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Communicable disease reporting is essential for public health surveillance, yet underreporting is common. California Title 17 mandates that health care providers report >80 communicable diseases to local health departments, according to the patient's residence. We conducted a cross-sectional survey assessing health care provider knowledge, attitudes, and practices related to reporting requirements in Alameda County, California. Of 145 health care providers surveyed from April through June 2025, 127 (87.6%) were aware of Title 17 requirements and 105 (72.4%) had submitted at least 1 report. In multivariable logistic regression analysis using Firth penalized likelihood, the following were significantly associated with higher odds of reporting communicable diseases: having an awareness of reporting requirements versus no awareness (adjusted odds ratio [AOR] = 6.91; 95% CI, 1.21-58.36), having >10 years of clinical experience versus <5 years of clinical experience (11-20 years: AOR = 11.07 [95% CI, 2.30-64.68]; >20 years: AOR = 10.89 [95% CI, 2.28-62.59]), and having training in systems of institutional reporting versus no training (AOR = 5.37; 95% CI, 1.56-22.52). Misunderstanding reporting responsibility versus accurately identifying reporting responsibility was associated with lower odds of reporting communicable diseases. Improving clinician training, clarifying reporting expectations, and expanding electronic reporting systems may strengthen public health surveillance.
This research examines the intersection of education and political systems, exploring how instructional practices align with neoliberal policies. Education is often viewed as a means to address societal issues such as unemployment and inequality; however, its emphasis on creativity, critical thinking, and ethical considerations may sometimes be overlooked. A shift toward fostering critical engagement and societal development could be benefi cial. Using a descriptive approach, this study retrieved articles from the Web of Science and Scopus databases. In Iran, the education system has undergone notable changes since the Islamic Revolution in 1979, primarily aligning with ideological objectives. While enrollment rates have increased, the system appears to face challenges such as outdated curricula, structural ineffi ciencies, centralized governance, and limitations in teacher training. Although reforms have aimed at reinforcing ideological priorities, their impact on fostering innovation and global competitiveness remains uncertain. Additionally, regional disparities and gender inequalities continue to be areas of concern. Key challenges may include an overreliance on rote learning, limited adoption of modern pedagogical methods, and insuffi cient coordination between research and policy implementation. Teacher motivation could also be aff ected by inadequate wages and institutional support, potentially infl uencing the overall quality of education. Furthermore, both teachers and students encounter barriers to accessing equitable and high-quality education, which may hinder educational progress. Psychological concerns among Iranian students appear to be rising, possibly due to academic stress, suboptimal educational environments, and family dynamics. Research suggests that supportive family and school settings may play a signifi cant role in improving mental wellbeing, motivation, and self-perception. Adolescents, in particular, seem to benefi t from strong familial bonds, which could positively impact their mental health and academic performance. Based on these fi ndings, it may be advisable to consider reducing political infl uence in education, modernizing curricula, investing in teacher re-training, and integrating psychological support within schools. Decentralizing governance and fostering innovation could contribute to a more dynamic and responsive education system. While Iran's education system has made strides in enrollment, addressing these structural and pedagogical challenges could enhance its ability to prepare students for the demands of modern society while supporting their psychological and social well-being. (Neuropsychopharmacol Hung 2026; 28(2): 115-130) Keywords: Educational, Iran, Psychology, current trends.
Moderate-to-severe thrombocytopenia (platelet count < 100 × 109/L) occurs in fewer than 1% of pregnancies, posing management challenges, particularly surrounding eligibility for neuraxial anesthesia. Although recent anesthesia guidelines recommend a platelet threshold ≥ 70 × 109/L, outcomes data applying these recommendations in moderate-to-severe thrombocytopenia remain limited. We conducted a retrospective study of 306 pregnancy encounters at a tertiary U.S. center (January 2018-December 2022) with ≥ 1 documented platelet count < 100 × 109/L. Etiology, platelet nadir, hematology consultation, treatment patterns, and neuraxial anesthesia (NA) use were assessed from antepartum through postpartum discharge. Gestational thrombocytopenia (gTCP) was the most common etiology (29%, n = 92). Thrombocytopenia severity differed across etiology, with higher platelet nadirs in gTCP (mean 84, median 88.5 × 109/L) compared with ITP (mean 62, median 66 × 109/L). Overall, 15% of pregnancies received hematology consultation, the majority of which were for individuals with ITP, and 78% underwent NA. Among pregnancies complicated by ITP, 71% received NA. Hematology consultation in ITP was associated with lower platelet nadirs and higher treatment rates. In this cohort of moderate-to-severe thrombocytopenia, institutional adherence to guideline-recommended platelet thresholds was high and associated with excellent neuraxial safety outcomes. These findings provide real-world support for current anesthesia recommendations in a higher-risk obstetric population.
Sudden cardiac arrest disproportionately affects youths from lower socioeconomic neighborhoods, yet the mechanisms of this disparity in youth athletes remain unclear. We retrospectively analyzed the HeartBytes National Youth Cardiac Registry (Simon's Heart, a US nonprofit for sudden cardiac death prevention), in which youth athletes aged <17 years completed standardized cardiovascular symptom questionnaires before attending community-based preparticipation screening events, including physical exam and 12-lead ECG, across the United States between April 2015 and May 2024. Neighborhood opportunity was determined by linking residential zip code to census tract level child opportunity index 3.0 scores (range 1-100; higher values indicate greater opportunity), a composite spanning educational, health, environmental, and social and economic domains, with athletes grouped into national quintiles. Multivariable logistic regression examined associations between child opportunity index quintile and exercise-related cardiac symptoms and ECG abnormalities, adjusting for demographics, anthropometrics, hemodynamics, and comorbidities. Among 7843 youth athletes (median age, 14 years; 38.9% female; 83.0% White), distribution across child opportunity index quintiles was 7.4% very low, 4.3% low, 6.7% moderate, 16.7% high, and 65.0% very high. Compared with the very high quintile, athletes in the very low quintile had higher prevalence of exercise-related chest pain (9.1% versus 3.7%), exercise-related fatigue (11.4% versus 7.0%), and abnormal ECGs (10.0% versus 5.1%; all P<0.001). After multivariable adjustment, participants in the very high child opportunity index quintile had lower odds of exercise-related chest pain (adjusted odds ratio, 0.45 [95% CI, 0.32-0.63]), exercise-related fatigue (adjusted odds ratio, 0.65 [95% CI, 0.47-0.87]), and abnormal ECGs (adjusted odds ratio, 0.58 [95% CI, 0.42-0.82]) relative to the very low quintile. Youth athletes from lower-opportunity neighborhoods were underrepresented in preparticipation screening and demonstrated higher prevalence and adjusted odds of exercise-related cardiac symptoms and ECG abnormalities. Prospective longitudinal studies are needed to determine clinical significance and inform equitable screening strategies.
The Chlamydiota phylum consists of obligate intracellular bacteria, including well-known pathogens and emerging environmental species, with diverse host ranges and metabolic capabilities. Among these bacteria, the gene which encodes nucleoside diphosphate kinase, ndk is present in variable numbers. While most chlamydial species carry a single paralog of ndk, some species have two paralogs. In Waddlia chondrophila, the two Ndk proteins encoded by ndk paralogs retain conserved kinase motifs but differ in subcellular localization, suggesting divergent functional roles. According to localization studies performed in heterologous expression systems, WcNdk1 is confined to the bacteria-containing vacuole and probably supports nucleotide metabolism, while WcNdk2 localizes to the host nucleus, perinuclear space, and Golgi apparatus, suggesting involvement in host interaction. Azidothymidine (AZT), a known Ndk inhibitor, impaired W. chondrophila growth, potentially through inhibition of WcNdk2. However, the lack of genetic tools currently limits definitive functional conclusions. Our data suggests potential functions for Ndks in W. chondrophila, providing a foundation for future studies on Ndk-mediated interactions between this pathogen and its host, which might possibly be translated into a new therapeutic approach.
Mercury is a highly toxic metal of major global health concern, with exposure disproportionately affecting low- and middle-income countries (LMICs) where artisanal and small-scale gold mining (ASGM) is common. While mercury exposure has been well documented among mining populations, less is known about exposure in general urban populations. We analyzed baseline data from 1000 adults enrolled in the Mwanza HIV and Cardiovascular Disease cohort (2015-2019) in northern Tanzania. Blood total mercury (T-Hg) and total gold (T-Au) concentrations were measured from dried blood spots using inductively coupled plasma mass spectrometry. Associations between T-Hg and T-Au concentrations were evaluated using Spearman's rank correlation. Associations between a priori-selected covariates and T-Au concentrations were assessed using multivariable bootstrap linear regression models with 1000 resampling iterations. All participants had detectable blood mercury levels, with a median T-Hg concentration of 5.02 μg/l, and 7.2% had levels exceeding the World Health Organization toxic threshold of ≥20 μg/l. Detectable T-Au was observed in approximately 60% of participants, with a median T-Au concentration of 0.09 μg/l. In bootstrap multivariable regression analyses, HIV infection was associated with higher T-Au concentrations (median β = 0.28; 95% bootstrap CI 0.12-0.51). T-Hg and T-Au concentrations were moderately positively correlated in Spearman's rank correlation (ρ = 0.45; p < 0.001). After multivariable adjustment, T-Hg remained positively associated with T-Au concentrations (median β = 0.39; 95% bootstrap CI 0.22-0.58). We found that T-Hg and T-Au were detectable in a general population living near an ASGM site, and associated with each other, suggesting a common source of exposure. Improved characterization of exposure routes is critical for informing targeted interventions to reduce mercury-related health risks in Tanzanian communities.
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The Healthy Living Practices (HLPs) outline nine essential guidelines for maintaining health in remote Aboriginal communities, yet high costs and poor availability make them financially out of reach for many families. We assessed the cost and availability of essential goods required to support the HLPs in eight remote Kimberley community stores, recording prices during three visits in 2022 as part of the SToP (See, Treat, Prevent) Skin Sores and Scabies Trial, and retrospectively comparing these (inflation-adjusted) with Perth and Broome prices in 2024. Owing to limited stock, data were analysed at a Cluster level (geographically proximal communities) using paired-sample t-tests in SPSS. Across 23 store visits, a standardised 'shopping basket' was significantly cheaper in Perth ($20.29) and Broome ($21.76) than in remote communities ($39.19-$47.87; p < 0.001); whitegoods (refrigerators, washing machines) were also significantly more expensive remotely (p < 0.01). Availability was inconsistent-the full basket was available in remote stores in only 56.5% of visits, with essential healthcare items frequently unavailable. These findings indicate that affordability and access to goods required to support the HLPs are substantially compromised in remote Kimberley communities, emphasising the need for targeted policy interventions to ensure equitable health outcomes.
Some drugs undergo gelation during the formulation development process, which not only poses significant challenges to the manufacturing process of solid dosage forms but also significantly restricts the drug dissolution and absorption. Could such gelation be utilized by designing the prescription to overcome the adverse effects and water solubility defect of drugs? Herein, this study attempted to design the self-gelation tablets of indomethacin (IND) by introducing small-molecule ligands and to explore the self-gelation mechanism. As a result, the designed tablets occurred to have spontaneous gelation with a typical 3D structure and viscoelasticity upon contact with a small amount of water, accompanied by amorphization transformation. Such a self-gelation behavior was significantly influenced by the composition ratios, storage temperatures, and medium pH values. In comparison to pure IND tablet, the designed IND-ligand tablets performed significantly increased apparent solubility (>200-fold) and intrinsic dissolution rate (>6000-fold) and maintained the long-term supersaturated dissolution with acid-base interactions, which was revealed by nucleation inhibition, fluorescence quenching, and phase solubility tests. Moreover, the self-gelled tablets significantly enhanced the membrane permeability of IND, demonstrating the potential for promoting oral absorption. Thus, this study revealed the self-gelation mechanism of the tablet combination and confirmed such prescription design involving self-gelation as an efficient solubilization strategy.
Color centers hosted in hexagonal boron nitride (hBN) have emerged as a highly promising platform for single-photon emission and spin-photon technologies relevant to quantum communication and quantum networking. As a wide bandgap van der Waals material, hBN can host optically active quantum defects across a broad spectral range. Here, we demonstrate a simple and scalable oxygen-plasma process that reproducibly creates single quantum emitters in hBN with blinking-free zero-phonon lines (ZPLs) spanning near-infrared (NIR) from 700 up to 971 nm. These emitters combine MHz-level brightness, single-photon purity up to 99.9%, and ultranarrow cryogenic line widths down to 2.7 GHz under quasi-resonant excitation, placing them in a particularly attractive regime for quantum photonics. Photostability measurements further reveal resistance to photobleaching, subnanometer spectral stability over long time scales, and near-shot-noise-limited intensity fluctuations. Analysis of the phonon sidebands shows weak vibronic coupling and ZPL-dominated emission, with Debye-Waller factors approaching 50%. Control experiments together with elemental mapping support oxygen incorporation as a necessary ingredient in activating the NIR emitter population, while first-principles calculations identify ONVN and ONVNH as the leading defect candidates. These results establish a high-performance NIR quantum-emitter platform in hBN for free-space quantum networking and future integrated quantum-photonic architectures.
Contemporary data on recurrent venous thromboembolism (VTE) after anticoagulation for isolated distal deep vein thrombosis (IDDVT) are limited. This post-hoc analysis of the Rivaroxaban for the treatment of symptomatic Isolated Distal deep vein ThrombosiS (RIDTS) trial-a randomized, double-blind trial comparing 6 vs. 12 weeks of rivaroxaban in patients with IDDVT without cancer- evaluated the short- and long-term incidence and predictors of post-treatment recurrent VTE. Sixty-one of 398 (15.3%) participants experienced recurrent VTE (median time from anticoagulation cessation, 6.2 months): 47 (77%) events were recurrent IDDVT, and 14 (23%) proximal DVT (nine, 14.8%) or symptomatic pulmonary embolism (five, 8.2%); 39 (63.9%) recurrences were symptomatic and 22 (36.1%) asymptomatic. During follow-up, six (1.5%) participants died (no deaths attributable to pulmonary embolism). The 6- and 24-month incidence rates per 100/person-years of any recurrence were: 15.8 (95% confidence interval [CI], 11.0-22.7) and 10.0 (95%CI, 7.8-12.9), respectively. The corresponding values were: 24.1 (95%CI, 16.1-36.4) and 15.7 (95%CI, 11.8-20.9) after unprovoked IDDVT; and 6.8 (95%CI, 3.0-15.1) and 4.5 (95%CI, 2.7-7.7) after provoked IDDVT. Recurrence rates were higher in patients who received 6 vs. 12 weeks of rivaroxaban, especially early after discontinuation (24.4 [95%CI, 16.1-37.0] and 7.5 [95%CI, 3.6-15.7] during the first 6 months, respectively). In multivariable analysis, shorter duration of anticoagulation (hazard ratio [HR], 1.8; 95%CI, 1.1-3.0), diabetes (HR, 2.5; 95%CI, 1.1-5.3) and unprovoked IDDVT (HR, 3.2; 95%CI, 1.7-5.7) were associated with increased posttreatment recurrence risk. In patients with IDDVT and without cancer completing 6-to-12 weeks of anticoagulation, recurrent VTE was not infrequent in selected subgroups; these data may inform improved risk stratification and individualized management.
Biogenic amines are involved in numerous physiological processes and human health. For instance, putrescine and spermine (SPM) influence cell growth and division, while spermidine (SPD) offers neuroprotective, lifespan-promoting, and heart-protective effects. As a result, there is considerable interest in developing fast, simple, and affordable assays for their detection. In this work, we present a fluorescent, room-temperature ionic liquid, trihexyltetradecylphosphonium 2-(naphthalen-1-yl)-1H-phenanthro[9,10-d]imidazolate (TPND), and its low-dimensional material, nTPND, which were characterized by various spectroscopic and microscopic techniques. The neat TPND functioned effectively as a solvent-free fluorescent ink that, upon exposure to SPM and SPD, changes its fluorescence from blue to green. Upon adding SPD and SPM to the nTPND solution, a distinct fluorescence shift from cyan to green was observed, accompanied by a decrease in fluorescence intensity. nTPND is highly specific and selective for SPD and SPM, with LODs of 0.17 µM and 0.52 µM by spectrophotometry and 36 nM and 59 nM by fluorometry, respectively, making nTPND an effective dual-nature probe. Finally, we tested the neat TPND on real mushroom samples and observed clear changes in fluorescence caused by biogenic amine vapors released from the stored food. The present report evokes a new approach in designing and developing IL-based sustainable advanced functional optical materials having potential for controlling food safety and environmental monitoring.
Abdominal aortic aneurysm (AAA) rupture is an important cause of death worldwide, with no effective drug therapies currently available. PCSK9 (proprotein convertase subtilisin/kexin type 9) regulates LDL-C (low-density lipoprotein-cholesterol) and modulates vascular inflammation, smooth muscle cell apoptosis, and extracellular matrix remodeling, all implicated in AAA pathogenesis. We conducted a systematic review and meta-analysis of studies evaluating the effects of PCSK9 upregulation or inhibition on AAA in mouse models. The primary outcome was AAA diameter, with secondary outcomes including lipid and inflammatory markers. Five articles (11 studies, 101 experimental, and 84 control mice) were included. Meta-analysis results were reported as standardized mean difference and 95% CIs. A custom tool, which integrated Cochrane criteria, ARRIVE guidelines, and methods from prior systematic reviews, was used to assess the risk of bias. PCSK9 upregulation significantly increased AAA diameter (standardized mean difference, 1.07 [95% CI, 0.33-1.81]; P=0.005) and blood concentrations of total cholesterol, LDL (low-density lipoprotein), and triglycerides while significantly reducing blood concentrations of high-density lipoprotein. PCSK9 upregulation also increased aortic IL (interleukin)-6 and IL1-β concentrations, as assessed by aortic immunohistochemical staining. PCSK9 inhibition significantly reduced AAA diameter (standardized mean difference, -0.97 [95% CI, -1.44 to -0.49]; P<0.0001) and blood concentrations of IL-1β, IL-6, and TNF-α (tumor necrosis factor-alpha). Risk of bias was low-to-moderate across studies. In mouse models, PCSK9 upregulation promoted larger AAAs, while PCSK9 inhibition promoted smaller AAAs. These effects were associated with changes in lipid and inflammatory markers. PCSK9 inhibition may be a target to limit AAA growth.
Pulmonary hypertension (PH) is a progressive cardiopulmonary disorder characterized by vascular remodeling, abnormal vasoconstriction of small lung arteries, and right heart failure. Hypoxia causes vascular damage, leading to vessel stenosis or occlusion by aberrant endothelial cells, hypertrophy of the tunica media, and thrombus formation. But the precise molecular mechanisms underlying the pathology of PH have been uncertain. To investigate the pathogenic role of Myl (myosin light chain) 9/12 in PH, we utilized the Sugen/hypoxia mouse model, generated by administration of the VEGF (vascular endothelial growth factor) receptor inhibitor SU5416 under hypoxic conditions (10% O2). Lung tissues of patients with PH and human lung microvascular endothelial cells were used to examine their endothelial changes. Platelet-specific Myl9-deficient mice were generated to determine the contribution of platelet-derived Myl9 to the development of PH. The therapeutic efficacy of the anti-Myl9/12 antibody was evaluated by hemodynamics, histological analyses, and single-cell RNA sequencing. Furthermore, serum MYL9, MYL12A, and MYL12B levels were measured in patients with PH and analyzed for clinical correlation. We identified microthrombi containing Myl9/12 in both patients with PH and the PH mouse model. Platelet-derived Myl9 partially contributed to PH development by promoting cellular infiltration. Furthermore, hypoxia upregulated the expression of Myl9/12 through EPAS1 (endothelial PAS domain protein 1) in proliferated lung vascular endothelial cells and induced the release of Myl9/12 into the extracellular space. Anti-Myl9/12 antibody treatment attenuated PH in the mouse model by reducing microthrombus formation, inflammatory cell infiltration, tissue hypoxia, and vascular remodeling. The established PH in Sugen/hypoxia mice was also attenuated by the treatment with anti-Myl9/12 antibody. Moreover, serum levels of Myl9 but not MYL12A or MYL12B levels reflected the severity of PH in patients. These findings reveal that Myl9/12 play a pathogenic role in developing vascular lesions of PH and could be a new therapeutic target for PH.
Primary central nervous system lymphoma (PCNSL) has poor outcomes despite high-dose methotrexate-based therapy. The Endothelial Activation and Stress Index (EASIX) is associated with prognosis in systemic lymphomas but has not been evaluated in PCNSL. Define the association of baseline EASIX in multivariate analysis with Memorial Sloan Kettering Cancer Center (MSKCC) score risk factors. A multicentre retrospective cohort included 128 immunocompetent adults with biopsy-proven diffuse large B-cell PCNSL. EASIX was calculated and the optimal cut-off (0.751) was determined by receiver operating characteristic (ROC) analysis. The primary end-points were overall survival (OS) and progression-free survival (PFS) in the low-EASIX and high-EASIX groups. The median age was 60 years. High EASIX (≥0.751, n = 55) was associated with Eastern Cooperative Oncology Group (ECOG) ≥2 (p = 0.002), elevated lactate dehydrogenase (LDH) (p < 0.001), deep brain lesions (p = 0.007) and cellular myelocytomatosis oncogene/B-cell lymphoma-2 (MYC/BCL-2) double expression (p = 0.01). After a median follow-up of 37 months, high EASIX was associated with inferior OS (27.4 months vs. not reached; p = 0.001) and PFS (25.6 months vs. not reached; p < 0.001). Multivariable Cox analysis confirmed high EASIX as an independent adverse factor for OS (hazard ratio [HR] 4.75) and PFS (HR 4.99), with additional prognostic discrimination within MSKCC risk groups. Baseline EASIX could potentially improve risk stratification and prognostic modelling in PCNSL.
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While most patients recover well from distal radius fracture, some experience prolonged deficits. We aimed to primarily compare high-intensity upper-limb activity 12 months after operative vs nonoperative treatment of malaligned distal radius fractures and secondarily to assess the impact of fracture alignment and compare activity levels with healthy older adults. This is a secondary analysis of the Distal Radius Fracture Trial.  The Distal Radius Fracture Trial was a multicenter, randomized controlled trial. Patients with malaligned distal radius fractures were randomized to operative treatment with a volar locking plate or nonoperative treatment. Patients with well-aligned distal radius fractures constituted a separate non-randomized group. High-intensity upper-limb activity was measured using wrist-worn accelerometers at 3 and 12 months. Healthy subjects were recruited for comparison. Longitudinal analyses were performed using linear mixed models.  157 patients and 59 healthy controls provided valid accelerometer data. At 12 months patients with malaligned fractures treated operatively had significantly higher high-intensity activity in the affected upper limb than those treated nonoperatively (37 vs 28 min/day; adjusted difference 8.5 min/day, 95% confidence interval [CI] 0.3-17). Fracture alignment was not significantly associated with activity. Compared with healthy subjects, operatively treated patients showed no clear difference (2.7 min/day, CI -8.3 to 14), whereas nonoperatively treated patients demonstrated lower activity levels (12 min/day, CI 4.4-20).  In patients with malaligned distal radius fractures, operative treatment was associated with higher high-intensity upper-limb activity at 12 months than nonoperative treatment. The activity level in operatively treated patients was similar to that observed in healthy older adults.
Many patients with chronic myeloid leukemia (CML) treated with adenosine triphosphate (ATP)-competitive tyrosine kinase inhibitors (TKIs) experience persistent adverse events (AEs) that negatively impact daily living and the ability to remain on treatment. Asciminib, an allosteric inhibitor of BCR::ABL1, was designed to enhance efficacy and reduce off-target effects vs ATPcompetitive TKIs. The phase 3 randomized ASC4FIRST trial established the overall favorable safety profile of asciminib in patients with newly diagnosed CML in chronic phase (CP). This exploratory post hoc analysis of ASC4FIRST focused specifically on the tolerability of asciminib vs imatinib and asciminib vs second-generation [2G] TKIs. Analyses were conducted within each stratum to account for differences between strata; patients prerandomized to the imatinib stratum were older and had higher cardiovascular risk than those in the 2G stratum. Within both strata, patients receiving asciminib experienced fewer difficult-to-tolerate AEs (such as gastrointestinal toxicity, rash, and pleural effusion) and fewer AEs leading to dose modifications and discontinuations due to nonhematologic and hematologic AEs vs the investigator-selected (IS) TKI comparator, with a shorter median duration of dose modification. Additionally, median onset of AEs leading to dose modification occurred later in patients receiving asciminib vs ISTKIs. The safety and tolerability of asciminib observed in the ASC4FIRST trial demonstrate asciminib's excellent benefit-risk profile as a frontline therapy for a broad range of patients with newly diagnosed CML-CP.
Digital PCR (dPCR), as a high-sensitivity technology for absolute nucleic acid quantification, holds significant value in biomedical research and environmental monitoring. However, current platforms still face challenges in multiplex fluorescence detection and rapid, high-precision droplet imaging. Moreover, the detection process is time-consuming (2-3 hours) and involves high costs. In this study, an integrated micro-droplet digital PCR (ddPCR) detection and analysis system was developed, featuring a droplet-based microfluidic chip, a high-precision thermal cycling module, and a seven-color filter-wheel-based imaging system (ATTO425 to CY7) to facilitate a seamless workflow from droplet generation to multiplex imaging. To address the challenges of identifying and segmenting massive droplets in complex fluorescence backgrounds, this paper proposes a detection method based on the You Only Look Once version 5 (YOLOv5) deep learning architecture. By integrating global coordinate remapping and sliding-window detection, the system enables rapid processing of ultra-high-resolution images (2448 × 10 000 pixels). The end-to-end analysis pipeline achieved 99.8% overall accuracy in under 800 ms. Consequently, the total detection cycle for the full digital PCR process has been successfully reduced to under one hour. Furthermore, full-process validation experiments demonstrated excellent linearity across all fluorescence channels, with R2 values exceeding 0.999, and a coefficient of variation (CV) for quantitative repeatability of less than 2% across various concentrations. These results verify the system's precision, stability, and reproducibility. The developed system significantly enhances the throughput and accuracy of ddPCR detection, and the proposed algorithm further advances the practical application of deep learning in digital PCR image analysis.
About one-half of the world's population is endangered by malaria, particularly those in underdeveloped countries. Because of poor prevention measures, in 2023, the WHO Africa region accounted for 95% of cases and 96% of deaths. Malaria is a prevalent tropical disease with high morbidity, mortality, and economic and social impact. The WHO recommends integrated vector management for malaria control, which has shown promise in reducing the diseas e burden. We conducted a cross-sectional qualitative study in Unyama and Koro subcounties in Gulu District. We collected data from eight focus group discussions and 10 in-depth interviews with community members, leaders, and health workers. We analysed data using thematic content analysis and Atlas ti software. The facilitators for community-integrated malaria control were government mosquito net distribution, village health teams, and combined preventive methods. The barriers were inconsistent preventive practices, financial and resource constraints, misuse of mosquito nets, cultural misconceptions, and limited support for volunteers. Although integrated malaria-prevention approaches have demonstrated effectiveness, their full implementation in Uganda remains constrained. Persistent socioeconomic barriers undermine both uptake and long-term sustainability at the community level. Addressing these structural and contextual challenges is essential to translate proven interventions into sustained malaria-control gains.