This study investigated the genetic and neurocognitive distinctions between the cases with Attention-Deficit/Hyperactivity Disorder (ADHD)-only, ADHD+ Oppositional Defiant Disorder (ODD), and typically developing controls (TDCs) by analyzing Synapsin (SYN) III gene polymorphisms and neurocognitive profiles. A total of 59 children with ADHD only, 42 children with ADHD+ODD, and 100 TDCs were evaluated through comprehensive genotyping of SYN III gene polymorphisms, a neurocognitive assessment using CNS Vital Signs test battery, an IQ evaluation, and a semi-structured psychiatric interview. Parents completed the Turgay ADHD Rating Scale IV. The presence of rs133946 C/G in the second haplotype was significantly less prevalent in ADHD+ODD cases (p < 0.001). The absence of C/G haplotype in SYN III rs133946 polymorphism was significantly associated with a heightened risk of ADHD+ODD (β = 2.49, OR = 12.14, p = 0.001) compared to ADHD-only. Neurocognitive analyses revealed that individuals having more rs133946 polymorphism C/G haplotype units exhibited higher Stroop Test-Simple Reaction Time scores (β = 49.50, p = 0.044), despite shared executive function and memory impairments across ADHD groups. However, there were no statistically significant direct differences between ADHD-only and ADHD+ODD groups across all neurocognitive test scores, although both clinical groups differed from TDCs in distinct ways across several tests. The findings suggest that the absence of C/G haplotype in the SYN III rs133946 polymorphism may serve as a genetic marker for ODD comorbidity in ADHD. Although the counter-intuitive association between the absence of C/G haplotype, faster reaction times, and ODD comorbidity may seem beneficial on the surface, it may be one of the potential underlying mechanisms of increased impulsivity or reduced inhibitory control in children with ADHD+ODD.

Vitamin A and iron deficiencies remain major nutritional issues in Filipino children and adolescents. To address this, fortified egg noodles were developed using alugbati (Basella alba) stem and leaf powders. The combined use of these two methods remains unexplored in the Philippines as a sustainable fortification method. This study used a mixed-methods approach that integrated quantitative nutrient profiling with qualitative sensory evaluation. Laboratory analyses were conducted at the Department of Science and Technology – Region X and the First Analytical Services and Technical Cooperative Laboratories. The results of the proximate analysis showed 63.55 g of moisture, 7.98 g of protein, 1.91 g of total fat, and 2.31 g of ash per 100 g of sample. Micronutrient analysis revealed 14.8 mg/kg iron and 2 IU/100 g vitamin A, indicating minimal vitamin A but meaningful iron content in the noodles. This study adds to the knowledge of Philippine food science, as the iron content of these products was previously unreported. Forty panelists (thirty Grade 11 students and ten teachers) participated in sensory evaluation comparing fortified egg noodles (A) with plain noodles (B). Twenty-eight out of forty panelists or 70% preferred the fortified noodles because of their pleasant aroma, chewy texture and nutritious taste while twelve or 30% favored the plain noodles because of their familiar flavor. The exact binomial sign test showed a significant difference at p&lt;0.05. This analysis may serve as a baseline for Alugbati-based fortification as an inexpensive method to improve the nutritional quality of staple foods in the Philippines.

Integrating topic-distribution features into forecasting and inventory optimization: Evidence from Taiwan's blood supply system.

Wildlife gut microbiota (GM) comprises a dynamic microbial community that plays a key role in host adaptation, ecological interactions and health. Human landscape disturbances (e.g., habitat loss and fragmentation) may alter the diversity and composition of wildlife GM. Therefore, it is important to understand whether these changes are driven by habitat loss, fragmentation per se, or a combination of fragmentation and additional disturbances (e.g., human activities, interaction with domestic animals). We reviewed recent literature (2013–2023) concerning the effects of human landscape disturbance on wildlife GM alpha diversity, focusing on studies employing quantitative or qualitative landscape metrics. Of 119 reviewed studies, 62.2% (n = 74) used some type of landscape metrics, 58% (n = 69) incorporated landscape disturbance as a variable in their analyses, and 49.5% (n = 59) reported significant differences in at least one alpha diversity index. Among studies on free-ranging wildlife that found significant differences in any alpha diversity index (n = 52), 69.2% (n = 36) employed landscape metrics, and 55.8% (n = 29) explicitly described the type of disturbance associated with changes in GM alpha diversity index, with higher values in less disturbed landscapes compared to more disturbed landscapes (binomial sign test; p = 0.04). With respect to host species exhibiting significant variations in their GM alpha diversity index due to human landscape disturbance, there is an overrepresentation of species classified as “Least Concern” and an underrepresentation of species from certain regions, particularly South America. Despite growing research interest in this field, the available studies remain insufficiently extensive to establish clear overall patterns and trends, both globally and across different taxonomic groups. This review identifies methodological and geographical biases and emphasizes the need for more comprehensive studies in this field, considering host species ecology and quantitative landscape metrics as a substantial contribution for predicting ecosystem-level responses and informing effective conservation efforts.

Clinical value of deep learning image reconstruction in chest computed tomography (CT) imaging: a systematic review.

Acid-base hydrolysis is a methodology that can be used for the chemical treatment of plastic waste. This research aims to apply the mentioned methodology in poly (ethylene terephthalate) PET from reused plastic bottles to obtain terephthalic acid (TPA) under acid and basic hydrolysis conditions. Subsequently, the performance of both methodologies was compared. On average, performance percentages of 70.77% and 66.7% respectively were obtained. These data were statistically analyzed using the sign test, finding that there are no significant differences between the medians of the data sets studied. The analysis by FTIR spectroscopy of the products obtained, specifically through the appearance of the characteristic band for –OH corresponding to carboxylic acid above 3000 cm-1 and the shift of the carbonyl group band from approximately 1700 cm-1 (type ester) up to approximately 1600 cm-1 (acid) allowed us to verify the obtaining of TPA.

BackgroundGlobally, 8 million babies are born with a congenital anomaly annually causing 240,000 neonatal deaths, with 95% disease burden in Low- and Middle-Income Countries (LMICs). Early neonatal screening, timely referral and management can lead to reduced disability and mortality. The WHO recommends employing lay health workers (HWs) as agents to promote health due to critical shortage of health service providers worldwide. This study aims to assess the effectiveness of a learner-centered educational intervention to train lay HWs to screen neonates for external congenital anomalies and to refer affected families towards care.MethodsThe CARe (Congenital Anomalies Registry) educational intervention was designed for lay HWs, with a two-week classroom component followed by two weeks of hands-on training under guided supervision at a selected hospital in Karachi. A focused curriculum was developed. Fifteen HWs underwent pre-service training. Knowledge was assessed using pre-, post- and delayed post-tests; Sign test was used to determine the effectiveness of the educational intervention by assessing if the difference between the scores was statistically significant (p-value of < 0.05). Association of median test scores with demographic factors was examined using the Kruskal Wallis test. Concordance between HWs and a helpline physician in identifying anomalies was assessed using Gwet’s AC. Skills assessment was conducted using a checklist and two focus group discussions (FGDs) were organized to capture HWs’ perspectives on the curriculum.ResultsA statistically significant increase (p-value < 0.001) in knowledge of HWs was depicted by the post-test scores, not associated with any socio-demographic factors. Skills assessment scores showed that 11 out of 15 HWs were either ‘Good’ or ‘Excellent’ in clinical and communication skills. Gwet’s AC showed concordance at 0.93 with a p-value < 0.001, indicating ‘very good’ inter-rater agreement. Thematic content analysis of FGDs disclosed positive feedback on overall training, with specific emphasis on the effective strategies used by content trainers.ConclusionsThis study provides preliminary evidence that the CARe educational intervention was effective. From our experience, the results could be attributed to effective training, which was reliant on meticulous planning, honest execution of the plan, teaching expertise, attitude of trainers, supportive supervision and an enabling learning environment. HWs could potentially be utilized to deliver public health interventions effectively, especially amid healthcare workforce shortages in LMICs.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12909-025-08095-6.

Shift work, particularly rotating schedules, disrupt sleep and cognition, affecting worker health and patient safety. Understanding schedule-chronotype misalignment is essential. We examined whether chronotype was associated with sleep quality, neurocognitive function, and near-miss incidents during consecutive morning shifts in a rotating shift system. In this cross-sectional study at a South Korea tertiary hospital, 67 nurses completed the Morningness-Eveningness Questionnaire, wore actigraphy devices, underwent CNS Vital Signs testing, and near-miss incidents were recorded. Thirty-one participants (46.3%) had an intermediate chronotype and 36 (53.7%) an evening chronotype. Evening chronotypes reported significantly poorer subjective sleep quality and showed shorter total sleep duration, longer sleep onset latency, and lower sleep efficiency compared with intermediate chronotypes. They also performed worse on composite and visual memory. Near-miss incidents did not differ significantly between groups. These findings suggest that aligning shift schedules with individual chronotypes could enhance sleep quality and workplace performance, potentially improving patient safety. The evidence suggests a need for adjustments in work schedules to align with individual circadian rhythms, which can lead to better patient safety by reducing cognitive errors and improving overall healthcare delivery.

ResumoObjetivoInvestigar o valor dos exames clínicos para diagnóstico de rupturas do ligamento cruzado anterior (LCA) com os testes da gaveta anterior, Lachman,pivot-shift, sinal de alavanca e sinal de flambagem ativa forçada (FAB, do inglêsforced active buckling).MétodosEste estudo transversal foi conduzido com 165 pacientes com lesão no joelho e indicação para artroscopia, entre janeiro e dezembro de 2022. Os resultados dos exames clínicos foram comparados ao padrão-ouro do procedimento para determinar o valor dos testes diagnósticos.ResultadosOs valores de sensibilidade e especificidade foram, respectivamente: teste da gaveta anterior: 77,5% e 86,1%; Lachman: 87,6% e 88,9%;pivot-shift: 65,9% e 94,4%; sinal de alavanca: 93,8% e 94,4%; e sinal de FAB: 81,4% e 97,2%.ConclusãoHá diversos exames clínicos para rupturas do LCA. O sinal da alavanca é um teste clínico útil para exame e diagnóstico dessa condição.

Abstract This paper explores Bayesian estimation for categorical data, focusing on simple yet effective models that provide a foundation for applying more advanced methods accurately and reliably in real-world applications. We begin by revisiting Bayesian estimators for the binomial distribution and investigating their properties. Next, we develop hypothesis tests for categorical data (sign test, homogeneity test, symmetry test) based on regularized maximum likelihood estimates of the probabilities. Finally, we formulate regularized versions of common association measures for contingency tables and study the regularized version of mutual information, particular for the situation where the regularized version can effectively handle zero counts.

Skin Carotenoid Score Level and Race Affect Intradevice Repeatability of Veggie Meter® at a Single Time Point.

Timely identification of individuals at-risk for Alzheimer's disease (AD) is pivotal for secondary prevention and requires innovative approaches. Combining remote smartphone-based cognitive assessments with blood-based biomarkers holds promise for both sensitive and scalable detection of early AD-related cognitive changes. Here, we aimed to investigate whether the Boston Remote Cognitive Assessment of NeuroCognitive Health (BRANCH) captures cognitive changes associated with early AD pathophysiology as measured by plasma p-tau217. N=254 cognitively unimpaired older adults (age=74.5±8.6, 68% female, 16.6±2.4 years of education) from four well-characterized cohorts completed multi-day BRANCH on their personal device. Multiday BRANCH includes two associative memory tests (Face Name and Groceries Prices) and a processing speed test with an associative memory component (Digit Signs) with identical stimuli repeated for seven consecutive days. For each test, an MDLC score was computed using an area under the curve method combining day 1 performance with a non-linear learning trajectory over the subsequent six days. MDLCs for each individual test were averaged into a BRANCH Composite MDLC. All cohorts had standardized in-clinic cognitive test data available, from which a Preclinical Alzheimer's Cognitive Composite (PACC-5) score was derived. Concentrations of plasma p-tau217 were measured using the Meso Scale Discovery platform. Linear regression models adjusting for age, sex, years of education and study cohort were used to investigate the association between p-tau217 (log-transformed values) and BRANCH MDLC scores. For comparison, similar analyses were run with PACC-5 scores and p-tau217. Lower BRANCH Composite MDLC scores were associated with higher p-tau217 levels (corrected std. β=-0.23, 95%CI [-0.44 - -0.02], p=0.031) (Figure 1), which was primarily driven by the Digit Signs test (corrected std. β=-0.22, 95%CI [-0.42 - -0.02], p=0.031). In contrast, we did not find an association between the PACC-5 and p-tau217 (corrected std. β=-0.15, 95%CI [-0.37 - 0.07], p=0.187). These results complement our previous work that multi-day BRANCH may improve the detection of very subtle memory deficits that are associated with early AD pathophysiology. Combining a remote and sensitive cognitive paradigm like BRANCH with plasma biomarkers may facilitate scalable detection of those at risk for AD-related cognitive decline.

Evaluation of bacteriophages as a signature of microbiome health: a systematic review and meta-analysis.

Conventional prognostic factors are typically assessed at diagnosis in metastatic hormone-sensitive prostate cancer (mHSPC). However, variations in vital signs and laboratory parameters occur during systemic treatment and may predict patients' prognosis and anticipate organ-specific toxicity development. This single-center retrospective study included 363 patients with de novo mHSPC treated between 2014 and 2023. Clinical and laboratory data were systematically collected from the hospital data warehouse, from treatment initiation through the following seven months. Variations in vital parameters and blood test results were graded using CTCAE V5.0 (dynamic variables). Cox regression analyses were performed to explore the impact of dynamic variables on progression-free survival (PFS) and overall survival (OS). Machine learning (ML) models (Support Vector Classifier, Random Forest, and LGBM Classifier) were developed to predict single organ-specific toxicities and to identify good and poor responders based on 7-month PSA levels, PFS and OS. We compared ML model performance when trained only on baseline factors (static models) with those integrating variables generated by vital sign and blood test monitoring within 3 and 7 months from treatment start (dynamic models). Dynamic model failed to improve the prediction of single organ-specific toxicities. Univariable Cox analysis revealed that the development of hematological, liver, and kidney-related toxicity, as well as the development of electrolyte disturbances within 3 or 7 months, was associated with shorter PFS (p = 0.011, 0.007, 0.174, and 0.02, respectively) and/or OS (p = 0.001, 0.099, 0.012, and 0.001, respectively). In multivariable Cox analysis, increasing alkaline phosphatase levels (HR = 1.93, p = 0.009), decreasing albumin (HR = 1.92, p = 0.008) and development of hyponatremia (HR = 1.79, p = 0.033) were associated with a shorter OS. The combination of static and dynamic variables significantly improved the ability of ML models to identify poor responders (shorter PFS: AUC range 0.91-0.94 vs. 0.79-0.89). The integration of conventional prognostic factors with the detection of significant changes in vital signs and blood tests occurring early during systemic treatment in patients with de novo mHSPC may enhance patient stratification and improve prediction of survival outcomes. Multicenter validation studies are needed to confirm these results.

BackgroundFast reaction time is essential for safe and effective driving.ObjectiveThe objective of this research was to ascertain the visual reaction time of school bus drivers and the effect of additional noise on this time.Methods28 volunteer professional school bus drivers were included in the study. Each participant was in both the experimental and control groups. Vehicle simulation was used to determine the reaction time of the participants. The participants' throttle response time was measured in the presence and absence of an 85 dBA (A-weighted decibels) supplemental noise. The Wilcoxon rank-order sign test and linear mixed-effects regression models were used for the statistical analysis.ResultsThe reaction time of the participants without additional noise was calculated to be 0.10 ± 0.02 (0.06-0.15 s). It was found that the noise statistically increased the reaction time of the participants.ConclusionsThe additional noise in the vehicle has been shown to have a detrimental effect on the reaction time of school bus drivers, thereby impacting their cognitive functions. The findings emphasise the practical significance of noise control strategies in both occupational and transportation contexts, with the objective of enhancing safety and cognitive efficiency.

At the outset of any project, every client's primary goal is to attain value for their investment by securing a top-quality structure completed on schedule and within budget. Consequently, this study is devoted to the identification and prioritization of crucial risk factors that influence the choice of procurement methods in construction projects within the local government areas (LGA) of Nassarawa (NSR), Dala (DAL), and Kano Municipal (KMC) in Kano state. The methodology utilized entails surveying 146 participants, including both contractors and consultants. To assess the likelihood of these risks, the Relative Importance Index (RII) and the sign test were applied using Statistical Package for Social Science (SPSS) version 26. The results unveiled that factor associated with the client, project timeline, and cost exert the most profound influence on the choice of procurement method in the three LGA’s in Kano state. The most influential factors among these include the client's financial capability, competition in pricing, constraints on project time, and procurement policies. In conclusion, a significant recommendation is for clients and consultants to enhance their procurement method oversight by involving skilled procurement specialists. This measure is essential for making informed choices, facilitating the attainment of a favourable return on investment, and guaranteeing the achievement of quality, timely, and budget-compliant project results.

This study aimed to validate a commonly used invitro methodology of testing the performance of the EALs. For that, clinical data obtained from teeth already scheduled for extraction were used to compare the accuracy and precision of an EAL in determining the position of the apical foramen in both clinical and laboratory settings using micro-CT imaging. In a clinical setting, the working length of 11 canals was established using the Root ZX II apex locator. Subsequently, these teeth were extracted and imaged with and without the file in place using micro-CT technology. Invitro measurements of the working length were then obtained in these same teeth using an alginate model and new micro-CT scans were performed. Datasets were co-registered and the accuracy and precision of both invivo and invitro models were compared by measuring the distance from the file tip to a tangential line crossing the foramen margins, with a tolerance level of ±0.5 mm. Statistical comparisons were performed using Friedman post hoc Related Samples Sign and Bland-Altman tests with a significance level set at 5%. Statistical analysis revealed no significant difference between the accuracy (p = 0.368) and precision (p = 0.761) measurements obtained in both invivo and invitro conditions. Additionally, the Bland-Altman analysis revealed an agreement between invivo and invitro methods (p > 0.05). The invitro methodology using freshly mixed alginate demonstrated consistent accuracy and precision in identifying the position of the apical foramen, when compared to invivo measurements.

BackgroundLong-term unemployment is associated with various health risks and low health literacy. Occupational rehabilitation organizations that employ individuals with a history of long-term unemployment may be ideal settings for promoting health literacy. The purpose of this study was to develop and test an intervention to enhance health literacy in this setting.MethodsThe intervention was developed using the steps of the Intervention Mapping protocol. It focused on nutrition, physical activity, and mental health literacy, and included both problem-based learning and practical activities. The intervention was tested using a single-arm pre-post design. Health literacy was assessed at the individual level using the European Health Literacy Scale (HLS-EU-Q16) for general health literacy, the Newest Vital Sign test for functional health literacy, and domain-specific literacies for food, physical activity and mental health literacy. Additionally, structured interviews were conducted with social workers and management staff in the participating organizations to evaluate organizational readiness for change, covering domains such as knowledge of existing efforts, leadership support, implementation climate, health literacy of participants, and available resources. Changes in individual outcome parameters over time were analyzed using paired t-tests. Regression models were used to assess the association between participation in the intervention activities and changes in outcomes.ResultsA total of nine organizations participated in the study. The organizational readiness assessment revealed an increase in management support, though a slight decline in the implementation climate was noted. A total of 171 participants (65% men; mean age = 51.9 years, SD = 9.9) were included in the baseline assessment, and 110 were included in the six-month follow-up. Approximately 50% of participants took part in the intervention activities. Positive trends over time were observed for food literacy and mental health literacy, but not for other outcomes. No clear pattern emerged in the relationship between participation in the intervention activities and changes in the outcome variables.ConclusionThis study revealed small improvements in proximal outcome variables indicating feasibility and potential impact. However, more research is necessary to determine the effectiveness of this novel problem-based learning intervention.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12889-025-25313-4.

Study DesignProspective Cohort Study.ObjectivesThis study aimed to (1) compare anticipated and encountered post-operative barriers following lumbar decompression surgery, (2) assess the relationship between encountering barriers and achieving meaningful improvement (MCID) in Oswestry Disability Index (ODI) scores, and (3) evaluate the association between socioeconomic status and encountered barriers via Social Vulnerability Index (SVI).MethodsPatients completed pre-operative surveys assessing anticipated recovery barriers and ODI. Post-operative surveys collected 6 weeks post-operation captured encountered barriers and ODI. Barriers were quantified with a 1-5 Likert scale. Wilcoxon Rank Sign tests assessed differences between anticipated and encountered barriers. Logistic regression evaluated associations between barriers and achievement of ODI MCID. Spearman correlation tested associations between SVI and barrier frequency.ResultsPatients were generally able to predict post-operative barriers accurately. Exercise adherence, financial stress, and care understanding were frequently reported concerns. Five post-operative barriers decreased the likelihood of achieving MCID: difficulty meeting exercise goals (OR = 0.43, P = 0.00036), difficulty obtaining medications (OR = 0.32, P = 0.030), transportation challenges (OR = 0.42, P = 0.036), communication issues with the care team (OR = 0.52, P = 0.015), and limited understanding of care plan (OR = 0.58, P = 0.044). Higher SVI scores correlated with difficulty obtaining medications (P = 0.035) and increased financial stress (P = 0.033).ConclusionsPost-operative recovery challenges-particularly in exercise adherence, medication access, transportation, and care plan comprehension-are associated with reduced odds of functional improvement. Higher social vulnerability exacerbates specific barriers. These findings underscore the importance of individualized peri-operative planning to optimize outcomes in lumbar decompression surgery.

To evaluate the feasibility and technical performance of a post-contrast T1-SPACE sequence using deep-learning based image reconstruction (DLBIR) for intracranial vessel wall imaging (IC-VWI) at 7T, comparing image quality, artifacts, and acquisition time with the standard-of-care (SOC) T1-SPACE sequence. In this retrospective single-center study, 36 patients (21 women; mean age, 53.3 ± 16.2 years) underwent IC-VWI at 7T using both SOC T1-SPACE and DLBIR-accelerated T1-SPACE sequences. Two independent neuroradiologists assessed overall image quality (noise, artifacts, sharpness, and overall quality), wall and lumen visualization along the intracranial vessels using a 4-point Likert scale. A cumulative-logit mixed-effects model (CLMM) of segment ratings was used for intersequence comparison. Segments were also pooled into proximal vs distal vessels and quality compared using exact paired sign test. Overall image quality metrics were compared using paired Wilcoxon tests and Bland-Altman plots. Inter-reader agreement was summarized using percent agreement. On segment-level analysis, T1-SPACEDL yielded markedly higher ratings than T1-SPACESOC [wall: OR = 22.79 (95% CI 15.83- 32.82), lumen: OR = 97.0 (95% CI 66.8-141.0); both FDR-adjusted p<0.001]. Effects remained large when segments were pooled into proximal and distal segments [For wall, proximal segment OR = 297.0 (95% CI 40-∞) and distal segment OR = 71.0 (28-404); for lumen, proximal OR = 82.0 (36-339) and distal OR = 225.0 (60-13350); all FDR-adjusted p<0.001]. Reader-wise Wilcoxon tests showed higher overall image quality scores across noise, artifacts, sharpness, and overall quality for T1-SPACEDL ([all p < 0.001]). Inter-reader agreement was uniformly high with T1-SPACEDL when compared to T1-SPACESOC. Bland-Altman analysis demonstrated a positive bias favoring T1-SPACEDL. Acquisition time was reduced from 7:30 minutes with T1-SPACESOC to 6:00 minutes (20% reduction) with T1-SPACEDL. Contrast-enhanced T1-SPACEDL at 7T may have potential clinical utility for IC-VWI, given the shorter acquisition, significantly improved image quality and reduced image artifacts. DLBIR＝deep learning-based image reconstruction; SNR＝signal-to-noise ratio; CNR＝contrast-to-noise ratio; VWI＝Vessel Wall Imaging; DL＝ deep-learning; SOC＝ standard-of-care.