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In Nicaragua, the production of dairy and beef is the most important source of household income for many smallholder producers. However, erratic volumes and quality of milk limit the participation of small- and medium-scale cattle farmers into higher-value dairy value chains. This research uses a system dynamics (SD) approach to analyze the Matiguás dairy value chain in Nicaragua. The paper presents the conceptual framework of the model and highlights the dynamic processes in the value chain, with a focus on improving feeding systems to achieve higher milk productivity and increased income for producers. The model was developed using a participatory group model building (GMB) technique to jointly conceptualize and validate the model with stakeholders.

Introduction To assess the efficacy of a chitosan-based gel (ChitoCare) for the treatment of non-healing diabetic foot ulcers (DFUs).Research design and methods Forty-two patients with chronic DFUs were randomized to the ChitoCare or placebo gel for a 10-week treatment period and 4-week follow-up. The primary study end point was the rate of complete wound closure at week 10, presented as relative rate.Results Thirty patients completed the 10-week treatment and 28 completed the 4-week follow-up. The ChitoCare arm achieved 16.7% complete wound closure at week 10 vs 4.2% in the placebo arm (p=0.297), 92.0% vs 37.0% median relative reduction in wound surface area from baseline at week 10 (p=0.008), and 4.62-fold higher likelihood of achieving 75% wound closure at week 10 (p=0.012). Based on the results of the Bates-Jensen Wound Assessment Tool, the wound state at week 10 and the relative improvement from the baseline were significantly better (median 20 vs 24 points, p=0.018, and median 29.8% vs 3.6%, p=0.010, respectively).Conclusions ChitoCare gel increased the rate of the DFU healing process. Several secondary end points significantly favored ChitoCare gel.Trial registration number NCT04178525.

Introduction In light of the burden of traumatic brain injury (TBI) in children and the excessive number of unnecessary CT scans still being performed, new strategies are needed to limit their use while minimising the risk of delayed diagnosis of intracranial lesions (ICLs). Identifying children at higher risk of poor outcomes would enable them to be better monitored. The use of the blood-based brain biomarkers glial fibrillar acidic protein (GFAP) and ubiquitin carboxy-terminal hydrolase-L1 (UCH-L1) could help clinicians in this decision. The overall aim of this study is to provide new knowledge regarding GFAP and UCH-L1 in order to improve TBI management in the paediatric population.Methods and analysis We will conduct a European, prospective, multicentre study, the BRAINI-2 paediatric study, in 20 centres in France, Spain and Switzerland with an inclusion period of 30 months for a total of 2880 children and adolescents included. To assess the performance of GFAP and UCH-L1 used separately and in combination to predict ICLs on CT scans (primary objective), 630 children less than 18 years of age with mild TBI, defined by a Glasgow Coma Scale score of 13–15 and with a CT scan will be recruited. To evaluate the potential of GFAP and UCH-L1 in predicting the prognosis after TBI (secondary objective), a further 1720 children with mild TBI but no CT scan as well as 130 children with moderate or severe TBI will be recruited. Finally, to establish age-specific reference values for GFAP and UCH-L1 (secondary objective), we will include 400 children and adolescents with no history of TBI.Ethics and dissemination This study has received ethics approval in all participating countries. Results from our study will be disseminated in international peer-reviewed journals. All procedures were developed in order to assure data protection and confidentiality.Trial registration number NCT05413499.

Natural deep eutectic solvents (NADES) are a class of liquids with promising properties as components in pharmaceutical formulations, such as a low toxicity profile, biodegradability and versatility. Recently, their potential use as anti-biofilm agents has been proposed, due to their ability to solubilize and stabilize biological macromolecules. In the current work, the ability to break down biofilm matrix and the biofilm killing activity of three NADES of neutral pH were investigated against Staphylococcus aureus ATCC 6538 and Pseudomonas aeruginosa ATCC 9027 biofilms. The tested NADES were choline chloride:xylitol (ChX), choline chloride:glycerol (ChG) and betaine:sucrose (BS). Two of the NADES (ChX and ChG) significantly reduced the number of remaining viable cells of both bacterial species in pre-formed biofilm by 4–6 orders of magnitude, while the average biofilm biomass removal for all NADES was 27–67% (S. aureus) and 34–49% (P. aeruginosa). The tested NADES also inhibited biofilm formation of both bacterial species at concentrations at or below 0.5 x the minimal inhibitory concentration (MIC), possibly in part due to observed restrictions imposed by NADES on planktonic growth. These results demonstrate the potential value of neutral NADES as anti-biofilm agents in future antimicrobial preparations.

Digital technology has become an important part of society and deserves attention and in-depth research, which is still lacking. The study presented in this paper includes international perspectives from six countries and examines which factors influence the use of digital technologies in future pedagogical work in primary schools. Specifically, we investigated how pre-service teachers assess their attitudes, knowledge, and skills towards digital technology, and we determined these factors’ role in the pre-service teachers’ future use of digital technologies in pedagogical work. For the purpose of the research, an online questionnaire was used, which contained open-ended questions, optional questions, and five-point Likert-type scales, and Spearman correlation and Stepwise linear regression statistical methods were used in the data analysis. The sample consisted of 573 full-time and part-time undergraduate pre-service teachers from the Faculties of Education’s higher professional programmes in Norway, Slovenia, Portugal, Turkey, Ukraine, and Jordan. Data were collected between June 2021 and May 2022 and processed using IBM SPSS. The present research showed the significant importance of knowledge and skills about digital technologies and professional attitude towards digital tool factors for pre-service teachers’ future professional use of digital technologies. The demonstrated intention of the future use of digital technologies showed the readiness of pre-service teachers regarding the inclusion of digital technologies in pedagogical work. Opportunities for further research are in the implementation of focus groups after surveying pre-service teachers, as well as regular measurements and the inclusion of other important constructs in the regression model.