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Abstract To enable detailed study of a wide variety of future health challenges, we have created future land use maps for the Netherlands for 2050, based on the Dutch One Health Shared Socio-economic Pathways (SSPs). This was done using the DynaCLUE modelling framework. Future land use is based on altitude, soil properties, groundwater, salinity, flood risk, agricultural land price, distance to transport hubs and climate. We also account for anticipated demand for different land use types, historic land use changes and potential spatial restrictions. These land use maps can be used to model many different health risks to people, animals and the environment, such as disease, water quality and pollution. In addition, the Netherlands can serve as an example for other rapidly urbanising deltas where many of the health risks will be similar.

Abstract Background There is critical need to strengthen the global nursing and midwifery workforce. This is especially true in Malawi where they are the primary providers of obstetric and neonatal care. In Neno district, Malawi, in 2017, we implemented an intensive training and longitudinal bedside mentorship intervention for nurses and midwives. From inception, there was a pre-planned project target completion after 5 years, including a staged handover to local ownership after 3 years. The objective of this study was to assess differences in reported maternal and neonatal complications following project completion and handover to local leadership. Methods The project was a partnership between an academic institution and local nongovernmental organization. In October 2020, the intervention was handed over and maintained by the local organization with limited support from the academic institution. Data from January 2019 to May 2023 were extracted from the Malawi District Health Information Software 2. Bivariate analyses explored differences in the pre- and post-handover periods for all government-collected, birth-related variables. The “pre-handover” period encompassed January 2019 to September 2020 and “post-handover” from October 2020 to May 2023. Multivariate linear regression explored outcomes while controlling for health facility. Results Data were collected from 10 health facilities in the district and included a total of 23,259 births. Overall, there were few significant changes between periods. Exceptions were in reporting of antepartum hemorrhage (p

Abstract H5N1 high pathogenicity avian influenza virus has killed thousands of marine mammals in South America since 2022. Here we report epidemiological data and full genome characterization of clade 2.3.4.4b H5N1 HPAI viruses associated with a massive outbreak in southern elephant seals (Mirounga leonina) at Península Valdés, Argentina, in October 2023. We also report on H5N1 viruses in concurrently dead terns. Our genomic analysis shows that viruses from pinnipeds and terns in Argentina form a distinct clade with marine mammal viruses from Peru, Chile, Brazil and Uruguay. Additionally, these marine mammal clade viruses share an identical set of mammalian adaptation mutations which were also present in tern viruses. Our combined ecological and phylogenetic data support mammal-to-mammal transmission and occasional mammal-to-bird spillover and suggest multinational transmission of H5N1 viruses in mammals. We reflect that H5N1 viruses becoming more evolutionary flexible and adapting to mammals in new ways could have global consequences for wildlife, humans, and/or livestock.

Abstract Immunotherapeutic strategies for Alzheimer’s and Parkinson’s disease would be facilitated by better measures of inflammation. Here we established an ultra-sensitive single-molecule pull-down immunoassay combined with direct stochastic optical reconstruction microscopy (dSTORM) to measure the number, size and shape of individual extracellular inflammasome ASC specks. We assayed human post-mortem brain, serum and cerebrospinal fluid of patients with Parkinson’s and Alzheimer’s as well as healthy elderly. The number of ASC specks increased and showed altered morphology in the blood of early-stage Parkinson’s and Alzheimer’s patients compared to controls, mimicking those found in the brain and cerebrospinal fluid. In serum samples we also measured the number of Aβ, p-tau and α-syn aggregates and formed a composite biomarker of (ASC + p-tau)/Aβ and (ASC + α-syn)/Aβ ratios that distinguished age-matched healthy controls from patients with early-stage Alzheimer’s with AUC of 92% and early-stage Parkinson’s with AUC of 97%. Our findings confirm ASC specks as a fluid candidate biomarker of inflammation for neurodegenerative diseases with blood being the main focus for further development as convenient sample for diagnostics and clinical trials.

Abstract Background Spinal manipulative therapy (SMT) is a guideline-recommended care for musculoskeletal pain taught in various undergraduate programs. Visual feedback through force-sensing tables can improve modulation of SMT force–time characteristics and, potentially, students’ confidence, both factors important for clinical competence and patient outcomes. However, it is unclear if a link exists between students’ confidence and ability in SMT force–time modulation. We aim to investigate this relationship and whether it was moderated by experience. Methods This cross-sectional study recruited first- to third-year Canadian Memorial Chiropractic College students. Participants provided information about their confidence in performing SMT using different impulse forces of 200N, 400N, and 800N with a pre-established pre-load and a time-to-peak force

Abstract Background African Americans with type 2 diabetes experience disparities in their care and diabetes health-related outcomes. Diabetes self-management programs such as Healthy Living with Diabetes (HLWD) are important but do not account for the unique cultural experiences of African Americans. Also, a culturally tailored program focused on addressing sociocultural beliefs and providing race-congruent peer support, Peers LEAD (Peers Supporting Health Literacy, Self-Efficacy, Self-Advocacy, and Adherence) was implemented in two midwestern cities to improve medication adherence but does not include diabetes self-management topics included in HLWD. In an attempt to fill the gaps from both HLWD and Peers LEAD, Peers EXCEL (Peers’ Experience in Communicating and Engaging in Healthy Living) was designed to integrate both programs. Methods Our study explored the perceptions of African American participants and facilitators of the separate HLWD and Peers LEAD programs, on the proposed new Peers EXCEL program using focus groups and interviews. Findings were analyzed by research assistants trained in qualitative research using deductive and inductive open coding approaches. Results Participants appreciated the cultural fit of Peers EXCEL for African American communities which is a feature that was lacking in HLWD. They shared the need to include topics such as the relationships between systemic racism and diabetes. Conclusion Participants’ feedback of Peers EXCEL reveals the importance of including various community members’ perspectives in the design of new diabetes self-management programs tailored for African Americans.

Abstract Background Preeclampsia is the second leading cause of maternal death in Uganda. WHO recommends using magnesium sulphate (MgSO4) to prevent and treat preeclampsia with severe features (PEC) and eclampsia. MgSO4 is used to prevent eclampsia and treat women who experience an eclamptic convulsion to avoid severe maternal/infant illnesses and death. We set out to assess MgSO4 administration patterns in women with PEC or eclampsia and the immediate newborn outcomes of neonates. Methods This was an analytical observational cohort study at Kawempe National Referral Hospital in Uganda. Two hundred ten pregnant mothers with PEC or eclampsia were recruited in the study after receiving the loading dose of MgSO4 and then followed through labour and delivery to observe MgSO4 administration patterns and immediate newborn outcomes using Apgar and Thompson scores. SPSS version 23 was used to analyse data, and both bivariate and multivariate logistic regressions were used to determine factors associated with the low Apgar score at five minutes. Results Overall, majority of the patients received more than one dose with 33.3% received a sixth dose of MgSO4. The majority, 84.8%, of the mothers delivered live babies, 31.0% babies had complications, and were admitted to the neonatal intensive care unit (NICU). NICU admissions were mostly due to respiratory distress21.4%, preterm delivery21.0%, and 5.5% died within seven days. Majority 93.3% of the newborns had an Apgar score of seven and above at five minutes, of the newborns who were Thompson scored, 70.4% scored between 1 to 10 which is mild HIE. Initiation of MgSO4 treatment within one hour from prescription (AOR = 0.49, CI: 0.01–1.94), 4-hourly timing of the first maintenance dose (AOR = 0.22, CI: 0.06–0.79) and having complete doses of MgSO4 treatment (AOR = 0.89, CI: 0.03–3.05) decreased the likelihood of having low Apgar scores at five minutes. Conclusions Timely administration of the first maintenance dose of MgSO4 decreases the likelihood of low Apgar score at 5 min and NICU admission in newborns, and most NICU admissions were due to respiratory distress and preterm delivery.

Objective: The purpose of the study was to compare the fluoride release in two conventional glass ionomer cements (Ionobond, Ketac Molar) and two resin-modified glass ionomer cements (Vitrebond, Fuji II LC) adapted with halloysite nanotubes preloaded with sodium fluoride at different concentrations. Methods: In total, 96 samples were prepared and distributed into four control groups and eight experimental groups (5 % and 10 %). Totals of 10 % and 5 % of the total weight of ionomer powder needed to prepare the samples were replaced with nanotubes, preloaded at 2,000 parts per million, respectively. The experimental groups were followed for 120 days at seven time intervals. All the samples were stored at 37 °C. Results: All the experimental groups showed significant differences compared with the control groups; likewise, differences were observed between the concentrations of 5% and 10%. Conclusion: The experimental groups (conventional and resin-modified glass ionomer cements adapted with preloaded nanotubes) released a higher and more constant amount of fluoride compared to the control groups.

Abstract Clinical risk scores that predict outcomes in patients with atrial fibrillation (AF) have modest predictive value. Machine learning (ML) may achieve greater results when predicting adverse outcomes in patients with recently diagnosed AF. Several ML models were tested and compared with current clinical risk scores on a cohort of 26,183 patients (mean age 70.13 (standard deviation 10.13); 44.8% female) with non-valvular AF. Inputted into the ML models were 23 demographic variables alongside comorbidities and current treatments. For one-year stroke prediction, ML achieved an area under the curve (AUC) of 0.653 (95% confidence interval 0.576–0.730), compared to the CHADS2 and CHA2DS2-VASc scores performance of 0.587 (95% CI 0.559–0.615) and 0.535 (95% CI 0.521–0.550), respectively. Using ML for one-year major bleed prediction increased the AUC from 0.537 (95% CI 0.518–0.557) generated by the HAS-BLED score to 0.677 (95% CI 0.619–0.724). ML was able to predict one-year and three-year all-cause mortality with an AUC of 0.734 (95% CI 0.696–0.771) and 0.742 (95% CI 0.718–0.766). In this study a significant improvement in performance was observed when transitioning from clinical risk scores to machine learning-based approaches across all applications tested. Obtaining precise prediction tools is desirable for increased interventions to reduce event rates. Trial Registry https://www.clinicaltrials.gov ; Unique identifier: NCT01468701, NCT01671007, NCT01937377.

INTRODUÇÃO: O envelhecimento provoca, simultaneamente, profundas mudanças na composição corporal e no estado nutricional do idoso. OBJETIVO: Avaliar as perdas de massas muscular e adiposa em residentes de uma Instituição de Longa Permanência para Idosos. MÉTODOS: Estudo observacional e longitudinal, com intervalo de três meses entre as duas avaliações. Participaram 34 idosos (média de idade: 81,8 anos; 23,5% homens; 76,5% mulheres), residentes em uma Instituição de Longa Permanência para Idosos de Teresina, Piauí. Medidas antropométricas da composição corporal, aferidas em triplicata, pelo mesmo pesquisador, por compasso de Lange e fita métrica inextensível da circunferência da panturrilha e prega cutânea tricipital, foram utilizadas para classificar o estado nutricional. RESULTADOS: Na avaliação inicial 24 (70,6%) e 16 (47,1%) indivíduos apresentaram desnutrição proteica e energética, segundo circunferência da panturrilha e prega cutânea tricipital, respectivamente. Após três meses, houve aumento da desnutrição proteica e energética para 27 (79,4% - circunferência da panturrilha) e 17 (50% - prega cutânea tricipital) indivíduos, sem significância estatística entre sexos. No entanto, houve piora significativa entre as médias de circunferência da panturrilha (29,9 ± 2,9; 28,8 ± 2,6; p < 0,05) nos idosos com idade entre 70 e 79 anos. Esse agravamento do estado nutricional, a partir de perdas nas reservas de massa muscular e adiposa, é reafirmado, inclusive, com diferenças significativas ao se comparar frequências e distribuições de circunferência da panturrilha e prega cutânea tricipital entre as duas avaliações do total de estudados. CONCLUSÃO: As avaliações nutricionais comprovaram mudanças importantes na composição corporal dos idosos institucionalizados, gerando risco nutricional, que requer atenção aos mais idosos.

En la perspectiva de la gestión integral del agua, el manejo de recursos de uso común y la sustentabilidad de los sistemas de riego, el presente trabajo analiza el diseño y funcionamiento de los módulos de riego del Distrito de Riego 061 Zamora (DR 061), y muestra aportes no considerados de los usuarios del riego en el mantenimiento de los sistemas. El diseño y funcionamiento organizativo se analizó en sus dimensiones de gobierno, administración y operación. Las aportaciones de los usuarios y ejidos se determinaron con base en una muestra de cuatro canales, donde se identificaron las tareas que realizan los módulos y los usuarios para el acceso al agua y el mantenimiento. Los resultados muestran que existe un manejo centralizado burocrático en las tareas de distribución del agua y mantenimiento de la red principal, reelección permanente de autoridades de los módulos, diseño de cuotas de riego no consensuadas con los usuarios, morosidad en la recuperación de cuotas y falta de transparencia en la rendición de cuentas. Se calculó que las aportaciones de los usuarios superan 13 veces lo invertido por los módulos, pero sus aportes no son considerados para la participación directa en la toma de decisiones, y en el gobierno y la administración de los módulos, lo cual muestra limitaciones y deficiencias en el diseño organizativo por módulos que debilitan la autogestión y sostenibilidad de estas organizaciones.

Background Low birth weight (LBW) is an important marker of fetal health that is predictive of mortality in childhood, stunting, and adult-onset chronic conditions globally. Approximately 20 million LBW births occur every year globally with 96.5% of them in developing countries. LBW contributes to 60%–80% of all neonatal deaths globally and the rates have remained high in developing countries such as Nigeria. This study therefore aimed to determine the prevalence and risk factors of LBW among neonates delivered in health facilities in Makurdi, Benue State, Nigeria. Materials and Methods A cross-sectional study was carried out in eight selected health facilities at different levels of care within the Makurdi metropolis. A total of 206 neonates were recruited, weighed, and examined within the first hour of life while sociodemographic data were collected using a pretested interviewer-administered questionnaire and analyzed using SPSS 23. Results Out of the 206 neonates studied, 24 (11.7%) were LBW. Among the 24 LBW neonates, 75% (18) were term while 25% (6) were preterm. The mean weight of the LBW neonates was 2.18 ± 0.18 kg. The mean gestation was 38.52 ± 1.61 weeks. The factors that were significantly associated with LBW were; gestational age at birth (P = 0.028), type of gestation (P = 0.004), socioeconomic class of the baby (P = 0.036), nonbooking for antenatal care (ANC) (P = 0.040), place of ANC (P = 0.028), and hypertension in pregnancy (P = 0.033). Conclusion The prevalence of LBW was lower than the national prevalence and not booking for ANC was found to be associated with increased risk for LBW. Hence, early and adequate ANC is recommended.

Congenital pulmonary airway malformation (CPAM) is a rare congenital lung malformation accounting for 25% of congenital malformations and 95% of congenital lung lesions. Diagnosis prenatally is by ultrasonography while postnatal diagnosis follows presentation with respiratory distress symptoms and radiographic imaging. Although they are often misdiagnosed radiologically, most cases of CPAM are manageable with proper assessment, diagnosis and interventions.

Abstract Objective The connectivity and genetic structuring of populations throughout a region influence a species’ resilience and probability of recovery from anthropogenic impacts. By gaining a comprehensive understanding of population connectivity, more effective management can be prioritized. To assess the connectivity and population genetic structure of a common cold-water coral species, Desmophyllum pertusum (Lophelia pertusa), we performed Restriction-site Associated DNA Sequencing (RADseq) on individuals from nine sites ranging from submarine canyons off New England to the southeastern coast of the United States (SEUS) and the Gulf of Mexico (GOM). Fifty-seven individuals and 3,180 single-nucleotide polymorphisms (SNPs) were used to assess genetic differentiation. Results High connectivity exists among populations along the SEUS, yet these populations were differentiated from those to the north off New England and in Norfolk Canyon along the North Atlantic coast of the United States, as well as those in the GOM. Interestingly, Norfolk Canyon, located just north of North Carolina, and GOM populations exhibited low levels of genetic differentiation, corroborating previous microsatellite analyses and signifying gene flow between these populations. Increasing sample sizes from existing populations and including additional sampling sites over a larger geographic range would help define potential source populations and reveal fine-scale connectivity patterns among D. pertusum populations.

Abstract Asparaginase (ASP)-containing regimens for acute lymphoblastic leukemia (ALL) are associated with venous thromboembolism (VTE). We evaluated the prevalence, risk factors, role of prophylaxis and clinical impact of VTE among adolescents and young adult (AYA) patients (15–50 years) treated on Dana-Farber Cancer Institute (DFCI) ALL protocols. The 1- and 2-year cumulative incidence of VTE were 31.9% (95% CI: 27.0%, 36.9%) and 33.5% (95% CI: 28.5%, 38.5%) respectively, with most events occurring during ASP-based consolidation phase (68.6%). VTE was more frequent in patients with overweight/obese vs. normal BMI (39.2% vs. 29.0%, p = 0.048). In a 1-year landmark analysis, the 4-year overall survival was 91.5%, without difference between patients with vs. without VTE (93.8% vs. 90.0%, p = 0.93). Relapse and non-relapse mortality rates were also similar. Among patients treated at Dana-Farber/Harvard Cancer Center, cerebral sinus vein thrombosis occurred in 3.6% of patients (8.5% of VTE events) in comparison to pulmonary embolism (32.9%) and deep vein thromboses (58.6%, 24.4% line-associated). In a Cox regression model for VTE free-time, elevated BMI was associated with shorter VTE free-time (HR 1.94 [95% CI 1.13-3.35], p = 0.018), while low molecular weight heparin (LMWH) prophylaxis as time-varying covariate was not. In conclusion, we found that VTE was frequent in AYAs treated on DFCI ALL protocols but did not impact survival outcomes. Overweight/obese BMI increased risk for VTE.

Abstract The global health crisis of antibacterial resistance (ABR) poses a particular threat in low-resource settings like East Africa. Interventions for ABR typically target antibiotic use, overlooking the wider set of factors which drive vulnerability and behaviours. In this cross-sectional study, we investigated the joint contribution of behavioural, environmental, socioeconomic, and demographic factors associated with higher risk of multi-drug resistant urinary tract infections (MDR UTIs) in Kenya, Tanzania, and Uganda. We sampled outpatients with UTI symptoms in healthcare facilities and linked their microbiology data with patient, household and community level data. Using bivariate statistics and Bayesian profile regression on a sample of 1610 individuals, we show that individuals with higher risk of MDR UTIs were more likely to have compound and interrelated social and environmental disadvantages: they were on average older, with lower education, had more chronic illness, lived in resource-deprived households, more likely to have contact with animals, and human or animal waste. This suggests that interventions to tackle ABR need to take account of intersectional socio-environmental disadvantage as a priority.

Abstract Spatially resolved molecular assays provide high dimensional genetic, transcriptomic, proteomic, and epigenetic information in situ and at various resolutions. Pairing these data across modalities with histological features enables powerful studies of tissue pathology in the context of an intact microenvironment and tissue structure. Increasing dimensions across molecular analytes and samples require new data science approaches to functionally annotate spatially resolved molecular data. A specific challenge is data-driven cross-sample domain detection that allows for analysis within and between consensus tissue compartments across high volumes of multiplex datasets stemming from tissue atlasing efforts. Here, we present MILWRM (multiplex image labeling with regional morphology)—a Python package for rapid, multi-scale tissue domain detection and annotation at the image- or spot-level. We demonstrate MILWRM’s utility in identifying histologically distinct compartments in human colonic polyps, lymph nodes, mouse kidney, and mouse brain slices through spatially-informed clustering in two different spatial data modalities from different platforms. We used tissue domains detected in human colonic polyps to elucidate the molecular distinction between polyp subtypes, and explored the ability of MILWRM to identify anatomical regions of the brain tissue and their respective distinct molecular profiles.

Abstract The construct of quality of life (QoL) includes aspects of health and well-being of people. Down syndrome [DS] or trisomy 21 is one of the most common congenital anomalies. DS is characterized by motor and cognitive alterations that affect health and QOL of both the child and caregiver. In pediatrics, there are various instruments to assess Health-Related Quality of Life (HRQoL) and QoL. The advantage of these instruments is that they can be implemented in any type of disease and population in general. However, they may have certain disadvantages, such as the difficulty in evaluating specific aspects of each disease or condition related to Down syndrome. The aim of this study was to identify 1: instruments used to assess quality of life in children with Down syndrome. 2: psychometrics properties of instruments validated in children with Down syndrome to assess quality of life. Methods A Scoping review was conducted to identify instruments used in children and adolescents with Down syndrome, and a second systematic searched psychometric properties of these instruments. The electronic databases PubMed, Embase, Epistemonikos and other sources were explored with a search strategy that included keywords such as “Down syndrome,” “Quality of life” or “Life Quality,” “Health-Related Quality of Life” and psychometrics properties. The quality of the included studies was evaluated using the COSMIN (Based Standards for the Selection of Health Measurement Instruments) methodology. Results Twenty-seven studies were selected that used twelve instruments to evaluate quality of life in children or adolescents with Down syndrome. Two of the twelve evaluated quality of life and ten health-related quality of life. In the second search, ten studies reported the psychometric properties of six instruments evaluated in minors with Down Syndrome. Conclusion There is limited information available regarding the psychometric properties of instruments used to assess quality of life, particularly health-related quality of life. Commonly employed instruments in this area include the PedsQL 4.0 and KIDSCREEN. Notably, while the PedsQL 4.0 lacks specific evaluation in children with DS, data from KIDSCREEN assessments are inconsistently reported. Rigorous evaluation of the performance of Kidslife and Kidslife Down in clinical settings is necessary, or the development of new instruments tailored for children with DS is warranted to comprehensively assess quality of life in clinical settings.

Abstract We present the case of a 7-year-old Ecuadorian mestizo girl with multiple orofacial malformations. The patient is the product of a first-degree relationship (father–daughter). A cytogenetic study revealed a normal karyotype. The genetic mapping array study identified 0.73 Gb of alterations, 727,087,295 bp involved in regions of homozygosity (ROH) in all chromosomes (25.2% of the genome) and 764,028 bp in gains in chromosomes 9 and 14. Genes from the TGFB, BMP, FGF, SHH and WNT families, among others, were identified in the ROH. They are related to craniofacial development and their protein products showed a strong association in the interactome analysis.

Abstract Genetic testing for Parkinson’s disease (PD) is infrequently performed due to perceptions of low utility. We investigated the personal utility in PD GENEration and how results lead to enrollment in additional research studies. Participants (n = 972) underwent genetic testing, results disclosure, genetic counseling, and completed a survey examining the perceived personal utility of their results and interest in participating in additional studies. Most participants found their genetic test results useful, including satisfying curiosity (81%), feeling good about helping the medical community (80%), and having information to share with family (77%). There were no significant differences in responses based on result type. Forty-five percent of participants expressed interest in participating in research studies; whereas 16% of participants confirmed enrollment. Our results suggest that participants find personal utility in genetic testing regardless of results. Although participants may be interested in enrolling in additional research, they may need support and resources.

Abstract Background Patients with COVID-19 may experience a persistent increase in the blood urea nitrogen over creatinine ratio (PI-BUN/Cr). Its elevation could reflect multiple underlying pathophysiological processes beyond prerenal injury but also warrants nuanced interpretation due to its complex interplay with various factors, underscoring the importance of investigating its effects on mortality and acute kidney injury in this population. Methods We analized a retrospective and longitudinal cohort of patients admitted to a single center in Mexico City for patients with severe COVID-19. Between March 5, 2020 and August 25, 2021, we included patients with confirmed positive diagnosis for SARS-CoV-2, age > 18 years, disease severity was defined by clinical data of respiratory distress syndrome and a ratio of partial oxygen pressure to inspired oxygen fraction 30 in more than 60% of measurements in the hospital. The outcomes included: risk factors to mortality and AKI in-hospital. Results The cohort included 3,007 patients with a median age of 54.6 ± 14.5 years. 35% of patients died; 44.6% developed PI-BUN/Cr ratio and 71.4% AKI. Mortality was associated with older age > 60 years [Hazard ratio (HR)] = 1.45, 95% CI: 1.28–1.65; p

Abstract Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease characterized by the loss of motoneurons (MNs), and despite progress, there is no effective treatment. A large body of evidence shows that astrocytes expressing ALS-linked mutant proteins cause non-cell autonomous toxicity of MNs. Although MNs innervate muscle fibers and ALS is characterized by the early disruption of the neuromuscular junction (NMJ) and axon degeneration, there are controversies about whether muscle contributes to non-cell-autonomous toxicity to MNs. In this study, we generated primary skeletal myotubes from myoblasts derived from ALS mice expressing human mutant SOD1G93A (termed hereafter mutSOD1). Characterization revealed that mutSOD1 skeletal myotubes display intrinsic phenotypic and functional differences compared to control myotubes generated from non-transgenic (NTg) littermates. Next, we analyzed whether ALS myotubes exert non-cell-autonomous toxicity to MNs. We report that conditioned media from mutSOD1 myotubes (mutSOD1-MCM), but not from control myotubes (NTg-MCM), induced robust death of primary MNs in mixed spinal cord cultures and compartmentalized microfluidic chambers. Our study further revealed that applying mutSOD1-MCM to the MN axonal side in microfluidic devices rapidly reduces mitochondrial axonal transport while increasing Ca2 + transients and reactive oxygen species (i.e., H2O2). These results indicate that soluble factor(s) released by mutSOD1 myotubes cause MN axonopathy that leads to lethal pathogenic changes.

Abstract Background Streptococcus pneumoniae is a major cause of mortality globally. The introduction of pneumococcal conjugate vaccines (PCVs) has reduced the incidence of the targeted serotypes significantly, but expansion of non-targeted serotypes, serotype replacement, and incomplete vaccine-targeting contribute to pneumococcal disease in the vaccine era. Here, we characterize the changing population genetic landscape of S. pneumoniae in Norway over a 41-year period (1982–2022). Methods Since 2018, all cases of invasive pneumococcal disease have undergone whole-genome sequencing (WGS) at the Norwegian Institute of Public Health. In order to characterize the changing population over time, historical isolates were re-cultured and sequenced, resulting in a historical WGS dataset. Isolates were assigned to global pneumococcal sequence clusters (GPSCs) using PathogenWatch and assigned to serotypes using in silico (SeroBA) and in vitro methods (Quellung reaction). Temporal phylogenetic analyses were performed on GPSCs of particular interest. Results The availability of WGS data allowed us to study capsular variation at the level of individual lineages. We detect highly divergent fates for different GPSCs following the introduction of PCVs. For two out of eight major GPSCs, we identified multiple instances of serotype switching from vaccine types to non-vaccine types. Dating analyses suggest that most instances of serotype switching predated the introduction of PCVs, but expansion occurred after their introduction. Furthermore, selection for penicillin non-susceptibility was not a driving force for the changing serotype distribution within the GPSCs over time. Conclusions PCVs have been major shapers of the Norwegian disease-causing pneumococcal population, both at the level of serotype distributions and the underlying lineage dynamics. Overall, the introduction of PCVs has reduced the incidence of invasive disease. However, some GPSCs initially dominated by vaccine types escaped the effect of vaccination through expansion of non-vaccine serotypes. Close monitoring of circulating lineages and serotypes will be key for ensuring optimal vaccination coverage going forward.

Taupō volcano lies underneath the largest lake in New Zealand. It undergoes unrest roughly every ten years, has minor eruptions every few hundred years, and has supereruptions. Understanding volcanic seismic signals provides insights into the volcano dynamics and helps to anticipate eruptions. Harmonic and non-harmonic volcanic tremor are common signals that indicate fluid mobilisation in volcanic systems. We observed a signal that resembled non-harmonic tremor during 2019 at Taupō volcano. Careful time-frequency analysis of seismic data and weather data from around the lake revealed that the signals were not magmatic in origin, but were most likely from lake microseisms caused by special conditions of the wind, which generates wind-driven waves in the lake. The frequency range of lake microseisms at Taupō starts and ends with a dominant frequency of 0.7–1.0 Hz, and during the maximum energy peak, the dominant frequency is of 0.50–0.56 Hz. Such signals may be common in caldera lakes, which need to be distinguished from tremor caused by volcanic activity, so as not to exaggerate the probability of eruptions.

Abstract This quantitative research predictive study evaluates the roles of four variables in developing student sustainability competencies through a curricular intervention. We used the MAKE framework, i.e., (1) motivation, (2) attitude, (3) knowledge, and (4) engagement, to promote the sustainability competencies among students enrolled in four undergraduate courses during the semester of February to June 2022. We surveyed the students to determine the role of the MAKE framework variables in developing sustainability competencies. One hundred four students answered an online Google survey, which gathered the data we subsequently analyzed using IBM SPSS version 26 software. Linear regression statistical results confirmed that the four variables of MAKE have a significant correlation where motivation was highly associated with developing sustainability competencies of students. These findings can guide professors and university policymakers in implementing the MAKE framework to promote sustainable development education.

Abstract The study examined the impact of Salicornia supplementation on the biological efficiency and biochemical properties of white Elm oyster mushrooms, Hypsizygus ulmarius. Four substrates were used to cultivate the mushrooms. Wheat straw was used as the main substrate and the Salicornia was used to partially replace the main substrate at the ratios of 5, 10, and 20% while 100% wheat straw was used as the control. The study found that the 20% Salicornia completed the mycelial run earlier (41 days), while the control treatment took the longest (45 days). The 5% Salicornia supplemented treatment and control treatment had the highest and lowest biological efficiencies (126 and 65%) respectively. The elemental concentration was undetectable for Copper (Cu), Lead (Pb), and Cadmium (Cd). The mushrooms from the control had the highest while those from the 20% treatment had the lowest (Zinc (Zn) levels (0.0115 ug/100 g) and 0.0078 ug/100 g). Conversely, Chromium (Cr) levels were highest and lowest in the 20% (0.0022 ug/100 g) and control treatments (0.0007 ug/100 g). Similarly, the total unsaturated fatty acids were highest in the control treatment (78%) and lowest in the 20% treatment (69%) while the opposite was true for the saturated fatty acids (22% and 31%). The mushrooms investigated in this study had higher essential amino acids (44–49%) compared to non-essential amino acids (17–20%). The results from this study suggest that Salicornia is a promising marine resource with the potential to enhance the health-promoting properties of oyster mushrooms.

Abstract Substance Use Disorders (SUDs) manifest as persistent drug-seeking behavior despite adverse consequences, with Alcohol Use Disorder (AUD) and Opioid Use Disorder (OUD) representing prevalent forms associated with significant mortality rates and economic burdens. The co-occurrence of AUD and OUD is common, necessitating a deeper comprehension of their intricate interactions. While the causal link between these disorders remains elusive, shared genetic factors are hypothesized. Leveraging public datasets, we employed genomic and transcriptomic analyses to explore conserved and distinct molecular pathways within the dorsolateral prefrontal cortex associated with AUD and OUD. Our findings unveil modest transcriptomic overlap at the gene level between the two disorders but substantial convergence on shared biological pathways. Notably, these pathways predominantly involve inflammatory processes, synaptic plasticity, and key intracellular signaling regulators. Integration of transcriptomic data with the latest genome-wide association studies (GWAS) for problematic alcohol use (PAU) and OUD not only corroborated our transcriptomic findings but also confirmed the limited shared heritability between the disorders. Overall, our study indicates that while alcohol and opioids induce diverse transcriptional alterations at the gene level, they converge on select biological pathways, offering promising avenues for novel therapeutic targets aimed at addressing both disorders simultaneously.

Abstract This study presents a comprehensive dataset of hydrological information gathered from five key eastern basins in Jalisco, Mexico. The dataset encompasses approximately 50 limnological variables and phytoplankton counts specifically for one of these basins. Water‐quality data were collected by the State Water Commission of Jalisco, adhering to the methods outlined in the Official Mexican Norm ‘NOM‐127’. Monthly samplings were conducted to assess environmental variables such as pH, temperature, oxygen, nutrients and heavy metals. Monitoring has been ongoing for three basins since 2009, while the remaining two basins have been monitored since 2015 and 2020. Phytoplankton data were obtained from monthly samples taken by the University of Guadalajara between 2014 and 2019 in Lake Cajititlán. The original data were cleaned and organized using tidy data principles, with codes accessible on GitHub. To facilitate data exploration and visualization, we developed a user‐friendly web application with the Shiny package in R. This application enables users to explore the dataset through summary statistics tables, time series plots and phytoplankton community analysis. The dataset is accessible on Zenodo. The presented data hold significance for environmental and water‐quality assessment and applications in machine learning, neural network models, community ecology and broader environmental research. Notably, the raw data, publicly accessible from the State Water Commission of Jalisco, have been previously utilized for these purposes. This dataset offers value due to its diverse limnological and phytoplankton variables, an extended time frame of availability, a curated and streamlined accessibility process and the inclusion of a web application for intuitive exploration and visualization.

Abstract The growing use of artificial neural network (ANN) tools for computed tomography angiography (CTA) data analysis underscores the necessity for elevated data protection measures. We aimed to establish an automated defacing pipeline for CTA data. In this retrospective study, CTA data from multi-institutional cohorts were utilized to annotate facemasks (n = 100) and train an ANN model, subsequently tested on an external institution’s dataset (n = 50) and compared to a publicly available defacing algorithm. Face detection (MTCNN) and verification (FaceNet) networks were applied to measure the similarity between the original and defaced CTA images. Dice similarity coefficient (DSC), face detection probability, and face similarity measures were calculated to evaluate model performance. The CTA-DEFACE model effectively segmented soft face tissue in CTA data achieving a DSC of 0.94 ± 0.02 (mean ± standard deviation) on the test set. Our model was benchmarked against a publicly available defacing algorithm. After applying face detection and verification networks, our model showed substantially reduced face detection probability (p

Abstract Colombia is among the countries with the most robust financial protection against personal health spending in the world, with out-of-pocket spending ranking lowest across OECD countries. We investigate the evolution, distribution, and persistence of health spending by age group, sex, health care setting, health condition and geographic region for over 19 million users of Colombia’s health system between 2013 and 2021 (contributory scheme). We use average patient-level expenditure data from the Health-Promoting Entities of the Ministry of Health and Social Protection. We applied multivariate statistical techniques such as multiple correspondence analysis, factor maps and correlations. For both sexes, average health expenditure increases gradually with age until 60 years, accelerating thereafter abruptly. Health conditions with the highest percentage of expenditure were those related to neoplasms, blood diseases, circulatory system, pregnancy, puerperium and perinatal period. We found that home-based care in Amazonía-Orinoquía is almost non-existent, and that outpatient care represents a high proportion in all age groups (over 65%) compared to the other regions. There is a strong persistence of expenditure from one year to the next (i.e. they can provide relevant information for prediction), especially in areas with a larger supply of health services such as Bogotá-Cundinamarca. To the authors’ knowledge, this is the most comprehensive and detailed micro-analysis of health spending that has been developed for a Latin American country to date.

Abstract With global C-section rates rising, understanding potential consequences is imperative. Previous studies suggested links between birth mode and psychological outcomes. This study evaluates the association of birth mode and neurodevelopment in young children across two prospective cohorts, using repeated psychometric assessments. Data from the ELEMENT (Early Life Exposures in Mexico to Environmental Toxicants) and PROGRESS (Programming Research in Obesity, Growth, and Environment and Social Stress) cohorts, comprising 7158 and 2202 observations of 1402 children aged 2 to 36 months, and 726 children aged 5 to 27 months, respectively, were analyzed. Exclusion criteria for the cohorts were maternal diseases such as preeclampsia, renal or heart disease, gestational diabetes, and epilepsy. Neurodevelopment was gauged via Bayley’s Scales of Infant Development: 2nd edition for ELEMENT and 3rd edition for PROGRESS. Mixed-effects models longitudinally estimated associations between birth mode and neurodevelopment scores, adjusting for cofounders. In ELEMENT, psychomotor development composite scores were significantly affected by birth mode from ages 2 to 8 months; the largest estimate within this range was at 2 months (β =-1.93; 95% CI: [-3.64, -0.22], reference: vaginal delivery). For PROGRESS, a negative association was found with motor development composite scores over all the studied age range (β=-1.91; 95% CI: [-3.01, -0.81]). The association was stronger between ages 6 to 18 months, with the strongest estimate at 11 months (β=-2.58; 95% CI: [-4.37, -0.74]). A negative impact of C-section on language scores in girls was estimated for the PROGRESS cohort (β=-1.92; 95% CI: [-3.57, -0.27]), most marked in ages 22 to 25 months (largest β at 24.5 months=-3.04; 95% CI: [-5.79, -0.30]). Children born by C-section showed lower motor and language development scores during specific age windows in the first three years of life. Further research is necessary to understand the complexities and implications of these findings.

Abstract Lifestyle interventions are strategies used to self‐manage medical conditions, such as epilepsy, and often complement traditional pharmacologic and surgical therapies. The need for integrating evidence‐based lifestyle interventions into mainstream medicine for the treatment of epilepsy is evident given that despite the availability of a multitude of treatments with medications and surgical techniques, a significant proportion of patients have refractory seizures, and even those who are seizure‐free report significant adverse effects with current treatments. Although the evidence base for complementary medicine is less robust than it is for traditional forms of medicine, the evidence to date suggests that several forms of complementary medicine including yoga, mindfulness meditation, cognitive behavioral therapy, diet and nutrition, exercise and memory rehabilitation, and music therapy may have important roles as adjuncts in the treatment armamentarium for epilepsy. These topics were discussed by a diverse group of medical providers and scientists at the “Lifestyle Intervention for Epilepsy (LIFE)” symposium hosted by Cleveland Clinic. Plain Language Summary There are many people with epilepsy who continue to have seizures even though they are being treated with medication or brain surgery. Even after seizures stop, some may experience medication side effects. There is research to suggest that certain lifestyle changes, such as yoga, mindfulness, exercise, music therapy, and adjustments to diet, could help people with epilepsy, when used along with routine treatment. Experts discussed the latest research at the “Lifestyle Intervention for Epilepsy (LIFE)” symposium hosted by Cleveland Clinic.

Abstract Background Opioid use disorder (OUD) remains a significant health care need for women, particularly those involved in the criminal legal system (CLS). There are no studies to date that focus on the utilization of telehealth as a platform for assessment and linkage to medications to treat opioid use disorder (MOUD) at community re-entry for women, despite the fact that women have unique risk factors that may contribute to opioid relapse in the community. The purpose of this mixed-methods study is to provide an overview of the innovative use of telehealth for linking incarcerated women to community MOUD treatment in the Kentucky-hub of the Justice Community Opioid Innovation Network (JCOIN). Methods This study incorporates qualitative and quantitative data collection with MOUD providers, recovery staff involved in peer navigation services, and women who are incarcerated to understand perceptions of the use of telehealth prior to jail release as a linkage to community services. Results Findings from this study suggest overall support for the use of telehealth between community MOUD treatment providers and women who are incarcerated using videoconferencing technology. On average, there was very little variation in provider favorable feedback related to clinical engagement or in face-to-face comparability, as well as how telehealth allowed the participant to discuss personal and sensitive issues during the clinical assessment. Conclusions Study findings suggest benefits associated with the use of telehealth in increasing access to treatment for women with OUD. Jails are critical venues for telehealth interventions because they provide the opportunity to reach women who have been actively using illicit substances, often have advanced-stage substance use disorders which have compromised their health and mental health, and often have not been previously identified as needing treatment. Trial registration : This study was originally registered on 8/23/19, ClinicalTrials.gov, #NCT04069624.

Abstract Background Escherichia coli (E. coli) is one of the main bacteria associated with preterm premature rupture of membranes by increasing pro-matrix metalloproteinase 9 (proMMP-9) and degradation of type IV collagen in human feto-maternal interface (HFMi). proMMP-9 is regulated by progesterone (P4) but it is unclear whether P4 inhibits proMMP in human maternal decidual (MDec). This study aimed to determine a role of P4 on proMMP-2 and − 9 and type IV collagen induced by E. coli infection in MDec. Methods Nine HFMi were mounted in a Transwell system. MDec was stimulated with P4 or E. coli for 3-, 6-, or 24-hours. proMMP-2, -9 and type IV collagen were assessed. Results Gelatin zymography revealed an increase in proMMP-9 after 3, 6, and 24 h of stimulating MDec with E. coli. Using immunofluorescence, it was confirmed the increase in the HFMi tissue and a reduction on the amount of type IV collagen leading to the separation of fetal amniochorion and MDEc. The degradative activity of proMMP-9 was reduced by 20% by coincubation with P4. Conclusions P4 modulates the activity of proMMP-9 induced by E. coli stimulation but it was unable to completely reverse the degradation of type IV collagen in human MDec tissue.

This paper examines the integration of school leaders' emotional intelligence and qualitative instruments into commonly used metrics for measuring school leadership effectiveness. Traditionally, these metrics rely heavily on questionnaires to assess leadership effectiveness. However, a weakness of these metrics is their excessive reliance on numerical data, which overlooks the qualitative dimensions of leadership. This study utilises Trait Emotional Intelligence Theory and Team Emotional Intelligence as units of analysis to redefine school leadership assessment. To make sense of the related literature and theories used in the study, an integrative literature review was employed as the methodological approach. The findings indicate that emotional intelligence significantly contributes to leadership effectiveness. The study also reveals that leaders who are self-aware of their emotional composition and its impact are more effective than those who are not. Furthermore, the results suggest that leaders who are cognisant and responsive to the emotional dynamics of their teams benefit from enhanced team cohesion, collaboration, and goal attainment. The study emphasises the importance of incorporating adaptable qualitative tools alongside quantitative instruments to accurately measure leadership effectiveness. Thus, this study adds to the existing literature by proposing a theoretically informed and adaptable framework that integrates an emotional intelligence construct and qualitative instruments for assessing school leadership effectiveness.

Social media’s pervasive influence on children’s eating habits presents both challenges and opportunities in addressing the global childhood obesity crisis. This paper examines the complex interplay between social media exposure and children’s dietary behaviors, proposing innovative strategies to leverage these platforms to promote healthy eating. The literature review reveals that while social media often contributes to unhealthy food choices through targeted advertising and unrealistic body ideals, it also offers unique potential for positive behavior change. The paper analyzes the psychological and social vulnerabilities that make children susceptible to unhealthy food marketing on social media, as well as the long-term health consequences of poor dietary habits established in childhood. Building upon current theoretical frameworks, including the Health Belief Model, the Social Cognitive Theory, and the Transtheoretical Model, the concept “Model of Health Behavior Transformation with Social Media as the Catalyst” is proposed. This model integrates key constructs such as social media exposure, social cognitive factors, motivational elements, and behavioral outcomes to guide effective interventions. The best practices are outlined for leveraging social media to promote healthy eating, including tailored content creation, strategic use of influencers, gamification, and interactive elements. The paper emphasizes the importance of ethical considerations in implementing social media interventions for children, addressing privacy concerns, data security, and the need for age-appropriate, culturally sensitive content. This research highlights the potential of integrating social media strategies with traditional health promotion approaches, calling for collaboration among policymakers, healthcare professionals, educators, and social media platforms. By providing actionable strategies and a theoretical framework, this paper offers guidance for stakeholders seeking to combat childhood obesity and promote lifelong healthy eating habits. Key areas for future research are identified, including the long-term efficacy of social media interventions, culturally adaptive messaging strategies, and the role of emerging technologies in health promotion for children. This comprehensive approach to reclaiming social media as a tool for positive health behavior change has implications for public health policy, childhood obesity prevention, and the overall well-being of future generations.

Background: The neurological, airway, respiratory, cardiovascular and other, with a subscore of surgical severity (NARCO-SS) is a scoring system which assesses the presence of systemic disease and the risk the operation poses to the patient. A number of patients that undergo major abdominal surgery suffer adverse events. The aim of the study was to determine the reliability of NARCO-SS in predicting peri-operative adverse events and to determine the risk factors for peri-operative adverse events in paediatric patients undergoing elective abdominal surgery. Materials and Methods: Prospective cohort study. Consecutively sampled patients from December 2019 to December 2020 were used. Patients scheduled for elective abdominal surgery were scored pre-operatively and end points were; when an adverse event occurred or up to day 30. Analysis of the reliability of the tool, bivariate and multivariate logistics regression was done. Results: One hundred and nineteen patients were enrolled and 49% of them had adverse events. Both bivariate and multivariate analyses showed no significant association between the NARCO-SS score and the occurrence of adverse events. The area under the receiver operating characteristics curve (area under the curve) of the NARCO-SS for adverse events was 0.518; there was a significant correlation between high scores and mortality. Longer duration of surgery and complex surgery were the risk factors for adverse events. Conclusions: The NARCO-SS score was found to be a poor predictor of adverse events with a fair inter-rater reliability as a scoring tool. Future research could evaluate a modification of neurological and airway categories.

The Cape gooseberry (Physalis peruviana L.) is renowned for its distinctive appearance and functional properties. Colombia has emerged as the world's leading producer and exporter of Cape gooseberries, with annual export growth of 1.2%, predominantly to countries such as the USA and the Netherlands. Traditionally sold with its calyx intact to minimize water loss and deterioration, recent interest in selling Cape gooseberries without the calyx to reduce volume has raised concerns regarding shelf life. Consequently, research has pivoted toward post-harvest management to extend shelf life. An experiment was conducted to explore various treatments and temperatures (5, 10, and 18 ℃), meticulously monitoring fruit quality over time. Findings underscore that calcium chloride and refrigerated storage at 10 ℃ preserve the quality of the Cape gooseberry fruit for up to 20 days. Moreover, temperature and time exerted a significant influence on fruit quality and physicochemical properties, with interactions impacting conservation methods. The application of calcium chloride as a barrier method yielded optimal preservation outcomes, safeguarding key fruit properties. Conversely, sodium hypochlorite treatment at 18 ℃ accelerated fruit ripening owing to heightened respiratory intensity. This study not only sheds light on effective preservation strategies for Cape gooseberries but also underscores the intricate interplay between environmental factors and post-harvest management techniques. By enhancing our understanding of these dynamics, the study catalyzes advancements in fruit preservation practices, thereby fortifying the agricultural and economic sectors, both domestically and internationally.

Abstract Background Parasitic neglected tropical diseases (NTDs) or ‘infectious diseases of poverty’ continue to affect the poorest communities in the world, including in the Philippines. Socio-economic conditions contribute to persisting endemicity of these infectious diseases. As such, examining these underlying factors may help identify gaps in implementation of control programs. This study aimed to determine the prevalence of schistosomiasis and soil-transmitted helminthiasis (STH) and investigate the role of socio-economic and risk factors in the persistence of these diseases in endemic communities in the Philippines. Methods This cross-sectional study involving a total of 1,152 individuals from 386 randomly-selected households was conducted in eight municipalities in Mindanao, the Philippines. Participants were asked to submit fecal samples which were processed using the Kato-Katz technique to check for intestinal helminthiases. Moreover, each household head participated in a questionnaire survey investigating household conditions and knowledge, attitude, and practices related to intestinal helminthiases. Associations between questionnaire responses and intestinal helminth infection were assessed. Results Results demonstrated an overall schistosomiasis prevalence of 5.7% and soil-transmitted helminthiasis prevalence of 18.8% in the study population. Further, the household questionnaire revealed high awareness of intestinal helminthiases, but lower understanding of routes of transmission. Potentially risky behaviors such as walking outside barefoot and bathing in rivers were common. There was a strong association between municipality and prevalence of helminth infection. Educational attainment and higher “practice” scores (relating to practices which are effective in controlling intestinal helminths) were inversely associated with soil-transmitted helminth infection. Conclusion Results of the study showed remaining high endemicity of intestinal helminthiases in the area despite ongoing control programs. Poor socio-economic conditions and low awareness about how intestinal helminthiases are transmitted may be among the factors hindering success of intestinal helminth control programs in the provinces of Agusan del Sur and Surigao del Norte. Addressing these sustainability gaps could contribute to the success of alleviating the burden of intestinal helminthiases in endemic areas.

Abstract The ongoing conflict in Gaza has led to severe destruction of the health system and eventually its collapse. Moreover, multiple attacks on health workers were reported which led to obstacles in service delivery. The conflict has led to further humanitarian crises including shortage of food, water sanitation, and hygiene, and outbreaks of infectious diseases. About 2 million of Gaza’s population are internally displaced with the majority in Rafah. Rafah’s population has increased by 500% in less than four months. This has led to acute food severity in Gaza for the whole of the population. Moreover, the cut of UNRWA aid is expected to further expand the humanitarian crisis as over 2 million of the population depends on the aid.

Background: The health-related quality of life (HRQoL) of individuals living with Attention-deficit/hyperactivity disorder (ADHD) is known to be impaired. Identifying factors that influence HRQoL can provide important information for the development of prevention and intervention programmes for affected children and adolescents. The aim of the present study was to investigate health care-related and psychosocial risk and protective factors for HRQoL in children and adolescents with an administrative ADHD diagnosis. Methods: In the consortium project INTEGRATE-ADHD, n = 4,809 parents of children and adolescents aged 7 to 17 years participated in an online survey between October 2021 and August 2022 and answered questions regarding HRQoL (KIDSCREEN-27), health care utilisation, and psychosocial risk and protective factors. Multiple linear regression analyses were conducted to assess the association between these factors and the five HRQoL dimensions of the KIDSCREEN-27. Results: Findings indicate that parental psychopathology and parental burden were risk factors for lower HRQoL in children and adolescents with ADHD. Further, a positive association was found between the five HRQoL dimensions and the psychosocial factors family climate and social support, indicating that these are protective factors. Conclusions: The results highlight the importance of prevention and intervention programmes for individuals with ADHD that consider parental mental health and aim to strengthen resources such as the availability of good family climate and social support.

Purpose - The purpose of this study is to analyse changes in tourism as a local economic development sector, considering environmental degradation and new global scenarios during and after the pandemic. The objective is to propose a sustainable, collaborative, and happinessoriented tourism management model to revive the tourism sector. Methodology/Design/Approach - The study utilizes grounded theory methodology, incorporating a systematic document review and a critical analysis of the successful UsiacuríAtlántico municipality in tourism management. This approach aids in developing the TUGMECOL tourism model, emphasizing collaborative networks and promoting dynamic, productive, participatory, legitimate, and respectful heritage tourism management. Results - The study’s findings converge in the TUGMECOL tourism management model, notable for its emphasis on quality of life and objective happiness as innovative dimensions for sustainable tourism sector development. This model is evident as a manifestation of political trust in local development. Originality of the research - This research is unique in its approach to sustainable tourism management as a collaborative strategy for local economic development. The use of grounded theory and critical analysis in the successful case of Usiacurí-Atlántico enhances the study’s originality and significance for potential replication in similar rural areas, opening avenues for further research to enhance the model.

Abstract An extensive dataset consisting of adsorption energies of pernicious impurities present in biomass upgrading processes on common catalysts and support materials has been generated. This work aims to inform catalyst and process development for the conversion of biomass-derived feedstocks to fuels and chemicals. A high-throughput workflow was developed to execute density functional theory calculations for a diverse set of atomic (Al, B, Ca, Cl, Fe, K, Mg, Mn, N, Na, P, S, Si, Zn) and molecular (COS, H2S, HCl, HCN, K2O, KCl, NH3) species on 35 unique surfaces for transition-metal (Ag, Au, Co, Cu, Fe, Ir, Ni, Pd, Pt, Re, Rh, Ru) and metal-oxide (Al2O3, MgO, anatase-TiO2, rutile-TiO2, ZnO, ZrO2) catalysts and supports. Approximately 3,000 unique adsorption geometries and corresponding adsorption energies were obtained.

Abstract The epidemiology and circulation patterns of various rhinovirus types within populations remains under-explored. We generated 803 VP4/VP2 gene sequences from rhinovirus-positive samples collected from acute respiratory illness (ARI) patients, including both in-patient and outpatient cases, between 1st January and 31st December 2014 from eleven surveillance sites across Kenya and used phylogenetics to characterise virus introductions and spread. RVs were detected throughout the year, with the highest detection rates observed from January to March and June to July. We detected a total of 114 of the 169 currently classified types. Our analysis revealed numerous virus introductions into Kenya characterized by local expansion and extinction, and extensive spatial mixing of types within the country due to the widespread transmission of the virus after an introduction. This work demonstrates that in a single year, the circulation of rhinovirus in Kenya was characterized by substantial genetic diversity, multiple introductions, and extensive geographical spread.

This study investigated the potential of chicken byproduct hydrolysates (CBH) characterized by a mixture of low-molecular-weight peptides (B. pinguin, BK: B. karatas, BRO: bromelain) on the histological and histopathological analysis of the liver and kidney in an MS-induced murine model. Methods: Thirty adult male Wistar rats were randomly assigned to six groups (n = 5): (1) standard diet (STD); (2) MS with a hypercaloric diet (MS + HC); (3) CBH-BP (200 mg/kg of body weight); (4) CBH-BK (200 mg/kg of body weight); (5) CBH-BRO (200 mg/kg of body weight); (6) carnosine (CAR) 50 mg/kg of body weight. Liver and kidney samples were processed by conventional hematoxylin and eosin (H&E) histological techniques, Masson’s trichrome stain (MTS), and the periodic acid–Schiff (PAS) histochemical method. A scoring scale was used for the histopathological evaluation with scores ranging from 0 (normal tissue) to 4 (severe damage). Results: CBHs demonstrated a significant therapeutic effect (p < 0.05) on hepatic and renal morphological alterations induced by MS. Hepatic scores for lipid inclusions, vascular congestion, and cellular alteration were all reduced to below two. Similarly, renal scores for tubular degeneration, vascular congestion, and dilation of Bowman’s space were also decreased to less than two. The therapeutic efficacy of CBHs was comparable to that of the positive control, CAR (β-alanyl-L-histidine). Conclusions: CBH-BP, CBH-BK, and CBH-BRO treatments reduced morphological alterations observed in liver and kidney tissues, which is relevant since from a histological and histopathological point of view, it allows us to understand at the cellular and tissue level the effects that these treatments can have on a living organism, indicating a potential to improve organ health in people with MS.

The vulnerability of commercial crops under a changing climate has led scientists to consider wild crop species as alternative food sources. The aim of this study was to identify plastic physiological and morphological traits that could be used to in vitro screen Amaranthus dubius and Galinsoga parviflora seeds for drought, salinity, and heat tolerance. To establish the lethal dose/temperature, 50% (LD/T50), for each stress, seeds for both were subjected to various mannitol and NaCl stresses and a range of temperatures. Percentage seedling emergence was selected as the initial indicator of tolerance and used to establish the LD/T50 for in vitro screening for both species. Seeds of both were then screened at the LD/T50 concentrations/temperatures established, and seedlings that emerged after 21 days were measured for leaf area, root (RL), shoot length (SL), chlorophyll content (Chl), fresh, dry mass, and leaf number. Data for these were used to quantify plasticity in terms of Valladares’s phenotypic plasticity index. For A. dubius, three (viz. RL, SL, and Chl) showed some plasticity (≥0.53) and tolerance across all three stressors. For G. parviflora all traits except SL showed some plasticity (≥0.58) and tolerance across all three stressors. Both species had high phenotypic plasticity across all three stressors, which suggests that wild leafy vegetables may possess the ability to tolerate climate change-associated stressors and should be considered for future breeding programs.

Abstract Collaborative, situated, and critical methodologies (CSCM) foster processes that provide dialogic and experiential working tools for emerging transdisciplinary agroecologies (TA). CSCM emphasize how local knowledge and practice (praxis) contribute to ensuring care for the common and the personal, safeguarding regenerative processes, actively protecting native seeds, and interweaving biodiverse life systems that support the multifunctional networks of agriculture. This work aimed to understand a selection of collaborative methodologies related to transdisciplinary agroecological processes. We identify these groups: 1. Agroecologies, 2. Popular and own pedagogies, 3. Engaged and transformative pedagogies, 4. Assessment of agroecological sustainability and incidence in public policy, and 5. Participatory marketing and guarantee mechanisms or systems. The CSCM contribute to understanding the relationships, times, meanings, and identities and the heterogeneity of context of each community. Thus, CSCM are essential positions and tools to strengthen the openness and respect required by intercultural spaces of praxis and shared dialogues between different epistemic communities while nourishing TA. TA are complexes of relationships and practices between humans and the diversity of life, and they delve into epistemological, ethical, ontological positions and heterogeneous praxis. These diverse methodological paths characterize the interactions that arise from the heterogeneity of knowledge, experience, and wisdom of interacting epistemic communities crossed by power relations. The shifts in positions and research journeys toward epistemological and environmental justice among biocultural diversities developed by the revised CSCM provide the tools to continue articulating processes, designs, and forms of organization of life networks converging with TA.

Abstract Given the early use of triplet and quadruplet regimens, most patients with multiple myeloma (MM) will be exposed and/or refractory to PIs, IMiDs, and anti-CD38 mAbs after first- or second-line treatment. Effective treatment for this group of triple class exposed/refractory (TCE/R) patients is crucial. Here we present a post-hoc subgroup analysis of TCE/R patients treated on the ALGONQUIN study of belantamab mafodotin plus pomalidomide-dexamethasone (belamaf-Pd) for relapsed MM. Of the 99 patients treated on the ALGONQUIN study, 69 were TCE and 56 were TCR and were included in this analysis. Patients had a median of three prior lines of therapy. The ORR was 86.4% in TCE patients and 84.9% in TCR patients, with ≥ very good partial response rates of 64% and 68% respectively. The median progression free survival was 18.3 months in TCE patients and 19.6 months in TCR patients, with overall survival not yet reached and 34.4 months, respectively for TCE and TCR patients. No new safety signals were identified. The most common Grade ≥ 3 AEs were keratopathy (48%), decreased visual acuity (42%), neutropenia (36%), thrombocytopenia (27%), and infection (25%). In this subgroup analysis of the ALGONQUIN study, patients with TCE/TCR disease treated with belamaf-Pd achieved high clinical response rates with durable remissions, comparable to other novel therapeutics in this space.

Abstract Background In most countries engaged on the last mile towards malaria elimination, residual transmission mainly persists among vulnerable populations represented by isolated and mobile (often cross-border) communities. These populations are sometimes involved in informal or even illegal activities. In regions with Plasmodium vivax transmission, the specific biology of this parasite poses additional difficulties related to the need for a radical treatment against hypnozoites to prevent relapses. Among hard-to-reach communities, case management, a pillar of elimination strategy, is deficient: acute malaria attacks often occur in remote areas, where there is limited access to care, and drugs acquired outside formal healthcare are often inadequately used for treatment, which typically does not include radical treatment against P. vivax. For these reasons, P. vivax circulation among these communities represents one of the main challenges for malaria elimination in many non-African countries. The objective of this article is to describe the protocol of the CUREMA study, which aims to meet the challenge of targeting malaria in hard-to-reach populations with a focus on P. vivax. Results CUREMA is a multi-centre, international public health intervention research project. The study population is represented by persons involved in artisanal and small-scale gold mining who are active and mobile in the Guiana Shield, deep inside the Amazon Forest. The CUREMA project includes a complex intervention composed of a package of actions: (1) health education activities; (2) targeted administration of treatment against P. vivax after screening against G6PD deficiency to asymptomatic persons considered at risk of silently carrying the parasite; (3) distribution of a self-testing and self-treatment kit (malakit) associated with user training for self-management of malaria symptoms occurring while in extreme isolation. These actions are offered by community health workers at settlements and neighbourhoods (often cross-border) that represent transit and logistic bases of gold miners. The study relies on hybrid design, aiming to evaluate both the effectiveness of the intervention on malaria transmission with a pre/post quasi-experimental design, and its implementation with a mixed methods approach. Conclusions The purpose of this study is to experiment an intervention that addresses both Plasmodium falciparum and P. vivax malaria elimination in a mobile and isolated population and to produce results that can be transferred to many contexts facing the same challenges around the world.

Abstract Introduction Colorectal cancer (CRC) is the second leading cause of cancer-related death worldwide. There is a significant burden of mortality from colorectal cancer in Africa. Due to the heterogeneity of dietary and lifestyle practices throughout Africa, our work sought to define risk factors for the development of CRC in the African continent. Methods We systematically searched PubMed, Embase, Global Health, CINAHL, Cochrane CENTRAL, and African Index Medicus for studies written in English, examining the incidence and risk factors of CRC in Africa. A systematic analysis was done to compare different risk factors in constituent studies. A meta-analysis random effects model was fitted to estimate the pooled incidence of CRC. Results Of 2471 studies screened, 26 were included for the quantitative analysis; 20 in the incidence analysis, and six in the risk factor analysis. The overall ASIR per 100,000 person-years of CRC for males and females was 7.51 and 6.22, respectively. The highest incidence rates were observed between 2012 and 2021. Risk factors for CRC in Africa include tobacco smoking, and consumption of red meat, butter, and alcohol. Protective factors included, regular consumption of fruits and regular physical activity. Conclusion The incidence of CRC in Africa is higher than that suggested by previous studies. Our study shows that nonmodifiable and modifiable factors contribute to CRC in Africa. High-quality studies conducted on generalizable populations that examine risk factors in a comprehensive fashion are required to inform primary and secondary prevention initiatives for CRC in Africa.