Changes In System Research Articles

Small fiber pathology in fibromyalgia syndrome.

About 50% of women with fibromyalgia syndrome have reduced skin innervation. This finding is consistent in patient cohorts from different regions of the world. Small fiber function may also be affected, as shown by various studies using different methods, such as quantitative sensory testing or special small fiber neurophysiology such as C-fiber microneurography. Microneurography in particular has shown increased spontaneous activity, mechanosensitivity, and enhanced activity-induced slowing in C fibers of patients with fibromyalgia. Generalized reduction of skin innervation, ie, proximally and distally, was associated with higher symptom severity and more pronounced central nervous system changes as seen in magnetic resonance tomography. The question whether peripheral or central nervous system changes come first, or whether both are signs of an underlying pathology, has not been resolved yet. For clinical practice, it is important to note that reduced skin innervation in fibromyalgia must not be confused with small fiber neuropathy, which is a separate entity with different characteristics and pathophysiology. Further prospective research is warranted to transfer these findings in the peripheral nervous system into clinical fibromyalgia patient management.

Avertible filicide: a call to action for early intervention and mental health support in India.

Maternal filicide is a deeply distressing and potentially preventable phenomenon that demands priority attention. This study aims toshed light on the psychological, social and systemic factors contributing to maternal filicide. It calls for robust early intervention strategies and the establishment of comprehensive mental health support systems to mitigate the risk and prevent the occurence of such tragedies.. A detailed evaluation of a mother who committed filicide was undertaken The assessments included in-depth psychiatric evaluations, interviews with family members, review of the individual's medical history, prior social circumstances, and existing legal records. This comprehensive approach allowed for the identification of potential warning signs and gaps in intervention. Additionally, a review of existing literature and national frameworks related to maternal mental health was undertaken to contextualize the findings within the broader socio-cultural and healthcare landscape of India. The case highlights a complex interplay of untreated mental health disorders, social stigma, lack of accessible mental health services, and a failure to recognize warning signs by family members and professionals. The analysis reveals missed opportunities for intervention that might have prevented the act of filicide. Key contributing factors included postpartum mental health issues, socio-economic stressors, and inadequate social and legal support for the mother. This case underscores the need for systemic changes, including improved mental health screening during the perinatal period and the establishment of crisis intervention services. Maternal filicide is not solely a legal issue but also a multifaceted public health and social problem that warrants a multidisciplinary response. The findings emphasize the need for an integrated approach involving healthcare professionals, social workers, and law enforcement agencies to address the mental health challenges faced by mothers in distress. Early identification of at-risk individuals, destigmatization of mental health care, and the provision of timely interventions are pivotal in preventing such tragedies. This study underscores the urgency of implementing mental health policies that prioritize maternal mental health, enhance public awareness, and ensure the availability of accessible, culturally sensitive support systems for at-risk families.

Abstract TP140: The Blood Proteome Profiling Identifies Biomarkers Associated With Ischemic Stroke Prognosis

Blackground: Due to the narrow therapeutic time window and strict indications, there are still a large number of patients unable to receive thrombolysis and endovascular therapy, resulting in a poor long-term functional prognosis. Moreover, it is unclear what effective therapeutic targets as well as molecular systemic changes in stroke in the chronic phase. Therefore, to provide useful insights into its pathogenesis, identification of therapeutic targets and biomarker discovery, we analyze the proteomic profile of blood in ischemic stroke patients in order to gain insights into the disease. Method: We use proteomics technologies to examine serum at baseline and use the modified Rankin Scale (mRS) to evaluate neurological function at baseline and 3-month follow-up after ischemic stroke. Based on data-independent acquisition mass spectrometry and parallel reaction monitoring (PRM) technology, we implement a staged discovery-confirmatory pipeline in serum samples from better prognosis patients(n=48) and poor prognosis patients(n=50) according to mRS to comprehensively identify and validate more accurate biomarker performance characteristics of candidate proteins. Results: In this proteomic study, we characterize 4,740 circulating proteins and 324 differentially expressed proteins in 98 patients. We identify circulating proteomic signatures for ischemic stroke prognosis, and correlate these with clinical data to develop a proteomic profile of 14 markers. Based on machine learning algorithms such as LASSO regression and exhaustive feature selection (EFS), we finally identify some biomarkers (IQGAP2, LYZ, PDGFD, EHD3, CETP, FYB1) are validated as contributors to the ischemic stroke prognosis model through verification of an additional 58 serum samples. (AUC range:0.65-0.99). Conclusion: We identify potential biomarkers and therapeutic targets and offer an opportunity for more precise prognosis and treatment in ischemic stroke.

The Neuroplastic Outcomes from Impaired Sensory Expectations (NOISE) hypothesis: How ACL dysfunction impacts sensory perception and knee stability.

The anterior cruciate ligament (ACL) is integral to maintaining knee joint stability but is susceptible to rupture during physical activity. Despite surgical restoration of passive or mechanical stability, patients struggle to regain strength and prior level of function. Recent efforts have focused on understanding how ACL-related changes in the nervous system contribute to deficits in sensorimotor control following injury and reconstruction. We hypothesize that these challenges are partially due to an increase in sensorimotor uncertainty, a state that reduces the precision of movement control. This review proposes the ACL NOISE (Neuroplastic Outcomes from Impaired Sensory Expectations) hypothesis, reframing current literature to provide a case that increased sensory noise following ACL injury and reconstruction disrupts sensory predictions, which are anticipations of immediate sensory outcomes or motor commands. This disruption in sensory predictions may contribute to altered neurophysiology, such as cross-modal brain activity, and other persistent clinical deficits. Narrative review RESULTS/FINDINGS: Following ACL injury and reconstruction, the knee and nervous system experience various neurophysiological alterations to overcome elevated sensory uncertainty and inaccurate sensory predictions, contributing to persistent motor deficits. We provide a theoretical case based on compelling evidence that suggests prolonged impairment after ACL injury may be secondary to uncertainty in knee sensory perception. Future research should consider testing the NOISE hypothesis by creating a paradigm that examines dynamic joint stability in response to unexpected perturbations. This approach would help assess motor coordination errors and drive the development of clinical strategies aimed at reducing sensory uncertainty following ACL reconstruction.

Iron metabolism dysfunction in neuropsychiatric disorders: Implications for therapeutic intervention.

Iron is a trace metal that takes part in the maintenance of body homeostasis by, for instance, aiding in energy production and immunity. A body of evidence now demonstrates that dysfunction in iron metabolism can have detrimental effects and is intricately associated with the development of neuropsychiatric disorders, including Major Depressive Disorder (MDD), anxiety, and schizophrenia. For instance, changes in serum and central nervous system (CNS) levels of iron and in proteins mediating iron metabolism have been documented in patients grappling with the aforementioned diseases. By contrast, targeting iron metabolism by using iron chelators, for instance, has proven to be effective in alleviating disease burden. Therefore, here we review the state-of-the-art regarding the role of iron metabolism and its dysfunction in the context of neuropsychiatric disorders. Furthermore, we discuss how targeting iron metabolism can be an effective therapeutic option to tackle this class of diseases. Finally, we discuss the mechanisms linking this dysfunction to behavioral changes in these disorders. Harnessing the knowledge of iron metabolism is not only key to the characterization of novel molecular targets and disease biomarkers but also crucial to drug repurposing and drug design.

Probing the interaction mechanism of tigecycline with γ-globulin and hemoglobin in the absence and presence of amikacin.

The interaction mechanism of tigecycline with γ-globulin and hemoglobin in the absence and presence of amikacin was investigated through multipectral, molecular docking and molecular dynamics simulation. The results show that tigecycline and γ-globulin/hemoglobin forms a ground state complex without or with amikacin. The presence of amikacin slightly increases the binding constant of tigecycline to γ-globulin/hemoglobin, but all are of moderate binding affinity, at 104Lmol-1. The equilibrium fraction of unbound tigecycline fu is >90%, but the presence of amikacin reduces the free concentration of tigecycline in γ-globulin and hemoglobin. Whether amikacin is present or not, the interaction between tigecycline and γ-globulin/hemoglobin is a synergistic interaction driven by enthalpy and entropy. Non-covalent forces are primarily hydrophobic interactions, but also include electrostatic forces and hydrogen bonds. In the presence of amikacin, the effect of tigecycline on the skeleton structure of γ-globulin/hemoglobin is more significant. The effect of tigecycline and/or amikacin on the secondary structure of γ-globulin/hemoglobin is not significant, while the secondary structure changes in different systems are not the same. Molecular docking shows that γ-globulin/hemoglobin-tigecycline (first)-amikacin ternary system is the most stable. Molecular dynamics simulation explores the stability and dynamic behavior of γ-globulin/hemoglobin-tigecycline complex without or with amikacin.

Estimation of water storage changes in a tropical lake-floodplain system through remote sensing

Estimation of water storage changes in a tropical lake-floodplain system through remote sensing

Impact of natural compounds on peroxisome proliferator-activated receptor: Molecular effects and its importance as a novel therapeutic target for neurological disorders.

Neurological disorders refer to the pathological changes of the nervous system involving multiple pathological mechanisms characterized by complex pathogenesis and poor prognosis. Peroxisome proliferator-activated receptor (PPAR) is a ligand-activated transcription factor that is a member of the nuclear receptor superfamily. PPAR has attracted considerable attention in the past decades as one of the potential targets for the treatment of neurological disorders. Several in vivo and in vitro studies have confirmed that PPARs play a neuroprotective role by regulating multiple pathological mechanisms. Several selective PPAR ligands, such as thiazolidinediones and fibrates, have been approved as pharmacological agonists. Nevertheless, PPAR agonists cause a variety of adverse effects. Some natural PPAR agonists, including wogonin, bergenin, jujuboside A, asperosaponin VI, monascin, and magnolol, have been introduced as safe agonists, as evidenced by clinical or preclinical experiments. This review summarizes the effects of phytochemicals on PPAR receptors in treating various neurological disorders. Further, it summarizes recent advances in phytochemicals as potential, safe, and promising PPAR agonists to provide insights into understanding the PPAR-dependent and independent cascades mediated by phytochemicals. The phytochemicals exhibited potential for treating neurological disorders by inhibiting neuroinflammation, exerting anti-oxidative stress and anti-apoptotic activities, promoting autophagy, preventing demyelination, and reducing brain edema and neurotoxicity. This review presents data that will help clarify the potential mechanisms by which phytochemicals act as pharmacological agonists of PPARs in the treatment of neurological disorders. It also provides insights into developing new drugs, highlighting phytochemicals as potential, safe, and promising PPAR agonists. Additionally, this review aims to enhance understanding of both PPAR-dependent and independent pathways mediated by phytochemicals.

Outcomes of simultaneous, adaptive, MRI-guided liver SBRT in patients with heavily pretreated colorectal cancer and four or more liver metastases.

160 Background: About one-third of colorectal cancer (CRC) patients (pts) develop metastases, most commonly in the liver (CRLM). Ablative treatment of multiple liver lesions is difficult and often not done with conventional CT-based radiation therapy, but feasible with MRI-guided adaptive radiation. This study reviews our experience treating pts with high burden CRLM using MRI-guided stereotactic body radiation therapy (MRgRT). Methods: This study identified pts with 4 or more CRLM treated with MRgRT between 7/2019 and 4/2024, all of whom had progressive disease during or after standard-of-care therapy. Ablative radiation was delivered to all sites of disease with no concurrent systemic therapy. All with Child-Pugh score 5-6 (class A) liver function. Local control was defined as no progression in any treated lesion on a per-patient basis. Descriptive statistics summarized the data. A Cox proportional hazards model was used to identify predictors of survival, while the Kaplan-Meier method was used to estimate survival functions. Statistical analysis was performed using SPSS. Results: Seventeen pts with 110 lesions were included, with a median follow-up of 10.7 months (range, 1.7–36.9). The majority (n=15) received systemic therapy in the year before MRgRT. The median number of prior lines of systemic therapy was 2 (range, 1–5). Eight pts (47.1%) had nodal and/or lung progression in addition to CRLM, and 4 pts (23.5%) had at least one prior course of MRgRT. A median of 6 liver lesions (range, 4–11) were prescribed a median dose of 60 Gy (range, 60–80), each delivered in 5 fractions. Median total gross tumor volume per pt was 23.8 cm 3 (range, 0.97–60.1). Seventy-four fractions were available for radiation delivery analysis, of which 55 (74.3%) were adapted. At least one target was modified in 51 (92.7%) of the adapted fractions. Acute toxicity occurred in 7 pts, all with self-limited fatigue and nausea. Progression in Child-Pugh classification from A to B occurred in three pts 3-6 months post-MRgRT. Late toxicity occurred in 1 patient with mild, possibly radiation-related peripheral biliary dilation. Two pts developed malignant biliary strictures. Per-patient local control was 50.8% and 34.8% at 1 and 2 years, respectively, while liver control was 28.7% at 2 years. Six-month systemic therapy-free survival was 31.9%. Two-year overall survival (OS) was 43.9%, with a median of 17.1 months (range, 8.6–25.7). The size of the largest tumor correlated with OS (HR 1.23, p=0.014). Conclusions: In this small series of CRC pts with 4+ CRLM, MRgRT is well-tolerated and shows promise as astrategy to consolidate disease and delay the immediate need for systemic therapy changes. Patient selection is critical to identify those most likely to benefit, though the overall impact on survival and disease trajectory remains uncertain.

Role of AIM2 and cGAS-STING signaling in high fat high carbohydrate diet-induced gut dysbiosis associated neurodegeneration.

Gut dysbiosis modulates CNS complications and cognitive decline through the gut-brain axis. The study aims to investigate the molecular mechanisms involved in gut dysbiosis-associated cognitive changes and the potential effects of probiotics in high fat-high carbohydrate diet-induced gut dysbiosis-associated neurodegeneration. We used high fat, high-carbohydrate diet (HFHCD) and high-fat diet (HFD) to induce gut dysbiosis-associated neurodegeneration in C57BL/6 mice. IVIS imaging system and biochemical changes using ELISA measured intestinal inflammation. We used fecal samples for qPCR profiling of intestinal bacteria, and serum was used for inflammatory marker analysis using ELISA. Behavioral studies measured cognitive changes, while histopathology, immunohistochemistry, and western blot analysis of hippocampal samples measured protein changes. The behavioral studies showed a significant decrease in cognitive function associated with gut dysbiosis in HFHCD and HFD animals. Gut dysbiosis was associated with intestinal inflammation and increased intestinal permeability, followed by systemic and neuroinflammatory changes. Molecular signaling studies showed the involvement of AIM2 inflammasome and cGAS-STING signaling pathways in neurodegeneration for HFHCD animals. Administration of probiotics restored the above processes and prevented gut dysbiosis-associated memory decline in mice. The study shows that alteration in microbial composition due to prolonged HFHCD could contribute to intestinal inflammation and increased intestinal permeability, facilitating the translocation of microbial toxins like LPS, leading to systemic inflammation, which eventually leads to neuroinflammation and neurodegeneration.

“We don't have time”: How imaginaries of urgent energy system change marginalise locally driven pathways

“We don't have time”: How imaginaries of urgent energy system change marginalise locally driven pathways

Educating healthcare workers in snakebite management: A study to determine the effectiveness of the snake bite life support workshop.

Snakebite envenomation is a significant global health issue, with India bearing a substantial burden. Despite the development of guidelines, knowledge gaps and lack of training persist among healthcare workers (HCWs), contributing to high morbidity and mortality. This study aimed to evaluate the impact of the Snake Bite Life Support (SBLS) workshop on HCWs' knowledge, practices, self-efficacy, and advocacy skills in snakebite management. A pre-post interventional study was conducted during the SBLS workshop at a tertiary care center in May 2024. HCWs' knowledge, practical skills, self-efficacy, and advocacy skills were assessed using standardized questionnaires and a modified General Self-Efficacy (GSE) scale, both before and after the workshop. Data were analyzed using SPSS v25.0, employing paired t-tests and Wilcoxon signed-rank tests for comparison. Forty-one HCWs completed the pre- and post-workshop assessments. Significant improvements were observed in knowledge, particularly in avoiding false positive 20-min whole blood clotting test (20WBCT) results (p=0.020) and premedication for antivenom (p<0.001). Participants reported a marked increase in self-efficacy across all GSE parameters and demonstrated enhanced advocacy intent in resource management, policy influence, and educational outreach. The workshop influenced practice changes, notably reducing the administration of antivenom in confirmed hump-nosed pit viper bites. The SBLS workshop effectively enhanced HCWs' knowledge, management practices, self-efficacy, and advocacy intentions, emphasizing the need for integrating such training into healthcare education to drive systemic change in snakebite management and improve patient outcomes. Future studies should focus on long-term impacts and broader implementation.

Examining Heart Failure Informal Care Partners Using Person and System Levels and Domains: A Meta-Synthesis.

Within the last decade, system and policy-level changes have driven substantial shifts in heart failure (HF) care from hospital to home, requiring greater support from informal care partners. What has not been examined is the state of the care partner science by person and system-level domains using qualitative studies to understand impact across multiple person and system levels. (1) Identify by person and system levels and domain what is known about informal care partners and (2) Identify gaps in the caregiving science and suggest ways to move forward. This secondary analysis of a large HF systematic review is guided by the National Institute on Minority Health and Health Disparities and MIRACLE frameworks and uses meta-synthesis techniques with critical realist approaches to synthesize and interpret the themes across papers. Using data from 46 papers and 1695 care partners, we identified patterns occurring across 6 domains (biological, behavioral, affective, physical/built environment, sociocultural environment, and healthcare system) and on 4 levels (individual, interpersonal, community, and societal). Existing research predominantly addressed affective and behavioral domains, followed by health system and sociocultural domains. Few studies focused on biological and physical/built environment domains, leaving large gaps in what is known about caregiving at the cellular (biological) and societal (community and societal) levels. HF caregiving continues to be studied at a very rudimentary level. This synthesis also reveals critical gaps in what is known about caregiving within the physical/built environment domain and at the community and societal levels.

Clinical Evaluation of Drug-Drug Interactions with Obeldesivir, an Orally Administered Antiviral Agent.

Obeldesivir is an oral nucleoside analog prodrug inhibitor of SARS-CoV-2 RNA-dependent RNA polymerase and other viral polymerases. Here, two Phase I studies evaluated potential drug-drug interactions between obeldesivir and substrates or inhibitors of cytochrome P450 and drug transporters in healthy participants. When obeldesivir was tested as a precipitant, pharmacokinetic parameter point estimates for midazolam (CYP3A4 inhibition/induction), caffeine (CYP1A2 inhibition), and metformin (organic cation transporter 1 inhibition) exposures were within 80-125% no-effect bounds representing the interval within which a systemic exposure change does not warrant clinical action based on EMA/FDA guidance. Dabigatran (P-glycoprotein substrate) and pitavastatin (organic anion transporting polypeptide 1B1/1B3 substrate) exposures decreased by approximately 25% and 30%, respectively, with obeldesivir coadministration; these were considered not clinically relevant, as these exposure changes are not associated with dose changes or precautions in the US prescribing information for these drugs. When obeldesivir was evaluated as an object, exposures of GS-441524, the parent nucleoside monophosphate metabolite of obeldesivir, were within the 80-125% no-effect bounds for ritonavir (P-glycoprotein inhibition) and cyclosporin A (breast cancer resistance protein inhibition) coadministration. Famotidine (gastric acid suppression) coadministration decreased GS-441524 exposure by approximately 26%; this was within the range of exposures observed in previous Phase III studies and was considered not clinically relevant. Obeldesivir was well tolerated, and adverse events were mild to moderate. These findings indicate that obeldesivir has low potential for drug-drug interactions. Obeldesivir remains a promising treatment against a broad spectrum of viruses given its antiviral activity and favorable safety profile.

Alzheimer's disease may develop from changes in the immune system, cell cycle, and protein processing following alterations in ribosome function.

The prevalence of Alzheimer's disease (AD) is increasing as society ages. The details of AD pathogenesis have not been fully elucidated, and a comprehensive gene expression analysis of the process leading up to the onset of AD would be helpful for understanding the mechanism. We performed an RNA sequencing analysis on a cohort of 1227 Japanese blood samples, representing 424 AD patients, 543 individuals with mild cognitive impairment (MCI), and 260 cognitively normal (CN) individuals. A total of 883 and 1169 statistically significant differentially expressed genes (DEGs) were identified between CN and MCI (CN-MCI) and between MCI and AD (MCI-AD), respectively. Pathway analyses using these DEGs, followed by protein-protein interaction network analysis, revealed key roles of ribosomal function in MCI progression, whereas immune responses, cell cycle, and protein processing in endoplasmic reticulum were involved in AD progression. Our findings indicate that the onset of AD might be associated with gene expression changes in the immune system, cell cycle, and protein processing following alterations in the expression of ribosomal protein genes during the MCI stage, although validation using brain tissue samples will be necessary in the future. Given the known effectiveness of delaying MCI progression in preventing AD, the genes related to ribosomal function might emerge as biomarkers for early diagnosis.

Existentialism in the age of climate crisis: Freedom, responsibility and authentic living amid global challenges

This research investigates the philosophical contributions of existentialism to understanding and addressing the global climate crisis. Drawing on the foundational ideas of Kierkegaard, Nietzsche, Sartre, and de Beauvoir, the study explores how existential themes - freedom, responsibility, and authenticity - offer tools for grappling with the ethical and existential dilemmas posed by ecological destruction. Existentialism’s emphasis on human agency is juxtaposed against the collective nature of environmental responsibility, revealing tensions between individual actions and systemic change. Central existential concepts, including the absurd and alienation, are analyzed to uncover their relevance in fostering ethical resilience and guiding action amidst the uncertainties of the Anthropocene. The study argues that existentialism challenges humanity to confront the climate crisis authentically, rejecting nihilism and embracing responsibility for the self and future generations. Through the lens of existential thought, the research underscores the imperative of aligning personal values with environmental ethics while advocating for systemic transformations that address the climate emergency. Existentialism’s focus on the individual’s ability to create meaning through deliberate choices provides a philosophical foundation for engaging with the moral complexities of climate justice and sustainability. The research concludes that existentialist philosophy not only critiques humanity’s historical failures but also offers a hopeful framework for constructing a meaningful response to the climate crisis. It calls for embracing the freedom to act in ways that promote sustainability and intergenerational justice, transforming despair into purposeful action amid an indifferent universe.

“Dance Isn’t a Sport, It’s for Girls”: Examining the Role of Gender in Interuniversity Sport Participation for Competitive Dancers

ABSTRACT This article examines the impact of gender in competitive dancers’ access to and recognition within interuniversity sport. We interviewed competitive dancers, dance coaches, and athletic department staff in universities across Ontario, Canada to understand how participants’ roles, prior knowledge and experience with dance and sport, and views on gender may influence their understandings of dance. We examined three themes: (1) dance as dominated by women, (2) gendered dynamics in athletic departments, and (3) the erasure of dancers as athletes. The findings highlight significant biases favoring men’s sports, the disadvantages of dance being understood as “female dominated,” and the ambiguous status of dancers as student-athletes and dance as a sport. Gender biases and societal stereotypes compounded these challenges, further perpetuating inequalities in university athletic departments. This study advocates for systemic changes within athletic departments to create an environment where dancers can not only participate as student-athletes, but be celebrated as true student-athletes.

Seeking New Ground for Managing—An Introduction to the Special Issue on “Awakening to Ourselves, One Another, and the Earth: Awareness Practices and Systems Change”

Seeking New Ground for Managing—An Introduction to the Special Issue on “Awakening to Ourselves, One Another, and the Earth: Awareness Practices and Systems Change”

Double burden of malnutrition among households in Ethiopia: a systematic review and meta-analysis

IntroductionThe double burden of malnutrition (DBM) at the household level has increased in sub-Saharan African countries as a result of rapid changes in global food systems and growing urbanization. The presence of overweight or obese mothers with undernourished (stunted, wasted, or underweight) children within the same household holds particular significance. However, no comprehensive study or meta-analysis has been conducted to summarize the national evidence of the double burden of malnutrition in mother–child pairs. Therefore, the purpose of this study was to determine the pooled prevalence of the double burden of malnutrition at the household level in Ethiopia in 2024.MethodsThis systematic review and meta-analysis was conducted on the prevalence of the double burden of malnutrition and associated factors among households in Ethiopia, using an advanced search of electronic databases and search engines. The standardized Joanna Briggs Institute (JBI) method was used to extract data from a Microsoft Excel spreadsheet and evaluate the quality of each article. The analysis was performed using STATA V.17. A random-effects model was used to conduct the meta-analysis. Heterogeneity was assessed using the I2 and Q tests.ResultsA total of seven publications met the inclusion criteria, including data from 56,877 and 43,770 mother–child pairs for the systematic review and meta-analysis, respectively. The pooled prevalence of the double burden of malnutrition among the mother–child pairs was 8.30% (95% confidence interval (CI): 1.51, 15.09). The heterogeneity test revealed extremely high heterogeneity (I2 = 99.91%; p = 0.00). In the subgroup analysis based on sample size, the pooled estimated prevalence of the double burden of malnutrition was high for a sample size of fewer than 1,000 mother–child pairs (11.69% (95% CI: 3.11, 20.28)). The pooled estimate from the subgroup analysis of the data collected 8 years ago was 8.61% (95% CI: 1.11, 22.33). Residence, household size, housing quality, wealth index, household food security status, mother’s age and educational status, and child’s age are some of the factors that influence the double burden of malnutrition among mother–child pairs.ConclusionIn Ethiopia, the double burden of malnutrition among mother–child pairs is rapidly emerging. As a result, double-duty interventions should be implemented to address this issue, taking into account multiple factors at the household level.Systematic review registrationThe protocol for the systematic review and meta-analysis was registered under the registration ID CRD42024517778 with the PROSPERO (International Prospective Register of Systematic Review and Meta-analysis).

Stress effects and neurosecretion in Earthworms: A Review

Earthworms, the poikilothermal first group of invertebrate, are subjected to stressful events, occasional (illumination), frequent (amputation due to predation) and seasonal (dehydration during summer), hydration (during monsoon), thermal (heat stress during summer, cold stress during winter) etc. These lowly evolved creatures often overcome the events of stress through eco-physiological adaptive changes in the central nervous system (CNS) neurosecretory system. In absence any endocrine gland and neurohaemal organ, their CNS is enriched with vascularisation and well defined neurosecretory cells (NSCs) (type A and type B). The type A NSCs - the source of peptide neurohormone and release their secretion through axonal transport, response mainly against osmotic stress (dehydration, hydration), light (when exposed to the sunlight), hypo and hyperthermia etc. The type B NSCs are source of amine neurohormone and release neurohormone mainly by perikarya and occasionally by axon. The type B cells show remarkable cytoplasmic changes in relation to metabolic compensation following food deprivation in earthworms. Both the type A and type B NSCs show adaptive response such axonal transport, cytoplasmic vacuoles followed normal secretory cycle (i.e. synthesis, storage, release) during amputation and subsequent regeneration in earthworm.