Search Results (9,244)

Background: Caesarean section (CS) is a critical intervention, yet stark inequities in access persist across low- and middle-income countries (LMICs). Over the last decade, governments have introduced policies to eliminate or subsidize user fees; however, the collective impact of these initiatives on utilization, equity, and financial protection has not been fully synthesized. Methods: We conducted a systematic review in line with PRISMA 2020 guidelines. Searches were conducted in PubMed, Dimensions, Google Scholar, Scopus, Web of Science, and government portals for studies published between 1 January 2009 and 30 May 2025. Eligible studies evaluated government-initiated financing reforms, including full user-fee exemptions, partial subsidies, vouchers, insurance schemes, and provider-payment restructuring. Two reviewers independently applied the PICOS criteria, extracted data using a 15-item template, and assessed the study quality. Given heterogeneity, results were synthesized narratively. Results: Thirty-seven studies from 28 LMICs were included. Most (70%) evaluated fee exemptions. Mixed-methods and cross-sectional designs predominated, while only six studies employed interrupted time series designs. Twenty-two evaluations (59%) reported increased CS uptake, ranging from a 1.4-fold rise in Senegal to a threefold increase in Kano State, Nigeria. Similar surges were also observed in non-African contexts such as Iran and Georgia, where reforms included incentives for vaginal delivery or punitive tariffs to curb overuse. Fourteen of 26 fee-exemption studies documented pro-rich or pro-urban drift, while catastrophic expenditure persisted for 12–43% of households, despite the implementation of “free” policies. Median out-of-pocket costs ranged from USD 14 in Burkina Faso to nearly USD 300 in Dakar’s slums. Only one study linked reforms to a reduction in neonatal mortality (a 30% decrease in Mali/Benin), while none demonstrated an impact on maternal mortality. Qualitative evidence highlighted hidden costs, delayed reimbursements, and weak accountability. At the same time, China and Bangladesh demonstrated how demographic reforms or voucher schemes could inadvertently lead to CS overuse or expose gaps in service readiness. Conclusions: Government-led financing reforms consistently increased CS volumes but fell short of ensuring equity, financial protection, or sustained quality. Effective initiatives combined fee removal with investments in surgical capacity, timely reimbursement, and transparent accountability. Future CS policies must integrate real-time monitoring of equity and quality and adopt robust quasi-experimental designs to enable mid-course correction. Full article

To address the bottleneck issues of traditional concrete T-beams, such as excessive self-weight, susceptibility to cracking, and insufficient durability, this study investigates the flexural performance of Ultra-High-Performance Concrete (UHPC) T-beams. Through systematic experiments, the combined effects of three UHPC material ratios and three rebar schemes were analyzed. Six UHPC T-beam specimens were designed, and flexural performance tests were conducted using a staged loading approach, focusing on crack propagation, failure modes, and load-deflection curves to reveal their mechanical behavior and failure mechanisms. The results indicate that steel fibers significantly enhance UHPC toughness. At a fiber content of 1.5%, the specimens exhibited a yield load of 395–418 kN, with an ultimate load increase of 93% compared to the fiber-free specimens. The failure mode transitioned from brittle shear to ductile flexural. Increasing the rebar ratio improved load-bearing capacity, with a 4.58% rebar ratio yielding an ultimate load of 543 kN (51% higher than B1-02), but reduced ductility by 36%. Steel fibers restricted crack widths to 0.1 mm via crack-bridging effects, raising the cracking load by 53% and the shear capacity by 2.8 times. UHPC mix ratio adjustments had a limited impact on beam performance at the same fiber content. Overall, UHPC T-beams exhibited a compressive concrete crushing-dominated failure mode, with load-deflection curves showing a 42% gentler slope than conventional concrete. The ductility coefficient ranged from 3.8 to 5.2. For engineering applications, it is recommended to maintain a steel fiber content of at least 1.5% and a rebar ratio of 2.5–4.0% to strike a balance between strength and ductility. Full article

Barium strontium titanates (Ba_1−xSr_xTiO₃, BST) with varying barium-to-strontium ratios were synthesized by the solid-state route (SSR) as well as by the sol–gel process (SGP). In the case of the SSR, the strontium amount x was varied from 0.0 to 0.25 in 0.05 steps, due to the enhanced synthetic effort, and in the case of the SGP, x was set only to 0.05, 0.15, and 0.25. The resulting properties after synthesis, calcination, and sintering, like particle size distribution, specific surface area, particle morphology, and crystalline phase were characterized. The expected tetragonal phase, free from any remarkable impurity, was found in all cases, and irrespective of the selected synthesis method. Pressed pellets were used for the measurement of the temperature and frequency-dependent relative permittivity enabling the estimation of the Curie temperatures of all synthesized BSTs. Irrespective of the selected synthesis method, the obtained Curie temperature drops with increasing strontium content to almost identical values, e.g., in the case of x = 0.15, a Curie temperature range 95–105 °C was measured. Thin BST films could be deposited on different substrate materials applying electrophoretic deposition in a good and reliable quality according to the Hamaker equation. The properties of the BSTs obtained by the simpler solid-state route are almost identical to the ones yielded by the more complex sol–gel process. In future, this result allows for a possible wider usage of BST perovskites for ferroelectric and piezoelectric devices due to the easy synthetic access by the solid-state route. Full article

The article addresses the challenges of beam position tracking in Free-Space Optical Communication (FSOC) systems. A review of available photodetector technologies is presented, highlighting their operating principles and applications in optical links. The analysis indicates that most current monitoring devices function with the visible and near- or short-infrared ranges. However, due to the propagation characteristics of radiation in terrestrial environments, the mid-wave infrared (MWIR) region offers particularly promising opportunities. To the end, the work introduces a novel detector module based on an MWIR quadrant detector capable of simultaneously performing two essential tasks: monitoring beam position and receiving transmitted data. Such an integrated approach has the potential to significantly simplify the design of mobile FSOC systems, especially those requiring accurate transceivers’ tracking. The concept was validated through laboratory experiments on an MWIR link model, where both the signal bandwidth and position transfer function of the quadrant detector were examined. Full article

Precision medicine approaches rely on accurate somatic variant detection, where the DNA input into genomic workflows is a key variable. However, there are no gold standard methods for total DNA quantification. In this study, a pentaplex reference gene panel using digital PCR (dPCR) was developed as a candidate reference method. The multiplex approach was compared between two assay chemistries, applied to healthy donor genomic DNA and plasma cell-free DNA (cfDNA) to measure the ERBB2 (HER2) copy number variation in cancer cell line DNA. The multiplex approach demonstrated robust performance with the two assay chemistries, demonstrating comparable results and a wide dynamic range. Ratios of reference genes were close to the expected 1:1 in healthy samples; however, some small but significant differences (<1.2-fold) were observed in one of the five targets. Expanded relative measurement uncertainty was 12.1–19.8% for healthy gDNA and 9.2–25.2% for cfDNA. The multiplex approach afforded lower measurement uncertainty compared to the use of a single reference for total DNA quantification, which is an advantage for its potential use as a calibration method. It avoided potential biases in the application to CNV quantification of cancer samples, where cancer genome instability may be prominent. Full article

Background/Objectives: Neuroblastoma (NB) is an aggressive pediatric malignancy that accounts for nearly 15% of all childhood cancer-related deaths, with high-risk cases showing a poor 20% prognosis and limited response to current therapies. Survivin, encoded by the BIRC5 gene, is an anti-apoptotic protein frequently overexpressed in NB and linked to treatment resistance and unfavorable clinical outcomes. Methods and Results: An analysis of 1235 NB patient datasets revealed a significant association between elevated BIRC5 expression and reduced overall and event-free survival, highlighting survivin as an important therapeutic target in NB. To explore this strategy, we evaluated the efficacy of YM-155, a small-molecule survivin inhibitor, across multiple NB cell lines. YM-155 displayed potent cytotoxic activity in six NB cell lines with IC₅₀ values ranging from 8 to 212 nM and significantly inhibited colony formation and 3D spheroid growth in a dose-dependent manner. Mechanistic analyses revealed that YM-155 downregulated survivin at both mRNA and protein levels, induced apoptosis by about 2–7-fold, and caused G0/G1 phase cell cycle arrest. Moreover, YM-155 treatment enhanced p53 expression, suggesting reactivation of tumor suppressor pathways. Notably, combining YM-155 and the chemotherapeutic agent etoposide resulted in synergistic inhibition of NB growth with ED75 values ranging from 0.17 to 1, compared to either agent alone. In the xenograft mouse model, YM-155 inhibited tumor burden in contrast to controls by about 3-fold, and without any notable toxic effects in vivo. Conclusion: Overall, our findings identify YM-155 as a promising therapeutic agent for high-risk NB by directly targeting survivin and enhancing chemosensitivity. These results support continued preclinical development of survivin inhibitors as part of rational combination strategies in pediatric cancer treatment. Full article

We present a theoretical model to explain how tubulin dimers in neuronal microtubules might achieve collective quantum coherence, resulting in wavefunction collapses that manifest as avalanches within a self-organized criticality (SOC) framework. Using the Orchestrated Objective Reduction (Orch-OR) theory as inspiration, we propose that microtubule subunits (tubulins) become transiently entangled via dipole–dipole couplings, forming coherent domains susceptible to sudden self-collapse. We model a network of tubulin-like nodes with scale-free (Barabási–Albert) connectivity, each evolving via local coupling and stochastic noise. Near criticality, the system exhibits power-law avalanches—abrupt collective state changes that we identify with instantaneous quantum wavefunction collapse events. Using the Diósi–Penrose gravitational self-energy formula, we estimate objective reduction times $T_{\mathrm{OR}}=\hslash /E_g$ for these events in the 10–200 ms range, consistent with the Orch-OR conscious moment timescale. Our results demonstrate that quantum coherence at the tubulin level can be amplified by scale-free critical dynamics, providing a possible bridge between sub-neuronal quantum processes and large-scale neural activity. Full article

Monitoring contamination in soil and food systems remains vital for ensuring environmental and public health, particularly in agriculture-intensive regions. Existing laboratory-based techniques are often time-consuming, equipment-dependent, and impractical for rapid on-site screening. In this study, we present a portable, non-faradaic electrochemical impedance-based sensing platform capable of simultaneously detecting Salmonella Typhimurium (S. Typhi) and Aflatoxin B1 in spiked soil run-off samples. The system employs ZnO-coated electrodes functionalized with crosslinker for covalent antibody immobilization, facilitating selective, label-free detection using just 5 µL of sample. The platform achieves a detection limit of 1 CFU/mL for S. Typhi over a linear range of 10–10⁵ CFU/mL and 0.001 ng/mL for Aflatoxin B1 across a dynamic range of 0.01–40.96 ng/mL. Impedance measurements captured with a handheld potentiostat were strongly correlated with benchtop results (R² > 0.95), validating its reliability in field settings. The duplex sensor demonstrates high precision with recovery rates above 80% and coefficient of variation below 15% in spiked samples. Furthermore, machine learning classification of safe versus contaminated samples yielded an ROC-AUC > 0.8, enhancing its decision-making capability. This duplex sensing platform offers a robust, user-friendly solution for real-time environmental and food safety surveillance. Full article

Coronaviruses (CoVs) were first described in poultry in the early 1930s and formally recognized as pathogens of both animal and human populations in the late 1960s. They are now considered among the most abundant viral families in the world. Though their distribution and diversity remain understudied in wild animals, representatives from 13 orders of wild birds worldwide have tested positive for CoVs of the gamma and delta genera over the last 25 years. Many of these wild bird species are in the orders Charadriiformes (shorebirds and their relatives) and Anseriformes (waterfowl including ducks, geese, and swans). Waterfowl are particularly concerning as potential reservoirs for CoVs because they are globally distributed; often congregate in large, mixed-species flocks; and may exist in close proximity to humans and domesticated animals. This review describes the history and current knowledge of CoVs in birds, provides an updated list of global detections of CoVs in 124 species of wild birds as reported in the peer-reviewed literature since 2000, and highlights topics for future research that would help elucidate the role of waterfowl in CoV transmission. Our review reiterates the need for continuous surveillance to detect and monitor CoVs across all bird species and for standardization in data reporting and analysis of both negative and positive results. Such information is critical to understand the potential role of free-ranging birds in the maintenance, evolution, and transmission of the virus. Further, we believe that research on the potential impacts of coronavirus infections and coinfections on avian demographics, especially reproduction in waterfowl, is warranted given known consequences in domestic poultry. Full article

LoRa is a long-range, low-power wireless communication technology widely used in Internet of Things (IoT) applications. However, its conventional implementation through Long Range Wide Area Network (LoRaWAN) presents operational constraints due to its centralized topology and reliance on gateways. To overcome these limitations, this work designs and validates a gateway-free mesh communication system that operates directly on commercially available commodity microcontrollers, implementing lightweight self-healing mechanisms suitable for resource-constrained devices. The system, based on ESP32 microcontrollers and LoRa modulation, adopts a mesh topology with custom mechanisms including neighbor-based routing, hop-by-hop acknowledgments (ACKs), and controlled retransmissions. Reliability is achieved through hop-by-hop acknowledgments, listen-before-talk (LBT) channel access, and duplicate suppression using alternate link triggering (ALT). A modular prototype was developed and tested under three scenarios such as ideal conditions, intermediate node failure, and extended urban deployment. Results showed robust performance, achieving a Packet Delivery Ratio (PDR), the percentage of successfully delivered DATA packets over those sent, of up to 95% in controlled environments and 75% under urban conditions. In the failure scenario, an average Packet Recovery Ratio (PRR), the proportion of lost packets successfully recovered through retransmissions, of 88.33% was achieved, validating the system’s self-healing capabilities. Each scenario was executed in five independent runs, with values calculated for both traffic directions and averaged. These findings confirm that a compact and fault-tolerant LoRa mesh network, operating without gateways, can be effectively implemented on commodity ESP32-S3 + SX1262 hardware. Full article

Aroma and flavor are central to consumer perception, product acceptance, and market positioning of animal-derived foods such as meat, milk, and eggs. These sensory traits arise from volatile organic compounds (VOCs) formed via lipid oxidation (e.g., hexanal, nonanal), Maillard/Strecker chemistry (e.g., pyrazines, furans), thiamine degradation (e.g., 2-methyl-3-furanthiol, thiazoles), and microbial metabolism, and are modulated by species, diet, husbandry, and post-harvest processing. Despite extensive research on food volatiles, there is still no unified framework spanning meat, milk, and eggs that connects production factors with VOC pathways and links them to sensory traits and consumer behavior. This review explores how production systems, feeding strategies, and processing shape VOC profiles, creating distinct aroma “fingerprints” in meat, milk, and eggs, and assesses their value as markers of quality, authenticity, and traceability. We have also summarized the advances in analytical techniques for aroma fingerprinting, with emphasis on GC–MS, GC–IMS, and electronic-nose approaches, and discuss links between key VOCs and sensory patterns (e.g., grassy, nutty, buttery, rancid) that influence consumer perception and willingness-to-pay. These patterns reflect differences in production and processing and can support regulatory claims, provenance verification, and label integrity. In practice, such markers can help producers tailor feeding and processing for flavor outcomes, assist regulators in verifying claims such as “organic” or “free-range,” and enable consumers to make informed choices. Integrating VOC profiling with production data and chemometric/machine learning pipelines can enable robust traceability tools and sensory-driven product differentiation, supporting transparent, value-added livestock products. Thus, this review integrates production variables, biochemical pathways, and analytical platforms to outline a research agenda toward standardized, transferable VOC-based tools for authentication and label integrity. Full article

A new sensor system for the determination of nitrogen-containing pharmaceutical substances has been proposed. It is based on the use of an ion association complex formed between cationic polyacrylamide (CPAA) and sulfonephthalein dye as a reagent. Bromocresol purple (BCP) interacts with CPAA to form a complex through hydrophobic interaction as well as electrostatic interaction. In the pH range from 3.5 to 5.5, this leads to an increase in the intensity of the dianionic form BCP band at 590 nm. The interaction between the polymer and the dye leads to an increase in the acidic properties of BCP, causing its pK_a2 to shift from 6.3 to 3.75. Subsequently, when loratadine (LOR) is added to the CPAA/BCP system, the strong electrostatic interaction between the BCP monoanion and the protonated form of LOR leads to a decrease in the intensity of the band at 590 nm and an increase in the absorbance of the band at 432 nm, which is related to the dye monoanion. Here, we have demonstrated that this facile methodology can enable the rapid, reliable, and selective determination of LOR with a detection limit of 1.6 mg L⁻¹ and a linear range from 5.0 to 120 mg L⁻¹. The environmental friendliness of the developed method was assessed using the AGREE metric and is characterized by a high score of 0.83. The developed method represents a new approach to the creation of extraction-free spectrophotometric methods based on ionic associates of anionic dyes with protonated forms of nitrogen-containing medicinal compounds. The method was successfully applied to the determination of LOR in pharmaceutical preparations with satisfactory precision and accuracy. Overall, the results obtained indicate that this method has great potential for application in pharmaceutical analysis. Full article

A novel, cost-effective, label-free biosensing strategy has been established for real-time quantification of alkaline phosphatase (ALP) activity, integrating the Tyndall effect with smartphone imaging technology. This method utilizes a handheld laser diode to probe the enzyme-triggered in situ assembly of Cu-guanosine monophosphate (Cu-GMP) coordination polymers, which exhibit tunable Tyndall scattering properties. In the absence of ALP, Cu²⁺ ions chelate with GMP to form Cu-GMP coordination polymers, generating an intense Tyndall effect. Conversely, ALP-mediated hydrolysis of GMP disrupts the formation of Cu-GMP coordination polymers, resulting in diminished light scattering. The intensity of the Tyndall effect is directly proportional to the concentration of Cu-GMP coordination polymers, which in turn correlates with ALP activity levels. A comprehensive investigation of experimental parameters was conducted, including pH, incubation temperature, GMP concentration, incubation time, synthesis duration, and CuSO₄ concentration. Under optimized conditions, the developed smartphone-assisted colorimetric assay enables the detection of ALP activity within the range of 0.375–3.75 U/mL, with a limit of detection of 0.184 U/mL. The application of this method to serum samples yielded recovery rates ranging from 102.6% to 109.0%. In summary, this smartphone-based colorimetric platform offers a portable and versatile approach for instrument-free detection of ALP activity, with potential applications in point-of-care diagnostics and resource-limited settings. Full article

This work explores the integration of Proton Exchange Membrane (PEM) electrolysis waste heat with district heating networks (DHN), aiming to enhance the overall energy efficiency and economic viability of hydrogen production systems. PEM electrolysers generate substantial amounts of low-temperature waste heat during operation, which is often dissipated and left unutilised. By recovering such thermal energy and selling it to district heating systems, a synergistic energy pathway that supports both green hydrogen production and sustainable urban heating can be achieved. The study investigates how the electrolyser’s operating temperature, ranging between 50 and 80 °C, influences both hydrogen production and thermal energy availability, exploring trade-offs between electrical efficiency and heat recovery potential. Furthermore, the study evaluates the compatibility of the recovered heat with common heat emission systems such as radiators, fan coils, and radiant floors. Results indicate that valorising waste heat can enhance the overall system performance by reducing the electrolyser’s specific energy consumption and its levelized cost of hydrogen (LCOH) while supplying carbon-free thermal energy for the end users. This integrated approach contributes to the broader goal of sector coupling, offering a pathway toward more resilient, flexible, and resource-efficient energy systems. Full article

Backyard poultry systems (BPS) are the most widespread form of animal production worldwide, contributing to household economies and improving food availability. However, limited biosecurity measures and close human–animal interactions raise concerns regarding zoonotic disease transmission. In recent years, consumer-driven motivations have given rise to non-traditional BPS with differential attributes (BPS-DA), yet there is limited knowledge about their food production practices. This study aimed to characterize and compare practices across 25 BPS and 25 BPS-DA in the Metropolitan Region using surveys, interviews, and direct observations of egg collections and poultry slaughters. Eggs were the main animal product in both systems, with women primarily responsible for care. Poultry slaughter was reported exclusively in BPS (60%), generally performed under inadequate hygienic conditions and without veterinary oversight. These practices, (poultry slaughter, food production and handling), may considerably increase the risk of human exposure to zoonotic pathogens, such as avian influenza viruses. In contrast, BPS-DA prioritized birds as companion animals (60%), free-range rearing (68%), and hobby-based production (80%). While both systems showed limited biosecurity, significant differences were found in the use of dedicated footwear (p = 0.01; V = 0.35), egg collection sites (p = 0.04; V = 0.29), and refrigeration (p = 0.004; V = 0.41). Veterinary access was limited in both (32% in BPS; 44% in BPS-DA). These findings highlight critical gaps in health management and underscore the need for context-specific educational and regulatory strategies for safer backyard poultry production. Full article