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Urine tenofovir adherence testing: Perspectives of recently diagnosed South African adolescents and young adults with HIV accessing care via mobile HIV clinics
Background Adolescents and young adults (AYA) living with HIV face several challenges to engaging in HIV care, which can impact adherence to antiretroviral therapy (ART). Point-of-care (POC) diagnostics that detect tenofovir in urine may be a useful tool to support ART adherence, but perspectives from AYA in South Africa have not been explored. Methods We conducted in-depth interviews (IDIs) among young people (age 18–24) newly diagnosed with HIV in Cape Town, and a focus group discussion (FGD) with HIV care providers to understand their perspectives regarding the use of POC urine tenofovir testing to support ART adherence. Transcripts were analyzed using Dedoose, with an iterative thematic approach. Results Transcripts from 8 IDI participants and 8 FGD participants were included in the analysis. Major themes identified during analysis related to beliefs about POC urine adherence testing and recommendations for future clinical implementation. Most IDI participants indicated they would want to use the tests if clinically available, and both IDI and FGD participants believed the tests would be helpful to clinicians. Participants believed the tests could motivate people to take their ART regularly, either by reassuring them ART was present in their bodies, or to avoid the negative consequences of being found to be non-adherent. Drawbacks of POC adherence testing identified by respondents included not wanting to be caught skipping ART doses, concerns about privacy, how the test results would be explained, and adding to the amount of testing required for HIV clinical care. Conclusions AYA living with HIV in South Africa had favorable views toward POC tenofovir adherence testing and felt utilizing these tests in HIV clinical care would motivate people to remain adherent to ART.
Zinc oxide seed priming enhances drought tolerance in wheat seedlings by improving antioxidant activity and osmoprotection
Abstract Drought can affect all growth stages and has a significant effect on seed germination, which affects all physiological and metabolic germination processes. It also leads to dehydration, which increases the oxidation of lipids and membranes and disrupts the functioning of biomolecules in plants. Zinc is an essential element for several enzymes involved in metabolism, cell elongation, preservation of the strength and integrity of cell membranes, seed development, and resistance to environmental stress. A pot experiment was conducted to determine how ZnO seed priming, either in the form of ZnO NPs (nanopriming) or ZnO bulk priming (60 mg L− 1), counteracts the negative impacts of drought at different levels (80% and 60% FC) on wheat (Triticum aestivum L.) seedlings at the seedling stage. A recent experiment revealed that seed priming agents significantly mitigate the negative effects of drought stress, especially at 60% FC, by positively influencing various parameters of wheat seedlings. Notably, the POD activity increased by 91.8% and 289.9% for the shoots, 218.6% and 261.6% for the roots, the phenolic content increased by 194.4% for the shoots and 1139.6% for the roots, the H2O2 scavenging percentage increased by 124.9% and 135.4% for the shoots and 147.6% for the roots, and the lipid peroxidation inhibition percentage increased by 320.6% and 433% for the shoots. Moreover, the utilization of seed priming agents had a profound effect on free amino acids (393.8%, 502.8% for roots) and soluble carbohydrates (183.4% for roots) compared with those in stressed seedlings without priming. Experimental and computational methods (time-dependent density functional theory (TD-DFT)) were employed to perform IR and XRD analyses of the isolated molecules of the ZnO NPs/Iso. In conclusion, the application of ZnO NPs or bulk ZnO was found to create effective mechanical and physiological barriers, as confirmed by the analysis of antioxidant enzyme activities, nonenzymatic components, free radical scavenging, and osmoprotectant constituents.
Navigating vaccination in pregnancy: Qualitative study in 21 ethnically diverse pregnant women
Background Vaccination during pregnancy is crucial for safeguarding maternal and neonatal health, but vaccination rates remain suboptimal, especially in women from Black and Asian ethnic minorities. We explored the perspectives and decision-making processes of pregnant women regarding uptake of the three recommended vaccines in pregnancy: Influenza, Pertussis (whooping cough) and COVID-19. We also explored women’s attitudes to taking part in vaccine trials during pregnancy and the use of artificial intelligence (AI) to obtain information on vaccines. Methods In 2023, we conducted in-depth telephone interviews with ethnically diverse pregnant women in the Greater London area using convenience and snowball sampling. The interviews focused on participants’ views on vaccination during pregnancy, participation in vaccine trials, information-seeking behaviours, and attitudes to emerging technologies for health information. Interviews were transcribed verbatim and thematically analysed. The data collection and analysis were conducted alongside the iterative development of the topic guide and coding framework, with key themes emerging through collaborative team discussions. Results Twenty one pregnant women aged 20–39 were interviewed of whom 67% were from ethnic minorities and 29% were from migrant backgrounds. Half the participants (53%) reported hesitancy towards at least one of the vaccines. The analysis revealed several themes: concerns about vaccine safety, particularly regarding newer vaccines due to lack of long-term data; reliance on healthcare professionals for guidance, balanced with personal research; and a strong desire for clear and comprehensive information specifically tailored to pregnant women. Pregnant women reported insufficient information, explanation, or recommendation by midwives. Additionally, there was widespread refusal regarding participation in vaccine trials; and mixed responses to the use of AI (such as chatbots) for obtaining vaccine information. Conclusions Pregnant women’s vaccination decisions are complex and require clear, unambiguous communication from healthcare providers, especially midwives, to address their specific concerns. Although information obtained via AI can be useful, responses were mixed.
Multi-resource constrained elective surgical scheduling with Nash equilibrium toward smart hospitals
Neutrophil-to-lymphocyte ratio as a prognostic indicator in COVID-19: Evidence from a northern tanzanian cohort
Background COVID-19 caused a profound global impact, resulting in significant cases and deaths. The progression of COVID-19 clinical manifestations is influenced by a dysregulated inflammatory response. Early identification of the subclinical progression is crucial for timely intervention and improved patient outcomes. While there are various biomarkers to predict disease severity and outcomes, their accessibility and affordability pose challenges in resource-limited settings. We explored the potentiality of the neutrophil-to-lymphocyte ratio (NLR) as a cost-effective inflammatory marker to predict disease severity, clinical deterioration, and mortality in affected patients. Methodology A hospital-based retrospective cohort study was conducted at KCMC Hospital among COVID-19 patients followed from admission to discharge between 1 st March 2020 and 31 st March 2022. NLR was calculated as the absolute neutrophil count in μL divided by the absolute lymphocyte count in μL. The NLR cut-off value was determined using Receiver Operating Characteristic (ROC) analysis and assessed its predictive ability at admission for in-hospital mortality. The Chi-square test compared the proportion of NLR by patient characteristics. The association of NLR with disease severity and mortality was analyzed using the modified Poisson and Cox regression models, respectively. Results The study included 504 patients, with a median age of 64 years, 57.1% were males, and 68.3% had severe COVID-19. The in-hospital COVID-19 mortality rate was 37.7%. An NLR cutoff value of 6.1 or higher had a sensitivity of 92.1% (95% CI 89.2%–94.0%) and a specificity of 92.0% (95% CI 89.7%–94.4%). Additionally, 39.5% of patients with an NLR value of 6.1 or higher had increased risk of severe disease, subsequent clinical deterioration, and mortality. Conclusion and recommendation An NLR value of 6.1 or higher at the time of hospital admission associated with severe disease, clinical deterioration, and mortality in patients with COVID-19. Integration of NLR as a prognostic parameter in COVID-19 prognosis scales could improve risk assessment and guide appropriate management strategies for COVID-19 patients, as well as for potential future viral-related pneumonias. Further prospective studies are necessary to validate these findings and evaluate the clinical utility of NLR in larger cohorts of patients.
Characterization of a chemically induced osteoarthritis model in zebrafish
Impact of re-operation on progression-free survival in patients with recurrent GBM: Experience in a tertiary referral center
Background Reoperation for patients with recurrent glioblastoma multiforme (GBM) is a highly debated topic within the medical community. GBM is known for its aggressive nature and poor prognosis, with most patients experiencing tumor recurrence despite initial treatments. Some studies suggest a survival benefit from a second surgery, while others do not. The aim of this study is to assess whether reoperation for recurrent GBM offers a survival benefit compared to patients who do not undergo re-resection and to identify the prognostic factors influencing patient selection for reoperation. Methods This study retrospectively reviewed medical records from the American University of Beirut Medical Center over a ten-year period, from 01/01/2012 to 01/01/2023. It included patients with recurrent GBM after initial surgical resection. Patients were categorized into two groups: those who underwent reoperation and those who received only medical management upon recurrence. Inclusion criteria included histologically confirmed GBM with previous tumor resection; patients who only had a biopsy were excluded. Time to progression and time to death were analyzed using the Kaplan-Meier curve, with differences between groups assessed by the log-rank test. Results Age categorization (≤50 vs. >50 years) and gender distribution did not significantly impact reoperation likelihood (p = 0.306 and p = 0.616, respectively). However, a notable association was observed with Charlson comorbidity index (CCI) ≤3, indicating higher reoperation rates (p = 0.022). Tumor size grouping (≤5 vs. >5 cm) showed no significant association with reoperation status (p = 0.175). Similarly, whether the tumor was unifocal or multifocal and the extent of initial tumor resection (GTR vs. subtotal) did not demonstrate significant associations with reoperation (p = 0.086 and p = 0.351, respectively). Remarkably, complications following the initial surgery emerged as a significant factor associated with the decision not to undergo reoperation (p = 0.018). The most common complications following both initial and subsequent surgeries included DVT, weakness, seizures, and wound leakage and infection. The progression-free survival for patients who underwent reoperation was 15.9 months, whereas for those who did not undergo reoperation, it was 6.7 months (log-rank p < 0.001) The median post progression survival for patients who underwent reoperation upon recurrence was 5.9 months, compared to 5.1 months for those who did not undergo reoperation. (log-rank p = 0.065). The median overall survival for patients who did not undergo reoperation was 11 months, compared to 21 months for those who underwent reoperation (log-rank p < 0.001). Conclusion In conclusion, reoperation for recurrent Glioblastoma Multiforme (GBM) appears to offer a survival benefit, as indicated by significantly longer disease-free intervals and higher progression-free and overall survival rates compared to patients who did not undergo reoperation.
Psychological differences in food addiction and binge eating in a general Polish population
Abstract The aim of the study was to identify the prevalence of food addiction (FA) and binge eating (BE) in a general Polish population, to explore the differences between these constructs, and to examine psychological differences among FA, BE, and FA + BE groups. 2123 participants completed the questionnaires: Yale Food Addiction Scale 2.0, Binge Eating Scale, The PTSD Checklist for DSM-5, Life Events Checklist, Adverse Childhood Experiences, Short UPPS-P scale (impulsive traits), Dutch Eating Behavior Questionnaire and Depression, Anxiety and Stress Scale − 21 items. 492 participants reported clinically significant symptoms of FA, BE, or both. Spearman’s correlations, Mann-Whitney U tests, and Kruskal-Wallis tests were performed to examine the relationships between variables. The present study showed that FA and BE symptoms are common in the adult sample. The FA, BE and FA + BE groups had higher scores than the control group for all variables included in the study. The FA + BE group presented a significantly higher level of behavioral and emotional symptoms, followed by the FA and the BE group with less severity of symptoms. This study supports the hypothesis of food addiction as a similar construct to BE. FA is a broader concept than BE, but individuals experiencing both indicated the greatest functional difficulties.
Allelopathic and auto-toxic effects of aqueous extracts of Codonopsis pilosula root secretions
Water-soluble constituents in the root exudates of C. pilosula exhibit both allelopathic and auto-toxic properties, which substantially impede its growth. To mitigate the constraints associated with the continuous cropping of C. pilosula, this study examined the impact of aqueous extracts from the root exudates at various developmental stages on seed germination and seedling growth. Additionally, we isolated and characterized significant auto-toxic allelochemicals. Our findings revealed that the inhibitory effects on seed germination, seedling growth, and the activity of antioxidant enzymes-collectively referred to as a comprehensive effect-intensified progressively with increasing concentrations of the aqueous extracts from C. pilosula root exudates. The most pronounced auto-toxic comprehensive effect was observed with extracts at a concentration of 50 mL during the reproductive phase, diminishing SOD and POD activities, and MDA levels in C. pilosula seedlings by 72.3%, 71.7%, and 83.3% respectively, compared to the control (P<0.05). Three primary allelopathic compounds-acetic acid, hexamethyl cyclotrisiloxane, and methoxybenzene oxime were isolated and identified in the aqueous extracts. Acetic acid, constituting 44.1% of the total chemical profile, exhibited a significant inhibitory effect on seed germination and seedling growth (P<0.05). In conclusion, the aqueous extracts of C. pilosula root exudates significantly inhibit seed germination and seedling growth, especially during the plant’s reproductive stage, with low molecular weight organic acids being the predominant allelopathic components.
A comprehensive assessment of a passive back support exoskeleton for load handling assistance
A prospective model of the potential clinical and economic impact of cervical cancer screening supported by a mobile phone app
Introduction Cervical cancer is a preventable and highly curable disease when detected early and adequately treated, yet it remains the leading cause of cancer-related death in women in Kenya due to low screening coverage and treatment. Implementing World Health Organization screening guidelines for human papillomavirus (HPV) is challenging due to the complex logistics of result return and follow-up requiring multiple clinic visits. Increasing the use of mobile technology can support follow-up care in cervical cancer screening programs. Methods We developed a prospective clinico-economic model to assess the potential impact of a mobile phone-based application (“app”) communicating laboratory results and recommendations to improve follow-up care for cervical cancer screening in Kenya. The model is structured to simulate a three-visit pathway for HPV-based screening used in a clinical trial of the app and based on epidemiological data, clinical guideline-based workflow, and patient-based behavioral pathways. Published literature, expert elicitation, and time-and-motion observations were used to estimate clinical data, care pathways, and visit-related costs. This analysis was conducted from a base-case healthcare system perspective with a scenario from a “limited” societal perspective. Results In a simulated cohort of women using the app-based intervention compared to conventional care, with 10,000 women in each arm, use of the app is projected to increase healthcare costs by $12.53 per enrolled woman during the trial period and to detect and treat an additional 247 women—229 with precancerous cervical lesions and 18 with cervical cancer. The incremental cost-effectiveness ratio of the app versus conventional care was $174 per case detected and treated. This would be cost-saving given the average lifetime cost per cervical cancer case of $1,000–$3,000. Conclusion Use of a mobile phone-based app is costlier than conventional screening but by improving visit compliance, it can be a cost-effective and cost-saving strategy to enhance detection and treatment in cervical cancer screening programs.
Impact of synthetic insecticides on the life table parameters of Trichogramma chilonis under laboratory conditions
Comparative performance of disability measures
Researchers and federal agencies are currently discussing the best way to measure disability in US federal surveys. One idea being discussed is expanding/supplementing the question sets commonly used to capture disability status in order to better capture a broader segment of the disabled population. We used data from the 2010–2018 National Health Interview Survey to examine the performance of questions commonly used to measure disability in the US–the ACS-6 and Washington Group Short Set questions–in capturing intellectual and developmental disabilities, mental health disabilities, and physical health disabilities. We found that neither set of disability questions was sufficient to fully capture these disability statuses. We contend that current disability questions used in US population surveys must be expanded/supplemented in order to increase the inclusiveness of disability measurement, and thereby, improve efforts to reduce disparities experienced by the disabled population.
Identification of an additional periplanone receptor family gene preferentially expressed in the male antennae of the American cockroach
Early detection of anxiety symptoms in Autism Spectrum Disorder: An exploratory study in a Spanish sample of 3–6 year old children
Current research often overlooks anxiety symptoms in preschoolers with Autism Spectrum Disorder (ASD), focusing on older children. This study examines anxiety symptomatology primarily in young children with ASD by analyzing data from 82 Spanish children aged 3- to 6 years. Parents completed the Anxiety Scale for Children with ASD and the Social Communication Questionnaire. Results indicate that 30.48% of the children exhibit significant anxiety symptoms, “with anxious uncertainty” being the most prevalent. Factor analysis reveals three principal components of the Anxiety Scale, supporting its reliability. Regression analysis highlights stereotypical behaviors as significant predictors of anxiety levels. These findings underscore the importance of early assessment and adaptation of assessment tools for preschoolers with ASD. Stereotypical behaviors are identified as key predictors of anxiety in this population.
Exploring the potential impacts of anthropogenic heating on urban climate during heatwaves
Impact of digital breast tomosynthesis on screening performance and interval cancer rates compared to digital mammography: A meta-analysis
Background The performance of digital breast tomosynthesis (DBT) alone, digital mammography (DM) plus DBT, and synthesized mammography (SM) plus DBT, in comparison to DM in breast cancer screening, remains a topic of ongoing debate. The effectiveness of these modalities in reducing interval cancer rates (ICR) is particularly contentious. Materials and methods A database of data was searched for articles published until July 2024. Initially, the pooled sensitivity and specificity of DBT (DBT alone, DM/DBT, and SM/DBT) and DM were estimated. Additionally, the sensitivity of breast cancer screening and ICR for DBT alone, DM/DBT, and SM/DBT compared to DM. The characteristics of interval breast cancer were compared with those screening BC, alongside differences across various screening methods. Results Eleven studies comparing DBT and DM were included. The sensitivity of DBT was higher than that of DM, with rates of 86% (95%CI: 81, 90) and 80% (95%CI: 76, 84), respectively. The specificities of both modalities were similar, recorded at 96% (95%CI: 95, 98) and 96% (95%CI: 95, 97), respectively. In comparison to DM, the screening sensitivities of DBT, DM/DBT, and SM/DBT were increased by 4.33% (95% CI: 1.52, 7.13), 6.29% (95% CI: 2.55, 10.03), and 5.22% (95% CI: 1.35, 9.10), respectively; however, the difference in the ICR was not statistically significant. Conclusion DBT offers advantages in enhancing the sensitivity of breast cancer screening; however, its impact on ICR remains uncertain. Consequently, further research is necessary to comprehensively evaluate both the effectiveness of screening and the potential risks associated with DBT.
Revealing the critical state and identifying individualized dynamic network biomarker for type 2 diabetes through advanced analysis methods on individual basis
Automated recognition and segmentation of lung cancer cytological images based on deep learning
Compared with histological examination of lung cancer, cytology is less invasive and provides better preservation of complete morphology and detail. However, traditional cytological diagnosis requires an experienced pathologist to evaluate all sections individually under a microscope, which is a time-consuming process with low interobserver consistency. With the development of deep neural networks, the You Only Look Once (YOLO) object-detection model has been recognized for its impressive speed and accuracy. Thus, in this study, we developed a model for intraoperative cytological segmentation of pulmonary lesions based on the YOLOv8 algorithm, which labels each instance by segmenting the image at the pixel level. The model achieved a mean pixel accuracy and mean intersection over union of 0.80 and 0.70, respectively, on the test set. At the image level, the accuracy and area under the receiver operating characteristic curve values for malignant and benign (or normal) lesions were 91.0% and 0.90, respectively. In addition, the model was deemed suitable for diagnosing pleural fluid cytology and bronchoalveolar lavage fluid cytology images. The model predictions were strongly correlated with pathologist diagnoses and the gold standard, indicating the model’s ability to make clinical-level decisions during initial diagnosis. Thus, the proposed method is useful for rapidly localizing lung cancer cells based on microscopic images and outputting image interpretation results.