Black participants are often excluded from electroencephalography (EEG) studies due to perceived difficulty in achieving acceptable electrode impedance for participants with tightly curled hair. This has led to unrepresentative samples and poor external validity in EEG research. Here we apply and validate contemporary recruitment and preparation recommendations to replicate emotional perception effects in a diverse sample and investigate an inconsistent finding in the ingroup/outgroup face processing literature. This was achieved via Bayesian multilevel modeling to assess signal-quality at the level of individual participants. Here three groups, including Black women, White women, and a group excluding Black and White women viewed emotionally arousing and neutral naturalistic scenes, as well as matched portraits of Black and White male faces. The modulation of onset-evoked ERPs including the P100, N170, early posterior negativity (EPN), and late parietal positivity (LPP) was analyzed to understand interindividual differences in categorical effects. With minor adjustments to recruitment and electrode cap placement procedures, no data from Black participants were excluded, and EEG artifacts and signal-quality were equivalent or better for all participants relative to those in the other groups. The ERP results showed strong consistency across the sample groups, replicating patterns of EPN and LPP modulation across 6 scene categories. Relative to White faces, portraits of Black faces evoked larger amplitudes in the N170, EPN, and LPP across all participant groups. The N170 was modestly predicted by rated arousal of the face portraits and self-reported quantity of outgroup social contact, but these moderators did not explain the large amplitude differences. Interpretations are considered, including the possibility that portrait lighting may be less suitable for Black faces, thus increasing a demand for configural processing associated with N170 amplitude. More speculatively, cultural stigmatization effects in the United States may also contribute to experienced arousal and ERP modulation across all groups.
Epigenetic age accelerations have been associated with the clinical expression of BD; however, with few available studies. We calculated Horvath, Hannum, EN, GrimAge, and PhenoAge epigenetic ages in a sample of 139 individuals with BD. We used a latent profile analysis to identify subgroups of individuals based on their profile of epigenetic age accelerations. We compared these profiles for socio-demographic characteristics, course of BD, associated psychiatric conditions, current medication use, telomere length, mitochondrial DNA copy number (mtDNAcn), markers of metabolic syndrome, and of systemic inflammation. The latent profile analysis identified two subgroups, one with accelerated and one with decelerated epigenetic aging (respectively 58% and 42%). Subgroups did not differ for socio-demographic characteristics, course of BD, associated psychiatric conditions, nor current medication use. The accelerated aging subgroup was characterized by higher depressive symptoms (p < 0.001), lower mtDNAcn (p < 0.001), higher levels of systemic inflammation (platelet/neutrophil ratio, neutrophil/lymphocyte ratio, systemic inflammation index, p < 0.001) that remained significant after correction for multiple testing. Some associations with anxiety symptoms, social functioning, blood pressure, and waist circumference did not remain significant after correction for multiple testing. Most individuals with BD were characterized by an accelerated epigenetic age profile. This study suggests a link between epigenetic age acceleration, systemic inflammation, and mtDNAcn. This subgroup might represent a target for personalized prevention and treatment.
Implantable neural microelectrodes are the core components enabling high spatiotemporal resolution neural signal recording and stimulation in brain-computer interfaces (BCIs). However, current technologies still face challenges in achieving high-throughput recording, precise implantation, and long-term stability. In this work, we present a high-throughput three-dimensional (3D) helical stretchable neural probe, fabricated via planar electrode micro-fabrication technology followed by thermally driven helical shaping. The main innovations are reflected in the following: First, through the helical deformation, it is possible to simultaneously achieve cross-tissue recording on cortical surface, deep brain, and inside blood vessels. Secondly, the helical structure can expand the wiring space of the electrodes into three dimensions, achieving high spatial resolution and good mechanical compatibility with the tissue. Interface mechanics simulations indicate that the helical structure effectively mitigates strain induced by brain micromotion. Electrochemical modification significantly reduces interface impedance and enhances charge storage capacity (CSC), while cyclic stretching tests confirm stable electrochemical performance under repeated high-strain conditions. Trans-tissue in vivo experiments further validate the probe's versatility: flexible planar MEAs successfully recorded high-quality subcutaneous electromyography (EMG) signals in mice; the helical probe captured single-unit activity in the deep brain of mice with long-term recording stability; and 1024-channel high-throughput signal acquisition was achieved in the pig cerebral cortex. This technology enables high-throughput, stretchable, and cross-scale long-term stable neural recording, providing a versatile tool for next-generation BCIs and clinical neuromonitoring.
Research on the deformation and failure mechanism of deep hard rock is of great significance for the prevention and control of rockburst in high-stress underground engineering. In this study, true triaxial single-face unloading rockburst tests were conducted on Jinchang diorite under different initial stress differences. The effect of initial stress difference on strength response, failure behavior, and energy evolution mechanism of diorite was investigated using scanning electron microscopy (SEM) and acoustic emission (AE) monitoring, and the fractal dimension of rockburst fragments and rockburst proneness were quantitatively discussed. The results demonstrated that the peak strength increases significantly with increasing initial stress difference, and the macroscopic failure pattern evolves from randomly distributed tensile-shear coupled cracking to localized tensile slabbing along the unloading free surface. The fracture surface morphology changes from rough surfaces with irregular step-like tearing features to smooth cleavage planes with river-like patterns, and AE activity changes from gradual cluster-type signals to sudden main-shock-type release. In addition, a true triaxial discrete element numerical model based on PFC3D was established and calibrated to investigate the microcrack evolution and orientation under different initial stress differences, and the numerical results were in good agreement with the experimental observations.
The clinical performance of standard chemotherapeutics is often limited by systemic toxicity and the rapid development of multidrug resistance. To address these challenges, we used an aqueous extract of Justicia adhatoda leaves to develop a sustainable, plant-based method for synthesizing Zinc Oxide (ZnO) and Silver (Ag) nanoparticles. This green approach provides a biocompatible alternative to traditional chemical methods, reducing hazardous waste. We characterized the resulting materials using XRD, FTIR, UV-Vis, FE-SEM, EDX, and Zeta potential analysis. Structural analysis confirmed that the synthesized ZnO nanoparticles formed a crystalline hexagonal wurtzite structure with an average particle size of 72.0 nm. In contrast, the Ag nanoparticles exhibited a face-centered cubic geometry with a mean particle size of 39.46 nm. Zeta potential measurements revealed high surface stability for both nanostructures, showing negative surface charges that prevent agglomeration. In the biological assay, ZnO NPs exhibited broader and more consistent antibacterial efficacy against Staphylococcus aureus and Klebsiella pneumoniae than Ag NPs in standard well diffusion. Time-kill kinetics further substantiated that ZnO NPs demonstrated more rapid, concentration-dependent bactericidal action over a 24-h window compared to Ag NPs. Conversely, MIC and MBC analyses showed that Ag NPs were highly effective against specific strains, such as S. aureus (1.56/3.125 µg/mL). Both nanostructures demonstrated potent, dose-dependent cytotoxicity against HeLa and A549 cancer cell lines. To the best of our knowledge, this is the first comparative study between ZnO and Ag nanoparticles synthesized from Justicia adhatoda under identical conditions. These findings highlight Justicia adhatoda as a powerful reducing and stabilizing agent, supporting the development of a scalable platform for multifunctional nanomaterials in targeted therapeutics.
To compare the facial emotion recognition (FER) accuracy and reaction time (RT) of patients with performance-type social anxiety disorder (pSAD) and generalized-type social anxiety disorder (gSAD) with healthy controls (HCs). A total of 56 patients who were diagnosed as having SAD (31 gSAD and, 25 pSAD) according to the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) were included in the study. Forty individuals with no psychiatric disorders were included as the HCs. FER skills were assessed using a task that included Ekman's basic emotions and a neutral face. Additionally, the Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), and the Liebowitz Social Anxiety Scale (LSAS) were administered to all participants. FER performances of patients with pSAD were similar to the HC group. The accuracy rates for emotions other than sadness in patients with gSAD were similar to those in the HC group. The RT to all facial expressions in patients with gSAD was statistically significantly shorter than in the HCs (p < 0.005). The RT given to facial emotions other than sadness was shorter in the pSAD patient group compared with the HC group. A negative correlation was found between STAI-state anxiety and neutral face recognition. (r = -0.308, p < 0.05). However, except for neutral face recognition, no significant correlation was observed between the BDI, STAI-state, STAI-trait, LSAS-fear, LSAS-avoidance, and FERT subscales. The current study casts doubt on some of the effects reported in the literature on SAD's FER ability. In this study, no significant difference was found in FER ability among SAD subtypes; this may suggest that a common mechanism exists in both subtypes.
Building on the World Health Organization's International Classification of Functioning, Disability, and Health (ICF) framework, the "F-words for Child Development" (Functioning, Family, Fitness, Fun, Friends, and Future) provide a holistic, strengths-based perspective on child development and have been adopted by many organizations. This study explores family caregivers' knowledge, attitudes, uses, and perceived barriers and facilitators to using the F-words to support their children's habilitation. Family caregivers receiving services from four Canadian children's developmental and rehabilitation service organizations completed an online survey with Likert-scaled and open-ended questions. Quantitative and qualitative data were analyzed descriptively and through content analysis, respectively. Findings show families (N = 58) are supportive of the F-words and value their holistic, strengths-based, and family-centred approach. They also face barriers using the F-words including limited F-words knowledge, mixed attitudes (e.g., preference for biomedical approach), and practical challenges within their respective organization. To facilitate use, family caregivers identified direct support is needed from service providers and organizations. Families value the F-words but may face barriers, limiting their use. Implementation should prioritize family-facing strategies (e.g., co-designed tools used with families in services) and consistent integration across health care services, education, and community settings. Families value and support the F-words, but face barriers in using them including limited knowledge of how to use the F-words in their lives and with service providers.System-level supports, including broader organizational support and service provider use of the F-words with families are needed for successful implementation.Collaborating with families is essential to ensure F-words implementation remains meaningful, accessible, and family-centred.
Up to 30% of adults with peripheral facial palsy (FP) develop synkinesis, but it's incidence in children remains unclear due to limited long-term data. Children (<18 years) treated for acute peripheral FP at Jena University Hospital between 2009 and 2021 were screened in this cross-sectional study. Bell's palsy and infection-associated FP (e.g., Lyme disease, Zoster) were included, while secondary causes such as tumors, trauma, CNS disorders, and conditions like Guillain-Barré syndrome or Chiari malformation were excluded. Video follow-ups collected clinicodemographic information and PROMs including Facial Clinimetric Evaluation Scale (FaCE), Facial Disability Index (FDI), and Synkinesis Assessment Questionnaire (SAQ). Facial movements were video-recorded and assessed using Sunnybrook and eFACE. Of 85 eligible patients, 26 participated (46% female; response rate 30.6%). Mean age at onset was 8.5 years (range: 0.2-16); 54% had idiopathic FP (IFP) and 46% Lyme-associated FP (LFP). Median follow-up was 7.56 years (range: 2.5-13). All LFP participants and 11 out of 14 IFP participants achieved complete or near-complete recovery (eFACE and Sunnybrook scores 90-100). Four participants (28.6%), exclusively from the IFP group, developed synkinesis, three with functional impairments in PROMs and video-based assessment. Seven participants (five (35.7%) from the IFP group and two (16.7%) from the LFP group) reported that they still experience mental health-related effects of FP today. The data indicate that a relevant proportion (around 21.4%) of children with Bell's palsy develop moderate to severe synkinesis. Long-term follow-up and further research on corticosteroids use in pediatric FP are warranted.
Monitoring wildlife in remote areas is a key challenge in conservation, with traditional methods proving increasingly inadequate in the face of accelerating biodiversity loss. Uncrewed Aerial Vehicles (UAVs) or drones help bridge data gaps, but methods require careful development and validation to ensure protocols are appropriate, accessible, reproducible, and generate reliable data. Herein, we develop detailed UAV-based protocols for surveying the endangered marine iguana (Amblyrhynchus cristatus), a lizard that is endemic to the coastlines of the Galápagos Islands, Ecuador. We outline steps from image collection and processing, through locating and counting animals, before validating results against traditional methods. We find that UAV-based surveys outperform traditional ground-based surveys in terms of count reliability and effort in the field in different types of terrain and various population densities. Moreover, we show that consumer-level drones can be used effectively - even by newly trained pilots - and describe a standardised manual flying protocol that mimics automated flying whilst maintaining flexibility in the field. Finally, we recommend the use of orthomosaics (geometrically corrected, high-resolution aerial image maps) for surveys on flat terrains and 3D models (digital representations of the surface in three dimensions) for cliffs and compare several common image-processing platforms in terms of success to reconstruct marine iguanas. Our protocols advance the effective monitoring of Galápagos marine iguanas. Whilst they were specifically developed for this species, we postulate that these could be applicable for other species across the archipelago, or in coastal and open landscapes worldwide.
Chikungunya virus (CHIKV) poses a significant public health threat in Somaliland; however, community knowledge and preventive practices remain understudied in this region. This study aimed to assess the knowledge, attitudes, and preventive behaviors regarding CHIKV infection among Burao residents. A community-based analytical cross-sectional study was conducted from March to June 2025 among 422 adult residents of Burao City, Somaliland, using a multistage cluster sampling technique. Data were collected through face-to-face interviews with a structured questionnaire adapted and validated for the local context. Knowledge, attitude, and preventive practice (KAP) scores were calculated, with ≥ 70% of the maximum score indicating good knowledge, positive attitudes, or good preventive practices. Descriptive statistics, chi-square tests, and multivariate survey-adjusted logistic regression analyses were performed to identify sociodemographic factors associated with KAP levels. Model diagnostics included an assessment of goodness-of-fit and multicollinearity. Statistical significance was set at p < 0.05. Awareness of CHIKV was very high at 97.4% (411/422; 95% CI: 95.3-98.5%), with most participants correctly identifying mosquitoes as the transmission vector (85.1%) and recognizing common symptoms such as fever and joint pain (91.0%). However, only 32.7% (95% CI: 28.3-37.3%) of participants demonstrated positive attitudes toward CHIKV prevention, and 44.5% (95% CI: 39.8-49.3%) exhibited good preventive practices. Higher educational attainment was associated with better knowledge (AOR = 5.28; 95% CI: 1.08-25.82) than among those with no formal education, while preventive practices varied across sociodemographic groups in adjusted analyses. Students also had higher odds of good knowledge (AOR = 3.14; 95% CI: 1.35-7.29). Age groups of 25-34 years (AOR = 2.65) and 35-44 years (AOR = 3.03) were more likely to have good knowledge than those aged 16-24 years. Employment status was positively associated with positive attitudes (AOR = 3.09; 95% CI: 1.81-5.28) among employed/farmer participants. Men had higher odds of good preventive practices than women (AOR = 1.56; 95% CI: 1.01-2.42), and participants aged 25-34 years were more likely to engage in good preventive behavior (AOR = 2.45; 95% CI: 1.20-5.01). Educational status and employment were not significantly associated with preventive practices in the adjusted model. Model diagnostics confirmed a good fit and no multicollinearity. Despite high CHIKV awareness in Burao, positive attitudes and preventive practices remain low, revealing a significant knowledge-behavior gap. Although education strongly predicts knowledge, higher education and employment do not consistently improve preventive practices because of socioeconomic and structural barriers. Effective control requires integrated interventions beyond health education, including improved waste management, water infrastructure, and environmental sanitation. Tailored communication for educated and employed groups, combined with active community engagement and strengthened public health systems, is essential to enhance prevention and reduce outbreak risks.
Disabled healthcare professionals offer valuable expertise yet face systemic barriers in education and practice. This study explores perspectives of professional organizations on the inclusion of students (SRA) and practitioners (PRA) requiring accommodations in health and human service (HHS) professions. Using an exploratory qualitative design framed within a critical disability studies lens, 28 representatives from professional organizations across 10 HHS professions in Canada participated in semistructured interviews. Data were analysed to identify key themes related to their perceived roles and perspectives on challenges faced by SRA/PRA, and how organizational policies impact inclusion. Three key themes highlighted the multilayered challenges of acknowledging and supporting SRA/PRA: (1) We do not know what we do not know; (2) not our responsibility; and (3) between a rock and a hard place. Many participants reported that this study marked the first time they had explicitly considered SRA/PRA within their organizational mandate, a foundational finding underpinning all three themes. Findings revealed limited awareness of SRA/PRA needs and experiences within organizational structure, uncertainty about their responsibility for addressing accessibility, often in favour of public protection or professional standards, and systemic obstacles constraining their ability to implement inclusive policies. Inclusion of SRA/PRA represents a 'wicked problem': While equity and inclusion are already embedded in many professional mandates, tacit ableist discourses constrain the agency of professional organization representatives and perpetuate the systemic marginalization of SRA/PRA in HHS professions. Results provide insights and recommendations for dismantling these barriers and promoting equitable and accessible pathways into and through HHS education and practice.
Timely and accurate diagnosis of mild traumatic brain injury (mTBI) remains challenging in acute care. In the Asia-Pacific (APAC) region, marked heterogeneity in healthcare infrastructure, computed tomography (CT) utilization, and diagnostic pathways underscores the need for practical, standardized approaches to assessment. Blood-based biomarkers, particularly glial fibrillary acidic protein (GFAP) and ubiquitin carboxy-terminal hydrolase L1 (UCH-L1), have shown promising diagnostic performance and have been incorporated into clinical pathways in other regions. However, their role in APAC emergency care workflows has not been systematically addressed. This study aimed to develop expert consensus on the definition, diagnosis, and clinical integration of these biomarkers into mTBI assessment across APAC. A structured modified Delphi process was employed, involving ten expert panelists representing emergency medicine, neurosurgery, and neurology from APAC countries including Australia, India, Indonesia, the Philippines, Singapore, Taiwan, and Thailand. A targeted literature review informed the development of 34 preliminary statements, consolidated into 11 statements covering mTBI definition, diagnostic approach, and biomarker integration. Panelists rated each statement using a 4-point Likert scale across two anonymous online voting rounds, with consensus defined as ≥ 70% agreement. Voting results were reviewed at a face-to-face meeting in Bangkok in May 2025, where statements were refined before Round 2 voting. All 11 final consensus statements achieved agreement ratings of 90% to 100% following Round 2 voting. Seven statements reached 100% agreement and four achieved 90% agreement. Statements addressed definitions of TBI and mTBI, the adjunctive diagnostic role of GFAP and UCH-L1 within a 12-hour post-injury window, their utility in diagnostically challenging subgroups such as anticoagulated and intoxicated patients, and the continued primacy of clinical assessment and local imaging pathways in guiding triage, imaging, discharge, and follow-up decisions. This modified Delphi study produced 11 high-consensus statements that provide a regional framework for the diagnosis of mTBI and for integration of GFAP and UCH-L1 into biomarker-supported assessment pathways across APAC. These biomarkers may help reduce avoidable CT imaging and support triage in selected patients when used as adjuncts to clinical assessment and established imaging decision-making. The statements are intended to support locally adapted protocols and future APAC-specific implementation and validation studies.
To explore the impact of cognitive frailty on falls, readmissions, and mortality in aged patients undergoing Maintenance Hemodialysis (MHD). A prospective cohort study. We collected baseline data from September 2023 to January 2024. We assessed cognitive frailty at baseline using the Frailty Scale and Montreal Cognitive Assessment. Older adults receiving MHD were followed for 12 months, with assessments at 6 and 12 months. Mortality was the primary outcome; falls and readmissions were secondary outcomes. We assessed adverse outcomes through multiple methods: mortality data were obtained via hospital electronic medical record system queries, dialysis registry platform verification, and confirmation by medical staff; falls and readmissions were ascertained through face-to-face interviews with patients during dialysis sessions, supplemented by hospital medical record system queries. We used the χ² test to compare group differences in adverse outcome rates, the Kaplan-Meier method with the log-rank test to estimate monthly cumulative event probabilities, and Cox regression to assess the association between cognitive frailty and the three adverse outcomes. Of 1,023 older adults on MHD, 300 (29.3%) had cognitive frailty. The other 723 (70.7%) did not. In 12 months, there were 101 deaths (9.8%), 190 falls (18.6%), and 299 readmissions (29.2%). The cognitive frailty group had higher incidences of death (59 [19.7%] vs. 42 [5.8%]), falls (94 [31.3%] vs. 95 [13.1%]), and readmissions (129 [43.0%] vs. 170 [23.5%]). After adjusting for confounders, cognitive frailty remained an independent risk factor for mortality (HR = 2.716, 95% CI 1.754-4.205, P < 0.001), falls (HR = 2.021, 95% CI 1.471-2.777, P < 0.001), and readmissions (HR = 1.996, 95% CI 1.585-2.514, P < 0.001). Cognitive frailty independently increases risk for mortality, falls, and hospital readmission in older adults undergoing MHD. Strengthen screening and assessment for cognitive frailty to help identify high-risk patients early and inform targeted interventions.
Objectives. Pneumoconiosis is a concerning occupational health hazard in dentistry. This cross-sectional study aimed to estimate the prevalence of pneumoconiosis and its association with age, gender, type of dental profession and duration of exposure among dental healthcare professionals (DHCPs). Methods. The study enrolled 138 DHCPs from an Indian tertiary care dental teaching institution who underwent structured face-to-face interviews, clinical examination, spirometry and chest radiography interpreted using International Labour Organization (ILO) classification. Potential pneumoconiosis was defined based on occupational exposure, clinico-spirometric examination and radiological findings consistent with pneumoconiosis (ILO category ≥ 1/0). The χ2 test was applied to examine association of demographic-occupational characteristics with clinical symptoms, spirometric findings, radiologic findings and pneumoconiosis occurrence. Results. The prevalence of pneumoconiosis was 3.6%, with 4.3% of subjects showing radiographic opacities. Spirometry results showed a restrictive pattern in 13.8% of participants. The frequency of potential pneumoconiosis based on clinical symptoms and radiological findings was significantly associated with age > 35 years (particularly among dental technicians) and duration of exposure > 20 years, respectively. Conclusions. Increased susceptibility of DHCPs, especially dental technicians, towards pneumoconiosis highlights the importance of adoption of stringent occupational health and safety precautions, and regular clinico-radiographic screening for timely detection of pneumoconiosis.
Indonesia has one of the highest number of tuberculosis (TB) cases globally. The previous treatment policy of the Ministry of Health was to administer TB drugs intermittently (three times per week) during the continuation phase. Since 2023, the treatment policy has changed to daily dosing during the continuation phase. However, evidence comparing the treatment outcomes and tolerability of these agents remains limited. This study compared patient characteristics, treatment success, and reported adverse events between intermittent and daily regimens among drug-susceptible TB patients. An observational cohort study was conducted using secondary data from medical records and the National TB Information System, with prospective ascertainment of adverse events via standardized telephone and face-to-face interviews among a subset of participants. Group comparisons were performed using chi-square tests, t-tests, and multivariable logistic regression (adjusted for age, HIV status, diabetes status, and baseline sputum). A total of 532 drug-susceptible TB patients were included (intermittent n = 247; daily n = 285). The daily group had a higher mean age and a greater proportion of HIV-positive and diabetic patients (p < 0.05). Treatment success rates were comparable between the two groups (87.85% vs. 87.37%; p = 0.850), with no significant association observed in the adjusted analyses (aOR = 1.23 [0.69-2.18]; p = 0.494). Among 327 patients with adverse event data available (61.47%), reported adverse events were more frequent in the daily group (100.00% vs. 84.38%; p < 0.001), particularly nausea/vomiting/fatigue/fever (aOR = 3.03; 95% CI: 1.69-5.55) and itching (aOR = 2.07; 95% CI: 1.27-3.41); however, these findings were based on a subset of participants and may be subject to recall and reporting bias. Intermittent and daily continuation-phase regimens showed comparable treatment success in this observational study. Among participants with available adverse event data, daily dosing was associated with more frequently reported adverse events; however, causal inference could not be made due to non-random regimen allocation, baseline differences between groups, incomplete ascertainment of adverse events, and potential recall and reporting bias. These findings suggest the potential importance of routine tolerability monitoring and targeted patient support in programmatic TB care, though confirmation from multicenter prospective studies is needed given the single-center design and incomplete adverse event ascertainment. Clinical trial number: not applicable.
This study aimed to examine and compare the effects of haptonomy and a mindfulness-based stress reduction program (MBSR) on psychological well-being, perceived stress, and fear of childbirth among primiparous pregnant women. This prospective, assessor-blinded, three-arm randomized controlled trial was conducted between January 1, 2024, and October 1, 2024. A total of 120 primiparous pregnant women were randomly assigned to the haptonomy group (n = 40), MBSR group (n = 40), or control group (n = 40). At baseline, participants completed the Personal Information Form, Psychological Well-Being Scale (PWBS), Perceived Stress Scale (PSS), and Wijma Delivery Expectancy/Experience Questionnaire Version A (W-DEQ-A). PWBS, PSS, and W-DEQ-A were reassessed at weeks 4 and 8. The interventions were conducted individually through face-to-face sessions, supported by home-based video/audio materials. Data were analyzed using descriptive statistics, chi-square test, repeated-measures ANOVA, and Bonferroni post hoc analyses. No statistically significant differences were observed between groups at baseline (p > .05). However, significant differences emerged at weeks 4 and 8 for all primary outcomes (p < .001). Compared with the control group, participants in both intervention groups demonstrated significantly higher psychological well-being scores and significantly lower perceived stress and fear of childbirth scores. At week 8, the haptonomy group demonstrated greater improvement than the MBSR group across all outcome measures. Both haptonomy and MBSR were effective in improving psychological well-being and reducing perceived stress and fear of childbirth among primiparous pregnant women. Haptonomy demonstrated greater effectiveness than MBSR across all primary outcomes. This trial was registered at ClinicalTrials.gov (NCT06699550; registered on November 19, 2024; retrospectively registered). The study protocol was finalized before participant recruitment; trial registration was completed subsequently due to administrative delays.
Rapid and accurate detection of multiple foodborne pathogens is critical for public health and food safety. Although various sensing methods exist, many still face challenges in simultaneously discriminating and quantifying several pathogens in a single, easy-to-implement format, particularly when high throughput and field adaptability are required. In this study, a novel multimodal sensing platform based on bovine serum albumin-templated copper nanoflowers (BSA-Cu NFs) was developed for the simultaneous discrimination and quantification of five common foodborne pathogens: Escherichia coli, Staphylococcus aureus, Listeria monocytogenes, Streptococcus mutans, and Pseudomonas aeruginosa. The BSA-Cu NFs, synthesized via a facile self-assembly approach, exhibited a well-defined flower-like hierarchical structure, uniform elemental distribution, and mixed Cu(II)/Cu(I) valence states, contributing to excellent peroxidase-like and laccase-like activities as well as intrinsic surface-enhanced Raman scattering (SERS) capability. By integrating multichannel colorimetric responses (using TMB, ABTS, and 2,4-DP as substrates) with the SERS fingerprint signal of oxidized TMB, a four-channel sensor array was constructed. This array enabled distinct clustering and differentiation of the five target pathogens using linear discriminant analysis and hierarchical cluster analysis, with a good signal response over the concentration range of 1 × 106 to 1 × 109 CFU/mL. The platform also reliably identified binary bacterial mixtures and maintained stable performance in complex food matrices such as milk tea, coffee, fruit juice, and tea, as validated by spike-recovery tests. This work deepens the potential of nanozyme-based multimodal sensor arrays for multiplex foodborne pathogen detection. By combining multiple colorimetric channels with SERS fingerprint signals in a single BSA-Cu NF platform, the proposed strategy overcomes the limitation of single-signal methods and enables high-throughput, field-adaptable screening. The reliable performance in real-world food matrices highlights its promise for on-site, multiplex food safety monitoring.
Smartwatches and other wearable technologies have become increasingly popular for health monitoring, offering potential benefits in the early detection of cardiac arrhythmias such as atrial fibrillation (AF). Despite their expanding use, limited data exist regarding public perceptions and usage patterns of these devices in Saudi Arabia. Understanding these perceptions is essential to inform strategies for digital health integration and preventive cardiovascular care. This study aimed to evaluate public perceptions, usage patterns, and factors influencing acceptance of smartwatches for early detection of cardiac arrhythmias among adults in Saudi Arabia. A cross-sectional study was conducted between May and October 2023 across five major regions of Saudi Arabia. A total of 459 adults aged ≥ 22 years participated through structured face-to-face interviews using a validated questionnaire adapted from prior studies. Descriptive statistics summarized demographic characteristics and usage trends, while Poisson regression analysis identified determinants of positive perceptions toward wearable technologies. Nearly half of the respondents (46.4%) reported using wearable devices for health monitoring, with smartwatches being the most preferred (42.0%). Among smartwatch users, (35.2%) had received notifications of cardiac arrhythmia through their devices. Most participants (76.5%) expressed willingness to use smartwatches for arrhythmia detection, and (48.1%) strongly agreed that wearable technologies could contribute to the early diagnosis and monitoring of arrhythmia. Younger adults (22-51 years) demonstrated significantly more positive perceptions compared to those > 51 years (p < 0.05). Previous experience with wearables was also a significant predictor of favorable perception (p = 0.015). Educational level showed a positive but non-significant trend (p = 0.061), while gender and cardiovascular history were not associated with perception. The Saudi public shows a high level of awareness and positive perception toward using smartwatches for early cardiac arrhythmia detection. Younger age and prior experience with wearables were the strongest predictors of acceptance, underscoring the importance of digital literacy and user familiarity. Integrating smartwatches into preventive cardiology and public health initiatives-supported by education and clinical validation-may enhance early arrhythmia detection and promote proactive heart health management in Saudi Arabia.
Artificial intelligence has been gaining popularity in all fields of dentistry. Orthodontic screening is needed to categorize patients for treatment eligibility and urgency of care in public orthodontic clinics. However, screening is time consuming due to high demand. This is the first study to investigate the use of artificial intelligence-supported teleorthodontics for orthodontic screening and triage. The objective of this study was to investigate the validity of teleorthodontics and artificial intelligence (TAI) in orthodontic screening and triage in comparison to face-to-face (F2F) screening. This study was designed as a single-centre crossover randomized controlled trial. A total of 255 patients referred for public orthodontic treatment were randomized into two sequences: control, F2F triage first, and test, TAI triage first. A total of 178 participants completed the trial (age range: 7-38 years) with 95 participants enrolled initially to the control and 83 to the test sequence, respectively. For TAI triage, patients submitted intraoral scans using Dental Monitoring™ (DM™), extraoral photos, and an online patient history survey. After a 2-month washout period, participants were re-triaged with the other method. The primary outcome was the validity of TAI triage in referral acceptance or rejection based on a minimum Index of Orthodontic Treatment Need (IOTN) Dental Health Component (DHC) threshold of ≥3. Secondary outcomes were diagnostic validity of TAI for all IOTN grades, at referral acceptance threshold IOTN ≥ 4, and triage duration comparison. Patients were randomized using a permuted randomized block design (allocation ratio 1:1). Investigators and participants could not be blinded to sequence allocation. Referral acceptance or rejection at IOTN ≥ 3, TAI triage had a sensitivity of 1, a specificity of 0.67, and an overall diagnostic accuracy of 0.98, with three referrals incorrectly rejected by TAI. Artificial intelligence could not detect OB and OJ correctly for some patients and did not measure important traits, including crossbite, contact point displacement, and functional shift. Teleorthodontic triage duration was 2.9 times faster than F2F. This study was conducted in a public orthodontic clinic, and results apply to this setting when using IOTN and the hybrid method used in this investigation. Teleorthodontics combined with DM™ is a valid and reliable tool for orthodontic screening of patients with mild and severe malocclusions but cannot be used to confidently assign IOTN-DHC grade for patients with borderline malocclusion severity yet. The duration of screening is significantly shorter using TAI. Australian New Zealand Clinical Trials Registry ID: ACTRN12623000327684.
In 2018, Uganda adopted Dolutegravir (DTG)-based regimens as the preferred first-line antiretroviral therapy (ART). This qualitative study explored the perspectives of people living with HIV (PLHIV) regarding switching from stable ART regimens to DTG at the Joint Clinical Research Centre (JCRC). We purposively sampled 24 participants (16 DTG-experienced, 8 DTG-naïve) and conducted face-to-face in-depth interviews. Data were analysed using inductive thematic analysis. DTG-experienced participants were those switched to DTG from a previous stable regimen, while DTG-naïve participants were eligible for but had not yet switched. Key themes emerged: (1) Initial apprehension due to fear of side effects, feeling stable on previous regimens, and perceiving the switch as compulsory or rushed; (2) Appreciation for DTG's benefits (e.g., smaller pill size, once-daily dosing, rapid viral suppression) which mitigated initial hesitancy over time; (3) The critical role of communication and preparation in facilitating a positive transition experience. The findings indicate that while switching from stable treatment initially creates tension, hesitancy decreases as benefits are realized and concerns are addressed through continuous, supportive health education. Effective client-provider communication is essential for successful ART policy transitions.