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Background Increasing choice among HIV pre-exposure prophylaxis (PrEP) products bears potential to increase uptake, persistence, and coverage amongst those at risk of HIV acquisition. Few studies have evaluated PrEP persistence during real-world delivery of multiple PrEP products from community-based sites to adolescents and young people. Methods The PrEPared to Choose (PtC) study delivers PrEP choice across oral, injectable, and vaginal ring options to adolescents and young people (15–29 years) and their potential male partners in Cape Town, South Africa. This phase 3B clinical trial utilizes a type 2 hybrid implementation design with co-primary clinical and implementation aims that include an analysis of PrEP persistence (defined as sustained use of PrEP product as intended with < 7 vs. < 28 day gap in dosing as scheduled) over the short term (7 months) and long term (18 months), and the identification of implementation strategies that best support PrEP adoption and persistence. PtC is delivered from a mobile clinic and a public health primary care clinic, staffed by trained nurses, HIV counsellors, and peer-navigators. PrEP selection is guided by a co-created PrEP choice counselling intervention, with allowance for product switching at subsequent visits, but no reimbursement for PrEP uptake or return. Discussion PrEPared to Choose will provide an early report of real-world PrEP choice delivery, including all three currently available and approved modalities. The protocol is designed to simulate a real-world environment that provides insight into likely PrEP persistence patterns and practical challenges to PrEP choice implementation in a high HIV burden setting (South Africa) and within high HIV incidence populations (adolescents and young people). The results will be used to inform PrEP choice delivery in South Africa and build a framework into which future, emerging PrEP modalities can be incorporated. Trial approvals and registration This is a phase 3B clinical trial registered with the South African Health Products Regulatory Authority (20230904). Ethical approval was granted by the Human Research Ethics Committee (Faculty of Health Sciences, University of Cape Town, 567/2023). It is registered with the South African National Clinical Trial Registry (DOH-27-012024-5189, 26 January 2024) and ClinicalTrials.gov (NCT06807736, retrospectively registered on 4 February 2025).

Background Adolescents and young people (AYP) are at increased risk of HIV acquisition and onward transmission in South Africa. The benefits of oral pre-exposure prophylaxis (PrEP) are well established, however, epidemic impact depends on access, effective use and scale-up. Methods FastPrEP is an implementation science project that aims to scale up oral and novel PrEP modalities through differentiated service delivery to improve uptake and optimal use of PrEP in key populations. Designed to leverage some of the attributes that make fast-food popular such as efficiency, access, variety (choice) and flexibility, FastPrEP aims to further “demedicalise” the buy-in and access to HIV prevention methods. Attracting young people regardless of HIV serostatus, FastPrEP will deliver PrEP as part of integrated sexual and reproductive health (SRH) packages tailored for key youth populations using mobile clinics ( n  = 4) and local government clinics ( n  = 12) as “hubs” for PrEP initiation. These and other community-based outlets such as youth clubs, courier delivery, schools and other youth frequented venues will serve as “spokes” for PrEP maintenance. FastPrEP aims to scale up PrEP in a dense, HIV-burdened, peri-urban community of approximately one million people in Cape Town. We will adopt the RE-AIM framework to evaluate the FastPrEP intervention among diverse AYP aged 15–29 years (targeting approximately 25 000 AYP) and their sexual partners of any age. We will use a phased approach to build the program and evaluate PrEP uptake and persistence in AYP over time. Discussion The overall objective is to evaluate whether community-wide, differentiated delivery of PrEP with regard to user choice leads to greater PrEP uptake among sexually active youths who would benefit most from comprehensive HIV protection. Secondary objectives include evaluating the differences in demographic, socio-behavioural, and risk behaviours between PrEP users and non-PrEP users to determine the effectiveness of demand creation strategies and evaluate the utility of different PrEP outlets. FastPrEP will evaluate the scale-up of community-delivered, differentiated PrEP to AYP and their sexual partners, aiming to improve understanding of the differentiated delivery of PrEP services and their impact on PrEP persistence in key populations.

Increasing choice among HIV pre-exposure prophylaxis (PrEP) products bears potential to increase uptake, persistence, and coverage amongst those at risk of HIV acquisition. Few studies have evaluated PrEP persistence during real-world delivery of multiple PrEP products from community-based sites to adolescents and young people. The PrEPared to Choose (PtC) study delivers PrEP choice across oral, injectable, and vaginal ring options to adolescents and young people (15-29 years) and their potential male partners in Cape Town, South Africa. This phase 3B clinical trial utilizes a type 2 hybrid implementation design with co-primary clinical and implementation aims that include an analysis of PrEP persistence (defined as sustained use of PrEP product as intended with < 7 vs. < 28 day gap in dosing as scheduled) over the short term (7 months) and long term (18 months), and the identification of implementation strategies that best support PrEP adoption and persistence. PtC is delivered from a mobile clinic and a public health primary care clinic, staffed by trained nurses, HIV counsellors, and peer-navigators. PrEP selection is guided by a co-created PrEP choice counselling intervention, with allowance for product switching at subsequent visits, but no reimbursement for PrEP uptake or return. PrEPared to Choose will provide an early report of real-world PrEP choice delivery, including all three currently available and approved modalities. The protocol is designed to simulate a real-world environment that provides insight into likely PrEP persistence patterns and practical challenges to PrEP choice implementation in a high HIV burden setting (South Africa) and within high HIV incidence populations (adolescents and young people). The results will be used to inform PrEP choice delivery in South Africa and build a framework into which future, emerging PrEP modalities can be incorporated.

Hydrogen‐rich water (HRW) supresses the development of the diseases caused by oxidative stress such as diabetes, cancer, arteriosclerosis, and neurodegenerative diseases. It also prevents the side effects caused by hemodialysis and anti‐cancer drugs. The active species in this water are hydrogen molecules and atoms. The antioxidant, antiapoptic, and anti‐inflammatory properties of HRW come from the presence of the active hydrogen atoms. They scavenge for reactive oxygen species (ROS), which cause oxidative stress‐related diseases. The mechanism through which the scavenging of ROS occurs is not yet fully understood. Therefore, it is advisable to be cautious when administering HRW to patients.

A mathematical model of malaria dynamics with naturally acquired transient immunity in the presence of protected travellers is presented. The qualitative analysis carried out on the autonomous model reveals the existence of backward bifurcation, where the locally asymptotically stable malaria-free and malaria-present equilibria coexist as the basic reproduction number crosses unity. The increased fraction of protected travellers is shown to reduce the basic reproduction number significantly. Particularly, optimal control theory is used to analyse the non-autonomous model, which incorporates four control variables. The existence result for the optimal control quadruple, which minimizes malaria infection and costs of implementation, is explicitly proved. Effects of combining at least any three of the control variables on the malaria dynamics are illustrated. Furthermore, the cost-effectiveness analysis is carried out to reveal the most cost-effective strategy that could be implemented to prevent and control the spread of malaria with limited resources.

Our review condensed evidence on the potential of medicinal plants to improve the reproductive performance of livestock. The success of any livestock farming operation is highly dependent on the reproductive performance of animals. However, infertility has limited the proficiency of livestock and resulted in economic losses. For centuries, farmers utilised medicinal plants extensively in managing reproductive disorders. These plants have few to no side effects, are cheap, easily accessible and readily available. Among others, the inclusion of Moringa olifera leaf extracts for 14 days at levels of 100–300 mg/kg body weight improved sperm characteristics. Zingiber officinale root extracts at levels of 500–1000 mg/kg body weight for 3 weeks increased sperm count, viability and mobility and testosterone. Furthermore, the increase in the volume of ejaculate and sperm concentration has been observed in sheep when Leucaena spp were added to their diets at 100–300 g/sheep/day for 60 days. However, there is little literature regarding the use of medicinal plants on ruminants, as the majority of studies have been laboratory-based and have used experimental animals, including rats and mice. Thus, future research is required through in vivo and in vitro studies to ascertain the efficacy of these medicinal plants in male ruminants.

This qualitative study aimed to identify the optimal formula for attaining organisational excellence by integrating quantitative performance measurements with a commitment to employee wellbeing. The article, grounded in comprehensive research from academic databases and industry publications, challenges the prevalent notion that high performance is the sole criterion for achieving exceptional performance. The study's results indicate that organisations can cultivate a culture of continuous improvement and achieve exceptional performance by adopting a balanced strategy that integrates high standards with empathetic and considerate leadership. Rigour in organisations is delineated, along with its components and the implications for operational efficiency and quality assurance. Moreover, the study elucidates how the application of data analysis and analytical tools can enhance an organisation's strategic performance. The significance of compassion is elucidated, along with its beneficial impact on fostering a pleasant work atmosphere characterised by empathy and emotional intelligence. The article further explores the convergence of rigour and compassion, identifying potential methods for attaining equilibrium. Additionally, it discusses the proposed theoretical foundations for the model, the measuring instruments, and the implementation plans, which encompass training and successful change management. Furthermore, identified research gaps are examined, along with the consequences of the findings for managers and leaders, and recommendations for organisations aiming for excellence are emphasised. The study ultimately indicates that sustainable success or excellence is attainable just through the integration of rigour and compassion, which would significantly affect stakeholders. This research advocates a transformation in organisational cultures and urges businesses to abandon the myth of the merciless high performance to facilitate enhanced innovation, commitment, and achievement.

Photodynamic therapy (PDT) is a groundbreaking approach involving the induction of cytotoxic reactive oxygen species (ROS) within tumors through visible light activation of photosensitizers (PS) in the presence of molecular oxygen. This innovative therapy has demonstrated success in treating various cancers. While PDT proves highly effective in most solid tumors, there are indications that certain cancers exhibit resistance, and some initially responsive cancers may develop intrinsic or acquired resistance to PDT. The molecular mechanisms underlying this resistance are not fully understood. Recent evidence suggests that, akin to other traditional cancer treatments, the activation of survival pathways, such as the KEAP1/Nrf2 signaling pathway, is emerging as an important mechanism of post-PDT resistance in many cancers. This article explores the dual role of Nrf2, highlighting evidence linking aberrant Nrf2 expression to treatment resistance across a range of cancers. Additionally, it delves into the specific role of Nrf2 in the context of photodynamic therapy for cancers, emphasizing evidence that suggests Nrf2-mediated upregulation of antioxidant responses and induction of drug efflux transporters are potential mechanisms of resistance to PDT in diverse cancer types. Therefore, understanding the specific role(s) of Nrf2 in PDT resistance may pave the way for the development of more effective cancer treatments using PDT.

This article looks at the analysis of heat transfer due to combustion of reactive materials in a stockpile modelled in a cylindrical domain. The transient heat analysis is studied through the investigation of effects kinetic parameters, embedded on the differential equation governing the problem, have on the temperature of the system. The temperature patterns due to the parameters effect, are depicted in graphs generated through Maple software. The complicated nonlinear partial differential equation is solved numerically using Finite difference method (FDM). The results show that parameters such as the order of reaction slow down the exothermic chemical reaction, while parameters like the reaction rate enhance the combustion process.

Freshwater macrophytes have attracted interest as an alternative source of natural extracts and minerals for a variety of therapeutic uses. However, few studies have rigorously investigated the phytochemical components, properties, and potential biological benefits of Phragmites australis as an emergent macrophyte. This study investigates the phytochemical profile of aqueous Phragmites australis (PAE) leaves extract using chromatographic-mass spectrometry and free radical scavenging analysis. LC-QToF-MS/MS analysis in both positive and negative ionization revealed the existence of thirty and eleven bioactive compounds, respectively tentatively identified as alkaloids, flavonoids, indoles, glycosides, and quinolines from the extract. The polyphenolic content of the PAE was found to be 39.17 ± 0.65 mg GAE/g total phenol, while the flavonoids content was 19.85 ± 2.64 mg QE/g, and proanthocyanins content was 119.65 ± 1.70 CE/g. The PAE was utilized to synthesize silver nanoparticles (AgNPs) to evaluate its nano-structural formation efficiency, with the PAE displaying a greater ability to scavenge free radicals against ABTS, DPPH, and FRAP when compared with PA-AgNPs. Both PAE and PA-AgNPs were tested for their antimicrobial and anticancer activities and the results indicated that PA-AgNPs (MIC value range of 7.8–62.5 µg/mL) had excellent antimicrobial activity, compared to PAE. Moreover, the antiproliferative effect of PA-AgNPs on human cancer cells showed a higher cell-specific dose response and two-fold apoptotic induction with increased phosphorylation in the DNA ss-strand break post-treatment in MCF-7 than in A549 cells. These findings reveal the potential of the leaf extract of PA as a potent antioxidant source for many biological applications.