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Background: To compare the visual outcomes of different anti-vascular endothelial growth factor (VEGF) drugs, including aflibercept, ranibizumab, and bevacizumab, in a real-world setting in Korea. Methods: We collected data from patients who received monotherapy using one of these three anti-VEGF drugs as naïve treatment after being diagnosed with neovascular age-related macular degeneration. The number of injections and visual acuity (VA) outcomes of each cohort were obtained and pairwise comparisons were performed using propensity score matching. Results: A total of 254 aflibercept, 238 ranibizumab, and 282 bevacizumab treatment-naïve eyes were included. The mean VA change at 3 years for all cohorts combined was -1.8 letters, and the mean number of injections was 9.4. In the direct comparison of the three drugs, the mean change in the VA letter score was +2.0 letters for aflibercept and -11.7 letters for bevacizumab (P < 0.001). The number of aflibercept injections was significantly higher than the number of bevacizumab injections (P = 0.002). The visual outcomes for aflibercept and ranibizumab were +4.7 letters and -1.9 letters, respectively, and comparable results were obtained (P = 0.13). The VA outcomes for ranibizumab and bevacizumab were also not significantly different (P = 0.09). The numbers of injections for aflibercept, ranibizumab, and bevacizumab were 10.8, 6.7, and 8.8, respectively. Significant differences were observed between the injection frequencies comparisons of aflibercept and ranibizumab and ranibizumab and bevacizumab (P < 0.001 and P = 0.002, respectively). Conclusions: In the Korean clinical medical environment, which included various confounding factors, especially socioeconomic ones, the aflibercept VA outcome was significantly better than that of bevacizumab, and aflibercept injections were the most numerous. These real-world data imply that the drug effect as well as the environment in which the drug can be sufficiently used affected patient final VA scores. [ABSTRACT FROM AUTHOR]

This study examines the impact of status inconsistency on status-threatening activities within NCAA Division I men's basketball teams. Specifically, we focus on a nested form of status that includes both individual and group-level elements. We argue that organizations dealing with status inconsistency stemming from such nested form face challenges in reducing status inconsistency. To maintain their deserved status, these status-inconsistent organizations tend to avoid activities that could further threaten their status, despite potential economic gains. An analysis of NCAA Division I men's basketball scheduling data from 2000 to 2019 provides robust support to our theoretical arguments. Our findings suggest that the status inconsistency between a team's status and its conference status diminished the likelihood of scheduling games with non-Division I teams, a behavior considered counter-normative in this context. This effect is most prominent among teams in "Mid Major" conferences, while teams with recent participation in the NCAA Tournament show a mitigated effect. [ABSTRACT FROM AUTHOR]

ObjectiveTo assess the safety of VivaGel® used vaginally twice daily for 14 days among healthy, sexually-abstinent women, aged 18-24 years in the USA and Kenya.DesignRandomized placebo controlled trial.MethodsParticipants were randomized 2∶1, VivaGel to placebo. Safety was assessed by comparing genitourinary (GU) adverse events (AEs), colposcopy findings, vaginal lactobacilli and laboratory abnormalities by arm.ResultsFifty-four women were enrolled; 35 in the VivaGel arm and 19 in the placebo arm. Twenty-six (74%) and 10 (53%) women reported taking all doses of VivaGel and placebo, respectively. No grade 3 or 4 AEs, or serious AEs occurred. Twenty-five (71%) participants in the VivaGel arm compared to 10 (53%) participants in the placebo arm had at least one grade 1 or 2 GU AE associated with product use (RR = 1.4, 95% CI 0.8-2.2). All seven grade 2 GU AEs associated with product use occurred among four women in the VivaGel arm. Vulvar and cervical erythema, cervical lesions, symptomatic BV, urinary frequency and metrorrhagia were more common in the VivaGel arm than the placebo arm. Twenty-nine (83%) participants in the VivaGel arm had a colposcopic finding compared to 10 (53%) participants in the placebo arm (RR = 1.6, 95%CI = 1.0-2.5). Two women in the VivaGel arm prematurely discontinued product use themselves due to a reported GU AE. Persistence of H₂O₂-producing and non-producing lactobacilli did not differ by study arm.ConclusionsGU AEs and colposcopic findings consistent with mild epithelial irritation and inflammation occurred more commonly among women in the VivaGel arm.Trial registrationClinicalTrials.gov NCT003311032.

Front-of-package (FOP) is one of the most direct communication channels connecting manufacturers and consumers, as it displays crucial information such as certification, nutrition, and health. Traditional methods for obtaining information from FOPs often involved manual collection and analysis. To overcome these labor-intensive characteristics, new methods using two artificial intelligence (AI) approaches were applied for information monitoring of FOPs. In order to provide practical implementations, a case study was conducted on infant food products. First, FOP images were collected from Amazon.com. Then, from the FOP images, 1) the certification usage status of the infant food group was obtained by recognizing the certification marks using object detection. Moreover, 2) the nutrition and health-related texts written on the images were automatically extracted based on optical character recognition (OCR), and the associations between health-related texts were identified by network analysis. The model attained a 94.9% accuracy in identifying certification marks, unveiling prevalent certifications like Kosher. Frequency and network analysis revealed common nutrients and health associations, providing valuable insights into consumer perception. These methods enable fast and efficient monitoring capabilities, which can significantly benefit various food industries. Moreover, the AI-based approaches used in the study are believed to offer insights for related industries regarding the swift transformations in product information status. [ABSTRACT FROM AUTHOR]

Myxomatous mitral valve disease (MMVD) is the most common cardiovascular disorder in dogs with a high prevalence, accounting for approximately 75% of all canine heart disease cases. MMVD is a complex disease and shows variable progression from mild valve leakage to severe regurgitation, potentially leading to heart failure. However, the molecular mechanisms and age-related changes that govern disease progression, especially at the early stage (B1) before the development of discernable clinical signs, remain poorly understood. In this prospective study, we aimed to compare gene expression differences between blood samples of aged beagle dogs with stage B1 MMVD and those of healthy controls using RNA sequencing. Clinical evaluation was also conducted, which revealed minimal differences in radiographic and echocardiographic measurements despite distinct biomarker variations between the two groups. Comparative transcriptomics revealed differentially expressed genes associated with extracellular matrix remodeling, prostaglandin metabolism, immune modulation, and interferon-related pathways, which bear functional relevance for MMVD. In particular, the top 10 over- and under-expressed genes represent promising candidates for influencing pathogenic changes in MMVD stage B1. Our research findings, which include identified variations in clinical markers and gene expression, enhance our understanding of MMVD. Furthermore, they underscore the need for further research into early diagnosis and treatment strategies, as, to the best of our knowledge, no prior studies have explored the precise molecular mechanisms of stage B1 in MMVD through total RNA sequencing. [ABSTRACT FROM AUTHOR]

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.

IntroductionThe methicillin-resistant Staphylococcus aureus (MRSA) genome varies by geographical location. This study aims to determine the genomic characteristics of MRSA using whole-genome sequencing (WGS) data from medical centers in Mexico and to explore the associations between antimicrobial resistance genes and virulence factors.MethodsThis study included 27 clinical isolates collected from sterile sites at eight centers in Mexico in 2022 and 2023. Antibiotic susceptibility testing was performed using VITEK 2. In addition, WGS was performed using a NovaSeq platform, and a bioinformatic analysis was conducted using several tools.ResultsIn this study, 21 strains were CC5, five were CC8, and one was CC93. Moreover, six strains were identified as ST5(CC5)-MRSA-IIa- t895, four strains were found to be ST1011(CC5)-MRSA-IIa-t895, five strains were found to be ST1011(CC5)-MRSA-IIa-t9364, one strain was found to be ST1011(CC5)-MRSA-IIa-t8116, another was found to be ST1011(CC5)-MRSA-IIa-t62, three were found to be ST8(CC8)-MRSA-IVa-t8, one strain was ST5(CC5)-MRSA-IVa-t2, one strain was as ST93(CC93)-MRSA-IVa-t3949, two strains were ST9003(CC8)-MRSA-IVa-t18492, and three strains were ST9034(CC5)-MRSA-V-t2. All SCCmec IIa strains showed resistance to levofloxacin and ciprofloxacin, and all but two strains were resistant to clindamycin. Among the strains that harbored the type IIa cassette, most had the aadD, blaZ, and ermA_SDS genes and the erm A gene. Multiple genes for adhesion, enzymes, immune evasion, and secretion system were detected, regardless of SCCmec type. Of the SCCmec IVa strains, most harbored the Panton-Valentine leukocidin encoding genes.ConclusionIn this study, the most frequently detected CC was CC5, followed by CC8, and CC93, and the most frequently detected MRSA ST was ST1011, followed by ST5. Most SCCmec elements were found to be type IIa, followed by type IVa. High MIC values were observed for ciprofloxacin, erythromycin, and clindamycin, particularly within SCCmec IIa. Of the SCCmec IVa strains, most harbored the lukS-PV and lukF-PV genes.

BackgroundRNA polymerase-binding protein A (RbpA) is an actinomycetes-specific protein crucial for the growth and survival of the pathogen Mycobacterium tuberculosis. Its role is essential and influences the transcription and antibiotic responses. However, the regulatory mechanisms underlying RbpA-mediated transcription remain unknown. In this study, we employed various computational techniques to investigate the role of RbpA in the formation and dynamics of the RNA polymerase complex.ResultsOur analysis reveals significant structural rearrangements in RNA polymerase happen upon interaction with RbpA. Hotspot residues, crucial amino acids in the RbpA-mediated transcriptional regulation, were identified through our examination. The study elucidates the dynamic behavior within the complex, providing insights into the flexibility and functional dynamics of the RbpA-RNA polymerase interaction. Notably, potential allosteric mechanisms, involving the interface of subunits α1 and α2 were uncovered, shedding light on how RbpA modulates transcriptional activity.ConclusionsFinally, potential ligands meant for the α1-α2 binding site were identified through virtual screening. The outcomes of our computational study serve as a foundation for experimental investigations into inhibitors targeting the RbpA-regulated dynamics in RNA polymerase. Overall, this research contributes valuable information for understanding the intricate regulatory networks of RbpA in the context of transcription and suggests potential avenues for the development of RbpA-targeted therapeutics.

Peyronie's disease (PD) is a disorder of the penis that is associated with poor mental health, lowered psychosocial- and sexual wellbeing, which may increase the risk of childlessness in men affected by the disorder. Although this is an issue of significant clinical importance, it has not been addressed in research to date. We conducted a longitudinal cohort study based on data from Swedish national registers utilizing a large sample of help-seeking men with PD, along with matched subjects from the general population. We assessed the probability and odds ratio of childlessness, modeled with logistic regressions, and offspring rate ratio, modeled with Poisson regression. We found that the probability of childlessness was somewhat lowered for men with PD aged between 35 and 71 years at end of follow-up. Men with PD aged 35 or less showed slightly elevated probabilities of childlessness. Specifically, odds ratios for childlessness were between 0.5 and 1.0 for men aged above 35, and between 1 and 1.5 for men aged less than 35, although the confidence intervals for increased odds partly included the null. Analyses of men's rate of offspring showed similar pattern, with higher rate ratios for older men and lower for younger men. Although more research is needed, the findings of this study suggest that clinical urological practice may be enhanced by a proactive discussions about the potential issue of childlessness in younger men with PD.

IntroductionEffective prevention of mother to child transmission (PMTCT) programmes require women and their infants to have access to a cascade of HIV care and treatment interventions. Retention in care reduces the risk of vertical transmission and opportunistic infections among mothers living with HIV. Uganda has made great strides in ensuring the success of the prevention of mother to child transmission program. Although an increasing number of people living with HIV (PLHIV) in Uganda are benefiting from the rapid scale-up of antiretroviral therapy (ART), retention in HIV care and treatment services remains a major concern. Identifying and understanding the reasons for dropping out of care among mothers enrolled in the Option B+ program among those who were retained and those who dropped out is key to inform policy and program practice.MethodsWe conducted a qualitative study to understand the facilitators of retention and reasons for loss to follow-up among HIV positive mothers in central Uganda who engaged in the Option B+ program. We conducted 29 focus group discussions (FGDs) with Village Health Teams (VHT) and 'Peer Mothers'. We performed 21 in depth interviews (IDI) with mothers who had been lost to follow up during the post-partum period, and 27 among those who remained in care. These were conducted in 18 districts in Central Uganda.ResultsParticipants identified barriers and facilitators to retention in HIV care. Barriers included self-stigma and fear of disclosure, mental health challenges, community perceptions, poor health provider attitudes and structural challenges, lack of transportation and food, long waiting time at health facilities and client mobility. Both the clients retained and not retained in care discussed mental illness, feeling sick and competing priorities as barriers. Facilitators for retention in care included adequate community support systems, early initiation on ART, giving birth to HIV negative children and economic stability. These were noted as key enabling factors for retention. It was also highlighted that presence of friendly clinic staff members, scheduling reminders were important aspects of retention.ConclusionFindings highlighting barriers covering personal, interpersonal, structural and community suggest that developing client-centered models addressing social and community barriers and provide more holistic services is key to retaining mother-infant pairs in care. Emphasis on the use of community health workers and provision of financing, as well as institutionalization of quality improvement would provide alternatives for overcoming barriers to retention in care.

The Satisfaction With Life Scale (SWLS) is a widely used self-report measure of subjective well-being, but studies of its measurement invariance across a large number of nations remain limited. Here, we utilised the Body Image in Nature (BINS) dataset-with data collected between 2020 and 2022 -to assess measurement invariance of the SWLS across 65 nations, 40 languages, gender identities, and age groups (N = 56,968). All participants completed the SWLS under largely uniform conditions. Multi-group confirmatory factor analysis indicated that configural and metric invariance was upheld across all nations, languages, gender identities, and age groups, suggesting that the unidimensional SWLS model has universal applicability. Full scalar invariance was achieved across gender identities and age groups. Based on alignment optimisation methods, partial scalar invariance was achieved across all but three national groups and across all languages represented in the BINS. There were large differences in latent SWLS means across nations and languages, but negligible-to-small differences across gender identities and age groups. Across nations, greater life satisfaction was significantly associated with greater financial security and being in a committed relationship or married. The results of this study suggest that the SWLS largely assesses a common unidimensional construct of life satisfaction irrespective of respondent characteristics (i.e., national group, gender identities, and age group) or survey presentation (i.e., survey language). This has important implications for the assessment of life satisfaction across nations and provides information that will be useful for practitioners aiming to promote subjective well-being internationally.

BackgroundPosttraumatic stress disorder (PTSD) affects 3.9% of the general population. While massed cognitive processing therapy (CPT) has demonstrated efficacy in treating chronic PTSD, a substantial proportion of patients still continue to meet PTSD criteria after treatment, highlighting the need for novel therapeutic approaches. Preliminary evidence supports the potential therapeutic action of psilocybin to alleviate PTSD symptoms. This open-label pilot study aims to evaluate the feasibility, tolerability, and preliminary efficacy of a single dose 25 mg psilocybin in combination with one week of massed CPT in patients with chronic PTSD.MethodFifteen participants with chronic PTSD will undergo 12 CPT sessions, two psilocybin-related psychotherapy sessions, and one psilocybin dosing session over a 7-days period. The primary outcomes are feasibility and tolerability, which will be measured by recruitment rates, withdrawal, data completion, adherence, number and nature of adverse events. Secondary objectives include assessing the preliminary efficacy of psilocybin-assisted CPT in reducing PTSD severity, self-reported treatment outcomes and exploring putative mechanisms of change. Participants will be monitored weekly for 12 weeks post-treatment and passive data relevant to mental health and well-being will be collected using a wearable device.DiscussionThis trial will generate important preliminary data on the use of psilocybin-assisted CPT for treating PTSD. The findings will guide the design of a multi-site, large-scale randomized control trial to more rigorously assess the efficacy of this intervention. De-identified data from this study will be available upon request after publication of the results. This study represents a promising and innovative approach to PTSD treatment, potentially offering an alternative therapeutic option for individuals unresponsive to conventional therapies.Trial registrationClinicalTrials.gov NCT06386003.

BackgroundTo date, few data to transcranial Doppler sonography (TCD) are available in patients with mild vascular cognitive impairment (VCI) at risk for vascular or mixed dementia. In a previous study in patients with mild VCI and cerebral small vessels disease, a hemodynamic pattern of cerebral hypoperfusion and enhanced vascular resistance were observed; however, longitudinal data are currently lacking. Here, we perform a clinical, psychopathological, and neurosonological follow-up of patients with VCI in order to monitor any progression and to identify TCD measures to detect it.MethodsFrom the original cohort of 161 patients, 127 with VCI (mean age 73.6 ± 7.1; 67 males) were re-evaluated after 5.0 ± 1.8 years. Namely, the Montreal Cognitive Assessment (MoCA), the 17-items Hamilton Depression Rating Scale (HDRS), and the Stroop Color-Word Interference Test (StroopT) were administered to screen for global cognitive status, to quantify depressive symptoms, and to explore executive functions, respectively. Mean blood flow velocity (MBFV), peak systolic blood flow velocity (PSV), end-diastolic blood flow velocity (EDV), pulsatility index (PI), and resistivity index (RI) were recorded from the middle cerebral artery, bilaterally.ResultsAt follow up, patients exhibited a significant worsening of both MoCA (21.7 ± 2.1 vs. 20.7 ± 2.0) and StroopT scores (57.4 ± 19.4 vs. 59.7 ± 18.6), whereas HDRS showed an improvement, although the mean raw score remained above the cut-off value for depression (10.3 ± 6.6 vs. 9.8 ± 6.3). MBFV, PSV, and EDV showed a significant increase in PSV and PI and a reduction in EDV. When focused to younger patients (ConclusionsNotwithstanding some limitations, such as the lack of a control group and neuroimaging data at follow-up, TCD may contribute to the early detection, monitoring, and management of VCI patients at risk for dementia. Together with compatible clinical and cognitive features, the exploration of early TCD markers that possibly indicate a higher risk of progression might represent an intriguing research direction and a significant clinical perspective.

BackgroundTechnological advancements and globalization have shifted dietary behaviours, contributing to increased chronic disease prevalence in Low- and Middle-Income Countries (LMICs) like India. Adolescents are particularly vulnerable due to these changes, which can impact their lifelong health. This study aimed to assess the nutritional status of adolescents in public schools in Chandigarh, India.MethodologyConducted as part of a cluster randomized control trial, the study used two-stage random sampling to select 12 schools and eighth-grade classes, recruiting 453 adolescents aged 10-16 years. Nutritional status was evaluated through dietary behaviour assessments, anthropometric measurements, and 24-hour urinary salt-level analysis. Dietary patterns were recorded using two 24-hour recalls, and analyzed with PURE study software based on 2010 Indian dietary data from ICMR-NIN. Anthropometric measures followed standardized protocols, and salt levels were assessed in laboratories.ResultsThe mean age of the adolescents was 13.06 years, with 55% being boys. Among them, 32% had high salt intake, and 55% had high sugar intake. Additionally, 90% had low fruit intake, and 83% had low vegetable intake. The adolescents were deficient in several macro and micronutrients, including energy, fats, fibre, iron, zinc, iodine, riboflavin, and vitamins B-6 and B-12. A higher proportion of boys (10%) were classified as thin compared to girls (2%), while a greater proportion of girls (36%) had abdominal obesity. In contrast, a larger proportion of boys (23%) were severely acutely malnourished. Nearly all adolescents exhibited high urinary excretory salt levels.ConclusionMost adolescents exhibited dietary risk factors, including high salt and sugar intake, along with low consumption of fruits and vegetables. Many were deficient in various macro and micronutrients, with the coexistence of both thinness and obesity. Regular nutritional assessments in schools are essential to address the dual burden of undernutrition and overnutrition. Furthermore, health-promoting interventions should be developed within school settings to encourage healthy dietary practices.

Breastfeeding (BF) is vital for maternal and infant health, yet post-hospital discharge support remains a challenge. The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides BF peer counseling prenatally and up to 1-year postpartum among low-income women in the United States. The Lactation Advice Through Texting Can Help (LATCH) intervention is an evidence-based two-way text messaging intervention that provides BF education and support in the WIC peer counseling program. The intervention is implemented by peer counselors (PCs) in the WIC program, with the supervision and support of a lactation consultant. The aim of this qualitative study was to assess the barriers and facilitators to the implementation of LATCH during the feasibility trial and to investigate strategies for adapting and scaling up the intervention. In-depth interviews with LATCH and PC program key informants aimed to evaluate the intervention and explore its adaptation and scale-up. Interviews were analyzed using line by line inductive thematic analysis. Findings were mapped to the Model for Adaptation Design and Impact (MADI) framework to describe the proposed adaptations, and to the Program Impact Pathways (PIP) framework to identify causal pathways and critical quality control points. Results demonstrate that LATCH facilitates continued engagement between PCs and WIC mothers; however, implementation feasibility issues remain. Suggested adaptations to LATCH include the use of an integrated comprehensive platform, ensuring continuity of care through an expanded spectrum of communication options, the need to develop a PC support model for "off hours" (non-business hours), and the need to obtain local WIC office management's buy-in for the communications platform and the off-hours PC model. Critical quality control points were identified when results were mapped to the MADI and PIP frameworks. Implementing these changes has the potential to expand access to BF peer counseling support and improve BF equity among low-income women.

BackgroundMenstrual Health (MH) knowledge, attitude and practice (KAP) are highly affected by access to information regarding menstruation. Despite being included in the school curriculum, Sexual and Reproductive Health (SRH) education is often not delivered in practice. School-based educational interventions have been shown to be effective in promoting MH.MethodsA school-based study was conducted in Indrawati rural municipality of Sindhupalchowk district in Nepal. 427 participants (175 boys and 252 girls), aged 11-13, completed a questionnaire evaluating MH KAP before receiving a structured training module on MH provided by experienced trainers from Putali Nepal using the Menstrupedia tool. The questionnaire was repeated one month after the training. Pre and post intervention scores were compared to determine the effect of the intervention. Focus group discussions were also conducted to understand the perceptions of participants toward SRH teaching. Association of independent socio-demographic with dependent variables knowledge and attitude towards menstrual health were analyzed using MANOVA test. The Wilcoxon signed-rank test was used to compare the median outcome of the pre and post-test attitude and knowledge. The maximum possible score was 6 for MH knowledge. The total attitude score ranged 14 to 70.ResultsThe median knowledge score increased by 1 point (p = ConclusionThe Menstrupedia comic educational intervention improved knowledge and attitude towards menstruation among Nepali adolescents. A scale-up of the Menstrupedia based intervention would significantly change knowledge and attitude towards menstruation in Nepali adolescents.

Texture is a significant component used for several applications in content-based image retrieval. Any texture classification method aims to map an anonymously textured input image to one of the existing texture classes. Extensive ranges of methods for labeling image texture were proposed earlier. However, computing the performance of these methods in the presence of various degradations is always an open area of discussion. Image noise is always a dominant factor among various image degradation factors, affecting the performance of these methods and making texture classification challenging. Therefore, it is essential to investigate the interpretation of these methods in the presence of prominent degradation factors such as noise. Applications for Segmentation-Based Fractal Texture Features (SFTF) include image classification, texture generation, and medical image analysis. They are beneficial for examining textures with intricate, erratic patterns that are difficult to characterize using conventional statistical techniques accurately. This paper assesses two texture feature extraction methods based on SFTF and statistical moment-based texture features in the presence and absence of Gaussian noise. The SFTF and statistical moments-based handcrafted features are passed to a multilayer feed-forward neural network for classification. These models are evaluated on natural textures from Kylberg Texture Dataset 1.0. The results show the superiority of segmentation-based fractal analysis over other approaches. The average accuracy rates using the SFTF are 99% and 97% in the absence and presence of Gaussian noise, respectively.

University students are at a pivotal stage of shaping cancer risk factors. Little is known about their dietary behavior in Lebanon, a country heavily burdened by cancer. This cross-sectional study assessed the dietary knowledge of and adherence to cancer prevention guidelines among university students in Beirut, Lebanon. We hypothesized that students would exhibit low knowledge, poor diet quality, and that knowledge predicted diet quality. Dietary knowledge was explored using a dedicated questionnaire, with scores above the 60th percentile considered as Knowledgeable (Kn+), and those below as less knowledgeable (Kn-). Dietary adherence to cancer prevention guidelines and the predictors of the Alternative Healthy Eating Index (AHEI)- a measure of diet quality calculated using the Modified Mediterranean Prime Screen, were also examined. The sample included 300 participants (55% females, mean age: 20 years). The mean knowledge score was 49.5%. Over 50% of students were aware of the association between red and processed meat, sodium, fruits and vegetables, obesity, and cancer. Kn+ group had a higher intake of vegetables and a lower intake of meats and sweetened beverages. Increased knowledge (B = 0.78, 95%CI: 0.18,1.37) and high physical activity (B = 4.62, 95%CI: 1.66,7.59) were associated with elevated AHEI scores. A significant positive interaction was observed between knowledge and enrollment in a health-related major. University students' dietary knowledge of and adherence to cancer prevention guidelines are suboptimal. Although higher knowledge predicts high-quality diets, the association was weak. Further studies should investigate the food systems influencing university students' dietary intake of university students in Lebanon and identify effective interventions to enhance health behavior.

IntroductionThis study aimed to evaluate the predictive validity and discriminatory ability of clinical outcomes, inflammatory activity, oxidative and vascular damage, and metabolic mechanisms for detecting significant improve maximum heart rate after physical activity training in individuals with psychiatric disorders and obesity comorbid using a longitudinal design and transdiagnostic perspective.MethodsPatients with major depressive disorder, bipolar disorder and, schizophrenia and with comorbid obesity (n = 29) were assigned to a 12-week structured physical exercise program. Peripheral blood biomarkers of inflammation, oxidative stress, vascular mechanisms, and metabolic activity, as well as neurocognitive and functional performance were assessed twice, before and after intervention. Maximum heart rate was considered a marker of effectiveness of physical activity. Mixed one-way analysis of variance and linear regression analyses were performed.ResultsIndividuals with psychiatric disorders and comorbid obesity exhibited an improvement in cognition, mood symptoms and body mass index, increase anti-inflammatory activity together with enhancement of the oxidative and cardiovascular mechanisms after physical activity training (pConclusionsThe regulation of the anti-inflammatory mechanisms may be essential for maintained of healthy physical activity across psychiatric disorders and obesity. Likewise, inflammatory activity, oxidative stress, vascular and cardio-metabolic mechanisms may be a useful to identify individuals at greater risk of multi-comorbidity.

[This corrects the article DOI: 10.1371/journal.pone.0301032.].

[This corrects the article DOI: 10.1371/journal.pone.0305291.].

Previous abdominal surgery (PAS) increases risk of small bowel obstruction (SBO) due to adhesions, and appendectomy (appy) is an independent risk factor for abdominal adhesion-related complications. Peritoneal inflammation, e.g., acute appendicitis (AA), causes formation of reactive ascitic fluid (rA) that activates peritoneum surface mesothelial cells (MCs) to form adhesions. Pathologic adhesions may arise if restoration of MC-regulated fibrinolysis and secretion of glycocalyx (GCX) are disrupted. Proteins affecting these processes may originate from peritoneal rA. This is a prospective observational IRB-approved study at three Level 1 trauma centers where rA is collected prior to surgical intervention for non-perforated AA or adhesiolysis for SBO. Samples from 48 appy and 15 SBO patients were used to treat human MCs and subjected to quantification of 85 inflammatory mediators. Results were compared between patients with surgically naïve abdomens (naïve) and patients with >1 PAS. Select rA caused MCs to form clusters of fibroblastic cells, extracellular matrix fibers (FIB), and secretion of GCX. PAS and naïve patient rA fluids were clustered into "fiber-GCX" (FIB-GCX) groups: highFIB-highGCX, highFIB-lowGCX, noFIB-highGCX, noFIB-lowGCX, and noFIB-noGCX. Between groups, 26 analytes were differentially abundant including innate immune response, wound healing, and mucosal defense proteins. Factors that contributed to the differences between groups were rA-induced highFIB and history of PAS. Overall, PAS patient rA showed a muted immune response compared to rA from naïve patients. Our data suggest that abdominal surgery may negatively impact future immune responses in the abdomen. Further, quantifying immunomodulators in peritoneal rA may lead to the development a personalized approach to post-surgical adhesion treatment and prevention.