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Heliyon

Elsevier BV

Preprints posted in the last 30 days, ranked by how well they match Heliyon's content profile, based on 152 papers previously published here. The average preprint has a 0.25% match score for this journal, so anything above that is already an above-average fit.

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The impact of Anxiety, Sleep Quality, Social Media Use, and Socioeconomic Background on Academic Performance in Bangladeshi Public University Students: A Structural Equation Modeling Approach

Tasnim, S.; Ahmed Rana, S.; Hossen, M. A.; Rahman, M. A.

2026-08-19 health systems and quality improvement 10.64898/2026.08.18.26360659 medRxiv
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Background: Academic achievement is crucial for university students, but various factors affect their performance. This study explores the impact of anxiety, sleep quality, social media use, and socioeconomic status on academic performance (CGPA) among public university students in Bangladesh. Data and Methods: Data were collected from 225 students using a structured questionnaire that assessed anxiety (GAD-7), sleep quality (PSQI), social media use (SMUQ), and socioeconomic status (income, parental education). Structural Equation Modeling (SEM) was used to analyze the relationships between these variables. Outcomes: The results showed that socioeconomic status had a strong positive effect on academic performance ({beta} = 0.745, p < 0.001), while anxiety negatively impacted academic outcomes ({beta} = -0.675, p < 0.001). Sleep quality was positively related to academic performance ({beta} = 0.113, p < 0.05), but with a weaker effect. Social media usage is found to have a negative significant effect on academic performance ({beta} = -0.137, p < 0.001). Conclusion: These findings highlight the importance of controlling social media usage and anxiety to enhance academic performance among adult students. Sleep quality and socioeconomic background of the students are also found to be meaningfully associated with their educational progress.

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Improvements in Family Member Quality of Life Following a Task-Shifted Psychosocial Intervention for Road Traffic Injury Survivors in Cameroon

Touko, A. D.; Dissak Delon, F. N.; Pola, G. M.; Oke, R.; Juillard, C.; Chichom Mefire, A.; Maqungo, S.

2026-08-12 surgery 10.64898/2026.08.10.26360156 medRxiv
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Abstract: Background: Road traffic injuries (RTI) related trauma is associated with heavy psychosocial burdens for family members involved as informal caregivers after the event. Little is known about the quality of life (QoL) experience of family members of RTI survivors in sub-Saharan Africa. This study investigated the QoL outcomes of family members after the administration of the Friendship Bench psychosocial intervention among RTI survivors in Cameroon. Methods: A pre post study design was utilized in two trauma centers in Cameroon. The relatives underwent assessment both at baseline (Session 1) and follow up sessions (Session 6) using the WHOQOL BREF tool, without being exposed to any intervention. The domain scores were scaled from 0 to 100. Statistical analysis consisted in paired t-tests/Wilcoxon signed-rank tests along with effect sizes using Cohen s d. Results: The study involved twenty nine participants. Baseline assessment revealed overall poor quality of life across all domains, with scores in the poor range (Social = 33.33 [IQR: 25.00 47.92]; Environmental = 34.38 [IQR: 25.78 45.31]; Psychological = 45.83 [IQR: 34.38 50.00]; Physical = 46.43 [IQR: 39.29 56.25]). These scores had a statistically significant increases across all domains after the intervention (p < 0.001), accompanied by medium to large effect sizes (Cohen s d:Social = 1.35; Environmental = 1.57; Psychological = 1.46; Physical = 0.73). The relationship type was found to predict social QoL (F(6,22) = 4.57, p = 0.004), with children of patients demonstrating the greatest gains. Conclusion: Family members of RTI survivors showed a significant improvement in QoL during the Friendship Bench intervention. These results highlight the importance of evaluating family member outcomes in task shifted psychosocial programs in LMICs. Keywords: Quality of life, WHOQOL BREF, road traffic injuries, family caregivers, Friendship Bench, Cameroon, spillover effects

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Beyond conventional statistics: Genomic Informational Field Theory (GIFT) identifies sex-specific herpes virus associations in multiple sclerosis

Ahmed, N.; Maple, P.; Tanasescu, R.; Giorgi, L.; Valentino, P.; di Sapio, A.; Gran, B.; Rauch, C.; Kreft, K. L.

2026-08-06 neurology 10.64898/2026.08.04.26359688 medRxiv
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Background: Detecting higher order relationships in datasets of complex traits, such as multiple sclerosis (MS), has been challenging. Conventional statistics largely rely on comparing averages across groups and thereby discard important information on the underlying distribution of datapoints. The Genomic Information Field Theory (GIFT) overcomes this limitation by ranking individuals based on linear measures, for example immunoglobulin titres. The exact role of humoral immune responses against several human herpes viruses in a sex-dependent manner in MS is currently unknown. Materials and methods: We compared the performance of GIFT with conventional statistical frameworks to detect differences in the humoral immune response against 4 highly prevalent herpes viruses linked to an individuals susceptibility to develop MS in 200 MS patients and 137 healthy controls. Results: GIFT validated the well-known association that the Epstein Barr Virus (EBV) protein EBNA1 is strongly linked to MS susceptibility in both sexes. In contrast to conventional statistics, GIFT also identified association between herpes simplex virus, varicella zoster virus and the EBV VCA protein and female susceptibility to develop MS, whereas male MS susceptibility was only linked to CMV immunoglobulin levels. None of these associations was observed using conventional statistical tools. Conclusion and discussion: We here show for the first time that GIFT is able to detect novel associations in human immunoglobulin data linked to MS susceptibility, which remained undetected by conventional statistical frameworks. This shows the power of GIFT to detect complex phenotype-trait associations and underlying subgroups within populations.

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Too slow Erythrocyte Sedimentation Rate: Deeper biophysical understanding, novel accurate parameters and new medical applications

Darras, A.; Qiao, M.; Peikert, K.; Hecksteden, A.; John, T.; Glass, H.; Stauffer, E.; Muniansi, I.; Champigneulle, B.; Pichon, A.; Furian, M.; Hancco Zirena, I.; Brugniaux, J. V.; Mühlbäck, A.; Simmonds, M. J.; Nader, E.; Joly, P.; Meyer, T.; Verges, S.; Hermann, A.; Danek, A.; Connes, P.; Wagner, C.; Kaestner, L.

2026-09-01 hematology 10.64898/2026.08.26.26360269 medRxiv
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The erythrocyte sedimentation rate (ESR) is one of the most common and widely used laboratory diagnostic parameters in connection with inflammatory reactions and it is probable that every reader has already experienced a determination of their ESR. A rapid ESR is a non-specific parameter that provides information about the inflammatory process. Although the origins of this methodology date back to antiquity, the description of the process as the collapse of a percolating gel formed from erythrocytes has only recently been achieved. It was not yet known whether slow ESR has any medically relevant significance. Here we show a variety of clinical pictures that exhibit a systematically slow ESR (e.g., sickle cell disease, neuroacanthocytosis syndromes, chronic mountain sickness). Using a combination of measured data and physical modelling, we show how the accuracy and significance of ESR data can be increased. With this improved ESR (supraESR), we introduce a completely new, cost-effective diagnostic parameter, based on an established and easily automated measurement method, that enables low-cost screening for neuroacanthocytosis syndrome, a group of rare neurodegenerative diseases previously detectable only through complex diagnostic tests.

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Epigenetics for Public Consumption: Evaluating Science Communication Strategies and Practices on YouTube

Raisa, A.; Santaliz-Moreno, I.; Ayala, A.; Hamilton, J. G.; McQueen, A.; Souroullas, G. P.; Maki, J.; Waters, E. A.

2026-08-17 genetic and genomic medicine 10.64898/2026.08.14.26360379 medRxiv
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Background: Epigenetics, the study of reversible changes in gene expression without altering the underlying DNA sequence, is increasingly applied in medical, commercial, and policy contexts. Yet, little is known about how this emerging science is communicated to the public. The purpose of this study was to examine communication strategies, sources, and modalities in epigenetic-related videos on YouTube- the most accessed platform for informal science education. Methods: We conducted a mixed-methods content analysis of 294 YouTube videos on epigenetics by conducting a keyword-based search on October 17, 2023. Video transcripts and meta-data were coded using a codebook developed both deductively and inductively. Qualitative analysis examined how communication strategies were used within videos and identified emergent themes (RQ1). Quantitative analyses examined the frequency of video and channel characteristics (RQ2), and presentation modalities (RQ3). Results: Findings reveal poor alignment with science communication best practices (RQ1): over 92% of videos failed to acknowledge scientific uncertainty, the comprehensibility level exceeded the recommended 8th-grade level (e.g., average readability grade 10.7), and professional research organizations were notably absent. Narrators were mostly male (56.7%) and white-presenting (73.7%) (RQ2). The majority of the videos used multi-modal strategies (e.g., visual texts mixed with animation and voice-over narration) to communicate epigenetic information (RQ3). Conclusion: Findings highlight the need for professional research organizations to be more proactive in public epigenetic communication efforts. Increasing narrator demographic diversity could broaden audience reach. Evidence-based communication tools are needed for health or science communicators discussing epigenetics on social media.

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Evaluation of Sex Hormones in Autoimmune Diseases in Pre- and Post-Menopausal Women

Krishnamurthy, H.; Yang, Y.; Song, Q.; Krishna, K.; Jayaraman, V.; Wang, T.; Bei, K.; Rajasekaran, J. J.

2026-08-22 endocrinology 10.64898/2026.08.19.26360795 medRxiv
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Autoimmune diseases have shown biased proportion in female population, existing clinical investigations of sex hormones in autoimmune populations have been relatively limited in terms of patient size and types of hormones investigated. In this study, we examined the relationship of sexual hormones and autoimmune antibodies in a large cohort of US women. This retrospective study sample included a total of 15319 female subjects medical information that were collected between December 2015 to May 2019 and tested in the Vibrant America Clinical Laboratory. The present serum sample was limited to female participants who had ever menstruated at the time of blood collection and completed the testing of the autoimmune antibodies and sex hormones. We focused on a total of 13 clinically significant autoantibodies including antinuclear antibody (ANA), 11 anti-extractable nuclear antigens (anti-ENAs), anti-cyclic citrullinated peptide 3 (anti-CCP3), and 11 female sex hormones. First, the prevalence of serological autoantibodies in a large set of adult female subjects divided by the menopause age was investigated. Next, the levels of sex hormones were compared in the seropositive autoimmune subjects and seronegative controls across the pre- and post-menopausal female groups. The presented study involving a large cohort of females showed no statistically different levels of sex hormones in seropositive autoimmune subjects and matched controls except for DHEA-s.

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Prevalence and Age-Sex Distribution of Thyroid-stimulating Hormone Abnormalities Among Hospital Outpatients in Jashore District, Bangladesh: A Cross-Sectional Study

Sazza, M. R.; Bashar, S.; Islam, M. D.; Noman, S. I.

2026-08-17 public and global health 10.64898/2026.08.16.26360524 medRxiv
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Background: Thyroid disorders represent a substantial endocrine disease burden across South Asia, yet systematic epidemiological data from specific regions of Bangladesh remain scarce. The objective of this study was to determine the prevalence and demographic distribution of thyroid stimulating hormone (TSH) abnormalities among hospital outpatients in Jashore district, southeastern Bangladesh. Methods: A cross-sectional survey was conducted among 200 consecutive outpatients presenting for thyroid evaluation at LabAid Hospital, Jashore, from October 2017 to December 2017. Serum TSH concentrations were measured, and participants were classified as euthyroid, hypothyroid, or hyperthyroid based on standard reference intervals, then stratified by sex and seven age categories. Results: Of the 200 participants (170 female, 30 male), 101 (50.5%) showed abnormal TSH values. Hypothyroidism was identified in 97 participants (48.5%) and hyperthyroidism in 4 (2.0%). The overall prevalence of thyroid dysfunction was nearly identical between sexes (female 50.6% vs male 50.0%, P=1.00), while age group showed a highly significant association with TSH abnormality (P<0.001), peaking in the 40-49-year group (89.7%). The female-to-male ratio for total thyroid dysfunction was 5.7:1, reflecting the much larger proportion of female participants rather than a higher within-sex risk. Conclusion: Thyroid dysfunction, principally hypothyroidism, is highly prevalent among hospital outpatients in Jashore City, with prevalence rising sharply with age and peaking in middle adulthood, supporting the case for systematic age-targeted thyroid screening in this population.

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Mapping the Pandemics Echo: Dynamic Narrative Detection and Spatio-Temporal Sentiment Modeling of COVID-19 Discourse on Twitter

maaskri, m.; Abdelfatah, M.; Mohamed, G.; Mohamed, D.; Djamal, S.

2026-08-07 epidemiology 10.64898/2026.08.05.26359769 medRxiv
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The COVID-19 pandemic triggered an unprecedented volume of real-time discourse on social media platforms, with Twitter serving as a global forum for public reactions, fears, and evolving narratives. Traditional sentiment analysis approaches treat tweets as independent, static samples, failing to capture the temporal evolution and geographic heterogeneity of public opinion. This paper presents a comprehensive spatio-temporal framework that integrates fine-grained sentiment classification using COVID-Twitter-BERT with dynamic topic modeling via BERTopic to automatically discover and track evolving narratives. Using a corpus of 2.4 million geolocated tweets collected between January 2020 and June 2022, our analysis reveals distinct pandemic phases: early fear-driven narratives about mask shortages (Q1 2020), vaccine optimism followed by polarization (2021), and pandemic fatigue (2022). Regional comparisons show significant differences, with US discourse dominated by freedom-versus-mandate debates while European discussions emphasized collective solidarity. Our framework achieved 76% F1-score in sentiment classification and successfully identified 50 distinct narratives with high coherence scores. This work provides a powerful methodology for real-time epidemiological narrative surveillance and crisis communication monitoring.

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Internal and External Validation of an Ensemble Learning Model Integrating Zygote Morphokinetics with Conventional Embryo Assessment for Blastocyst Prediction

ZHAO, M.; LIU, J.; HAN, D.; ZHANG, C.; ZHOU, Y.; CHEN, S.; LIU, C.

2026-08-23 obstetrics and gynecology 10.64898/2026.08.19.26359526 medRxiv
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Objective: To perform internal and external validation of a gradient-boosted decision tree (GBDT) fusion model that integrates zygote morphokinetic parameters with conventional embryo assessment features for blastocyst prediction, and to compare its discriminative performance against senior embryologists. Methods: This retrospective cohort study included 631 normally fertilized zygotes from 218 treatment cycles. A GBDT fusion model integrating 84 zygote morphokinetic parameters and 8 conventional assessment features was evaluated internally (5-fold cross-validation) and externally on a public dataset of 523 embryos with blastocyst outcomes. Model performance was assessed using area under the ROC curve (AUC), area under the precision-recall curve (AUPRC), F1 score, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Discrimination was compared with embryologist consensus using the DeLong test; agreement was assessed with Cohen's kappa. Results: The model achieved an internal AUC of 0.78 (95% CI 0.74-0.82), AUPRC 0.72, F1 0.73, sensitivity 0.74, specificity 0.77, PPV 0.72, and NPV 0.79. External validation on the public dataset demonstrated acceptable generalizability (AUC 0.76, 95% CI 0.71-0.81). The model significantly outperformed embryologist consensus (AUC 0.70, P<0.001) with moderate agreement (kappa=0.56). Decision curve analysis confirmed clinical net benefit at threshold probabilities of 0.15-0.55. Conclusions: The GBDT fusion model integrating zygote morphokinetics with conventional assessment demonstrates good discrimination and external generalizability for blastocyst prediction, providing an interpretable decision-support tool for embryo selection in IVF practice.

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Modular Robotic NOSES-II for Mid-Rectal Cancer: A Preliminary Feasibility Study of a Structured Surgical Procedure

Liu, P.; Zhang, l.; Yu, K.; Lu, X.; Li, W.

2026-08-17 surgery 10.64898/2026.08.15.26359890 medRxiv
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Background and Objectives: Robotic-assisted natural orifice specimen extraction surgery (NOSES) is a minimally invasive approach for mid-rectal cancer, but it is technically complex and lacks a standardized operational framework. This study aimed to propose and preliminarily validate a structured modular robotic NOSES II surgical procedure for mid-rectal cancer. Methods: This was a retrospective observational study that consecutively enrolled 11 patients with mid-rectal cancer who underwent modular robotic NOSES-II surgery at our center between December 2024 and August 2025. All procedures were performed by the same surgical team strictly following the predefined six-module structured surgical protocol. Perioperative indicators, pathological outcomes, and patient-reported outcomes (PROs) at 4 to 8 months postoperatively were collected. Key techniques were analyzed via high-definition surgical videos. Results: All 11 procedures were completed successfully without conversion to open surgery. The mean operative time was 299.6 plus or minus 54.2 minutes, and the mean intraoperative blood loss was 94.1 plus or minus50.6 mL. The mean number of harvested lymph nodes was 17.4 plus or minus 8.4, with a 100% R0 resection rate. No severe complications (Clavien-Dindo grade [&ge;] III) occurred. The mean postoperative hospital stay was 8.2 plus or minus 1.5 days. Postoperative PROs indicated good defecatory function, urinary function, and overall quality of life. Conclusions: Preliminary findings demonstrate that the structured modular robotic NOSES-II procedure is safe and feasible for the treatment of mid-rectal cancer. This modular protocol provides a clear and reproducible technical framework for this complex procedure, and it is expected to achieve favorable functional preservation while ensuring oncological radicality.

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Diagnostic Accuracy Of Visual Inspection With Acetic Acid For Cervical Cancer Screening Among Women Living With Human Immunodeficiency Virus In Osogbo, Nigeria

Bola-Oyebamiji, S.; Awowole, I. O.; Adeyemo, S. C.; Oyeniran, A. O.; Bamkefa, T. A.; Olatunji, B. Y.; Adekanle, D. A.; Olabode, E. D.

2026-08-07 hiv aids 10.64898/2026.08.05.26359761 medRxiv
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Background Women living with Human Immunodeficiency Virus (WLHIV) are at high risk of cervical cancer. While Human Papilloma Virus Deoxyribonucleic acid (HPV DNA) testing is the standard of care, its cost limits widespread use in resource-limited settings, therefore visual inspection with acetic acid (VIA) remains the primary screening method. This study therefore evaluated the diagnostic accuracy of VIA compared to HPV DNA testing for cervical cancer screening among WLHIV in Nigeria. Methods This cross-sectional analytical study was conducted between November 2022 and November 2024 in Osogbo, Nigeria among 300 WLHIV on antiretroviral therapy aged 25-49 years underwent cervical cancer screening using VIA and HPV DNA testing (Ampfire HPV test kits, ATILA Biosystems(R) USA). All 309 participants underwent colposcopy and biopsy regardless of their screening results, with histological examination serving as the gold standard. Data were analyzed using Stata, with diagnostic performance measures calculated using histology as the gold standard. Results The mean age of participants was 42.6 {+/-} 6.4 years. Thirty-six of 309 women (11.7%) were VIA-positive, while 91 (29.4%) were HPV-positive. Histology confirmed CIN2+ in 22 participants (7.1%). HPV testing demonstrated significantly higher sensitivity than VIA for detecting CIN2+ (91.2%, 95% CI: 76.3-98.1 vs. 44.1%, 95% CI: 26.7-62.6; p<0.001) and higher negative predictive value (98.9%, 95% CI: 96.3-99.8 vs. 92.0%, 95% CI: 88.0-95.0; p<0.001). However, VIA showed higher specificity (91.7%, 95% CI: 87.8-94.7 vs. 83.3%, 95% CI: 78.4-87.6; p=0.003). The agreement between the two tests was fair (kappa = 0.20, p<0.001). Both HPV positivity (adjusted OR: 42.1, 95% CI: 9.5-186.2; p<0.001) and VIA positivity (adjusted OR: 6.9, 95% CI: 2.6-18.4; p<0.001) were independently associated with CIN2+. Conclusion HPV DNA testing demonstrated superior sensitivity and negative predictive value compared to VIA for detecting CIN2+ among WLHIV, while VIA showed higher specificity. Keywords: Cervical cancer screening, visual inspection with acetic acid, Human Papilloma Virus Women living with HIV, Nigeria

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Progesterone and hCG in expectant management success in tubal ectopic pregnancy: retrospective single-centre cohort study

Ahmad, A. K.; Pandrich, M.; Naik, A.; Astruc, A.; Lafferty, K.; Shah, N. M.; Ofili-Yebovi, D.

2026-08-07 obstetrics and gynecology 10.64898/2026.08.05.26359789 medRxiv
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Background: Early access to pregnancy assessment units now detects many tubal ectopic pregnancies (TEP) at a stage when they could resolve spontaneously, creating a management dilemma. Methods: We performed a hypothesis-generating exploratory analysis in a retrospective study to assess whether serum progesterone (P4) levels in women with TEP are associated with management outcome. Results: Ninety-one cases of TEP managed in a single centre over three years were analysed. Receiver operating characteristic (ROC) curve analysis was used to explore serum levels of progesterone (P4), first human chorionic gonadotropin (hCG) and peak hCG (alone and in combination) in relation with successful completion of expectant management. Decision-tree analysis using first hCG and P4 was additionally performed to explore clinical sequential risk stratification. 23% (n=21) successfully completed expectant management. P4 concentrations in the expectant management group (median 3 nmol/L, IQR 2.00 to 8.50) were significantly lower than in those requiring surgical or medical management (median 17 nmol/L, IQR 5.75 to 29.25; p=0.0002). Area under the ROC curve (AUC) values for P4, log10 first hCG, log10 peak hCG and P4 with log10 first hCG were 0.766, 0.814, 0.811 and 0.835, respectively, for predicting successful expectant management. However, hCG was not significantly outperformed. Nonetheless, Youden optimised thresholds for hCG and P4 are reported, alongside decision-tree analysis that identified sequential first hCG and P4 thresholds associated with successful expectant management. Conclusion: Lower P4 levels are associated with successful expectant management of TEP but they do not outperform hCG either alone or as an adjunctive marker.

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Aesthetic Appreciation and Environmental Values: A Cross-Cultural Study of Teachers in 34 Countries

Munoz, F.; Castera, J.; Bogner, F.; Clement, P.

2026-08-12 scientific communication and education 10.64898/2026.08.07.743443 medRxiv
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BackgroundThe relationship between aesthetic appreciation and environmental values remains a critical yet under-researched area in environmental psychology. Although the Two-Major Environmental Values (2-MEV) model--encompassing preservation and utilization dimensions--serves as a standard framework for assessing environmental attitudes, the integration of aesthetic perception within this structure has largely remained unexplored. This study investigates the conceptual linkages across a diverse international sample to determine whether aesthetic appreciation functions independently of a traditional environmental value framework. Methods and FindingsWe conducted a large-scale, cross-sectional survey involving 11,800 pre- and in-service teachers across 34 countries. Participants environmental values were evaluated using the 2-MEV scale, while their aesthetic appreciation of nature and the built environment was assessed using Osgoods semantic differential technique. Employing principal component analysis, hierarchical exploratory factor analysis (EFA), analysis of variance (ANOVA), and within-class analysis (WCA), we accounted for cross-national variations and evaluated response consistency. The results demonstrate that aesthetic appreciation comprises two distinct dimensions-- focusing separately on nature and the built environment--that operate independently of traditional preservation and utilization values, showing only weak correlations. Furthermore, while the overarching psychological structure remains consistent globally, our findings reveal significant cross-national variations in respondent scores, particularly concerning utilization-related values. ConclusionsThese findings establish that aesthetic appreciation constitutes a distinct psychological construct separate from conventional environmental value frameworks. The observed cross-cultural variability underscores the necessity of accounting for national and cultural contexts when designing environmental education programs. By leveraging a robust, comprehensive global dataset, this study provides a vital empirical foundation for integrating aesthetic and value-based dimensions into future environmental research and educational policy.

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Semantic networks as a tool for analyzing conceptual organization in active teaching methodologies in Microbiology

Nastaro, C. D.; Correa, B. R.; Tarantini, G.; Marana, S. R.; Cafe Ferreira, R. d. C.

2026-08-20 scientific communication and education 10.64898/2026.08.18.745559 medRxiv
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Active teaching methodologies have been widely used to promote meaningful learning and student autonomy. In this context, quantitative approaches can help assess how students organize and integrate knowledge throughout the learning process. Among these approaches, semantic co-occurrence networks stand out, as they are capable of identifying relationships between words and revealing the conceptual structure of textual productions. The objective of this study was to investigate whether semantic network analyses can characterize differences in students conceptual organization in Microbiology during their participation in the active teaching methodology "Adopt a Bacterium." To this end, a case study was conducted in the Bacteriology course at the Institute of Biomedical Sciences of the University of Sao Paulo, analyzing the textual productions of two groups of students in the years 2024 and 2025 during their study of the bacterial genus Bacillus. The texts were evaluated using semantic co-occurrence networks, taking into account metrics of structure and conceptual integration. The results showed that both groups covered the microbiological content outlined in the course, though with different thematic focuses and approaches to integrating the concepts. Although both years featured modular structures (a statistical mode of 9 subgraphs), in 2025 the network exhibited greater discursive robustness (2 to 4 times more words with high Betweenness centrality) than in 2024. It is concluded that semantic network analysis allows for the characterization of differences in conceptual organization among students using active learning methodologies, serving as a complementary tool for assessing meaningful learning in Microbiology.

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Waterlogging exposure and mental well-being: a cross-sectional study in rural southwest Bangladesh

Clech, L.; Bonnet, E.; Rezoan, D.; Kabir, M. M.; Shenk, M.; Ridde, V.

2026-08-06 epidemiology 10.64898/2026.08.04.26359716 medRxiv
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Background Waterlogging, a form of chronic, stagnant flooding, is increasing in the Ganges-Brahmaputra delta in Bangladesh due to the compounding effects of land-use change, including the expansion of brackish shrimp farming, poor water management, and changing rainfall regimes. Its effects are negatively impacting livelihoods and health; its association with mental wellbeing is less known. Methods We hypothesised that 1-recent waterlogging, 2-social disadvantage (women, older individuals, the poorest, the least educated, those with chronic illness, and religious minorities) would be associated with lower wellbeing, and 3-chronic illness would modify the association between waterlogging and mental wellbeing. 1260 respondents from 595 households in Tala upazila, southwest Bangladesh, were interviewed about their mental wellbeing, chronic illness, and exposure to waterlogging in the 12 months prior to data collection, in August and September 2022. Associations between WHO-5 wellbeing scores and waterlogging and covariates were assessed using multi-level linear mixed-effects models with household random effects and cluster fixed effects. Results Our results confirm our hypotheses: wellbeing was lower among disadvantaged groups and chronic health vulnerability modifies the association between waterlogging and wellbeing: waterlogging exposure was associated with 18.31-point lower WHO-5 scores among individuals with chronic illness (95% CI -26.45 to -10.17), an association markedly attenuated among those without chronic illness (interaction {beta}=14.21, 95% CI 5.48 to 22.95, p=0.001). Conclusion These results suggest that chronic illness may increase vulnerability to the mental health burden associated with waterlogging. As waterlogging is increasing, policies addressing both its environmental drivers and the needs of vulnerable populations should be considered.

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The Influence of Hand Muscle Fatigue on Fine Motor Performance During Selected Activities of Daily Living in Healthy Adults.

Alwash, M. A.; Karimi, H.

2026-08-10 rehabilitation medicine and physical therapy 10.64898/2026.08.07.26359929 medRxiv
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[Purpose] By pairing repeated peripheral muscle fatigue induction with a functional and ADL-based assessment, this study tests whether hand muscle fatigue alone is sufficient to im pair fine motor performance in healthy adults performing ADL-inspired tasks. [Participants and Methods] Thirty healthy male and female university students performed 11 tasks twice, once in the pre-fatigue condition and once in the post-fatigue condition. The performance of each task was graded on a 0-4 scale. The score and the time to finish the task (TTFT) were recorded twice, for both the pre- and post-fatigue phases. Maximum force gen eration (MFG) of each participant's grip was recorded prior to the tasks in the pre-fatigue phase and again in the fatigue condition after performing the fatigue protocol. [Results] Muscle fatigue did not have a significant effect on the fine motor performance of the thirty participants, neither (TTFT) nor the scores of each task (p > 0.05) (r=0.08). In contrast, hand muscle fatigue led to a significant decrease in the mean (MFG) for both males and females (p<0.01). [Conclusion] Hand muscle fatigue led to a significant decrease in the mean grip MFG for both sexes. However, this reduction did not translate into impaired fine motor performance during ADL-like tasks. Consequently, under muscle fatigue, hand grip changes during fine tasks tested are rare and have minor to no impact on hand performance. This study suggests that acute peripheral muscle fatigue can coexist with preserved fine motor performance in healthy populations.

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Lactate Dehydrogenase Activity and Carbohydrate Metabolism under Vanadium Citrate Exposure: Sex- and Dose-Dependent Effects in Rat Tissues

Iskra, R.; Klymets, H.; Oliynyk, I.

2026-08-24 biochemistry 10.64898/2026.08.23.746541 medRxiv
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Vanadium (V) is a potential insulinomimetic that can modulate carbohydrate metabolism, but its biological effects are sensitive to chemical form, concentration, and sex. Chelation of vanadium with organic ligands, in particular citrate, allows to increase its bioavailability and optimize pharmacokinetic properties. The aim of the study was to evaluate tissue-, dose-, and sex-dependent changes in physiological parameters and activity of the key glycolytic enzyme - lactate dehydrogenase (LDH) - under the influence of vanadium citrate. The study was conducted on 6-week-old Wistar rats of both sexes. The animals received vanadium citrate orally for 36-38 days at doses of 3, 12.5, and 50 g VCit/kg body weight. LDH activity in skeletal muscle, liver, kidney, and pancreas was investigated. No pronounced toxic effect on physiological parameters was detected: body weight dynamics corresponded to age norms, no behavioral changes were observed. LDH activity demonstrated pronounced sexual dimorphism and depended on the dose received. It was established that the optimal dose, which provides a modulating effect without signs of metabolic stress, for females is 12.5 g VCit/kg, while for males - 3 g VCit/kg. The most significant changes in LDH activity were recorded in the pancreas at a dose of 50 g V/kg, where the indicators decreased from 0.81 to 0.31 mol/(min x mg protein) in females and from 1.02 to 0.28 mol/(min x mg protein) in males. The effect of vanadium citrate on carbohydrate metabolism, as well as its dose-, tissue- and sex-specific nature, is likely determined by a dual action: the insulin-like effect of vanadium (redirecting pyruvate to oxidation) and the allosteric inhibition of glycolysis by the citrate ligand (substrate limitation for LDH). The obtained results emphasize the importance of considering sex and dose in the research and development of metabolically active compounds.

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Salicyl-Carnosine Protects Primary Cortical Rat Neuron Cultures in Conditions of Oxygen-Glucose Deprivation and NMDA-Induced Excitotoxicity by Preventing Oxidative Stress

Lopachev, A. V.; Abaimov, D. A.; Kulikova, O.; Rogneda, K.; Fedorova, T.; Khutorova, A.

2026-08-13 pharmacology and toxicology 10.64898/2026.08.07.743511 medRxiv
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Therapy of ischemic stroke is currently limited to pharmacological and/or mechanical recanalization. There are no neuroprotective therapies approved for use during the rehabilitative phase of ischemic stroke, which is characterized by neurodegenerative changes. Thus, the search for neuroprotective compounds capable of preventing neuronal death caused by pathogenetic cascades triggered during hypoxia is an urgent task. In this study, we demonstrate increased culture viability following pre- and post-incubation with salicyl-carnosine (SC) in a model of oxygen glucose deprivation on a primary culture of rat cortical neurons. Its neuroprotective properties were greater than that of acetylsalicylic acid and carnosine, and it was effective in lower concentrations. In addition, SC protected the culture from NMDA-induced excitotoxicity. We also showed the passage of SC into neurons, and the presence of its direct antioxidant activity in a model of paraquat-induced oxidative stress. The neuroprotective effects of SC are associated with a decrease in the level of pro-apoptotic protein Bak and a decrease in the activation of kinase p38, as well as an increase in the activation of kinase ERK1/2. The acquired data suggests that SC is a promising neuroprotective compound, and warrants further investigation in vivo.

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Effect of household boiling on ciprofloxacin and enrofloxacin residues in cow milk from Dhaka, Bangladesh: paired HPLC-UV screening and dietary exposure assessment

Ahmed, M.; Asif, M. A.; Rinky, F.; Mostafa, M. G.; Bhuiyan, M. N. I.; Afrin, S.; Ahmed, T.; Rahman, A.

2026-08-21 epidemiology 10.64898/2026.08.18.26360522 medRxiv
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Boiling raw milk before drinking is a common practice in Bangladesh, but its impact on residue levels of ciprofloxacin and enrofloxacin is not well known. This study looked at these antibiotics in 120 raw cow milk samples from 12 dairy areas near Dhaka, collected between November 2023 and March 2024. Each sample was split into two parts: one tested as raw milk and the other after boiling at home for 15 minutes. Residues were checked using matrix-matched HPLC-UV. Ciprofloxacin and enrofloxacin were found in 113 out of 120 samples (94.2%), and at least one of them was present in 117 samples (97.5%). We considered a level of 12.5 micrograms per liter or higher as detected. The average combined amount of these antibiotics dropped from 194.61 micrograms per kilogram in raw milk to 179.57 micrograms per kilogram after boiling, a decrease that was statistically significant (p < 0.001). However, the percentage of samples exceeding the EU maximum residue limit of 100 micrograms per kilogram only went down from 92.5% in raw milk to 90.0% after boiling, which was not statistically significant (p = 0.250). Using national milk consumption data as an estimate of intake, the hazard index for adults was 0.360 for raw milk and 0.332 for boiled. Calculated with a 10 kg body weight, these values were 2.159 and 1.992, respectively. Overall, boiling at home did reduce the levels of ciprofloxacin and enrofloxacin, but it usually did not bring high-residue samples below the EU limit.

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Predictors of Brain Injury: The Performance of Biomechanical Head Acceleration Severity Metrics for Concussion Prediction in Men's and Women's Rugby League Players

Tooby, J.; Owen, C.; Whitehead, S.; Scantlebury, S.; Vishnubala, D.; Wu, L.; Kitchin, M.; Ji, S.; Rowson, S.; Tucker, R.; Zhang, C.; Jones, B.

2026-08-13 sports medicine 10.64898/2026.08.12.26360260 medRxiv
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ObjectiveDescribe and compare the biomechanical severity of head acceleration events (HAEs) associated with diagnosed concussion in elite mens and womens rugby league using instrumented mouthguards (iMGs) and evaluate the diagnostic accuracy and screening performance of severity metrics within the current Head Injury Assessment (HIA) process. MethodsA prospective cohort of 398 men and 252 women from Super League teams wore iMGs across 515 matches. Following a matching and data quality screening procedure, 123 HIAs (106 men, 17 women) were matched to HAEs, 52 of which were diagnosed concussions (44 men, 8 women). High-magnitude asymptomatic control HAEs (22,676 men, 3,200 women) were sampled proportionally to the number of HIAs. A range of biomechanical severity metrics were calculated for HAEs. Statistical comparisons between outcomes were made. Receiver operating characteristic (ROC) analysis evaluated diagnostic accuracy (ability to predict diagnosed concussions within the HIA). Precision-recall analysis evaluated screening performance (ability to discriminate observable concussion signs from asymptomatic events). ResultsDiagnosed concussions had greater severity than asymptomatic HAEs across all metrics in both sexes. For diagnostic accuracy, area under the ROC curve ranged from 0.61 to 0.72 in men and 0.53 to 0.86 in women. For screening performance, optimal thresholds in several metrics provided theoretical improvements to precision over current thresholds used in rugby, but recall remained <0.20. ConclusionThese findings support integrating iMG-derived severity metrics into a multimodal, clinician-led HIA pathway as objective adjuncts for diagnosis and screening, while reinforcing that they cannot replace clinical judgement or other assessment modalities. What is already known on this topicInstrumented mouthguards are increasingly used in rugby to quantify head acceleration events and trigger Head Injury Assessment (HIA) alerts, but current screening thresholds based on simple peak kinematics have low sensitivity for identifying HAEs linked with visible concussion signs, and very few iMG-measured concussions, particularly in women, have been reported in current research. What this study addsThis study provides the largest dataset of iMG-measured concussions in any sport, shows that concussive HAEs are more severe than asymptomatic events across multiple biomechanical metrics in both sexes, and identifies several severity metrics with diagnostic accuracy comparable to existing HIA sub-tests and modest theoretical improvements over current screening thresholds. How this study might affect research, practice or policyThese findings support incorporating iMG-derived severity metrics as objective adjuncts within clinician-led HIA pathways, highlight the need for sex-inclusive iMG datasets and multimodal concussion identification, and may inform future refinement of iMG screening thresholds in elite rugby and other contact sports.