GERIATRICS 10.21926/obm.geriatr.2604342
Authors: André M. Suguihura Maycon J. Ferreira Alexia P. Hammonds Vilma Gómez Lucimere Bohn Emerson Sebastião
Despite well-established health benefits of regular physical activity, participation rates remain suboptimal among adults, particularly older adult populations. More evident during the COVID-19 pandemic, online exercise training has emerged as an interesting strategy for different groups of individuals to remain physically active. The present study explored perceptions, barriers, and facilitators of online exercise training in adults at different stages of adulthood. This qualitative study was a secondary analysis of de-identified data from semi-structured interviews previously conducted by an exercise specialist with 14 adult participants who had engaged in online exercise training for at least one year. Interviews were conducted via Zoom, transcribed verbatim, and analyzed thematically by the research team. Across the 14 interviews with adults at different stages of adulthood (aged 34-71 years), four major themes emerged: (1) benefits of online exercise training, (2) enablers of online exercise training, (3) challenges of online exercise training, and (4) client and professional profile. Participants described perceived benefits, barriers, and facilitators of online exercise training, including convenience, individualized guidance, technological challenges, and digital literacy demand. These findings provide context for understanding how adults across adulthood, including older adults, experience online exercise training but do not establish comparative effectiveness, causal effects on adherence, or sustained engagement. ]]>Authors: Muhammad Haziq
The Internet of Underwater Things (IoUT) has significantly improved underwater communication. However, due to the unique and challenging characteristics of underwater acoustic channels, such as long multipaths, high propagation delay and Doppler variation, and severe energy and bandwidth limitation, IoUT networks are highly vulnerable to security threats. These conditions make conventional Internet of Things (IoT) intrusion detection systems (IDS) less effective. Improving the security of IoUT networks requires specialised intrusion detection approaches tailored to address these challenges. This paper reviews intrusion detection in IoUT. It describes the architecture of IoUT networks, and demonstrates how the channel dynamics affect the capabilities of an IDS. It also categorises threats across the physical, data link, network, transport, and application layers, together with cross-layer attacks, insider threats, and advanced persistent threats. Furthermore, the review compares anomaly-based, trust-based, and hybrid detection frameworks, with emphasis on machine learning, federated learning, blockchain-assisted security, and density-based clustering. The results are compared based on evaluation metrics, latency, energy efficiency, and computational complexity. Finally, the paper outlines open challenges and future research directions, focusing on cross-layer detection, communication-efficient federated learning, adaptive thresholding, dataset availability, and validation at sea. ]]>Authors: Yohannes Shuka Jara Mekonnen Abera Anbesa
Today, the global community is facing significant environmental challenges due to widespread pollution entering ecosystems, such as toxic dyes in water bodies. This global issue requires environmentally conscious approaches and the development of innovative, eco-friendly and affordable solutions. In this study, activated carbon (AC) derived from Vernonia amygdalina stem bark (VA) was prepared by the chemical activation method as an efficient biosorbent for the removal of methylene blue (MB) from the water system. The porosity, structural characteristics, and morphology of the prepared VA biosorbent were investigated using the iodine number, methylene blue (MB) number, pH point of zero charge (pHpzc), Fourier-transform infrared spectroscopy (FT-IR), and scanning electron microscopy (SEM). The analysis revealed that the biosorbent has higher microporosity with a greater sorption capacity, interactions of functional groups on a slightly acidic surface, and changes in morphology before and after adsorption. The maximum removal efficiency of 95% was achieved at optimal conditions, which were determined to be a dosage of 0.25 mg/L, pH 8, 10 mg/L MB concentration, 60 min contact time, and 55°C for the batch studies. Thermodynamic analysis indicated a endothermic character, spontaneous, interfacial randomness and weak physical adsorption process. Adsorption isothermal studies best fit the Langmuir model (R2 = 0.99) with a maximum capacity of 3.94 mg·g-1, and kinetic data followed a pseudo-second-order model (R2 = 0.99). Finally, the results show that activated carbon derived from VA stems bark offers a cost-effective, eco-friendly, and practical solution for removing toxic chemicals from water systems. ]]>TRANSPLANTATION 10.21926/obm.transplant.2604278
Authors: Uzodinma Onwuasoanya Brown Uyobong Williams Rex-Ogbuku Billy Musa Paul Onah
Kidney transplantation is the treatment of choice for patients with end-stage renal disease. Kidneys with complex vascular anatomy are prevalent in donors, and due to donor shortage, the acceptance of these kidneys for transplantation has increased over time. Donor kidneys with both complex vascular and urological anatomy are rare and using it in a recipient for second kidney transplantation with successful outcome is very rare. We report a case managed at our facility. A 40-year-old male presented at the urology clinic, Zenith Medical and Kidney Center, Abuja, Nigeria, as a potential kidney donor for a 62-year-old male with end-stage kidney disease (ESKD) secondary to human immunodeficiency virus-associated nephropathy (HIVAN). Donor renal angiogram revealed 3 left renal arteries and 2 right renal arteries, with bilateral duplex ureters. The donor had a left open donor nephrectomy that yielded a kidney with 3 renal arteries, 1 renal vein, and 2 ureters. This was used for the recipient surgery, which was a second kidney transplant with a successful outcome. The need for more donors for kidney transplantation has led to the use of donor kidneys with both complex vascular and urological anatomy. The outcome following these surgeries was successful for both the donor and recipient, with immediate graft function after kidney transplant. ]]>Authors: Bashiru Ibrahim Hamza Kanayo Lucy Oguzie John Ojinere Anyanwu Christogonus Oudney Akalezi Emeka Emmanuel Oguzie
The formic acid oxidation reaction (FAOR) is a key anodic process in direct formic acid fuel cells and requires efficient electrocatalysts with high activity and resistance to catalyst poisoning. In this study, a graphitic carbon nitride (g-C3N4)-modified glassy carbon electrode (g-C3N4/GC) was fabricated and evaluated for FAOR in acidic media. The electrocatalytic performance of the modified electrode was investigated using cyclic voltammetry (CV), electrochemical impedance spectroscopy (EIS), chronoamperometry (CA), and atomic force microscopy (AFM). Compared with the bare glassy carbon electrode, the g-C3N4/GC electrode exhibited significantly enhanced electrocatalytic activity toward FAOR, characterized by substantially higher peak current densities, lower charge-transfer resistance, and improved long-term stability. EIS analysis revealed faster interfacial electron-transfer kinetics following surface modification, while CV studies indicated an increase in electrochemically active surface area and improved accessibility of catalytic sites. Chronoamperometric measurements further demonstrated enhanced durability and reduced activity loss during prolonged operation. The improved electrochemical performance is attributed to the nitrogen-rich structure, increased conductivity, and abundant active sites provided by g-C3N4. These findings demonstrate that g-C3N4-modified glassy carbon electrodes represent a promising metal-free electrocatalyst platform for formic acid electrooxidation and may contribute to the development of cost-effective direct formic acid fuel cell technologies. ]]>NEUROBIOLOGY 10.21926/obm.neurobiol.2604355
Authors: Yordanis Arias Barthelemy Justo Reinaldo Fabelo Roche Carmen Juana Burgal Cintra Serguei Iglesias Moré
In present-day Cuba, there are psychosocial risks (such as stress, psychoactive substance use, an inverted hierarchy of needs, and emigration) that can contribute to mental disorders. Therefore, medical students in Cuba need professional training to serve as online mental health promoters. To achieve this, these students must be trained using the “significant semantic core” method. This initiative aligns with several objectives of the 2030 Agenda for Sustainable Development, which advocates for reducing the morbidity associated with mental disorders. Furthermore, a master’s degree program specializing in mental health promotion should be established at a higher education institution. Officials from the Cuban Ministry of Public Health should train university mid-level technicians as health promoters to support existing public health programs. Finally, the creation of a virtual exchange platform is proposed, enabling medical students trained as mental health promoters to assist Cuban citizens experiencing mental health issues. ]]>Authors: David Goldman Thomas Waterfall Matthew Nagra
The carnivore diet consists of meat, fish, eggs, and animal fats, and excludes all plant-based foods. Controlled prospective studies have not evaluated the implications of the carnivore diet for cardiovascular safety, and the existing evidence base remains limited in quality and scope. This narrative review evaluated the scientific literature on the carnivore diet to assess nutrient adequacy, metabolic effects, and alignment with established dietary guidelines for cardiovascular disease (CVD) prevention. We searched PubMed and Google Scholar through April 2026. Eligible studies included modeling research, surveys, case reports, and reviews of carnivore diets; findings from ketogenic and low-carbohydrate diets were drawn upon extensively, given the absence of carnivore-specific trial data. Carnivore diets provide high intakes of saturated fat, cholesterol, sodium, heme iron, and protein and lack fiber and essential nutrients such as folate, vitamin C, magnesium, and potassium. Reported short-term benefits (e.g., improved glycemic control, weight loss, and elevated HDL-cholesterol) are derived primarily from self-reported survey data and case reports, and are therefore highly susceptible to selection, recall, and reporting biases, alongside the absence of objective clinical verification. Significant elevations in total and LDL-cholesterol were also documented. The carnivore diet is inconsistent with public health guidelines recommending plant-based dietary patterns for CVD risk reduction, and current evidence does not support its long-term safety. Based on currently available evidence, the carnivore diet cannot be considered a heart-healthy eating pattern; however, well-designed prospective trials are needed to definitively characterize its long-term cardiovascular effects. ]]>GENETICS 10.21926/obm.genet.2604363
Authors: Fatima Abbas Nasser Albawi Mourouge Saadi Abbas Alwash Liqaa Yehya Mohsen
Multidrug-resistant Pseudomonas aeruginosa is a major cause of hospital-acquired infections and is responsible for high mortality rates due to its intrinsic and acquired resistance mechanisms to various antibiotics. This study aimed to investigate the prevalence of the AmpC beta-lactamase enzyme and the MexAB-OprM efflux pump genes, as well as the effect of the inhibitors cloxacillin and Phe-Arg β-naphthylamide dihydrochloride (PAβN) on its antibiotic resistance. The current cross-sectional study included 227 P. aeruginosa isolates collected from patients hospitalized at AL-Hillah Teaching Hospital, Babil Teaching Hospital, Marjan Medical City, and associated medical microbiology laboratories in Babylon province. The antibiotic resistance pattern, beta-lactamase production, and the effect of inhibitors on these isolates were determined phenotypically, while the prevalence of beta-lactamase and efflux pump genes was investigated using the PCR technique. Of these isolates, 114 (50.2%) were multidrug-resistant. These multidrug-resistant isolates exhibited complete resistance (100%) to aztreonam, cefepime, and ceftazidime-clavulanic acid, but were most susceptible to piperacillin-tazobactam (59.6%). Antibiotic resistance in the multidrug-resistant isolates decreased after adding cloxacillin and PAβN inhibitors, with resistance to several antibiotics markedly reduced (e.g., ceftazidime from 84% to 42% and meropenem from 97% to 48%). Among the genes encoding the beta-lactamase AmpC, the blaDHA was the most prevalent, detected in 55% (17/31) of the isolates, followed by blaFOX (39% (12/31)). The blaACT-1/MIR-1 and blaMOX were each detected in 7% (2/31) of the isolates, while the blaLAT was detected in only one isolate (3%). Among the MexAB-OprM efflux pump systems, the mexB was the most prevalent (48.4% (15/31)) compared to the mexA (16.1% (5/31)), while the oprM was identified in 12.9% (4/31) of isolates. High resistance has been detected in P. aeruginosa isolates, where the use of cloxacillin and PAβN plays a role in decreasing antibiotic resistance. This high resistance is concerning and warrants stricter antibiotic prescribing policies. ]]>NEUROBIOLOGY 10.21926/obm.neurobiol.2604354
Authors: Adeel Ahmed Abbasi Nasrollah Moradikor
Alzheimer’s disease (AD) impacts the brain in multiple ways and has varied clinical features and progression. Sex differences exist in the epidemiology and fundamental biology of AD. Machine learning (ML) tools can integrate and analyze multiple biomarkers, improving AD diagnosis and prognosis. However, machine learning tools underuse and under-explore predictive modeling of sex differences. This translational narrative review synthesises the existing literature on studies that explore sex differences in Machine Learning models that utilise data collection techniques that incorporate biomarkers from Positron Emission Tomography (PET) scans, Magnetic Resonance Imaging (MRI) scans, Cerebrospinal Fluid (CSF), serum assays, genetic variants, including single-nucleotide polymorphisms (SNPs), and Electroencephalography (EEG). We emphasize the role of sex in biomarker manifestations which include but are not limited to: the dissimilarity of amyloid and tau in PET imaging, the effects of sex in structural and functional brain alterations in MRI, sex-specific alterations in cerebrospinal fluid (CSF) composition (e.g., Aβ42 concentration, total tau, and phospho-tau) and the alterations in peripheral and systemic inflammatory and metabolic blood markers, the modulation of genetic risk particularly in relation to APOE and some of the single nucleotide polymorphisms (SNPs), and the variability in sex differences in EEG network disruption and/or modularity. When sex is incorporated as a biological variable or when sex-stratified models are created, new ML methods, such as deep learning, ensemble techniques, and multimodal fusion frameworks, demonstrate promising diagnostic and prognostic capabilities. Many studies, however, remain constrained by modest datasets, a lack of external validation, and limited interpretability, thereby limiting clinical applicability. This review highlights the importance of sex-aware modeling techniques to advance precision medicine in AD. We offer several methodological suggestions, including analysing disaggregated sex data, aligning data across multiple approaches, using explainable AI, and including longitudinal data. Filling these gaps may help develop ML tools that offer accurate, fair, and clinically useful early detection and prognosis of AD across a wide range of populations. ]]>GENETICS 10.21926/obm.genet.2604362
Authors: Hamed Haghparast Mojdehi Niloofar Faraji Hadi Habibollahi
Pancreatic cancer is a highly aggressive and therapy-resistant malignancy. This study evaluated the cytotoxic effects of Syzygium aromaticum (clove) aqueous extract on PANC-1 pancreatic cancer cells and its effect on TP53 mRNA expression. PANC-1 cells were exposed to increasing concentrations of the extract (10-1000 μg/ml) for 48 h. We assessed cell viability using the MTT assay and calculated the half-maximal inhibitory concentration (IC50) using four-parameter logistic regression. TP53 mRNA expression was quantified by quantitative real-time PCR (qRT-PCR). Statistical analyses were performed using one-way ANOVA followed by Dunnett’s post hoc test, with P < 0.05 considered statistically significant. The extract significantly reduced PANC-1 cell viability in a concentration-dependent manner (P < 0.0001), with viability decreasing from 39.55% at 10 μg/ml to 9.01% at 1000 μg/ml. The calculated IC50 was 2.743 μg/ml (95% CI: 0.5627-6.345 μg/ml). TP53 mRNA expression increased approximately 2.3-fold following treatment compared with untreated controls (P = 0.0058). S. aromaticum aqueous extract demonstrated potent antiproliferative activity against PANC-1 cells and increased TP53 mRNA expression. However, the functional significance of TP53 upregulation and its contribution to apoptosis or other cellular mechanisms require further investigation. ]]>Authors: Natalia Guadalupe Saez María Verónica Lancelle Cedrolla Alicia Ernestina Gómez Yanina Pavón Daniela Marta Guglielmotti María Luján Capra
Gluten-free (GF) bread making faces significant sensory, technological, and nutritional challenges. GF breads, typically formulated with commercial premixes, often exhibit deficiencies in texture, flavor, and nutritional value compared to wheat-based breads, leading to dissatisfaction among consumers with celiac disease or similar conditions. Although sourdough (SD) improves technological and sensory attributes, its production is laborious and complex. Starter cultures of selected lactic acid bacteria (LAB) strains are used to prepare alternative sourdoughs (type II), allowing for process standardization and shortening. The aim of this study was to obtain an improved GF bread formulation by using an SD starter culture and seed fortification to counteract the technological and sensory limitations inherent to GF bakery products. Therefore, commercial premixes were used to elaborate GF breads fermented with type II SD prepared with Weissella confusa 20 (W20) and fortified with seeds. Two commercial premixes (C and D) were selected for the elaboration of experimental breads (15% or 50% w/w replacement with SD, and 10% w/w addition of ground seeds). The formulation was optimized using a multidisciplinary approach, characterizing its mechanical behavior via TPA (texture profile analysis), its sensory profile through QDA (quantitative descriptive analysis), and its macro-and micronutrient composition via theoretical assessment. ]]>GENETICS 10.21926/obm.genet.2604361
Authors: Aishwarya Rani Shalesh Gangwar Neha Sharma Khalid Raza Sameer Gupta Devinder Toor
Fetuin-A, encoded by the AHSG gene, is a hepatokine that regulates metabolism, ectopic calcification, and cardiovascular homeostasis. Beyond mineral sequestration, it binds Bone Morphogenetic Protein (BMP) ligands, modulating their extracellular availability. BMP-10 supports endothelial integrity, vascular remodeling, and signaling through BMP receptor type 2 (BMPR2). Impaired BMP-10 signaling is linked to cardiovascular diseases (CVDs). Non-synonymous single-nucleotide polymorphisms (nsSNPs) in AHSG can alter fetuin-A structure and potentially disrupt its interaction with BMP-10. A total of 398 missense nsSNPs were analyzed using PredictSNP (functional impact), DUET, I-Mutant 2.0, and DynaMut2 (stability), ConSurf (conservation), and Project HOPE (structural effects). Further, the selected variants underwent 100-ns molecular dynamics simulations, and molecular docking was performed with BMP-10-BMPR2. Using the computational framework, seven high-confidence deleterious variants- I48T, I80S, I82T, E86G, R103S, V142G, F125S- plus two clinically relevant variants (M248T, S256T) from reported GWAS literature were identified. MD simulations showed significant deviations: S256T displayed the greatest conformational shift from wild type, while E86G increased solvent exposure and flexibility. Docking investigations predicted a stable interaction between wild-type fetuin-A and the BMP-10-BMPR2 complex. Most variants showed reduced predicted binding interactions relative to wild type. These computational findings provide hypothesis-generating evidence of a structural basis for how AHSG variants may impair BMP-10 regulation, potentially contributing to cardiovascular dysregulation. The proposed framework may help prioritize variants for targeted experimental and genotype-phenotype studies to determine their functional and clinical relevance. ]]>Authors: Aleksandar Anastasovski
Creating industrial symbiosis can improve resource efficiency by creating technically feasible and economically viable exchanges of energy, water, materials, by-products, and services among firms. Pinch technology, originally developed for process integration, systematically optimizes heat, material, water, by-product, and supply-chain exchanges, as well as emissions minimization. It is also suitable for inter-firm industrial symbiosis. However, there are some other specific methodologies that are used for the design of industrial symbiosis. They are more favored than Pinch technology. This paper reviews and compares the benefits and limitations of Pinch technology with other methodologies that have already been used in industrial parks to transform them into symbiotic systems. Sources are selected based on PRISMA. Many projects used for internal process integration showed great performance with increased efficiency. But that is rare in the design of industrial symbiosis. The analysis and results of integration support the use/reuse of energy (heat exchange), materials (mass exchange), products (goods exchange), minimization of environmental footprints, and supply chains. Pinch technology offers technical solutions for designing common exchange systems between companies that want to implement industrial symbiosis. Many updates in Pinch technology, like R-curve analysis, total site integration, and exergy-based analysis, have improved its usage. Solutions can increase flexibility. This symbiosis can have a better response to fluctuations. Furthermore, we propose an algorithm for implementing Pinch technology in industrial symbiosis design. It combines different types of Pinch technologies. ]]>Authors: Tryfon Kekes Constantina Tzia
The primary objective of the present work was to evaluate the effect of edible coatings in the preservation of green olives. Two different polysaccharides (chitosan and pectin) and a mixture of them were used as edible coatings on table green olives, which were subsequently packaged under modified atmosphere conditions and stored at three temperatures (4, 20, and 40°C). During storage, the weight loss, color change, texture, pH, salinity, acidity, as well as the sensory characteristics of the olives were evaluated. Edible coatings proved to significantly contribute to preserving olive quality by limiting physicochemical and sensory alterations during storage. Pectin showed the strongest preservation performance, limiting weight loss to approximately 1.52% compared with 2.7% for the uncoated samples after 42 days at 4°C, while ΔE remained below 2 throughout storage. Kinetic analysis using the Arrhenius model confirmed that edible coatings decreased the rate of sensory degradation and extended the predicted shelf life of the olives, with pectin coatings showing the greatest increase in shelf life (111 days for pectin-coated olives at 4°C, compared with 64 days for the uncoated samples). Overall, the results highlight the potential of pectin-based edible coatings, particularly pectin alone, as a practical natural preservation approach for the food industry. Their application in combination with modified atmosphere packaging may contribute to maintaining the quality, sensory acceptability and commercial shelf stability of green table olives during storage. ]]>Authors: Jonathan K Sinclair Lauren Baker Lindsay M Bottoms
Poor sleep and insomnia are prevalent and carry substantial health and societal costs. Tart cherry (Prunus cerasus) contains polyphenols and melatonin and has been proposed as a dietary strategy to support sleep. This systematic review and meta-analysis synthesised evidence from randomised controlled trials (RCTs) evaluating the effects of tart cherry supplementation on sleep quality and biomarkers linked to inflammatory and melatonin-related pathways. PubMed, Scopus, and Web of Science were searched from inception to January 2026, alongside clinical trial registries. Eligible studies were human RCTs in adults (≥18 years) comparing tart cherry (juice, concentrate, powder, or capsules) with placebo or control. Sleep quality was the primary outcome with melatonin and inflammatory biomarkers extracted as secondary outcomes where available. Two reviewers screened records and assessed risk of bias using risk-of-bias tool for randomised trials (RoB 2.0) and certainty of evidence using Grading of Recommendations Assessment, Development and Evaluation (GRADE). Random-effects meta-analyses were conducted using Hedges’ g as the standardised mean difference. Ten RCTs involving 294 enrolled or randomised participants were included. The studies were published between 2010 and 2024. Interventions ranged from short protocols to 12 weeks and used juice-based products or capsules. Across all trials, tart cherry produced a small, non-significant improvement in overall sleep quality compared with placebo (Hedges’ g = 0.064; 95% CI -0.147 to 0.275; P = 0.552). In participants with insomnia (two trials), tart cherry significantly improved sleep quality (Hedges’ g = 0.732; 95% CI 0.051 to 1.412; P = 0.035). No significant effects were observed for melatonin or inflammatory biomarkers. Reported compliance was high (mean 95.76 ± 3.48%), and adverse events were infrequent. Overall risk-of-bias judgements ranged from some concerns to high. Certainty was very low for overall sleep quality in mixed populations and for inflammatory biomarkers, and low for the insomnia subgroup and melatonin. Tart cherry supplementation did not significantly improve pooled sleep quality across mixed adult populations. A benefit was observed in two small insomnia trials, but this finding was based on low-certainty evidence and should be considered preliminary. Larger, rigorously designed RCTs with standardised sleep outcomes and mechanistic biomarkers are required. ]]>GENETICS 10.21926/obm.genet.2603360
Authors: Samaa Asaad Hameed Thikra Adnan Jawad Banimusleum Zahraa Isam Jameel
Sepsis has a complex genetic background; many genes may directly or indirectly affects its development. Since cytokines control the type, severity, and consequences of pathogenesis, they are also involved in some aspects of sepsis. This research aims to investigate the relationship between IL-6 gene polymorphism and sepsis. For this research, a total of 75 patients with sepsis disease and another 75 individuals without the disease were taken as the controls for this genetic study. The IL-6 gene has many high-frequency polymorphisms; these polymorphisms were amplified using well-chosen primers. In the serum of individuals with sepsis (240.42 ± 84.25 pg/mL), IL-6 was found to be higher compared to the control group (203.58 ± 22.47 pg/mL). Finally, the rs1800796 polymorphism is correlated with the risk of developing sepsis, with the G/A heterozygous variation providing a high level of risk under the dominant inheritance model of the polymorphism. There is no relationship with the recessive model, suggesting that the presence of the GA genotype and the dominant model (GA + AA) had significantly higher chances of sepsis compared with other genotypes (OR = 4.05 and 3.00, respectively; p < 0.05). The findings show a clear link between the genetic variation of the IL-6 gene and the regulation of IL-6 during sepsis. ]]>Authors: Tamru Tesseme Aragaw Kidest Tadesse Yoseph Kebede Rahel Kaba Tarun Kumar Lohani
The research aimed to assess the urban water, sanitation, and hygiene (WASH) systems enabling environment in ten selected Ethiopian secondary cities. It comprises Adama, Bahir Dar, Bishoftu, Dessie, Dire Dawa, Harar, Hawassa, Kombolcha, Mekelle, and Shashemene cities. The study used a two-phase assessment, integrating the USAID Urban WASH Activity with the modified WASH Systems Building Blocks Framework adapted from the Sustainable Services Initiative (SSI), Agenda for Change (AfC). A cross-sectional mixed-methods municipal scoping assessment was carried out from March 6 to April 16, 2023, using desk reviews, field evaluations, and stakeholder mapping. Semi-structured key informant interviews were also conducted with representatives from water utilities, municipal administrations, and all concerned sector offices, as well as community stakeholders. Nine WASH system building blocks containing 54 indicators were used for assessment and evaluation, applying a predefined three-point scoring scheme (0, 0.5, and 1). The results showed that the overall WASH-enabling environment was rated moderately in most cities, with significant institutional capacity differences between them. Bishoftu showed the highest overall enabling environment (70.13%), while Mekelle scored the lowest (49.03%). All cities received excellent ratings for having defined institutional mandates and roles for all municipal stakeholders, specific WASH sector policies, legal frameworks and standards, methods for users to complain, and inclusive planning. The absence of bylaws, inadequate cross-sectoral coordination among WASH stakeholders, a lack of technical and administrative capacity to manage sanitation and hygiene, and limited budgeting resulted in poor assessment outcomes in all cities. The study concluded that systems-thinking approaches are a promising tool for diagnosing governance challenges and directing policy decisions in rapidly growing cities in a developing country (Ethiopia) that faces WASH challenges. ]]>Authors: Taiwo Ayodele Aderinola Uche Capulet Anyaiwe Sinmiloluwa Esther Ogunbowale
This study evaluates the potential of composite flours made from cassava, sorghum residue, and garden egg (both ripe and unripe) to create a nutritionally enhanced doughmeal. Seven flour blends were formulated: A (100% cassava), B (95% cassava, 2.5% sorghum residue, 2.5% ripened garden egg), C (95% cassava, 2.5% sorghum residue, 2.5% unripened garden egg), D (90% cassava, 5% sorghum residue, 5% ripened garden egg), E (90% cassava, 5% sorghum residue, 5% unripened garden egg), F (85% cassava, 7.5% sorghum residue, 7.5% ripened garden egg), and G (85% cassava, 7.5% sorghum residue, 7.5% unripened garden egg). Results showed that supplementation with sorghum residue and garden egg increased moisture (64.20-69.12%), protein (0.47-13.77%), fibre (0.95-2.03%), and ash (0.95-2.09%) contents, while reducing carbohydrate content (11.98-32.77%) compared to the control (A). Sample E had the highest moisture content (69.12%), while B and D, with ripened garden egg, showed higher protein content. Mineral analysis revealed that supplementation increased essential minerals, with D showing the highest values for calcium (15.09-77.25 mg/100 g), magnesium (35.27-92.01 mg/100 g), and potassium (42.02-62.49 mg/100 g). Phytochemical analysis showed higher total phenol (0.603-6.19 mg GAE/g) and flavonoid (0.026-0.027 mg RE/g) contents in samples with ripened garden egg. Samples with higher sorghum residue and ripened garden egg showed significant inhibition of α-amylase (10.77-54.87%) and α-glucosidase (7.05-67.95%), which may help manage postprandial glucose levels. Sensory evaluation revealed that while the control sample was preferred, samples with ripened garden egg were more acceptable than those with unripened garden egg, indicating their potential for developing nutritionally improved cassava-based doughmeals. ]]>TRANSPLANTATION 10.21926/obm.transplant.2603277
Authors: Anastasia Doroshenko Matthias Reimers Gary Sawers Gerald Schlaf
Donor-specific antibodies (DSA) directed against human leukocyte antigens (HLA) are regarded as the principal cause of graft failure, including allograft loss. Especially cytotoxic, i.e., complement-fixing, antibodies have long been classified as clinically highly deleterious in the context of graft failure. The complement-dependent cytotoxicity assay (CDC), performed in cell-tray analyses, has been used to define these antibodies for more than 40 years, but generally lacks sensitivity. Due to its limited resolution, which does not exceed the single-donor level, it also cannot specify distinct antigens, especially in highly immunized patients. About fifteen years ago, this problem was overcome by broadly established Luminex-based single-antigen specification assays (SAB), which identify antibodies directed against recombinant single HLA antigens. To specify complement-fixing antibodies of postulated higher clinical relevance, these assays were supplemented by two commercial kits, initially by the C1q assay and later by the C3d assay. Here, we used the C3d assay to investigate serum from 74 selected patients on kidney waiting lists, which represent three groups, each with increasing levels of immunization/panel-reactive antibodies (%PRA): (i) with only anti-HLA class I antibodies (n = 24); (ii) with only anti-HLA class II antibodies (n = 21); and (iii) with combined anti-HLA class I and class II antibodies (n = 29). Our data show that C3d assay-defined cytotoxicity, especially for anti-HLA class I antibodies, strongly correlates with the mean fluorescence intensity (MFI). Anti-HLA class I antibodies appear cytotoxic when corresponding SAB MFI values exceed 6,000 to 7,000, whereas below this threshold cytotoxicity does not appear. Dilution experiments showed that cytotoxic antibodies could be converted to non-cytotoxic antibodies simply by falling below this threshold MFI value. In contrast, anti-HLA class II antibodies with cytotoxicity-defining threshold MFI-values between 1,500 and 2,000 differ by having a higher proportion of non-cytotoxic antibodies that even lie above these MFI-values. Nevertheless, we conclude that due to strong correlations with SAB MFI-values (Pearson correlation coefficients of 0.69 for HLA-class I and 0.63 for HLA-class II), there is insufficient clinical applicability to justify the considerable amount of work involved, and especially the high associated costs, for routine use of the C3d assay. ]]>GENETICS 10.21926/obm.genet.2603359
Authors: Syahrul Tuba Luluk Sakdiyyah Natanael Panjaitan F. Josse Pasca Pradana Adi Priyono Budi Sumaryono
Tamoxifen remains a cornerstone in the treatment of estrogen receptor-positive (ER+) breast cancer; however, variability in patient response underscores the necessity of a pharmacogenomic approach. This review integrates germline and somatic pharmacogenomics to elucidate the molecular determinants of tamoxifen metabolism, efficacy, and resistance. Germline polymorphisms, particularly in CYP2D6, CYP3A4/5, UGT2B7, and SULT1A1, significantly influence endoxifen levels, driving therapeutic variability across ethnic populations. Moreover, somatic mutations, notably in ESR1, TP53, and enhancer regions, confer acquired resistance and affect treatment outcomes. Ethnicity-specific distributions of these variants further highlight the inadequacy of a one-size-fits-all dosing strategy. Although CPIC and DPWG guidelines focus on CYP2D6 genotyping, they do not incorporate critical somatic data and phase II metabolism. To achieve truly personalized tamoxifen therapy, clinical algorithms must evolve to integrate germline and somatic profiles, enabling predictive, population-aware, and mutation-guided endocrine treatment. This review advocates for expanded multi-omics frameworks and multiethnic databases to optimize tamoxifen use and overcome endocrine resistance globally. ]]>