Atmospheric and Oceanic Sciences

This work presents a compact dual-band millimeter wave (mmWave) antenna that operates at 17-27 GHz and 36-43 GHz, with resonance frequencies centred at 21.1 GHz and 38.3 GHz, respectively. The multiple embedded arc-shaped mmWave antenna geometry provides compact, effective dual-band operation. The concentric arcs of the antenna structure are effectively optimized to produce a dual band of operation with good impedance matching. The resulting antenna has gain of 4.8 dBi at 26 GHz and 6.1 dBi at 37 GHz frequencies. The developed antenna is intended for widespread usage in satellite and 5G networks. Despite providing significant bandwidth for 5G and other next-generation communication systems, mmWave frequencies are susceptible to path loss, particularly in congested urban areas. This study further investigates the performance of the designed dual-band mmWave antennas in various urban environments. Both Line-of-Sight (LOS) and Non-Line-of-Sight (NLOS) scenarios are considered to capture realistic deployment conditions. To accurately model propagation behaviour, the analysis incorporates the ABG and CI path-loss models, which comprehensively account for environmental factors such as shadowing, diffraction, and precipitation.

OBJECTIVE: To investigate hospital-level variation in the supplementation of calcium, magnesium, phosphate, and potassium in critically ill patients. DESIGN: Retrospective cohort study. SETTING: Premier Healthcare Database of inpatients from the USA. PATIENTS: Adults (age ≥ 18 years) admitted to an intensive care unit (ICU) on hospital day 1 between October 1, 2022 and July 31, 2024, who had at least one calcium (total or ionized), magnesium, phosphate, or potassium level measured in an ICU between day 2 and 28. We excluded patients with renal failure, a pregnancy-related diagnosis, and intracranial bleeding on admission. INTERVENTIONS: Calcium, magnesium, phosphate, or potassium supplementation. MEASUREMENTS AND MAIN RESULTS: We included 47,988 patients from 67 ICUs across 52 hospitals, totaling 167,621 patient-days with a measurement of one of the studied electrolytes. Median age was 64 years (interquartile range [IQR] 52-74) and 46% (22,057) were female. There were 38,621 patients (80.5%) with a minimum value below a lower limit of normal, and 33,626 (70.1%) patients who received supplementation. Across hospitals, the median (IQR) percentages receiving supplementation per day were: calcium 9.4% (6.7-12.2); magnesium 28.6% (22.6-35.0); phosphate 19.1% (15.9-23.2); potassium 28.9% (25.8-34.6). From a multilevel model, the median relative odds of supplementation, comparing any two hospitals, ranged from 1.51 (95% confidence interval [CI] 1.48-1.55) for potassium to 2.09 (95% CI 1.99-2.19) for magnesium. At most hospitals, there were no calcium or phosphate levels at which the percentage receiving supplementation exceeded 50%. At 75% of hospitals there was a magnesium level at which the percentage receiving magnesium supplementation was 50% or more (range: 1.5-2.1 mg/dL), and at 96% of hospitals there was an analogous potassium level (range: 3.3-3.9 mmol/L). CONCLUSION: Supplementation of calcium, magnesium, phosphate, or potassium is common in critically ill patients and varies across hospitals, suggesting a need for randomized trials to clarify optimal supplementation practices.

Depression and suicide are leading public health problems requiring complex multilevel interventions. This study protocol details the COMBINA trial, which expands the evidence-based European Alliance Against Depression (EAAD) Community-Based 4-level intervention to also focus on improving wellbeing and tailored to five groups with increased vulnerability to depression: young people, older people, migrants/refugees, the long-term unemployed, and people with an existing mental health condition. In this prospective, non-randomised controlled trial, the COMBINA project will be newly implemented during a 24-month period, from late 2024 to late 2026, in five regions in Albania, Estonia, Greece, Ireland, and Spain. These regions will be compared to five control regions in the same countries, chosen to reflect a similar context, size, and sociodemographic characteristics. Main outcomes are a comparison between the intervention and control regions in the rates of deaths by suicide and hospitalisations for suicide attempts and the levels of wellbeing, depressive symptoms, anxiety symptoms, depression-related stigma, and willingness to seek psychological help in the general population. A process evaluation and economic evaluation will also be conducted. This intervention protocol also details the steps taken to promote successful implementation across a range of different cultural and regional contexts, with challenges including different existing mental health resources and differing capacities for the population to use digital tools. The COMBINA project includes co-creation, whereby materials and implementation strategy were designed with people from the vulnerable groups. The trial is funded by the European Union (grant agreement no. 101080651 and carried out according to the Declaration of Helsinki. Ethical approval has been obtained in all participating countries. The results will be published in peer-reviewed academic journals, presented at scientific meetings and disseminated through COMBINA stakeholders, with participation from the co-creators. This trial protocol (version 1.1, 24/10/2024) was registered in the ISRCTN registry (ISRCTN10521127) on 14/11/2025 (https://www.isrctn.com/ISRCTN10521127).

The Epstein-Barr virus (EBV) infects over 95% of adults, establishing lifelong latency and contributing to the development of various malignancies, including Burkitt lymphoma and nasopharyngeal carcinoma. However, the RNA structures regulating the splicing of the critical EBV gene, latent membrane protein 1 (LMP1), remain uncharacterized. To identify these regulatory elements, we applied spliceosome inhibition with RNA probing and sequencing (SIRP-seq) to the BJAB-B1 cell line. By utilizing the spliceosome inhibitor pladienolide B, we enriched pre-mRNA species, enabling the detection of structural features within both the full-length pre-mRNA (LMP1-FL) and an alternatively spliced isoform retaining intron 2 (LMP1-AS). The resulting chemical probing datasets informed the RNA folding algorithms RNAfold and ScanFold to generate the first high-resolution secondary structure models for the LMP1 pre-mRNA, encompassing both exonic and intronic regions. Our results identify 11 novel, thermodynamically stable RNA structures, with several key elements positioned near splice junctions. Notably, three structures (Structures 8, 9, and 10) were identified near the 3' splice site of intron 2, appearing in alternative conformations that may influence splicing accessibility. Furthermore, these structures map to regions containing disease-relevant mutations associated with patient survival in Burkitt lymphoma. This structural framework provides new insights into how LMP1 splicing may be regulated by RNA structure and identifies potential novel therapeutic targets for mitigating EBV-associated diseases.

Brain tumors are one of the most fatal disorders that cause one of the highest mortalities in the world. Gliomas are the most common primary brain tumors originating from glial cells in the central nervous system. Traditionally, a tissue sample is extracted and examined for its genetic and characteristic properties. This method is invasive, painful, and takes a longer period to produce results. Various automatic Deep learning (DL) based schemes have been presented for the brain glioma detection, but they lack due to poor explainability, lower generalization, poor feature depiction, class imbalance problem and lower detection rate. This paper presents a deep learning based brain tumor detection using two way feature depiction model (TWFDM) that combines the 2D-Deep Convolution Neural Network (DCNN) and 1D-DCNN. The 2D-DCNN accepts the raw MRI images and the 1D-DCNN accepts the handcrafted local binary pattern (LBP), gray level cooccurrence matrix (GLCM), and Histogram of Oriented Gradient (HOG) features. Furthermore, improved particle swarm optimization (IPSO) is used for feature selection to minimize the computational complexity of the TWFDM system. The proposed TWFDM achieves an overall accuracy of 96.25%, a recall of 96.34%, a precision of 96.31%, and an F1-score of 96.32% on the Brain MRI dataset for four-class classification, representing an important improvement over traditional techniques.

Obesity is a primary global public health concern, often associated with impaired muscle function and an increased risk of exercise-related injuries. This cross-sectional study aimed to elucidate the associations among muscular strength, body load, and functional capacity in young adults with obesity. A total of 75 male university students were recruited, including a normal-weight group (n = 47, BMI 18.5-24.99) and an obese group (n = 28, BMI ≥ 30). Assessments included handgrip strength, one-repetition maximum (1RM) for squat, deadlift, and bench press, as well as isokinetic strength evaluations across four major joints (shoulder, elbow, hip, and knee), yielding 32 strength-related variables. After normalizing all strength measures to body weight, the obese group demonstrated significantly lower relative strength across all parameters compared to the normal-weight group (P < 0.001), indicating a distinct "strength-to-load imbalance." To identify key predictors of handgrip strength while addressing potential overfitting, we employed least absolute shrinkage and selection operator (LASSO) regression with cross-validation. The final model retained five predictors: elbow flexion maximum work at 180°/s (EF180°Wmax), elbow flexion peak torque at 180°/s (EF180°Fmax), elbow extension peak torque at 60°/s (EE60°Fmax), shoulder flexion peak torque at 60°/s (SF60°Fmax), and group (obese vs. normal), together explaining 63.3% of the variance in handgrip strength (adjusted R² = 0.606), although this finding should be interpreted with caution due to the sample size and requires validation in larger cohorts. Notably, group membership remained a significant independent predictor (β = -0.23, P = 0.014), underscoring the persistent deficit in relative strength associated with obesity even after accounting for joint-specific strength. By incorporating a multidimensional assessment of strength across multiple joints, this study moves beyond the limitations of single-joint evaluations and offers theoretical support for the potential use of handgrip strength as a practical indicator of overall muscle function in obese populations. Further research with larger samples and longitudinal designs is needed to validate its utility as a screening tool. These findings have important implications for designing function-oriented, precision-based exercise interventions for obese populations.

Technological innovation drives high-quality economic development, and artificial intelligence (AI) represents a new impetus for developing productive forces with new qualities. AI is becoming a focal point in economic development plans and national strategies worldwide due to its contribution to economic growth and the transformation of traditional production methods. This paper examines the impact and mechanism of AI on the export technological complexity of Chinese manufacturing enterprises from a corporate perspective. It utilizes data from listed manufacturing companies on the Shanghai and Shenzhen A-shares from 2008 to 2021 and employs a fixed-effects model. The results indicate that: (1) AI positively promotes the export technological complexity of Chinese manufacturing enterprises, with more pronounced effects in regions with higher export technological complexity. (2) Heterogeneity analysis indicates that AI significantly enhances the export technological complexity across various categories of enterprises. Particularly notable impacts are observed among state-owned enterprises, light textile enterprises, and enterprises located in the eastern and central regions. (3) Mechanism analysis reveals that AI indirectly promotes the export technological complexity of manufacturing enterprises by improving labor structure and enhancing corporate innovation capabilities. This study proposes relevant policy recommendations from four aspects: strengthening AI technology research and application, optimizing labor structure, enhancing corporate innovation development, and promoting balanced AI development.

In this study, electrical discharge machining (EDM) of AISI D2 die steel was performed by varying three different process parameters: peak current (Ip), pulse-on time (Ton), and duty cycle (c). Enhancing both surface quality and machining performance is very important for die steel applications; therefore, a hybrid approach for multi-objective optimization was employed. A Box-Behnken design of response surface methodology (RSM) was utilized to conduct the experiments, while analysis of variance (ANOVA) was used to examine the influence of process parameters on the responses. Mathematical models were developed using RSM, which were finally utilized as fitness functions for the Non-Dominated Sorting Genetic Algorithm II (NSGA-II) to get solutions of multi-objective optimization. The algorithm generated a set of non-dominated solutions forming the Pareto frontier. To identify the most desirable solution, the Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) was used. The optimal results obtained through TOPSIS analysis were a surface roughness of 5.22 µm and a material removal rate (MRR) of 0.250 g/min, corresponding to the process parameters: peak current (Ip) = 10.03 A, pulse-on time (Ton) = 30.70 µs, and duty cycle (c) = 14.94%.

BACKGROUND: Bile leakage remains a clinically relevant complication after hepatectomy and contributes to morbidity, prolonged drainage, extended hospital stay, and the need for reintervention. Intraoperative indocyanine green (ICG) fluorescence imaging can be used to visualize bile leaks from the transection plane or biliary stump, enabling targeted repair. However, evidence for the effect of this technique on clinically relevant bile leakage is heterogeneous and has not been systematically synthesized. METHODS AND ANALYSIS: This protocol describes a systematic review and meta-analysis of randomised controlled trials and comparative nonrandomised studies evaluating indocyanine green fluorescence imaging-guided intraoperative bile leak detection during hepatectomy. MEDLINE, Embase, Cochrane CENTRAL, and the Web of Science Core Collection will be searched from inception, along with trial registries and citation tracking. The primary outcome is clinically relevant postoperative bile leakage, defined as International Study Group of Liver Surgery (ISGLS) grade B or C. Secondary outcomes include any bile leakage, bile leak-related interventions, major postoperative complications, length of postoperative hospital stay, and mortality. Randomised and nonrandomised studies will be synthesized separately. A meta-analysis will be performed when the studies are sufficiently comparable; otherwise, the findings will be summarized narratively. Planned analyses include random-effects models, subgroup analyses stratified according to the route of indocyanine green administration, sensitivity analyses, and an assessment of the certainty of evidence using the Grading of Recommendations Assessment, Development and Evaluation approach. This protocol is registered in PROSPERO (CRD420261291065). This manuscript describes the planned methods only; study selection, data extraction, and evidence synthesis results will be reported in the completed systematic review. ETHICS AND DISSEMINATION: This study will use data from published studies and does not require ethics approval. The findings will be disseminated through peer-reviewed publications and conference presentations.

INTRODUCTION: Obese, osteoporotic patients with intertrochanteric fractures face higher surgical risks and delayed recovery. The "Gold Wrist," an auxiliary curved guiding instrument for proximal femoral nail anti-rotation (PFNA), was developed to assist guidewire placement and improve procedural efficiency. METHODS: In this retrospective cohort study, 500 patients (almost all with BMI > 28 and varying degrees of osteoporosis) underwent PFNA using either the Gold Wrist (n = 250) or conventional instruments (n = 250). Outcomes included operative time, fluoroscopy exposure, incision length, inflammatory markers, functional recovery, internal medicine complications, mechanical complications, hospitalization cost, and estimated carbon footprint. Finite element analysis assessed device mechanical stability. RESULTS: Finite element analysis confirmed reliable mechanical performance. The Gold Wrist group had shorter operative time (114.7 ± 34.6 vs. 127.3 ± 34.3 min), smaller incisions (6.15 ± 1.88 vs. 7.27 ± 1.79 cm), and lower TNF-α, IL-6, CRP, and CK levels (all P < 0.0001). Functional recovery was faster, with higher Harris Hip Scores (87.7 ± 2.7 vs. 84.7 ± 3.4) and greater hip motion. Internal medicine complications-including infection, deep vein thrombosis, pulmonary embolism, and cardiovascular events-were significantly reduced. Mechanical complications, including implant failure, were reported separately. Hospitalization costs and estimated carbon footprint were also lower. CONCLUSION: The auxiliary Gold Wrist device improves surgical precision, accelerates recovery, and reduces internal medicine complications in obese, osteoporotic patients undergoing PFNA. It offers a clinically effective and sustainable approach to managing high-risk intertrochanteric fractures.

INTRODUCTION: Chronic alcohol consumption induces multisystem dysfunction, including cardiovascular instability, hematological alterations, and oxidative stress imbalance. However, the extent of short-term recovery following structured detoxification remains incompletely characterized. OBJECTIVE: To evaluate the short-term effects of a standardized inpatient alcohol detoxification protocol on cardiovascular, hematological, and oxidative stress biomarkers. METHODS: A prospective observational before-and-after cohort study was conducted on 75 male participants, including 50 patients with alcohol use disorder and 25 healthy controls. Patients underwent a 21-day inpatient detoxification program comprising pharmacological stabilization and nutritional rehabilitation. Clinical and biochemical parameters-including body mass index, vital signs, lipid profile, complete blood counts, troponin-I, and oxidative stress markers (TBARS, glutathione peroxidase, and catalase)-were assessed at baseline and post-treatment. RESULTS: Compared to healthy controls, treatment-naïve patients with alcohol use disorder (AUD) exhibited significantly elevated baseline levels of lymphocytes, total cholesterol, low-density lipoprotein (LDL), thiobarbituric acid reactive substances (TBARS), and catalase (CAT), alongside significantly lower heart rate (HR), systolic blood pressure (SBP), neutrophil-to-lymphocyte ratio (NLR), high-density lipoprotein (HDL), and glutathione peroxidase (GPx). Baseline anthropometric, vital, hematological, and metabolic markers-including BMI, diastolic blood pressure (DBP), hemoglobin (Hb), platelets, total white blood cell count (WBCs), cardiac troponin-I (cTnI), and triglycerides-showed no statistically significant differences. Following a 21-day inpatient detoxification protocol, post-treatment assessments revealed significant increases in red blood cell parameters (RBCs, Hb, Hct), neutrophils, lymphocytes, NLR, and HDL. Conversely, standard detoxification induced significant reductions in cardiovascular, lipid, and oxidative stress indices, specifically HR, SBP, mean corpuscular volume (MCV), total WBCs, cTnI, total cholesterol, triglycerides, TBARS, and CAT. No significant post-treatment alterations were observed in BMI, DBP, platelet counts, LDL, or GPx. CONCLUSION: Short-term alcohol detoxification leads to partial recovery of cardiovascular and hematological parameters, while oxidative stress markers show limited normalization within the 21-day period. These findings highlight differential recovery patterns across biological systems following early abstinence.

Our objective was to investigate the relationship between self-concept clarity, intolerance of uncertainty, and schizotypal traits, with a focus on whether intolerance of uncertainty moderates the association between self-concept clarity and positive schizotypy in a non-clinical context. A sample of 315 adults (on average 43 (SD = 12) years, 247 women) completed the Self-Concept Clarity Scale, the Intolerance of Uncertainty scale, and the Schizotypal Personality Questionnaire - Brief Revised. Lower self-concept clarity was significantly associated with higher levels of positive, negative, and disorganized schizotypy, as well as with greater inhibitory intolerance of uncertainty. Importantly, a moderation analysis revealed that intolerance of uncertainty significantly altered the strength of the negative relationship between self-concept clarity and both positive and disorganized schizotypy. Specifically, this association was strongest among individuals with low levels of intolerance of uncertainty. In contrast, at higher levels of intolerance of uncertainty, the negative relationship between self-concept clarity and both positive and disorganized schizotypy was weaker. This pattern suggests that, among individuals with lower tolerance for uncertainty, a better-defined self-concept is more strongly associated with lower levels of positive and disorganized schizotypy. These results underscore the importance of considering both self-structure and uncertainty tolerance in models of schizotypy and psychosis risk. Our findings suggest that self-concept clarity and intolerance of uncertainty are interrelated cognitive factors that synergistically explain variance in schizotypal traits. As intolerance of uncertainty is a potentially modifiable cognitive process, the results have implications for early interventions aimed at reducing psychosis risk by improving self-concept clarity and tolerance for uncertainty. Although the study used a non-clinical sample, it supports a dimensional approach to psychosis and highlights key targets for future research.

Chitosan nanoparticles (ChNPs) have gained attention due to their biodegradability, biocompatibility, and non-toxicity, and are found in a wide range of agricultural products. The green synthesis and characterization of ChNPs using ginger extract were evaluated for their effects on biochemical and morphological parameters in sesame (Sesamum indicum L.). Ginger-loaded ChNPs synthesis, size, structure, morphology, and crystallinity were confirmed via UV-Vis spectrophotometry, DLS (151.7 nm, ± 30 mV), FTIR, SEM, and XRD, respectively. Foliar applications of ChNPs (50 mg L-1 and 100 mg L-1) and pesticides confidor (2.5 mL L-1) confidor + talstar (2.5 mL L-1) were applied at flowering and capsule stages under controlled conditions. ChNPs at 100 mg L ⁻ ¹ significantly enhanced plant height 5.3%, leaf area 26.5%, number of capsules 43.6%, capsule weight (12.4%), stem diameter 34.4%, total chlorophyll 11.9%, and catalase activity 53.1% compared with the control (P < 0.05), while reducing peroxidase 85.7% and PAL 59%. In contrast, confidor and confidor + talstar treatments showed compromised effects. Present research demonstrated that green synthesized ChNPs have good potential for use in agriculture and can significantly increase sesame growth and yield.

BACKGROUND: Delayed Health-seeking behavior among cancer patients is a major contributor to late diagnosis, poor prognosis, and high mortality, particularly in low-resource settings like Ethiopia. However, evidence on the magnitude and determinants of delayed care-seeking remains fragmented. OBJECTIVE: This systematic review and meta-analysis aimed to estimate the pooled prevalence of delayed Health-seeking behavior among cancer patients in Ethiopia and to identify associated factors influencing delays. METHODS: This study employed a systematic review and meta-analysis design to assess delayed Health-seeking behavior and its influencing factors among cancer patients in Ethiopia. A systematic search was conducted in PubMed, Scopus, Web of Science, CINAHL, AJOL, Google Scholar, and Ethiopian University repositories until April 27, 2025. The data were extracted from March 10-20 and analyzed from March 21-30, with report generation till April 27, 2025, using R software. Meta-analysis was performed using a random-effects model, with forest plots illustrating pooled prevalence and associated factors. Heterogeneity was assessed using the I² statistic, and study quality was evaluated using a validated tool. RESULTS: Seven studies conducted across multiple regions of Ethiopia were included in the final analysis with a total of 2,641 participants. The pooled prevalence of delayed Health-seeking behavior among cancer patients was 54% (95% CI: 39%-68%). Meta-analysis of associated factors showed that rural residence was significantly associated with delayed Health-seeking behavior, with patients residing in rural areas having more than threefold higher odds of delay (AOR = 3; 95% CI: 1.81-4.19), poor knowledge about cancer was strongly associated with delay, with nearly seven times higher odds among patients with poor knowledge compared to those with adequate knowledge (AOR = 6.63; 95% CI: 2.21-11.05), lack of cancer awareness was also a significant predictor of delayed Health-seeking behavior (AOR = 2.63; 95% CI: 1.75-3.51), and patients without pain were over three times more likely to delay Healthcare(AOR = 3.38; 95% CI: 2.44-4.67) were factors associated with delayed Health-seeking behavior. CONCLUSIONS: Our review showed that half of the cancer patients in Ethiopia experienced delayed health-seeking behavior. Delayed care-seeking was associated with rural residence, poor knowledge, limited awareness of cancer, and absence of pain symptoms. Targeted interventions, including public awareness campaigns, expansion of healthcare services in rural areas, and financial support initiatives, are urgently needed to reduce delays and improve early cancer diagnosis and outcomes. PROSPERO REGISTRATION NUMBER: CRD420251037845.

AIMS: Conventional biomarkers such as estimated glomerular filtration rate (eGFR) and urinary albumin-to-creatinine ratio (uACR) primarily reflect glomerular damage and often fail to detect early tubular injury. Consequently, patients with "non-albuminuric diabetic kidney disease (DKD)" may be overlooked. This study evaluated the independent association between urinary post-translationally modified fetuin-A fragments (uPTM-FetA) and DKD risk stratification in Japanese patients with type 2 diabetes. METHODS: We conducted a cross-sectional study of 219 outpatients with type 2 diabetes between November 2023 and February 2024 at Edogawa Hospital. First-morning urine samples were analyzed for uPTM-FetA and urinary liver-type fatty acid-binding protein (uL-FABP) using enzyme-linked immunosorbent assays. DKD risk was classified into four categories based on the KDIGO guidelines. The association between uPTM-FetA and higher DKD-risk (categories 2 + 3 + 4) was assessed using multiple logistic regression and restricted cubic spline (RCS) analyses, validated by bootstrapping. RESULTS: The optimal cutoff value for uPTM-FetA was determined to be 11.76 ng/mgCr. Multivariable analysis adjusted for potential confounders revealed that high uPTM-FetA levels were significantly and independently associated with DKD-risk categories 2 + 3 + 4 (adjusted odds ratio: 3.88; 95% CI: 2.02-7.45; P < 0.01). RCS analysis indicated a significant non-linear association (P = 0.04). Notably, high uPTM-FetA was detected in 38.8% of patients with normoalbuminuria and 42.0% of those with preserved eGFR. A striking discrepancy was observed compared to uL-FABP: while high uL-FABP was completely absent (0.0%) in patients within the low-to-moderate risk categories (categories 1 and 2), high uPTM-FetA was observed in 34.0% and 60.8% of these patients, respectively. CONCLUSIONS: uPTM-FetA is independently associated with DKD severity and is elevated in a substantial proportion of patients with early-stage disease where conventional markers remain normal. Unlike uL-FABP, which increases predominantly in advanced stages, uPTM-FetA appears to identify tubular stress earlier. Thus, uPTM-FetA serves as a valuable complementary biomarker to uACR for refining DKD risk stratification.

INTRODUCTION: Growth monitoring and promotion (GMP) can be used to address developmental halting before a child's health deteriorates. However, there hasn't been much research done on the GMP uptake in the Wondo district. OBJECTIVE: The study aimed to evaluate GMP uptake and its associated factors among children aged under two years old in the Wondo District in 2024. METHODS: A cross-sectional design was conducted using random sampling. The data were analysed using SPSS version 25. Descriptive statistics and logistic regression with a p-value of less than 0.05 were used. RESULTS: GMP uptake was 14.2%. Household income above $32 monthly [AOR = 4.857, 95% CI: (2.009-11.744), read and write [AOR = 10.625, 95% CI: (2.667-42.334)], primary education [AOR = 9.067, 95% CI: (3.218-25.546)], secondary and above[AOR = 8.060, 95% CI: (2.952-22.007)], ANC follow up, [AOR = 2.871, 95% CI: (1.158-7.120)], health facility delivery [AOR = 4.037, 95% CI: (1.706-9.554)], PNC follow up [AOR = 4.110, 95% CI: (1.898-8.900)], maternal community conversation [AOR = 4.162, 95% CI: (1.974-8.775)], and family health cards utilization [AOR = 6.825, 95% CI: (2.935-15.867)] were significant variables. CONCLUSION: The GMP uptake was 14.2%. ANC follow-up, institutional delivery, PNC follow-up, family/child health card utilization, maternal community discussions, mother's educational status, and household income were associated factors. Community conversations, family health cards, ANC, institutional delivery, and PNC follow-up can improve GMP services.

BACKGROUND: Contrast-associated acute kidney injury (CA-AKI) is a renal impairment that occurs after several days of intravascular administration of iodine-containing contrast media. ClpP is a key protease that plays an important role in cellular mitochondrial function. This study investigated the role of ClpP in mitochondrial dynamics and early injury in an in‑vitro CA‑AKI model. METHODS: mRNA sequencing was performed on HK-2 cells with or without iohexol exposure. Cell viability, mitochondrial dynamics-related protein expression, mitochondrial membrane potential (MMP), and cell apoptosis were assessed by cell counting kit-8, immunoblotting, JC‑1 staining and flow cytometry, respectively. RESULTS: Iohexol treatment at 80 mg I/mL reduced HK-2 cell viability to 63.44%, induced mitochondrial fission, inhibited mitochondrial fusion and promoted apoptosis. mRNA sequencing revealed significant upregulation of Opa1 and ClpP gene expression, as well as alterations in proteasome‑related signaling in iohexol-induced HK-2 cell. Western blot analysis further confirmed elevated ClpP protein expression after iohexol exposure. Importantly, ClpP knockdown partially restored MMP, increased Opa1 expression, improved mitochondrial morphology, and alleviated iohexol‑induced apoptosis. CONCLUSION: ClpP deficiency may exert cytoprotective effects against iohexol-induced HK-2 cell injury, at least partly through changes associated with mitochondrial dynamics, partial preservation of MMP, and attenuation of apoptosis. These findings suggest that ClpP may represent a potential molecular target for further investigation in CA-AKI.

OBJECTIVE: Even after long-term nucleos(t)ide analogue (NA) therapy achieves hepatitis B virus (HBV) DNA suppression in patients with chronic hepatitis B (CHB), serum HBV RNA may remain detectable. HBV RNA reflects intrahepatic viral transcriptional activity. This study identified baseline traits and predictors of persistent HBV RNA positivity during NA therapy after sustained HBV DNA suppression. METHODS: This retrospective study included 155 CHB patients who underwent liver biopsy before initiating NA therapy, subsequently achieved sustained HBV DNA suppression on continuous NA therapy. Patients were classified into two groups according to HBV RNA status during therapy. Baseline clinical, virological and histological variables were assessed by multivariate logistic regression. Correlations between HBV RNA and serological markers were also assessed. The diagnostic performance of the model was analyzed using area under the receiver operating characteristic (AUC) and boostrap internal validation. RESULTS: Overall, 47.7% achieved undetectable serum HBV RNA. Higher baseline HBV DNA and absence of intrahepatic hepatitis B core antigen (HBcAg) independently predicted persistent HBV RNA positivity (both P < 0.001). The combined assessment of HBcAg with HBV DNA improved predictive accuracy (AUC = 0.780), outperforming either marker alone. The AUC value of bootstrap internal validation was 0.756. Across the cohort, HBV RNA showed moderate correlation with hepatitis B surface antigen (HBsAg), hepatitis B e antigen (HBeAg) and hepatitis B e antibody (HBeAb). Correlations were minimal in HBeAg-negative patients and most evident in HBeAg-positive patients. CONCLUSION: Incorporating HBcAg histology with baseline HBV DNA may enable more individualized treatment strategies during antiviral therapy. Correlations between HBV RNA and traditional markers are primarily observed in HBeAg-positive patients.

Siphonophores (Cnidaria: Hydrozoa) are pelagic colonial marine invertebrates with many highly specialized bodies (zooids) within a single colony. Their unique biology and ecological importance have made them of particular interest, and motivate questions on their genomic structure, organization and content. To investigate siphonophores' genome biology and develop resources for future studies, we sequenced the genome of a single Nanomia septata to chromosome scale. The haploid genome is 1.7 GB across 8 chromosomes. Relative to closely related hydrozoan genomes, this is an expansion in length but a reduction, from 15, in chromosome number, indicating multiple chromosomal fusion events. We found no genomic features clearly associated with siphonophores' exceptional colony-level complexity. Gene families that play critical roles in cnidarian development have not expanded, and gene proximity was not generally correlated to their expression across zooids, except in male gonophores. To contextualize these observations, we sequenced 20 additional Nanomia specimens across the globe and mapped them to our chromosome-scale reference. Population genomic analyses support three previously recognized species of Nanomia, and at least one additional undescribed species. Present day overlapping geographic distribution of some Nanomia species raises the possibility of reproductive isolation in sympatry. Phylogenetic analyses of genome size indicate Nanomia septata and Nanomia cara have similarly large genomes around 1.7 GB, while Nanomia bijuga and an undescribed species show a secondary reduction to 0.7 GB. These results highlight how genomic factors have shaped colony organization and genome diversity within Nanomia.

BACKGROUND AND AIMS: The impact of hospital rurality and weekend admission on outcomes in decompensated cirrhosis remains unclear. Studies suggest mixed effects of weekend admission on mortality and increased mortality in rural hospital admissions for decompensated cirrhosis. This study evaluated the influence of hospital rurality, weekend admission, and their interaction on outcomes in decompensated cirrhosis from 2016 to 2020. METHODS: A cross-sectional analysis of the National Inpatient Sample (NIS) assessed in-hospital mortality (primary outcome), likelihood of specific procedures (esophagogastroduodenoscopy, paracentesis, TIPS, hemodialysis), and time to first procedure. Regression models adjusted for demographics, liver disease etiology, clinical severity (APR-DRG mortality risk), and other factors. RESULTS: Among 11,845,223 hospitalizations, rural hospitalizations were linked to lower in-hospital mortality (OR: 0.84; 95% CI: 0.80-0.86) and higher transfer rates for severe cases (7.2% vs. 2.8%, p < 0.001). Weekend admissions showed a statistically significant but only modest reduction in mortality odds (OR: 0.99; 95% CI: 0.975-0.998). No significant interaction existed between rurality and weekend admission regarding mortality. Rural hospitals showed lower odds of performing procedures (95% CIs < 1), though time to procedure was comparable, except for earlier hemodialysis (-1.35 days; 95% CI: -2.59 to -0.11). Weekend admissions did not significantly impact procedure rates, except for paracentesis (OR: 0.94; 95% CI: 0.88-0.99). CONCLUSIONS: Using a national cohort of hospitalized patients with decompensated cirrhosis, we showed that rural hospitals exhibited lower in-hospital mortality, fewer procedures, and higher transfer rates, and that weekend admissions showed only a minimal, clinically insignificant reduction in mortality, irrespective of hospital rurality.

The feasibility of reusing granular weathered (GW) soil as foundation fill is closely related to the strength and stability. Initial moisture content and compaction energy were identified as the main factors affecting the strength and deformation behavior of GW soil. GW soil samples were prepared with different initial moisture contents ranging from 7 ~ 15% and compacted under varying compaction energies ranging from 50 ~ 125%, respectively. The results indicate that the permeability coefficient decreases sharply with increasing compaction energy and then gradually stabilizes at higher compaction energy levels, suggesting that compaction energy is the dominant factor governing soil permeability. Higher initial moisture content leads to larger strains due to the presence of thicker adsorbed water films, whereas higher compaction energy enhances interparticle bonding, reduces the void ratio, and increases soil stiffness. In particular, the void ratio is affected by both initial moisture content and compaction energy, highlighting the necessity of incorporating compaction energy into predictive permeability models. Furthermore, a compaction-energy-based permeability prediction model was developed, with the predicted results showing strong agreement with the experimental data. These findings provide practical guidance for optimizing the compaction of GW soil to enhance foundation stability and reduce the risks associated with rainfall infiltration, and seepage failure.