Coordinated effects of air pollution control devices on polychlorinated naphthalenes emissions from coal-fired power plants in China.

Older adults experiencing social marginalization may face inequitable access to publicly funded home care services. In Ontario, Canada, the Ontario Marginalization Index (ON-Marg) provides a multidimensional measure of area-level marginalization. This study examined whether ON-Marg dimensions were associated with access to publicly funded home care among community-dwelling adults aged 75years and older. We conducted a population-based retrospective cohort study using linked administrative health data from Ontario, Canada, for the year 2019. The cohort included individuals aged 75 + residing in the community (excluding those in long-term care). Home care access was stratified by ON-Marg dimensions: residential instability, material deprivation, dependency, and ethnic concentration. The primary outcomes were receipt of long-stay (≥ 90days) and short-stay (< 90days) home care aggregated at the community level (Aggregated Dissemination Areas -ADAs). Multivariable regression models adjusted for age, sex, hospitalization, and health complexity. Among 1,071,899 older adults, 14% received long-stay home care and 9% received short-stay home care. Communities in the highest deprivation and ethnic concentration quintiles had a 1.60 and 2.77 percentage point greater probability, respectively, of receiving long-stay care compared to the least marginalized areas. In contrast, the most dependent communities had a 0.68 percentage point lower probability of long-stay access. For short-stay care, the highest instability quintile was associated with a 0.90 percentage point greater probability of access, while the highest ethnic concentration quintile was associated with a 2.26 percentage point lower probability. Regional analyses revealed considerable variation in these patterns across Ontario. Access to home care in Ontario varies by dimension of marginalization. While some marginalized groups may have greater access-likely reflecting higher underlying need-populations with high dependency may face persistent barriers. Equity-focused reforms should consider how specific forms of marginalization affect not only need but also access and service delivery.

Laryngeal fracture is a rare but potentially life-threatening injury requiring prompt recognition and management due to the risk of airway compromise. We present the case of a 42-year-old man who presented to a tertiary center with symptoms of dysphonia and neck pain following blunt trauma sustained when a barbell fell on him while bench pressing without assistance. Computed tomography (CT) imaging confirmed a displaced fracture of the thyroid cartilage. He was managed conservatively with corticosteroids and high dependency unit airway monitoring. He recovered well and later resumed weightlifting with appropriate supervision. This case outlines the stages of assessment and management of laryngeal fractures, including airway evaluation, CT imaging and ear nose and throat (ENT) involvement. We discuss the benefit of conservative management in selected cases even when there are significant clinical findings and the importance of public health messaging to prevent such injuries. A high index of suspicion is essential for emergency physicians and ENT specialists when evaluating patients with neck trauma and voice changes.

The impact of body mass index on Esophagectomy: perioperative and oncological outcomes.

Photodynamic therapy (PDT) is hampered by high oxygen dependence and off-target phototoxicity, and existing tumor-activatable strategies are severely plagued by the aggregation-induced reactive oxygen species (ROS) quenching post-activation. We herein resolve these challenges through pioneering a smart "nano-isolation" strategy, synergized with aggregatin-induced emission (AIE)-hemicyanine (Hcy) photosensitizers with an aggregation-gated ROS generation feature. Propelled-type AIE motifs were introduced to planar Hcy derivatives to construct twisted donor-π-acceptor photosensitizers, among which MTPAON with the largest conformational twist exhibited the best AIE effect and the highest ROS generation, predominantly generating less oxygen-dependent type I ROS. Crucially, MTPAON's ROS generation is gated by aggregation degree, where only tightly packed aggregates activate ROS generation. Leveraging this, we pioneered a "nano-isolation" strategy by encapsulating MTPAON in glutathione (GSH)-responsive nanoparticles at a high polymer ratio (SSPEG-7 NPs). This nano-isolation initially suppresses MTPAON's tight aggregation and silences ROS generation. Upon encountering tumor-overexpressed GSH, SSPEG-7 NPs disassemble and release MTPAON to form type I ROS-competent aggregates in tumor cells. SSPEG-7 NPs thus demonstrated promising antitumor performance under low-dose laser irradiation, while exhibiting negligible off-target phototoxicity to normal tissues. This "nano-isolation" strategy establishes a new paradigm for precision PDT: leveraging stimulus-triggered aggregation to spatially control PDT activation, thereby reconciling the conflict between systemic safety and therapeutic potency.

The Automated Insulin Delivery among Pregnant women with Type 1 diabetes (AiDAPT) trial demonstrated that using the CamAPS FX automated insulin delivery (AID) was associated with improved glycaemic outcomes. This study aimed to assess the clinical and economic impact of improving third-trimester HbA1c. Using the AiDAPT data, a health economics model was built to estimate clinical outcomes and healthcare resource utilisation associated with third-trimester HbA1c categories (<42 mmol/mol, 42-53 mmol/mol, ≥53 mmol/mol). AiDAPT HbA1c distribution and associated clinical outcomes (obstetric: pre-eclampsia, delivery method; neonatal: length of stay in normal/critical/intensive care) were used to estimate perinatal complications. UK-specific healthcare costs were extracted from the NHS National Schedule and other published sources. Total costs to the UK healthcare system were estimated using an incremental 3.3 mmol/mol (0.3%) HbA1c reduction observed with CamAPS FX AID over Standard Care in AIDAPT. In the model, HbA1c improvement with CamAPS FX AID was associated with projected reductions in pre-eclampsia risk (-13%), high dependency neonatal care days (-16%), neonatal intensive care unit days (-12%) and clinic visits. The model projected cost reduction for the NHS healthcare system of £6,696,636 under conservative modelling assumptions, being cost saving at 96.8% of the simulations. The projected incremental cost difference per woman treated with CamAPS FX AID was -£1016, mainly derived from a modelled shift in the distribution of neonatal care, with reduced length of stay in high dependency neonatal intensive care. CamAPS FX AID improves third-trimester HbA1c with projected cost reductions for the UK healthcare system.

Recent advances in the microbial production of L-arginine and its derivatives using engineering Corynebacterium glutamicum and Escherichia coli.

ABSTRACT Challenges faced by students and professionals with visual impairment in reading and understanding digital content have always been a great area of concern, particularly in subjects like mathematics and science due to their high dependency on special symbols. On one hand, useful tools are limited by complex formats; on the other hand, most available tools are directional dependent as standard textual information does not support an effective tactile form of knowledge. This research therefore, developed Optical Braille Recognition Methodology (OBRM) for transforming printed documents into Braille language files. The proposed methodology integrates image segmentation with multistage AI processing to enhance recognition of textual content and interpretation of mathematical and special symbols. A novel key-element quantification strategy reduces overall complexity and minimizes memory usage. Multi-format document acquisition followed pre-processing steps to enhance quality and remove noises before starting OCR processing that again used additional Neural Network backend for structured parsing which finally ended the tactile symbol generation stage, where new 3-bit encoding implemented readable form creation in a BRF extension file output. Even the semantic structure organized text making similar word or symbol placed together assists easier understanding during the later tactile reading learning process. A user-experience survey involving target users was organized and carried out on the system as a beta test.

Kenya Electronic Medical Records (KenyaEMR) has improved data availability for patient services and programmatic purposes in Kenya. Maturity models provide a framework to assess health information systems (HIS) capabilities across maturity levels to ensure they are effective. This study aimed to determine KenyaEMR's current and goal maturity status, highlight gaps, and establish priorities for continuous improvement. The HIS Stages of Continuous Improvement (SOCI) Toolkit guided KenyaEMR's maturity assessment across five HIS domains and five maturity stages: 1-emerging/ad hoc; 2-repeatable, 3-defined, 4-managed, and 5-optimized. Participants included KenyaEMR experts representing the Ministry of Health, implementing partners, donor agencies, and faith-based organizations. The consensus-building process to determine final maturity scores utilized a two-round modified Delphi process. Improvement roadmaps were developed as action plans to bridge identified gaps. The assessment occurred in August 2024. Thirty-two stakeholders participated in the assessment. The overall KenyaEMR average maturity score was 3.2/5. Across the five HIS domains, the highest maturity scoring domain was standards and interoperability (4.4/5) and the lowest was management and workforce (2.3/5). The other domains maturity scores include leadership and governance (2.8/5), Information and Communication Technology (ICT) infrastructure (2.9/5), data quality and use (3.7/5). Among the 39 subcomponents, 7/39 (17.9%) scored at the 5-optimized maturity stage, of which six included data exchange standards, terminology management, master facility list, unique person identity management, person data exchange, and aggregated data exchange under the standards and interoperability domain. In comparison, 6/39 (15.4%) subcomponents scored lowest at the 2-repeatable level, with three (HR policy, HIS financing plan, and resource mobilization) under the management and workforce domain. The overall goal status maturity score was 4.6/5, with all subcomponents expected to reach 4-managed or 5-optimized levels by 2027. KenyaEMR's overall maturity level was 3.2/5. The workforce and management domain will require attention so that national-level investments in the HIS workforce and an increase in local funding sources can decrease the high donor funding dependency by the Kenya Ministry of Health. Conducting routine assessments coupled with the upcoming promising commitments from the local government to increase digital health investments will benefit continued support for KenyaEMR as it evolves.

Haploid parthenogenetic embryos (HPEs) typically exhibit poor in vitro development, which may be attributed to the absence of paternal factors. Since the metabolic pattern determines the developmental potential of early embryos, the present study aimed to ascertain whether the compromised developmental potential of HPEs reflects distinct metabolic requirements compared to normally fertilized embryos (NFEs). The developmental trajectories and utilization of key metabolic substrates of HPEs and NFEs of Swiss albino mice were assessed by culturing them in M16 medium with varying concentrations of glucose (0-5g/L) and pyruvate (0-90mg/L). mRNA expression of glucose transporter-4 (Glut-4), glycolytic [glucose-6-phosphate dehydrogenase (G6pd) and pyruvate dehydrogenase (Pdha1)] and antioxidant [superoxide dismutase (Sod1), catalase (Cat), glutathione s- transferase (Gstcd) and glutathione reductase (Gsr)] enzymes were assessed at various developmental stages. Higher blastocyst rate was obtained when HPEs were cultured in elevated glucose (5g/L) and pyruvate (54mg/L) concentrations. Inhibition of glycolysis using 2-deoxy glucose resulted in high percentage of HPEs getting arrested at 2-cell stage, while NFEs were able to progress to 4-cell stage. Spent media analysis revealed that HPEs exhibit high glucose dependency compared to NFEs. Further, G6pd, Pdha1, Sod1 and Cat were upregulated, while Gsr and Gstcd were downregulated in HPEs. Our findings suggest that the HPEs have altered metabolic requirements compared to NFEs and provide an insight into the paternal contribution in regulation of metabolic pathways in early embryos. This study forms a basis for optimizing culture conditions for in vitro development of parthenogenetic embryos.

Public innovation has become an imperative for the contemporary state, driving governance models that shift the focus from hierarchical centrality toward public–private partnerships. This research aims to analyze public officials' perceptions of the implementation of the "Pact for a Sustainable and Inclusive Region" in the Los Lagos Region, Chile, highlighting their experiences during the process, as well as the catalysts and barriers it encountered. The study adopts a qualitative exploratory case study approach, utilizing document analysis and 22 semi-structured interviews that were transcribed and analyzed using thematic analysis, following a hybrid approach that integrates deductive categories from the literature on public innovation and collaborative governance with emergent categories derived from participants' narratives. The main findings reveal that, while collaborative governance acts as an integrating framework that generates social capital, trust, and mutual learning, its effectiveness is limited by significant constraints, including the burden of contingency planning placed on public sector employees, a lack of structural resources, and a high dependence on the incumbent political leadership. In conclusion, the study demonstrates that collaborative governance can constitute a relevant form of public innovation at the subnational level by facilitating dialogue, learning, and consensus-building processes among diverse actors; however, its long-term sustainability depends on the capacity to institutionalize these mechanisms, secure adequate resources, and reduce dependence on temporary political leadership.

A halogen bond is formed by a wide range of divalent CR2 carbenes with ICN as the Lewis acid, and the results are examined via DFT calculations. These carbenes form much stronger halogen bonds than more common Lewis bases such as NH3 and OH2. The binding occurs through the carbene C lone pair and is enhanced if the central C is covalently attached to C on the R substituent, as compared to O or N. Interaction energies are as high as 30 kcal mol-1, and the C⋯I bond contains a certain degree of covalent character. The two lone pairs on the C atom of the carbene, when connected through dative bonds to units such as NH3 and OH2, make this C especially strongly nucleophilic, enough so as to partially extract the I from the ICN unit. The carbene halogen bonds have all of the characteristics of their classic counterparts, including a high dependence upon Coulombic interaction.

In the context of global health, commercial centrifuges are effective precision separation tools. However, their high cost, large size, and dependence on a stable power supply hinder improvements in medical standards and limit the adoption of point-of-care testing (POCT) technology in resource-limited settings. Here, we have designed a novel and convenient detection platform that combines the function of a DIY centrifuge for whole blood pretreatment with a rotational paper-based analytical device for a multiplex sandwich-type enzyme-linked immunosorbent assay (ELISA). The platform is used to detect the inflammatory biomarkers C-reactive protein (CRP) and procalcitonin (PCT). The rotational paper-based analytical device demonstrates excellent analytical performance for CRP and PCT, with detection limits of 659 pg mL-1 for CRP and 15.04 pg mL-1 for PCT, respectively. We believe that this reliable technical platform offers a promising solution for disease diagnosis in resource-limited settings or remote regions.

Interactions between mRNA lipid nanoparticles and immune cells in fresh human whole blood.

INTRODUCTIONSmoking cessation success in real-world clinical settings remains limited, particularly among individuals with high levels of nicotine dependence. Although smoking cessation clinics are widely used, evidence regarding factors influencing both short- and long-term cessation outcomes is still limited. This study aimed to evaluate the association of nicotine dependence, smoking pattern changes, and sociodemographic characteristics with short-term (6-month) and long-term (12-month) smoking cessation outcomes.METHODSThis retrospective cohort study was conducted at the Smoking Cessation Outpatient Clinic of Kırşehir Ahi Evran University Faculty of Medicine Hospital. Adult patients who applied to the clinic between June 2023 and June 2024 and completed a 12-month follow-up between June 2024 and June 2025 were included. Sociodemographic characteristics, smoking-related variables, nicotine dependence assessed using the Fagerström test for nicotine dependence (FTND), and psychological characteristics were obtained retrospectively from medical records and self-reported follow-up assessments. Smoking cessation status at 6 and 12 months was analyzed using multivariable logistic regression analyses.RESULTSAt 12 months, 36.1% of participants achieved smoking cessation. Higher levels of nicotine dependence were consistently associated with lower odds of smoking cessation at both 6 and 12 months. Participants with very high nicotine dependence had significantly lower adjusted odds of smoking cessation at 12 months compared with those with very low dependence (adjusted odds ratio, AOR=0.078; 95% CI: 0.03–0.22). Changes in smoking patterns during follow-up, including both increases and decreases in cigarette consumption, were also independently associated with reduced long-term cessation success.CONCLUSIONSNicotine dependence severity and changes in smoking behavior are key determinants of long-term smoking cessation outcomes in real-world clinical settings. Identifying individuals at high risk of cessation failure may support more individualized follow-up strategies in smoking cessation clinics.

Betel quid chewing, a culturally embedded habit among tribal populations, poses significant oral health risks due to its addictive and carcinogenic potential. However, data on dependence patterns and their impact on oral health among Kerala's tribal communities remain scarce. Hence this study aimed to estimate the prevalence of betel quid chewing, assess dependence levels and associated factors, and examine their relationship with oral health status among tribal adults in Wayanad, Kerala. A community-based cross-sectional study was conducted among 283 tribal adults aged ≥ 18 years from selected habitations in Wayanad by convenient sampling. Data were collected through face-to-face interviews covering sociodemographic details, chewing habits, and the 16-item Betel Quid Dependence Scale (BQDS). Oral health was assessed using the DMFT (Decayed, Missing, and Filled Teeth) index, and participants were also screened for features suggestive of oral submucous fibrosis and visible mucosal lesions. Data were analysed using SPSS version 22 and Jamovi software. 2.6.2. The prevalence of betel quid chewing among tribal adults in Wayanad was 67.5% (95% CI: 62.0-72.9). Among current users (n = 191), 56.5% (95% CI: 49.5-63.6) exhibited high dependence. In multivariable analysis, separated/widowed individuals had significantly higher odds of high dependence (AOR = 3.93; 95% CI: 1.13-13.62; p = 0.031). The mean DMFT score was 6.43 ± 8.51, indicating a substantial burden of dental caries. In multivariable linear regression analysis, occupation and high betel quid dependence was independently associated with higher DMFT scores (β = 2.17; 95% CI: 0.17-4.16; p = 0.033), (β = 2.546; 95% C.I = 0.532 - 4.560; p = 0.014). Betel quid use and dependence are highly prevalent among tribal adults in Wayanad and are linked to poorer oral health. Targeted community-based interventions integrating cessation support and routine oral screening are essential.

Perceived disease risk is a key determinant of smoking cessation, yet many smokers underestimate their personal vulnerability to smoking-related diseases. This study identified distinct risk-perception profiles for lung cancer and asthma among smokers and examined their associations with sociodemographic factors, nicotine dependence, and readiness to quit. A cross-sectional study was conducted among 310 adult cigarette smokers in Khuzestan Province, Iran (January-September 2024). Perceived susceptibility and perceived severity of lung cancer and asthma, nicotine dependence, and stage of change (readiness to quit) were assessed using validated instruments. Hierarchical cluster analysis (Ward's method, Euclidean distance) was used to identify risk-perception profiles. Associations between clusters and participant characteristics were examined using Chi-square and Kruskal-Wallis tests. Multinomial logistic regression was fitted to identify independent predictors of cluster membership. Four distinct risk-perception profiles emerged for both diseases: Indifferent (low susceptibility/low severity), Optimistic Bias (low susceptibility/high severity), Dismissive (high susceptibility/low severity), and Concerned (high susceptibility/high severity). In adjusted analyses, the Indifferent cluster was independently characterized by low nicotine dependence, whereas the Concerned cluster combined high dependence with greater readiness to quit. In the asthma model, the Optimistic Bias cluster-despite low perceived personal susceptibility-displayed the most favorable quit readiness profile, including the highest proportion planning to quit within one month. Male gender independently predicted the Optimistic Bias cluster, and higher income reduced its likelihood in the asthma model; for lung cancer, low income and moderate or high nicotine dependence were significant independent predictors. Smokers exhibit heterogeneous risk-perception profiles that are distinctly linked to nicotine dependence and quit readiness. The finding that the Indifferent profile is marked by low rather than high dependence suggests that lack of risk perception in this group stems from other cognitive or socioeconomic barriers beyond addiction. Tailored interventions should move beyond generic risk messages: for Indifferent smokers, addressing underlying barriers to risk acknowledgment; for Optimistic Bias smokers, leveraging their high perceived severity; and for Concerned smokers, coupling cessation support with dependence treatment.

Energy system resilience is essential for maintaining energy security and system stability under growing global uncertainty. Based on panel data for 30 Chinese provinces over the period 2012–2023, this paper investigates the relationship between digital technology and energy system resilience. Digital technology and energy system resilience are measured with entropy-weighted composite indices, and the empirical tests are conducted using a two-way fixed-effects model, mediation-effect models, and a panel threshold model. The results show that digital technology significantly improves energy system resilience, and this finding remains stable after endogeneity treatment and several robustness checks. The mechanism analysis further shows that industrial structure upgrading, digital industrial agglomeration, and green innovation serve as important channels linking digital technology to energy system resilience. The threshold results further show that the effect of digital technology is stage-dependent. Digital technology has a positive effect in all three stages, with the strongest effect occurring in the medium digital development stage, followed by slower marginal improvement in the high digital development stage. The heterogeneity results show that the effect is more pronounced in provinces with high resource dependence and in the central and western regions. By contrast, the eastern region presents a weaker marginal effect, while the northeastern region faces stronger constraints in transforming digital technology into resilience improvement. These findings suggest that digital technology is an important driver of energy system resilience and can support a more stable and sustainable energy transition, although its effect varies across development stages and regional conditions.

Given the limited ocular pathology data for common cuttlefish Sepia officinalis and hummingbird bobtail squid Euprymna berryi despite their high visual dependency, the purpose of this study was to investigate and describe the ophthalmic lesions in a cohort of laboratory-housed common cuttlefish and hummingbird bobtail squid. Cases were retrospectively selected from the International Zoo Veterinary Group Pathology database that reported confirmed clinical ophthalmic lesions or histopathological lesions. Twenty-five cases were identified that included clinical records and gross and histopathological examination of whole specimens. The cases included 19 common cuttlefish and six hummingbird bobtail squid, thus providing a sample of 50 eyes and orbital cavities. Thirty-two of 50 individual eyes (64%) and 30 of 50 white bodies (60%) were affected. The most frequent lesion that was observed was inflammation (n = 29/32, 91%), primarily manifesting as uveitis (n = 23/32, 72%) and phakitis (n = 10/32, 31%). Cataracts were also common (n = 14/32, 44%), often with cataract-associated inflammation (n = 9/14, 64%). Leukopoietic hyperplasia of the white body was bilaterally observed in 15 of 25 animals (60%) and was thought to be associated with exophthalmos. In the absence of notable intraocular or infraorbital lesions in some animals, this change was considered reactive, likely in response to nonocular lesions, such as ulcerative dermatitis and branchitis. Notable additional findings included hypopyon-like lesions (n = 3/32, 9%), a single case of congenital ocular malformation, and one case with mesenchymal proliferations that were reminiscent of florid fibroplasia. This study contributes to the expanding knowledge of cephalopod ocular pathology, with previously unreported findings in these cephalopods including congenital ocular malformation and cases of -hypopyon-like lesions with proteinaceous material exudation and hemocytes in the anterior chamber. Additionally, it offers specific insights into the ocular pathology of the hummingbird bobtail squid.

Valorization of food side streams for sustainable cultivated meat production.