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The rapid worldwide emergence of the amphibian pathogen Batrachochytrium dendrobatidis (Bd) is having a profound negative impact on biodiversity. However, global research efforts are fragmented and an overarching synthesis of global infection data is lacking. Here, we provide results from a community tool for the compilation of worldwide Bd presence and report on the analyses of data collated over a four-year period. Using this online database, we analysed: 1) spatial and taxonomic patterns of infection, including amphibian families that appear over- and under-infected; 2) relationships between Bd occurrence and declining amphibian species, including associations among Bd occurrence, species richness, and enigmatic population declines; and 3) patterns of environmental correlates with Bd, including climate metrics for all species combined and three families (Hylidae, Bufonidae, Ranidae) separately, at both a global scale and regional (U.S.A.) scale. These associations provide new insights for downscaled hypothesis testing. The pathogen has been detected in 52 of 82 countries in which sampling was reported, and it has been detected in 516 of 1240 (42%) amphibian species. We show that detected Bd infections are related to amphibian biodiversity and locations experiencing rapid enigmatic declines, supporting the hypothesis that greater complexity of amphibian communities increases the likelihood of emergence of infection and transmission of Bd. Using a global model including all sampled species, the odds of Bd detection decreased with increasing temperature range at a site. Further consideration of temperature range, rather than maximum or minimum temperatures, may provide new insights into Bd-host ecology. Whereas caution is necessary when interpreting such a broad global dataset, the use of our pathogen database is helping to inform studies of the epidemiology of Bd, as well as enabling regional, national, and international prioritization of conservation efforts. We provide recommendations for adaptive management to enhance the database utility and relevance.

BackgroundHuman biomonitoring is crucial for regulatory toxicology, yet data on biomarker concentrations in the UAE are lacking. This study addresses this gap by analyzing urinary concentrations of 16 metals in UAE young adults, assessing correlations with personal characteristics, dietary patterns, and lifestyle habits.MethodsA cross-sectional pilot study was conducted among 144 randomly selected young adults (71 males and 73 females) from Sharjah, UAE, between January and March 2023. Participants provided urine samples, which were analyzed for 16 heavy metals using ICP-OES, and completed detailed questionnaires covering sociodemographic factors, lifestyle, and dietary habits. Descriptive statistics were used to summarize participant characteristics, and linear regression analysis was applied to explore associations between metal concentrations and factors such as gender, dietary habits, and exposure to environmental risks. Non-parametric tests, including the Mann-Whitney test, were used to assess differences by gender. Statistical significance was set at p < 0.05. Ethical approval was obtained, and informed consent was secured before participation.ResultsSignificant findings include dietary influences on metal exposure, with rice consumption linked to higher metal concentrations. Sex differences were significant, with females showing elevated levels of arsenic, lead, and cadmium. Lifestyle factors, such as smoking and incense use, were correlated with increased barium and boron levels.ConclusionThis study highlights the significant role of dietary habits, especially the consumption of rice, in metal exposure among young adults in Sharjah. The findings highlight the urgent need for comprehensive human biomonitoring to understand environmental exposures and reform public health policies. The gender-specific differences in metal distribution suggest the necessity for targeted public health strategies. The study, however, is limited by its cross-sectional nature and the focus on a specific geographic area, warranting further research for broader generalizability. Future investigations, particularly on the impact of incense exposure on metal levels, are essential for developing comprehensive health interventions and preventive strategies in the UAE.

Poor adherence to medication is frequent in bipolar disorder (BD) and has been associated with several factors. To date, the relationship between low adherence and neuropsychological functioning in BD is still unclear. As age and neuropsychological functioning might have opposing influences on adherence, our aim was to investigate this link with a particular focus on the effect of age.In a cross-sectional study, we included 353 patients divided into two age-groups (16-46; 47-71) from a French cohort diagnosed with BD (type I, II, NOS) and strictly euthymic. All patients had a standardized clinical and neuropsychological assessment and were categorized as high (n = 186) or low (n = 167) adherent based on their score from the Medication Adherence Rating Scale. Clinical information was collected based on a standardized interview and clinical validated scales. Neuropsychological performances were evaluated with an established standardized neuropsychological battery for bipolar disorder patients. After univariate analysis, neuropsychological and clinical predictors of low adherence were included in two age-specific stepwise multiple logistic regressions.A smaller number of hospitalizations (OR = 0.846, p = 0.012), a shorter illness duration (OR = 0.937, p = 0.003) and higher adverse effects (OR = 1.082, p

Background: Stunting is a vital indicator of chronic undernutrition that reveals a failure to reach linear growth. Investigating growth and nutrition status during adolescence, in addition to infancy and childhood is very crucial. However, the available studies in Ethiopia have been usually focused in early childhood and they used the traditional stastical methods. Therefore, this study aimed to employ multiple machine learning algorithms to identify the most effective model for the prediction of stunting among adolescent girls in Ethiopia., Methods: A total of 3156 weighted samples of adolescent girls aged 15-19 years were used from the 2016 Ethiopian Demographic and Health Survey dataset. The data was pre-processed, and 80% and 20% of the observations were used for training, and testing the model, respectively. Eight machine learning algorithms were included for consideration of model building and comparison. The performance of the predictive model was evaluated using evaluation metrics value through Python software. The synthetic minority oversampling technique was used for data balancing and Boruta algorithm was used to identify best features. Association rule mining using an Apriori algorithm was employed to generate the best rule for the association between the independent feature and the targeted feature using R software., Results: The random forest classifier (sensitivity = 81%, accuracy = 77%, precision = 75%, f1-score = 78%, AUC = 85%) outperformed in predicting stunting compared to other ML algorithms considered in this study. Region, poor wealth index, no formal education, unimproved toilet facility, rural residence, not used contraceptive method, religion, age, no media exposure, occupation, and having one or more children were the top attributes to predict stunting. Association rule mining was identified the top seven best rules that most frequently associated with stunting among adolescent girls in Ethiopia., Conclusion: The random forest classifier outperformed in predicting and identifying the relevant predictors of stunting. Results have shown that machine learning algorithms can accurately predict stunting, making them potentially valuable as decision-support tools for the relevant stakeholders and giving emphasis for the identified predictors could be an important intervention to halt stunting among adolescent girls., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2025 Zemariam et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: The World Health Organization (WHO) recommended cryptococcal antigen (CrAg) screening for people presenting with advanced HIV disease (AHD) and for those with positive CrAg without evidence of meningitis to initiate preemptive antifungal medication. Data on the implementation of WHO recommendations regarding CrAg screening is limited. We estimated pooled prevalence of CrAg screening uptake, cryptococcal antigenemia, lumbar puncture, cryptococcal meningitis and initiation of preemptive antifungal medication from available eligible published studies conducted in Africa., Methods: PubMed, Cochrane Library and Embase were searched for articles published between January 2011 and December 2023. CrAg uptake was defined as percentage of eligible people (CD4 ≤ 200 cells/mm3 or WHO stage III/IV) who received cryptococcal antigen testing. Stratified analysis to compare uptake and cryptococcal antigenemia between studies that involved multiple vs single sites was performed. Using random effects models, we computed the pooled estimate of CrAg screening uptake, cryptococcal antigenemia, lumbar puncture, cryptococcal meningitis, preemptive antifungals treatment and 95% confidence intervals (CIs)., Results: Ten studies with 18,820 individuals with AHD were analyzed. Overall, the pooled estimate of CrAg screening uptake was 57.1% (95% CI: 41.4-72.7). CrAg screening uptake was significantly lower among studies that involved multiple sites compared to those that involved single site, (47.3% vs 73.3%; p<0.001). Overall, the pooled prevalence of cryptococcal antigenemia was 9.6% (95% CI:6.4-12.9). Cryptococcal antigenemia was significantly lower among studies that involved multiple sites compared to those that involved single site, (9.1% vs 10.4%; p<0.001). Among those who tested positive for CrAg, 84.6% (95% CI: 54.1-99.0) received preemptive antifungal treatment, though nearly 25% did not undergo lumbar puncture, highlighting gaps in diagnostic follow-up. Six studies evaluated CrAg positive patients with lumbar puncture and the overall prevalence of lumbar puncture was 74.9% (48.0-94.8). The overall prevalence of cryptococcal meningitis was 58.1% (46.6-69.6)., Conclusions: Not screening for CrAg among people with AHD and failure to initiate antifungal medications among eligible patients with cryptococcal antigenemia presents a significant missed opportunity. Emphasis on improving CrAg screening is critical given its proven cost-effective benefits., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2025 Ally et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Pain management is a crucial component of patient care that promotes relaxation, lowers complications, improves quality of life, and shortens hospital stays. Several studies assessed the nurses' pain management practices in Ethiopia. However, the findings of these studies are highly variable and inconsistent. Therefore, the study aims to determine the overall prevalence of pain management practice and associated factors among nurses working in Ethiopia., Method: The study included all observational quantitative research articles conducted among nurses in Ethiopia. We used Google Scholar, PubMed, Cochrane Library, and Scopus searching databases. The Newcastle-Ottawa Scale was used to check the study quality. Then I2 statistics and Cochran's Q test were used to evaluate heterogeneity. The Funnel, Egger's test, and non-parametric trim and fill effect tests were used to check publication bias by using a random effect model. Finally, we conducted subgroup analysis and sensitivity tests to evaluate statistical heterogeneity and the presence or absence of any influential study., Result: In the final analysis, we included eighteen studies, and 4,213 nurses participated. The overall pooled prevalence of nurses with good pain management practice was 43.79% (95% CI: 38.52, 49.06%). In-service training AOR; 95% CI 3.21 (1.87, 4.54), good knowledge AOR; 95% CI 2.44 (1.78, 3.09), positive attitudes AOR; 95% CI 2.84 (1.24, 4.44), and pain management guidelines in health facilities AOR; 95% CI 3.46 (1.48, 5.44) were the significant associated factors with pain management practice among nurses in Ethiopia., Conclusion: This study found that over half of Ethiopian nurses had poor pain management practices. Knowledge, attitude, training, and pain management guidelines in health facilities were significant factors. Therefore, health managers and stakeholders should prioritize pain management awareness, attitudes, availability of guidelines, and in-service training to improve patient care and outcomes., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2025 Munie et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Professor Richard Klein and his students built a bicycle with a rather interesting feature: no one was able to ride it. A prize was offered. Hundreds of students and cycling enthusiasts attempted it. Years passed, and the prize money grew. Klein's rear-steered bicycle became a canonical example of how non-minimum phase systems can be difficult and sometimes nearly impossible to control. It has been lauded as a particularly effective educational example in which students can experience the loss of controllability in a seemingly simple, albeit unorthodox bicycle. The primary result of the work reported here is a demonstration that it is possible for a human of modest athletic ability to ride Klein's unridable bicycle, to keep it balanced, and to control its direction of travel. There is a secret to riding Klein's rear-steer bicycle. The secret is revealed through an exploration of the dynamics and control of the bike that contains three elements: (1) modeling the physics of the actively steered bicycle as an inverted pendulum riding atop a carriage; (2) recognizing that the steer kinematics leads to competing physical mechanisms which an aspiring rider might exploit; and (3) examining limitations of controllability and stabilizability of the system from a state space perspective. From this vantage point, one can devise a novel strategy, based on a component of lateral acceleration that dominates at low speed, for riding the so-called "unridable" bike and solving Klein's puzzle. The work adds a new chapter on the dynamics and control of the rear-steered bicycle, a problem of academic interest., Competing Interests: The author has declared that no competing interests exist., (Copyright: © 2025 B. D. Coller. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Introduction: An unintended pregnancy refers to a situation where a pregnancy occurs either when there is no desire for a child (unwanted) or when it takes place at a time that was not anticipated (mistimed). Pregnant women infected with HIV face a two to tenfold increased risk of mortality during both pregnancy and the postpartum period compared to those who are not infected. A national level cohort study has identified that about 70 babies born HIV positive, 60% of them were from unplanned pregnancy. In pregnant women living with HIV and on antiretroviral therapy, preterm birth and low birth weight have been reported. A systematic review and meta-analysis were conducted on the rate of vertical transmission of HIV in East Africa and revealed the pooled prevalence of 7.68% (ranges from 1.58-32.1%), which is far from the desired target of WHO, which is below 5%., Methods: Appropriate and comprehensive searches of PubMed, MEDLINE, EMBASE, Google Scholar, HINARI, and Scopus have been performed. The electronic literature search was last performed on December 28/2023. All observational study designs were eligible in this SRMA (systematic review and meta-analysis). Primary studies lacking the outcome of interest, were excluded from the SRMA. The extracted Microsoft Excel spreadsheet data were imported into the STATA software version 17 (STATA Corporation, Texas, USA) for analysis. A random-effects model was used to estimate the pooled prevalence of unintended pregnancy among women living with HIV in East Africa. The Cochrane Q-test and I2 statistics were computed to assess the heterogeneity among the studies included in the SRMA., Result: A total of 2140 articles were found by using our search strategies and finally ten studies were included in the SRMA, comprised of 4319 participants. The pooled prevalence of unintended pregnancy among women living with HIV in East Africa was 40.98% (95% CI: 28.75, 53.20%). The finding of this subgroup analysis by study country showed that the pooled prevalence of unintended pregnancy among women living with HIV was lower in Ethiopia (28.38%; 95% CI: 15.54, 41.21%) and higher in Rwanda (62.7%; 95% CI: 58.71, 66.69%). Unemployment (AOR = 2.75, 95% CI: 1.82, 4.16), high parity (AOR = 3.16, 95% CI: 2.34, 4.36) and no formal education (AOR = 2.04, 95% CI: 1.23, 3.38) were significantly associated with unintended pregnancy among women living with HIV in East Africa., Conclusion: The findings of this SRMA suggest a substantial need for concerted efforts to reduce unintended pregnancies among women living with HIV. It underscores the importance of continuous and rigorous initiatives to enhance women's empowerment, focusing on improving both employment and educational status. Additionally, all stakeholders are urged to diligently implement the WHO recommendations, particularly emphasizing a four-pronged approach to a comprehensive PMTCT strategy and the prevention of unintended pregnancies., Competing Interests: The authors have declared that no competing interests exist., (Copyright: This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.)

Introduction: Anemia is a significant health problem that has a profound impact on young children under the age of five. It can result in severe consequences, such as stunted growth, impaired cognitive and motor development, increased illness, and even death. In Ghana, anemia is the leading cause of child mortality, yet there is a lack of information available on the prevalence of anemia and the factors associated with its severity in children under five in the country. To fill this gap, this study was conducted to investigate the prevalence and determinants of anemia severity among children aged 6-59 months in Ghana., Methods: This study used data from the 2022 Ghana Demographic and Health Survey (GDHS) and included a weighted total sample of 3585 children aged 6-59 months. Given the hierarchical nature of the DHS data and the ordinal nature of anemia, a multilevel ordinal logistic regression model was employed. The Brant test was used to determine whether the proportional odds assumption was met (P ≥0.05). Deviance was used for model comparison. For the multivariable analysis, variables with a p-value ≤0.2 in the bi-variable analysis were considered. The Adjusted Odds Ratio (AOR) with a 95% Confidence Interval (CI) was reported as a factor associated with anemia severity in the multivariable multilevel proportional odds model., Results: A study conducted in Ghanaian children aged 6-59 months found that 49.1% of them had anemia (95% CI: 47.4%-50.7%). The results indicated that 27.6% of patients had mild anemia, while 21.4% had moderate to severe anemia. Factors that were significantly associated with higher odds of childhood anemia included being 6-23 months old, male, having a maternal age of 15-24 or 25-34 years, belonging to poorer or wealthier households, having a higher birth order, being stunted, having maternal anemia, no media exposure, and living in the Northern, Upper East, or Upper West regions., Conclusion: Anemia among children aged 6-59 months in Ghana is a major public health concern. It is recommended to improve access to the media, address maternal anemia through targeted interventions, and strengthen the wealth status of families. Furthermore, preconception care for mothers during pregnancy should be supported to reduce anemia in the long-term. Additionally, the early detection and management of stunted children should be strengthened to decrease childhood anemia., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Asgedom et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Introduction: Use of oral anticoagulants (OACs) for stroke reduction in atrial fibrillation (AF) varies by race and geography within the United States. We seek to better understand the relationship between OAC underutilization, race, and US geography., Methods: Patients with AF were selected from the US Centers for Medicare & Medicaid Services claims database from January 1, 2013, to December 31, 2016. The final population consisted of patients with 12 months of health plan enrollment before and after their index AF diagnosis, with a baseline CHAD2S2-VASc ≥2 and of either Black or White race (other races are underrepresented in the data). Among those with AF that met the inclusion criteria, patients who were prescribed warfarin or DOACs within 12 months after the index date were extracted. Each patient was assigned to a US county based on their 5-digit zip code and OAC use was stratified by race. Statistically significant differences were determined by student's t-test and chi-square., Results: Of the 2,390,830 final patients, 94.1% were White and 5.9% were Black patients. Mean (SD) age and HASBLED scores were 78 (9) and 3.9 (1.2) respectively, for Black patients and 80 (9) and 3.3 (1.2), respectively, for White patients (p<0.0001). The mean (SD) CHAD2S2-VASc scores were 4.5 (1.9) for White patients, and 5.3 (1.9) for Black patients with p<0.0001, respectively. Black patients (vs White patients) had a higher non-treatment (no DOAC or warfarin) rate (56.1% vs 47.4%, p<0.0001) across the US which was particularly notable in the southeast. In addition, treatment rates were highly variable within each US state. Counties with dense population more frequently demonstrated significant differences by race than counties with sparse population., Conclusion: Our study showed differences in the use of OACs across US counties and among various racial groups. These disparities highlighted the areas of unmet need for both Black and White patients., Competing Interests: The authors have read the journal’s policy and have the following competing interests: BDA is an employee of Inova Health System, and was a paid consultant to Bristol-Myers Squibb/Pfizer in connection with this study. LRJ is an employee of Duke University, and was a paid consultant to Bristol-Myers Squibb/Pfizer in connection with this study. VN was employed by STATinMED, a paid consultant company to Bristol Myers Squibb/Pfizer, outside of the submitted work. AK, NA, MH, and JJ are employees of Bristol Myers Squibb, a study sponsor. DMH is an employee of Pfizer, a study sponsor. There are no patents, products in development or marketed products associated with this research to declare. This does not alter our adherence to PLOS ONE policies on sharing data and materials., (Copyright: © 2024 Jackson et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

This study aimed to investigate the impact of a lubricant derived from trimethylolpropane trioleate on power consumption and surface roughness during high-speed drilling of Al-6061, with the goal of developing an environmentally friendly cutting fluid. The study investigated the impact of additive concentration, spindle speed, and feed rate on energy consumption and surface roughness using a Taguchi L27 orthogonal array. Through analysis of the Taguchi experimental outcomes and single-to-noise ratios, the parameters were ranked accordingly. The results of the ANOVA analysis reveal that spindle speed has the greatest impact on Power (87.89%), followed by followed feed rate (6.96%) and additive concentration (2.98%). However, feed rate (43.51%) has the most significant influence on surface roughness, followed by speed (38.48%) and additive concentration (11.90%). Varying additive concentration affects more on surface quality rather than power consumption. Furthermore, a machine learning algorithm was developed to forecast and compare various key aspects of high-speed drilling machinability, including power and surface roughness. Three different measures of accuracy were used to evaluate the performance of the projected values: coefficient of determination (R2), mean absolute percentage error, and mean square error. The decision tree performed better than other models in accurately predicting power and surface roughness. This research introduces an innovative method for assessing the most effective biodegradable cutting fluid and forecasting power and surface quality by developing an optimal combination., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Kathmore et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Objectives: To eliminate vertical transmission of HIV, global institutions recommend using a risk-guided approach for HIV prevention services in antenatal and postnatal settings. Identifying predictors of maternal HIV acquisition can inform the development of risk-guided approaches, but individual studies of predictors can have limited power and generalizability., Methods: We conducted a systematic review and narrative synthesis to identify common predictors of maternal HIV acquisition in sub-Saharan Africa (SSA). We searched four databases for full-text articles that estimated associations between at least one predictor and risk of HIV acquisition among pregnant and/or lactating women (PLW) in SSA. We restricted our synthesis to predictors assessed in at least four study populations. For these predictors, we summarized how each predictor was defined and used vote counting and descriptive statistics to characterize overall trends., Results: We identified 26 eligible publications that summarized results from 24 unique studies. Studies were implemented in 12 countries between 1988 and 2021 and enrolled a total of 164,480 PLW at risk of acquiring HIV. Of the 66 predictors evaluated, 16 met our inclusion criteria. Estimated associations tended to be imprecise and variability in how predictors were measured precluded meta-analyses. We observed trends towards a higher risk of maternal HIV acquisition among young women and women who reported early coital debut, multiple partnerships, sexually transmitted infections, being unaware of partner HIV status, or having a partner living with HIV. In most studies, PLW in stable, monogamous relationships experienced a lower risk of acquiring HIV than those who were single, separated, or in a polygynous marriage. HIV risk perception, condom use, and vaginal drying were also commonly associated with HIV acquisition risk., Conclusions: In our systematic review and narrative synthesis, we identified several easily measured characteristics that were associated with HIV acquisition among PLW in multiple study populations across SSA. Such findings can support the development and refinement of risk-guided approaches for HIV prevention in the region., Competing Interests: Drs. Graybill and Chi received consulting fees from UNICEF. This does not alter our adherence to PLOS ONE policies on sharing data and materials. All other authors reported no conflicts of interest., (Copyright: © 2024 Graybill et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Artificial Intelligence (AI)-based deep learning methods for predicting protein structures are reshaping knowledge development and scientific discovery. Recent large-scale application of AI models for protein structure prediction has changed perceptions about complicated biological problems and empowered a new generation of structure-based hypothesis testing. It is well-recognized that proteins have a modular organization according to archetypal folds. However, it is yet to be determined if predicted structures are tuned to one conformation of flexible proteins or if they represent average conformations. Further, whether or not the answer is protein fold-dependent. Therefore, in this study, we analyzed 2878 proteins with at least ten distinct experimental structures available, from which we can estimate protein topological rigidity verses heterogeneity from experimental measurements. We found that AlphaFold v2 (AF2) predictions consistently return one specific form to high accuracy, with 99.68% of distinct folds (n = 623 out of 628) having an experimental structure within 2.5Å RMSD from a predicted structure. Yet, 27.70% and 10.82% of folds (174 and 68 out of 628 folds) have at least one experimental structure over 2.5Å and 5Å RMSD, respectively, from their AI-predicted structure. This information is important for how researchers apply and interpret the output of AF2 and similar tools. Additionally, it enabled us to score fold types according to how homogeneous versus heterogeneous their conformations are. Importantly, folds with high heterogeneity are enriched among proteins which regulate vital biological processes including immune cell differentiation, immune activation, and metabolism. This result demonstrates that a large amount of protein fold flexibility has already been experimentally measured, is vital for critical cellular processes, and is currently unaccounted for in structure prediction databases. Therefore, the structure-prediction revolution begets the protein dynamics revolution!, Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Haque et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Hepatitis B is a global health problem with high morbidity and mortality. The risk of transmission is more common among health care personnels and medical students during their professional health trainings. Vaccination is the most effective means of prevention. The main objective of this study was to determine the level of knowledge, attitude, and practice regarding Hepatitis B and vaccination among pre-clinical students in a medical college., Materials and Methods: A web-based, single-center, descriptive cross-sectional study was conducted among pre-clinical medical students in Bangladesh from April 28, 2024, to May 4, 2024. The whole sampling technique method was used taking the entire population for our study. Data were collected using a self-administered questionnaire and analyzed using JMP Pro V17 Statistical Software., Results: Sixty-one (34%) students were vaccinated against Hepatitis B, of whom 18% received all three doses with a booster dose. The most common reason for non-vaccination was lack of awareness of one's vaccination status (43%). The median knowledge, attitude, and practice (KAP) scores were 54 (50-60), 19 (17-21) and 20 (19-23) respectively, and they were moderately positively correlated. Forty-six (25.98%) students had a good overall KAP score (≥ 102)., Conclusion: Only one-third of the students had been vaccinated, and the commonest reason for non-vaccination was lack of awareness of one's vaccination status. Nearly one-fourth of the participants had good knowledge, attitude, and practice related to Hepatitis B. Therefore, education regarding Hepatitis B infection, risk factors, and importance of vaccination is a must among pre-clinical medical students in Bangladesh., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Lamichhane et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: The occurrence of failed induction led to higher rates of health problems and death among mothers, mainly as a result of complications related to cesarean delivery, such as postpartum bleeding, morbidly adherent placenta and surgical site infection. Even though a systematic review and meta-analysis were done before July 2020 with limited studies, there were varies inconsistent studies after that and no updated summarize evidence about the issue as a nation. Therefore, this systematic review and meta-analysis aimed to assess the current pooled prevalence of failed induction and its associated factors in Ethiopia by including multiple inconsistent studies., Methods: Comprehensive literature was searched in PubMed, Google Scholar, and HINARI from January 1, 2013, to September 23, 2023. A random effect model was used to estimate pooled prevalence and adjusted odds ratio. Stata (version17.0) was used to analyze the data. Cochrane Q-test and I squared statistics were computed to assess heterogeneity among studies. A sub group analysis was done based on study region to minimize underling heterogeneity. Funnel plot and Eggers test were done to assess publication bias and corrected by trim and fill analysis., Result: Overall, one thousand fifty-two articles were retrieved and finally twenty-eight studies were included in this systematic review, including 9757 participants. The pooled prevalence of failed induction of labor was 22.39% (95% CI: 21.57-23.21). Subgroup analysis showed that failed induction of labor was highest in Addis Ababa and lowest in Tigray region. Rural residence (AOR = 3.31, 95% CI: 2.39-4.57), nullipara women (AOR = 2.63, 95% CI: 2.14-3.24), unfavorable bishop score (AOR = 3.98, 95% CI: 2.19-7.08), hypertensive disorder during pregnancy (AOR = 3.63, 95% CI: 2.69-5.01) and premature rupture of membranes before the onset of labor (AOR = 2.51, 95% CI: 1.5-4.26) were significantly associated with failed induction of labor., Conclusion: The pooled prevalence of failed induction of labor in Ethiopia was high. Unfavorable bishop score, nulliparous, rural residence, women who had premature rupture of membrane and hypertensive disorder during pregnancy were significantly associated with failed induction of labor. Therefore, Healthcare providers or obstetricians should consider proper cervical assessment for bishop score before the initiation of induction. The Ministry of Health ought to create a distinct set of guidelines specifically addressing the cervical ripening and/or induction protocol for women who experienced premature rupture of membranes (PROM) and had a hypertensive disorder during pregnancy, especially those who were administered magnesium sulfate (MgSO4)., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Ayele et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Mesenchymal stem cell (MSC)-derived exosomes (EXs) have emerged as promising therapeutic agents for wound healing. However, the optimal conditions for manufacturing MSC-derived EXs that maximize their wound-healing potential have yet to be established. Hence, we compared the efficacy of five different MSC culture media, including three different serum-free, a platelet-supplemented, and a fetal bovine serum-supplemented media, in exosome manufacturing for wound healing applications. Although umbilical cord-derived MSCs (UCMSCs) cultured in these media exhibited similar proliferation, morphology, MSC surface marker expression, and stemness, EXs derived from UCMSCs cultured in different culture media displayed varying levels of growth factors and cytokines. Notably, EXs derived from platelet-supplemented media (DM-PLT&#95;EXs) exhibited significantly higher concentrations of keratinocyte growth factor (KGF), vascular endothelial growth factor (VEGF-A), platelet-derived growth factor (PDGF-BB), interleukin 6 (IL-6), interleukin 7 (IL-7), and interleukin 8 (IL-8) than EXs from other media. These differences correlated with the superior capability of DM-PLT&#95;EXs to promote human skin fibroblast proliferation and stimulate angiogenesis of human umbilical vein endothelial cells, making them a more suitable choice for wound healing applications. Our findings emphasize the significance of the culture medium selection in tailoring the therapeutic potential of UCMSC-derived EXs for wound healing., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Dao et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Immune literacy garnered significant attention in recent years due to the threat posed by emerging infectious diseases. The pace of immunological discoveries and their relevance to society are substantial yet coordinated educational efforts have been rare. This motivated us to create a task force of educators to reflect on pedagogical approaches to teaching immunology and to draft, develop, and evaluate key competencies for undergraduate immunology education. The research questions addressed include: 1) Which competencies are considered important by educators? 2) Are the illustrative skills clear, accurate and well aligned with the core competencies listed in the Vision and Change report?; 3) What are the concerns of immunology educators about competencies and skills? We collected data on the draft competencies using surveys, focus groups, and interviews. The iterative revision phase followed the community review phase before finalizing the framework. Here, we report a hierarchical learning framework, with six core competencies, twenty illustrative skills, and companion immunology-specific example learning outcomes. Predominant themes from interviews and focus groups, which informed revisions of this framework are shared. With the growing need for immunology education across the sciences, the ImmunoSkills Guide and accompanying discussion can be used as a resource for educators, administrators and policymakers., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Pandey et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Vulnerable groups, such as pregnant women, are at increased risk of potentially life-threatening infections with extended-spectrum beta-lactamase-producing Enterobacterales (ESBL-E) for both mother and newborn. However, data regarding ESBL-E carriage and associated risk factors in Ghanaian pregnant women remain scarce., Objective: This study aimed to determine the prevalence of ESBL-E carriage and its associated risk factors among pregnant women attending the antenatal clinic at the Korle Bu Teaching Hospital., Methods: A systematic sample of 700 pregnant women with gestational age ≥ 34 weeks attending the antenatal clinic at Korle Bu Teaching Hospital was included in the study. After administering a structured questionnaire to assess potential risk factors associated with ESBL-E carriage, patients were given a sterile stool container to submit at least 1 g of stool specimen. Recovered isolates from faecal specimens were identified using MALDI-TOF-MS technology. These isolates were then subjected to susceptibility testing and ESBL identification. A random subset of 24 ESBL-producing Escherichia coli isolates was whole-genome sequenced on the MiSeq Illumina platform. Risk factors associated with ESBL-E carriage were determined using multivariable logistic regression analysis., Results: Among the 700 pregnant women, 42% (294) carried ESBL-E. The predominant ESBL-producing Enterobacterales were Escherichia coli (95%). Fifty percent (50%) of ESBL-E were multidrug resistant isolates (MDRs). Whole-genome sequencing of 24 ESBL-producing E. coli isolates revealed that blaCTX-M-15 (96%) was the most prevalent ESBL gene type. Notably, most isolates belonged to commensal phylogenetic groups (A, B1, and C; 88%). Having a primary level of education (aOR 1.45, 95% CI 1.05-1.96) and consuming legumes as the main source of protein (aOR 0.17, 0.40-0.83) were significantly associated with intestinal carriage of ESBL-E., Conclusion: This study identified a high prevalence of ESBL-E and MDR-ESBL-E carriage among pregnant women. Our findings underscore the urgent need for public health interventions to control the spread of AMR., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Obeng-Nkrumah et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Studies on animal energetics often focus on standardized metabolic rates to facilitate comparison across systems. Yet these standardized measurements often do not capture the realistic demographic and environmental variation that is common in natural settings. Rather, individuals included in these studies are often non-reproducing, uninjured, resting adults that have not recently eaten-far from a representative sample. We measured the respiratory rates of the sand fiddler crab Leptuca pugilator in air immediately after capture in the field, and compared rates between males, females of different reproductive states, and juveniles. As expected, we show that metabolic rates were influenced by body mass and activity level. We also show that being vitellogenic or gravid had only minor impacts on metabolic costs of females. Importantly, we demonstrate how considering demographics allows for the detection of phenomena that would otherwise go unnoticed. We found that field metabolic rates of L. pugilator in air are as much as an order of magnitude higher than previous standard metabolic rates measured on post-prandial, quiescent individuals. These higher rates may reflect a combination of high activity and active digestion, as fiddler crabs actively feed during low tide periods. Our results highlight the importance of considering differences in sex, life history stage, and reproductive state of organisms in fluctuating environments, such as intertidal habitats, when assessing energy expenditure., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Stancil et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Purpose: Human papillomavirus (HPV) causes an estimated 300,000 high grade cervical dysplasias and 36,000 preventable cancers each year in the United States alone. Despite having a safe, effective and long lasting vaccine since 2006, the rate of uptake has been suboptimal, particularly in rural areas. In 2020, Utah ranked near last in teenage HPV vaccination rates with rural areas trailing urban areas by about 18 percent. In this study, we identified factors that affect the intent of rural Utah parents to vaccinate their children against HPV., Methods: A survey was distributed electronically to Utah residents in rural areas. Recruitment was carried out through targeted advertising, community organizations, and professional survey panels. The survey was open from Nov. 15, 2022 to April 15, 2023. A total of 410 respondents were used for analysis. Survey results were analyzed using exploratory factor analysis, confirmatory factor analysis, and structural equation modeling., Findings: Distance to care was shown to negatively influence direct intent to vaccinate, while trust in government, general vaccine attitudes, and HPV knowledge positively influence intent to vaccinate. It was found that religious practice decreased vaccine hesitancy while cautious sexual attitudes, distance to care, and general negative vaccine attitudes increased vaccine hesitancy. Conservative political identity and high income were both shown to decrease vaccine hesitancy as covariates., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Lee et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Menstrual hygiene management is a critical aspect of adolescent health. However, access to adequate menstrual hygiene products and sanitation facilities is severely restricted during times of war. There is a dearth of information about the menstrual hygiene needs of adolescent girls during humanitarian crises. This study investigated the menstrual hygiene management needs of the internally displaced adolescent girls in the war-torn region of Tigray, Ethiopia., Methods: A qualitative study was conducted in three centers for internally displaced people in Mekelle, Tigray Region. Four focus-group discussions and six in-depth interviews were conducted using the local language among 39 adolescent girls aged 13-19 years. The collected data were recorded, transcribed, translated, and analyzed using the ATLAS.ti-7.5.18 software through a qualitative thematic analysis approach., Results: Six primary themes were identified: 1) shortage of menstrual pads; 2) poor accommodation of latrine facilities; 3) silence around menstruation; 4) exchange of menstrual pads for life-saving commodities, 5) lack of privacy; 6) menstruation is a "curse" for adolescent girls living in displaced people's camps. The study highlights the significant challenges faced by internally displaced adolescent girls in managing their menstrual hygiene while living in camps for internally displaced people. Lack of access to adequate menstrual hygiene management supplies often leads them to use rags or worn-out clothing instead of menstrual pads., Conclusion: Access to adequate menstrual hygiene products and sanitation facilities is severely limited among displaced adolescent girls in Tigray. The findings emphasize the urgent need to address menstrual hygiene issues during emergencies. Supplying essential items such as sanitary pads, soap, water, sanitation infrastructure, and improved information on menstrual hygiene management should be prioritized., Competing Interests: LLW serves as a non-compensated member of the board of directors of the charity, Dignity Period. The other authors have no competing interests to declare. This does not alter our adherence to PLOS ONE policies on sharing data and materials., (Copyright: © 2024 Betsu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

The utilization of satellite images in conservation research is becoming more prevalent due to advancements in remote sensing technologies. To achieve accurate classification of wildlife habitats, it is important to consider the different capabilities of spectral and spatial resolution. Our study aimed to develop a method for accurately classifying habitat types of the Himalayan ibex (Capra sibirica) using satellite data. We used LISS IV and Sentinel 2A data to address both spectral and spatial issues. Furthermore, we integrated the LISS IV data with the Sentinel 2A data, considering their individual geometric information. The Random Forest approach outperformed other algorithms in supervised classification techniques. The integrated image had the highest level of accuracy, with an overall accuracy of 86.17% and a Kappa coefficient of 0.84. Furthermore, to delineate the suitable habitat for the Himalayan ibex, we employed ensemble modelling techniques that incorporated Land Cover Land Use data from LISS IV, Sentinel 2A, and Integrated image, separately. Additionally, we incorporated other predictors including topographical features, soil and water radiometric indices. The integrated image demonstrated superior accuracy in predicting the suitable habitat for the species. The identification of suitable habitats was found to be contingent upon the consideration of two key factors: the Soil Adjusted Vegetation Index and elevation. The study findings are important for advancing conservation measures. Using accurate classification methods helps identify important landscape components. This study offers a novel and important approach to conservation planning by accurately categorising Land Cover Land Use and identifying critical habitats for the species., Competing Interests: The authors declare no conflict of interest., (Copyright: © 2024 Dutta et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Paclitaxel is a chemotherapy drug widely used for the treatment of various cancers based on its ability to potently stabilize cellular microtubules and block division in cancer cells. Paclitaxel-based treatment, however, accumulates in peripheral system sensory neurons and leads to a high incidence rate (over 50%) of chemotherapy induced peripheral neuropathy in patients. Using an established preclinical model of paclitaxel-induced peripheral neuropathy (PIPN), we examined proteomic changes in dorsal root ganglia (DRG) of adult male mice that were treated with paclitaxel (8 mg/kg, at 4 injections every other day) relative to vehicle-treated mice. High throughput proteomics based on liquid chromatography electrospray ionization mass spectrometry identified 165 significantly altered proteins in lumbar DRG. Gene ontology enrichment and bioinformatic analysis revealed an effect of paclitaxel on pathways for mitochondrial regulation, axonal function, and inflammatory purinergic signaling as well as microtubule activity. These findings provide insight into molecular mechanisms that can contribute to PIPN in patients., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Hanna et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Importance: Racial and ethnic disparities in chronic disease are a major public health priority., Objective: To determine if the amount of federal grant funding to federally-qualified health centers (FQHCs) was associated with baseline overall prevalence of uncontrolled hypertension and uncontrolled diabetes, as well as prevalence by racial and ethnic subgroup., Design: Cross-sectional multivariate regression analysis of Uniform Data System 2014-2019, which includes clinic-level data from each FQHC regarding demographics, chronic disease control by race and ethnicity, and grant funding., Exposures: Our main exposure were the average values of the prevalence of uncontrolled hypertension and uncontrolled diabetes among the overall population and by racial and ethnic group from 2014-2016., Main Outcomes: Average federal grant funding per patient from 2017-2019, as measured by annual health center funding from the Bureau of Primary Health Care (BPHC) and overall federal grant funding., Results: We analyzed 1,205 FQHCs from 2014-2019; the average BPHC grant per patient across all FQHCs in 2019 was $168 while the average total federal grant was $184 per patient. Increasing shares of total patients with uncontrolled hypertension or uncontrolled diabetes were not associated with increased total federal grant funding in either unadjusted or adjusted analysis. Increased shares of patients who are American Indian or Alaskan Native (AI-AN) with uncontrolled hypertension and diabetes were associated with increasing total federal grant funding in both unadjusted and adjusted analysis (adjusted beta hypertension $168.3, p <0.001; adjusted beta diabetes 59.44, p = 0.02). However, cardiovascular clinical need among other racial and ethnic groups was not significantly associated with grant funding., Conclusions: FQHCs with higher overall rates of uncontrolled hypertension or diabetes do not receive more federal funds, and there is no significant association between federal funding levels and rates of uncontrolled blood pressure or diabetes within most racial and ethnic groups, with the exception of AI-AN populations. To narrow inequities in cardiovascular disease, HRSA should consider more explicitly targeting federal grants to clinics with higher levels of clinical need., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Kishore et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Objectives: This study aimed to evaluate the psychometric properties of the Australian Interprofessional Socialisation and Valuing Scale (ISVS)-21 and provide an invariant measure for health practitioners and students to assess interprofessional socialisation., Methods: The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) were used as guidelines. This research began with a key step: conducting a pilot study to assess content validity, a requirement of COSMIN for item development. The ISVS-21 has not yet been validated in Australia. Content validity checks ensure the developed items accurately represent the measured construct in the intended cultural context. In addition to conducting more comprehensive tests of psychometric properties compared to previous studies on ISVS-21, this paper introduces something new by evaluating the internal structure of the instrument involving measurement invariance and hypothesis testing for construct validity based on several assumptions related to interprofessional socialisation and values. An invariant measure validates the use of the Australian ISVS-21 on practitioner and student equivalently, allowing the comparison of outcomes at both levels., Results: The evaluation of content validity indicated that the items were relevant, comprehensible (practitioners and students had an agreement score of >70% for all 21 items), and comprehensive to the concepts intended to be measured. Structural validity confirms ISVS-21 Australia as unidimensional, with good internal consistency reliabilities, Cronbach's α scores = 0.96 (practitioner) and 0.96 (student). Measurement invariance tests confirm ISVS-21 Australia is configural, metric and scalar invariance (ΔCFI ≤ 0.01) across the tested groups of practitioner and student, and therefore suitable for use by both cohorts in Australia. Age and length of work/study were discriminant factors for interprofessional socialisation in both cohorts; the professional background was a differentiating factor for practitioners but not for students. Hypotheses testing results support the COSMIN construct validity requirement for the measure, with 83.3% of assumptions tested accepted., Conclusion: The Australian ISVS has good psychometric properties based on evaluating the content validity, internal structure, and hypotheses testing for construct validity. In addition, Australian ISVS is an invariant measure for use by health practitioners and students and, therefore, confirmed as a quality measure to assess interprofessional socialisation for both cohorts in Australia., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Ardyansyah et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Combination monoclonal broadly neutralizing antibodies (bnAbs) are currently being developed for preventing HIV-1 acquisition. Recent work has focused on predicting in vitro neutralization potency of both individual bnAbs and combination regimens against HIV-1 pseudoviruses using Env sequence features. To predict in vitro combination regimen neutralization potency against a given HIV-1 pseudovirus, previous approaches have applied mathematical models to combine individual-bnAb neutralization and have predicted this combined neutralization value; we call this the combine-then-predict (CP) approach. However, prediction performance for some individual bnAbs has exceeded that for the combination, leading to another possibility: combining the individual-bnAb predicted values and using these to predict combination regimen neutralization; we call this the predict-then-combine (PC) approach. We explore both approaches in both simulated data and data from the Los Alamos National Laboratory's Compile, Neutralize, and Tally NAb Panels repository. The CP approach is superior to the PC approach when the neutralization outcome of interest is binary (e.g., neutralization susceptibility, defined as inhibitory 80% concentration < 1 μg/mL). For continuous outcomes, the CP approach performs nearly as well as the PC approach when the individual-bnAb prediction algorithms have strong performance, and is superior to the PC approach when the individual-bnAb prediction algorithms have poor performance. This knowledge may be used when building prediction models for novel antibody combinations in the absence of in vitro neutralization data for the antibody combination; this, in turn, will aid in the evaluation and down-selection of these antibody combinations into prevention efficacy trials., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Williamson et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Introduction: Infectious diseases remain the leading causes of death in low and middle-income countries including Ethiopia. The existence of emerging, re-emerging, and drug-resistant infectious agents maximizes the importance of infection prevention and control. Healthcare workers are the key actors in the prevention and control of infection. As a result assessing the knowledge, attitude, and practice of healthcare workers toward infection prevention and control is very critical in the prevention and control of infectious diseases. Therefore, this systematic review and meta-analysis aimed to assess the knowledge, attitude, and practice of healthcare providers toward infection prevention in Ethiopia., Method: PubMed, Scopus, SEMANTIC SCHOLAR, Google Scholar, and Addis Ababa University Digital Library were systematically searched for relevant literature until November 18/2023. The quality of the included studies was assessed using the Joanna Briggs Institute quality appraisal tool. Data were abstracted using a Microsoft Excel spreadsheet and analyzed using STATA version 11. A random-effects model was used to estimate the pooled prevalence. Heterogeneity among reported studies was assessed by Forest plot, Cochran's Q-statistics, and I2 test. Publication bias was checked using funnel plots, and Egger's regression test. In addition, sub-group and sensitivity analyses were conducted., Result: A total of 7,681 articles were retrieved of which 19 studies with 5,650 healthcare workers were included in this systematic review and meta-analysis. About 74.5% (95% CI, 65.88, 83.12), 66.71% (95% CI 55.15, 78.28), and 55.2% (95% CI 48.22, 62.18) of healthcare workers were knowledgeable, had positive attitudes, and good standard of practice on infection prevention respectively., Conclusion: Despite acceptable knowledge and attitude, about half of the healthcare workers have unsafe infection prevention and control practices in Ethiopia. Hence, serious attention should be given to healthcare workers' application of infection prevention standards in their working environment., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Wubneh et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Genome wide association studies (GWAS) have associated thousands of loci with quantitative human blood trait variation. Loci and related genes that impact blood trait variation may regulate blood cell-intrinsic biological processes, or alternatively impact blood cell development and function via systemic factors. Clinical observations have linked tobacco or alcohol use with altered blood traits, but these trait relationships have not been systematically explored at the genetic level. Applying a Mendelian randomization (MR) framework to GWAS summary statistics, we explore relationships between smoking and drinking behaviors with 15 quantitative blood traits. We find that the effects of smoking and drinking are confined to red blood cell traits. An instrumental variable (IV) comprised of 113 single nucleotide polymorphisms (SNPs) associated with smoking initiation is associated with decreased hemoglobin (HGB: Effect = -0.07 standard deviation units [95% confidence interval = -0.03 to -0.10 SD units], P = 1x10-4), hematocrit (HCT: Effect = -0.06 [-0.03 - -0.09] SD units, P = 4x10-4), and red blood cell count (RBC: Effect = -0.05 [-0.02 - -0.09] SD units, P = 5x10-3) without impacting platelet count (P = 0.9) or white blood cell count (P = 0.6). Similarly, an IV associated with an increased number of alcoholic drinks consumed per week is associated with decreased HGB (Effect = -0.22 [-0.42 - -0.02] SD units, P = 3x10-2) and RBC (Effect = -0.27 [-0.51 - -0.03] SD units, P = 3x10-2). Using multivariable MR and causal mediation analyses, we find that an increased genetic predisposition to smoking initiation is associated with increased alcohol intake, and that alcohol use mediates the genetic effect of smoking initiation on red blood cell traits. These findings demonstrate a novel role for genetically influenced behaviors on human blood traits, revealing opportunities to dissect related pathways and mechanisms that influence hematopoiesis and blood cell biology., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Shivakumar et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Monosodium glutamate (MSG) is a widely used food additive with conflicting evidence regarding its potential effects on human health, with proposed relevance for obesity and metabolic syndrome (MetS) or chronic kidney disease. As being able to accurately quantify the MSG dietary intake would help clarify the open issues, we constructed a predictive formula to estimate the daily intake of MSG in a rat model based on the urinary metabolic profile. Adult male Wistar rats were divided into groups receiving different daily amounts of MSG in drinking water (0.5, 1.5, and 3.0 g%), no MSG, and MSG withdrawal after 3.0% MSG treatment for 4 weeks. We then analyzed 24-hour urine samples for chemistries and metabolites using 1H NMR spectrometry and observed a strong correlation between urine pH, sodium, bicarbonate, alpha-ketoglutarate, citrate, fumarate, glutamate, methylamine, N-methyl-4-pyridone-3-carboxamide, succinate, and taurine and the daily MSG intake. Following the multiple linear regression analysis a simple formula model based on urinary Na+, citrate, and glutamate was most accurate and could be validated for estimating daily MSG intake. In conclusion, we propose that the daily MSG intake correlates with urinary metabolites in a rat model and that this new tool for monitoring the impact of MSG on health measures., Competing Interests: The authors have declared that no competing interests exist., (Copyright: This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.)

Brain tumors, characterized by the uncontrolled growth of abnormal cells, pose a significant threat to human health. Early detection is crucial for successful treatment and improved patient outcomes. Magnetic Resonance Imaging (MRI) is the primary diagnostic tool for brain tumors, providing detailed visualizations of the brain's intricate structures. However, the complexity and variability of tumor shapes and locations often challenge physicians in achieving accurate tumor segmentation on MRI images. Precise tumor segmentation is essential for effective treatment planning and prognosis. To address this challenge, we propose a novel hybrid deep learning technique, Convolutional Neural Network and ResNeXt101 (ConvNet-ResNeXt101), for automated tumor segmentation and classification. Our approach commences with data acquisition from the BRATS 2020 dataset, a benchmark collection of MRI images with corresponding tumor segmentations. Next, we employ batch normalization to smooth and enhance the collected data, followed by feature extraction using the AlexNet model. This involves extracting features based on tumor shape, position, shape, and surface characteristics. To select the most informative features for effective segmentation, we utilize an advanced meta-heuristics algorithm called Advanced Whale Optimization (AWO). AWO mimics the hunting behavior of humpback whales to iteratively search for the optimal feature subset. With the selected features, we perform image segmentation using the ConvNet-ResNeXt101 model. This deep learning architecture combines the strengths of ConvNet and ResNeXt101, a type of ConvNet with aggregated residual connections. Finally, we apply the same ConvNet-ResNeXt101 model for tumor classification, categorizing the segmented tumor into distinct types. Our experiments demonstrate the superior performance of our proposed ConvNet-ResNeXt101 model compared to existing approaches, achieving an accuracy of 99.27% for the tumor core class with a minimum learning elapsed time of 0.53 s., Competing Interests: NO authors have competing interests., (Copyright: © 2024 Gunasekaran et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Inadequate menstrual hygiene management can result in physical, social, psychological, and educational challenges for schoolgirls. To address these issues, researchers have conducted intervention studies, but the impact on school attendance has varied. This review has systematically collected and evaluated evidence about the effects of menstrual hygiene interventions on schoolgirls., Method: A systematic search of the literature was done and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA statement). Both peer-reviewed journals and gray literature were searched using PubMed and Google Scholar. The search included individual, or cluster randomized controlled trials, and quasi-experimental studies, and covered the period from the date of indexing until January 3, 2023., Result: A review of sixteen trial studies showed that menstrual hygiene interventions have a positive effect on schoolgirls' school attendance, performance, and dropout rates, as well as on their menstrual knowledge, attitudes, practices, and emotional well-being. There was a low to medium risk of bias in most of the studies. Additionally, the literature overlooked the impact of interventions that involve parental and male engagement, interventions correcting community misperceptions about menstruation, and the impact of infrastructure improvements on water, sanitation, and hygiene., Conclusion: Interventions aimed at improving menstrual hygiene management can enhance schoolgirls' educational outcomes, and can improve their menstrual knowledge, attitudes, and practices by helping them manage their periods more effectively. Most interventions have focused on the provision of menstrual products and menstrual education but have neglected improvements in the physical environment at home and school and the social norms surrounding menstruation. Trial studies should take a holistic approach that considers the total socio-cultural environment in which menstrual hygiene management takes place, thus enabling stakeholders and policymakers to develop sustainable, long-term solutions to these problems., Competing Interests: LLW serves as a non-compensated member of the board of directors of the charity, Dignity Period. The other authors have no competing interests to declare. This does not alter our adherence to PLOS ONE policies on sharing data and materials., (Copyright: © 2024 Betsu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Introduction: The World Health Organization defines women with an unmet need for family planning as individuals who are fecund, sexually active, and wanting to either to limit childbirth or postpone their next birth but are not utilizing any form of contraception. Previous meta-analyses and systematic reviews have focused on this topic, but no comprehensive summary of the evidence was available. Therefore, the aim of this study was to provide a summary of the findings on the unmet need for family planning among reproductive-aged women in Ethiopia., Method: A search was conducted in PubMed, Google Scholar, CINAHL, Scopus, Cochrane Library, and RESEARCH 4 LIFE including Hinari, to identify relevant systematic reviews and meta-analyses of studies on the prevalence and determinants of the unmet need for family planning in Ethiopia. The methodological quality of the included studies was assessed using the Assessment of Multiple Systematic Reviews tool, and the estimates were pooled using a random-effects meta-analysis model., Results: The umbrella review included five studies with a total of 56,169 reproductive-aged women. The pooled prevalence of unmet need for family planning was found to be 27.44% (95% CI: 22.32-32.55), with the heterogeneity index (I square = 99.45%, P = 0.000). Failure to discuss with her partner about family planning methods (OR: 2.90, 95% CI: 1.81, 4.00), being illiterate (OR: 2.17, 95% CI: 1.42, 2.92), age at first marriage (OR: 1.37, 95% CI: 1.30, 1.44), and educational status of woman's partner (OR: 2.61, 95% CI: 0.83, 4.40) were the factors significantly and positively associated with unmet needs for family planning., Conclusion: The study concludes that the unmet need for family planning in Ethiopia is a significant issue that can be addressed through increasing the educational levels of women and their partners, promoting open discussions about family planning, and preventing early marriages. Collaboration between families, school administrators, and healthcare providers is essential to mitigating this problem., Competing Interests: The authors have declared that no competing interests exist, (Copyright: © 2024 Ayele et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Deubiquitinating enzymes (DUBs) play a pivotal role in regulating the antiviral immune response by targeting members of the RLR signaling pathway. As a pivotal member of the RLR pathway, TRAF3 is essential for activating the MAVS/TBK-1/IRF3 signaling pathway in response to viral infection. Despite its importance, the function of DUBs in the TRAF3-mediated antiviral response is poorly understood. Ubiquitin-specific protease 26 (USP26) regulates the RLR signaling pathway to modulate the antiviral immune response. The results demonstrate that EV71 infection upregulates the expression of USP26. Knockdown of USP26 significantly enhances EV71-induced expression of IFN-β and downstream interferon-stimulated genes (ISGs). Deficiency of USP26 not only inhibits EV71 replication but also weakens the host's resistance to EV71 infection. USP26 physically interacts with TRAF3 and reduces the K63-linked polyubiquitination of TRAF3, thereby promoting pIRF3-mediated antiviral signaling. USP26 physically interacts with TRAF3 and reduces the K63-linked polyubiquitination of TRAF3, thereby promoting pIRF3-mediated antiviral signaling. Conversely, knockdown of USP26 leads to an increase in the K63-linked polyubiquitination of TRAF3. These findings unequivocally establish the essential role of USP26 in RLR signaling and significantly contribute to the understanding of deubiquitination-mediated regulation of innate antiviral responses., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Sheng et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Introduction: Participatory health research (PHR) as a research paradigm, guides the research process and strives to achieve positive change in society in the interest of people's health. In this scoping review, PHR will be used as an umbrella term considering a wide range of collaborative research approaches in the health context. PHR is conducted 'with' or 'by' those it intends to benefit, as opposed to 'on' and 'for' them. Their involvement throughout the research process seeks to shift power and decision-making from where they traditionally lay within academia toward community, patient and public end-users. Research cannot be truly participatory without concurrently addressing power dynamics within the partnership and power imbalances in decision making. Therefore, power sharing can be defined as a major factor in building effective academic-community collaborations. This scoping review aims to identify, clarify, and map existing literature on power and power sharing in PHR from both theoretical and practical perspectives. Specifically, we will explore how power is conceptualised throughout the literature, and how power and power sharing are applied and addressed in real-life PHR partnerships., Materials and Methods: This scoping review will be conducted in accordance with the guidelines outlined in the Joanna Briggs Institute (JBI) Reviewer's Manual. This scoping review will consider both empirical and non-empirical research that report on understanding power and power sharing in participatory health research partnerships. All appropriate studies will be retrieved from the following five electronic databases: PubMed, Scopus, Embase, PsycINFO, SocIndex. This review will be limited to articles published in English and from January 1998 to March 2024. As the scoping review aims to capture more than peer-reviewed and published literature, it will also include grey literature such as theses and dissertations, reports, conference proceedings, and editorials. Data from the included literature will be extracted based on the data extraction tool, defined in advance., Ethics and Dissemination: As primary data will not be collected, ethical approval is not required to conduct the scoping review. The findings of this study will be disseminated through peer-reviewed publications., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Burduladze et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Although promising efforts have been made so far, HIV remains a public health concern. Women in Ethiopia are disproportionately affected by HIV, accounting for a majority of new infections and AIDS-related deaths. However, the geospatial distribution of HIV among women in Ethiopia is not well understood, making it challenging to develop geographically targeted measures. Besides, to accelerate the pathway of decreasing HIV prevalence and plan geographically specific interventions, understanding the geospatial distribution of HIV seropositivity and its predictors among women plays a significant role., Methods: A spatial and multiscale geographically weighted regression analysis was conducted using the 2016 EDHS dataset, comprising 14,778 weighted samples of women in the reproductive age group. The EDHS sample underwent two-stage stratification and selection. The data were extracted between October 18 and 30, 2023. Non-spatial analysis was carried out using STATA version 17. Additionally, ArcGIS Pro and Sat Scan version 9.6 were used to visually map HIV seropositivity. Global Moran's I was computed to evaluate the distribution of HIV seropositivity. The Getis-Ord Gi* spatial statistic was utilized to identify significant spatial clusters of cold and hot spot areas. Geographically weighted regression analysis was subsequently performed to identify significant predictors of HIV seropositivity. Significance was established at a P-value <0.05 throughout all statistical analyses., Results: HIV seropositivity among women in Ethiopia is distributed non-randomly (Global Moran's I = 0.16, p-value <0.001 and Z-score = 7.12). Significant hotspot clustering of HIV seropositivity was found in the Addis Ababa, Harari, Dire Dawa, and Gambela region. Poor wealth index, being divorced and widowed, having more than one sexual partner, and early first sexual experience (<15 years) were found to be predictors of geographical variation of HIV seropositivity among women., Conclusion: HIV seropositivity among women in Ethiopia varies geographically. Thus, deploying additional resources in high hotspot regions is recommended. Programs should focus on improving the economic empowerment of women to prevent the from engaging in risky sexual behaviors. Furthermore, comprehensive sex education programs in schools and community settings regarding the consequences of early first sexual debut might play a role in reducing HIV seropositivity among women in Ethiopia., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Kitaw et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Nowadays, federated learning is one of the most prominent choices for making decisions. A significant benefit of federated learning is that, unlike deep learning, it is not necessary to share data samples with the model owner. The weight of the global model in traditional federated learning is created by averaging the weights of all clients or sites. In the proposed work, a novel method has been discussed to generate an optimized base model without hampering its performance, which is based on a genetic algorithm. Chromosome representation, crossover, and mutation-all the intermediate operations of the genetic algorithm have been illustrated with useful examples. After applying the genetic algorithm, there is a significant improvement in inference time and a huge reduction in storage space. Therefore, the model can be easily deployed on resource-constrained devices. For the experimental work, sports data has been used in balanced and unbalanced scenarios with various numbers of clients in a federated learning environment. In addition, we have used four famous deep learning architectures, such as AlexNet, VGG19, ResNet50, and EfficientNetB3, as the base model. We have achieved 92.34% accuracy with 9 clients in the balanced data set by using EfficientNetB3 as the base model using a GA-based approach. Moreover, after applying the genetic algorithm to optimize EfficientNetB3, there is an improvement in inference time and storage space by 20% and 2.35%, respectively., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Fu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Effective breastfeeding is crucial for maternal and child health, particularly in low-resource settings like Ethiopia. It encompasses a range of skills and strategies, including proper latch, positioning, and frequency of feeding. These techniques not only ensure sufficient milk transfer but also foster bonding between mother and child, enhancing the breastfeeding experience. To effectively prioritize maternal and child health, it is crucial to comprehensively understand the prevalence and factors influencing effective breastfeeding nationwide. Therefore, this study aimed to provide a pooled prevalence of effective breastfeeding techniques and associated factors among lactating mothers in Ethiopia., Methods: The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) checklist, focusing on studies conducted in Ethiopia. We identified eight relevant studies through Google Scholar, Medline, PubMed, Scopus, and the Cochrane Library. Analysis was conducted using STATA version 11, and systematic data extraction employed a checklist to extract relevant data. I2 tests and the Cochrane Q test statistic were used to evaluate heterogeneity. To explore potential publication bias, Egger's weighted regression, Begg's test, and a funnel plot were utilized., Results: We identified a total of 955 research articles. Eight studies meeting the eligibility criteria were incorporated into this meta-analysis and systematic review. The pooled prevalence of effective breastfeeding techniques was 41.99% [95% CI 32.16-51.81]. According to the results of the current meta-analysis, effective breastfeeding techniques were significantly associated with antenatal care follow-up [OR = 1.75, 95% CI 1.10-2.78], maternal educational status [OR = 2.70, 95% CI 1.55-4.71], breastfeeding technique counseling [OR = 2.02, 95% CI 1.41-2.90], the absence of breast problems [OR = 2.26, 95% CI 1.49-3.43], breastfeeding experience [OR = 1.98, 95% CI 1.14-3.46], and immediate skin-to-skin contact [OR = 2.32, 95% CI 1.56-3.44]., Conclusion: Our findings highlight the vital role of various factors in shaping effective breastfeeding., Implications: To improve practices and health outcomes, we recommend targeted interventions, such as strengthening antenatal care, implementing maternal education, and providing comprehensive breastfeeding counseling. Proactively addressing breast problems and prioritizing immediate skin-to-skin contact is crucial for successful breastfeeding., Competing Interests: The authors declared that there is no conflict of interest., (Copyright: © 2024 Kitil et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Poor attachment, suckling, and positioning contribute to ineffective breastfeeding techniques. Poor weight gain, stunting, and decreased immunity are caused by insufficient breast milk intake owing to ineffective breastfeeding techniques. Numerous primary studies conducted in Ethiopia have revealed negative effects of ineffective breastfeeding techniques. However, inconsistencies have been observed among these studies, and no review has been conducted to report the amalgamated magnitude and associated factors. Therefore, this review aimed to estimate the national prevalence and factors associated with ineffective breastfeeding techniques in Ethiopia., Methods: Using PRISMA standards, we systematically reviewed and meta-analyzed articles from PubMed, Cochrane Library, and Google Scholar to investigate the prevalence and associated factors of ineffective breastfeeding techniques. Q and I2 tests were used to assess heterogeneity across studies. To evaluate the national prevalence and effect size of the linked covariates, a weighted inverse variance random-effects model was used. Subgroup analysis was performed based on the region, sample size, and year of publication. Funnel plots and Egger's regression tests were used to examine publication bias. A sensitivity analysis was also performed to determine the impact of the studies., Results: The analysis included a total of eleven studies with 4,470 participants used in the analysis. The pooled prevalence of ineffective breastfeeding techniques in Ethiopia was 53.13% (45.49, 60.78) no formal education (AOR = 3.42; 95% CI:1.67-5.18; I2 = 72.2%; P = 0.0132), primipara (AOR = 2.72;95% CI:1.81-3.64; I2 = 46.7%; P = 0.131), postnatal care (PNC) (AOR = 1.84; 95% CI:1.35-2.32; I2 = 0%; P = 0.53), breastfeeding counseling (AOR = 1.93; 95% CI:1.23-2.63; I2 = 0%;P = 0.35), home delivery and having breast problem (AOR = 3.11; 95% CI:1.09-5.16; I2 = 0%;P = 0.877) and (AOR = 2.22; 95% CI:1.28-3.16; I2 = 0%;P = 0.80) respectively were significantly associated with ineffective breastfeeding techniques., Conclusion: The prevalence of ineffective breastfeeding techniques in Ethiopia remains high. Policymakers and program officials should focus on empowering women, increasing institutional delivery, and providing counseling on breastfeeding throughout the maternal continuum of care. These measures will improve breastfeeding techniques and lead to better health of both infants and women., Competing Interests: The authors have declared that no competing interests exist, (Copyright: © 2024 Yilak et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Introduction: Mental fatigue is an early and enduring symptom in persons with autoimmune disease particularly multiple sclerosis (MS). Neuromodulation has emerged as a potential treatment although optimal cortical targets have yet to be determined. We aimed to examine cortical hemodynamic responses within bilateral dorsolateral prefrontal cortex (dlPFC) and frontopolar areas during single and dual cognitive tasks in persons with MS-related fatigue compared to matched controls., Methods: We recruited persons (15 MS and 12 age- and sex-matched controls) who did not have physical or cognitive impairment and were free from depressive symptoms. Functional near infrared spectroscopy (fNIRS) registered hemodynamic responses during the tasks. We calculated oxyhemoglobin peak, time-to-peak, coherence between channels (a potential marker of neurovascular coupling) and functional connectivity (z-score)., Results: In MS, dlPFC demonstrated disrupted hemodynamic coherence during both single and dual tasks, as evidenced by non-significant and negative correlations between fNIRS channels. In MS, reduced coherence occurred in left dorsolateral PFC during the single task but occurred bilaterally as the task became more challenging. Functional connectivity was lower during dual compared to single tasks in the right dorsolateral PFC in both groups. Lower z-score was related to greater feelings of fatigue. Peak and time-to-peak hemodynamic response did not differ between groups or tasks., Conclusions: Hemodynamic responses were inconsistent and disrupted in people with MS experiencing mental fatigue, which worsened as the task became more challenging. Our findings point to dlPFC, but not frontopolar areas, as a potential target for neuromodulation to treat cognitive fatigue., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Baldasso et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

The existence of a shadow economy is recognized as an impediment to sustainable development. By applying the Bayesian approaches, the current article investigates the linkage between financial development, green trade, and the scope of the shadow economy, aiming to contribute to a comprehensive understanding of how these factors address the challenge posed by the shadow economy in Emerging and Growth-Leading Economies (EAGLE) from 2003 to 2016. The results demonstrate that (i) The progress of the financial sector is expected to diminish the scale of the shadow economy. Specifically, the expansion of financial institutions and markets has a strong and negative influence on the shadow economy. (ii) Increased involvement in green trade is likely to result in a decreased shadow economy. Empirical findings provide evidence for effective policymaking in simultaneously promoting sustainable trade practices, strengthening financial systems, and curtailing informal economic activities for inclusive economic development., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Thanh et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Objectives: This study aimed to validate the Collaborative Practice Assessment Tool (CPAT) in the Australian setting and provide a quality instrument in terms of psychometric properties that can be used to measure interprofessional outcomes for both healthcare practitioners and students. The outcomes evaluated include the capacity to work in an interprofessional team, good interprofessional communication skills, leadership skills, ensuring clear division of tasks and roles in a team, effective conflict management, and being actively involved with patients and their families/communities in care., Methods: The COSMIN (COnsensus-based Standards for the selection of health Measurement INstruments) taxonomy and standards were used as guides for evaluating the psychometric properties of the Australian CPAT, which include evaluations regarding instrument development requirements of sample target and size, content validity, internal structure (structural validity, internal consistency reliability and measurement invariance), and hypotheses testing. CPAT Australia was developed through two stages involving pilot studies and a validation study, both of which included healthcare practitioners and students as participants. A pilot study examined content validity regarding item relevance, item comprehensibility, and instrument comprehensiveness. The validation study was carried out to assess the internal structure of CPAT Australia for aspects of structural validity, internal consistency reliabilities, and configural, metric and scalar measurement invariance. The structural validity was explored using the following three steps: exploratory, confirmatory, and multi-group factor analysis. Construct validity was evaluated to confirm direct and indirect paths of assumptions based on a previously validated model. Data collected between August 2021 and May 2022., Results: The content validity evaluation confirmed that all items were relevant, understandable and comprehensive for measuring interprofessional collaborative care in Australia. Three hundred ninety-nine participants contributed to the validation study (n=152 practitioners; n=247 students). The original instrument model of 8-Factor 56-Item was improved in the Australian CPAT. Two items, Item 27 (Physicians assume the ultimate responsibility) and Item 49 (Final decision rest with the physician), were consistently rejected and therefore discarded. The internal structure of the 7-Factor 54-Item solution was confirmed as a suitable model with fit indices meeting COSMIN standards for a good model in practitioner and student cohorts. Configural, metric and scalar invariances were confirmed, indicating the invariance of the instruments when used for the practitioner and student cohorts. The construct validity evaluation indicated that 81.3% of direct and indirect assumptions were accepted, fulfilling the COSMIN requirement of >75% of proposed assumptions being accepted., Conclusion: The Australian CPAT with a 7-factor 54-item solution was confirmed as a quality measure for assessing interprofessional education and collaborative practice for both healthcare practitioners and students in Australia with robust psychometric properties., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Ardyansyah et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Introduction and establishment of non-indigenous species (NIS) has been accelerated on a global scale by climate change. NIS Magallana gigas' (formerly Crassostrea gigas') global spread over the past several decades has been linked to warming waters, specifically during summer months, raising the specter of more spread due to predicted warming. We tracked changes in density and size distribution of M. gigas in two southern California, USA bays over the decade spanning 2010-2020 using randomly placed quadrats across multiple intertidal habitats (e.g., cobble, seawalls, riprap) and documented density increases by 2.2 to 32.8 times at 7 of the 8 sites surveyed across the two bays. These increases in density were coincident with 2-4° C increases in median monthly seawater temperature during summer months, consistent with global spread of M. gigas elsewhere. Size frequency distribution data, with all size classes represented across sites, suggest now-regular recruitment of M. gigas. Our data provide a baseline against which to compare future changes in density and abundance of a globally-spread NIS of significant concern., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Wolfe et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Onasemnogene abeparvovec has been approved for the treatment of spinal muscular atrophy 5q type 1 in several countries, which calls for an independent assessment of the evidence regarding efficacy and safety., Objective: Conduct a meta-analysis to assess the efficacy and safety of onasemnogene abeparvovec in patients diagnosed with SMA type 1, based on the available evidence., Methods: This article results from searches conducted on databases up to November 2022. Outcomes of interest were global survival and event-free survival, improvement in motor function and treatment-related adverse events. Risk of bias assessment and certainty of evidence were performed for each outcome. Proportional meta-analysis models were performed when applicable., Results: Four reports of three open-label, non-comparative clinical trials covering 67 patients were included. Meta-analyses of data available in a 12-month follow-up estimate a global survival of 97.56% (95%CI: 92.55 to 99.86, I2 = 0%, n = 67), an event-free survival of 96.5% (95%CI: 90.76 to 99.54, I2 = 32%, n = 66) and a CHOP-INTEND score ≥ 40 points proportion of 87.28% (95%CI: 69.81 to 97.83, I2 = 69%, n = 67). Proportion of 52.64% (95%CI: 27.11 to 77.45, I2 = 78%, n = 67) of treatment-related adverse events was estimated., Conclusion: The results indicate a potential change in the natural history of type 1 SMA, but the methodological limitations of the studies make the real extent of the technology's long-term benefits uncertain., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Fernandes et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)