Environment and weight class linked to skin microbiome structure of juvenile Eastern hellbenders (<i>Cryptobranchus alleganiensis alleganiensis</i>) in human care

by Andrea C. Aplasca, Peter B. Johantgen, Christopher Madden, Kilmer Soares, Randall E. Junge, Vanessa L. Hale, Mark Flint

Amphibian skin is integral to promoting normal physiological processes in the body and promotes both innate and adaptive immunity against pathogens. The amphibian skin microbiota is comprised of a complex assemblage of microbes and is shaped by internal host characteristics and external influences. Skin disease is a significant source of morbidity and mortality in amphibians, and increasing research has shown that the amphibian skin microbiota is an important component in host health. The Eastern hellbender (Cryptobranchus alleganiensis alleganiensis) is a giant salamander declining in many parts of its range, and captive-rearing programs are important to hellbender recovery efforts. Survival rates of juvenile hellbenders in captive-rearing programs are highly variable, and mortality rates are overall poorly understood. Deceased juvenile hellbenders often present with low body condition and skin abnormalities. To investigate potential links between the skin microbiota and body condition, we collected skin swab samples from 116 juvenile hellbenders and water samples from two holding tanks in a captive-rearing program. We used 16s rRNA gene sequencing to characterize the skin and water microbiota and observed significant differences in the skin microbiota by weight class and tank. The skin microbiota of hellbenders that were housed in tanks in close proximity were generally more similar than those housed physically distant. A single taxa, Parcubacteria, was differentially abundant by weight class only and observed in higher abundance in low weight hellbenders. These results suggest a specific association between this taxa and Low weight hellbenders. Additional research is needed to investigate how husbandry factors and potential pathogenic organisms, such as Parcubacteria, impact the skin microbiota of hellbenders and ultimately morbidity and mortality in the species.

Association between cardiometabolic risk factors and multidrug-resistant tuberculosis: A case-control study

by Sishir Poudel, Laxman Wagle, Tara Prasad Aryal, Binay Adhikari, Sushan Pokharel, Dipendra Adhikari, Kshitiz Bhandari, Kshitiz Rijal, Jyoti Bastola Paudel

Background

Multidrug-resistant tuberculosis (MDR-TB) continues to be a major public health concern, especially in high-burden countries like Nepal. While individual risk factors are known, the cumulative impact of cardiometabolic factors on MDR-TB is not well understood.

Methods

A health-facility-based, age- and sex-matched 1:2 case-control study was conducted at MDR-TB treatment centers in Gandaki Province, Nepal. MDR-TB patients (cases) and drug-sensitive tuberculosis (DS-TB) patients (controls) were enrolled. Cases were defined as adults (≥18 years) with confirmed MDR-TB; controls were adults with sputum-positive DS-TB. Data on sociodemographics, cardiometabolic risk factors (alcohol, tobacco, abnormal body mass index, hypertension, diabetes), TB literacy, and treatment history were collected using a structured, pretested questionnaire by trained medical officers. Data were analyzed using Stata v13.0. Binary logistic regression was used to assess associations between risk factors and MDR-TB. Ethical approval was obtained from the Nepal Health Research Council and written informed consent was obtained from all participants.

Results

A total of 183 participants (61 cases, 122 controls) were included. Mean age of participants was 42.5 years (SD = 18.5); 73.8% were male. Most participants were from urban areas (74.9%), and 66.7% were unemployed. Cardiometabolic risk factors were present in 79.2% of participants. Alcohol and tobacco use were reported by 59.6% and 45.9%, respectively; 9.8% had diabetes and 7.1% had hypertension. Known TB contact and prior TB history were reported by 26.8% and 31.1% respectively. In multivariate analysis, unemployment (AOR: 5.24, 95% CI: 1.33–20.64), and known TB contact (AOR: 8.89, 95% CI: 2.46–32.15) were significantly associated with MDR-TB. Cardiometabolic risk factors were not significantly associated.

Conclusion

Known TB contact and unemployment were significantly associated with MDR-TB, while the cumulative effect of cardiometabolic risk factors showed no significant impact, indicating that interventions should prioritize established TB-related risk factors.

Prevalence and associated factors of delay in seeking malaria treatment among under five children in the Horn of Africa: A systematic review and meta-analysis

by Muluken Chanie Agimas, Mekuriaw Nibret Aweke, Berhanu Mengistu, Lemlem Daniel Baffa, Elsa Awoke Fentie, Ever Siyoum Shewarega, Aysheshim Kassahun Belew, Esmael Ali Muhammad

Introduction

Malaria is a global public health problem, particularly in sub-Saharan African countries. It is responsible for 90% of all deaths worldwide. To reduce the impact and complications associated with delayed treatment of malaria among children under five, comprehensive evidence about the magnitude and determinants of delayed treatment for malaria could be the solution. But there are no national-level studies in the Horn of Africa for decision-makers.

Objective

To assess the prevalence and associated factors of delay in seeking malaria treatment among under-five children in the Horn of Africa.

Method

Published and unpublished papers were searched on Google, Google Scholar, PubMed/Medline, EMBASE, SCOPUS, and the published articles’ reference list. The search mechanism was established using Medical Subject Heading (MeSH) terms by combining the key terms of the title. Joana Brigg’s Institute critical appraisal checklist was used to assess the quality of articles. A sensitivity test was conducted to evaluate the heterogeneity of the studies. The visual funnel plot test and Egger’s and Begg’s statistics in the random effect model were done to evaluate the publication bias and small study effect. The I² statistics were also used to quantify the amount of heterogeneity between the included studies.

Results

The pooled prevalence of delayed treatment for malaria among under-five children in the Horn of Africa was 48% (95% CI: 34%–63%). History of child death (OR =2.5, 95% CI: 1.73–3.59), distance >3000 meters (OR = 2.59, 95% CI: 2.03–3.3), drug side effect (OR = 2.94, 95% CI: 1.86–4.67), formal education (OR = 0.69, 95% CI: 0.49–0.96), middle income (OR = 0.42, 95% CI: 0.28–0.63), expensiveness (OR = 4.39, 95% CI: 2.49–7.76), and affordable cost (OR = 2.13, 95% CI: 1.41–3.2) for transport were factors associated with malaria treatment delay among children.

Conclusion and recommendations

About one out of two parents in the Horn of Africa put off getting their kids treated for malaria. High transportation expenses, long travel times (greater than 3,000 meters) to medical facilities, and anxiety about drug side effects were major risk factors that contributed to this delay. On the other hand, a middle-class income was found to be protective of treatment delays. These results highlight how crucial it is to improve access to healthcare services, both financially and physically, to minimize delays in treating malaria in the area’s children.

Household resilience and its role in sustaining food security in rural Bangladesh

by Ismat Tasnim, Md. Asif Iqbal, Ismat Ara Begum, Mohammad Jahangir Alam, Morten Graversgaard, Paresh Kumar Sarma, Kiril Manevski

Food insecurity and agriculture in South Asia, including Bangladesh, pose significant threats to the well-being and livelihoods of its people. Building adaptive capacities and resilient food systems is crucial for sustainable livelihoods. This study employs the Resilience Index Measurement and Analysis II framework to construct a Resilience Capacity Index (RCI) and analyze its relationship with food security using data from the Bangladesh Integrated Household Survey 2018. The study applies Exploratory Factor Analysis and Structural Equation Modeling to examine the impact of key resilience components such as Access to Basic Services, Adaptive Capacity, and Assets on household resilience. The findings reveal that access to basic services, land assets, and farm equipment positively influences households’ resilience capacity. However, the presence of livestock assets has a negative impact, potentially due to market volatility, climate vulnerability, and disease outbreaks. Additionally, adaptive capacity has a positive but insignificant influence on RCI, suggesting that without enhancing economic opportunities, institutional support, and inclusive development strategies, adaptive capacity could not be enough to foster resilience. However, resilient capacity enhances food security metrics such as the Food Consumption Score and Expenditure. These findings underscore the importance of policies that focus on increasing and maintaining access to basic services, promoting sustainable land management practices, and strengthening social safety nets. This study emphasizes the importance of focusing on livestock assets to ensure their sustainability by stabilizing the livestock market, improving veterinary services, and providing subsidies to reduce maintenance costs.

Factors associated with prolonged hospitalizations for COVID-19 during the first three waves of the pandemic: Evidence from a Southeastern State of Brazil

by Juliana Rodrigues Tovar Garbin, Franciéle Marabotti Costa Leite, Ana Paula Brioschi dos Santos, Larissa Soares Dell’Antonio, Cristiano Soares da Silva Dell’Antonio, Luís Carlos Lopes-Júnior

A comprehensive understanding of the factors influencing the epidemiological dynamics of COVID-19 across the pandemic waves—particularly in terms of disease severity and mortality—is critical for optimizing healthcare services and prioritizing high-risk populations. Here we aim to analyze the factors associated with short-term and prolonged hospitalization for COVID-19 during the first three pandemic waves. We conducted a retrospective observational study using data from individuals reported in the e-SUS-VS system who were hospitalized for COVID-19 in a state in a southeast state of Brazil. Hospitalization duration was classified as short or prolonged based on a 7-day cutoff, corresponding to the median length of hospital stay during the second pandemic wave. Bivariate analyses were performed using the chi-square test for heterogeneity. Logistic regression models were used to estimate odds ratios (ORs) and their respective 95% confidence intervals (CIs), with statistical significance set at 5%. When analyzing hospitalization duration across the three waves, we found that 51.1% (95%CI: 49.3–53) of hospitalizations in the first wave were prolonged. In contrast, short-duration hospitalizations predominated in the second (54.7%; 95% CI: 52.4–57.0) and third (51.7%; 95% CI: 50.2–53.2) waves. Factors associated with prolonged hospitalization varied by wave. During the first wave, older adults (≥60 years) (OR=1.67; 95%CI: 1.35–2.06), individuals with ≥10 symptoms (OR=2.03; 95%CI: 1.04–3.94), obese individuals (OR=2.0; 95%CI: 1.53–2.74), and those with ≥2 comorbidities (OR=2.22; 95%CI: 1.71–2.89) were more likely to experience prolonged hospitalization. In the second wave, he likelihood of extended hospital stays was higher among individuals aged ≥60 years (OR=2.04; 95%CI: 1.58–2.62) and those with ≥2 comorbidities (OR=1.77; 95%CI: 1.29–2.41). In the third wave, prolonged hospitalization was more frequent among older adults (OR=1.89; 95%CI: 1.65–2.17,), individuals with 5–9 symptoms (OR=1.52; 95%CI: 1.20–1.92), obese individuals (OR=2.2; 95%CI: 1.78–2.73), and those with comorbidities (OR=1.45; 95%CI: 1.22–1.72 and OR=2.0; 95%CI: 1.69–2.45). In conclusion, we identified variations in hospitalization patterns across the pandemic waves, although the differences were relatively subtle. These variations likely reflect gradual shifts in the risk factors associated with prolonged hospital stays. Our findings highlight t the importance of implementing targeted public health interventions, particularly those designed to reduce disease severity and improve clinical outcomes among vulnerable populations at greater risk of extended hospitalization.

Malaria, urogenital schistosomiasis and co-infection and nutritional status of school children in Ondo state

by Esther Mofiyinfoluwa Ola, Temitope Helen Balogun, Rasheed Olayinka Isijola, Oluwaremilekun Grace Ajakaye

Parasitic infections are a major cause of morbidity and mortality in Nigeria, with malaria and schistosomiasis having the highest burden. This study investigated the prevalence of malaria, urogenital schistosomiasis, and co-infections and their impact on the nutritional status of schoolchildren in two communities in Ondo State. A total of 185 participants from Ipogun and Oke Igbo were screened for malaria and schistosomiasis infection using the ParaHit malaria rapid diagnostic test kit and urine microscopy. Anthropometric measurements were used to assess the nutritional status of the participants. In this study, a higher prevalence of malaria was recorded in Oke Igbo, with 36 individuals (57.1%), compared to 60 individuals (49.2%) in Ipogun. Urogenital schistosomiasis was also more prevalent in Oke Igbo, affecting 18 individuals (28.6%), while only 5 individuals (4.1%) were affected in Ipogun. Co-infection with both diseases was more common in Oke Igbo, with 13 cases (20.6%), compared to 4 cases (3.3%) in Ipogun. However, malnutrition rates were similar between the two communities, with 60 cases (77.9%) in Ipogun and 28 cases (75.5%) in Oke Igbo. Notably, participants with either malaria or urogenital schistosomiasis, as well as those co-infected, exhibited a higher frequency of chronic malnutrition. The likelihood of co-infection was significantly associated with gender and locality, with individuals in Oke Igbo being 0.78 times less likely to be co-infected (P = 0.00; CI = 0.09–0.49), while males were 2.19 times more likely to have co-infections (P = 0.02; CI = 1.13–4.28). This study emphasised the significant health burden posed by malaria and urogenital schistosomiasis co-infections among schoolchildren in Ondo State, highlighting the need for comprehensive health and nutritional interventions to address the challenges associated with these parasitic diseases.

Registered nurse effect on long length of stay in the heart failure hospitalizations of African Americans

by Tremaine B. Williams, Pearman Parker, Milan Bimali, Maryam Y. Garza, Alisha Crump, Taiquitha Robins, Emel Seker, Ava Storey, Allison Purvis, Mya Tolbert, Anthony Drake, Taren Massey Swindle, Kevin Wayne Sexton

African Americans experience approximately 2.5 times more heart failure hospitalizations than Caucasians and the complexity of heart failure requires registered nurses to work in collaboration with other types of healthcare professionals. The purpose of this study was to identify care team configurations associated with long lengths of hospital stay in African Americans with heart failure hospitalizations and the related effect of the presence of registered nurses on their length of hospital stay. This study analyzed electronic health record data on the heart failure hospitalizations of 2,274 African American patients. Binomial logistic regression identified the association between specific care team configurations and length of stay among subgroups of African American patients. Of the significant team configurations, a Kruskal-Wallis H test and linear regression further assessed the team composition and the specific change in days associated with a one-unit change in the number of registered nurses on a patient’s care team. Six team configurations were associated with a long length of stay among all African Americans regardless of age, sex, rurality, heart failure severity, and overall health severity. The configurations only differed significantly in the proportion of registered nurses with respect to other care team roles. An increase in one additional registered nurse on a care delivery team was associated with an increase in length of stay of 8.4 hours (i.e., 504 minutes). Identifying the full range of social and technical care delivery tasks performed by RNs, and controlling for their effect on length of stay, may be a key strategy for reducing length of stay and explaining why these six configurations and RNs are associated with long LOS. The identification of these models can be used to support decision-making that optimizes the availability of patient access to high-quality care (e.g., clinical staffing and supplies).

Medicinal effects of <i>Ephedra foeminea</i> aqueous extracts: Metabolomic characterization, biological evaluation, and molecular docking

by Giulia Bennici, Inas Al Younis, Abeer Sharfalddin, Mutaz Akkawi, Fuad Al-Rimawi, Khaled Sawalha, Abdul-Hamid Emwas, Mariusz Jaremko

Ephedra foeminea Forssk. is a medicinal plant traditionally used across various cultures and recognized for its historical significance in herbal medicine. It has been used as an herbal infusion to treat multiple respiratory diseases, headaches, and nasal congestion, as well as to prevent and manage breast cancer. In order to evaluate the validity of this ancestral knowledge, we aimed to investigate hot aqueous extracts of E. foeminea branches and fruits firstly by using untargeted metabolomic analysis, characterizing the chemical profiles of hot aqueous extracts from E. foeminea branches and fruits through the use of nuclear magnetic resonance, gas chromatography–mass spectrometry, and liquid chromatography–mass spectrometry. Subsequently, two in vitro studies were conducted to assess the anticancer and antioxidant potentials of the extracts. Antioxidant activity was evaluated using a 2,2-diphenyl-1-picrylhydrazyl assay and a total phenolic content assay. Anticancer activity was evaluated by assessing cytotoxicity using the MTT assay on MCF-7 (human breast cancer) and HeLa (cervical cancer) cell lines. Additionally, molecular docking was performed to explore the interactions between compounds identified in E. foeminea and selected cancer-related proteins, as well as the main protease of SARS-CoV-2. The results revealed that the branch extract exhibited superior antioxidant activity compared to the fruit extract, which was associated with a higher phenolic content in the branch extract (49.5 ± 0.7 mg GAE/g). The fruit extract exhibited greater cytotoxicity against MCF-7 cells, suggesting potential anticancer activity. Molecular docking analysis identified henryoside, guajavarin, and neohancoside as the most active compounds with anticancer and antiviral properties. These findings support the traditional use of E. foeminea Forssk. and highlight its potential as a source of bioactive compounds for further research into therapeutic applications.

Mode of birth and maternal depression/severe anxiety: Findings from Millennium Cohort Study

by Elizabeth O. Bodunde, Fergus P. McCarthy, Karen O’connor, Karen Matvienko-Sikar, Ali S. Khashan

Introduction

Limited evidence exists on the association between mode of birth and long-term depression and/or severe anxiety in mothers. We aimed to examine the association between mode of birth and depression and/or severe anxiety by 14 years postpartum.

Methods

We used data from the Millennium Cohort Study. Data on mode of birth were collected when mothers were 9 months postpartum, and categorized as spontaneous vaginal birth (VB), assisted VB, induced VB, emergency cesarean section (CS), planned CS, and CS after induction. Depression/severe anxiety were collected as one variable and self reported by mothers at 9 months, 3, 5, 7, 11, and 14 years postpartum based on a doctor diagnosis. The primary outcome measure was a diagnosis of depression/severe anxiety up to 14 years postpartum. We used multivariable logistic regression models to estimate crude and adjusted odds ratios (OR) for the association between mode of birth and depression/severe anxiety by 14 years postpartum.

Results

There were 10,507 singleton mothers included in our analyses. Fully adjusted odds ratio (aOR)for the association between mode of birth and depression/severe anxiety by 14 years postpartum was induced VB, (aOR, 1.13 [95% CI], 1.01–2.28), assisted VB (aOR, 1.03 [95% CI], 0.89–1.19), Emergency CS, (aOR, 1.08 [95% CI], 0.92–1.27), planned CS (aOR, 1.09 [95% CI], 0.93–1.27), and CS after induction (aOR, 1.08 [95% CI], 0.91–1.28). Fully adjusted models did not report any significant association between mode of birth and depression/severe anxiety at other postpartum time points.

Conclusions

The present findings provide support for association between induction of labor and the risk of long-term depression/severe anxiety by 14 years postpartum. The findings provide no evidence to support association between other modes of birth and maternal depression/anxiety.

Prevalence, pathogenic bacteria, and risk factors associated with pediatric sepsis among under five children in a rural district hospital in Rwanda

by Patrick Orikiriza, Deogratius Ruhangaza, David S. Ayebare, Ezechiel Bizimana, Jean Baptiste Niyibizi, Irene Nshimiyimana, Louis Mujyuwisha, Abebe Bekele

Background

Pediatric sepsis poses a significant health challenge in Sub-Saharan Africa, with limited data on prevalence and pathogen profiles. This study determined the prevalence of pediatric sepsis, identified bacterial pathogens, and evaluated associated risk factors among children aged 1–59 months at Butaro Hospital, Rwanda.

Methods

A cross-sectional study was conducted from March 2022 to December 2022. The study included 114 children aged 1–59 months with suspected sepsis admitted to the pediatric ward at Butaro Hospital. Blood cultures were analyzed, and risk factors assessed using multiple logistic regression. Data were analyzed using Stata 17.

Results

Of 114 enrolled children, 60.5% (n = 69) had positive blood cultures (95% CI: 51.2–69.1). Among these 69 children, the majority were females, 70.0% (n = 35) (95% CI: 53.7–81.3) and below 6 months 68.1% (n = 15) (95% CI: 45.3–84.7). Pathogenic bacteria identified were Coagulase-Negative Staphylococci (CNS), 59.4% (n = 41) and Staphylococcus aureus, 40.6% (n = 28). Female gender (AOR = 2.4, 95% CI: 1.0–5.4, p = 0.045) and leukocytosis (AOR = 6.0, 95% CI: 2.0–20.2, p = 0.003) were the risk factors for sepsis.

Conclusions

The study reveals a high prevalence of sepsis among children under-five, especially females and less than 6 months with female gender and diagnosis with leukocytosis being a significant risk factor. Diagnostic strategies should focus on WBC counts to better manage at-risk children. These single-center study results however may not be broadly representative due to regional and resource differences, but they offer valuable insights for improving pediatric care in similar low-resource settings.

Impact of vitamin D on glycemic control and microvascular complications in type 2 diabetes: A cross-sectional study

by Salma Ahi, Amirreza Reiskarimian, Mohammad Aref Bagherzadeh, Zhila Rahmanian, Parisa Pilban, Saeed Sobhanian

Vitamin D has been increasingly recognized for its potential role in modulating various health conditions, including diabetes and its complications. Despite growing evidence suggesting that adequate vitamin D levels may reduce the risk of developing type 2 diabetes and its associated microvascular complications, the precise nature of this relationship remains unclear. This study aims to elucidate the connection among vitamin D status, glycemic control, and microvascular complications in patients with type 2 diabetes, thereby highlighting the importance of vitamin D in diabetes management.This analytical cross-sectional study included 199 type 2 diabetic mellitus (T2DM) patients from the Jahrom city endocrinology clinic. Serum 25(OH)D levels were measured, and their microvascular complications (microalbuminuria, retinopathy, neuropathy, macroalbuminuria) and glycemic control (HbA1C) were measured and confirmed according to ADA guidelines and endocrinologist supervision. All analysis were done with SPSS software. The study enrolled 199 type 2 diabetic patients with a mean age of 56.79 ± 10.8 years, of which 63.3% were female and 57.3% had hypertension. The mean BMI was 28.91 kg/m², and 29.1% of participants had vitamin D deficiency. The prevalence of microvascular complications was 25.6% for retinopathy, 14.1% for neuropathy, and 40% for nephropathy. Vitamin D deficiency was notably higher among patients with retinopathy (37.25%), neuropathy (50%), and macroalbuminuria (56.25%). Patients with neuropathy and retinopathy had significantly lesser serum 25(OH)D concentrations compared to patients without these complications. There was a slight inverse correlation between vitamin D levels and both the urine albumin creatinine ratio (r = -0.175, p = 0.018) and HbA1C (r = -0.19, p = 0.007). Although the link between vitamin D levels and retinopathy was not statistically significant (η = 0.903, p = 0.68), the alteration in vitamin D levels was suggestively linked with neuropathy (η = 0.975, p 

Health-related quality of life in Brazilian patients with cutaneous leishmaniasis using EQ-5D

by Janaína de Pina Carvalho, Sarah Nascimento Silva, Tália Santana Machado de Assis, Endi Lanza Galvão, Mayra Soares Moreira, Mônica Viegas Andrade, Kenya Valéria Micaela de Souza Noronha, Gláucia Cota

Cutaneous leishmaniasis (CL) is a neglected infectious disease with a global distribution and a known health-related quality of life (HRQoL) impact. However, no utility-based HRQoL assessments for CL patients are available. The aim of this study was to quantitatively assess the health-related quality of life among patients with CL attending a Brazilian reference center. A retrospective interview-based longitudinal study was conducted using the EQ-5D-3L/VAS to assess the current health status during active disease, and retrospectively before the onset of disease symptoms. In addition, socioeconomic data were collected via a standardized questionnaire, and sociodemographic and clinical data were collected directly from medical records. A total of 143 patients with a mean age of 52 (±17) years were included, 73% of whom were men. The mean utility score before the onset of CL symptoms was 0.858. Comparison of responses related to health status before and after disease onset revealed significant losses (p 

Therapeutic application of nano-encapsulated pomegranate peel extract attenuated DSS-induced colitis: Antioxidant and anti-inflammatory role and reduction of exaggerated response of endoplasmic reticulum stress

by Abdallah Tageldein Mansour, Safaa I. Khater, Hemmat M. Eissa, Helal F. Al-Harthi, Areej A. Eskandrani, Mohammed Ageeli Hakami, Wafa S. Alansari, Amirah Albaqami, Hanan M. Alharbi, Tarek Khamis, Doaa Ibrahim

The medicinal application of pomegranate peel extract enriched with polyphenols (PPE) as a therapeutic strategy for managing inflammatory bowel diseases (IBD) is still limited. Integrating pomegranate peel extract (PPE) into an effective nanocarrier system could enhance its mechanistic actions, potentially aiding in the remission of colitis. Therefore, this approach aimed to enhance PPE’s stability and bioavailability and investigate mitigating impact of pomegranate peel extract-loaded nanoparticles (PPE-NPs) in a colitis model. Colonic injury was induced by 5% dextran sulfate sodium (DSS) and efficacy of disease progression after oral administration of PPE-NPs for 14 days was assessed by evaluating clinical signs severity, antioxidant and inflammatory markers, expressions of endoplasmic reticulum associated genes and histopathological and immunostaining analysis in colonic tissues. Clinical signs and disease activity index were effectively reduced, and the levels of fecal calprotectin were decreased in groups treated with PPE-NPs compared to DSS group. The colitic group showed a significant increase (P IL-17, TNF-α, and IL-1β (increased up to 2.99, 4.36 and 4.90 respectively unlike PPE-NPsIII that recorded reduced levels of CRP, MPO and NO (8,96, 78.30 and 123 nmol/g tissue respectively) and much lower (P CHOP, JUNK, ATF6, BIP, and Elf-2) and immunostaining expression regulation of key markers regulating autophagy (Beclin-2) in this group. The histopathological changes in the colon were less severe in the PPE-NPs received groups (especially at the level of 150 mg/kg) compared to DSS group. Collectively, these findings suggest that the nanoencapsulation of PPE enhances its effectiveness in promoting recovery of colonic tissue damage and achieving remission of colitis.

Trace metals and their human health risks in sesame seeds from the main cultivation areas of Ethiopia

by Bewketu Mehari, Tarekegn Fentie Yimer, Tihitna Beletkachew, Eyob Alem, Worku Negash, Mengistu Mulu, Dereje Yenealem, Ayalnesh Miretie

Sesame (Sesamum indicum L.) is a major oilseed crop globally, and white sesame is a key contributor to the foreign exchange earnings of Ethiopia. The main production districts of white sesame in Ethiopia are Humera, Metema, Tegedie, Mirab-Armachiho and Tachi-Armaciho. This study assessed the levels of trace metals (Fe, Cu, Zn, Mn and Ni) in white sesame seeds from these regions and evaluated the associated health risks to consumers. A total of 53 samples were collected from 19 farmer villages across the five districts. Homogenized samples from each village were analyzed using the acid digestion method followed by flame atomic absorption spectroscopy (FAAS). The limit of detection of the method ranged from 0.75 to 865 mg/kg, and the limit of quantitation ranged from 2.55 to 28.8 mg/kg for the different elements analyzed. The recovery of the method was in the range of 90.9‒99.6%. The results showed trace metal levels ranging from 164 ± 6 to 381 ± 4 mg/kg for Fe, 94.0 ± 1.9 to 126 ± 0.8 mg/kg for Zn, 11.8 ± 0.4 to 14.2 ± 0.4 mg/kg for Cu, 11.9 ± 0.9 to 15.0 ± 0.7 mg/kg for Mn and 16.2 ± 1.1 to 21.0 ± 1.2 mg/kg for Ni across the production districts. One-way ANOVA revealed significant differences (p

Enhanced nitrate removal in aquatic systems using biochar immobilized with algicidal <i>Bacillus</i> sp. AK3 and denitrifying <i>Alcaligenes</i> sp. M3: A synergistic approach

by Khomsan Ruangrit, Kittiya Phinyo, Sahassawat Chailungka, Kritsana Duangjan, Apitchaya Naree, Jearanai Thasana, Wassana Kamopas, Senoch Seanpong, Jeeraporn Pekkoh, Nuttapol Noirungsee

This study investigates the effectiveness of biochar immobilized with algicidal Bacillus sp. AK3 and denitrifying Alcaligenes sp. M3 in mitigating harmful algal blooms (HABs) and reducing nitrate pollution in aquatic environments. Over a six-day period, we analyzed changes in algal bloom-forming Microcystis density, chlorophyll-a levels (indicative of algal biomass), nitrate concentration, and microbial community composition in water treated with biochar and Bacillus sp. AK3 and Alcaligenes sp. M3-immobilized biochar. In water treatment using the AK3 and M3-immobilized biochar, Microcystis density decreased from 600,000 cells/mL to 80,000 cells/mL, and chlorophyll-a concentrations also substantially reduced, from 85.7 µg/L initially to 42.8 µg/L. Nitrate concentrations in the AK3 and M3-immobilized biochar treatment significantly decreased from approximately 23 mg/L to around 14 mg/L by Day 6, demonstrating the enhanced denitrification capabilities of the immobilized Alcaligenes sp. M3 and associated bacterial communities. The results also showed significant shifts in bacterial communities, with a decrease in Microcystis, highlighting the specific algicidal activity of Bacillus sp. AK3. The study underscores the potential of biochar-based treatments as a sustainable and effective approach for improving water quality and mitigating the environmental impacts of nutrient pollution and HABs.

Mental health challenges and perceptions of stigma among youth living with HIV in Tanzania

by Laura S. Mkumba, Fortunata Nasuwa, Blandina T. Mmbaga, Aisa M. Shayo, Coleen K. Cunningham, Karen E. O’Donnell, Dorothy E. Dow

Youth living with HIV (YLWH) face psychosocial challenges and HIV-related stigma, which impact adherence to antiretroviral therapy (ART). This study was designed to understand better the change in mental health symptoms and experiences with stigma among YLWH in Tanzania who completed the original pilot Sauti ya Vijana (SYV), a mental health and life skills group intervention. YLWH who completed SYV and demonstrated a change of ≥2 points in either direction on their Patient Health Questionnaire PHQ-9 (depression screener) from baseline to 18 months were purposively sampled. HIV Stigma was measured using 10-questions from the Berger HIV Stigma Scale, and findings ranged from 4–16 for internal stigma and 6–24 for external stigma. In-depth interviews (IDI) were conducted in Kiswahili and included topics such as history of mental health challenges, perceptions of stigma, and experiences with the SYV intervention. Interviews were transcribed, translated to English, and analyzed for emergent themes. Ten youth, 18–25 years of age, were interviewed; 70% were male. Mean (SD) PHQ-9 scores were 7.3 (SD = 3.5) at baseline and 5.6 (SD = 5.0) at 18 months. All participants reported experiencing intermittent episodes of mental health challenges due to difficult interpersonal relationships and fear of stigma. Youth relied on peer support and skills from the SYV intervention to cope with mental health challenges and stigma. Participants reported fear of being stigmatized by others, which led to behaviors such as skipping medication or avoiding situations for worry about unintentional disclosure. All participants endorsed experiencing external stigma on the HIV stigma scale; however, only 3 of 10 participants reported experiencing enacted stigma when directly asked to describe an experience during in-depth interviews. Participants described how SYV helped them have “more confidence”, accept themselves, and incorporate positive coping skills such as relaxation (deep breathing) when they felt stressed. The findings suggest SYV helped YLWH accept themselves, develop positive coping methods, and identify and form peer social support; but stigma remains common. Descriptions of stigma were not recognized as such; experiences of enacted stigma were acknowledged by some participants. More research is needed to understand and measure mental distress and wellness as well as stigma in this population so that interventions may more accurately detect change in key outcomes.

Depression among people living in rural and urban areas of Thailand: A cross-sectional study

by Wiriya Mahikul, Wisut Lamlertthon, Kanchana Ngaosuwan, Pawaree Nonthasaen, Napat Srisermphoak, Wares Chancharoen, Saimai Chatree, Arpaporn Arnamwong, Pisinee Narayam, Chatchamon Wandeecharassri, Pakin Wongpanawiroj

Background

Depression has a growing trend in the population worldwide. In this cross-sectional study, we investigated the prevalence and associated factors of depression among individuals residing in rural (Ban Luang district, Nan Province) and urban (Lak Si, Bangkok) areas of Thailand. Understanding the differences in depression between these two settings can provide insights for specific targeted interventions and mental health policies.

Methods

The multistage stratified random sampling was applied to select the study participants. We recruited participants from rural and urban communities in Thailand using a structured survey questionnaire through either face-to-face interviews or in paper or electronic form. We collected data on depression using the Patient Health Questionnaire-9 (PHQ-9) tool and sociodemographic characteristics and conducted descriptive statistics and logistic regression analysis.

Results

Of 867 survey participants, 420 were from rural areas (Nan) and 447 were from urban areas (Bangkok). Participants’ mean age was 55.9±9.5 years in rural areas and 56.0±12.0 years in urban areas. Most participants in urban areas were women, married, and had lower education levels (71.1%, 50.3%, 58.8%, respectively). The overall prevalence of depression across both settings was 18.6%. We found a higher prevalence of depression in the urban (31.8%) than the rural (4.5%) setting. In multiple logistic regression analysis, urban residence was significantly associated with higher rates of depression compared with rural residence (adjusted odds ratio [AOR] 9.43, 95% confidence interval [CI] 5.08–17.52). Nuclear family and using social media were associated with lower levels of depression in urban areas (AOR 0.50 and 0.43, 95% CI 0.27–0.93 and 0.22–0.84, respectively). Higher education level was significantly associated with higher levels of depression in rural areas (AOR 3.84, 95% CI 1.19–12.42).

Conclusion

This study emphasized the difference in depression and related factors between rural and urban areas of Thailand, highlighting a greater prevalence in urban areas. To help prevent depression, it is important to address specific challenges in each setting, such as those faced by highly educated individuals living in rural areas with high depression rates, exploring social media use patterns in urban populations, and understanding dynamics of the nuclear family. Our findings can inform the development of public health policies aimed at effectively mitigating the burden of depression and improving overall mental well-being in specific settings.

Blood transfusion service readiness and its associated factors in health facilities providing blood transfusion services across Ethiopia: A secondary analysis of the 2018 Service Availability and Readiness Assessment (SARA) survey

by Tirualem Asmare Fenta, Gizachew Tadele Tiruneh, Nebiyou Fasil Ayele

Introduction

Timely and safe blood transfusion services are crucial for saving lives in emergencies. Previous studies have focused on hospital inpatient care access but have overlooked blood transfusion service readiness. This study examined the readiness of blood transfusion services in health facilities across Ethiopia and its determinants.

Methods

This study used Service Availability and Readiness Assessment (SARA) 2018 data from 632 facilities. Readiness was measured based on seven components: the presence of at least one trained staff for appropriate use of blood and safe transfusion; guidelines for appropriate use and transfusion; blood storage refrigerator; blood typing; cross-match typing; blood supply safety; and blood supply sufficiency. Data were analyzed using descriptive and inferential statistics. Facility characteristics were summarized using frequency tables and summary statistics. Bivariate and multivariable linear regression analyses examined the predictors of service readiness.

Results

Facilities offering blood transfusion services had a mean readiness score of 4.5 (out of 7), with only 5% having all items. Most facilities performed blood typing, but less than one-third conducted cross-match testing, and over half lacked guidelines and trained staff. Service readiness varied significantly across regions. Facilities in Oromia (Coef.: -0.74; 95% CI: [-1.32, -0.15]) and Somali (Coef.: -1.26; 95% CI: [-2.21, -0.31]) had lower readiness scores compared to Addis Ababa. Increased availability of medical equipment corresponded to a 49% increase in readiness scores (Coef.: 0.49; 95% CI: [0.19, 0.79]).

Conclusion

The study highlights deficiencies in blood transfusion service readiness and regional disparities, emphasizing the need for targeted support to enhance readiness across regions.

Adolescent school retention post COVID-19 school closures in Kenya: A mixed-methods study

by Ruth Nanjekho Wafubwa, Erica Soler-Hampejsek, Eva Muluve, Daniel Osuka, Karen Austrian

This mixed methods study investigated factors associated with school retention among marginalized adolescents in four different settings in Kenya, following COVID-19 school closures. Logistic regressions were used to examine factors associated with school retention in 2022 among 1798 adolescent students aged 10–19 in 2020. Qualitative data from 89 in-depth interviews (64 adolescents aged 11–19 and 25 parents), and 21 key informants were thematically analysed. Among female adolescents, age (aOR = 0.76, 95% CI: 0.67, 0.87) and internet access (aOR = 0.55, 95% CI: 0.35, 0.87) were negatively associated with school retention. Engaging in income-generating activities was similarly linked to reduced school retention (aOR = 0.27, 95% CI: 0.16, 0.46). For male adolescents, household loss of income (aOR = 0.40, 95% CI: 0.21, 0.76) and engaging in income-generating activities (aOR = 0.07, 95% CI: 0.02, 0.19) were associated with lower school retention. The qualitative findings highlighted the gendered nature of barriers to school retention. Specifically, pregnancy, child marriage, and related childcare responsibilities emerged as important constraints for girls, whereas engaging in income-generating activities and drug and alcohol use were more dominant factors for boys. Across both genders, financial constraints were a key barrier to school retention. This study underscores the multifaceted nature of factors influencing school retention among marginalized adolescents in times of crisis such as the COVID-19 pandemic. The findings provide useful information for designing targeted policies and programmes for adolescent school retention in times of crisis.

Development and feasibility of an mHealth intervention for psychoeducational support of Nigerian women diagnosed with breast cancer undergoing chemotherapy: A pilot randomized controlled trial

by Oluwadamilare Akingbade, Ka Yi Hong, Oluwabukola Sharon Ayo, Adetutu Sefinat Alade, Moshood Akinwumi Lawal, Ibironke Elizabeth Somoye, Victoria Adediran, Olamide Sado, Ka Ming Chow

Background

Breast cancer (BC) remains a significant health burden globally, with high incidence and mortality rates, particularly in Nigeria. Chemotherapy, a common treatment modality for BC, often leads to various physical and psychological side effects, impacting patients’ quality of life. Despite the growing use of mobile health (mHealth) interventions to provide psychoeducational support, there is a paucity of evidence regarding their feasibility and acceptability among Nigerian women with BC.

Objective

To develop and investigate the feasibility and acceptability of a mHealth psychoeducational intervention (mPEI) named the ChEmo Nurse Breast cancer Application (CENBA) programme.

Methods

A multi-centre, assessor-blinded, parallel-group pilot randomised controlled trial (RCT) was conducted at Lagos State University Teaching Hospital (LASUTH) and Lagos University Teaching Hospital (LUTH). Thirty women newly diagnosed with BC and undergoing chemotherapy were randomly assigned to an intervention or a control group. The intervention group received the CENBA programme, which included BC education, coping skills training, a discussion forum, and nurse-led consultations, delivered via a mobile application and phone calls over six weeks. The control group received standard care. Feasibility was assessed through consent, attrition, and completion rates, while acceptability was explored via qualitative interviews.

Results

The completion rate was 93.3%. Qualitative data indicated that participants found the intervention beneficial, particularly appreciating the educational content and the emotional support provided through the discussion forum and nurse consultations.

Conclusion

The CENBA programme was perceived as a feasible and acceptable mHealth intervention for providing psychoeducational support to Nigerian women with BC undergoing chemotherapy. These findings suggest that the CENBA programme could be a valuable tool in addressing the psychoeducational needs of this population, warranting further investigation in a full-scale RCT.

Trial registration

This manuscript reports a feasibility study preceding the full trial, which was registered with the United States Clinical Trials registry (number NCT05489354).