PLOS ONE Alerts: New Articles

Knowledge, attitudes, and practices (KAP) regarding occupational protection among orthopedic theatre nurses using orthopedic power tools (OPTs): A cross-sectional study

2026-05-15T14:00:00Z

by Hang Li, Zhao-Li Guo, Tao Chen, Wen-Qian Wang, Zheng Gao

Introduction

The objective of this study was to explore the factors associated with the knowledge, attitudes, and practices (KAP) of orthopedic theatre nurses with regard to occupational protection when orthopedic power tools (OPTs) are used to provide a reference for ensuring the occupational safety of nurses working in orthopedic surgery rooms.

Methods

This cross-sectional survey involved 272 orthopedic theatre nurses across eight tertiary hospitals in Shanxi Province, China, between September and December 2024. An occupational protection assessment tool that was self-developed and included 3 dimensions (Knowledge, Attitude, and Practice), containing a total of 45 items, was utilized among operating theatre nurses with OPTs.

Results

The median as the cutoff, 52.9% (144/272) of respondents had an adequate Knowledge score, while 47.1% (128/272) had a good score; 54.0% (147/272) of the respondents had a positive Attitude score, and 46.0% (125/272) had a negative attitude; 53.7% (146/272) of the participants demonstrated good performance in the Practice score, whereas 46.3% (126/272) showed poor performance. Multivariable regression analysis revealed that the knowledge scores of those with a bachelor’s degree (aOR=7.040; 95% CI: 3.204–15.466; p < 0.001), senior professional title (aOR=5.216; 95% CI: 1.228–22.155; p = 0.025), occupational protection training frequency less than 6 months (aOR=10.085; 95% CI: 4.146–24.533; p < 0.001) or 6–12 months (aOR=6.550; 95% CI: 3.262–13.153; p < 0.001) and actively consulting the latest professional protection knowledge (aOR=2.652; 95% CI: 1.426–4.931; p = 0.002) were higher and statistically significant. Senior title (aOR=5.226; 95% CI: 1.409–19.387; p = 0.013), occupational exposure (aOR=2.770; 95% CI: 1.484–5.169; p = 0.001) and Knowledge scores (aOR=2.663; 95% CI: 1.581–4,448; p < 0.001) yielded attitude scores that were higher and statistically significant. Attitude scores (aOR=3.683; 95% CI: 2.106–6.441; p < 0.001), actively consulting the latest professional protection knowledge (aOR=2.962; 95% CI: 1.686–5.201; p = 0.001), and higher Knowledge scores (aOR=2.255; 95% CI: 1.294–3.930; p = 0.004) were independently associated with better practice scores.

Conclusion

Nurses in the orthopedic operating room had a positive attitude toward the occupational protection of using power tools, but their knowledge was insufficient, and their practice behavior was poor. Normative guidelines for occupational protection in the workplace of an orthopedic theatre and a training and evaluation system should be developed. Moreover, future measures should focus on education and training for occupational protection. Additionally, developing and designing occupational protective equipment that is more convenient for orthopedic surgery is important.

Reporting method

This research was designed as a cross-sectional survey study that was conducted in strict accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines.

Evaluation of Colombian silk fibroin hydrogels functionalized with recombinant LSECtin for intervertebral disc tissue engineering

2026-05-15T14:00:00Z

by Lyda Cenobia Caballero-Méndez, Augusto Zuluaga-Vélez, Jhon Jairo Melchor-Moncada, Adrián Quintero-Martinez, Luc Mongeau, Sara Nejati, Juan Carlos Sepúlveda-Arias

This study evaluated the potential of Colombian silk fibroin hydrogels functionalized with recombinant LSECtin (rLSECtin) for intervertebral disc tissue engineering. In silico analysis indicated that rLSECtin may interact with glycans similar to those found in human adipose-derived stem cells (ADSCs) through residues Asn105, Asp106, Glu93, Asn87, and Glu85, which coordinate calcium to form hydrogen bonds with GlcNAc hydroxyl groups. rLSECtin was successfully produced, purified, and incorporated into silk fibroin hydrogels. Thermal analysis showed that the hydrogels were resistant to sterilization, and rheological studies demonstrated predominantly elastic, gel-like behavior. The secondary structure of the hydrogels was largely determined by α-helical content, which is related to silk I with β-sheets also contributing as a result of sonication-induced structuring. Metabolic activity assays indicated that rLSECtin was associated with increased ADSC metabolic activity under two-dimensional conditions, whereas hydrogels containing rLSECtin maintained cell viability, as confirmed by cell viability assays. Differentiated constructs exhibited glycosaminoglycan-rich extracellular matrix and chondrocyte-like morphology, whereas rLSECtin-functionalized hydrogels showed increased transcription of SOX9, ACAN, and COL2A1, along with elevated COL10A1 of uncertain significance for nucleus pulposus stability. Overall, Colombian silk fibroin hydrogels provide a mechanically stable and cytocompatible platform relevant for nucleus pulposus tissue engineering, in which rLSECtin appears to act primarily as a biochemical modulator rather than a structural modifier. These findings support a proof of concept for lectin-functionalized biomaterials in intervertebral disc regeneration. However, further studies, including mechanistic validation of glycan–lectin interactions, protein-level confirmation, quantitative extracellular matrix analysis, and evaluation of signaling pathways, are required to establish functional and translational relevance.

Autonomic nervous system modulation by G protein-biased mu-opioid receptor agonists: A translational scoping review protocol

2026-05-15T14:00:00Z

by Yi Zhang, Qiuxiang Chen, Yuanyuan Zhou, Qingjun Zeng, Haishan Cui, Yukai Zhou

Background

G protein-biased mu-opioid receptor (MOR) agonists such as oliceridine and tegileridine were developed to reduce opioid-related side effects while keeping analgesic efficacy. The US FDA approved oliceridine in 2020 and China NMPA approved tegileridine in January 2024. Clinical development mainly focused on respiratory depression and gastrointestinal problems, but little attention has been paid to the autonomic nervous system (ANS) effects of these drugs. Traditional opioids change heart rate variability (HRV) and sympathovagal balance mainly through central mechanisms. It is not clear whether biased agonists show different autonomic profiles compared with traditional opioids. There is an ongoing scientific debate about whether the benefits of these drugs come from true signaling bias or from low intrinsic efficacy.

Methods

We will conduct a scoping review following JBI methodology and report according to PRISMA-ScR guidelines. We will search PubMed, Embase, Web of Science and Cochrane Library from database start to March 2026. FDA and NMPA regulatory documents will also be searched. Two reviewers will screen studies and extract data independently. We will include in vitro cellular assays, in vivo animal experiments, and clinical studies examining oliceridine, tegileridine or other biased MOR agonists that report cardiovascular or autonomic outcomes. Results will be organized in an Evidence Matrix by drug, evidence level and measurement timepoint. Animal studies will be stratified by anesthetic state (conscious versus anesthetized).

Discussion

We will map the evidence against three mechanistic paradigms: that biased agonism preserves autonomic homeostasis; that observed benefits come from partial agonism rather than signaling bias; or that no meaningful autonomic differences exist between biased and traditional agonists. This review will map evidence gaps and inform future clinical trial design with autonomic endpoints. We note that tegileridine has much less published data than oliceridine, and this gap analysis will help set research priorities.Protocol registration: Open Science Framework (OSF) [https://doi.org/10.17605/OSF.IO/N2XZC].

A comparative analysis of objectively assessed physical activity levels in kindergarten and home among children aged 5 to 6

2026-05-15T14:00:00Z

by Jarosław Herbert, Piotr Matłosz, Wojciech Ratkowski, Justyna Wyszyńska

Children’s physical activity (PA) is positively associated with a wide range of developmental and health outcomes. This study compared individual levels of PA in children aged 5–6 years across two settings: kindergarten and home. A total of 522 children (51.9% girls) participated. PA was objectively measured using ActiGraph GT3X-BT accelerometers, and selected socioeconomic indicators (SSI) were parent-reported. Children accumulated significantly more light physical activity (PA) in kindergarten than at home, whereas moderate, vigorous, and total moderate-to-vigorous physical activity (MVPA) were significantly higher at home than in kindergarten (all p < 0.001). Boys showed consistently higher PA levels than girls in both environments. Notably, median MVPA in boys was 22.7 min at home and 17.3 min in kindergarten, compared to 19.0 and 14.0 min in girls, respectively. Median daily step counts in the total sample were also significantly higher at home (3315.5) than in kindergarten (3111.0). Significant associations were observed between selected SSI and PA. Lower parental education levels were associated with higher step counts, light (father’s education) and moderate PA (mother’s education) in kindergarten. Children from families with less favorable financial conditions also had higher MVPA in kindergarten. These findings underscore the importance of the home environment and suggest that certain aspects of socioeconomic disadvantage may be linked to higher PA levels in early childhood.

The mediating roles of personal mastery and health-promoting behaviors in the relationship between self-regulatory fatigue and quality of life among patients with type 2 diabetes mellitus

2026-05-15T14:00:00Z

by Guiqiu Fang, Weidong Gong, Lihua Xia, Liping Li, Peng Sun, Jie Song, Yufeng Cui, Xiaochun Tang, Youxing Wu, Panfeng Li, Xiaoyan Zhang, Xing Ni, Feng Lu, Jiangyun Ru, Jun Yin, Yuanzhi Li, Zhangyi Wang

Background

Quality of life (QoL) is a pivotal prognostic indicator for patients with Type 2 Diabetes Mellitus (T2DM). While the impact of various factors on QoL is recognized, the complex interplay between psychological and behavioral determinants remains underexplored. Understanding these pathways is essential for developing effective interventions.

Objective

This study aimed to investigate the status of QoL and its associated factors among T2DM patients, and to examine the mediating effects of personal mastery (PM) and health-promoting behaviors (HPB) in the relationship between self-regulatory fatigue (SRF) and QoL by using structural equation modeling.

Methods

The study adhered to the STROBE guidelines for cross-sectional reporting. From July 2025 to February 2026, 432 T2DM patients were recruited from three tertiary grade-A hospitals across two cities in China by using convenience sampling. Data were collected using the Demographic Characteristics Questionnaire, Self-Regulatory Fatigue Scale, Personal Mastery Scale, Diabetes Health Promotion Scale, and Diabetes-Specific Quality of Life Scale. Pearson’s correlation, multiple linear regression, and structural equation modeling were employed for data analysis. The mediating effects were tested using the bias-corrected (BC) bootstrap method with 5,000 resamples.

Results

The total scores for SRF, PM, HPB, and QoL were 38.63 ± 12.84, 26.12 ± 7.62, 97.69 ± 20.87, and 69.41 ± 20.89, respectively. Correlation analysis indicated that QoL was significantly positively correlated with SRF (r = 0.581, p < 0.01), and negatively correlated with PM (r = −0.557, p < 0.01) and HPB (r = −0.613, p < 0.01). Multiple linear regression analysis revealed that age, educational level, medical insurance payment method, smoking status, glycemic control status, number of comorbidities, self-care ability, self-regulatory fatigue, personal mastery, and health-promoting behaviors were independent predictors of QoL. Furthermore, the structural equation modeling demonstrated a significant total indirect effect of self-regulatory fatigue on QoL. The mediating effect of personal mastery accounted for 30.2% of the total indirect effect, while that of health-promoting behaviors explained 60.2%. The chain mediating pathway contributed 9.5% of the total indirect effect.

Conclusion

This study suggests that SRF is statistically associated with directly and indirectly poorer QoL in T2DM patients, primarily by being associated with lower PM and fewer HPB. These findings highlight the importance of addressing psychological and behavioral mechanisms in diabetes care. From a nursing perspective, interventions targeting SRF, strengthening PM, and promoting HPB may be beneficial.

Prevalence and risk factors of abuse against older adult women: A cross-sectional community study in Eastern Andalusia, Spain

2026-05-15T14:00:00Z

by Yolanda María de la Fuente-Robles, Adrián Jesús Ricoy-Cano, María Dolores Muñoz-de-Dios, Marta García-Domingo

Abuse against older adult women remains a serious public health issue and a flagrant violation of human rights in Spain. However, research specifically addressing abuse against older adult women is still limited, contributing to a significant gap in scientific knowledge. This study aimed to estimate the prevalence of overall abuse, and its different forms, experienced by older adult women (≥ 60 years) in a specific area of Eastern Andalusia, Spain, over the past twelve months, and to identify associated risk factors. A community-based cross-sectional study was conducted with 209 non-institutionalised older adult women, using the Geriatric Mistreatment Scale and collecting sociodemographic and lifestyle data. A high prevalence of abuse was found, with 49.3% of participants reporting some type of abuse, with psychological abuse being the most common (36.4%), followed by physical (23.0%), economic (13.9%), sexual (11.0%) and neglect (7.7%). Factors such as age, marital status, self-perceived health status and feelings of loneliness were identified as significant risk factors. These findings highlight the need to strengthen detection, prevention and response strategies within community and household settings, particularly by equipping primary care, social services and other community-based professionals—especially social workers—with the skills to identify both overt and subtle forms of abuse experienced by older adult women living at home.

Unraveling the significance of decorin in endometriosis development through single cell sequencing and experimental approaches

2026-05-15T14:00:00Z

by Guansheng Chen, Wenjing Li, Lingyu Liu, Yongjun Wang

Background

A link exists between decorin (DCN) and endometriosis, nevertheless, the role of DCN in this condition remains unclear. This study aims to bioinformatically characterize DCN expression, diagnostic value, and related signaling in endometriosis using single-cell and bulk transcriptomic data, with experimental validation of expression level.

Methods

Single-cell RNA sequencing (scRNA-seq) was analyzed using Scissor and ROGUE algorithms to identify key cell types associated with endometriosis. CIBERSORTx was used to construct a signature matrix for deconvolution of bulk RNA-seq data and estimation of immune and stromal subpopulation proportions. DCN expression was explored across datasets and validated by reverse transcription-quantitative polymerase chain reaction (RT-qPCR) in endometrial and endometriotic stromal cells. Its diagnostic value was assessed by receiver operating characteristic (ROC) curve analysis, and associated pathways were predicted by gene set enrichment analysis (GSEA). Potential DCN-targeted drugs were predicted via bioinformatic databases.

Results

Stromal cells were identified as the key cell type with high heterogeneity and dominant DCN expression. Ten stromal subtypes were delineated, with Activated/Myofibroblast-like Stromal Cells (AMSC), Fibrosis-Effector Stromal Cells (FESC), Stemness-Remodeling Stromal Cells (SRSC), and dStromal showing significantly altered proportions in endometriosis. DCN was significantly upregulated in endometriosis at both transcriptomic and cellular levels, with area under the curve (AUC) > 0.8 in two independent datasets, supporting its diagnostic potential. GSEA indicated DCN correlates with complement/coagulation cascades, TGF-β signaling, and other pathways linked to tissue remodeling and inflammation. Seven candidate drugs targeting DCN were predicted as hypothesis-generating leads.

Conclusion

This study provides bioinformatic and correlative evidence that DCN is abnormally upregulated in endometriotic stromal cells and exhibits favorable diagnostic value. DCN is associated with pathways relevant to endometriosis pathogenesis and represents a promising biomarker and therapeutic candidate pending future functional and mechanistic validation.

Analysis of Torquetenovirus DNA levels in NSCLC patients treated with immune checkpoint inhibitors

2026-05-15T14:00:00Z

by Lilia Cinti, Lucrezia Tuosto, Piergiorgio Roberto, Roberta Campagna, Aurelia Rughetti, Chiara Napoletano, Alain J. Gelibter, Daniele Santini, Guido Antonelli, Ombretta Turriziani

In recent years, Torquetenovirus (TTV) load has emerged as a potential biomarker of immune competence across various clinical contexts, albeit its significance in cancer patients undergoing immunotherapy remains largely unexplored. This study aimed to investigate the level of TTV viral load in non-small cell lung cancer (NSCLC) patients treated with immune checkpoint inhibitors (ICIs). A total of 64 NSCLC patients were enrolled. Serum TTV DNA levels were quantified by real-time PCR at baseline (T0) and after three months of ICI therapy (T1). As control, TTV levels were also measured in a cohort of healthy donors at a single time point. Statistical analyses were performed to compare TTV copy numbers across groups and time points. At baseline, cancer patients exhibited significantly higher TTV viral loads than healthy donors, consistent with an immunocompromised status. Following ICI treatment, a significant decline in TTV levels was observed in the oncologic cohort, reaching values comparable to those of healthy individuals, with a more pronounced decrease observed in patients responsive to therapy. This study provides the first evidence that TTV viral load decreases following immunotherapy in NSCLC patients, potentially reflecting a restoration of immune competence. These findings support the hypothesis that TTV monitoring could serve as a surrogate marker of immune function during ICI treatment. Further large-scale, longitudinal studies are warranted to validate its clinical meaning in oncologic settings.

An entropy-based framework for genomic variability analysis: A South American case study of human papillomavirus

2026-05-15T14:00:00Z

by Alan López Leal, Elizabeth Valdés-Muñoz, Jorge Y. Faundez-Acuña, Víctor Rojas-Pérez, Vivían D´ Afonseca, Fabián Silva-Aravena

The genetic diversity of Human Papillomavirus (HPV) poses challenges for molecular detection and genotyping, particularly in regions with distinctive circulating variants such as South America. This study aimed to quantitatively characterize HPV genomic variability using Shannon entropy (H) and to establish a reproducible framework for systematic variability assessment. Positional entropy was calculated across complete and partial HPV genomic sequences and aggregated by gene to compare intra- and intergenotypic conservation patterns using publicly available South American sequences. Intragenotypic analyses showed that most genomic positions were highly conserved (H ≈ 0), consistent with functional constraints. In contrast, intergenotypic comparisons revealed a dual pattern of variability: early genes E5, E6, and E7 displayed higher divergence, whereas capsid genes L1 and L2 were comparatively conserved. These patterns align with known functional and evolutionary constraints across HPV genes. Rather than proposing diagnostic implementations, these results provide a quantitative basis for the preliminary prioritization of conserved and variable genomic regions. Entropy profiling provides a quantitative framework for characterizing genomic variability and may support the identification of conserved and variable regions for future investigation and genomic surveillance efforts, although experimental validation is required to determine diagnostic performance. Overall, this work presents a reproducible and data-driven approach for assessing HPV genomic variability and contributes to the understanding of regional viral diversity in South America.

An exploratory study on cortical hemodynamics and handgrip strength phenotypes in long-term hospitalized patients with stable schizophrenia

2026-05-15T14:00:00Z

by Yanping Feng, Yilin Wang, Binyou Wang

Objective

This exploratory study aims to investigate the relationship between handgrip strength (HGS) phenotypes and cortical hemodynamics in long-term hospitalized patients with stable schizophrenia, and to evaluate whether HGS could serve as a potential indicator of neurocognitive function in this population.

Methods

In this cross-sectional study, 96 patients with stable schizophrenia were enrolled. HGS was assessed using a calibrated dynamometer. Cortical hemodynamic responses during a Verbal Fluency Task (VFT) were measured using functional near-infrared spectroscopy (fNIRS), with metrics derived from both oxygenated hemoglobin (Oxy-Hb) and total hemoglobin (Total-Hb) signals, including the S-integral, T-centroid, and K-activation. Statistical analyses comprised Spearman correlation analysis, univariate linear regression, and general linear models with post hoc comparisons.

Results

Among the participants, 40.60% (39/96) were male and 59.40% (57/96) were female, with a median (P25, P75) age of 52 (42, 56) years. Univariate linear regression revealed a significant positive association between HGS asymmetry and frontal lobe S-integral values (Oxy-Hb: β = 65.650, 95% CI: 18.488–112.812, P = 0.007; Total-Hb: β = 64.878, 95% CI: 19.360–110.395, P = 0.006). However, after adjusting for potential confounders, general linear models revealed no significant differences in frontal S-integral values across HGS asymmetry subgroups, regardless of whether asymmetry was classified by percentage-based thresholds or dominance type (all Bonferroni-adjusted P > 0.05).

Conclusion

In this exploratory study, HGS asymmetry was associated with frontal S-integral values unadjusted; however, after adjusting for confounders and multiple comparisons, no significant independent association remained. HGS phenotypes cannot be considered reliable or simple surrogate markers of neurocognitive activity in this population, underscoring the substantial influence of confounding neurophysiological factors in schizophrenia.

Experimental and computational models for intracardiac flow analysis with blood speckle imaging

2026-05-15T14:00:00Z

by Megan Laughlin, Justin T. Jack, Sam E. Stephens, Elijah Bolin, Paul C. Millett, Morten O. Jensen

Intracardiac flow analysis aims to evaluate blood flow patterns and associated parameters for the assessment of cardiac function. However, there is limited understanding as to how flow parameters are influenced by various sources, such as pressure upstream/downstream and cardiac chamber compliance. The objective of this study was to investigate experimental and computational tissue-mimicking models to be used alongside 2D Blood Speckle Imaging for intracardiac flow analysis. Two geometries, an axisymmetric swell and idealized left ventricle, were utilized. As an initial parameter of interest, the pressure-drop across each geometry was determined from tissue-mimicking phantoms using direct pressure measurements, blood speckle imaging, and 3D computational fluid dynamics simulations with fluid-structure interaction. The results indicate limited quantitative agreement between direct measurements, 2D blood speckle imaging, and 3D computational fluid dynamics, with qualitative agreement capturing a consistent shape of the pressure drop curve between methods. Additionally, the importance of phantom design is demonstrated due to the likely impact of gel thickness on flow patterns and their associated measurements. The findings of this study indicate that future work focusing on the optimization of BSI settings and increasing model complexity with the inclusion of cardiac valves and patient-specific geometries are still required. These models may then allow for further tuning of variables to better understand their effect on various intracardiac flow parameters, and ultimately their clinical applicability.

Enhanced nitrogen removal via simultaneous nitrification and denitrification by a newly isolated strain Enterobacter cloacae GW6 from estuarine sediment

2026-05-15T14:00:00Z

by Shufeng Chen, Zhicai Zhang, Yinhua Wang, Chunping Wang, Xin Zhang, Xu Wang, Yalin Wu, Yidong Wang, Hongyu Guo

Excessive nitrogen has been discharged into natural environments due to anthropogenic activities, leading to numerous negative impacts on natural ecosystems worldwide and becoming a global environmental issue. Therefore, effective removal of nitrogenous contaminants from natural ecosystems is crucial for the protection of both ecological sustainability and human interests. In this study, a strain of Enterobacter cloacae GW6 was newly isolated from natural estuarine sediment. This strain could utilize ammonium, nitrite and nitrate, with removal efficiencies of 99.60%, 93.73% and 98.79%, and the maximum removal rates of 39.96, 40.39 and 44.65 mg/L/h, respectively. Importantly, Strain GW6 showed excellent simultaneous heterotrophic nitrification and aerobic denitrification (HN-AD) capability with the maximum TN removal rate of 35.27 mg/L/h, which is greater than those of many other HN-AD bacteria reported previously, indicating that Strain GW6 was suitable for the efficient nitrogen removal in aquatic ecosystems with high ammonium, nitrite and nitrate concentrations. The detection of functional genes amoA, hao, napA, nirK and nosZ from Strain GW6 further confirmed its HN-AD capability. Strain GW6 exhibited strong nitrogen removal capability across a wide range of environmental conditions, which makes it a promising candidate as a HN-AD bacterium for the effective biological treatment of nitrogen contamination and eutrophication in natural aquatic ecosystems, thereby contributing to better environmental protection.

A solo journey in the shadow of a double-edged pandemic: A qualitative study of women’s experience of being pregnant during the COVID-19 pandemic

2026-05-15T14:00:00Z

by Ylva-Li Lindahl, Helene Norén, Andrea Hess Engström, Maria Grandahl, Cecilia Åslund

The COVID-19 pandemic profoundly affected the emotional well-being of pregnant women. In Sweden, no national lockdown was implemented; instead, healthcare restrictions were imposed, most notably limiting partner involvement in perinatal care. This marked a significant shift from standard practices that emphasize partner participation as a key component for maternal support and well-being. This study aimed to explore women’s experiences of being pregnant during the COVID-19 pandemic. A qualitative interview study was conducted in Sweden, including 30 pregnant women. The data were analyzed using content analysis with an inductive approach. Four overarching themes were identified: Living in the Shadow of the Pandemic, Missing Out on the Shared Journey, Unpredictability Creates Worry and Fear, and Adaptation and Growth in a Threatening World. The findings describe pregnant women’s experiences during the COVID-19 pandemic as a period marked by vulnerability, partner exclusion, uncertainty and emotional strain. However, many participants also demonstrated resilience and developed adaptive strategies. A recurring desire emerged for more inclusive, consistent healthcare practices and clearer communication tailored to the needs of expectant families. The findings highlight the importance of patient-centered, accessible perinatal healthcare and contribute to the existing research by emphasizing the role of support systems and national guidelines in safeguarding maternal and family well-being during future pandemics.

Individual work performance questionnaire: Translation and validation in Chinese

2026-05-15T14:00:00Z

by Guihong Tang, Safiah Omar, Raida Abu Bakar

The Individual Work Performance Questionnaire (IWPQ) serves as a recognized multidimensional instrument employed for the assessment of work performance, covering task performance, contextual performance, and counterproductive work behavior. Although extensively utilized, limited research has explored its psychometric attributes within the organizational framework in China. This study aims to bridge this research void by executing a comprehensive validation investigation with a sample of 833 Chinese workers. Multiple models including the three-factor model, higher-order model, and bi-order model demonstrating strong psychometric properties. Among these, the three-factor model was chosen for more detailed examination. The initial step involved conducting confirmatory factor analysis using AMOS, evaluating factors such as normality, factor loadings, reliability, common method bias, and overall model adequacy. Subsequently, a multigroup confirmatory factor analysis was performed to investigate measurement equivalence among subgroups based on gender. Following this, structural equation modeling in SmartPLS was utilized to assess criterion-related validity by examining the correlation between overall work performance and accomplishment as gauged by Seligman’s PERMA framework. The findings indicated robust psychometric characteristics, with factor loadings surpassing 0.70, high reliability and convergent validity (CR > 0.70 and AVE > 0.50), and adequate model suitability (RMSEA < 0.05). Assessment of measurement invariance validated the stability of the tripartite structure across genders, as evidenced by RMSEA values meeting criteria for both male and female cohorts. Criterion validity assessment unveiled a substantial positive correlation between overall individual work performance and accomplishment (β = 0.511, p < 0.001), denoting a noteworthy predictive capacity. These findings establish the IWPQ as a reliable and conceptually grounded instrument suitable for assessing individual work performance in Chinese organizational contexts.

Research on the allocation mechanism of grassland ecological compensation among different industries based on ecosystem product value accounting

2026-05-15T14:00:00Z

by Li Ma, Yaojie Wu

The manifestation and allocation of the positive externalities of grassland ecosystem products are critical to realizing the value of ecological compensation. Previous studies on ecological compensation have largely overlooked the heterogeneity of ecosystem products within regions and the differences in compensation among various industrial sectors, particularly the alignment and regulatory role between industrial structure and ecological compensation. In response, this study shifts the focus from interregional horizontal compensation to intraregional structural compensation, emphasizing the rational allocation mechanism of ecosystem product value among different industrial actors. Based on meteorological monitoring data and land-use data, the value of grassland ecosystem products is estimated using the water balance method and soil erosion equations. Furthermore, an inter-industry ecological compensation allocation model is constructed based on the consumption value of grassland ecosystem products and the proportion of industrial structure. The results show that: (1) From 2013 to 2023, none of the four major pastoral regions are required to bear ecological compensation for carbon sequestration and oxygen release consumed by the livestock industry; however, the average ecological compensation surplus decreased from 7.38 × 10⁸ CNY to 7.09 × 10⁸ CNY. (2) Most regions are required to bear ecological compensation for air purification consumed by the industrial sector, while some regions in Inner Mongolia and Xinjiang are also required to compensate for water conservation consumed by industry. (3) No region is required to bear ecological compensation for water conservation and soil retention consumed by the tourism industry; however, regions such as Turpan and Alxa are required to compensate for carbon sequestration and oxygen release consumed by tourism, with the average compensation increasing from 1.35 × 10⁶ CNY to 1.54 × 10⁷ CNY.

Development of a multiplex fluorescent qPCR assay for the simultaneous detection of bovine viral diarrhea virus and pathogenic Escherichia coli

2026-05-15T14:00:00Z

by Wenxin Zhu, Huanxing Zhu

Neonatal calf diarrhea, primarily caused by bovine viral diarrhea virus (BVDV) and enterotoxigenic Escherichia coli K99, poses a significant threat to the cattle industry. This study aimed to develop a multiplex qPCR assay for the simultaneous detection of both pathogens. We established specific primers and probes and generated optimized qPCR standard curves, achieving high analytical sensitivity, with limits of detection of 10² copies/μL for the BVDV target fragment and 10¹ copies/μL for the E. coli K99 plasmid DNA, without cross-reactivity with other bovine pathogens. The assay demonstrated good repeatability and was validated using clinical samples, confirming its effectiveness for accurate diagnostics. This multiplex qPCR assay enhances monitoring of BVDV and E. coli infections in livestock, potentially reducing economic losses from outbreaks.

Trauma-informed care for everyone: A study on patient and provider perspectives in an urban primary care setting

2026-05-15T14:00:00Z

by Jannah M. Wigle, Clara Juando-Prats, Andree Schuler, Katie Sussman, Alyssa Swartz, Chantal Sorhaindo, Seema Bhandarkar, William Watson, Allison Farber

Background

The importance of trauma-informed care is increasingly acknowledged as essential to generating a trusted relationship and safe environment in which to mitigate harms or effects of seeking health services by both patient and primary health care providers. Despite established models and principles of trauma-informed care, in practice there is limited research on the implementation of trauma-informed care within interdisciplinary primary care settings.

Methods

This research was conducted at a multi-site interdisciplinary primary health care team in Toronto, Canada. Guided by an interpretative qualitative and patient-oriented methodological approach, we conducted semi-structured interviews with 10 patients and 13 primary care providers from January 2023 to March 2024.

Results

Patients and primary health care providers conceptualized trauma-informed care as a holistic, patient-centred approach that is foundational to delivering quality, primary health care. Ensuring that primary health care is universally trauma-informed was perceived by all participants as essential to better understanding patients’ health, care-seeking, and health system experiences. Primary care providers are uniquely positioned to integrate trauma-informed care into clinical practices given sustained relationships and trust with patients. The availability and accessibility of trauma-specific supports and underlying contextual factors also inherently shaped the lived experiences of obtaining or delivering care among patients and providers.

Conclusions

A paradigmatic shift towards a more holistic and person-centred approach is fundamental to integrating trauma awareness and precautions in primary care and the health system. Overcoming obstacles that circumscribe the availability and accessibility of trauma-informed care and trauma-specific resources is paramount to promoting health, mental health, and health equity.

Burden of head and neck cancers in five East Asian countries from 1990 to 2023: Observation, comparison, and forecast from the global burden of disease study 2023

2026-05-15T14:00:00Z

by Yinghong Li, Mingjie Tang, Shiwei Li, Peipei Yang, Qiurong Li, Peng Shu

Background

Head and neck cancer (HNC) poses a significant public health challenge worldwide, yet the long-term trends and heterogeneity of its burden within East Asia remain inadequately characterized. This study aims to provide a comprehensive assessment of the HNC burden in five East Asian countries from 1990 to 2023 and project future trends.

Methods

Utilizing data from the Global Burden of Disease (GBD) 2023, we analyzed the incidence, prevalence, mortality, and disability-adjusted life years (DALYs) of HNC in China, Japan, the Republic of Korea, the Democratic People’s Republic (DPR) of Korea, and Mongolia. We employed a comprehensive analytical approach encompassing age-standardized rates, temporal trends, Joinpoint regression, risk factor attribution, age-period-cohort analysis, as well as decomposition and forecasting analyses.

Results

From 1990 to 2023, substantial heterogeneity was observed. China demonstrated significant declines in age-standardized incidence rate (ASIR) and mortality rate (ASMR). Conversely, Japan experienced concerning increases in ASIR and ASMR. The Republic of Korea maintained a stable ASIR while achieving a marked ASMR reduction. The Democratic People’s Republic of Korea showed increases in both ASIR and ASMR, while Mongolia reported declines in ASIR and ASMR. Age distribution shifted markedly towards older populations in China, Japan, and the Republic of Korea. Smoking remained the predominant risk factor across HNC subtypes. Forecasts to 2038 project a continued rise in ASIR for Japan and the DPR of Korea, and a high ASMR for the DPR of Korea.

Conclusion

The HNC burden in East Asia exhibits divergent national trajectories, with smoking remaining the predominant attributable risk factor. Further research is needed to elucidate underlying causes of these cross-country disparities.

Unstructured spare time as an international predictor of adolescent crime

2026-05-15T14:00:00Z

by David Buil-Gil, Christopher Birkbeck, Dirk Enzmann, Karin Arbach, Marina Rezende Bazon, Muhamed Budimlić, Danielle T. Cooper, Marta Dąbrowska, Esther Fernández-Molina, Carolyn Gentle-Genitty, Aurea E. Grijalva-Eternod, Ewa M. Guzik-Makaruk, Sandrine Haymoz, Neal Hazel, Markus Kaakinen, Janne Kivivuori, Iza Kokoravec Povh, Camilla Løvschall Langeland, Patrik Manzoni, Anna Markina, Gorazd Meško, Sandra Kobajica Mišanović, Kim Moeller, Solbey Morillo-Puente, Aušra Pocienė, Zuzana Podaná, Juan Antonio Rodríguez, Margret Valdimarsdottir, Lars Westfelt, Ineke Haen Marshall

This study investigates whether unstructured spare time is a significant correlate of self-reported offending among adolescents in multiple countries. Drawing on survey data from 58,425 13-to-17-year-olds in 21 countries in Europe, North America, and South America, we examine whether time spent in unstructured out-of-home and at-home activities, as well as structured time at home, is associated with offending prevalence and incidence. Using multivariate models that control for key criminological predictors, we find that unstructured out-of-home spare time is a robust and consistent correlate of self-reported offending. Its estimated association is larger than that of most classical predictors. While structured spare time at home is associated with lower levels of offending, unstructured spare time, particularly out-of-home, is strongly linked to both prevalence and incidence of crime involvement. Country-specific analyses reveal that this pattern holds across most national samples. Simulation analyses suggest that modest reductions in unstructured out-of-home spare time may be associated with lower levels of adolescent offending. These findings indicate that unstructured time environments constitute a cross-culturally robust correlate of adolescent offending, with potential relevance across dispositional and opportunity-based explanations, and with implications for how prevention frameworks conceptualize adolescents’ everyday environments.

In vivo evaluation of binder jet 3D-Printed monetite, brushite, and octacalcium phosphate: A comparative study for bone regeneration in a rat calvarial defect model

2026-05-15T14:00:00Z

by Ticomporn Luangwattanawilai, Faungchat Thammarakcharoen, Autcharaporn Srion, Kasem Rattanapinyopituk, Jintamai Suwanprateeb, Ruedee Hemstapat

Background

Three-dimensional (3D)-printed hydroxyapatite (3DP-HA), fabricated via binder jetting of calcium sulfate-based powders followed by phase conversion, has demonstrated bone regeneration efficacy in both in vitro and in vivo studies. However, the inherently low solubility nature of hydroxyapatite (HA) led to slow resorption, which may impede new bone formation. This study aimed to evaluate the in vivo bone regeneration efficacy of three newly developed resorbable 3D-printed calcium phosphate scaffolds, including brushite (3DP-BRU), monetite (3DP-MO), and octacalcium phosphate (3DP-OCP), fabricated using the similar technology as 3DP-HA.

Methods

The scaffolds were implanted in a rat calvarial defect model and compared with control groups, including 3DP-HA and two commercial bone grafts: bovine bone graft (BBG) and freeze-dried bone allograft (FDBA). Bone regeneration and material resorption were assessed using micro-computed tomography (micro-CT), histological, and immunohistochemical analyses.

Results

Micro-CT and histological evaluations demonstrated that 3DP-MO and 3DP-BRU scaffolds significantly enhanced new bone formation and bone cell activities within the defect sites compared with the controls. Furthermore, both 3DP-MO and 3DP-BRU exhibited considerably lower residual graft material compared to the controls, indicating superior resorption characteristics.

Conclusion

Resorbable 3D-printed calcium phosphate scaffolds, particularly 3DP-MO and 3DP-BRU, exhibit superior resorbability and enhanced bone regeneration compared with conventional materials. These findings highlight their potential as promising biomaterials for clinical application in bone defect repair.

Backbone 3.0: An R package for extracting network backbones

2026-05-15T14:00:00Z

by Zachary P. Neal

The backbone package for R implements models for extracting the backbone – a sparse unweighted network containing only the most ‘important’ edges – from a weighted or unweighted network, where different models adopt different perspectives on what makes an edge important. The use of network backbones simplifies analysis and visualization when the original network is weighted or dense. This paper introduces and demonstrates the use of the backbone package for R to extract network backbones. After providing an overview of backbone’s workflow and structure, I describe several backbone extraction models, illustrating backbone extraction in a series of toy examples. I then present a complete empirical case study using bill sponsorship data from the 108^th U.S. Senate. I conclude with some recommendations for backbone extraction, and an agenda for planned extensions to backbone.

RF-SVR-based prediction methodology for metal tube-bending rebound: Handling non-uniformity and limited sample challenges

2026-05-15T14:00:00Z

by Ziluo Fang, Pengfei Zhang, Liangyou Li, Qingzhu Zhang

This paper explores a prediction algorithm for determining the rebound angle of non-uniform and small-sample tubes. To address the issues of non-uniform and small-sample data, this paper proposes an algorithm based on Random Forest-Support Vector Regression (RF-SVR). Firstly, the polynomial feature generation method is introduced to solve the problem of non-uniform data. Secondly, after obtaining the data generated by the polynomial features, RF (Random Forest, an algorithm based on classification trees) is introduced to select the rebound features of the tubes, so that the features that have a profound influence on the rebound Angle can be retained. After obtaining the new data set, SVR (Support Vector Regression, an algorithm specifically designed for solving regression problems) is used to predict the rebound model of the bending of the metal tubes. The experimental results show that the RF-SVR method is superior to the traditional RF-BP and SVR methods, achieving higher prediction accuracy on small samples and non-uniform datasets.

The relationship between task value of learning English and English achievement among art majors: A moderated chain mediation model analysis

2026-05-15T14:00:00Z

by Yan Qin, Xiaoming Wang, Bocun Zhang, Yue Zhang, Xiaoke Xie, Shihua Mao, Juan Wang, Yupeng Yang

Art majors often face a distinct learning context for English as a Foreign Language (EFL) learning, characterized by structural and cognitive barriers that increase the difficulty of engaging in English study. However, the motivational mechanisms linking task value of learning English to English achievement within this specific context remain underexplored. This study employed the expectancy-value-cost theory (EVCT) to investigate the role of task value in their unique learning context. By testing a moderated chain mediation model, it systematically analyzed the relationships among task value of learning English, learning engagement, learning procrastination, self-efficacy, and English achievement. An online survey was administered to 588 art majors from a university in China. Data were analyzed using SPSS 26.0, AMOS 24.0, and the PROCESS macro (Model 6 and 91) with bootstrap methods. The results revealed that task value was associated with English achievement not directly, but through a sequential pathway: it was positively related to learning engagement, which in turn was linked to reduced procrastination, and ultimately to better achievement. Learning engagement emerged as a pivotal sequential mediator, whereas procrastination did not mediate the relationship independently. Furthermore, self-efficacy moderated the association between learning engagement and procrastination, with a stronger negative link observed among students with high self-efficacy. These findings highlight the importance of fostering engagement and building self-efficacy to translate task value into successful learning outcomes for art majors, offering practical implications for instructional design in this unique context.

Lived experience of cognitive-communication changes for people with acquired brain injury and familiar communication partners: A qualitative evidence synthesis

2026-05-15T14:00:00Z

by Nicholas Behn, Iben Christensen, Madeline Cruice, Katerina Hilari, Ian Kellar, Leanne Togher

Background and objectives

Cognitive-communication disorder (CCD) is common after acquired brain injury (ABI), reported in about two-thirds of people who sustain an injury. Quantitative studies have found that the disorder can negatively impact a person’s ability to socially re-integrate into the community, return to work or education and achieve a good quality of life. However, little is known about how the disorder impacts people with ABI and the family. Therefore, the aim of this qualitative evidence synthesis was to provide a detailed exploration of the lived experience of CCD for people with ABI and their family members.

Methods

A systematic literature search was conducted across eight databases (CINAHL Ultimate, PsycINFO, PsycARTICLES, Medline, EMBASE, AMED, Scopus, PubMed) to August 2025. Studies were included if they reported on people with ABI who present with CCD (or similar term) and/or familiar communication partners whereby the impact of the disorder was described. Relevant data were extracted, and studies were critically appraised using the Critical Appraisal Skills Programme (CASP) qualitative checklist and the confidence of the findings was assessed using GRADE-CERQual tool. The final included studies were synthesised using thematic analysis.

Results

13 articles met the eligibility criteria and reported on 103 people with ABI with CCD and 66 familiar communication partners including spouses, parents, friends, carers, siblings and children. Methodologies comprised interviews (n = 10), focus groups (n = 1), spoken discourse samples (n = 1) and online survey (n = 1). Eight main analytic themes were identified centred around the experiences of both people with ABI: (1) communicating is not easy; (2) lack of awareness and feeling tired; (3) anxiety, embarrassment and isolation; (4) connecting with others; and (5) participation and identity; and their familiar communication partner: (6) adjusting to giving increased support; (7) emotional toll of supporting; (8) relationship and life role changes.

Conclusions

This review highlights the broad and unique impacts of CCD for both people with ABI and their familiar communication partners. People with ABI require tolerance to manage their communication difficulties; and communication partners require education, support and training to manage the change in relationship. These findings underpin the need for interventions to include partners in rehabilitation and for therapists to consider the diverse needs of people with ABI including emotions, relationships, social participation and changes to identity.

A curated dataset and lightweight deep learning framework for tea leaf disease classification

2026-05-15T14:00:00Z

by Sakibul Hasan Chowdhury, Md Shohel Arman, Masrafe Bin Hannan Siam, Md Rayhan Khan, Afia Hasan, Parvez Ahmed Moju Fahim

Tea (Camellia sinensis) is the world’s second most consumed beverage, enjoyed daily by more than two billion people. In Bangladesh, it serves as a cornerstone agricultural export and a major sector of the domestic economy. However, commercial tea cultivation remains highly vulnerable to fungal and pest-related diseases such as Blight, Red Rust, and Helopeltis which severely reduce crop yield and compromise leaf quality. While early detection is critical to preventing widespread outbreaks, traditional manual inspection is slow, subjective, and highly error-prone. Deep learning provides a scalable alternative, yet single-branch networks often struggle to capture both minute disease lesions and broader structural degradation simultaneously. To address this, we propose a Hybrid Feature Fusion architecture that runs two highly efficient feature extractors in parallel: EfficientNetV2-Small to isolate fine-grained local textures, and MobileNetV3-Small to capture the global structural context of the leaf. The models were trained and evaluated on a real-world dataset of 2,000 annotated images, evenly distributed across the four target classes (Blight, Red Rust, Helopeltis, and Healthy). Before training, the images underwent a standardized preprocessing pipeline including resizing to 224 × 224 pixels and normalization, supplemented by a dynamic augmentation strategy featuring random rotations, horizontal flips, and brightness adjustments to improve model robustness. The proposed hybrid framework achieved an outstanding peak classification accuracy of 96.80% alongside a macro Area Under the Curve (AUC) of 0.9980. To rigorously validate its performance, the hybrid model was benchmarked against six diverse architectures: a Vision Transformer (ViT-B16 at 76.40%), a Custom CNN (89.60%), MobileNetV3 (94.40%), ResNet50 (95.60%), DenseNet121 (96.40%), and EfficientNetV2-B3 (97.60%). Although EfficientNetV2-B3 achieved a marginally higher raw accuracy, the proposed dual-branch framework delivered a superior precision-recall balance and faster convergence stability. These findings demonstrate that the proposed hybrid methodology is highly reliable and computationally balanced, making it an ideal candidate for integration into Internet of Things (IoT) edge devices for real-time disease monitoring in precision agriculture.

Social factors related to the quality of life among older adults in southwestern Poland

2026-05-15T14:00:00Z

by Antonina Kaczorowska, Małgorzata Kołodziej, Anna Sebastjan, Zofia Ignasiak

Background

The quality of life of older adults is closely linked to functioning in the living environment. This study aims to assess the quality of life of older adults in southwestern Poland and the social factors determining it.

Methods

This cross-sectional study included a voluntary sample of 1108 older adults aged 60‒90. The WHOQoL-BREF questionnaire was used to assess quality of life.

Results

The overall quality of life of the respondents (57%) was good. Men had a better quality of life in the psychological (69.0 ± 9.5 vs. 63.0 ± 6.5, p < 0.001) and environmental (69.0 ± 6.0 vs. 63.0 ± 9.5, p < 0.01) domains compared to women. In comparison, those living in a relationship had a better quality of life in the somatic (75.0 ± 9.0 vs. 69.0 ± 9.0, p = 0.034), social (75.0 ± 12.5 vs. 69.0 ± 9.5, p < 0.001), and environmental (69.0 ± 6.0 vs. 63.0 ± 9.5, p < 0.001) domains. Those with higher education had a better quality of life in the somatic (75.0 ± 6.0 vs. 69.0 ± 9.0 and 69.0 ± 9.0, p < 0.001), psychological (69.0 ± 6.5 vs. 63.0 ± 9.5 and 63.0 ± 6.5, p < 0.001), and environmental (69.0 ± 6.0 vs. 63.0 ± 9.5 and 63.0 ± 6.5, p < 0.001) domains compared to those with secondary and primary education. Respondents in good health had a better quality of life in all domains.

Conclusions

Good quality of life in older adults surveyed is determined by male gender, marital status in a relationship, higher education, good health ratings, and fewer chronic diseases. Our results can guide policymakers, highlighting the fact that good health, fewer chronic diseases, and higher education, translate into a better quality of life. Therefore, there should be improved access to education for all people. And good population health should be prioritized by decision-makers.

Trial registration

ISRCTN platform as 18225729; January 2021.

Chrysoprase color grading with machine learning: A systematic approach

2026-05-15T14:00:00Z

by Yuansheng Jiang, Ying Guo, Vien Cheung, Pohsun Wang, Stephen Westland

The color of gemstones plays a pivotal role in determining their quality and significantly impacts their market value. However, inconsistencies in gemstone color evaluation, stemming from the subjective nature of color perception, have hindered standardization in the market. Chrysoprase, celebrated for its distinctive apple-green color, is no exception. To address these challenges, this study employs a machine learning-based approach to automate chrysoprase color grading. CIE (1976) L^*a^*b^* data were measured for 51 chrysoprase samples and 676 green reference points generated using the GemDialogue Color Reference using an X-Rite SP62 spectrophotometer. K-means was applied for color clustering, with Fisher discriminant analysis used to validate the clustering results. Various machine learning algorithms, including logistic regression, neural networks, k-nearest neighbors, support vector machines, and random forest, were trained on labeled data to assign chrysoprase colors to different groups. Logistic regression and neural network achieved comparably high macro F1-scores, and logistic regression was ultimately selected due to its simplicity, interpretability, and computational efficiency. In independent evaluation on 51 real chrysoprase samples, all samples were correctly classified within the present dataset. Additional mixed cross-validation incorporating both synthetic and real samples yielded consistent performance (macro F1-score = 99.59%), further supporting the robustness of the proposed approach. These results demonstrate the feasibility of applying machine learning techniques to structured gemstone color grading. The proposed framework provides a reproducible approach for objective chrysoprase color evaluation and may be adaptable to other gemstones with comparable colorimetric characteristics, subject to further validation. A publicly accessible chrysoprase color grading application is available at: https://github.com/harden2009190006/Chrysoprasecolorclassifier.

Health commodities inventory management performance and associated challenges in selected public health facilities of South Gondar Zone, Amhara Region, North Central Ethiopia: A mixed-methods cross-sectional study

2026-05-15T14:00:00Z

by Zewdu Tessema, Tesfaye Tsigu, Zelalem Tilahun, Gashew Tessema, Ayenew Berhan, Eskinder Eshetu Ali

Introduction

In the healthcare system, the supply chain refers to the coordinated flow of physical and technical resources needed to deliver quality patient care while adhering to budget constraints. To achieve this, measuring inventory management performance is essential. This process involves evaluating the efficiency and effectiveness of activities against predefined standards using established indicators. Therefore, this study aimed to assess the inventory management performance of health facilities in the South Gondar Zone, Northcentral Ethiopia.

Methods

This study employed a facility-based cross-sectional study design with a concurrent mixed-methods approach. Eighteen health facilities, representing 30% of the 57 health facilities in the South Gondar Zone, were included in this study. Quantitative data were collected using structured tools and analyzed in Microsoft Excel. Meanwhile, qualitative data were gathered from expert interviews and thematically analyzed to identify the major challenges faced by these facilities.

Results

Emergency ordering was frequent, with 83.3% of facilities placing at least one emergency order in 2020–2021, increasing to 100% placing two or more orders in 2021–2022. Inventory record accuracy was suboptimal, with an average accuracy rate of 71.3% (±9.6), and only 16.7% of facilities maintained up-to-date stock cards. While reporting rates were high (98.2%), report completeness (52.8%) and accuracy (72.2%) remained inconsistent. Storage performance was inadequate, as only 16.7% of facilities met acceptable storage standards (≥80% of criteria), despite high compliance with vaccine cold-chain requirements (94.1%). Qualitative findings identified human resource constraints, limited training, weak data management systems, and inadequate infrastructure as key contributors to poor inventory performance.

Conclusion

The performance of inventory management for health commodities in the study health facilities is low. This is primarily due to a shortage of skilled personnel, insufficient management support and budget, a lack of ongoing professional training, poor record-keeping practices, inaccurate data quality, and inadequate storage conditions. This investigation discovered that the frequency of emergency orders is the most important indicator, and all responsible bodies should pay more attention to reducing it, in addition to implementing other sound inventory management operations to build a strong health care delivery system.

Real world experience with cyclin dependent kinase inhibitors in metastatic breast cancer in India

2026-05-15T14:00:00Z

by Anindya Mukherjee, Pankaj Goyal, Rupal Tripathi, Sumit Goyal, Ullas Batra, Vineet Talwar, Varun Goel, Arpit Jain, Shekhar Saha, Sneha Bothra, Chaturbhuj Agrawal, Swati Chugh, Dinesh Chandra Doval

Background

The present study evaluated the real-world experience with cyclin dependent kinase 4/6 inhibitors palbociclib and ribociclib in hormone receptor-positive/ human epidermal growth factor receptor 2-negative (HR + /HER2-) metastatic breast cancer.

Method

This study was conducted on the HR + /HER2- metastatic breast cancer patients who received palbociclib/ ribociclib in the first line or recurrent setting between January 2021 and January 2023 along with endocrine therapy. Data was retrieved from the Hospital medical records.

Results

In the patients receiving palbociclib, a better median progression free survival (PFS) was observed in patients with Eastern Cooperative Oncology Group (ECOG) performance status (PS) 1 (27.3 months,p-value <0.0001), de novo disease (17.5 months,p-value 0.0155), first line hormonal therapy (22.5 months,p-value <0.0001) and no prior chemotherapy (20.3 months,p-value 0.0001). Similarly, in the patients receiving ribociclib, a better median PFS was observed in patients with ECOG PS 1 (22.2 months,p-value <0.0001), de novo disease (21.7 months,p-value 0.0042), first-line hormonal therapy (22.5 months,p-value <0.0001) and no prior chemotherapy (21.7 months,p-value <0.0001). On multivariate analysis, ECOG PS, line of hormone therapy and prior chemotherapy showed significance (p-values <0.0001, < 0.0001 & 0.0269, respectively).

Conclusion

The study shows real-world experience with cyclin dependent kinase 4/6 inhibitors palbociclib and ribociclib in metastatic breast cancer in India.

Gender, status, and team interaction: A microdynamic exploration of wearable sensor data across 11 research groups

2026-05-15T14:00:00Z

by Jörg Müller, Alvaro Uzaheta, Julián Salas Piñón

Diversity research is increasingly moving beyond a static focus on linear relationships between team-level diversity attributes and outcomes toward a dynamic, configurational perspective on team processes. Recent developments emphasise the structural dimensions of interpersonal relations within teams and how dyadic relationships, mutual perceptions, and behaviours shape team-level outcomes over time. Drawing on real-world organisational data, we apply a hierarchical Dynamic Actor Network Model to examine the role of gender homophily, professional status, and gender-based status cues in face-to-face interactions across 11 R&D teams. Our analysis of wearable sensor data reveals nuanced patterns that challenge any clear-cut diversity effects within teams. Although mixed‑gender interactions are generally more common, the interplay between professional status and gender‑based status cues changes across organisational contexts. Professional status shows no clear effect on interaction frequency, whereas gender‑based status effects are observed in research laboratories but not in private companies. These findings underscore the continued relevance of demographic attributes and associated status dynamics, while highlighting the value of a configurational and temporally sensitive approach to understanding team interaction.