Abstract: Background/Objectives: Pre-exposure prophylaxis (PrEP) is highly effective in preventing the sexual acquisition of HIV but does not directly protect against other sexually transmitted infections (STIs). This study sought to characterize the extent of PrEP awareness and knowledge among current users, former users, and non-users and, secondarily, to describe prevention and sexual health experiences among those who currently or previously used it. Methods: An exploratory cross-sectional observational study was conducted using an anonymous, self-administered web survey distributed through social media and LGBTIQ+ community networks in Colombia. The instrument included sociodemographic variables, prior awareness, sources of information, 15 objective knowledge items, and modules conditional on PrEP-use experience. Projected Results: Overall, 69.8% had heard of PrEP; 21.6% were current users and 6.8% were former users. Knowledge was high in 53.6% and low in 39.9%. Among current or former users, 59.5% reported decreased condom use, 41.8% quarterly screening during use, and 58.2% less sexual anxiety. Conclusions: Awareness was substantial, although incomplete and unequal, and knowledge gaps persisted between users and non-users. Democratizing PrEP requires moving it beyond specialized settings into primary care and comprehensive sexual health services, with community participation, clinical support, and combination prevention.

Abstract: Autism spectrum disorder is characterized by substantial heterogeneity in developmental trajectories, biological profiles, adaptive functioning, regulatory capacity, family-contextual factors, and response to intervention. Although evidence-informed interventions may benefit many autistic children, therapeutic response remains variable, limited, or fluctuating in a significant proportion of cases. This variability highlights the need for stratification frameworks that can better characterize when, how, and under what conditions an autistic child becomes accessible to therapeutic input. This Hypothesis and Theory manuscript proposes the Therapeutic Engagement Index (TEI) as a hypothesis-generating stratification construct for understanding variability in therapeutic accessibility and intervention responsiveness in autism. TEI is situated within FIAP^® — Framework for Integrated Autism Precision Care — and is conceptualized as a multidimensional framework integrating regulatory availability, attentional and interactional access, responsiveness to therapeutic support, persistence and adaptive effort, contextual transfer, and relational/motivational engagement. The manuscript further clarifies the concept of functional bottlenecks as multidimensional constraints that may limit access to intervention despite the availability of therapeutic support. These bottlenecks may involve regulatory instability, sensory overload, fatigue, sleep disruption, anxiety, communication barriers, family-contextual stress, or mismatch between intervention demands and the child’s adaptive capacity. TEI is not presented as a validated clinical scale, diagnostic instrument, predictive model, or intervention protocol. Rather, it is proposed as a research-oriented conceptual architecture requiring feasibility testing, inter-rater reliability assessment, construct validation, longitudinal evaluation, and empirical testing in clinical and community contexts. Similarly, TEI-Precision is framed as a conceptual translational architecture for future human-supervised digital implementation, not as an implemented digital health platform, autonomous artificial intelligence system, or validated decision-support tool. By operationalizing TEI domains, clarifying illustrative engagement profiles, and outlining a staged validation roadmap, this manuscript aims to support future research on precision autism care, therapeutic responsiveness, biological burden, and responsible digital health translation.

Abstract: We present the Defactorized Homomorphic Polynomial Public Key (D-HPPK) Encapsulation Mechanism, a post-quantum cryptosystem whose security reduces to searching over the ephemeral secret x in F_p. Classical secret recovery requires Θ(2^l) field-element trials, with O(L₂) bit operations per trial, yielding l+2log₂L bits of classical security and l/2+log₂L bits of quantum security. The scheme uses a three-layer architecture of additive random masking and hidden ring embeddings. Masking destroys exploitable factorisation structure, while hidden moduli S₁,S₂ and multipliers R₁,R₂ (all coprime to p) prevent adversaries from evaluating the cancellation condition in F_p. Key recovery requires O(p³) operations and is not the bottleneck. Under the Hidden Modulus Product Problem and uniform decryption assumptions, we prove the base PKE satisfies message-recovery security; a double-encryption consistency check yields IND-CCA2 security in the random oracle model. A unified parameter set (n=2,m=3,log₂p=λ) ensures efficient, uniquely invertible decryption at NIST security levels. At Level V (λ=256), D-HPPK achieves a 1234-byte public key and 392-byte CCA2 ciphertext — 21% smaller public keys and 87% smaller ciphertexts than Kyber-1024 — with 8× faster encapsulation and 4× faster decapsulation in reference implementations, all without requiring SIMD or NTT acceleration. A single implementation scales across levels. D-HPPK demonstrates that polynomial-based cryptography can deliver rigorous security, compact footprints, and practical efficiency.

Abstract: Orofacial myofunctional therapy (OMT) addresses functional impairments involving tongue and lip function, swallowing, and breathing behaviors. Mobile health (mHealth) platforms may facilitate structured delivery and monitoring of home-based exercises, but evidence regarding feasibility in clinical practice remains limited. This study evaluated the feasibility of a smartphone-based OMT platform by examining pre- to post-intervention changes in functional measures and adherence. A retrospective observational analysis was conducted using 15 de-identified clinical records from a single clinical database. Eligible records included documented platform use, baseline and post-intervention measurements, symptoms of at least six months’ duration, and participation in the 16-week intervention. Measures included lip pressure, tongue pressure, swallowing performance, peak nasal inspiratory flow (PNIF), forward head posture, and incentive spirometry. Paired t-tests or Wilcoxon signed-rank tests were used as appropriate. Significant pre- to post-intervention changes were observed in forward head posture, PNIF, incentive spirometry, lip pressure, tongue pressure, and swallowing performance. Adherence was high, with 14 of 15 participants (93%) completing the 16-week program. No adverse events were reported. This retrospective analysis provides preliminary feasibility data for smartphone-delivered OMT. Findings are exploratory and do not establish efficacy, causality, diagnostic validity, or effectiveness for specific medical conditions. Prospective controlled studies using standardized outcome measures are warranted.

Abstract: Isaac Newton believed that gravity requires the universe to be centreless and infinite in all directions. For Issac Newton, the idea that the universe exploded out of nothing was unthinkable. He believed that in the universe, time does not play any role; the universe is eternal. In Post-Newtonian cosmology, universal space is time-invariant. Time, as the duration of stellar objects motion in space, is an emergent physical quantity that enters existence in the process of measurement. The universe is uncreated and eternal. AGNs are rejuvenating systems of the universe. The model of the stationary universe is based on direct reading of astrophysical data and is far superior to the Big Bang theory. We re-examine the origin of the universe in some distant physical past and find that it is a theoretical mistake based on a misinterpretation of astrophysical data.

Abstract: Wildfires are an escalating natural hazard in Australia and a growing public health concern. Exposure to wildfire smoke is associated with acute and chronic adverse health effects, placing wildland firefighters at elevated risk due to recurrent occupational exposure. Although protective behaviours and personal protective equipment (PPE) are recommended, uptake remains inconsistent due to operational and behavioural barriers. This descriptive qualitative study applied the Health Belief Model to explore firefighters’ risk awareness, protective practices, motivators, and barriers. Semi-structured interviews were conducted with eleven wildland firefighters in Southeast Queensland, Australia. Participants demonstrated strong awareness of short-term health effects, informed by personal experience, but limited understanding of long-term health risks. Compliance with mandatory PPE (clothing, gloves, boots, helmets) was high and motivated by prevention of immediate injury. However, respiratory protective equipment use was inconsistent due to discomfort, poor fit, communication difficulties, and operational constraints. Additional barriers to health protective behaviours included limited decontamination access and inequities in PPE design, particularly for women. Participants identified improved health education, practical PPE options, and further research as priorities for strengthening occupational health protection. Addressing these barriers through improved knowledge translation, organisational support, and approaches such as cultural burning may reduce exposure and improve workforce health.

Abstract: Background: Simulation is a key clinical teaching tool in the context of uncommon but high-risk clinical contexts such as ischaemic priapism – a urological emergency. This initiative aims to develop a novel, low-cost priapism task-trainer as part of a priapism workshop to boost confidence and knowledge of urology resident doctors in the aetiology and management of priapism. Methods: A workshop comprising a 30-minute presentation on priapism aetiology and management, and 45-minute practical component, was delivered to a group of 6 urology resident doctors as part of the local departmental teaching programme. Consultant oversight in preparation and delivery of the session was used for content quality-assurance. The practical workshop component focussed on corporal aspiration utilising an innovative design of a priapism task-trainer with easily sourced and low-cost primary materials, short assembly time and acceptable fidelity with real-world clinical presentations. Results: Pre (N=5) /post (N=4) session responses showed increase in 10-point Likert scale median confidence scores in priapism aetiology (3 increased to 8) and management (2 to 8.5). Knowledge scores in aetiology and management were similar pre-post session (60% vs 63% average clinical scenario scores). Comments on the task-trainer showed participants valued the realism, accuracy, ease-of-use and interactivity that the task-trainer enabled. To improve, participants commented on longer time for practice. Discussion: This novel priapism workshop and corporal aspiration task-trainer represent a feasible, low-cost, realistic tool for boosting confidence of urology residents in priapism management, including corporal aspiration. Objective assessment of aspiration skills and knowledge scores should be considered in future larger-scale studies.

Abstract: Introduction: Following the end of the COVID-19 pandemic, excess mortality rates declined in many countries. However, Japan’s excess mortality rate remained elevated even in 2024. Most countries have stopped administering booster vaccines on a large scale; however, Japan continues to recommend COVID-19 vaccination for elderly individuals, and its booster vaccination per capita rate is the highest in the world. This study attempted to identify the variables related to excess mortality rates during and after the pandemic. Methods: The age-adjusted numbers of deaths and excess mortality rates were calculated for Japan's 47 prefectures from 2020 to 2024. Scatter plots were generated to visualize the relationship between the excess mortality rates and doses of COVID-19 booster vaccine administered. The regression model was subsequently conducted to examine variables associated with excess mortality rates during and after the pandemic across Japan's 47 prefectures. Results: In Japan, age-adjusted excess mortality was not observed in 2020 and 2021; however, it increased to 5.9% in 2022 and 4.9% in 2023. This increase continued even in 2024, when the pandemic ended, reaching 5.7%. During the pandemic period from January to September 2022, when vaccine doses were limited to four, the age-adjusted excess mortality rate showed a negative correlation with the number of vaccine doses (r=-0.55, p<0.01). From June 2023 to September 2024, however, after the pandemic ended and doses 5 to 7 were added, a positive correlation emerged ( r=0.25, p=0.1). A multiple regression analysis showed that excess mortality rates after the pandemic was more strongly associated with the number of booster vaccine doses than with the number of COVID-19 infections and population density of the 47 prefectures. Conclusions: This ecological analysis underscore the importance of continued surveillance of excess mortality in super-aged societies and highlight the need for individual-level and mechanistic studies to elucidate the relative contributions of SARS-CoV-2 infection, demographic factors, healthcare changes, and vaccination.

Abstract: Urban regeneration increasingly uses tourism scenario activation to renew heritage, public space and local economies. Yet the production of urban attractiveness can intensify tourism gentrification, commercial reorientation and the erosion of ordinary urban life. This integrative review synthesises research across urban regeneration, touristification, tourism gentrification, place branding, speculative and platform urbanism, liveability, publicness and collaborative governance. Through a problem-driven comparison of these literatures, it formalises touristic desirability as the relational and institutionally organised value logic through which anticipated visitor-oriented attention, experience and value shape what becomes visible, investable, programmable and materially actionable. It develops urban cohabitation as an evaluative criterion for whether tourism-led regeneration sustains heterogeneous forms of residence, use, livelihood, memory and collective agency. The review identifies four operations of desirability and eight interdependent conditions of cohabitation, then translates their relationship into governance principles centred on anticipation, shared urban capacities, alignment of value, voice and responsibility, and sustained public and collective direction. It concludes that regeneration becomes inclusive when becoming more visitor-oriented strengthens, rather than narrows, the conditions through which cities remain inhabitable, plural and collectively governable.

Abstract: Milling cutters are subjected to variable mechanical loads during machining, which can affect their structural integrity and thermal condition. This study aims to evaluate the effect of external cutting force on the stress–strain and thermal responses of a mushroom-shaped slot milling cutter. A three-dimensional model of a six-tooth cutter with a 14 mm cutting diameter and an 8 mm shank diameter was developed in SolidWorks Simulation. The cutter was modeled using AISI M2 high-speed steel, while an AISI 4340 steel workpiece was included to represent the cutter–workpiece contact. Static analyses were performed under forces of 500, 750, and 1000 N, and the von Mises stress, resultant displacement, and equivalent strain were determined. Thermal analyses were additionally conducted using corresponding heat inputs. The maximum von Mises stresses were 158.8, 238.4, and 326.9 MPa, while the corresponding displacements were 0.04529, 0.05818, and 0.09097 mm for 500, 750, and 1000 N, respectively. The maximum temperatures increased from 380.15 to 561.95 and 748.85 °C with increasing load. The results demonstrate a systematic increase in both mechanical and thermal responses with increasing cutting force, providing a basis for identifying critical regions and assessing cutter operating conditions.

Abstract: Auditing a firewall as a black box means learning, from accept/deny answers alone, whether a device implements the intended policy. A companion paper showed this is inherently expensive classically: a hidden rule in a header space of size N = 2^104 forces N − 1 queries, while structured tree-rule and disjoint listed-rule policies are learned with Θ(m log W) queries (m rules, field width W). We ask what changes when the auditor is quantum. If the firewall records which rule it hit (a hit counter), every quantum advantage vanishes: the counter is a projective measurement of the query register. Quantum queries do not help on structure: localising a tree-rule or disjoint listed-rule policy still needs Ω(m log W) queries, by a direct-sum theorem for the adversary bound over m independent ordered searches. On overlapping listed-rule policies, a hidden-corner family shows that re-localising one rule whose corner lies on an antichain of width n, the other rules being known, costs Ω(n) classically and Θ(√n) quantumly against O(log W) for a tree boundary: in incremental audits, overlap can be exponentially more expensive than tree structure. Only unstructured tasks keep the Grover square root (Θ(√N) hidden rule, Θ(√(N/M)) witness, Θ(√m) certificate replay). Simulations with real policies compiled into quantum oracles confirm the constants.

Abstract: Deciding whether a vertex of a cubical complex lies on a locally well-composed surface reduces to a finite question: examine the occupancy pattern of the eight voxels incident to the vertex and decide whether the resulting active incidence structure is connected and 2-regular. We give a symbolic account of this decision. Writing \(n_E(S)\) and \(n_F(S)\) for the numbers of active edges and faces determined by elementary local activity rules, we show that every active face has degree exactly two and every active edge has degree two or four, yielding the identity \(n_F(S)=n_E(S)+k(S)\) for a single defect count \(k(S)\), and hence a surface criterion equivalent to \(\mathrm{comps}(S)=1\wedge n_E(S)=n_F(S)\). We further prove that the active incidence structure is invariant under complementation as a literal identity, not merely up to isomorphism, and combine this duality with a finite case analysis to classify explicitly which pairs \((|S|,d_1(S))\) of cardinality and Hamming-adjacency count are realized by a surface state, yielding an exact threshold classification as a proved corollary. The classification is established by a complete finite case analysis up to cube symmetries for \(|S|\le4\) and by duality for \(|S|\in\{5,6,7\}\).

Abstract: Civil infrastructure failures pose profound socioeconomic risks, demanding advanced diagnostics over traditional Structural Health Monitoring (SHM), which relies on expensive wired networks and periodic inspections that miss rapid real-time buckling in slender columns. This paper presents a low-cost Cyber-Physical Digital Twin (CPDT) framework linking affordable IoT hardware with rigorous numerical validation. A 25 mm × 6 mm × 490.22 mm flat-plate steel column was tested under incremental axial compression; a nonlinear Abaqus model (incorporating elasto-plasticity and a 1.5 mm geometric imperfection) predicted the 3,150 N failure load within 0.6%. A custom $25.30 Arduino-based IoT node calibrated to this baseline converged within 0.28% of the peak load benchmark. Training nine machine learning algorithms on a 1,000-sample Latin Hypercube dataset, Gaussian Process Regression (GPR) emerged superior, achieving R²=0.993 (cross-validation) and R²=0.999 (testing). Parallel-threaded Python middleware guarantees sub-millisecond latency for live synchronization of Abaqus Von Mises stress contours. An autonomous closed-loop alert successfully triggered pre-failure warnings at 90.3% of the ultimate load. Furthermore, a Multi-Geometry Scaling Framework—utilizing an Inverse Strain Recovery algorithm (\(\mathcal{E} = \frac{\mathrm{Papp}}{\mathrm{ExAbase}}\)) and Double V-Lookup database interpolation—scales the system to arbitrary dimensions without physical recalibration, yielding a 1.75% mean absolute percentage error across ten blind-validation specimens. This provides a scalable, verified blueprint for autonomous structural risk mitigation, reducing costs by over 97% versus conventional SHM.

Abstract: Virtual influencers are used to communicate luxury-brand meanings, but the process by which source attributes become purchase intention remains insufficiently established. This study integrates source credibility, meaning-transfer, and parasocial perspectives and tests paths from virtual-influencer attributes through parasocial interaction and brand attitude to purchase intention, including theory-driven serial indirect effects. Online data were obtained from 631 Chinese Generation Z respondents and after the filtering of those without virtual influencer exposure, the database retained 511 with prior virtual-influencer experience. PLS-SEM in SmartPLS 4 and artificial neural networks in R were combined. PER4, PSI3, and PSI5 were removed after first-run loadings of 0.569, 0.509, and 0.583. The final model explained 34.3% of parasocial interaction, 42.6% of brand attitude, and 44.3% of purchase intention. All specific indirect effects were positive; three serial paths were supported, while the expertise chain was equivocal because its percentile interval excluded zero but p = 0.055. Anthropomorphism strengthened the brand attitude–purchase intention relationship, while emotional engagement did not moderate the parasocial-interaction path. Repeated nested validation produced predictor rankings consistent with PLS-SEM, but ANN errors did not differ significantly from matched linear benchmarks. Relational and attitudinal conversion, rather than widespread direct persuasion or strong nonlinearity, was central to virtual luxury influence.

Abstract: Turboshaft engines must maintain nearly constant power-turbine speed under rapid rotor-load variations while respecting limits on spool speed, turbine temperature, and compressor pressure. Performance regulation and engine protection are often designed and assessed separately, leaving their interaction insufficiently explored. This paper presents an integrated Full Authority Digital Engine Control (FADEC) architecture for a GE T700-class turboshaft engine, developed using a nonlinear T-MATS model. The architecture combines a sliding mode fuel-flow controller, two-dimensional variable guide vane scheduling based on corrected gas-generator speed and Mach number, actuator and sensor dynamics with transport delays, and an industrial Min–Max protection layer with anti-windup compensation. A gain-scheduled PI controller designed using the same loop-shaping specification serves as the baseline, allowing the comparison to isolate the effects of control structure rather than loop bandwidth. The vane schedule improved compressor surge margin in three of the four mission segments. During scheduled operating-point transitions, the two controllers exhibited comparable performance, as the shared feedforward schedule dominated the fuel command. Under ±20% and ±40% load disturbances, the sliding mode controller reduced the peak power-turbine speed deviation at every event, with an average reduction of 4.1%, while requiring 40% fewer protection-limiter activations. This difference is substantially larger than the advantage indicated by conventional transient metrics, which do not capture the residual baseline oscillations when they remain within the settling band. Automatic code generation produced 301 lines of code and 192 bytes of static RAM, corresponding to 39% less code than the baseline with identical memory requirements. Software-in-the-loop verification further confirmed the functional equivalence of the generated implementation.

Abstract: Distributional gaps in poorly documented Neotropical mammals often reflect the combined effects of ecological filtering, low detectability, taxonomic uncertainty, and incomplete sampling. We reassessed the documented distribution of L. brachyotis (Dobson, 1879), a rarely collected forest-dwelling phyllostomid bat, using an expanded occurrence dataset and specimen-based validation. Independently, we used ecological niche models to characterize climatic suitability under current and paleoclimatic conditions. We compiled 125 documentary or specimen records from published sources and museum material, including new voucher-based records from southern Ecuador and northern Colombia, and consolidated them into 121 reviewed unique locality-coordinate units. After environmental screening and cell-level deduplication, 115 unique presence cells were used for model calibration. The best-supported model used linear, quadratic, and hinge features with a regularization multiplier of 2.5 and performed significantly better than null-model expectations. Under current conditions, climatic suitability was broad but spatially heterogeneous across northern South America, with additional suitable areas in Mesoamerica, the Andean–Amazonian in-terface, central Brazil, and southeastern Brazil. Temporal projections identified recurrent areas of climatic suitability across northern South America, but were interpreted as climatic context rather than direct evidence of historical occupancy or demographic continuity. The new records indicate that the documented distribution remains incomplete along its margins. Our results support a revised interpretation of L. brachyotis as a rarely recorded humid-forest bat with a coherent Amazonian–Guianan core and peripheral extensions consistent with the combined influence of climatic suitability, habitat heterogeneity, and incomplete sampling.

Abstract: Agentic reinforcement learning scales training by expanding programmatic environments and synthesizing diverse tasks. We show that this scaling can paradoxically narrow training coverage through how data are constructed. Existing pipelines often construct tasks from executable paths or successful workflows, inducing a construction-induced selection bias toward feasible requests. In real-world applications, however, users often state goals without observing the environment state or environment-specific constraints, leaving such interactions underrepresented in training. This bias shows that scaling training around executable tasks alone cannot adequately represent the user--environment relations encountered in real-world applications. For such interactions, the existence of a conflict, its valid resolutions, and the corresponding supervision must be jointly determined with respect to the same environment instance. We therefore rethink agent training by taking the training scenario, rather than the executable task alone, as the unit of construction and verification. We introduce ReAgent to instantiate this view through scenario co-design, using environment-supported conflicts and valid resolutions as the common basis for jointly defining the task, user behavior, and supervision. ReAgent constructs feasible and conflict scenarios over execution-tested programmatic environments. Across two model scales and three agent benchmarks, ReAgent yields consistent gains spanning executable, blocked, and partially resolvable requests.

Abstract: Word decoding as a foundational reading skill is significantly associated with phonological awareness in children with typical development as well as children with intellectual disabilities. Phonological awareness is often assessed using traditional behavioral methods, which may underestimate abilities, particularly in individuals who are difficult to test due to behavioral, communication or attentional difficulties. This study tested whether an eye-tracking “looking-while-listening” paradigm provides an additional recording option which is appropriate and potentially informative to examine the cognitive process while solving phonological awareness tasks in the assessment of children with intellectual disabilities. Fifty-nine children with mild to moderate intellectual disabilities (aged 8–14 years) completed sound, syllable, and phoneme blending and segmentation tasks in paper-based and eye-tracking formats. Participants were classified as proficient or non-proficient based on behavioral performance in the paper-based format. Eye-tracking indices included fixation duration, counts, revisits, and first fixation on target, phonologically similar, and distractor images. Proficient participants showed longer fixation durations and more fixations on target images, as well as greater attention to phonologically similar competitors than distractors, compared to non-proficient participants, who showed no such differentiation. These findings suggest that eye-tracking is a process-oriented method for assessing phonological awareness in children with intellectual disabilities and may capture cognitive mechanisms not reflected in traditional assessment procedures.

Abstract: Background/Objectives: Malnutrition, feeding difficulties, and morbidity frequently coexist among vulnerable children and contribute to poor health and developmental outcomes. However, limited evidence has examined how these factors interact across diverse care settings or how structured nutrition interventions influence child health over time. This study examined the relationships among malnutrition, feeding difficulties, disability, and morbidity in children enrolled in Holt International's Child Nutrition Program (CNP) and evaluated changes in nutritional status, feeding difficulties, and morbidity after one year of participation. Methods: We retrospectively analyzed deidentified health and nutrition records from 13,370 children (0–18 years) enrolled in the CNP across eight low- and middle-income countries. Nutritional status was classified using WHO growth standards and references. Logistic regression examined associations between baseline malnutrition, disability, and morbidity, adjusting for age and sex. A longitudinal subset (n = 1,452) was used to assess associations between feeding difficulties and morbidity and changes in nutritional status, feeding difficulties, and morbidity after one year using McNemar tests. Results: At baseline, 45.5% of children were moderately or severely malnourished, 17.6% had at least one morbidity, 12.8% had feeding difficulties, and 22.3% had disabilities. Severe malnutrition was associated with higher odds of morbidity (OR = 1.39, 95% CI: 1.25–1.56), hospitalization (OR = 2.52, 95% CI: 1.92–3.31), cough, and constipation. Feeding difficulties were independently associated with morbidity (OR = 1.86, 95% CI: 1.53–2.25). After one year, nutritional status improved in 29.2% of children, feeding difficulties and morbidity declined, and the greatest improvements in malnutrition were observed among children with disabilities. Conclusions: Malnutrition and feeding difficulties were independently associated with increased morbidity among vulnerable children. Participation in a structured nutrition intervention was accompanied by improved nutritional status and modest reductions in morbidity over one year. These findings support integrating nutrition rehabilitation, feeding assessment, and routine health monitoring into child nutrition programs serving vulnerable populations in low- and middle-income countries.

Abstract: CCDC69 was previously identified as a gene upregulated during adipogenic differentiation of human Simpson–Golabi–Behmel syndrome (SGBS) preadipocytes but not mouse 3T3-L1 preadipocytes. Here, we investigated the role of CCDC69 in adipogenesis using SGBS cells. CCDC69 expression during adipogenic differentiation was assessed by quantitative reverse transcription PCR and Western blotting. CCDC69 function was examined by adenovirus-mediated overexpression and knockdown, followed by analyses of lipid accumulation, adipocyte marker expression, cell morphology, and cytoskeletal organization. CCDC69 expression increased during adipogenesis. CCDC69 overexpression enhanced adipogenesis, as indicated by increased lipid accumulation, a higher proportion of cells containing lipid droplets, and increased expression of adipocyte marker genes and proteins. Unexpectedly, CCDC69 knockdown also enhanced adipogenesis. Time-course analysis showed that CCDC69 overexpression suppressed PPARG mRNA expression during early adipogenesis but increased its expression at later stages, whereas knockdown increased PPARG expression at later stages. CCDC69 overexpression induced a flattened cell morphology accompanied by reduced fibrillar α-tubulin structures and F-actin stress fibers and increased punctate F-actin structures, whereas knockdown increased the number of small, round cells. These findings indicate that CCDC69 may regulate adipogenesis in a stage-dependent manner and is associated with adipocyte morphology and cytoskeletal organization.