Atmospheric and Oceanic Sciences

BACKGROUND: Non-communicable diseases (NCDs) account for 74% of global deaths, significantly affecting children and adolescents, particularly in low and middle-income countries. Addressing risk factors such as smoking, poor diet and physical inactivity through school-based interventions is crucial for reducing NCD prevalence and improving long-term health outcomes among youth. Therefore, this study aims to explore school children's lifestyle habits, identify barriers and assess facilitators for adopting a healthy lifestyle. METHODS: This study utilized qualitative research methodology (focus group discussions (FGDs) and in-depth interviews (IDIs)) to collect comprehensive insights from school children, teachers, parents, and school canteen staff. It was carried out in both rural and urban regions of Jodhpur district, Rajasthan, a western state of India with a purposive sample of 31 participants. Thematic analysis was performed using NVivo 14. RESULTS: Our study reveals that while participants have a basic understanding of NCDs, there is a significant gap in their knowledge of NCD-related health initiatives. Barriers to healthy lifestyles include limited access to recreational spaces, unhealthy food options, and socioeconomic factors. However, family and peer support and school initiatives are crucial in promoting healthy behaviours. CONCLUSION: Bridging the gap between health knowledge and practice requires a holistic approach. Enhancing communication about health programs, improving access to recreational spaces, and implementing policies to regulate unhealthy foods are essential. Engaging families and educators and integrating health education into school curriculums will help promote healthier behaviours and reduce the risk of non-communicable diseases.

Text classification using traditional machine learning techniques has been used in natural language processing (NLP) tasks to distinguish translated from non-translated languages, with high accuracy scores indicating the distinctive style of translated languages. While deep learning (DL) has demonstrated impressive performance in terms of representation learning and capturing nuanced patterns in natural language data, DL models act as black boxes, making their results difficult to interpret. This study addresses this issue by demonstrating an explainable AI (XAI) DL framework in a case study of United Nations (UN) meetings. The framework consists of three stages: i) train a variational autoencoder (VAE) combined with BERT embeddings converted from translated and non-translated texts; ii) utilize the majority vote from three classifiers selected from a stacked ensemble to classify the VAE's latent representations; iii) implement a perturbation-based XAI method to interpret the DL model's decisions. The results indicate that the VAE-based model effectively distinguishes the two text types, with accuracy scores above 0.8. The XAI analysis reveals that interpreting the VAE-based model's decision uncovers stylistic differences between the two text types beyond superficial lexical and syntactic features. This proof-of-concept study demonstrates the potential of the XAI DL framework in other NLP studies that aim to analyze style.

The initiation, expansion and penetration of cracks in rock masses are important reasons for rock mass failure. Orthogonal crack is the most typical form of cracks. There is still a lack of in-depth and detailed research on the law of expansion and penetration of orthogonal cracks. In this paper, the RFPA software is used to study the failure process of the rock mass with orthogonal fractures, and the influence of the change of the angle α between the main fracture and the loading direction on the failure mode and the failure mechanical properties of the specimen is comprehensively explored. The simulation results show that the angle α between the different main fractures and the loading direction affects the internal stress state of the rock, redistributes the stress field at the tip of the fracture and the surrounding area, resulting in the difference in the energy required for the expansion of the new fracture, which is manifested in the macroscopically as the difference in the strength of the rock and acoustic emission quantity.

The power transformer bushing is a critical insulation component and a frequent contributor to transformer failures. This paper presents combined electrical and Multiphysics approaches for mapping failure mechanisms in Resin-Impregnated Paper (RIP) transformer bushings using frequency response analysis (FRA) and electrostatic analysis. An 11 kV/0.433 kV, 500 kVA power transformer bushing is selected as a case study and modeled using a MATLAB-based equivalent circuit to simulate its FRA characteristics. Variations in bushing circuit capacitance are introduced to represent insulation degradation, surface pollution, and insulator damage, and the corresponding failure modes are mapped through their distinctive FRA signatures. To provide physical insight into these failure mechanisms, a detailed model is developed in COMSOL Multiphysics, where degradation, pollution, and destructive damage are analyzed using electric field and electric potential distributions. The results from the FRA simulation and electrical Multiphysics in this paper provide a framework for understanding the behavior of transformer bushing failures and enable early fault detection. This also improves the transformer bushing maintenance and condition monitoring.

Cervical spinal cord injury (SCI) often results in severe motor and sensory deficits, leading to substantial impairment in activities of daily living. Malnutrition is common after SCI and may adversely affect recovery; however, the association between early nutritional status and subsequent neurological and functional recovery remains unclear. This study examined the association between early nutritional status and neurological and functional recovery after acute traumatic cervical SCI. Ninety-one patients admitted within 72 hours of injury and followed for at least 6 months were retrospectively analyzed. Neurological function was assessed using the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) total motor score, and functional independence was evaluated using the Spinal Cord Independence Measure version Ⅲ (SCIM Ⅲ). Nutritional status after SCI was assessed using the Prognostic Nutritional Index (PNI), Geriatric Nutritional Risk Index (GNRI), and Controlling Nutritional Status (CONUT) score. Recovery rates were calculated as the proportion of the maximum possible improvement achieved between 4 weeks and 6 months after SCI. Patients with higher PNI at 4 weeks after SCI showed greater neurological and functional recovery. Mean ISNCSCI total motor score recovery rates were 43.89%, 28.08%, and 18.7% in the good, normal, and poor PNI groups, respectively (p for trend = 0.0005), with corresponding SCIM III recovery rates of 40.65%, 26.1%, and 22.41% (p for trend = 0.0072). GNRI and CONUT scores were also associated with ISNCSCI total motor score recovery; however, PNI showed the strongest predictive performance (p = 0.0031). In multivariable linear regression analyses adjusting for age, sex, and baseline neurological and functional status, PNI remained independently associated with ISNCSCI total motor score recovery (β = 0.857 per 1-point increase, 95% CI 0.011-1.703, p = 0.0471). These findings indicate that early nutritional status, particularly as assessed by the PNI, is independently associated with neurological recovery after cervical SCI and may be useful for early prognostic assessment.

INTRODUCTION: Maternal undernutrition remains a major public health concern globally, particularly in Somalia, where conflict, poverty, and food insecurity exacerbate nutritional deficiencies. Undernutrition during pregnancy poses serious risks to both maternal and fetal health, including increased maternal mortality, low birth weight, and adverse developmental outcomes. Despite its critical implications, there is limited evidence on the burden and associated factors of maternal undernutrition in Somalia. This study assessed the prevalence and associated factors of undernutrition among pregnant women attending antenatal care (ANC) services in public hospitals in Mogadishu. METHODS: A facility-based cross-sectional study was conducted among 734 pregnant women attending antenatal care (ANC) services in public hospitals in Mogadishu. Participants were selected using a multistage sampling technique. Data were collected using interviewer-administered questionnaires and anthropometric measurements. Undernutrition was assessed using mid-upper arm circumference (MUAC < 23 cm), a measure commonly applied in clinical and humanitarian settings. Household food insecurity was assessed using the Household Food Insecurity Access Scale (HFIAS). Data were analyzed using SPSS version 26, and multivariable logistic regression was performed to identify factors associated with undernutrition at a significance level of p < 0.05. RESULTS: The prevalence of maternal undernutrition was 75.7% (95% CI: 72.6%-78.9%). Factors independently associated with undernutrition included maternal age 25-31 years (AOR = 2.61, 95% CI: 1.28-5.30) and 32-38 years (AOR = 2.18, 95% CI: 1.04-4.55), tertiary education (AOR = 3.43, 95% CI: 1.89-6.21), employee occupation (AOR = 6.38, 95% CI: 2.90-14.04), private business occupation (AOR = 9.79, 95% CI: 4.27-22.43), large household size (AOR = 1.96, 95% CI: 1.34-2.88), urban residence (AOR = 2.40, 95% CI: 1.39-4.15), household monthly income < USD 500 (AOR = 1.98, 95% CI: 1.33-2.94), lack of latrine facility (AOR = 2.00, 95% CI: 1.23-3.26), second (AOR = 8.59, 95% CI: 5.29-13.97) and third trimester (AOR = 6.91, 95% CI: 2.97-16.08), primigravidity (AOR = 2.29, 95% CI: 1.52-3.45), contraceptive use (AOR = 1.98, 95% CI: 1.34-2.90), substance use (AOR = 2.79, 95% CI: 1.93-4.04), and severe household food insecurity (AOR = 1.76, 95% CI: 1.01-3.08). However, some associations with large effect sizes should be interpreted with caution, as they may reflect residual confounding, small subgroup sizes, or model instability. CONCLUSION: This study revealed a high prevalence of maternal undernutrition among pregnant women attending ANC services in Mogadishu, with multiple factors found to be associated with undernutrition. These findings highlight the need for targeted, multi-sectoral interventions to improve maternal nutrition through enhanced food security, health education, and access to nutrition-sensitive and nutrition-specific services. Targeted strategies such as supplementation programs, nutrition counseling, and improved water, sanitation, and hygiene (WASH) services are critical to mitigating maternal undernutrition and achieving Sustainable Development Goals related to maternal and child health.

This paper examines the effect of the 1984 Hatch-Waxman Act and its 2003 amendment - the Medicare Prescription Drug, Improvement, and Modernization Act - on the level of innovation in pharmaceutical firms. In part, the purpose of these policies was to balance the exclusivity rights of pioneer drug manufacturers with generic drug competition, which would allow for more consumer affordability. Using difference-in-difference regression analysis, we analyze how, relative to innovation in other industries, pharmaceutical innovation changes surrounding the implementation of the two laws. Results from several difference-in-difference tests show that, relative to non-pharmaceutical firms, research and development (R&D) in pharmaceutical firms markedly increased during the post-Hatch-Waxman period. We do not find, however, that the 2003 amendment directly influenced pharmaceutical innovation. If anything, the latter policy was associated with a reduction in innovation. These findings seem to suggest that the level of pharmaceutical innovation is highly sensitive to changes in policy that might change the incentives for firms to innovate.

Although COVID-19 vaccines are widely available and effective, vaccination anxiety remains a significant public health challenge that is distinct from behavioral vaccine hesitancy. While various scales measure hesitancy, few specifically capture the multifaceted psychological anxiety regarding COVID-19 vaccines, and none have been validated for the Japanese population. To directly quantify this affective component, this study aimed to develop and validate the COVID-19 Vaccination Anxiety Scale for Japanese adults. A two-wave web-based survey was conducted with 500 Japanese adults. Participants completed the newly culturally adapted 25-item scale alongside validation measures assessing fear of COVID-19, vaccination readiness, conspiracist beliefs, and perceived vulnerability to disease. Test-retest reliability was evaluated after a four-week interval. Factor analyses revealed a three-factor structure: Anxiety Related to Vaccine Confidence, Emotional Symptoms of Anxiety, and Anxiety about Infection after Vaccination. The scale showed good internal consistency and high test-retest reliability, and multigroup analyses suggested approximate comparability of the three-factor structure across gender. Construct validity was supported through significant, theoretically aligned correlations with the external criteria. Specifically, vaccination anxiety was strongly associated with lower vaccination readiness, higher fear of infection, and greater conspiratorial beliefs. These findings highlight that vaccination anxiety is a complex emotional response that requires specific measurement. From a public health perspective, the results suggest that addressing affective concerns-rather than solely providing analytic risk data-is crucial for effective communication. The COVID-19 Vaccination Anxiety Scale provides a useful tool for monitoring population-level anxiety and evaluating targeted interventions in Japan. Future studies should examine whether the same structure is replicated in younger and more age-balanced samples and whether the scale can be adapted for use in other settings.

PURPOSE: To characterize bullous keratopathy (BK) associated with a shallow anterior chamber (AC) and to examine whether a shallow AC itself may be associated with corneal endothelial decompensation, even in the absence of acute primary angle closure (APAC) or argon laser iridotomy (ALI). METHODS: This multicenter retrospective observational study included 96 eyes that underwent Descemet membrane endothelial keratoplasty (DMEK) for endothelial dysfunction between 2015 and 2025 with ≥12 months of follow-up. The primary comparative analyses compared eyes with Fuchs endothelial corneal dystrophy (FECD) and eyes with endothelial dysfunction associated with a shallow AC. The shallow anterior chamber phenotype group comprised eyes with a documented history of APAC or ALI (PACD/ALI) and those without a documented history of either condition (shallow-AC). Anterior chamber depth (ACD), axial length, corneal thickness, endothelial parameters, and postoperative outcomes were compared between groups. RESULTS: Pre-cataract ACD was significantly shallower in the shallow anterior chamber phenotype group than in the FECD group (1.93 ± 0.40 mm vs. 2.28 ± 0.27 mm, P < 0.001), and this relative difference persisted after cataract surgery. Within the shallow anterior chamber phenotype group, 10 eyes were classified as shallow-AC and had no documented history of APAC or ALI. Five-year graft survival after DMEK exceeded 90% and did not differ significantly between the shallow anterior chamber phenotype and FECD groups, nor between PACD/ALI and shallow-AC subgroups. CONCLUSIONS: A shallow anterior chamber may be associated with corneal endothelial decompensation, even in the absence of APAC or ALI. With appropriate perioperative management, DMEK may provide favorable long-term outcomes in these eyes.

Rural spatial justice studies lack frameworks addressing rural-urban contextual gaps. We bridge this by proposing a three-dimensional model (recognition-distribution-participation) to quantify villagers' spatial justice perceptions in transitional villages with old-new coexistence. Using 314 surveys across Zhushan (Hunan) and Dabitou (Guangxi), structural equation modeling (SEM) confirms the model explains 63% of variance-highlighting the interconnected nature of recognition, distribution, and participation in shaping justice perceptions, a nuance that single-dimension approaches may overlook.Key results reveal: Distributive justice (e.g., infrastructure equity) dominantly shapes perceptions (β = 0.45);Recognition justice is mediated by cultural symbols but constrained by weak revitalization; Participatory justice remains critically low due to governance deficits. Qualitative contrasts suggest how endogenous governance in Zhushan may strengthen recognition, while capital-driven monopolies in Dabitou appear to suppress participation.This study advances rural geography by:Adapting urban-centered justice theory to rural transitions;Providing a preliminary metric for spatial equity assessment in similar aging rural contexts. Findings offer context-specific insights for optimizing public space allocation in transforming villages facing comparable demographic challenges.

Post COVID-19 condition (PCC) significantly affects health-related quality of life (HRQoL), but involvement and interconnectivity of different health dimensions is still underexplored. This study aims to characterize the multidimensional health status of individuals with and without PCC after at least one year follow-up. Hospitalized and non-hospitalized COVID-19 patients were included from three hospitals in the Netherlands. HRQoL, pulmonary and metabolic health, muscle strength, physical capability, symptoms, psychological- and social wellbeing, and cognitive function were measured using validated objective and subjective methodology. Presence of PCC was based on self-report. 139 participants were included, of which 87 with PCC and 52 without PCC. HRQoL was lower in the PCC group compared to the non-PCC group (EQ-5D: p = 0.005; VAS: p < 0.001). Individuals with PCC also more frequently reported fatigue, anxiety/depression, stress and loneliness, alongside lower subjective cognitive functioning and sleep quality (p < 0.05). Inspiratory muscle strength and exercise capacity (p = 0.024 and p = 0.007) were lower in the PCC group than the non-PCC group. Pulmonary function and residual CT-abnormalities, body composition, cardiometabolic risk, expiratory- and peripheral muscle strength, mobility, physical activity, and cognitive function tests were not different between groups. Perceived health burden in PCC is reflected by lower health status, more frequently reported symptoms of fatigue and poor sleep quality, and lower psychological- and social wellbeing and subjective cognitive functioning compared to non-PCC. These differences are only partially reflected in objectively assessed dimensions of muscle strength and physical capability, but not in pulmonary/metabolic health and cognitive function. The findings indicate a discordance between subjective health burden and currently available objective assessments in individuals with PCC.

[This corrects the article DOI: 10.1371/journal.pone.0321223.].

[This corrects the article DOI: 10.1371/journal.pone.0351706.].