Conectar
by Napapat Sitthikitpanya, Alissara Reungsang
The increasing occurrence of microplastics (MPs) in organic waste streams raises concerns about their impact on anaerobic digestion (AD). This study examined the effect of polypropylene MPs (PP-MPs) on methane production during AD of food waste for 150 days under batch conditions. PP-MPs were added at 10–300 mg g-1 total solids (TS), covering reported MP levels in food waste and food packaging materials and extending to worst-case scenarios. Methane yields ranged from 310.2 to 324.4 mL CH4 g-1 volatile solids (VS) across treatments versus 334.3 ± 5.2 mL CH4 g-1 VS in the control, with no significant differences (p = 0.634). Kinetic modeling confirmed no consistent inhibitory trends. FTIR and SEM analyses indicated minor surface oxidation and cracking on PP-MPs, while the polymer backbone remained intact, suggesting only superficial aging. These results provide critical assurance for waste-to-energy facilities processing plastic-contaminated organic waste streams. Although PP-MPs do not impair AD performance, their persistence and potential fragmentation pose environmental risks. These findings provide critical insight into the resilience of AD systems and emphasize the need for strategies to mitigate secondary MP formation in biogas production from contaminated waste streams.by Melissa Beck Wells
Students classified under Other Health Impairment (OHI), a category that includes Attention-Deficit/Hyperactivity Disorder (ADHD), are frequently disciplined in school settings despite ADHD being classified as a neurodevelopmental rather than a behavioral disorder. This study examined patterns of disciplinary removal among students served under the Individuals with Disabilities Education Act (IDEA), Part B, focusing on comparisons between OHI and Emotional Disturbance (ED). Using publicly available IDEA Part B discipline data, a descriptive longitudinal analysis was conducted across three academic years (2019–2020, 2020–2021, and 2021–2022). Percentage-based indicators were analyzed to examine the proportion of students ages 3–21 subject to disciplinary removal by disability category and state. Across all three years, students classified under OHI experienced disciplinary removal at rates comparable to, and in many states exceeding, those of students classified under ED. These patterns persisted despite year-to-year variation associated with the COVID-19 pandemic. Findings are interpreted through IDEA procedural safeguards and DSM-5 diagnostic frameworks, highlighting a potential misalignment between neurodevelopmental disability classification and behavioral support provision. The study discusses how Universal Design for Learning (UDL) may reduce disciplinary risk through proactive design, while emphasizing that individualized behavioral interventions, including Functional Behavioral Assessments and Behavior Intervention Plans, remain legally required when behavior is a manifestation of disability.To explore the views of healthcare practitioners in Britain regarding the role of midwives and nurses in the delivery of medical and surgical abortion.
An observational study of the Shaping Abortion for Change study healthcare practitioner survey (2021–2022).
Relationships between healthcare practitioner type, participant characteristics, knowledge of and attitudes towards abortion, and views about nurses' and midwives' role in abortion care were examined using Pearson's Chi-squared tests of association and multivariable logistic regression.
Amongst 763 participants including doctors, nurses, midwives and pharmacists, 71.6% supported specialist nurses in sexual and reproductive health and abortion clinics and hospitals, expanding their roles to include prescribing abortion medications and surgical abortion methods. Support was lower for midwives (35.8%) and primary care nurses (32.5%). There was considerable support for all nursing and midwifery groups to be involved in adjacent tasks of abortion care. Differences in support by healthcare practitioner type persisted after adjustment for exposure variables.
There is strong support for specialist nurses to expand their role in abortion care. This change could be implemented following clarification of the legal position. Some healthcare practitioner groups are more reluctant to support broader involvement of nurses and midwives in abortion provision.
Expanding specialist nurses' role in abortion care could increase service capacity and improve patient access and experience. Understanding and addressing the concerns of healthcare practitioners opposing this change is critical for successful implementation and patient safety.
This study addresses the potential for nurse and midwife role expansion in abortion care. The findings highlight broad support for specialist nurses whilst identifying barriers to wider role expansion. The research informs policy discussions on workforce optimisation and access to abortion services across Britain.
This study adheres to the STROBE guidelines for reporting observational studies.
In the SACHA study, patient and public involvement was included at all stages to inform study design, recruitment, data collection and analysis.
To examine the contexts and mechanisms that enable compassionate mentorship in healthcare, in order to generate evidence-informed insights for fostering healthier, more sustainable work environments.
A rapid realist review.
Systematic searches were conducted in Ovid MEDLINE (1946–December 2024), Embase (1974–December 2024) and CINAHL (1981–December 2024). Additional sources included Google Scholar searches, reference list scanning and grey literature (e.g., practice guidelines, policy briefs, professional reports). The review was conducted between August 2024 and July 2025.
Realist review methods were applied to answer the question: What works, for whom, under what circumstances and why? The review proceeded in four stages: defining scope and research questions with an expert panel; iterative searching and screening; data extraction and synthesis into context–mechanism–outcome configurations (CMOCs); and development of a programme theory.
Twenty-two documents were included, spanning nursing, medicine, allied health and interdisciplinary contexts. Six CMOCs were identified, encompassing the following themes: (1) relationship compatibility; (2) vulnerability and self-exploration; (3) growth through untapped strengths; (4) anti-oppression and equity; (5) mentors' pride and confidence; and (6) culture of mentorship. The resulting programme theory conceptualises compassionate mentorship as a dynamic, multi-level process with cumulative impacts on individual well-being, professional development and organisational culture.
Compassionate mentorship represents not only a relational practice but also a structural intervention for healthier workplaces. Programmes should prioritise compatibility, cultivate psychological safety, invest in mentee growth, embed equity, recognise mentor contributions and institutionalise mentorship culture.
These strategies offer actionable pathways to strengthen workforce resilience, retention and sustainability.
One co-author is a retired nurse, ethicist and person with lived experience in the healthcare system. This co-author was integral to this project, serving on the scientific steering committee from project conceptualisation and funding application through study conduct and publication.
To describe interventions to mitigate weight bias among practicing healthcare providers and examine their effectiveness.
An integrative review.
The framework of Whittemore and Knafl (2005) was utilised to identify and synthesise studies of weight bias interventions. Covidence reference management software facilitated screening using predetermined eligibility criteria that is, published in peer-reviewed journals, reported in English, and described outcomes for weight bias mitigation interventions among healthcare providers with a professional practice licence. We evaluated study quality using Joanna Briggs Institute's Critical Appraisal Tools for qualitative and quantitative studies.
Five databases were searched (CINAHL, Embase, EBSCOhost, APA PsycINFO, and Scopus) in July 2024.
Sixteen articles met the inclusion criteria. Four themes emerged: (1) active learning lessens weight bias more than passive learning, (2) multicomponent approaches yield better outcomes, (3) healthcare providers are willing to change their practices, and (4) explicit attitudes and beliefs are more amenable to change than implicit ones. Four sub-themes within theme one included the use of in-person workgroups; films, computer-based, and podcast delivery; written modules; and physical characteristic modifications, such as the use of an adiposity empathy suit. Intervention designs using a theory-based, active learning approach with repeated sessions were most successful at decreasing negative weight-biased attitudes and beliefs.
Interventions that effectively reduce weight bias among practicing healthcare providers vary, yet evidence suggests that weight bias mitigation is achievable. These interventions offer strategies to improve patient-centred care among patients living with obesity.
Healthcare providers often display weight bias. This review synthesises information on effective interventions for reducing bias, which may limit the subsequent negative patient outcomes associated with it.
The Preferred Reporting Items for Systematic Reviews and Meta-Analyses was the structure used for this paper.
There were no patient or public contributions.
Objectives
To describe orthopaedic department-level organisational characteristics, the availability of multidisciplinary specialist support, the role of external support mechanisms, and the presence of in-hospital orthopaedic training opportunities across hospitals delivering orthopaedic and trauma services in Tanzania.
National cross-sectional survey.
Hospitals delivering orthopaedic and trauma services across all levels of care and ownership categories in Tanzania.
Licensed orthopaedic and trauma surgeons practising in Tanzania served as key informants for their respective hospitals. A total of 171 surgeons provided data on 92 unique hospitals nationwide.
Primary outcomes included orthopaedic departmental structural capacity, availability of multidisciplinary specialist support, external support mechanisms and in-hospital orthopaedic training activities.
A response rate of 77.7% yielded data on 92 hospitals delivering orthopaedic and trauma services nationwide. Structural capacity varied widely, with only 19.6% of hospitals reporting more than 50 orthopaedic beds, 43.5% relying on a single orthopaedic surgeon, and 47.8% operating with one or two functional theatres. Access to specialist support was limited, with vascular trauma surgeons available in 9.8% of hospitals and plastic and reconstructive surgeons in 8.7%. Intensivists were available in 41.3% of facilities and anaesthesiologists in 57.6%, while physiotherapists were present in 90.2% of hospitals but occupational therapists in only 28.3%. External dependence was common, with 41.3% of hospitals relying on donated implants and 29.3% participating in outreach programmes. In-hospital orthopaedic training opportunities were limited, with seminars or workshops available in 25.0% of hospitals. Across domains, higher-tier hospitals demonstrated significantly greater structural capacity and specialist availability.
Orthopaedic and trauma services in Tanzania are available across multiple levels of the health system but are characterised by inequitable workforce distribution, limited capacity at lower-tier hospitals and substantial reliance on external assistance. Integrated strategies linking infrastructure development, multidisciplinary workforce expansion, sustainable procurement and decentralised training are essential to strengthen the organisation and resilience of orthopaedic and trauma services nationwide.
The aim of this study was to develop an educational video introducing an innovative panel survey approach to facilitate guideline panels in making inferences about patient values and preferences.
A user testing of the educational video through one-on-one interviews and iterative refinement of the video through brainstorming meetings.
Interviews and brainstorming meetings were conducted through Zoom.
The participants of the interviews include guideline panellists who had used the panel survey approach, and guideline panellists who had not used the approach but would or would not participate in a panel survey soon. The participants of the brainstorming meetings were a steering committee with expertise in guideline methodology and qualitative research.
The understandability and usefulness of the educational video.
We interviewed 18 guideline panellists from eight different guideline panels, all of whom carefully reviewed the video. Most participants found the video useful in explaining the panel survey approach and its role in incorporating patient values and preferences. Participants suggested improvements, including clarifying key concepts and using plain language instead of technical terminology to make the content more accessible. The major change the steering committee decided to make through brainstorming meetings was to add clarification, refine the wording and replace some text with animation.
User testing resulted in an improved educational video that is more useful and understandable for guideline panellists. Wider implementation of this resource has the potential to enhance the incorporation of patient values and preferences in guideline recommendations, supporting more patient-centred decision-making.
Personalised nutrition that incorporates genetic results into dietary interventions holds significant potential to optimise weight management and metabolic outcomes. While traditional calorie-restricted diets remain effective, emerging evidence suggests that variations in macronutrient distribution may offer additional benefits. Genetic variants help explain interindividual differences in dietary responses, with certain alleles showing enhanced weight loss and metabolic improvements with specific macronutrient distributions. However, comprehensive reviews of randomised controlled trials (RCTs) examining genotype-based dietary effects, particularly those focusing on macronutrient distribution metabolic pathway interactions, are lacking, limiting the development of robust evidence-based guidelines for nutrigenetic counselling. This systematic review aims to assess the influence of genetic variants on weight loss outcome in adults in response to varying macronutrient distribution diets (eg, low-fat, low-carbohydrate, high-protein diets) using evidence from RCTs.
We will systematically review RCTs examining weight loss outcomes of macronutrient-varied diets in adults with genotype stratifications to risk and protective allele. Multiple databases, PubMed, Cochrane Library, Scopus, Science Direct and Google Scholar, will be used. Reviewers will screen studies, extract data on study characteristics, weight loss, metabolic marker outcomes and genetic data, and assess the risk of bias using the Cochrane Risk of Bias Tool 2.0 tool.
All eligible RCTs will first be summarised in structured tables describing study characteristics, macronutrient distribution and genetic variants and will be analysed with narrative synthesis. For quantitative analysis, interventions will be grouped into three predefined diet types (high-protein, low to moderate carbohydrate and low-fat diet). Because heterogeneity across diet categories is expected, pooled effects will be estimated separately within each diet subgroup using random-effects meta-analysis, expressed as mean differences in weight change (kg). Within each subgroup, and when at least 10 studies or data are available, random-effects meta-regression will be used to examine potential moderators, including intervention duration, physical activity and ancestry. Heterogeneity will be evaluated using I2 and 2, and publication bias assessed when feasible. Evidence certainty will be graded using Grading of Recommendations Assessment, Development and Evaluation.
Ethical approval is not required for this protocol as it involves the analysis of data from primary studies. The findings will be disseminated through publication in peer-reviewed journals. Any enquiries regarding research integrity of this protocol may be directed to the Head of the Doctoral Program in Medical Health and Sciences, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada via the institutional email address s3fk@ugm.ac.id, as the responsible academic authority for research integrity.
CRD420251050587.
To map self-care activities related to indwelling urinary catheters in community-residing adults.
Scoping review guided by Joanna Briggs Institute methodology.
Systematic searches of electronic databases (CINAHL, MEDLINE, Embase) and targeted grey literature search were conducted for documents published between 2000 and October 2023.
Documents describing self-care activities and the management of catheter-related complications in community-residing adults (aged ≥ 18 years) were included. Three independent reviewers used Covidence to screen titles and abstracts and full-text articles, appraise the quality of the literature, and extract data. Directed content analysis of the extracted data was conducted, informed by the mid-range theory of self-care of chronic illness, and summarised narratively.
A total of 32 documents were included; nine qualitative studies, eight expert opinions, six quantitative studies, five guidelines, two quality improvement projects, and two reviews. The majority (81.3%) of the documents were concerned with the prevention and management of catheter-associated urinary tract infection (CAUTI; n = 26). Many self-care activities were reported across the self-care processes of maintenance, monitoring, and management. Maintaining the catheter and drainage system, and self-care education topics related to maintaining the catheter were the most cited (n = 17 [53.1%] and n = 20 [62.5%], respectively). Less emphasis was given to management self-care activities, such as seeking support from clinicians (n = 13, 40.6%).
The scoping review findings provide a greater understanding of how persons with indwelling catheters maintain and monitor their catheters and highlight that much less is known about how they manage situations when complications arise.
The findings can guide the design of community care programmes and serve as a basis for developing patient self-care education resources. These findings should be consolidated and examined by nursing researchers, clinicians, and persons with lived experience to provide holistic guidance on self-care of indwelling catheters and associated complications.
To verify the efficacy of virtual reality compared to tablet games for pain and anxiety management in children undergoing percutaneous bone pin and/or suture removal procedures.
Randomised clinical trial using two parallel groups: (1) virtual reality or (2) tablet game.
Three-center, randomised pragmatic clinical trial, using a parallel design with two groups (experimental group: immersive virtual reality; active comparator: tablet games). Children aged 6–17 requiring percutaneous pins and/or sutures were recruited between 2020 and 2022 from three outpatient orthopaedic clinics in paediatric hospitals. Pain was measured with the Numerical Rating Scale and anxiety with the Child Fear Scale before and immediately after the procedure.
A total of 188 participants were assigned to either the virtual reality group (96 participants) or the tablet group (92 participants). At the first assessment, there was no noticeable difference between the two groups in terms of pain or anxiety levels. However, further analysis revealed that participants aged 13 and older in the virtual reality group experienced significantly lower anxiety.
Virtual reality was not more efficacious than games on a tablet for pain and anxiety of children undergoing removal of bone pins or sutures. However, virtual reality demonstrated a benefit in reducing anxiety for teenagers, particularly those aged 13-older.
Virtual reality games provide an immersive, non-pharmacological alternative of for anxiety management of teenagers during pins and/or sutures removal.
This study showed that a virtual reality game may help reduce anxiety during pins and/or sutures removal procedures in patients aged 13 years and older.
We adhered to the CONSORT checklist for reporting results.
A patient partner reviewed the study design, methods and final manuscript.
NCT03680625
by Ploy Khongrungjarat, Chonnikan Tothong, Chanyanut Pankaew, Suchada Phimsen, Nopawit Khamto, Nutthamon Kijchalao, Warissara Wongkham, Piyathida Wongkham, Wipaporn Chuaymaung, Adsadayu Thonnondang, Apinun Limmongkon
Prenylated stilbenoids, particularly trans-arachidin-1 (Ara-1) and trans-arachidin-3 (Ara-3), have gained attention for their notable bioactivities and potential health-promoting properties. This study presents the first comprehensive investigation into the stability and biological efficacy of these compounds in both peanut hairy root culture crude extracts (PCE) and partially purified fractions derived from elicited peanut hairy root cultures. PCE stored at –20 °C and 4 °C maintained higher antioxidant capacity, total phenolic content compared to samples stored at room temperature. In cytotoxicity assays using SW480 colon cancer cells, the extract stored at –20 °C retained bioactivity with only minor changes in IC₅₀ values over three months, demonstrating superior stability under frozen conditions. Over a six-month period, partially purified fractions of Ara-1 and Ara-3 showed a time-dependent decline in compound content. However, Ara-3 maintained strong cytotoxicity against KKU-100 cholangiocarcinoma cells, while Ara-1 exhibited a significant loss in activity. These findings demonstrate that low-temperature storage, particularly at –20 °C, is crucial for preserving the chemical integrity and bioactivity of stilbenoid-rich extracts. The study underscores the importance of optimizing storage conditions to ensure consistent bioactivity, supporting the potential application of these compounds in the development of stable and effective pharmaceutical or nutraceutical products.The objective of this study was to determine the association between viral subtype/clade and disease severity.
Multicentre retrospective cohort study.
This study used data from the Global Influenza Hospital Surveillance Network (GIHSN). The dataset comprised hospitalised influenza patients with viral sequencing data across 14 countries, collected from August 2022 through October 2023.
A total of 761 hospitalised patients were enrolled during the study period, and 745 patients were included in the analysis. We excluded patients with missing data on explanatory or outcome variables, those infected with viral clades represented by fewer than 11 sequences, and those enrolled at study sites contributing fewer than 5 patients.
Disease severity was defined by admission to intensive care unit (ICU), receipt of non-invasive oxygen supplementation, 3-variable definition (ICU, mechanical ventilation or death) or 4-variable definition (3-variable plus oxygen supplementation).
Outcomes were analysed in association with subtype or clade using the mixed-effects logistic regression models, adjusting for age group, sex, underlying medical conditions, influenza vaccination status, antiviral use, country income level and epidemic period, while study site was included as a random effect.
745 patients were included: 263 A(H1N1)pdm09, 380 A(H3N2), 102 B/Victoria. A(H1N1)pdm09 infection was associated with increased odds of ICU admission (adjusted ORs (aORs) 2.5, 95% CI 1.1 to 5.8) compared with A(H3N2). 6B.1A.5a.2a.1 clade of A(H1N1)pdm09 was associated with increased severity compared with 6B.1A.5a.2a clade (aOR 3.0, 95% CI 1.0 to 9.5) and (aOR 5.4, 95% CI 1.6 to 18.3) for the 3-variable and 4-variable definitions respectively. Among A(H3N2), the (3C.2a1b.2a.)2b clade showed a trend toward increased severity using the 4-variable definition compared with the 2a.1b clade (aOR 2.9, 95% CI 0.8 to 10.0).
This analysis highlights the differential impact of influenza subtypes and clades on disease severity in hospitalised patients. Future research should investigate the role of specific viral mutations of these clades in modulating immune evasion or disease severity. These findings reinforce the GIHSN’s critical role in global surveillance. Ongoing genomic surveillance is crucial for understanding the clinical impact of emerging influenza variants and informing public health responses.
Prehospital care, though critical to injury survival, is largely unavailable in many low and middle-income countries, including Cameroon. Lay first responder (LFR) programmes train persons with high injury exposure in first-aid and emergency transport, but stakeholder buy-in from trainees and healthcare workers (HCWs) is essential. To design a context-appropriate prehospital care system, we evaluated barriers and facilitators of implementing a driver-based LFR programme in Cameroon.
In April 2023, we performed a mixed-methods evaluation targeting commercial mototaxi drivers and HCW in Limbe, Cameroon. Drivers were recruited for focus groups through union leaders. Trauma HCW at Limbe Regional Hospital completed Likert surveys and a subgroup completed semistructured interviews. Data collection focused on perceptions, barriers and facilitators of LFR programme implementation. Survey data were summarised using median and IQR. Interviews were recorded, transcribed, translated and analysed with open and axial coding using reflexive thematic analysis.
Overall, 92 mototaxi drivers and 34 HCWs participated in the LFR programme assessment. Among the HCW surveyed, 93% felt mototaxi drivers were capable of training as LFR but only 44% felt that drivers would be able to provide care safely. Interviews identified negative HCW perceptions of drivers, including drivers being uneducated and financially motivated, as key barriers, whereas driver exposure to injury was identified as a facilitator to LFR programme implementation. Driver groups demonstrated a positive perception of LFR training but identified unpaid time spent transporting injured persons as a significant barrier. Both groups described a need for hospital involvement in trainings and bidirectional standardised communication with HCW.
In Cameroon, driver-based LFR may facilitate increased prehospital care but further exploration of possible systems of collaboration that promote long-term success of the programme is required. Specifically, sustainable implementation will need to include clear bidirectional communication guidelines and provide driver incentive commensurate to effort.
To report how person-centred care principles are applied to care planning and to explore the contextual factors affecting their implementation in older adult care homes in England.
A combined framework analysis and quantitative content analysis study.
Using a semi-structured questionnaire, we interviewed 22 care home managers in England, exploring topics around care planning processes. Audio recordings were transcribed verbatim. Transcripts were analysed through a combined framework approach and content analysis.
Most care home managers discussed person-centred care planning in terms of understanding residents' values and preferences and their engagement in decision-making. Factors facilitating person-centred planning implementation included accessible planning tools, supportive care home leadership, effective communication and collaborative partnerships. Inhibiting factors included regulatory and care practice misalignment, time constraints and adverse staffing conditions.
Differences between care home practitioners' understanding and practice of person-centred care planning require further examination to improve understanding of the sector's complexity and to develop suitable care planning instruments.
Findings demonstrate a need for improved staff access to specialised person-centred care training and an opportunity for care home nursing practitioners to lead the co-development of digital person-centred care planning tools that reflect the reality of long-term care settings.
Identifying factors influencing the implementation of holistic approaches to care planning makes clear the need for modernising long-term care policy and practice to adapt to the contemporary challenges of the care home sector.
Study reporting was guided by the Standards for Reporting Qualitative Research.
Two public involvement advisors with lived experience of caring for a relative living in a care home contributed to the development of the interview guide, advised on care home engagement, guided the interpretation of the findings and commented on the drafted manuscript.
by Melissa M. Baker, Lyonel Nerolin Doffou Assalé, David Doledec, Romance Dissieka, Ahmenan Claude Liliane Konan, Agnes Helen Epse Assagou Mobio, Koffi Landry Kouadio, Oka René Kouamé, Ama Emilienne Yao, Hubert Zirimwabagabo
BackgroundWhile recent data on vitamin A deficiency (VAD) prevalence is lacking, the 2004 Côte d’Ivoire Nutrition and Mortality Survey reported that 26.7% of children aged 6–59 months were affected by VAD, and approximately 60% were at risk. Since 2016, the government has transitioned from mass campaigns to routine vitamin A supplementation (VAS) delivery integrated into health services. However, evidence on the cost-effectiveness of the routine distribution approaches is limited. This study evaluated the cost, coverage, and cost-effectiveness of three routine VAS delivery strategies across two health districts in northern Côte d’Ivoire.
MethodsA mixed-methods study evaluated three routine VAS delivery strategies – routine-fixed, advanced community-based, and catch-up – across two health districts, Ferkessédougou and Niakaramadougou, in northern Côte d’Ivoire. The quantitative cost data were collected via a structured tool covering six cost categories: planning, procurement, training, social mobilization, distribution, and supervision. VAS coverage was assessed through a post-event coverage survey (PECS) via a two-stage cluster sampling methodology. A cost-effectiveness analysis determined the cost per child supplemented, the cost per DALY averted, and a sensitivity analysis tested the robustness of the findings under different cost scenarios.
ResultsThe total program cost for July-December 2023 was 25.5 million FCFA, with personnel costs comprising over 70% of expenditures. In Ferkessédougou, the routine advanced community-based strategy was the most cost-effective, at 458 FCFA per child in rural areas (versus 596 FCFA for the routine-fixed facility-based approach in the same area). In Niakaramadougou, the December catch-up was more cost-effective in rural areas (606 FCFA per child) than the routine-fixed approach (714 FCFA). Across both districts combined, the routine-fixed strategy averaged roughly 651 FCFA per child supplemented, and the cost per DALY averted ranged from 30,093 FCFA (advanced strategy in Ferkessédougou) to 89,550 FCFA (catch-up Jul 2023 in Niakaramadougou) – all below Côte d’Ivoire’s cost-effectiveness threshold (0.5 x GDP per capita; approximately USD 1,265).
ConclusionAll three strategies were cost-effective, though the advanced community-based strategy achieved the best balance of reach and efficiency. Scaling advanced strategies within health system constraints may enhance sustainability and coverage in low-resource settings.
by Allison Anbari, Zachary Massey, Abigail Adediran, Na Wang, LaRissa Lawrie, Priscilla Martinez, Denis McCarthy
Alcohol consumption increases breast cancer risk. We evaluated the responses of 748 United States female participants ages 21–29 to health warning messages addressing the relationship between alcohol consumption and increased breast cancer risk. In an online experiment, participants were randomly assigned to view standalone health warning messages about alcohol, breast cancer, and breast cancer health effects with varying picture and text attributes. Participants then completed post-message exposure assessments that included an immediate open-ended response to the message prompt. We conducted a qualitative content analysis of the responses and coded deductively based on constructs from the Message Impact Framework including message reactions, attitudes and beliefs, and behavioral intentions. These constructs and corresponding variables were present in participants’ responses. Response type did not vary by participants’ demographics or the attributes of the health warning message they viewed. The code new information was applied to 20% of the responses, indicating that those participants had no prior knowledge of alcohol and breast cancer risk. Alcohol and breast cancer messaging could impact drinking behaviors. Given the frequency of responses indicating a lack of awareness, more work in cancer prevention and population health messaging is warranted.by Nailya Ibragimova, Arailym Aitynova, Seitzhan Turganbay, Marina Lyu, Alexandr Ilin, Tamari Gapurkhaeva, Galina Ponomareva, Karina Vassilyeva, Diana Issayeva, Amirkan Azembayev, Serzhan Mombekov, Aralbek Rsaliyev, Nurgul Sikhayeva, Yergali Abduraimov, Saki Raheem
Iodine-based antiseptics are essential in wound care but are often limited by cytotoxicity, instability, and rapid iodine release. Novostron is a novel polymer–iodine complex incorporating dextrin, polyvinyl alcohol, and metal ions, designed to enable controlled iodine release. Structural integrity and composition were confirmed by ¹H and 13C NMR spectroscopy and physicochemical analysis, indicating a molecular weight of ~9500 g/mol, a pH of 4.23, and an iodine content of 8.13%. Pharmacokinetic analysis in rabbits demonstrated that following a single dermal application, systemic iodine absorption was minimal, with peak blood iodine concentrations remaining within physiological limits and rapid elimination within 24 hours. Evaluation of thyroid function revealed no significant changes in serum T₃, T₄, or TSH levels compared with those of the controls, confirming that topical application of Novostron does not disrupt thyroid homeostasis. In compliance with OECD guidelines in rabbits, guinea pigs, and rats, Novostron showed no signs of dermal irritation, skin sensitization, or systemic toxicity (LD₅₀ > 2000 mg/kg). In a rat cotton pellet granuloma model, Novostron significantly reduced the inflammatory mass (23.65% inhibition), supporting its anti-inflammatory potential. In a murine burn model, Novostron accelerated wound contraction (25.95% at day 10), increased epidermal thickness, and enhanced collagen deposition (~44%), outperforming controls and matching or exceeding betadine. These findings suggest that Novostron promotes tissue repair by modulating inflammation. Overall, Novostron demonstrated a favourable preclinical safety and efficacy profile, and its polymer–iodine composition, which enables controlled release and localized activity highlights its potential as a promising topical therapeutic. However, the study was limited to animal models and short-term observation; further long-term and clinical investigations are needed to confirm its translational potential in human wound healing.by Merga Abdissa Aga
We propose the Fréchet–Power Function (FPF) distribution, a novel two-parameter model that combines the bounded support of the Power Function distribution with the heavy-tailed flexibility of a Fréchet-type generator. This combination enables the FPF to capture complex features such as skewness, heavy tails, and diverse hazard rate shapes—limitations present in existing bounded lifetime models. We provide explicit forms for the probability density, cumulative distribution, and quantile functions, along with detailed statistical properties including moments and hazard rate behavior. Parameters are estimated using maximum likelihood, with bootstrap and simulation techniques employed to assess estimator performance. Empirical applications to survival, reliability, and environmental datasets show that the FPF distribution consistently outperforms traditional models in terms of goodness-of-fit and flexibility. This work introduces a powerful and versatile tool for modeling bounded lifetime data, offering enhanced accuracy and interpretability across disciplines.by Danai Sangthong, Pradit Sangthong, Warin Rangubpit, Prapasiri Pongprayoon, Eukote Suwan, Kannika Wongpanit, Wissanuwat Chimnoi, Pacharathon Simking, Sinsamut Sae Ngow, Serge Morand, Roger W. Stich, Sathaporn Jittapalapong
Phylogenetic and population genetic analyses were conducted on tick specimens collected from cattle in northern, northeastern, central, and southern regions of Thailand. Morphological identification indicated these ticks consisted of three species, Rhipicephalus microplus from all four regions, R. sanguineus from the northern and northeastern regions, and a Haemaphysalis species only collected from the northeastern region. Analysis of cytochrome c oxidase subunit I gene (COI) sequences identified R. microplus clades A and C, while clade B was not detected in this study. The same analysis indicated specimens morphologically identified as Haemaphysalis were H. bispinosa, confirming previous reports of their prevalence in northeastern Thailand. H. bispinosa showed low haplotype and nucleotide diversity, suggesting either a bottleneck or founder effect. Both R. microplus clades displayed high haplotype diversity and low nucleotide diversity, a pattern associated with population expansion. Genetic structural analysis revealed significant genetic differences in R. microplus clade A, especially between mainland (northern, northeastern, and central regions) and peninsular (southern region) populations, which indicated limited gene flow between these areas while suggesting movement of these ticks across the mainland. The sequence analyses described in this report enhance understanding of the natural history of ticks in Thailand and are expected to guide and strengthen tick control strategies across Southeast Asia.by Ariene Silva do Carmo, Paulo César Pereira de Castro Júnior, Thais Cristina Marquezine Caldeira, Daniela Silva Canella, Rafael Moreira Claro, Luiza Delazari Borges, Larissa Loures Mendes
The present study analyzed the prices of food sold in canteens of Brazilian private schools and described price-based marketing strategies, according to the NOVA food classification system. This is a mixed methods study combining a cross-sectional component and time series analysis, with data from 2,241 canteens in private elementary and secondary schools in the 26 capitals of Brazil and the Federal District, collected between June 2022 and June 2024. Price data collected for unprocessed, minimally processed, or processed foods and culinary preparations based on these foods (UMPCP), and ultra-processed foods and culinary preparations based on these foods (UpCP) sold in school canteens and from the National System of Consumer Price Indices (SNIPC), were used to create a data set containing deflated monthly prices for food and beverages sold between August 2022 and July 2024. Calculations were made for adjusted prices (R$/100 g or ml) and absolute prices (R$ per portion), and frequency of use of strategies such as combos and promotions. UMPCP showed lower adjusted price, but higher absolute price than UpCP, especially for solid foods. About 27% of the study canteens implemented pricing strategies for both food groups. Most of these strategies did not exclusively favor healthy foods, indicating that promotions and combos were used without distinction. The affordability of healthy foods is disadvantaged in school canteens when considering the price per portion, which may negatively influence students’ food choices. The findings show that current prices for food sold in most canteens discourage the purchase of healthy items, but favor the purchase of unhealthy ones. These results reinforce the importance of interventions for promoting healthy foods and making them more affordable.
FreshRSS 