Search

BackgroundWashington, DC, and sub-Saharan Africa are both affected by generalized HIV epidemics. However, care for persons living with HIV (PLWH) and clinical outcomes may differ in these geographically and culturally diverse areas. We compared patient and clinical site characteristics among adult persons living with HIV (PLWH) enrolled in two longitudinal HIV cohort studies-the African Cohort Study (AFRICOS) and the DC Cohort.MethodsThe DC Cohort is a clinic-based city-wide longitudinal cohort comprised of PLWH attending 15 HIV clinics in Washington, DC. Patients' socio-demographic characteristics, clinical evaluations, and laboratory data are retrospectively collected from electronic medical records and limited manual chart abstraction. AFRICOS is a prospective observational cohort of PLWH and uninfected volunteers attending 12 select HIV care and treatment facilities in Nigeria, Kenya, Uganda and Tanzania. AFRICOS study participants are a subset of clinic patients who complete protocol-specific visits every 6 months with history and physical examination, questionnaire administration, and blood/sputum collection for ascertainment of HIV outcomes and comorbidities, and neurocognitive and functional assessments. Among participants aged ≥ 18 years, we generated descriptive statistics for demographic and clinical characteristics at enrollment and follow up and compared them using bivariable analyses.ResultsThe study sample included 2,774 AFRICOS and 8,420 DC Cohort participants who enrolled from January 2013 (AFRICOS)/January 2011 (DC Cohort) through March 2018. AFRICOS participants were significantly more likely to be women (58.8% vs 27.1%) and younger (83.3% vs 61.1% aged < 50 years old) and significantly less likely to be MSM (only 0.1% of AFRICOS population reported MSM risk factor) than DC Cohort. Similar rates of current viral suppression (about 75% of both samples), hypertension, hepatitis B coinfection and alcohol use were observed. However, AFRICOS participants had significantly higher rates of CD4ConclusionsWith similar viral suppression outcomes, but many differences between our cohorts noted, the combined sample provides unique opportunities to assess and compare HIV care and treatment outcomes in the U.S. and sub-Saharan Africa. Comparing these two cohorts may inform care and treatment practices and may pave the way for future pathophysiologic analyses.

The DC Cohort is an ongoing longitudinal observational study of persons living with HIV. To better understand HIV-1 drug resistance and potential transmission clusters among these participants, we performed targeted, paired-end next-generation sequencing (NGS) of protease, reverse transcriptase and integrase amplicons. We elected to use free, publicly-available software (HyDRA Web, Stanford HIVdb and HIV-TRACE) for data analyses so that laboratory personnel without extensive bioinformatics expertise could use it; making the approach accessible and affordable for labs worldwide. With more laboratories transitioning away from Sanger-based chemistries to NGS platforms, lower frequency drug resistance mutations (DRMs) can be detected, yet their clinical relevance is uncertain. We looked at the impact choice in cutoff percentage had on number of DRMs detected and found an inverse correlation between the two. Longitudinal studies will be needed to determine whether low frequency DRMs are an early indicator of emerging resistance. We successfully validated this pipeline against a commercial pipeline, and another free, publicly-available pipeline. RT DRM results from HyDRA Web were compared to both SmartGene and PASeq Web; using the Mantel test, R2 values were 0.9332 (p

To characterize the host response to dendritic cell-based immunotherapy and subsequent combined antiretroviral therapy (cART) interruption in HIV-1-infected individuals at the plasma protein level.An autologous dendritic cell (DC) therapeutic vaccine was administered to HIV-infected individuals, stable on cART. The effect of vaccination was evaluated at the plasma protein level during the period preceding cART interruption, during analytical therapy interruption and at viral reactivation. Healthy controls and post-exposure prophylactically treated healthy individuals were included as controls.Plasma marker ('analyte') levels including cytokines, chemokines, growth factors, and hormones were measured in trial participants and control plasma samples using a multiplex immunoassay. Analyte levels were analysed using principle component analysis, cluster analysis and limma. Blood neutrophil counts were analysed using linear regression.Plasma analyte levels of HIV-infected individuals are markedly different from those of healthy controls and HIV-negative individuals receiving post-exposure prophylaxis. Viral reactivation following cART interruption also affects multiple analytes, but cART interruption itself only has only a minor effect. We find that Thyroxine-Binding Globulin (TBG) levels and late-stage neutrophil numbers correlate with the time off cART after DC vaccination. Furthermore, analysis shows that cART alters several regulators of blood glucose levels, including C-peptide, chromogranin-A and leptin. HIV reactivation is associated with the upregulation of CXCR3 ligands.Chronic HIV infection leads to a change in multiple plasma analyte levels, as does virus reactivation after cART interruption. Furthermore, we find evidence for the involvement of TBG and neutrophils in the response to DC-vaccination in the setting of HIV-infection.

Washington DC has a high burden of HIV with a 2.0% HIV prevalence. The city is a national and international hub potentially containing a broad diversity of HIV variants; yet few sequences from DC are available on GenBank to assess the evolutionary history of HIV in the US capital. Towards this general goal, here we analyze extensive sequence data and investigate HIV diversity, phylodynamics, and drug resistant mutations (DRM) in DC.Molecular HIV-1 sequences were collected from participants infected through 2015 as part of the DC Cohort, a longitudinal observational study of HIV+ patients receiving care at 13 DC clinics. Sequences were paired with Cohort demographic, risk, and clinical data and analyzed using maximum likelihood, Bayesian and coalescent approaches of phylogenetic, network and population genetic inference. We analyzed 601 sequences from 223 participants for int (~864 bp) and 2,810 sequences from 1,659 participants for PR/RT (~1497 bp).Ninety-nine and 94% of the int and PR/RT sequences, respectively, were identified as subtype B, with 14 non-B subtypes also detected. Phylodynamic analyses of US born infected individuals showed that HIV population size varied little over time with no significant decline in diversity. Phylogenetic analyses grouped 13.5% of the int sequences into 14 clusters of 2 or 3 sequences, and 39.0% of the PR/RT sequences into 203 clusters of 2-32 sequences. Network analyses grouped 3.6% of the int sequences into 4 clusters of 2 sequences, and 10.6% of the PR/RT sequences into 76 clusters of 2-7 sequences. All network clusters were detected in our phylogenetic analyses. Higher proportions of clustered sequences were found in zip codes where HIV prevalence is highest (r = 0.607; P

We sought to benchmark the quality of HIV care being received by persons living with HIV in care in Washington, DC and identify individual-level and structural-level differences. Data from the DC Cohort, an observational HIV cohort of persons receiving outpatient care in DC, were used to estimate the Institute of Medicine (IOM) and Department of Health and Human Services (HHS) quality of care measures. Differences in care by demographics and clinic type were assessed using χ2 tests and multivariable regression models. Among 8,047 participants, by HHS standards, 69% of participants were retained in care (RIC), 95% were prescribed antiretroviral therapy (ART), and 84% were virally suppressed (VS). By IOM standards, 84% were in continuous care; and 78% and 80% underwent regular CD4 and VL monitoring, respectively. Screening for syphilis, chlamydia, and gonorrhea was 51%, 31%, and 26%, respectively. Older participants were 1.5 times more likely to be RIC compared to younger participants (OR: 1.5; 95% CI: 1.3, 1.8). Participants enrolled in community-based clinics were more likely to be RIC (OR: 1.7; 95% CI: 1.4, 2.0) versus those enrolled at hospital-based clinics. Older participants were more likely to achieve VS than younger participants (OR: 1.8; 95% CI: 1.5, 2.2) while Black participants were less likely compared to white participants (OR: 0.4; 95% CI: 0.3, 0.5). Despite high measures of quality of care, disparities remain. Continued monitoring of the quality of HIV care and treatment can inform the development of public health programs and interventions to optimize care delivery.

Smoking is a potentially causal behavioral risk factor for type 2 diabetes (T2D), but not all smokers develop T2D. It is unknown whether genetic factors partially explain this variation. We performed genome-environment-wide interaction studies to identify loci exhibiting potential interaction with baseline smoking status (ever vs. never) on incident T2D and fasting glucose (FG). Analyses were performed in participants of European (EA) and African ancestry (AA) separately. Discovery analyses were conducted using genotype data from the 50,000-single-nucleotide polymorphism (SNP) ITMAT-Broad-CARe (IBC) array in 5 cohorts from from the Candidate Gene Association Resource Consortium (n = 23,189). Replication was performed in up to 16 studies from the Cohorts for Heart Aging Research in Genomic Epidemiology Consortium (n = 74,584). In meta-analysis of discovery and replication estimates, 5 SNPs met at least one criterion for potential interaction with smoking on incident T2D at p

Current knowledge of the genetic architecture of key reproductive events across the female life course is largely based on association studies of European descent women. The relevance of known loci for age at menarche (AAM) and age at natural menopause (ANM) in diverse populations remains unclear. We investigated 32 AAM and 14 ANM previously-identified loci and sought to identify novel loci in a trans-ethnic array-wide study of 196,483 SNPs on the MetaboChip (Illumina, Inc.). A total of 45,364 women of diverse ancestries (African, Hispanic/Latina, Asian American and American Indian/Alaskan Native) in the Population Architecture using Genomics and Epidemiology (PAGE) Study were included in cross-sectional analyses of AAM and ANM. Within each study we conducted a linear regression of SNP associations with self-reported or medical record-derived AAM or ANM (in years), adjusting for birth year, population stratification, and center/region, as appropriate, and meta-analyzed results across studies using multiple meta-analytic techniques. For both AAM and ANM, we observed more directionally consistent associations with the previously reported risk alleles than expected by chance (p-valuesbinomial≤0.01). Eight densely genotyped reproductive loci generalized significantly to at least one non-European population. We identified one trans-ethnic array-wide SNP association with AAM and two significant associations with ANM, which have not been described previously. Additionally, we observed evidence of independent secondary signals at three of six AAM trans-ethnic loci. Our findings support the transferability of reproductive trait loci discovered in European women to women of other race/ethnicities and indicate the presence of additional trans-ethnic associations both at both novel and established loci. These findings suggest the benefit of including diverse populations in future studies of the genetic architecture of female growth and development.

BackgroundWe compared HbA1c values obtained from capillary blood collection kits versus venous whole blood collections in study participants with type 1 or type 2 diabetes.MethodsA total of 122 subjects, 64 with type 2 diabetes participating in the Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness (GRADE) Study and 58 with type 1 diabetes from the Epidemiology of Diabetes Interventions and Complications (EDIC) Study, participated in the validation study. Capillary tubes were filled by fingerstick by the participants on the same day as the collection of venous whole blood samples in EDTA-containing test tubes and were mailed to the central laboratory. HbA1c in all samples was measured with the same high-performance liquid chromatography. GRADE participants also completed a questionnaire on the ease of performing capillary collections.ResultsParticipants from 22 clinical centers (GRADE n = 5, EDIC n = 17) were between 35 and 86 years of age, with 52% male and diverse race/ethnicities. Venous HbA1c results ranged between 5.4-11.9% (35.5-106.6 mmol/mol) with corresponding capillary results ranging between 4.2-11.9% (22.4-106.6 mmol/mol). The venous and capillary results were highly correlated (R2 = 0.993) and 96.7% differed by ≤0.2% (2.2 mmol/mol). Of participants surveyed, 69% indicated that the instructions and collection were easy to follow and 97% felt the collection method would be easy to do at home.ConclusionsThe capillary blood HbA1c results compared well with the conventional venous whole blood results. The capillary kits can be employed in other studies to reduce interruption of critical data collection and potentially to augment clinical care when in-person visits are not possible.

BackgroundRisk factors for the development of severe COVID-19 disease and death have been widely reported across several studies. Knowledge about the determinants of severe disease and mortality in the Indian context can guide early clinical management.MethodsWe conducted a hospital-based case control study across nine sites in India to identify the determinants of severe and critical COVID-19 disease.FindingsWe identified age above 60 years, duration before admission >5 days, chronic kidney disease, leucocytosis, prothrombin time > 14 sec, serum ferritin >250 ng/mL, d-dimer >0.5 ng/mL, pro-calcitonin >0.15 μg/L, fibrin degradation products >5 μg/mL, C-reactive protein >5 mg/L, lactate dehydrogenase >150 U/L, interleukin-6 >25 pg/mL, NLR ≥3, and deranged liver function, renal function and serum electrolytes as significant factors associated with severe COVID-19 disease.InterpretationWe have identified a set of parameters that can help in characterising severe COVID-19 cases in India. These parameters are part of routinely available investigations within Indian hospital settings, both public and private. Study findings have the potential to inform clinical management protocols and identify patients at high risk of severe outcomes at an early stage.

White blood cells have been shown in animal studies to play a central role in the pathogenesis of diabetic retinopathy. Lymphoblastoid cells are immortalized EBV-transformed primary B-cell leukocytes that have been extensively used as a model for conditions in which white blood cells play a primary role. The purpose of this study was to investigate whether lymphoblastoid cell lines, by retaining many of the key features of primary leukocytes, can be induced with glucose to demonstrate relevant biological responses to those found in diabetic retinopathy.Lymphoblastoid cell lines were obtained from twenty-three human subjects. Differences between high and standard glucose conditions were assessed for expression, endothelial adhesion, and reactive oxygen species.Collectively, stimulation of the lymphoblastoid cell lines with high glucose demonstrated corresponding changes on molecular, cellular and functional levels. Lymphoblastoid cell lines up-regulated expression of a panel of genes associated with the leukocyte-mediated inflammation found in diabetic retinopathy that include: a cytokine (IL-1B fold change = 2.11, p-value = 0.02), an enzyme (PKCB fold change = 2.30, p-value = 0.01), transcription factors (NFKB-p50 fold change = 2.05, p-value = 0.01), (NFKB-p65 fold change = 2.82, p-value = 0.003), and an adhesion molecule (CD18 fold change = 2.59, 0.02). Protein expression of CD18 was also increased (p-value = 2.14x10-5). The lymphoblastoid cell lines demonstrated increased adhesiveness to endothelial cells (p = 1.28x10-5). Reactive oxygen species were increased (p = 2.56x10-6). Significant inter-individual variation among the lymphoblastoid cell lines in these responses was evident (F = 18.70, p < 0.0001).Exposure of lymphoblastoid cell lines derived from different human subjects to high glucose demonstrated differential and heterogeneous gene expression, adhesion, and cellular effects that recapitulated features found in the diabetic state. Lymphoblastoid cells may represent a useful tool to guide an individualized understanding of the development and potential treatment of diabetic complications like retinopathy.

Type 1 diabetes (T1DM) patients are at increased risk of coronary artery disease (CAD). This pilot study sought to evaluate the relationship between epicardial adipose tissue (EAT) and intra-thoracic adipose tissue (IAT) volumes and cardio-metabolic risk factors in T1DM.EAT/IAT volumes in 100 patients, underwent non-contrast cardiac computed tomography in the Diabetes Control and Complications Trial /Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) study were measured by a certified reader. Fat was defined as pixels' density of -30 to -190 Hounsfield Unit. The associations were assessed using-Pearson partial correlation and linear regression models adjusted for gender and age with inverse probability sample weighting.The weighted mean age was 43 years (range 32-57) and 53% were male. Adjusted for gender, Pearson correlation analysis showed a significant correlation between age and EAT/IAT volumes (both p

Implementation of multicenter and/or longitudinal studies requires an effective quality assurance program to identify trends, data inconsistencies and process variability of results over time. The Diabetes Control and Complications Trial (DCCT) and the follow-up Epidemiology of Diabetes Interventions and Complications (EDIC) study represent over 30 years of data collection among a cohort of participants across 27 clinical centers. The quality assurance plan is overseen by the Data Coordinating Center and is implemented across the clinical centers and central reading units. Each central unit incorporates specific DCCT/EDIC quality monitoring activities into their routine quality assurance plan. The results are reviewed by a data quality assurance committee whose function is to identify variances in quality that may impact study results from the central units as well as within and across clinical centers, and to recommend implementation of corrective procedures when necessary. Over the 30-year period, changes to the methods, equipment, or clinical procedures have been required to keep procedures current and ensure continued collection of scientifically valid and clinically relevant results. Pilot testing to compare historic processes with contemporary alternatives is performed and comparability is validated prior to incorporation of new procedures into the study. Details of the quality assurance plan across and within the clinical and central reading units are described, and quality outcomes for core measures analyzed by the central reading units (e.g. biochemical samples, fundus photographs, ECGs) are presented.

Refractive error (RE) is a complex, multifactorial disorder characterized by a mismatch between the optical power of the eye and its axial length that causes object images to be focused off the retina. The two major subtypes of RE are myopia (nearsightedness) and hyperopia (farsightedness), which represent opposite ends of the distribution of the quantitative measure of spherical refraction. We performed a fixed effects meta-analysis of genome-wide association results of myopia and hyperopia from 9 studies of European-derived populations: AREDS, KORA, FES, OGP-Talana, MESA, RSI, RSII, RSIII and ERF. One genome-wide significant region was observed for myopia, corresponding to a previously identified myopia locus on 8q12 (p = 1.25×10(-8)), which has been reported by Kiefer et al. as significantly associated with myopia age at onset and Verhoeven et al. as significantly associated to mean spherical-equivalent (MSE) refractive error. We observed two genome-wide significant associations with hyperopia. These regions overlapped with loci on 15q14 (minimum p value = 9.11×10(-11)) and 8q12 (minimum p value 1.82×10(-11)) previously reported for MSE and myopia age at onset. We also used an intermarker linkage- disequilibrium-based method for calculating the effective number of tests in targeted regional replication analyses. We analyzed myopia (which represents the closest phenotype in our data to the one used by Kiefer et al.) and showed replication of 10 additional loci associated with myopia previously reported by Kiefer et al. This is the first replication of these loci using myopia as the trait under analysis. "Replication-level" association was also seen between hyperopia and 12 of Kiefer et al.'s published loci. For the loci that show evidence of association to both myopia and hyperopia, the estimated effect of the risk alleles were in opposite directions for the two traits. This suggests that these loci are important contributors to variation of refractive error across the distribution.

To identify loci affecting the electrocardiographic QT interval, a measure of cardiac repolarisation associated with risk of ventricular arrhythmias and sudden cardiac death, we conducted a meta-analysis of three genome-wide association studies (GWAS) including 3,558 subjects from the TwinsUK and BRIGHT cohorts in the UK and the DCCT/EDIC cohort from North America. Five loci were significantly associated with QT interval at P

Introduction: There is a worldwide dearth in literature on the nature, causes, and consequences of structural stigma in mental healthcare. This study aimed to address this gap by exploring key components for measuring structural stigma in healthcare system settings., Methods: We used a modified Delphi method consisting of 3 rounds with global experts (stigma researchers, persons with lived experiences of mental health conditions (PWLEs), and policymakers). In the first round, indicators identified through a literature review (n = 39 studies) were appraised through expert consultation workshops with 22 panellists, including 54.5% women, 41% PWLEs, and 68.2% from low-and-middle income countries (LMICs). Round 2 (n = 53 panellists; 51% women, 8.3% PWLEs, and 56.6% from LMICs) involved ranking indicators through an online survey, and Round 3 (n = 58 panellists; 46% women, 21.7% PWLEs, and 60.4% from LMICs) involved re-ranking the results from Round 2. Smith's salience index was calculated to measure consensus and Kendall's coefficient of concordance to determine the degree of agreement. Narrative opinions and feedback from panellists during all three Delphi rounds were also sought., Results: A list of indicators within five core measurement domains was identified in Round 1. Round 2 results were heterogeneous as indicated by the low to moderate salience of most indicators. Round 3 resulted in 4-5 indicators in each domain, that were ranked as highly salient by the expert panellists. Experts also provided narrative feedback on the definition of structural stigma, barriers to its measurement, domain-specific comments, and indicators-specific comments., Conclusion: The framework aids in defining mental health-related structural stigma in healthcare and framing it in terms of inequities within healthcare system structures. These structures result in negative experiences of PWLEs and limit their access to quality healthcare. This conceptualization, informed by PWLE and stakeholders in LMICs, makes it easier to measure structural stigma and monitor changes in diverse healthcare settings around the world., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2025 Gurung 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: Cardiopulmonary resuscitation (CPR) is an evidence-based intervention that saves lives. In low- and middle-income countries like Nepal, the occurrence of the problem and its outcome are seldom studied. The study aims to highlight the prevalence, performance, and outcome of CPR in government hospitals of Nepal., Methods: A mixed method study was done for two months in central and provincial government hospitals of Nepal. A total of 80 resuscitations were evaluated using a questionnaire based on the American Heart Association 2020 guidelines for cardiopulmonary resuscitation. An in-depth interview was conducted with 15 active participants of the resuscitation in different sites. Thematic analysis was done using the framework of the chain of survival of arrest victims., Results: The overall prevalence of CPR was found to be 1.92% [95% CI: 0.01,0.02] with 5.4% in central hospitals and 0.65% in provincial hospitals with 60% cardiac arrests occurring in the intensive care unit. Estimated time from recognition of the arrest to initiating CPR was 1.9 ±1.4 minutes. Asystole 66.25% was the commonest arrest rhythm and 21.25% had difficulty interpreting rhythm. Only 11.25% of the victims had return of spontaneous circulation and were subsequently transferred for post-arrest care. The qualitative analysis highlighted the lack of trained staff, a dedicated system, feedback mechanism, and provision of post-arrest care., Conclusion: Across various level of Nepal's healthcare system, cardiopulmonary resuscitation is prevalent with poor performance and outcome. To improve outcomes, it is essential to implement standardized procedures and ensure high quality resuscitation delivery before and after the event supported by well-trained healthcare personnel and adequate infrastructure., Competing Interests: The authors have declared that no competing interest exist., (Copyright: © 2025 Hamal 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.)

Relationships between parasites, host physiology, and behaviours are complex. Parasites can influence host hormonal microenvironment and behaviour through "sickness behaviours" that generally conserve energy. Using a parasite removal experiment, we examined the effects of gastrointestinal parasites on fecal glucocorticoid metabolites (fGC) and behaviours of vervet monkeys (Chlorocebus pygerythrus) at Lake Nabugabo, Uganda. We collected parasitological, hormonal, and behavioural data from adult and subadult male and female vervets (N = 19) in 2014 across four study phases: pre-deworming, post-deworming, early reinfection, and late reinfection as well as in 2015. Overall, there was no decrease in fGC after deworming, but there was an increase following natural reinfection. There was no change in feeding across study phases; however, moving, grooming, and resting changed between the post-deworming and late reinfection phases, but not always in the predicted direction. Comparing behaviour across the same months in the following year as in the 2014 experimental study period, we found no differences in moving, feeding, grooming, and resting events. Despite behavioural variation between study phases, we cannot conclude that behavioural changes are due to parasitism rather than other seasonal variation. However, fGC increased following reinfection, which is consistent with parasitism being costly for hosts., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2025 Upadhayay 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.)

Soybean [Glycine max (L.) Merrill] is one of the most widely grown legumes in the world, with Brazil being its largest producer and exporter. Breeding programs in Brazil have resulted from multiple cycles of selection and recombination starting from a small number of USA cultivar ancestors in the 1950s and 1960s years. This process has led to the successful adaptation of this crop to tropical conditions, a phenomenon known as tropicalization. Many studies describe a narrow genetic background in Brazilian soybean cultivars. Various factors can affect the genetic diversity in species, especially in cultivated crops, such as the reproduction type, artificial selection, and the number and sources of variability in the breeding programs. In turns, the genetic diversity can affect the linkage disequilibrium blocks (LD) patterns and, consequently, molecular breeding strategies for selection of target loci for agronomic traits. We used high-throughput genotyping with SoySNP50K Illumina SNP markers to assess a collection of 370 Brazilian soybean accessions covering more than 60 years of soybean breeding in Brazil. Our goal was to investigate population structure and genetic diversity in the Brazilian germplasm, detect patterns of LD blocks, and identify regions presenting signals of selective swaps linked with quantitative trait loci (QTLs) of agronomic interest. Population structure analysis revealed two major groups among all genotypes, primarily differentiated by the year of release, separating old and new cultivars (before and after 2000´s years), and by growth habit (stem termination type-SST). The group I comprises about 75% of the panel and includes cultivars release before 2000`s years, including the oldest cultivars released in Brazil, most of which exhibit a determinate growth habit and maturity groups VI and VII. Group II includes only 83 materials, but shows higher levels of diversity than group I, representing most recent introductions in Brazilian germplasm. Further analysis of substructure within Group I, identified seven subgroups with no clear trend for segregation based on maturity group, STT or year of release. Instead, these subgroups were based on the contribution of key donors of disease resistance and adaptability, as soybean cultivation expanded from the South to Central region of Brazil. This finding is consistent with the history of soybean expansion in Brazil. We identified 123 genomic regions under selection among the groups of Brazilian cultivars associated with 440 quantitative trait loci (QTLs), revealing regions fixed across the breeding process associated with yield, disease resistance, water efficiency use, and others., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2025 Silva 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 Facial Action Coding System (FACS) is an objective observation tool for measuring human facial behaviour. It avoids subjective attributions of meaning by objectively measuring independent movements linked to facial muscles, called Action Units (AUs). FACS has been adapted to 11 other taxa, including most apes, macaques and domestic animals, but not yet gorillas. To carry out cross species studies of facial expressions within and beyond apes, gorillas need to be included in such studies. Hence, we developed the GorillaFACS for the Gorilla spp. We followed similar methodology as previous FACS: First, we examined the facial muscular plan of the gorilla. Second, we analysed gorilla videos in a wide variety of contexts to identify their spontaneous facial movements. Third, we classified the individual facial movements according to appearance changes produced by the corresponding underlying musculature. A diverse repertoire of 42 facial movements was identified in the gorilla, including 28 AUs and 14 Action Descriptors, with several new movements not identified in the HumanFACS. Although some of the movements in gorillas differ from humans, the total number of AUs is comparable to the HumanFACS (32 AUs). Importantly, the gorilla's range of facial movements was larger than expected, suggesting a more relevant role in social interactions than what was previously assumed. GorillaFACS is a scientific tool to measure facial movements, and thus, will allow us to better understand the gorilla's expressions and communication. Furthermore, GorillaFACS has the potential be used as an important tool to evaluate this species welfare, particularly in settings of close proximity to humans., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2025 Correia-Caeiro 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.)

Colombia currently hosts nearly three million Venezuelan refugees and migrants and is home to seven million internally displaced Colombians. For forcibly displaced populations in Colombia, and especially for women, gender-based violence (GBV) poses a threat during transit and in their new homes where xenophobia, lack of accessible and adequate services, limited safe economic opportunities, and lack of information on access to services, further increase risk. The dearth of livelihood opportunities also affects forcibly displaced populations, especially women. This study will conduct a randomized-controlled trial (RCT) of HIAS' Entrepreneurship School with Gender Lens (ESGL), a program that targets forcibly displaced GBV survivors and women at-risk to help them develop business ideas, access needed support for the prevention of and response to GBV, and improve overall self-reliance. The RCT will be conducted within three cities in Colombia; approximately 80 eligible participants will be enrolled in each city and randomized to a treatment or control arm. Survey questionnaires will be administered to participants at baseline, eight months following baseline (endline), and 3-4 months after endline. Outcomes of interest include household self-reliance, mental health, resilience, empowerment, utilization of GBV services, and social support., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2025 Stark 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.)

A methodology is proposed, which addresses the caveat that line-of-sight emission spectroscopy presents in that it cannot provide spatially resolved temperature measurements in non-homogeneous temperature fields. The aim of this research is to explore the use of data-driven models in measuring temperature distributions in a spatially resolved manner using emission spectroscopy data. Two categories of data-driven methods are analyzed: (i) Feature engineering and classical machine learning algorithms, and (ii) end-to-end convolutional neural networks (CNN). In total, combinations of fifteen feature groups and fifteen classical machine learning models, and eleven CNN models are considered and their performances explored. The results indicate that the combination of feature engineering and machine learning provides better performance than the direct use of CNN. Notably, feature engineering, which is comprised of physics-guided transformation, signal representation-based feature extraction and Principal Component Analysis is found to be the most effective. Moreover, it is shown that when using the extracted features, the ensemble-based, light blender learning model offers the best performance with RMSE, RE, RRMSE and R values of 64.3, 0.017, 0.025 and 0.994, respectively. The proposed method, based on feature engineering and the light blender model, is capable of measuring nonuniform temperature distributions from low-resolution spectra, even when the species concentration distribution in the gas mixtures is unknown., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2025 Kang 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.)

Trade in wood and forest products spans the global supply chain. Illegal logging and associated trade in forest products present a persistent threat to vulnerable ecosystems and communities. Illegal timber trade has been linked to violations of tax and conservation laws, as well as broader transnational crimes. The United States is the largest importer globally of wood and forest products, such as pulp, paper, flooring, and furniture-importing $78 billion in 2021. Transaction-level data such as shipping container manifests and bills of lading provide a comprehensive data source that can be used to detect and disrupt trade that may be suspected of containing illegally harvested or traded forest products. Owing to the volume, velocity, and complexity of shipment data, an automated decision support system is required for the purposes of detecting suspicious forest product shipments. We present a proof of concept framework using machine learning and big data approaches-combining domain expertise with automation-to achieve this objective. We formulated the underlying machine learning problem as an anomaly detection problem and collected and collated forest sector-specific domain knowledge to filter and target shipments of interest. In this work, we provide the overview of our framework, with the details of domain knowledge extraction and machine learning models, and discuss initial results and analysis of flagged anomalous and potentially suspicious records to demonstrate the efficacy of this approach. The proof of concept work presented here provides the groundwork for an actionable and feasible approach to assisting enforcement agencies with the detection of suspicious shipments that may contain illegally harvested or traded wood., Competing Interests: We have the following interests: Funders (WWF) contracted one of the authors, JS, who is the sole employee at Simeone Consulting, LLC, to help execute the study. There are no patents, products in development or marketed products to declare. This does not alter our adherence to all the PLOS ONE policies on sharing data and materials., (Copyright: © 2025 Datta 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.)

Petroleum hydrocarbon pollution causes significant damage to soil, so accurate prediction and early intervention are crucial for sustainable soil management. However, traditional soil analysis methods often rely on statistical methods, which means they always rely on specific assumptions and are sensitive to outliers. Existing machine learning based methods convert features containing spatial information into one-dimensional vectors, resulting in the loss of some spatial features of the data. This study explores the application of Three-Dimensional Convolutional Neural Networks (3DCNN) in spatial interpolation to evaluate soil pollution. By introducing Channel Attention Mechanism (CAM), the model assigns different weights to auxiliary variables, improving the prediction accuracy of soil hydrocarbon content. We collected soil pollution data and validated the spatial distribution map generated using this method based on the drilling dataset. The results indicate that compared with traditional Kriging3D methods (R2 = 0.318) and other machine learning methods such as support vector regression (R2 = 0.582), the proposed 3DCNN based method can achieve better accuracy (R2 = 0.954). This approach provides a sustainable tool for soil pollution management, supports decision-makers in developing effective remediation strategies, and promotes the sustainable development of spatial interpolation techniques in environmental science., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2025 Miao 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: Accurate assessment of cardiovascular disease (CVD) risk is crucial for effective prevention and resource allocation. However, few CVD risk estimation tools consider social determinants of health (SDoH), despite their known impact on CVD risk. We aimed to estimate 10-year CVD risk in the Eastern Caribbean Health Outcomes Research Network Cohort Study (ECS) across multiple risk estimation instruments and assess the association between SDoH and CVD risk., Methods: Five widely used CVD risk estimation tools (Framingham and WHO laboratory, both laboratory and non-laboratory-based, and ASCVD) were applied using data from ECS participants aged 40-74 without a history of CVD. SDoH variables included educational attainment, occupational status, household food security, and perceived social status. Multivariable logistic regression models were used to compare differences in the association between selected SDoH and high CVD risk according to the five instruments., Findings: Among 1,777 adult participants, estimated 10-year CVD risk varied substantially across tools. Framingham non-lab and ASCVD demonstrated strong agreement in categorizing participants as high risk. Framingham non-lab categorized the greatest percentage as high risk, followed by Framingham lab, ASCVD, WHO lab, and WHO non-lab. Fifteen times more people were classified as high risk by Framingham non-lab compared with WHO non-lab (31% vs 2%). Mean estimated 10-year risk in the sample was over 2.5 times higher using Framingham non-lab vs WHO non-lab (17.3% vs 6.6%). We found associations between food insecurity, those with the lowest level compared to the highest level of education, and non-professional occupation and increased estimated CVD risk., Interpretation: Our findings highlight significant discrepancies in CVD risk estimation across tools and underscore the potential impact of incorporating SDoH into risk assessment. Further research is needed to validate and refine existing risk tools, particularly in ethnically diverse populations and resource-constrained settings, and to develop race- and ethnicity-free risk estimation models that consider SDoH., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2025 Schwartz 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.)

Diabetes, a chronic condition affecting millions worldwide, necessitates early intervention to prevent severe complications. While accurately predicting diabetes onset or progression remains challenging due to complex and imbalanced datasets, recent advancements in machine learning offer potential solutions. Traditional prediction models, often limited by default parameters, have been superseded by more sophisticated approaches. Leveraging Bayesian optimization to fine-tune XGBoost, researchers can harness the power of complex data analysis to improve predictive accuracy. By identifying key factors influencing diabetes risk, personalized prevention strategies can be developed, ultimately enhancing patient outcomes. Successful implementation requires meticulous data management, stringent ethical considerations, and seamless integration into healthcare systems. This study focused on optimizing the hyperparameters of an XGBoost ensemble machine learning model using Bayesian optimization. Compared to grid search XGBoost (accuracy: 97.24%, F1-score: 95.72%, MCC: 81.02%), the XGBoost with Bayesian optimization achieved slightly improved performance (accuracy: 97.26%, F1-score: 95.72%, MCC:81.18%). Although the improvements observed in this study are modest, the optimized XGBoost model with Bayesian optimization represents a promising step towards revolutionizing diabetes prevention and treatment. This approach holds significant potential to improve outcomes for individuals at risk of developing diabetes., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2025 Khurshid 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.)

Food insecurity (FI), the lack of access to adequate food, is linked with negative health and psychological outcomes. FI is typically measured retrospectively over the last year; although this measurement is useful to understand FI prevalence to inform broad policy, it leaves the experience of FI in everyday life poorly understood. Understanding how FI varies across shorter periods of time (days or weeks) can help inform FI prevention and/or intervention. This study characterizes within-person (day-to-day) variance in FI in everyday life. Low-income parents of school-aged children at risk for FI (n = 153) completed daily text message surveys in two-week bursts. Daily FI was measured with 4 yes/no items ranging in severity: worry about food, parent eating less than they should, child eating less than they should, and skipping meals. Items were analyzed as a sum score and individually (to examine FI severity). Among parents who reported FI at least once, FI meaningfully varied day-to-day within individuals (~26% of variation). Different indicators of FI, however, had different proportions of between- and within-person variability: Worry about food, a less severe aspect of FI, had 32% daily variation, whereas the more severe aspect of meal skipping had 45% daily variation. Thus, although substantial between-person differences in FI exist, there is meaningful within-person variability in FI. -person FI variability may be related to the indicator (e.g., severe FI shows greater within-person variability). Considering within-person FI variability, and not just average FI level, may help us understand how FI undermines functioning and how and when best to intervene., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2025 Hines 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.)

Disruption of host-associated microbial communities can have detrimental impacts on host health. However, the capacity of individual host-associated microbial communities to resist disturbance has not been well defined. Using a novel fecal sampling method for honey bees (Apis mellifera), we examined the resistance of the honey bee gut microbiome to disruption from a low dose of the antibiotic, tetracycline (4.5 μg). Prior to the experiment, bacterial communities from fecal samples were compared to communities from dissected whole guts of the same individuals to ensure fecal samples accurately represented the gut microbiome. Fecal samples were collected from lab-caged honey bees prior to, and five days after, tetracycline exposure to assess how antibiotic disturbance affected the communities of individuals. We used metrics of alpha and beta diversity calculated from 16S rRNA gene amplicon sequences to compare gut community structure. Low dose tetracycline exposure did not consistently change honey bee gut microbiome structure, but there was individual variation in response to exposure and specific taxa (one ASV assigned to Lactobacillus kunkeei and one ASV in the genus Bombella) were differentially abundant following tetracycline treatment. To assess whether individual variation could be influenced by the presence of tetracycline resistance genes, we quantified the abundance of tet(B) and tet(M) with qPCR. The abundance of tet(M) prior to tetracycline treatment was negatively correlated with change in community membership, assessed by difference in Jaccard dissimilarity over the five-day experiment. Our results suggest that the honey bee gut microbiome has some ability to resist or recover from antibiotic-induced change, specific taxa may vary in their susceptibility to tetracycline exposure, and antibiotic resistance genes may contribute to gut microbiome resistance., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2025 Gregory 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.)

1. Analysis of co-occurrence data with traditional indices has led to many problems such as sensitivity of the indices to prevalence and the same value representing either a strong positive or strong negative association across different datasets. In our recent study (Mainali et al 2022), we revealed the source of the problems that make the traditional indices fundamentally flawed and unreliable-namely that the indices in common use have no target of estimation quantifying degree of association in the non-null case-and we further developed a novel parameter of association, alpha, with complete formulation of the null distribution for estimating the mechanism of affinity. We also developed the maximum likelihood estimate (MLE) of alpha in our previous study. 2. Here, we introduce the CooccurrenceAffinity R package that computes the MLE for alpha. We provide functions to perform the analysis based on a 2×2 contingency table of occurrence/co-occurrence counts as well as a m×n presence-absence matrix (e.g., species by site matrix). The flexibility of the function allows a user to compute the alpha MLE for entity pairs on matrix columns based on presence-absence states recorded in the matrix rows, or for entity pairs on matrix rows based on presence-absence recorded in columns. We also provide functions for plotting the computed indices. 3. As novel components of this software paper not reported in the original study, we present theoretical discussion of a median interval and of four types of confidence intervals. We further develop functions (a) to compute those intervals, (b) to evaluate their true coverage probability of enclosing the population parameter, and (c) to generate figures. 4. CooccurrenceAffinity is a practical and efficient R package with user-friendly functions for end-to-end analysis and plotting of co-occurrence data in various formats, making it possible to compute the recently developed metric of alpha MLE as well as its median and confidence intervals introduced in this paper. The package supplements its main output of the novel metric of association with the three most common traditional indices of association in co-occurrence data: Jaccard, Sørensen-Dice, and Simpson., 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.)

Among the factors, such as emotions, that distort time perception, vestibular stimulation causes a contraction in subjective time. Unlike emotions, the intensity of vestibular stimulation can be easily and precisely modified, making it possible to study the quantitative relationship between stimulation and its effect on time perception. We hypothesized that the contraction of subjective time would increase with the vestibular stimulation magnitude. In the first experiment, participants sat on a rotatory chair and reproduced time intervals between the start and the end of whole-body passive rotations (40° or 80°; dynamic condition) or between two consecutive low-amplitude shakes (static condition). We also assessed reaction time under the same conditions to evaluate the attentional effect of the stimuli. As expected, duration reproduction in the 40° rotation was shorter than that observed in the static condition, but this effect was partly reversed for 80° rotations. In other words, vestibular stimulation shortens the perceived time interval, but this effect weakens with stronger stimulation. Attentional changes do not explain this unexpected result, as reaction time did not change between conditions. We hypothesized that the space-time interaction (i.e., spatially larger stimuli are perceived as lasting longer) could explain these findings. To assess this, in a second experiment participants were subjected to the same protocol but with three rotation amplitudes (30°, 60°, and 120°). The duration reproductions were systematically shorter for the lower amplitudes than for the higher amplitudes; so much so that for the highest amplitude (120°), the duration reproduction increased so that it did not differ from the static condition. Overall, the experiments show that whole-body rotation can contract subjective time, probably at the rather low level of the interval timing network, or dilate it, probably at a higher level via the space-time interaction., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2025 Navarro Morales 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.)

Testosterone, an essential sex steroid hormone, influences brain health by impacting neurophysiology and neuropathology throughout the lifespan in both genders. However, human research in this area is limited, particularly in women. This study examines the associations between testosterone levels, gray matter volume (GMV) and cerebral blood flow (CBF) in midlife individuals at risk for Alzheimer's disease (AD), according to sex and menopausal status. A cohort of 294 cognitively normal midlife participants, 83% female, ages 35-65 years, with an AD family history and/or Apolipoprotein E epsilon 4 (APOE-4) genotype, underwent volumetric Magnetic Resonance Imaging (MRI) to measure GMV and MR-Arterial Spin Labeling (ASL) for measurement of CBF. We used voxel-based analysis and volumes of interest to test for associations between testosterone (both total and free testosterone) and brain imaging outcomes, stratified by sex and menopausal status. Higher total and free testosterone levels were associated with larger GMV in men, with peak effects in frontal and temporal regions. Conversely, in women, higher testosterone levels correlated with higher CBF, with peak effects in frontal and limbic regions, subcortical areas and hypothalamus. Among women, associations between testosterone and GMV were observed at the premenopausal and perimenopausal stages, but not postmenopause, whereas associations of testosterone with CBF were significant starting at the perimenopausal stage and were more pronounced among hormone therapy non-users. Results were independent of age, APOE-4 status, midlife health indicators, and sex hormone-binding globulin levels. These findings indicate sex-specific neurophysiological effects of testosterone in AD-vulnerable regions in midlife individuals at risk for AD, with variations observed across sex and menopausal status. This underscores the need for further research focusing on the neuroprotective potential of testosterone in both sexes., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2025 Nerattini 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.)

Genomics is an increasingly important part of biology research. However, educating undergraduates in genomics is not yet a standard part of life sciences curricula. We believe this is, in part, due to a lack of standard concepts for the teaching of genomics. To address this deficit, the members of the Genomics Education Alliance created a set of genomics concepts that was then further refined by input from a community of undergraduate educators who engage in genomics instruction. The final genomics concepts list was compared to existing learning frameworks, including the Vision and Change initiative (V&C), as well as ones for genetics, biochemistry and molecular biology, and bioinformatics. Our results demonstrate that the new genomics framework fills a niche not addressed by previous inventories. This new framework should be useful to educators seeking to design stand-alone courses in genomics as well as those seeking to incorporate genomics into existing coursework. Future work will involve designing curriculum and assessments to go along with this genomics learning framework., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2025 Reed 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.)

Tequila bats (genus Leptonycteris) have gained attention for their critical role in pollinating different plant species, especially Agave spp. and columnar cacti. Leptonycteris nivalis is the largest nectar-feeding bat in the Americas, and the females exhibit migratory behavior during the breeding season. Due to its relatively small and seemingly declining population sizes, this species is protected by government agencies in the United States and Mexico. We conducted population genetics and phylogeographic analyses to elucidate the genetic structure and demographic history of the species using two mitochondrial markers and a Y chromosome-associated gene, to describe both maternal and paternal lineages. We estimated high haplotypic diversity measures for the different markers (Dloop-Hd = 0.775; Cyt-b-Hd = 0.937; DBY -Hd = 0.946). We found that geographic genetic differentiation is very low, and there is high connectivity among localities. The estimated divergence time between L. nivalis and L. yerbabuenae, the other species in the genus found in Mexico, aligns with previous estimates for the genus (6.91-9.43 mya). A demographic expansion was detected approximately at 600 ka-700 ka (thousands of years ago). The historical demographic changes observed in L. nivalis appear to be associated with environmental shifts during the Pleistocene, which likely impacted the distribution range of the plants that these bats feed on, such as Agave species., Competing Interests: he authors have declared that no competing interests exist., (Copyright: © 2025 Trejo-Salazar 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: Treadmill belt perturbations have high clinical feasibility for use in perturbation-based training in older people, but their kinematic validity is unclear. This study examined the kinematic validity of treadmill belt accelerations as a surrogate for overground walkway trips during gait in older people., Methods: Thirty-eight community-dwelling older people were exposed to two unilateral belt accelerations (8 m s-2) whilst walking on a split-belt treadmill and two trips induced by a 14 cm trip-board whilst walking on a walkway with condition presentation randomised. Anteroposterior margin of stability (MoS), number of falls, and trunk and lower limb kinematics were quantified for the step prior and five recovery steps following the treadmill perturbations and the walkway trips which elicited elevating and lowering strategies., Findings: Rates of falls following the treadmill accelerations and walkway trips were 0% and 13.1%, respectively. MoS was similar during the first recovery step (P>0.05) but less negative during subsequent recovery steps following treadmill belt accelerations than walkway trips (P<0.01) regardless of recovery strategy. Excluding the first recovery step in the lowering strategy, recovery step lengths, toe clearance, maximum trunk, hip and knee angles (P<0.05) were smaller during recovery on the treadmill compared to the walkway., Interpretation: Destabilisation by treadmill belt accelerations quickly dissipated after only one recovery step but continued for multiple recovery steps following walkway trips. Smaller trunk displacement, step lengths, toe clearance and no falls on the treadmill indicate treadmill belt accelerations may not accurately simulate the biomechanical challenge of obstacle-induced trips in older people., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2025 Jung 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.)

Marine protected areas (MPAs) are widely used to conserve and manage coastal resources. Protected areas are governed by a variety of institutional arrangements, yet little is known concerning the relative performance of different governance approaches. This research draws upon a unique dataset that combines details on the reported International Union for Conservation of Nature (IUCN) governance categories of 217 global MPAs and their ecological outcomes to compare the performance of alternative governance arrangements. We find that MPAs with shared governance arrangements, where management authority is shared among multiple government and non-government actors, are 98% more likely to have higher fish biomass than MPAs governed by state agencies (i.e., primarily government) alone (mean effect size and 95% C.I = 0.32 ± 0.31). We also find higher biomass in older MPAs, those in countries with higher gross domestic product (GDP), and those with a higher proportion of no-take area. With targets to protect 30% of our oceans driving new commitments to expand MPA coverage globally, our results suggest that multi-stakeholder participation and collaboration facilitated by shared and decentralized governance arrangements can play an important role in achieving conservation outcomes., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2025 Mast 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: Ethiopia has made notable progress in reducing maternal and perinatal mortality, yet challenges remain in meeting the 2030 Sustainable Development Goals. Persistent issues such as low service utilization, coupled with poor quality, fragmented care, and ineffective referral systems hinder progress. The "Improve Primary Health Care Service Delivery (IPHCSD)" project, implemented by JSI and Amref Health Africa since April 2022, seeks to address these gaps through a Networks of Care (NoCs) approach. This paper describes the lessons learned from implementing the NoCs approach to optimize primary health care in Ethiopia., Methods: The project incorporates embedded implementation science, guided by the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework. Key implementation strategies co-designed included strengthening community engagement, establishing NoCs, and introducing quality improvement initiatives using the Model for Improvement. Routine program monitoring data, NoCs process evaluation, and facility service statistics were utilized for this study. Service statistics were analyzed using Student's t-test and interrupted time-series analysis to compare maternal and child care outcomes before and after the NoCs intervention, with counterfactual estimates generated to assess the intervention's impact. Qualitative data from key informant interviews were transcribed, coded, and analyzed to identify themes and patterns using Atlas.ti., Results: The NoCs approach has significantly enhanced relational linkages between primary health care facilities and health care providers, fostering stronger collaboration and communication. This has fostered trust, improved care coordination, optimized primary health care performance, and increased health service utilization within woreda health systems. The interrupted time series analysis indicated that the rate of ANC 8+ visits was 29.8% per month higher than expected without the NoCs strategy (Coef: 2.39; p-value < 0.01) and an 18.4% increase in obstetric complications managed (Coef: 1.71; p-value = 0.050), with a 43% overall increase. Perinatal mortality decreased by 34%, from 31.3 to 20.1 per 1,000 births [t-test: 2.12; p-value: 0.040)]., Conclusion: The NoCs approach in Ethiopia has proven effective in enhancing the relational elements, care coordination, and quality of primary health care services, leading to better maternal and child health outcomes. The findings expand the existing body of research on NoCs implementation best practices and further confirm that it provides a scalable model for strengthening health services in low-resource settings., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2025 Tiruneh 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: Early initiation of treatment for lung cancer has been shown to improve patient survival. The present study investigates disparities in time to treatment initiation of invasive lung cancer within and between Black and White patients in Tennessee., Methods: A population-based registry data of 42,970 individuals (Black = 4,480 and White = 38,490) diagnosed with invasive lung cancer obtained from the Tennessee Cancer Registry, 2005-2015, was analyzed. We conducted bivariate ANOVA tests to examine the difference in time to treatment initiation among independent factors, and multivariable Cox proportional hazard models to identify independent factors that influence median time to treatment initiation after diagnosis., Results: When considering the estimate of the proportion of time to treatment initiation based on the combined influence of all independent factors (sex, age, race, marital, county of residence, health insurance, cancer stage, and surgical treatment), Black patients were generally more at risk of delayed treatment compared to Whites. Black patients aged <45 years (adjusted hazard ratio [aHR] = 1.40; 95% confidence interval [CI] = 1.01-1.94) and married White patients (aHR = 1.13; 95% CI = 1.07-1.18) had the highest increased risk of late treatment among their respective racial subgroups. In the general sample, patients with private health insurance had (aHR = 1.08; 95% CI = 1.01-1.16) higher risk of late treatment beyond 2.7 weeks compared to self-pay/uninsured patients. This was consistent among both Black and White subsamples. Patients with localized and regional lung cancer stages had a decreased risk of delayed treatment compared to those diagnosed at the distant stage among both Black and White patients., Conclusions: Black patients were often at greater risk of late initiation of treatment for invasive lung cancer in Tennessee. Additional research is needed to understand factors influencing time to treatment initiation for Black patients in Tennessee. Further, cancer care resources are needed in Black communities to ensure timely treatment of invasive lung cancer, reduce disparities, and promote equitable care for all cancer patients., 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.)

Background: Myopia has been a rising problem globally. Early-onset myopia significantly increases the risk of high myopia later in life. Despite the proven benefits of increased outdoor time, optimal strategies for preventing early-onset myopia in premyopic children need further investigation., Methods: This randomized controlled trial aims to evaluate the efficacy of optical (Defocus Incorporated Multiple Segments [DIMS] spectacle lenses) and pharmacological (0.01% atropine eye drops) interventions in preventing myopia among premyopic preschoolers. We will recruit 234 premyopic, asymptomatic 5-to-6-year-old children who will have received cycloplegic autorefraction examination in a countywide kindergarten eye care program in Yilan County, Taiwan. Eligible participants will be randomly assigned to DIMS spectacles (n = 78), 0.01% atropine (n = 78), or usual care (n = 78). In the DIMS group, preschoolers will be instructed to wear spectacles at home before entering elementary school but to wear them all the time after school entry. In the atropine group, subjects will be given 0.01% atropine eyedrops nightly throughout the study period. All participants will be encouraged to spend time outdoors for 2 hours every day. During the 18-month study period, cycloplegic spherical equivalent (SE) refraction, axial length, and subfoveal choroidal thickness will be measured every three months, and parents-administered questionnaires regarding risk factors for myopia will be performed every nine months., Primary Outcome: The change in mean cycloplegic SE., Secondary Outcomes: The cumulative percentage of incident myopia, the cumulative percentage of a fast myopic shift of SE, and the changes in mean axial length., Other Pre-Specified Outcomes: The time to myopia onset, alteration in subfoveal choroidal thickness, and levels of near work/outdoor activities., Trial Registration: This study is registered at www.clinicaltrials.gov as NCT06200194., Conclusion: This trial will provide insights into myopia prevention strategies and inform new eye care policies for early identification and intervention in premyopic preschoolers., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Yang 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: Globally, as of March 2024, the number of confirmed Coronavirus Disease 2019 (COVID-19) cases and deaths were over 774 million and seven million, respectively. Since there are no proven treatment in place against the disease, controlling strategy mainly rely on preventive measures. However, data on the extent of implementing physical distancing and other preventive measures during the pandemic of COVID-19 were inadequate in the study setting. This study is, therefore, documenting these gaps among people in Arba Minch town, South Ethiopia., Methods: We conducted a community-based cross-sectional survey and qualitative study at Arba Minch in June 2020. Quantitative data were collected using an interviewer-administered questionnaire and check-list from study participants (head of household or any adult ≥18 years old in a household) and analyzed using SPSS version 20. Qualitative data were collected using key informant interviews (KIIs) and analyzed by using a thematic approach., Results: Of the total surveyed adults (459), only 43.6% achieved above the mean score on adherence to implementing preventive measures of COVID-19. We found that 29.8% of participants kept physical distancing, only 37.7% of study participants had face-mask use practice, 20.5% had hand sanitizer use practice, 42.5% of participants avoided attendance in public gatherings, 44.7% stopped touching their nose, eye, and mouth, 55.6% practiced stay at home, and 60% had frequent hand washing practice. Besides, the main emerged barriers of adherence to implementing COVID-19 preventive measures were poverty, distrust of government, misbelief, lack of ownership, lack of attention and sustained actions, lack of ownership, socio-cultural influence, lack of coordination and leadership., Conclusions: The finding of this study suggests inadequate adherence to implementing COVID-19 preventive measures in adults in Arba Minch. Although inadequately implemented, a lot of lessons have been learned from COVID-19 pandemic preventive measures that would help in prevention and control of such a pantomimic disease happened., 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.)

Misperceptions of the social world can lead to actions and social policy that are detrimental to an individual's or group's well-being. Here we investigate whether misperceptions arise when participants make predictions of the modal number of ideal future sexual partners reported by heterosexual cohorts (younger cohort: 18-23 years; older cohort: 24-29 years). For both men and women and in both cohorts, the modal number of reported partners equaled 1.0, but men's averages were higher than women's averages due to a subgroup of men who reported desiring large numbers of partners (that is, the distributions had the same shape, but men's distributions had a longer tail). Study 1: When asked to estimate the mode directly, participants performed poorly and, in some conditions, dramatically so (e.g., 40% of younger men reported wanting one sexual partner, but 0% of younger men predicted 1 to be the most frequent response). Study 2: When asked to estimate the shape of the whole distribution, participants underestimated the number of respondents who would desire the mode and thus replicated patterns in the literature for misestimations of skewed distributions. Study 3: When provided information about others' actual modal desired number of partners, the number of male participants who reported desiring one sexual partner increased, suggesting that misperceptions of social norms may influence preferences. We discuss how the mean and mode can lead to two accurate but different interpretations of the data (mean: men report desiring more sexual partners than women; mode: the most frequent response reported by both men and women is 1.0). Discrepancies of this sort can lead to mischaracterizations that may not be uncommon in the research literature. These discrepancies cannot be differentiated by significance tests that seek to find differences in the mean but can be resolved with attention to other methods of analyses., Competing Interests: No authors have competing interests, (Copyright: © 2024 Shapiro 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.)

During the SARS-CoV-2 pandemic, a need for methods to decontaminate and reuse personal protective equipment (PPE) and medical plastics became a priority. In this investigation we aimed to develop a contamination evaluation protocol for laboratory pipette tips, after decontamination. Decontamination methods tested in this study included cleaning with a common laboratory detergent (2.5% Alconox® solution followed with steam decontamination), exposure of ozone vapor at 250 and 14400 PPM * minute, and exposure to cold atmospheric plasma (CAP). All tips (control and experimental groups) were introduced to the methods described, while tips exposed to DNA extracts of Aeromonas hydrophila (ATCC-23211) were assessed for experimental groups. Decontamination was determined by turnover ratio and log reduction in detectable genomic material on the contaminated products using real-time quantitative PCR (qPCR) assay. Our results showed, cleaning tips with lab detergents along with steam decontamination removed genetic material, resulting in the highest log reduction, compared with ozone or CAP treatments. Detergent/washing methods showed the second highest turnover ratio (95.9%) and log reduction (5.943). However, the excessive residue (post- cleaning) on the plastic, within inner filters, and tip boxes suggested that washing with lab detergents was not favorable for reuse. Ozone vapor at 14400 PPM * minute showed the highest turnover ratio (98.4%) and log reduction (4.511). CAP exposure with tips inverted (the tip end exposed closer to the plasma flame) for 1 minute showed a turnover ratio of (68.3%) and log reduction (4.002). Relatively, lower turnover ratio and log reduction of CAP could be improved by optimization, such as increasing the exposure time. Future testing would provide fine-tuned conditions for CAP-specific decontamination of plasticware. In this study we were able to provide fundamental insight into a non-traditional decontamination method for single-use plasticware that could render these products reusable., 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.)

This study explores the perceived walkability of one-way commercial streets by utilizing immersive 360-degree virtual reality (VR) videos. While one-way roads are often introduced to facilitate smooth traffic flow on narrow roads, providing safe and walkable environments for pedestrians on the one-way roads is crucial, especially in commercial areas with heavy pedestrian traffic. We recruited 40 students to assess the perceived walkability of one-way roads based on ten VR scenarios. For each scenario, variables such as road width, one-way traffic status, vehicle approach direction, and the presence of sidewalks were configured differently. This study found that while there is awareness of one-way road types, the presence of sidewalks is considered critical factor contributing to enhanced perceived walkability on narrow commercial street. In the condition of narrow road width, one-way roads are the only applicable road layout to have a sidewalk, implying the potential of one-way roads for better walkability. Besides, the study also revealed the high correlation between five dimensions of perceived walkability, emphasizing their role to enhance perceived walkability in a setting of one-way roads. This study's findings could be utilized for more systematic walkability assessments and urban design improvements, especially in constrained road spaces., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Vo, Kim. 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.)