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Interventions for combating COVID-19 misinformation: A systematic realist review

Misinformation is a growing concern worldwide, particularly in public health following the COVID-19 pandemic in which misinformation has been attributed to tens of thousands of unnecessary deaths. Therefore a search for effective interventions against misinformation is underway, with widely varying proposed interventions, measures of efficacy, and groups targeted for intervention. This realist systematic review of proposed interventions against COVID-19 misinformation assesses the studies themselves, the characteristics and effectiveness of the interventions proposed, the durability of effect, and the circumstances and contexts within which these interventions function. We searched several databases for studies testing interventions published from 2020 onwards. The search results were sorted by eligibility, with eligible studies then being coded by themes and assessed for quality. Thirty-five studies were included, representing eight types of intervention. The results are promising to the advantages of game-type interventions, with other types scoring poorly on either scalability or impact. Backfire effects and effects on subgroups were reported on intermittently in the included studies, showing the advantages of certain interventions for subgroups or contexts. No one intervention appears sufficient by itself, therefore this study recommends the creation of packages of interventions by policymakers, who can tailor the package for contexts and targeted groups. There was high heterogeneity in outcome measures and methods, making comparisons between studies difficult; this should be a focus in future studies. Additionally, the theoretical and intervention literatures need connecting for greater understanding of the mechanisms at work in the interventions. Lastly, there is a need for work more explicitly addressing political polarisation and its role in the belief and spread of misinformation. This study contributes toward the expansion of realist review approaches, understandings of COVID-19 misinformation interventions, and broader debates around the nature of politicisation in contemporary misinformation.

Research on mechanical automatic food packaging defect detection model based on improved YOLOv5 algorithm

With the rapid development of industrial automation, traditional manual detection methods are inefficient and error-prone, which cannot meet the needs of modern production for high efficiency and high precision. Therefore, it is particularly important to develop a mechanical automatic inspection system that can automatically identify food packaging defects. In this study, aiming at the limitations of existing technologies in identifying small targets and subtle defects, an enhanced YOLOv5-based model for detecting food packaging flaws is introduced. Firstly, we integrated a Convolutional Attention module (CBAM) to enhance the model’s attention on crucial image features. This mechanism prioritizes significant features by weighting the feature map in channel and spatial dimensions, which improves accuracy in detecting minor defects and small objects. Secondly, feature fusion across scales is achieved with pyramid and aggregation networks, so that the model can capture defects of different sizes at the same time, which enhances the recognition ability of diverse defects in food packaging. In addition, this study also optimizes the backbone network structure of YOLOv5. By integrating the streamlined YOLOv5s model and adding an Adaptive Spatial Feature Fusion module (ASFF), the model’s ability to blend features from different scales was enhanced. In this study, 7400 images with 512×512 resolutions were applied to develop the proposed model. The experimental results show that the improved model outperforms the original YOLOv5 model in terms of Accuracy (Ac), Recall (Re), and F1 score, with values of 0.96, 0.94, and 0.94, respectively, effectively improving the automation and accuracy of food packaging defect detection when compared with YOLOv5+ASFF (Ac=0.94, Re=0.95, and F1=0.94), original YOLOv5 (Ac=0.82, Re=0.85, and F1=0.88), and YOLOv5+CBAM (Ac=0.88, Re=0.9, and F1=0.89). Additionally, the present performance of an improved YOLOv5 model (CBAM+Fusion Pyramid Network (FPN)+Path Aggregation network (PANet)+ASFF) was significantly comparable to the related research works.

Communication and relationship satisfaction of Fly-in, Fly-out workers and partners

Fly-in fly-out (FIFO) work involves commuting long distances and living in provided accommodation for 1–4 weeks while on shift. Little is known about couple communication and relationship satisfaction of this population. Separate cohorts of FIFO workers and partners of FIFO workers completed daily surveys to self-report time spent communicating with their partner (in person, over the computer, and by phone) and relationship satisfaction for up to 7 days during on-shift and 7 days during off-shift periods (806 observations from N = 106 with 19 couples). For FIFO workers, but not partners of FIFO workers, relationship satisfaction was lower during on-shift days than off-shift days. This difference was completely mediated by time spent communicating with romantic partner, such that after accounting for the impact of lower time spent communicating on relationship satisfaction, there remained no significant difference in relationship satisfaction on-shift vs off-shift. Communication between FIFO workers and their romantic partners is essential to ensure the relationship does not suffer while the worker is away from home. FIFO organisations need to investigate ways to ensure quality communication between romantic partners can be maintained while the worker is on-site and partner spend long periods of time away from one another.

The importance of human interaction for curriculum and school life satisfaction among Japanese medical graduates: A web-based survey study

Background This study aimed to assess the curriculum and school life of Japanese medical students on the verge of graduation. Methods A web-based questionnaire survey was conducted to gauge the goals of graduating medical students across various themes: Subjective academic achievement in each curriculum, Length of each curriculum, Timing for summative examination preparation, and Satisfaction with total medical school life, accomplishments, extracurricular activities, and friendships. Results With a 67.8% response rate (80/118), the study found that subjective accomplishment in Clinical Clerkship (CC) was significantly lower than in other curriculums (P<0.05 each). Social medicine had significantly lower subjective accomplishment compared to basic medicine (P=0.040). Graduating students reported that the basic medicine curriculum was significantly longer than clinical medicine, CC, and general education (P < 0.05 each). Preparation timing for Pre-CC and Post-CC OSCE was significantly later compared to other summative tests (P < 0.05 each). Total satisfaction with medical school life correlated significantly with school friendships (P < 0.001), while subjective accomplishment and extracurricular activity did not. Conclusion Graduating medical students express lower subjective accomplishment in CC compared to other curriculums, suggesting a need for CC content improvement. Additionally, the study highlights the significant role of school friendships in influencing total medical school life satisfaction.

Patient-centered perspectives: A qualitative evaluation of the Hip Instructional Prehabilitation Program for Enhanced Recovery (HIPPER)

Over 55,000 total hip replacement (THR) surgeries were performed in Canada in 2021, with the number rising each year. Excluding rehabilitation, the cost of hip replacement procedures exceeded $675 million, a large burden on the Canadian healthcare system. Considering this large financial impact, prehabilitation delivered through electronic health (eHealth) can improve post-surgical outcomes and reduce overall healthcare expenditures by enhancing recovery and reducing hospital length of stay. This study utilized grounded theory to examine user experience of the Hip Instructional Prehabilitation Program for Enhanced Recovery (HIPPER), an eHealth approach to prehabilitation education. Participants were purposively sampled and conventional content analysis was conducted on 18 transcribed semi-structured interviews with participants who completed the HIPPER program in preparation for THR surgery. We identified three categories and seven subcategories: 1) ‘That wasn’t so hard!’, with the subcategories easy to use, learning information and appreciating HIPPER, which describe how participants were able to learn information and use the modules easily; 2) ‘I’m ready’, comprising of the subcategories being prepared for surgery and having a smooth and good experience which relates to how participants were prepared and confident going into surgery; 3) ‘I’d like to have seen’, including the subcategories having differing experiences and suggesting additions, which explore participants’ constructive criticism and ideas for improvement. Our results show useful features to include in eHealth programs and demonstrate how educational prehabilitation in the form of eHealth is helpful and usable for older adults undergoing THR. We also discuss and inform the integration of feedback and development of eHealth programs for elective surgical procedures. This study was registered with ClinicalTrials.gov on November 21, 2016 with the registration number NCT02969512.

DYNAMO-A: A generic simulation model coupling crop growth and disease epidemic

Very few dynamic simulation models truly involve explicit, quantitative, two-way couplings of epidemiological and agrophysiological processes. Our aim is to develop a generic, transparent and simple, coupled disease-crop model, DYNAMO-A, where a polycyclic epidemic develops within the canopy of an annual crop. DYNAMO-A builds upon existing models, RICEPEST and WHEATPEST, respectively designed as crop loss simulation platforms for rice and wheat, and the generic model GENEPEST, which was designed for further crop-specific development and educational purposes. Two intertwined components constitute DYNAMO-A: (1) an agrophysiological component simulates crop growth, which alters the carrying capacity of epidemics; and (2) an epidemiological component simulates epidemics, which affect crop growth through damage mechanisms. Analyses using DYNAMO-A consider different simulation scenarios according to the pathogen lifestyle (trophism) and production situations. First, scenarios consider a biotrophic ideotype which is a light stealer and assimilate diverter, and a necrotrophic ideotype which is a light stealer and an accelerator of leaf senescence. Second, scenarios consider two production situations (favourable or less favourable), i.e., two contexts leading to differing attainable (un-injured) crop yields (good or average). Epidemics caused by a biotrophic pathogen reduce the green leaf area and diverts plant assimilates to the pathogen tissues, resulting in a decrease in yield. In epidemics caused by a necrotrophic pathogen, both diseased and green leaf areas are reduced because of disease-induced senescence, resulting also in yield loss. Overall, at a given level of disease epidemic, absolute yield losses are higher with a biotrophic pathogen in a more favourable production situation, whereas yield losses to a necrotrophic pathogen tend to be similar irrespective of production situations. Our results concur with previous studies, both field-experiment and model-based, on several crop-disease systems. Future modelling with DYNAMO-based models should enable interdisciplinary research addressing plant disease impacts on current and future agricultural production.

Ultra-broadband optical amplification using nonlinear integrated waveguides

Abstract Four-wave mixing is a nonlinear optical phenomenon that can be used for wideband low-noise optical amplification and wavelength conversion. It has been extensively investigated for applications in communications 1 , computing 2 , metrology 3 , imaging 4 and quantum optics 5 . With its advantages of small footprint, large nonlinearity and dispersion-engineering capability, optical integrated waveguides are excellent candidates for realizing high-gain and large-bandwidth four-wave mixing for which anomalous dispersion is a key condition. Various waveguides based on, for example, silicon, aluminium gallium arsenide and nonlinear glass have been studied 6–10 , but suffer from considerable gain and bandwidth reductions, as conventional design approaches for anomalous dispersion result in multi-mode operation. We present a methodology for fabricating nonlinear waveguides with simultaneous single-mode operation and anomalous dispersion for ultra-broadband operation and high-efficiency four-wave mixing. Although we implemented this in silicon nitride waveguides, the design approach can be used with other platforms as well. By using higher-order dispersion, we achieved unprecedented amplification bandwidths of more than 300 nm in these ultra-low-loss integrated waveguides. Penalty-free all-optical wavelength conversion of 100 Gbit s −1 data in a single optical channel of over 200 nm was realized. These single-mode dispersion-engineered nonlinear waveguides could become practical building blocks in various nonlinear photonics applications.

Amyloid β induces hormetic-like effects through major stress pathways in a C. elegans model of Alzheimer’s Disease

Amyloid β (Aβ) is a peptide known for its characteristic aggregates in Alzheimer’s Disease and its ability to induce a wide range of detrimental effects in various model systems. However, Aβ has also been shown to induce some beneficial effects, such as antimicrobial properties against pathogens. In this work, we explore the influence of Aβ in stress resistance in a C. elegans model of Alzheimer’s Disease. We found that C. elegans that express human Aβ exhibit increased resistance to heat and anoxia, but not to oxidative stress. This beneficial effect of Aβ was driven from Aβ in neurons, where the level of induction of Aβ expression correlated with stress resistance levels. Transcriptomic analysis revealed that this selective stress resistance was mediated by the Heat Shock Protein (HSPs) family of genes. Furthermore, neuropeptide signaling was necessary for Aβ to induce stress resistance, suggesting neuroendocrine signaling plays a major role in activating organismal stress response pathways. These results highlight the potential beneficial role of Aβ in cellular function, as well as its complex effects on cellular and organismal physiology that must be considered when using C. elegans as a model for Alzheimer’s Disease.

Nutritional and microbiological dynamics in the preparation of prahoc fish paste

Prahoc is a traditional fermented fish widely consumed in Cambodia. Nevertheless, the processing and nutritional values of this daily-consumed product were poorly described. This study offers a detailed analysis of the biochemistry, nutritional composition, and microbiota during the six-month Prahoc incubation. Macronutrients (e.g. lipids, proteins) are rather well preserved during the preparation of the fish paste but the fatty acid and amino acid profiles are slightly modified at the end of the unit operation. Free amino acids increased, which facilitates the in vitro digestibility of the final paste, while beneficial fatty acids, such as eicosapentaenoic and docosahexaenoic acids, decreased. At the end of the process, the peroxide value was nearly five times greater than the limit set by the Codex Alimentarius (10 meq O2/kg). Biogenic amines, particularly cadaverine, were present but remained within acceptable limits. Metabarcoding analysis revealed that salt-tolerant bacteria dominated the fermentation process, while fungal activity was minimal. Lactic acid bacteria, such as Vagococcus and Streptococcus, were predominant before salt addition, while the fish pathogen Aeromonas established itself immediately after. Clostridium remained steady throughout, and Lentibacillus became dominant after six months. Food safety concerns related to biogenic amines, peroxides, and Clostridium highlight the need for establishing standard operational practices among national processors to mitigate food risks.

A systematic narrative review of the research evidence of the impact of intersectionality on service engagement and help-seeking across different groups of women, trans women, and non-binary individuals experiencing homelessness and housing exclusion

Background Women with experience of homelessness face severe health inequalities, with their average age at death being nearly half that of the general population. Recent research emphasises the compound challenges women with homeless experiences face in seeking help,accessing and engaging with support services, but we know little about the influence of different intersectional dimensions on their support access and experiences. The paper aims to review the evidence and critically engage with the impact of gender/sex, race, ethnicity, age, disability, class/poverty, migration status, religion, pregnancy/maternity and sexual orientation on women’s homelessness trajectories and engagement with services. Methods We conducted a systematic narrative review of studies in 2023 investigating the impact of intersectional dimensions on women, trans women, and non-binary individuals with experiences of homelessness’ engagement with services and help-seeking. Primary qualitative, quantitative or mixed method research, written in English and published after 2010, was included. Narrative methods were utilised in the synthesis and analysis of the research. Results The search identified 4109 articles after deduplication from which 52 were included for review. The findings highlighted intersectional experiences in help-seeking and engagement across housing, healthcare, the police, social services, and voluntary organisations. The women, trans women and non-binary individuals included in the studies reported a range of barriers, stigma, and discrimination, often rooted in systematic and intersectional disadvantage which delayed or prevented help-seeking and recovery. Conclusion The review investigates the multiple challenges faced by women, trans women and non-binary individuals with experiences of homelessness, highlighting systemic and intersectional disadvantages which impinge on their agency. Changes in policy and practice are recommended to develop more effective person-centred, culturally and gender-sensitive approaches that can transform intersectional dimensions into strengths, empowering women and improving their recovery and engagement with services.

A wetter ancient Arabia could have enabled easier intercontinental species dispersal

The mHealth clinical decision-making tools for maternal and perinatal health care in Sub-Saharan Africa: A systematic review

Introduction mobile Health (mHealth) refers to use of mobile wireless technologies for health. The potential for mHealth to enhance healthcare delivery is supported by near-universal availability of mobile phones and their expanding coverage in low- and middle-income countries. This systematic review analyses the available evidence on mHealth clinical decision-making tools in maternal and perinatal health, and whether they lead to improved maternal and perinatal health outcomes in Sub-Saharan Africa (SSA). Methods Eligibility criteria: Studies conducted in SSA describing mHealth tools piloted or used for clinical decision-making in maternal or perinatal healthcare. Exclusion criteria included mHealth tools used outside of maternal and perinatal healthcare, publications lacking sufficient detail (where information couldn’t be obtained through contacting authors), articles where tools were used on a laptop or desktop computer, and articles not published in English. Data sources: PubMed, CINAHL, EMBASE, Global Health, and Web of Science were searched for relevant articles following a predetermined search strategy with no date restrictions. A limited grey literature search was conducted. Risk of bias: We assessed the quality of included studies using the Cochrane Risk of bias 2 tool, Newcastle- Ottawa scale and COREQ. This comprehensive approach ensured a rigorous evaluation of bias and validity in our systematic review. Data extraction and synthesis: Two independent reviewers screened articles and extracted data. Results 1119 records were screened, and 36 articles met the inclusion criteria. Fifteen mHealth tools were identified across 11 SSA countries. Conclusion mHealth tools for clinical decision-making in maternal and perinatal care were found to be feasible, usable, and acceptable. They demonstrated adequate user satisfaction, and some demonstrated improvement of pregnancy outcomes. However, technologies lack scalability, with only one scaled up nationally, and few tools interacted with existing health information systems or had plans for sustainability. This review will help establish best practice for developing and scaling up mHealth clinical decision-making tools, helping to improve maternal and perinatal healthcare in SSA.

Cardiovascular disease outcomes in relation to 25-hydroxyvitamin D and its seasonal variation: Results from the BiomarCaRE consortium

Background It has been hypothesized but seldom tested that the winter excess in cardiovascular disease (CVD) is related to hypovitaminosis D. The present study examined the association between CVD and (i) seasonality of 25-hydroxyvitamin D (25[OH]D) and (ii) individual 25(OH)D concentrations. Methods and findings Harmonized 25(OH)D data were obtained from the Biomarkers for Cardiovascular Risk Assessment in Europe (BiomarCaRE) project, including 79,570 participants examined between 1984 and 2010. One 25(OH)D measurement was available per participant. Primary endpoints were CVD incidence (coronary heart disease or stroke; n = 6006) and CVD mortality (n = 2985). To study (i), Poisson regression-derived rate ratios were compared according to two-month categories, ordered by baseline 25(OH)D concentrations. To study (ii), Cox regression-derived hazard ratios were compared according to quarters of baseline 25(OH)D concentrations. With respect to (i), despite a median 25(OH)D concentration ratio of 1:1.79, the trough months of 25(OH)D in March and April had a similar CVD incidence as the peak months of 25(OH)D in August and September (rate ratio: 1.07, 95% CI: 0.98–1.17). CVD mortality was slightly higher in the trough months compared to the peak months (rate ratio: 1.27, 95% CI: 1.12–1.44) but not compared to the other months (despite median 25[OH]D concentration ratios up to 1:1.62; p ≥ 0.077). The CVD mortality peak in January preceded the 25(OH)D trough, not adhering to the temporality criterion of Bradford Hill. With respect to (ii), compared to the lowest quarter, the highest quarter of 25(OH)D was associated with lower CVD incidence (hazard ratio: 0.82, 95% CI: 0.76–0.89) and CVD mortality (hazard ratio: 0.64, 95% CI: 0.57–0.72). Conclusion The present study does not support the hypothesis that seasonal increases in CVD are driven by short-term reductions in 25(OH)D. As in most observational studies, higher 25(OH)D concentrations were inversely associated with CVD.

Comprehensive interrogation of synthetic lethality in the DNA damage response

Abstract The DNA damage response (DDR) is a multifaceted network of pathways that preserves genome stability 1,2 . Unravelling the complementary interplay between these pathways remains a challenge 3,4 . Here we used CRISPR interference (CRISPRi) screening to comprehensively map the genetic interactions required for survival during normal human cell homeostasis across all core DDR genes. We captured known interactions and discovered myriad new connections that are available online. We defined the molecular mechanism of two of the strongest interactions. First, we found that WDR48 works with USP1 to restrain PCNA degradation in FEN1/LIG1-deficient cells. Second, we found that SMARCAL1 and FANCM directly unwind TA-rich DNA cruciforms, preventing catastrophic chromosome breakage by the ERCC1–ERCC4 complex. Our data yield fundamental insights into genome maintenance, provide a springboard for mechanistic investigations into new connections between DDR factors and pinpoint synthetic vulnerabilities that could be exploited in cancer therapy.

Identification of potential riboswitch elements in Homo sapiens mRNA 5’UTR sequences using positive-unlabeled machine learning

Riboswitches are a class of noncoding RNA structures that interact with target ligands to cause a conformational change that can then execute some regulatory purpose within the cell. Riboswitches are ubiquitous and well characterized in bacteria and prokaryotes, with additional examples also being found in fungi, plants, and yeast. To date, no purely RNA-small molecule riboswitch has been discovered in Homo Sapiens. Several analogous riboswitch-like mechanisms have been described within the H. Sapiens translatome within the past decade, prompting the question: Is there a H. Sapiens riboswitch dependent on only small molecule ligands? In this work, we set out to train positive unlabeled machine learning classifiers on known riboswitch sequences and apply the classifiers to H. Sapiens mRNA 5’UTR sequences found in the 5’UTR database, UTRdb, in the hope of identifying a set of mRNAs to investigate for riboswitch functionality. 67,683 riboswitch sequences were obtained from RNAcentral and sorted for ligand type and used as positive examples and 48,031 5’UTR sequences were used as unlabeled, unknown examples. Positive examples were sorted by ligand, and 20 positive-unlabeled classifiers were trained on sequence and secondary structure features while withholding one or two ligand classes. Cross validation was then performed on the withheld ligand sets to obtain a validation accuracy range of 75%-99%. The joint sets of 5’UTRs identified as potential riboswitches by the 20 classifiers were then analyzed. 1533 sequences were identified as a riboswitch by one or more classifier(s) and 436 of the H. Sapiens 5’UTRs were labeled as harboring potential riboswitch elements by all 20 classifiers. These 436 sequences were mapped back to the most similar riboswitches within the positive data and examined. An online database of identified and ranked 5’UTRs, their features, and their most similar matches to known riboswitches, is provided to guide future experimental efforts to identify H. Sapiens riboswitches.

A qualitative exploration of counterfeit, substandard, spurious, and adulterated drugs in Pakistan: A perspective of drug law experts

Objectives The issue of quality of medicine is a worldwide phenomenon and counterfeit, substandard, spurious, and adulterated (CSSA) drugs are a substantial threat to public health. This issue is rampant in the context of low-middle-income countries such as Pakistan. The current study involved a phenomenology-based qualitative approach to explore these drugs’ perception, knowledge, practice, and issues in combating this menace. Methods A semi-structured interview guide was developed. Eleven drug law experts were interviewed through a purposive sampling technique. All interviews were audio recorded, transcribed verbatim, and analysed using a framework analysis approach, yielding seven distinct themes. Results The results showed that CSSA drugs are a serious public health threat and drug law experts confirmed its prevalence in the market. They indicated shortcomings in legislation up to the extent of undue amendments, failure to interpret and implement the law by regulators, ineffective law enforcement machinery, the sub-optimum performance of quality control boards, drug testing laboratories, and courts, and the dubious role of rogue middlemen and wholesalers in drug supply chain and corruption were salient issues highlighted. Conclusion The study revealed that proper drug surveillance, ensuring the presence of a pharmacist, enforcing the law, securing the supply chain, infrastructure for a drug control regime, and training regulators can help tackle this problem.

Maternal complication of instrumental vaginal delivery and its associated factors: Systematic review and meta-analysis

Background While instrumental vaginal delivery is generally a safe procedure, but it is associated with significant risks for both the mother and the newborn in developing countries. However, burden of maternal instrumental delivery complications and its predictors in Ethiopia is highly varied and there isn’t data that indicate nation-level cumulative evidence. Therefore, this study aimed to assess pooled prevalence of maternal complication related to instrumental vaginal delivery and its associated factors among mothers who underwent instrumental vaginal delivery in Ethiopia. Methods In this study, we conducted a search on PubMed, Scopus, Cochrane library, HINARI, and Google Scholar academic databases for studies published until August 2024. Keywords such as instrumental delivery, forceps, vacuum, complication, factors and Ethiopia were used to access literatures from the databases. For quality assessment and data extraction, The Joanna Briggs Critical Appraisal Tools and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were utilized. Random-effect model was used to calculate the pooled prevalence of maternal complication of instrumental vaginal delivery. Subgroup analyses were also conducted to explore potential heterogeneity. The publication bias was assessed using Funnel plot and Egger’s. Results A total of 12 studies with 3745 study participants were participated in the present meta-analysis. The pooled prevalence of maternal complication of instrumental vaginal delivery was 21% (95% CI, 15.0%-28.0%). The prevalence of maternal complication was significantly different among studies conducted between ([2015–2020), and those conducted between [2020 and 2024]. Lowest (14%) in studies conducted before 2020 and highest (26%) among studies conducted 2020 and after (P-value<0.001). Type of instrument (AOR: 1.99, 95% CI: 1.37–2.90), episiotomy status (AOR: 3.49, 95% CI: 2.12–5.76), birthweight (AOR: 3.06, 95% CI: 1.88–4.97) and parity (AOR = 2.96, 95%CI: 1.80–4.85) were the factors associated with maternal complication of instrumental vaginal delivery. Conclusion Our study shows that approximately one in five mothers who underwent instrumental vaginal delivery develop serious maternal complication. Type of the instrument, episiotomy status, birthweight and parity were important predictors of the maternal complication of instrumental vaginal delivery. Effective evaluation of indication, contra indication and precondition for each instrument helps to prevent the maternal complication of instrumental vaginal delivery. Trial registration Registered in PROSPERO with ID: CRD42022366360.

Increased thermal suitability elevates the risk of dengue transmission across the mid hills of Nepal

The burden of climate-sensitive, mosquito-borne diseases, including dengue, has significantly increased in recent years. Understanding the temporal and spatial variations of these diseases is essential for effectively controlling potential outbreaks. In this study, we utilized Moderate Resolution Imaging Spectroradiometer (MODIS) satellite land surface temperature (LST) data (MOD11A2) and a temperature-dependent mechanistic model (R0) to predict the monthly suitability for dengue transmission in Nepal from 2001 to 2020 for both mosquito vectors, Aedes aegypti and Ae. albopictus. We divided the study period into two episodes: 2001–2010, which we characterized as the period of dengue emergence, and 2011–2020, identified as the period of rapid expansion. We compared the thermal suitability across these two time periods. The results indicated that approximately half of Nepal is thermally suitable for dengue transmission for at least one month, with the maximum transmission risk lasting up to nine months each year, a trend that has more or less remained stable over the past 20 years. However, strong temporal dynamics were observed in the hilly regions and around major urban centers such as Kathmandu and Pokhara, where the length of thermal suitability extended up to six months for both vector species. Consequently, the population exposed to thermal suitability increased significantly on a monthly basis. Compared to the emergence period, the proportion of the population exposed to a suitable thermal environment for six months or longer each year increased by 18% for Ae. aegypti and 20% for Ae. albopictus. These findings provide evidence-based insights that could assist health authorities in the control and management of dengue in Nepal.

Developing a real-time hand-gesture recognition technique for wheelchair control

At present, significant number of people in the world are having motor disabilities. They need to use wheelchair for performing regular movements and activities. However, there are a lot of issues and challenges in using the conventional wheelchairs. Safe navigation, independent mobility and low cost are the key issues for wheelchair users. This paper presents a new mathematical model for an efficient and real-time hand gesture recognition technique for a smart wheelchair control system, in line with contemporary technologies. The model is developed using the positions of the significant hand landmarks, distances among them and some critical thresholds which are determined by good number of samples of hands. The proposed method offers more users’ flexibility through less hand movement in operation of the wheelchair. The model is tested for hands of different sizes, irrespective of any background in indoor or outdoor under sunlight. The experimental study demonstrates that it outperforms the existing methods in terms of success rate with good performance metrics.

Moderate to severe chronic arteriolar lesions is an independent risk factor for adverse renal outcomes in IgA nephropathy

Background The impact of chronic arteriolar lesions on the prognosis of IgA nephropathy remains controversial. This study aims to explore the value of chronic arteriolar lesions of varying degrees in predicting the prognosis of IgA nephropathy patients and analyze the associated risk factors that contribute to the formation. Methods A retrospective analysis was conducted on 853 patients diagnosed with IgA nephropathy through renal biopsy at Guangdong Provincial Hospital of Traditional Chinese Medicine between September 1, 2005, and December 31, 2021. Eventually, a total of 574 cases were included in this study. According to the degree of chronic arteriolar lesions, the patients were divided into four groups: no lesion group (n=115), mild lesion group (n=287), moderate lesion group (n=131), and severe lesion group (n=41). Relevant clinical and pathological features and renal outcomes were recorded. Kaplan-Meier analysis, Cox proportional hazards regression, and receiver operating characteristic (ROC) curve analysis were utilized to examine the relationship between different degrees of chronic arteriolar lesions and the prognosis of IgA nephropathy. Additionally, risk factors associated with the development of moderate to severe chronic arteriolar lesions were identified. Results Worse clinical and pathological features were observed in the moderate to severe lesions group (P<0.05). Moderate to severe chronic arteriolar lesions (aHR=3.357, 95%CI: 1.018–11.071, P=0.047), creatinine, S1, E1, T2, and C2 were identified as independent risk factors for adverse renal outcomes. Cox multivariate regression analysis on moderate to severe chronic arteriolar lesions demonstrated that creatinine, T2, and C2 were independent risk factors for adverse renal outcomes in patients with moderate to severe chronic arteriolar lesions. Conclusion Moderate to severe chronic arteriolar lesions independently increases the risk of adverse renal outcomes.