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This article presents a non-linear mathematical model that captures the dynamics of drinking prevalence within a population. The model is analyzed under an optimal control framework, dividing the total population into four compartments: susceptible, heavy drinker, drinker in treatment, and recovered classes. The model’s validity is affirmed through considerations of positivity, boundedness, reproduction number, stability, and sensitivity analysis. Stability theory is employed to explore both local and global stabilities. Sensitivity analysis identifies parameters with a significant impact on the reproduction number (R0{R}_{0}), with maximum sensitivity observed in parameters related to drinking transmission and transitions from heavy drinking to treatment stages. These parameters exhibit sensitivity indices of (0.538,1)\left(0.538,1), indicating that a 10% increase in these parameters would result in a (5.38,1)\left(5.38,1) increase in the threshold quantity. The study introduces an optimal control strategy that involves awareness campaigns and treatment as control variables. These controls aim to minimize the number of heavy drinkers while maximizing the number of recovered individuals. Pontryagin’s maximum principle is used to solve optimal control problems. Additionally, the research explores various parametric settings for each compartment, enriching the study environment. The effectiveness of the proposed control scheme is evaluated through rigorous numerical simulations, highlighting its competitive edge. The results, validated using MATLAB simulations, are detailed throughout the article.

This paper presents a new development of an Adaptive Network-based Fuzzy Inference System (ANFIS) for a Hybrid Ground Source Heat Pump (HGSHP). The HGSHP is equipped with a supplementary heat sink composter to process organic solid waste (OSW), utilizing excess hot air from the condensing unit to aerate the compost pile. The Fuzzy Logic Controller (FLC) was developed using data collected by effective sensors installed in the HGSHP system. The main objective is to control the water flow rate with a Variable Speed Drive (VSD) to improve overall system performance. The dataset for ANFIS has been created and trained using MATLAB® software, then implemented on a Raspberry Pi nano-computer with Python coding. This paper compares the performance of ANFIS with two different cases: ANFIS with Triangular Membership Function (TriMF) and ANFIS with Gaussian Membership Function (GaussMF). After implementing ANFIS with TriMF and GaussMF, the average COP during composter operation and system cooling significantly increased. In contrast, the HGSHP system power consumption is sufficiently reduced in both case studies. Moreover, ANFIS also benefits the composting process, as evidenced by the increase in composter operation time, and vice versa for system cooling time. Ultimately, the implementation of ANFIS can improve the HGSHP system performance in both the TriMF and GaussMF cases, with the TriMF case showing a significant improvement in the HGSHP system performance compared to the GaussMF case.

This article proposes a nonlinear deterministic mathematical model that encapsulates the dynamics of the prevailing degree of corruption in a population. The objectives are attained by exploring the dynamics of the corruption model under fractional-order derivative in the Caputo sense. The outcomes of the research are facilitated by stratifying the population into five compartments: susceptible class, exposed class, corrupted class, recovered class, and honest class. The developed model is validated by proving pivotal delicacies such as positivity, invariant region, basic reproduction number, and stability analysis. The Ulam–Hyers stability technique is used to prove the stable solution. The Adam–Bashforth numerical scheme is employed to estimate the numerical solution. Moreover, the research environment is further enriched by studying each compartment with respect to a wide range of relevant parametric settings. The realizations of this study indicate that susceptible individuals remain subject to being influenced by corrupt individuals. In addition, it is observed that the population of exposed individuals, recovered individuals, and honest individuals asymptotically approach toward the corruption equilibrium point, whereas the magnitudes of susceptible individuals and corrupted individuals decrease asymptotically to the corruption equilibrium state. The compartment dynamics are witnessed to be sensitive for various fractional-orders indicating the utility of the fractional approach. The findings of this study support the fundamental understanding of conceptualizing corruption in accordance with the viral transmission of infectious disease.

Weeds pose a severe threat to wheat productivity in rice-wheat cropping system (RWCS). Mulching residues of allelopathic crops into soil could be one of the viable organic strategies to manage weeds and sustain productivity. A two-year field experiment was conducted to study the effect of residue mulch of allelopathic crops on the weed population in wheat. The study consisted of three allelopathic crop residue mulch (CRM) treatments (wheat, rice and sorghum) each applied at 4 t ha-1 and three nitrogen (N) sources (ammonium sulphate, calcium ammonium nitrate and urea) each applied at 125 kg N ha-1. Plastic mulch and no mulch were used as controls. Results indicated that all mulches significantly inhibited dry biomass and density of all types of weeds during both growing seasons; however, the highest inhibition of weeds was found with plastic mulch. Among allelopathic mulches, maximum suppression in dry biomass and density of narrow leaved weeds (NLWs), broad leaved weeds (BLWs) and total weeds (TWs) was found in wheat mulch followed by sorghum and rice mulch. Compared with the control (no nitrogen), nitrogen applications generally increased the growth of weeds in terms of thei dry biomass only. The highest grain harvest was recorded in plastic mulch treatments followed by sorghum and wheat mulch. Calcium ammonium nitrate exhibited higher grain yield than other nitrogen sources. A negative correlation was found for grain yield and soil water soluble phenolics with dry biomass and density of weeds. In crux, use of allelopathic CRMs may be a pragmatic approach to manage weeds, improving competitiveness of crop plants with weeds and wheat productivity. [ABSTRACT FROM AUTHOR]

This research primarily aims at the in-depth exploration of thermal conductivity dynamics of Graphene-Silver (C-Ag) nano-composites on various parametric fronts. The parametric settings and resultant experimental states are mimicked by the rigorous launch of molecular dynamic (MD) simulations with Green-Kubo multiscale modeling approach. The enumeration of thermal conductivity of C-Ag nano-composites is instigated along with three orientations that is C-Ag (1 0 0), C-Ag (1 1 0) and C-Ag (1 1 1). Further, the conductive subtleties are expounded with respect to numerous factors of practical concerns such as, temperature, length of composite, composite width and number of Ag layers. [ABSTRACT FROM AUTHOR]

Background: Orthostatic headache (OH) is a common feature of various conditions, including spontaneous intracranial hypotension (SIH), but no precise definition currently exists outlining the typical OH characteristics. This ambiguity risks misdiagnosis with unnecessary investigations and delay in institution of treatment. The present study aimed to carry out structured phenotyping of OH in patients with SIH with the aim of outlining its typical characteristics., Methods: Eligible patients with clinico-radiological confirmed SIH underwent a structured interview, after which a specialist interest group utilised the modified Delphi process to analyse the data and achieve consensus on defining the typical characteristics of OH in SIH., Results: In total, 137 patients were recruited. OH was present in 75.9%. Typical OH characteristics in SIH were defined as having a baseline severity (lying flat) on waking up of ≤3 (0-10, verbal response scale), headache onset-time of ≤4.5 h on becoming upright, time to peak severity of ≤7.5 h and an offset to baseline severity within 1.5 h of recumbency. Intra-individual consistency in the onset and offset-time was deemed a necessary characteristic., Conclusions: Defining typical OH characteristics has the potential of enhancing SIH diagnostics and management, at the same time as minimising unwarranted invasive procedures., Competing Interests: Declaration of conflicting interestsDM, SC, SG, SK, PS, AT, CD, AQ, ID and JW have no competing interests.MSM is chair of the medical advisory board of the CSF Leak Association; has served on advisory boards for Allergan, Autonomic Technologies Inc, Eli Lilly, Novartis, Pfizer, Salvia and TEVA; has received payment for educational presentations from Allergan, electroCore, Eli Lilly, Novartis and TEVA; has received grants from Abbott, Medtronic and electroCore; and has a patent on system and method for diagnosing and treating headaches (WO2018051103A1, issued). JA has received remuneration for consultancy advice and education provision from Allergan/AbbVie and TEVA. HA-L has lectures and education paid by International Medical Press, Sanofi and Eisai. BD has received remuneration for consultancy advice and education provision from TEVA, Allergan and Lilly. PJD has received fees or educational support from Abbvie, Lilly, Novartis, Pfizer and TEVA, and has shareholdings in Novo Nordisk, Lilly, Regeneron, Alnylam and Ionis Pharma. SL has received fees for attending advisory meetings, presentations and preparing presentation materials from Abbvie, TEVA, Eli Lilly, Tillots Pharma, Salvia and Novartis. CJ is a member of CSF Leak Association. JDR has received funding from a Miriam Marks Brain Research UK Senior Fellowship, an MRC Clinician Scientist Fellowship (MR/M008525/1) and the NIHR Rare Disease Translational Research Collaboration (BRC149/NS/MH), as well as the MRC UK GENFI grant (MR/M023664/1), the Bluefield Project and the JPND GENFI-PROX grant (2019-02248).

The growing field of social neuroscience is reliant on the development of robust, ecologically valid paradigms for simulating social interaction and measuring social cognition in highly controlled laboratory settings. Perspective taking is a key component of social cognition, and accordingly several paradigms aimed at measuring perspective taking exist. A relatively novel paradigm is the ball detection task, in which participants and a virtual agent form independent beliefs about the presence of a target stimulus behind an occluder. Previous studies have shown that incongruent trials (in which the participant's and the agent's beliefs differ) affect participant reaction times and elicit increased neural activity in the so-called mentalizing network. This paradigm has important advantages over previous ones, in that experimental conditions can be fully randomized, and ceiling effects are not found even for adult populations. Here, we combined this paradigm with a stress induction and a nonstressful control task. In an online study, we found no evidence of perspective taking at the behavioral level. Combining the task with functional magnetic resonance imaging, we found no evidence of perspective taking at the behavioral or neural level, even for the control condition. While this paradigm is reliable on its own, implementing it in the context of a task-switching paradigm appears to reduce participants' focus on task-irrelevant perspective taking elements. Our findings highlight the fragility of existing social cognition paradigms and the need for reliable, simple, and ecologically valid measures of perspective taking., Competing Interests: The authors declare no competing financial interests., (Copyright © 2024 Cheema et al.)

Background: Short-lasting unilateral neuralgiform headache attacks (SUNHA) are trigeminal autonomic cephalalgias that feature intense and recurrent paroxysms of pain and autonomic symptoms. Many patients are left with debilitating symptoms despite best-available treatment. Psychedelics, such as the serotonin 2A partial agonist psilocybin, have shown promise in related disorders such as migraine and cluster headache. In this open-label phase Ib ascending dose study, we aimed to assess the effects of low-dose oral psilocybin with psychological support in six to 12 patients with chronic SUNHA. Study objectives were to determine effects on cognition, as well as safety, tolerability, and effects on headache severity and frequency., Methods: Oral psilocybin in ascending doses of 5, 7.5, and 10 mg (one dose per session; three dosing sessions in total) were administered. Cognition was assessed via the Cambridge Neuropsychological Tests Automated Battery. Headache attacks were assessed via headache diaries and the six-item Headache Impact Test (HIT-6). Subjective dose intensity was assessed via the five-Dimensional Altered States of Consciousness Questionnaire (5D-ASC). The study was terminated early due to recruitment difficulties; four patients were enrolled, three of whom were study completers. Post hoc, we undertook a thematic analysis of the applicable free-text clinical trial notes from the dosing and subsequent visits (n = 22). An inductive method was employed to establish emergent themes., Results: No significant adverse events were recorded. We were unable to collect data as planned on cognitive function during the acute experience due to high ratings of subjective dose intensity (mean 5D-ASC scores 37.8-45.7). The impact of the headaches remained severe throughout the duration of the trial (HIT-6 mean scores 64.3-65.7). There were limited effects on headache duration and severity based on the diaries; however, mean daily attack frequency decreased by >50% in two participants at final follow-up (22.9 to 11.0 and 56.4 to 28.0, respectively). Completing participants and their clinicians recorded "much" (two participants) or "minimal" improvements (one participant) at final follow-up via the Clinical Global Impression rating scale. Thematic analysis indicated that psychological insights were key features of participants' experience; these insights included re-configured relationships to their headache pain., Conclusion: The study met with recruitment difficulties and cognition could not be assessed during the acute experience due to subjective dose intensity, likely mediated in part by expectancy effects. The clinical results provide no conclusive evidence for the use of psilocybin in SUNHA. We suggest that accounting for psychological factors in chronic SUNHA may be an important facet of treatment., (© 2024 The Author(s). Headache: The Journal of Head and Face Pain published by Wiley Periodicals LLC on behalf of American Headache Society.)

Background: Cutaneous leiomyosarcoma (cLMS) is a rare soft tissue neoplasm, showing smooth muscle differentiation, that arises from the mesenchymal cells of the dermis. To-date, genetic investigation of these tumours has involved studies with small sample sizes and limited analyses that identified recurrent somatic mutations in RB1 and TP53, copy number gain of MYCOD and IGF1R, and copy number loss of PTEN., Objectives: To better understand the molecular pathogenesis of cLMS, we comprehensively explored the mutational landscape of these rare tumours to identify candidate driver events., Methods: In this retrospective, multi-institutional study, we performed whole-exome sequencing and RNA sequencing on 38 cases of cLMS., Results: TP53 and RB1 were identified as significantly mutated, thus, represent validated driver genes of cLMS. COSMIC mutational signatures SBS7a/b and DBS1 were recurrent, thus, ultraviolet light exposure may be an aetiological factor driving cLMS. Analysis of significantly recurrent somatic copy number alterations, which represent candidate driver events, found focal (<10Mb) deletions encompassing TP53 and KDM6B, and amplifications encompassing ZMYM2, MYOCD, MAP2K4 and NCOR1. A larger (24 Mb) recurrent deletion encompassing CYLD was also identified as significant. Significantly recurrent broad copy number alterations, involving at least half of a chromosome arm, included deletions of 6p/q, 10p/q, 11q, 12q, 13q and 16p/q, and amplification of 15q. Notably PTEN is located on 10q, RB1 on 13q and IGFR1 on 15q. Fusion gene analysis identified recurrent CRTC1/3::MAML2 fusions, as well as many novel fusions in individual samples., Conclusions: Our analysis of the largest number of cLMS cases to-date highlights the importance of large cohort sizes and the exploration beyond small targeted gene panels when performing molecular analyses, as it allowed a comprehensive exploration of the mutational landscape of these tumours and identification of novel candidate driver events. It also uniquely afforded the opportunity to compare the molecular phenotype of cLMS with LMS of other tissue types, such as uterine and soft tissue LMS. Given that molecular profiling has resulted in the development of novel targeted treatment approaches for uterine and soft tissue LMS, our study now allows the same opportunities to become available for patients with cLMS., (© The Author(s) 2024. Published by Oxford University Press on behalf of British Association of Dermatologists. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Background: The primary objective worldwide during the coronavirus disease 2019 (COVID-19) pandemic had been controlling disease transmission. However, lockdown measures used to mitigate transmission affected human behavior and altered lifestyles, with a likely impact on chronic non-communicable diseases. More than a year into the pandemic, substantial peer-reviewed literature emerged on altered lifestyles following the varying lockdown measures imposed globally to control the virus spread. We explored the impact of lockdown measures on six lifestyle factors, namely diet, physical activity, sleep, stress, social connectedness, and the use of tobacco, alcohol, or other harmful substances., Methods: We comprehensively searched PubMed and the World Health Organization's global literature database on COVID-19 and retrieved 649 relevant articles for the narrative review. A critical interpretative synthesis of the articles was performed., Results: Most of the articles included in the review identified the negative effect of lockdown measures on each of the lifestyle factors in many parts of the world. Encouraging lifestyle trends were also highlighted in a few articles. Such trends can positively influence the outcome of lifestyle-related chronic diseases, such as obesity and diabetes., Conclusions: The lockdown associated with COVID-19 has largely had a negative impact on the lifestyles of individuals and communities across many countries and cultures. However, some individuals and communities also initiated positive lifestyle-related behavioral changes. If the knowledge generated by studying the impact of COVID-19-related lockdowns on the six lifestyle factors is further consolidated, it could improve chronic disease outcomes. This will help better understand lifestyle behaviors amidst crises and assist in redesigning extreme public health measures such as lockdowns.. It is up to governments, communities, and healthcare/academic entities to derive benefit from lessons learned from the pandemic, with the ultimate objective of better educating and promoting healthy lifestyles among communities., Competing Interests: No competing interests were disclosed., (Copyright: © 2024 Doraiswamy S et al.)

Competing Interests: Competing interests: None declared.

Background: Human Papilloma Virus (HPV) infection is a significant public health concern in the Gulf Cooperation Council countries, being widely prevalent and the main risk factor for cervical cancer. We aimed to assess knowledge and perception towards HPV, acceptability of the HPV vaccine, and HPV vaccination rates among university students in Education City, Doha, Qatar., Methods: This cross-sectional survey utilized proportional quota-sampling, with quotas based on university, sex, and nationality, to recruit students from seven universities between February and September 2022. The English language questionnaire requested socio-demographic information, knowledge, and attitudes about HPV infection and the vaccine. The chi-square test, Student t-test, Mann-Whitney-Wilcoxon tests and multivariable ordinal logistic regression were used to assess differences in proportion, mean, and median according to broad HPV knowledge categories., Results: Three hundred and ninety-eight students were recruited (response rate = 82.3%), of whom 251 (63.1%) were female. Mean age was 21.7 years. Eighty-nine (22.4%, 95% CI 18.4-26.8%) students had poor knowledge about HPV, 220 (55.3%, 95% CI 50.2-60.2%) students had some awareness, and 89 (22.4%, 95% CI 18.4-26.8%) students were knowledgeable. Age, nationality, and field of study influenced the students' knowledge about HPV. Only 25 (6.3%) students had previously been vaccinated against HPV. However, 71% of the unvaccinated students reported being willing to get vaccinated if recommended by their healthcare provider., Conclusions: Overall, 77.7% of the student population had some-to-good levels of knowledge about HPV-related infection, cancer, and vaccination. There are gaps in the student population's understanding and knowledge about HPV. Increasing knowledge can be key toward shared decision-making for HPV vaccination among eligible populations. Targeted public health campaigns and integration into childhood vaccination programs should be critical first steps, especially as most of the surveyed students had a positive outlook on getting vaccinated. Healthcare professionals should be incentivized to increase their HPV knowledge and communication skills, while policymakers can work toward easing barriers in integrating HPV vaccinations in the immunization schedule and encouraging overall HPV vaccination uptake., (© 2024. The Author(s).)

Lipoprotein lipase (LPL) hydrolyzes circulating triglycerides (TGs), releasing fatty acids (FA) and promoting lipid storage in white adipose tissue (WAT). However, the mechanisms regulating adipose LPL and its relationship with the development of hypertriglyceridemia are largely unknown. WAT from obese humans exhibited high PAR2 expression, which was inversely correlated with the LPL gene. Decreased LPL expression was also inversely correlated with elevated plasma TG levels, suggesting that adipose PAR2 might regulate hypertriglyceridemia by downregulating LPL. In mice, aging and high palmitic acid diet (PD) increased PAR2 expression in WAT, which was associated with a high level of macrophage migration inhibitory factor (MIF). MIF downregulated LPL expression and activity in adipocytes by binding with CXCR2/4 receptors and inhibiting Akt phosphorylation. In a MIF overexpression model, high-circulating MIF levels suppressed adipose LPL, and this suppression was associated with increased plasma TGs but not FA. Following PD feeding, adipose LPL expression and activity were significantly reduced, and this reduction was reversed in Par2-/- mice. Recombinant MIF infusion restored high plasma MIF levels in Par2-/- mice, and the levels decreased LPL and attenuated adipocyte lipid storage, leading to hypertriglyceridemia. These data collectively suggest that downregulation of adipose LPL by PAR2/MIF may contribute to the development of hypertriglyceridemia.

Background Chronic kidney disease (CKD) is a globally increasing health concern, and there is a growing focus on early screening and prevention efforts. However, the availability of data on CKD prevalence in Pakistan, particularly in the urban area of Lahore district, is limited. The objective of the Kidney Early Evaluation Program (KEEP) Lahore was to assess the prevalence of CKD in a high-risk population residing in the urban area of Lahore, Pakistan. Methods A cross-sectional study was conducted involving 254 participants, who were over 18 years old and belonged to a high-risk population according to the pre-defined operational definitions. The participants were randomly selected from various towns in Lahore. Screening camps were set up to measure serum creatinine levels and urinary albumin to creatinine ratio (UACR), and then the estimated glomerular filtration rate (eGFR) was calculated using the CKD Epidemiology Collaboration 2021 (CKD EPI) equation. Results Out of the total 254 participants, a diagnosis of CKD was made in 62 (24.2%) individuals. Significant associations were found between CKD and risk factors including hypertension, diabetes, family history of CKD, ischemic heart disease (IHD) or congestive heart failure (CHF), intake of painkillers, and herbal medicines. However, no association was found between obesity (BMI ≥ 30) and CKD. Participants diagnosed with CKD had a mean age of 49.9 years and a mean serum creatinine level of 1.2 mg/dL, while non-CKD participants had a mean age of 43.7 years and a mean serum creatinine level of 0.7 mg/dL. Conclusion Our study revealed that CKD was prevalent in about one-fourth of the participants from the high-risk population of Lahore, indicating a high prevalence of the disease within society. Moreover, hypertension, diabetes, family history of CKD, heart disease, painkillers, and the use of herbal medicines were all significantly linked to CKD in the surveyed sample population., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Ethical Review Board Allama Iqbal Medical College/Jinnah Hospital, Lahore issued approval 59th/ERB dated May 14, 2020. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Khan et al.)

Post-traumatic stress disorder (PTSD) genetics are characterized by lower discoverability than most other psychiatric disorders. The contribution to biological understanding from previous genetic studies has thus been limited. We performed a multi-ancestry meta-analysis of genome-wide association studies across 1,222,882 individuals of European ancestry (137,136 cases) and 58,051 admixed individuals with African and Native American ancestry (13,624 cases). We identified 95 genome-wide significant loci (80 new). Convergent multi-omic approaches identified 43 potential causal genes, broadly classified as neurotransmitter and ion channel synaptic modulators (for example, GRIA1, GRM8 and CACNA1E), developmental, axon guidance and transcription factors (for example, FOXP2, EFNA5 and DCC), synaptic structure and function genes (for example, PCLO, NCAM1 and PDE4B) and endocrine or immune regulators (for example, ESR1, TRAF3 and TANK). Additional top genes influence stress, immune, fear and threat-related processes, previously hypothesized to underlie PTSD neurobiology. These findings strengthen our understanding of neurobiological systems relevant to PTSD pathophysiology, while also opening new areas for investigation., (© 2024. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.)

International differences in the incidence of many cancer types indicate the existence of carcinogen exposures that have not yet been identified by conventional epidemiology make a substantial contribution to cancer burden 1 . In clear cell renal cell carcinoma, obesity, hypertension and tobacco smoking are risk factors, but they do not explain the geographical variation in its incidence 2 . Underlying causes can be inferred by sequencing the genomes of cancers from populations with different incidence rates and detecting differences in patterns of somatic mutations. Here we sequenced 962 clear cell renal cell carcinomas from 11 countries with varying incidence. The somatic mutation profiles differed between countries. In Romania, Serbia and Thailand, mutational signatures characteristic of aristolochic acid compounds were present in most cases, but these were rare elsewhere. In Japan, a mutational signature of unknown cause was found in more than 70% of cases but in less than 2% elsewhere. A further mutational signature of unknown cause was ubiquitous but exhibited higher mutation loads in countries with higher incidence rates of kidney cancer. Known signatures of tobacco smoking correlated with tobacco consumption, but no signature was associated with obesity or hypertension, suggesting that non-mutagenic mechanisms of action underlie these risk factors. The results of this study indicate the existence of multiple, geographically variable, mutagenic exposures that potentially affect tens of millions of people and illustrate the opportunities for new insights into cancer causation through large-scale global cancer genomics., (© 2024. The Author(s).)

Spontaneous intracranial hypotension (SIH) is a highly disabling but treatable secondary cause of headache. Recent progress in neuroradiological techniques has catalysed understanding of its pathophysiological basis and clinical diagnosis, and facilitated the development of more effective investigation and treatment methods. A UK-based specialist interest group recently produced the first multidisciplinary consensus guideline for the diagnosis and treatment of SIH. Here, we summarise a practical approach to its clinical and radiological diagnosis, symptomatic and non-targeted interventional treatment, radiological identification of leak site and targeted treatment of the leak once it has been localised., Competing Interests: Competing interests: SC received research fellowship sponsored by Abbott. DM received research fellowship sponsored by Medtronic. SK, ID, AQ and PS—none. MM—chair of the medical advisory board of the CSF Leak Association, serves on the advisory board for Abbott, Allergan, Novartis, Eli Lilly, Medtronic, Autonomic Technologies and TEVA, and has received payment for the development of educational presentations from Allergan, electroCore, Eli Lilly, Novartis and TEVA., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Although many outcome studies pertaining to sports-related concussion exist, female athletes with concussion remain an understudied group. We examined whether neurocognitive performance in adolescent females with sports-related concussion (SRC) is related to menstrual cycle-related hormone levels measured at one-week post-concussion, one-month post-concussion, or both. Thirty-eight female athletes, ages 14-18, were matched into two groups: SRC or healthy control. Self-reported symptom scores were higher among concussed females in the luteal phase, when progesterone levels are highest. Results suggest that progesterone levels may contribute to a heightened experience of symptoms during the acute phase of SRC, providing further evidence of a possible link between progesterone and symptom scores following concussion.

Sleep disturbances like poor and insufficient sleep are common among medical students in the Middle East and North Africa (MENA) countries; however, the extent of medically defined sleep disorders (SDs) remains unclear. This meta-analysis determines SD prevalence and identifies associated factors among medical students in the MENA. PubMed, Web of Science, Google Scholar, and reference lists of included studies were searched (latest search: June 2022). Meta-analyses included 22 studies and were performed using random-effect models. Included studies used self-reported screening tools for assessing SDs and then estimated the proportion of participants at high risk of developing a SD. Central disorders of hypersomnolence were the most prevalent SD [prevalence pooled range: 30.9% (Jordan) to 62.5% (Saudi Arabia)], followed by insomnia disorders [prevalence pooled range: 30.4% (Jordan) to 59.1% (Morocco)], circadian rhythm sleep-wake disorders [prevalence pooled range: 13.5% (Jordan) to 22.4% (Saudi Arabia)], sleep-related breathing disorders [prevalence pooled range: 12.2% (Jordan) to 22.5% (Pakistan)], sleep-related movement disorders [prevalence pooled range: 5.9% (Egypt) to 30.6% (Saudi Arabia)], and parasomnias [prevalence pooled range: 5.6% (Jordan) to 17.4% (Saudi Arabia)]. Female sex, studying in the latter academic years, having anxiety, excessive internet use, and poor academic performance were significantly associated with SDs. SDs are prevalent among MENA medical students. Implementing student-centered interventions targeting high risk groups in medical schools should be considered to improve students' health and wellbeing., (© 2024. The Author(s).)

Background: In this priority-setting exercise, we sought to identify leading research priorities needed for strengthening future pandemic preparedness and response across countries., Methods: The International Society of Global Health (ISoGH) used the Child Health and Nutrition Research Initiative (CHNRI) method to identify research priorities for future pandemic preparedness. Eighty experts in global health, translational and clinical research identified 163 research ideas, of which 42 experts then scored based on five pre-defined criteria. We calculated intermediate criterion-specific scores and overall research priority scores from the mean of individual scores for each research idea. We used a bootstrap (n = 1000) to compute the 95% confidence intervals., Results: Key priorities included strengthening health systems, rapid vaccine and treatment production, improving international cooperation, and enhancing surveillance efficiency. Other priorities included learning from the coronavirus disease 2019 (COVID-19) pandemic, managing supply chains, identifying planning gaps, and promoting equitable interventions. We compared this CHNRI-based outcome with the 14 research priorities generated and ranked by ChatGPT, encountering both striking similarities and clear differences., Conclusions: Priority setting processes based on human crowdsourcing - such as the CHNRI method - and the output provided by ChatGPT are both valuable, as they complement and strengthen each other. The priorities identified by ChatGPT were more grounded in theory, while those identified by CHNRI were guided by recent practical experiences. Addressing these priorities, along with improvements in health planning, equitable community-based interventions, and the capacity of primary health care, is vital for better pandemic preparedness and response in many settings., Competing Interests: Disclosure of interest: The authors completed the ICMJE Disclosure of Interest Form (available upon request from the corresponding author) and declare the following activities and/or relationships: IR is the Co-Editor in Chief, PS is the China Regional Editor, and DA is an Editorial Board Member of the Journal of Global Health. To ensure that any possible conflict of interest relevant to the journal has been addressed, this article was reviewed according to best practice guidelines of international editorial organisations., (Copyright © 2024 by the Journal of Global Health. All rights reserved.)

Empowering the Participant Voice (EPV) is an NCATS-funded six-CTSA collaboration to develop, demonstrate, and disseminate a low-cost infrastructure for collecting timely feedback from research participants, fostering trust, and providing data for improving clinical translational research. EPV leverages the validated Research Participant Perception Survey (RPPS) and the popular REDCap electronic data-capture platform. This report describes the development of infrastructure designed to overcome identified institutional barriers to routinely collecting participant feedback using RPPS and demonstration use cases. Sites engaged local stakeholders iteratively, incorporating feedback about anticipated value and potential concerns into project design. The team defined common standards and operations, developed software, and produced a detailed planning and implementation Guide. By May 2023, 2,575 participants diverse in age, race, ethnicity, and sex had responded to approximately 13,850 survey invitations (18.6%); 29% of responses included free-text comments. EPV infrastructure enabled sites to routinely access local and multi-site research participant experience data on an interactive analytics dashboard. The EPV learning collaborative continues to test initiatives to improve survey reach and optimize infrastructure and process. Broad uptake of EPV will expand the evidence base, enable hypothesis generation, and drive research-on-research locally and nationally to enhance the clinical research enterprise., (© The Author(s) 2024.)

Generally, university students are at risk of burnout. This likely was exacerbated during the COVID-19 pandemic. We aimed to investigate burnout prevalence among university students during the COVID-19 pandemic and examine its distribution across countries, sexes, fields of study, and time-period. PubMed, EMBASE, PsycINFO, World Health Organization's Global COVID-19 database, Scopus, Epistemonikos, ERIC and Google Scholar were searched (protocol: https://doi.org/10.17605/OSF.IO/BYRXW ). Studies were independently screened and extracted. Random-effects meta-analysis was performed. Study quality was appraised, and certainty of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation approach. We identified 44 primary studies comprising 26,500 students. Global prevalence rates were 56.3% for high emotional exhaustion (EE), 55.3% for high cynicism (CY) and 41.8% for low personal accomplishment (PA). Prevalence of EE, CY, and PA domains varied significantly across fields of study, countries and WHO and World Bank regions, but not sex. All studies demonstrated good internal validity, although substantial heterogeneity existed between studies. The certainty of evidence was rated as moderate. Considering its potentially severe consequences, burnout is a significant public health concern. The development and implementation of evidence-based localized interventions at organizational and individual levels are necessary to mitigate burnout., (© 2024. The Author(s).)

Over the course of history global population has witnessed deterioration of unprecedented scale caused by infectious transmission. The necessity to mitigate the infectious flow requires the launch of a well-directed and inclusive set of efforts. Motivated by the urge for continuous improvement in existing schemes, this article aims at the encapsulation of the dynamics of the spread of infectious diseases. The objectives are served by the launch of the infectious disease model. Moreover, an optimal control strategy is introduced to ensure the incorporation of the most feasible health interventions to reduce the number of infected individuals. The outcomes of the research are facilitated by stratifying the population into five compartments that are susceptible class, acute infected class, chronic infected class, recovered class, and vaccinated class. The optimal control strategy is formulated by incorporating specific control variables namely, awareness about medication, isolation, ventilation, vaccination rates, and quarantine level. The developed model is validated by proving the pivotal delicacies such as positivity, invariant region, reproduction number, stability, and sensitivity analysis. The legitimacy of the proposed model is delineated through the detailed sensitivity analysis along with the documentation of local and global features in a comprehensive manner. The maximum sensitivity index parameters are disease transmission and people moved from acute stages into chronic stages whose value is (0.439, 1) increase in parameter by 10 percent would increase the threshold quantity by (4.39, 1). Under the condition of a stable system, we witnessed an inverse relationship between susceptible class and time. Moreover, to assist the gain of the fundamental aim of this research, we take the control variables as time-dependent and obtain the optimal control strategy to minimize infected populations and to maximize the recovered population, simultaneously. The objectives are attained by the employment of the Pontryagin maximum principle. Furthermore, the efficacy of the usual health interventions such as quarantine, face mask usage, and hand sanitation are also noticed. The effectiveness of the suggested control plan is explained by using numerical evaluation. The advantages of the new strategy are highlighted in the article., (© 2024. The Author(s).)

Background and Objectives: Deep brain stimulation (DBS) of the ventral tegmental area (VTA) is a surgical treatment option for selected patients with refractory chronic cluster headache (CCH). We aimed to identify clinical and structural neuroimaging factors associated with response to VTA DBS in CCH., Methods: This prospective observational cohort study examines consecutive patients with refractory CCH treated with VTA DBS by a multidisciplinary team in a single tertiary neuroscience center as part of usual care. Headache diaries and validated questionnaires were completed at baseline and regular follow-up intervals. All patients underwent T1-weighted structural MRI before surgery. We compared clinical features using multivariable logistic regression and neuroanatomic differences using voxel-based morphometry (VBM) between responders and nonresponders., Results: Over a 10-year period, 43 patients (mean age 53 years, SD 11.9), including 29 male patients, with a mean duration of CCH 12 years (SD 7.4), were treated and followed up for at least 1 year (mean follow-up duration 5.6 years). Overall, there was a statistically significant improvement in median attack frequency from 140 to 56 per month (Z = -4.95, p < 0.001), attack severity from 10/10 to 8/10 (Z = -4.83, p < 0.001), and duration from 110 to 60 minutes (Z = -3.48, p < 0.001). Twenty-nine (67.4%) patients experienced ≥50% improvement in attack frequency and were therefore classed as responders. There were no serious adverse events. The most common side effects were discomfort or pain around the battery site (7 patients) and transient diplopia and/or oscillopsia (6 patients). There were no differences in demographics, headache characteristics, or comorbidities between responders and nonresponders. VBM identified increased neural density in nonresponders in several brain regions, including the orbitofrontal cortex, anterior cingulate cortex, anterior insula, and amygdala, which were statistically significant ( p < 0.001)., Discussion: VTA DBS showed no serious adverse events, and, although there was no placebo control, was effective in approximately two-thirds of patients at long-term follow-up. This study did not reveal any reliable clinical predictors of response. However, nonresponders had increased neural density in brain regions linked to processing of pain and autonomic function, both of which are prominent in the pathophysiology of CCH., (© 2023 American Academy of Neurology.)

Objective: We aimed to investigate the association between university students' dietary patterns, their demographics and lifestyle in a cross-sectional study in Qatar. Participants: 370 students in eight universities in Qatar enrolled between February 2017 and February 2018. Methods: Based on a structured questionnaire, dietary patterns were identified using principal component analysis, and their associations with student characteristics were assessed using logistic regression. Results: Four dietary patterns were identified. The 'fast food' pattern was associated with being younger and male ( p -values ≤ 0.1). The 'traditional diet' pattern was associated with not skipping meals or eating when bored ( p -values = 0.1). The 'healthy diet' pattern was associated with regular exercise and having time to eat healthy foods ( p -values ≤ 0.01). The 'protein shake' pattern was associated with being male and engaging in more vigorous physical activity ( p -values ≤ 0.01). Conclusions: Our findings provide a roadmap for the prioritization of population-specific interventions in university students within Qatar and the region.

Summary: A study was conducted to determine the prevalence of metabolic syndrome (MetS) in urban and rural areas of Ludhiana district, Punjab. A total of 1000 subjects aged 25-65 years were selected for screening. The study found that both urban and rural areas had an average body mass index above 23.0 kg/m2, with rural populations having higher waist circumference, hip circumference, and waist-hip ratios. Abdominal obesity was more prevalent in women in both areas. Rural men and women had higher fasting blood glucose and systolic blood pressure/diastolic blood pressure levels. MetS prevalence in urban areas is lower among men (7%) and women (10%) compared to rural areas (34% and 26%). The timely detection of metabolic disorder risk factors and intervention can effectively address MetS in the Indian population, thereby improving the country's health statistics., (Copyright © 2023 Copyright: © 2023 Indian Journal of Public Health.)

Background: We aimed to create a multidisciplinary consensus clinical guideline for best practice in the diagnosis, investigation and management of spontaneous intracranial hypotension (SIH) due to cerebrospinal fluid leak based on current evidence and consensus from a multidisciplinary specialist interest group (SIG)., Methods: A 29-member SIG was established, with members from neurology, neuroradiology, anaesthetics, neurosurgery and patient representatives. The scope and purpose of the guideline were agreed by the SIG by consensus. The SIG then developed guideline statements for a series of question topics using a modified Delphi process. This process was supported by a systematic literature review, surveys of patients and healthcare professionals and review by several international experts on SIH., Results: SIH and its differential diagnoses should be considered in any patient presenting with orthostatic headache. First-line imaging should be MRI of the brain with contrast and the whole spine. First-line treatment is non-targeted epidural blood patch (EBP), which should be performed as early as possible. We provide criteria for performing myelography depending on the spine MRI result and response to EBP, and we outline principles of treatments. Recommendations for conservative management, symptomatic treatment of headache and management of complications of SIH are also provided., Conclusions: This multidisciplinary consensus clinical guideline has the potential to increase awareness of SIH among healthcare professionals, produce greater consistency in care, improve diagnostic accuracy, promote effective investigations and treatments and reduce disability attributable to SIH., Competing Interests: Competing interests: JA: remuneration for consultancy advice and education provision from Allergan/AbbVie and TEVA. HA-L: lectures and education paid by International Medical Press, Sanofi and Eisai. LCJ: lecture fees received from Radiopaedia. SC: research fellowship sponsored by Abbott. LD'A: supported by an NIHR Academic Clinical Fellowship and was the recipient of a research fellowship sponsored by B Braun. BD: remuneration for consultancy advice and education provision from TEVA, Allergan and Lilly. PJD: shareholding in BMS, Regeneron and Ionis Pharma. SE: owns the North Midlands Neurosciences. VI: reports speaker fees and honoraria from Theravance Biopharma and Jensen, outside of the present work; supported by the National Institute for Health and Care Research University College London Hospitals Biomedical Research Centre. SL: received fees for attending advisory meetings, presentations and preparing presentation materials from Allergan, TEVA, Eli Lilly and Novartis. MSM: chair of the medical advisory board of the CSF Leak Association, serves on the advisory board for Abbott, Allergan, Novartis, Eli Lilly, Medtronic, Autonomic Technologies and TEVA, and has received payment for the development of educational presentations from Allergan, electroCore, Eli Lilly, Novartis and TEVA. CJ, SM, JP, RS, TT: members of CSF Leak Association. S-JW: received honoraria as a moderator from AbbVie, Pfizer, Eli Lilly and Biogen, and has been the PI in trials sponsored by AbbVie, Novartis and Lundbeck. He has received research grants from the Taiwan Minister of Technology and Science (MOST), Brain Research Center, National Yang Ming Chiao Tung University from The Featured Areas Research Center Program within the framework of the Higher Education Sprout Project by the Ministry of Education (MOE) in Taiwan, Taipei Veterans General Hospital, Taiwan Headache Society and Taiwan branches of Eli Lilly and Novartis., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)