of trauma-informed care curricula in chiropractic programs: A scoping document analysis protocol

Background Trauma is a significant public health issue that affects both mental and physical health. Healthcare delivery based on trauma-informed care (TIC) principles is designed to mitigate the risk of re-traumatization in healthcare settings to improve patient outcomes. Chronic pain is a common comorbidity of trauma and a common reason that people seek healthcare, including chiropractic care. The extent to which TIC training is integrated into chiropractic education and Doctor of Chiropractic Programs (DCPs) remains unclear. Objective This study aims to evaluate the presence of TIC principles in educational curricula documents from accredited DCPs across the United States and Canada to identify potential gaps in trauma-sensitive education within chiropractic training. Methods A scoping document analysis will be conducted using educational curricula documents (program handbooks, course catalogs, and course syllabi) from DCPs accredited by the Council on Chiropractic Education (CCE-USA). Documents will be evaluated for TIC-related search terms based on established frameworks from the Substance Abuse and Mental Health Services Administration and the Harvard Medical School TIC Core Competencies. The analysis will assess the presence of TIC principles such as safety, trust, empowerment, and cultural sensitivity. A phased approach will be used for data extraction, ensuring a comprehensive review of TIC integration. Results The study will quantify the inclusion of TIC principles in chiropractic education in the United States and Canada and identify trends or gaps related to TIC education. Conclusion Our findings can inform future curriculum review and development, ensuring DCPs integrate TIC effectively to enhance care for trauma-exposed patients.

Connecting Colombia’s protected areas: Using a functional approach for tapir species

Colombia is the world’s fourth most biodiverse country for mammal species. This condition is evidenced in the high number of mammal species reported in specific groups, such as tapirs. The country is considered a hotspot for the genus Tapirus, reporting three of the four species scientifically valid (Tapirus bairdii, T. pinchaque, and T. terrestris). Approximately ~ 49% of Colombia’s natural ecosystems have been transformed by human activities, and  ~  16% of the national territory is designated protected areas (PAs). In this context, the ecological connectivity between PAs is essential to improve the conservation of threatened large mammals such as tapirs and to contribute to the effectiveness of management of these areas in the current scenario of global change. We developed connectivity models for the tapir species and identified critical areas to conserve and improve ecological connections between PAs in Colombia. To this end, we constructed (i) distribution models for tapir species, (ii) movement resistance surfaces, and (iii) mapped least-cost corridors (LCCs). We also used the circuit and least-cost models to locate conservation priorities and restoration opportunities, estimating the equivalent connected area (ECA) index. Our results provide a national-level assessment of functional connectivity priorities for tapir species. This assessment could be considered as an input to guide efforts related to conservation, restoration, and implementation of management tools that facilitate the movement of tapirs through transformed landscapes. Implementing of these actions could contribute to meeting the goals of the post-2020 global biodiversity framework, which aims to achieve effective, ecologically representative, well-connected, and equitably managed PAs.

Knowledge increases informative reporting by the public about urban coyotes

Many municipalities use information about human-wildlife interactions collected in citizen-provided reports to monitor conflicts and guide management actions. However, high volumes of reports that describe benign wildlife behaviour can reduce the efficiency with which officials address reports that require management interventions, a situation that has occurred in Edmonton, Canada. We used data from a survey of Edmonton residents (n = 5,926) that asked respondents to anticipate whether they would alert officials if they witnessed (a) a coyote exhibiting benign behaviour in a natural area and (b) conflict-prone behaviour near human dwellings. We used path models to explore the predictors for two response variables; the agreement with reporting a benign sighting and the difference between scores for agreement to report conflict-prone behaviour and a benign sighting, which we interpreted as more informed reporting. As predictor variables, we considered a set of demographic, situational, cognitive, and experiential factors measured in the survey. A greater tendency to report the benign sighting was associated with prior 311 calls, higher risk perceptions, having experienced less severe interactions with coyotes, and greater knowledge of the consequences of food conditioning in coyotes. A greater tendency to anticipate reporting a conflict-prone coyote was associated with lower risk perceptions and greater knowledge of the consequences of food conditioning in coyotes, which is frequently associated with conflict. Further, individuals with higher risk perceptions were more likely to have experienced more severe interactions with coyotes, which were sometimes associated with living on a greenspace. Our results suggest that education campaigns could help people recognize benign behavior and identify and mitigate potential conflicts with coyotes. Education could occur as part of report receipt by city staff and outreach could target areas where coyote interactions are more likely, such as in residential areas along greenspaces.

Green synthesized Polyscias fulva silver nanoparticles ameliorate uterine fibroids in female Wistar Albino rats

Uterine fibroids affect a substantial proportion of women in their reproductive age. Despite their effectiveness, surgical options such as hysterectomy are invasive, costly, and associated with recurrences. Pharmacological treatments are non-curative, only alleviate symptoms, and associated with adverse effects. Polyscias fulva (Araliaceae) is traditionally used to manage uterine fibroids in East Africa. In this study we synthesized Polyscias fulva silver nanoparticles (PFAgNPs), evaluated their toxicity and activity against monosodium glutamate (MSG)-induced uterine fibroids in Wistar albino rats. The UV-visible spectroscopy showed maximal absorbance at 425 nm with adequate stability at varying temperatures, pH and storage conditions. Dynamic light scattering (DLS) analysis revealed an average hydrodynamic size of 107.4 d.nm, polydispersity index of 0.264, and zeta potential of -18.3 mV. X-ray diffraction (XRD) confirmed the crystalline nature of PFAgNPs with an average size of 25 nm while scanning electron microscopy (SEM) showed a spherical shape with an average size of 35 nm. The PFAgNPs caused lethargy, hyperventilation, and hyperactivity at a dose of 300 mg/kg BW, whereas 2000 mg/kg caused severe toxicity, resulting in death in acute toxicity testing. The no observed adverse effect level was 50 mg/kgBW, the lowest observed adverse effect level was 100 mg/kgBW, and median lethal dose (LD50) was 1000 mg/kg. The PFAgNPs significantly decreased (P < 0.05) serum proteins, cholesterol, estrogen and progesterone alongside preservation of the histoarchitecture of the uterus. Further research is needed to investigate the clinical safety of PFAgNPs in managing uterine fibroids.

Oxygen desaturation and lung ultrasonography as markers of diffuse parenchymal lung diseases severity

Purpose we aimed to evaluate lung ultrasound (LUS) and oxygen desaturation as markers for the severity of diffuse parenchymal lung disease (DPLD), specifically the fibrotic subtypes, and correlate the findings with high-resolution computed tomography (HRCT) and other physiologic parameters. Methods A case-control study was conducted recruiting 31 DPLD patients and 20 age-matched healthy controls from our institution. All participants had a spirometry, HRCT, 6-minute walk test (6MWT), echocardiography and full-night cardio-respiratory polygraph. LUS for B-line quantification and pleural examination was performed on 6 zones bilaterally. Results Compared to controls, patients had a statistically significant higher total number of B-lines, lower 6MWT nadir O2 and lower nadir nocturnal oxygen saturation (SpO2). Among patients; fibrotic DPLD (58.1%) had more B-lines, pleural irregularities with or without fragmentation, higher Warrick scores and lower 6MWT nadir SpO2 (p = 0.01, 0.008, < 0.005, 0.03 respectively). There was a statistically significant positive correlation between LUS findings and Warrick score that inversely correlated with the forced vital capacity (FVC)% predicted (p < 0.001). A score of LUS findings, 6MWT nadir SpO2 and time spent with SpO2 < 90% (T90) ≥2 points had a sensitivity of 91.7% and specificity of 66.7% in predicting severe fibrotic DPLD (area under curve (AUC)= 0.832, CI95% = 0.723–0.941, p = 0.001). Conclusions The number of B-lines and pleural irregularities in LUS, nocturnal desaturation and exercise desaturation can play a role as markers of DPLD severity.

Empowering refugee voices: Using Nominal Group Technique (NGT) with a diverse refugee Patient Advisory Committee (PAC) to identify health and research priorities in Calgary, Canada

Background Despite rising forced displacement globally, refugees’ health and research priorities are largely unknown. We investigated whether a diverse refugee committee could utilize participatory methods to identify health priorities and a research agenda to address them. Methods We conducted a qualitative study with focus groups of current and former refugees, asylum claimants and evacuees from a specialized refugee clinic over a year in Calgary, Alberta, Canada. We collected sociodemographic data using standardized instruments, then utilized a four-step nominal group technique process (idea generation, recording, discussion, and voting) to identify and rank participants’ health and research priorities. Participants ranked their top five priorities across three time periods: Pre-migration/early arrival (0–3 months), post-migration (3 months–2 years), and long-term health (>2 years). Participants created overarching priorities and corroborated findings via a member checking step. Findings Twenty-three participants (median age 35 years) attended one or more of five focus groups. Twenty-one completed sociodemographic surveys: 16/21 (76%) were women, representing 8 countries of origin. Participants identified “more family physicians” and “improving health system navigation” (11/60 votes each) as top health and research priorities respectively across all resettlement periods. Participants also prioritized pre-departure healthcare system orientation and improved post-arrival and long-term mental health services. Twelve participants completed the member checking process, affirming the results with minor clarifications. Interpretation This proof-of-concept study illustrates how refugees can use a rigorous consensus process without external influence to prioritize their healthcare needs, direct a health research agenda to address those needs, and co-produce research. These low-cost participatory methods should be replicated elsewhere.

Design of the multi-material structure using an MMC-SIMP sequential topology optimization method

The present paper introduces a sequential topology optimization method for multi-material structure design. In the proposed method, the moving morphable component (MMC) method and the solid isotropic material with penalization (SIMP) method are performed in sequence to achieve multi-material structure optimization. First, the structural topology is obtained using the MMC method, and then the material layout of the determined structural topology is optimized using the SIMP method. The connection between MMC method and SIMP method is established through components mapping elements, where changes in the material layout within these elements do not affect the external structural topology. The proposed method effectively combines the advantages of two optimization methods, enabling the achievement of an explicit external structural topology and greater freedom in internal multi-material layouts, while remaining easy to implement. The key MATLAB codes for the proposed method are provided in the paper. Finally, the feasibility of the proposed method is verified through some numerical examples.

Family environment and prosocial behavior tendency of college students: The chain mediating role of empathy and moral sensitivity

Objectives In order to explore the influence mechanism of family environment on the prosocial behavior tendency of college students and the chain mediating role of empathy and moral sensitivity in this relationship. Methods A survey was conducted on 451 college students using the Family Adaptability and Cohesion scales, the Dispositional Moral Sensitivity Questionnaire, the Prosocial Tendencies Measure and the Chinese Version of the Interpersonal Reactivity Index-C. Results The results showed that empathy and moral sensitivity significantly mediate the effect of family environment on college students’ prosocial behavior tendency. This is manifested in three mediation paths: the mediating role of empathy (with 28.57% of the mediating effect), the mediating role of moral sensitivity (with 61.90% of the mediating effect), and the chain mediating role of empathy and moral sensitivity (with 9.53% of the mediating effect). Conclusions The study reveals the mechanism by which family environment affects college students’ prosocial behavior, which provides some theoretical guidance and practical inspiration for cultivating college students’ prosocial behavior.

Unlocking the power of reticulocyte analysis: Advancing care for patients with abnormal haemoglobin variants at Eastern Regional Hospital, Koforidua

Reticulocytes are immature erythrocytes that have been released into the peripheral circulation after being extruded from the bone marrow. However, it has not been investigated whether these reticulocyte indicators are helpful in treating conditions linked to abnormal haemoglobin variants. In the current investigation, participants with abnormal haemoglobin variants were evaluated for the utility of reticulocyte parameters using a high-end haematology analyser. We conducted a prospective cross-sectional study among 217 participants with abnormal haemoglobin variants at the Eastern Regional Hospital, Koforidua. Statistical analyses were performed with IBM SPSS V.26.0 (Chicago, IL, USA) and R programming language version 4.2.3. A p-value of < 0.05 was considered statistically significant for all analyses. We found a significant association between age groups and anaemia severity (p = 0.016). Haemoglobin levels varied significantly among abnormal haemoglobin variants (p < 0.05), with the “SF” phenotype showing the lowest levels. Production defects accounted for 1.4% of cases, while maturation defects were present in 91.7%. An increase in low-fluorescence reticulocytes was linked to a 0.03 g/dL rise in haemoglobin (β = 0.03, p < 0.05), whereas increases in high- and medium-fluorescence reticulocytes led to declines of 0.069 g/dL and 0.052 g/dL, respectively (p < 0.05). Haemoglobin levels were significantly lower in participants with maturation abnormalities (p < 0.01). The study found relationships between the severity of anaemia, age, and haemoglobin phenotypes in individuals with abnormal haemoglobin variants. Given the predominance of maturation defects, management aimed at addressing ineffective erythropoiesis is necessary. The differences in how reticulocyte subpopulations affect haemoglobin levels imply that reticulocyte indices may be helpful biomarkers for monitoring and guiding therapeutic approaches.