Buoyancy-Assisted Fabrication of Liquid Diode: Janus Nanofibrous Membrane for Efficient Wastewater Treatment.

The pressing need for effective methods to separate oil and water in oily wastewater has spurred the development of innovative solutions. This work presents the creation and evaluation of a Janus nanofibrous membrane, also known as the Liquid Diode, developed using electrospinning (e-spinning) and buoyancy-assisted hydrothermal techniques. The membrane features a unique structure: one side is composed of PVDF nanofibers embedded with a GO/TiO2 composite, exhibiting in-air superhydrophobic and superoleophilic properties, while the reverse side consists of PVDF nanofibers with a ZnO nanorod array, demonstrating in-air superhydrophilic and underwater (UW) superoleophobic properties. This distinct asymmetric wettability enables the membrane to effectively separate both water-in-oil (w-in-o) and oil-in-water (o-in-w) emulsions, achieving an impressive liquid flux and separation efficiency (SEff). The in-air superhydrophobic side of the Janus nanofibrous membrane achieves a maximum oil flux (Fo) of 3506 ± 250 L m-2 h-1, while the in-air superhydrophilic side achieves a maximum water flux (Fw) of 1837 ± 150 L m-2 h-1, with SEff exceeding 98% for both sides. Furthermore, the Janus nanofibrous membrane maintained reliable mechanical stability after 10 cycles of sandpaper abrasion test and demonstrated excellent chemical stability when subjected to acidic, alkaline, cold water and hot water conditions for 24 h. These properties, combined with its ability in breaking down of organic contaminants (98% ± 2% in 210 min) and pharmaceutical contaminants (97% ± 2% in 210 min) under visible light, highlight its photocatalytic potential. Additionally, the membrane's antifouling and antibacterial properties suggest long-term and sustainable use in wastewater treatment applications. The synergistic combination of these superior properties positions the Janus nanofibrous membrane as a promising solution for addressing complex challenges in wastewater treatment and environmental remediation.

Construction of Hierarchical Black TiO2/Carbon Fiber: Enhanced Photocatalytic Activity Based on Schottky Heterojunctions.

Photocatalytic antimicrobials, as emerging advanced oxidative antimicrobial materials, have the advantages of low price and long-lasting antimicrobial properties. Nevertheless, with catalysts increasingly trending toward nanoscale dimensions, the environmental challenge of catalyst recycling becomes more pronounced. In this paper, we propose utilizing one-dimensional carbon fiber as a substrate, employing the nucleating agent method to induce Titanium dioxide (TiO2) growth on the fiber surface. Furthermore, the material's band gap underwent modification through hydrogen calcination, thus resulting in the attainment of hierarchical black TiO2/carbon fiber composites with visible light-driven capabilities. The characterization of the materials was conducted via scanning electron microscope (SEM), X-ray diffraction (XRD), transmission electron microscopy (TEM), and X-ray photoelectron spectroscopy (XPS). The results revealed that when the black hydrogenated TiO2 was composited with carbon fiber, the Schottky heterojunction was formed, and thus effectively improved the photocatalytic effect of the composites. Notably, the degradation rate of methylene blue achieved 96.25% within 150 min when utilizing black TiO2/carbon fiber composites, while the inactivation rate of Escherichia coli (E. coli) reached 97.58% within 0.5 h and attained complete inactivation within 60 min.

Coordination-Driven Templated Synthesis of Hierarchically Porous Zeolitic Imidazolate Frameworks for Cascade Enzyme Cycle Amplification Coupled Immunoassay.

Although hierarchically porous zeolitic imidazolate frameworks (HPZIFs) not only inherit the intrinsic architectural and chemical stabilities of their microporous counterparts but also afford open space for the efficient mass diffusion of the macromolecules involved, their rational design and construction are still challenging. Herein, HPZIFs with tailorable pore sizes ranging from 18 to 54 nm were successfully fabricated by using a newly developed soft-template-directed strategy. Our success rooted in the fact that the screened PS81-PVP44-PEO113 triblock copolymer could effectively coordinate with the metal precursor for the directed crystallization of ZIFs along surfactant assemblies. The advantages of continuous large pores and open structures in such HPZIFs were fully taken into account to serve as a bioreactor for the efficient immunoassay. The expanded large pores provided not only a significantly vast surface area to enhance the density of capture antibodies but also enough space for accommodating multiple conjugated biomolecules in one pore channel. In combination with a cascade enzyme cycle amplification strategy, a model biomarker of prostate-specific antigen (PSA) at the femtomolar level was checked with a limit of detection of 92 fM using the developed immunosensor. Specific screening on patients with prostate cancer or even benign prostatic hyperplasia was exemplified through accurately quantifying small changes of PSA concentration in clinical serum samples, prefiguring the great potential of the developed HPZIF-8 immunosensor platform for the early monitoring and diagnostics of diseases.

Unraveling the orientation-dependent mechanics of dental enamel in the red-necked wallaby.

Dental enamels of different species exhibit a wide variety of microstructural patterns that are attractive to mimic in bioinspired composites to simultaneously achieve high stiffness and superior toughness. Non-human enamel types, however, have not yet received the deserved attention and their mechanical behaviour is largely unknown. Using nanoindentation tests and finite element modelling, we investigate the mechanical behaviour of Macropus rufogriseus enamel, revealing a dominating influence of the microstructure on the effective mechanical behaviour and allowing insight into structural dependencies. We find a shallow gradient in stiffness and low degree of anisotropy over the enamel thickness that is attributed to the orientation and size of microstructural features. Most notably, M. rufogriseus's modified radial enamel has a far simpler structural pattern than other species', but achieves great property amplification. It is therefore a very promising template for biomimetic design. STATEMENT OF SIGNIFICANCE: The diversity of dental enamel structures in different species is well documented, but the mechanical behaviour of non-human enamel types is largely unknown. In this work, we investigate the microstructure and structure-dependent mechanical properties of marsupial enamel by nanoindentation and finite element simulations. Combining these methods gives valuable insights into the performance of modified radial enamel structures. Their stiffness and toughness stems from a unique structural design that is far less complex than well-studied human enamel types, which makes it a uniquely suitable template for biomimetic design.

Enhanced Electromagnetic Interference Shielding Properties of CNT/Carbon Composites by Designing a Hierarchical Porous Structure.

With the widespread use of electronic devices, electromagnetic interference (EMI) has become an increasingly severe issue, adversely affecting device performance and human health. Carbon nanotubes (CNTs) are recognized for their electrical conductivity, flexibility, and stability, making them promising candidates for EMI shielding applications. This research developed hierarchical porous-structured CNT/carbon composites for enhancing electromagnetic interference (EMI) shielding properties. Featuring a CNT film with nano-scale pores and an amorphous carbon layer with micro-scale pores, the CNT/carbon composites are strategically arranged to promote the penetration of EM waves into the composite's interior and facilitate multiple reflections, thereby improving the EMI shielding performance. An impressive EMI shielding effectiveness of 61.4 dB was achieved by the CNT/carbon composites, marking a significant improvement over the 36.5 dB measured for the pristine CNT film. Owing to the micro pores in the amorphous carbon layer, a notable reduction in the reflection shielding efficiency (SER) but, concurrently, a substantial increase in the absorption shielding efficiency (SEA) compared with the pristine CNT film was realized in the composites. This study successfully validated the effectiveness of the hierarchical porous structure in enhancing the EMI shielding performance, providing a promising new strategy for the development of lightweight, flexible, and efficient EMI shielding materials.

Model Selection for Exposure-Mediator Interaction.

In mediation analysis, the exposure often influences the mediating effect, i.e., there is an interaction between exposure and mediator on the dependent variable. When the mediator is high-dimensional, it is necessary to identify non-zero mediators M and exposure-by-mediator ( X -by- M ) interactions. Although several high-dimensional mediation methods can naturally handle X -by- M interactions, research is scarce in preserving the underlying hierarchical structure between the main effects and the interactions. To fill the knowledge gap, we develop the XMInt procedure to select M and X -by- M interactions in the high-dimensional mediators setting while preserving the hierarchical structure. Our proposed method employs a sequential regularization-based forward-selection approach to identify the mediators and their hierarchically preserved interaction with exposure. Our numerical experiments showed promising selection results. Further, we applied our method to ADNI morphological data and examined the role of cortical thickness and subcortical volumes on the effect of amyloid-beta accumulation on cognitive performance, which could be helpful in understanding the brain compensation mechanism.

Jellyfish-inspired Polyurea Ionogel with Mechanical Robustness, Self-Healing, and Fluorescence Enabled by Hyperbranched Cluster Aggregates.

Ionogels are promising for soft iontronics, with their network structure playing a pivotal role in determining their performance and potential applications. However, simultaneously achieving mechanical toughness, low hysteresis, self-healing, and fluorescence using existing network structures is challenging. Drawing inspiration from jellyfish, we propose a novel hierarchical crosslinking network structure design for in situ formation of hyperbranched cluster aggregates (HCA) to fabricate polyurea ionogels to overcome these challenges. Leveraging the disparate reactivity of isocyanate groups, we induce the in situ formation of HCA through competing reactions, enhancing toughness and imparting the clustering-triggered emission of ionogel. This synergy between supramolecular interactions in the network and plasticizing effect in ionic liquid leads to reduced hysteresis of the ionogel. Furthermore, the incorporation of NCO-terminated prepolymer with dynamic oxime-urethane bonds (NPU) enables self-healing and enhances stretchability. Our investigations highlight the significant influence of HCA on ionogel performance, showcasing mechanical robustness including high strength (3.5 MPa), exceptional toughness (5.5 MJ m-3), resistance to puncture, and low hysteresis, self-healing, as well as fluorescence, surpassing conventional dynamic crosslinking approaches. This network design strategy is versatile and can meet the various demands of flexible electronics applications.

One-Step Electrochemically Prepared Bionic Hierarchical Nickel Black@Graphene Composite Membrane for Desalination by Solar-Thermal Energy Conversion.

Ingenious microstructure construction and appropriate composition selection are effective strategies for achieving enhanced performance of photothermal materials. Herein, a broccoli-like hierarchical nickel black@graphene (Ni@Gr) membrane for solar-driven desalination was prepared by a one-step electrochemical method, which was carried out simultaneously with the electrochemical exfoliation of graphene and the co-deposition of Ni@Gr material. The bionic hierarchical structure and the chemical composition of the Ni@Gr membrane increased the sunlight absorption (90.36%) by the light-trapping effect and the introduction of graphene. The Ni@Gr membrane achieved high evaporation rates of 2.05 and 1.16 kg m-2 h-1 under simulated (1 sun) and outdoor sunlight conditions, respectively. The superhydrophilicity and the hierarchical structure of the Ni@Gr membrane jointly reduced the evaporation enthalpy (1343.6 kJ/kg), which was beneficial to break the theoretical limit of the evaporation rate (1.47 kg m-2 h-1). This work encourages the application of bionic metal-carbon composite photothermal materials in solar water evaporation.

3D-Printed Hierarchically Microgrid Frameworks of Sodiophilic Co3O4@C/rGO Nanosheets for Ultralong Cyclic Sodium Metal Batteries.

Herein, hierarchically structured microgrid frameworks of Co3O4 and carbon composite deposited on reduced graphene oxide (Co3O4@C/rGO) are demonstrated through the three-dimensioinal (3D) printing method, where the porous structure is controllable and the height and width are scalable, for dendrite-free Na metal deposition. The sodiophilicity, facile Na metal deposition kinetics, and NaF-rich solid electrolyte interphase (SEI) formation of cubic Co3O4 phase are confirmed by combined spectroscopic and computational analyses. Moreover, the uniform and reversible Na plating/stripping process on 3D-printed Co3O4@C/rGO host is monitored in real time using in situ transmission electron and optical microscopies. In symmetric cells, the 3D printed Co3O4@C/rGO electrode achieves a long-term stability over 3950 at 1 mA cm-2 and 1 mAh cm-2 with a superior Coulombic efficiency (CE) of 99.87% as well as 120 h even at 20 mA cm-2 and 20 mAh cm-2, far exceeding the previously reported carbon-based hosts for Na metal anodes. Consequently, the full cells of 3D-printed Na@Co3O4@C/rGO anode with 3D-printed Na3V2(PO4)3@C-rGO cathode (≈15.7 mg cm-2) deliver the high specific capacity of 97.97 mAh g-1 after 500 cycles with a high CE of 99.89% at 0.5 C, demonstrating the real operation of flexible Na metal batteries.

Structure-function coupling reveals the brain hierarchical structure dysfunction in Alzheimer's disease: A multicenter study.

BACKGROUND: Alzheimer's disease (AD) is a neurodegenerative condition characterized by cognitive decline. To date, the specific dysfunction in the brain's hierarchical structure in AD remains unclear. METHODS: We introduced the structural decoupling index (SDI), based on a multi-site data set comprising functional and diffusion-weighted magnetic resonance imaging data from 793 subjects, to assess their brain hierarchy. RESULTS: Compared to normal controls (NCs), individuals with AD exhibited increased SDI within the posterior superior temporal sulcus, insular gyrus, precuneus, hippocampus, amygdala, postcentral gyrus, and cingulate gyrus; meanwhile, the patients with AD demonstrated decreased SDI in the frontal lobe. The SDI in those regions also showed a significant correlation with cognitive ability. Moreover, the SDI was a robust AD neuroimaging biomarker capable of accurately distinguishing diagnostic status (area under the curve [AUC] = 0.86). DISCUSSION: Our findings revealed the dysfunction of the brain's hierarchical structure in AD. Furthermore, the SDI could serve as a promising neuroimaging biomarker for AD. HIGHLIGHTS: This study utilized multi-center, multi-modal data from East Asian populations. We found an increased spatial gradient of the structure decoupling index (SDI) from sensory-motor to higher-order cognitive regions. Changes in SDI are associated with energy metabolism and mitochondria. SDI can identify Alzheimer's disease (AD) and further uncover the disease mechanisms of AD.

Kiwi-Inspired Rational Nanoarchitecture with Intensified and Discrete Magneto-Fluorescent Functionalities for Ultrasensitive Point-of-Care Immunoassay.

Fluorescent lateral flow immunoassays (FLFIA) is a well-established rapid detection technique for quantitative analysis. However, achieving accurate analysis of biomarkers at the pg mL-1 level using FLFIA still poses challenges. Herein, an ultrasensitive FLFIA platform is reported utilizing a kiwi-type magneto-fluorescent silica nanohybrid (designated as MFS) that serves as both a target-enrichment substrate and an optical signal enhancement label. The spatially-layered architecture comprises a Fe3O4 core, an endocarp-fibers like dendritic mesoporous silica, seed-like quantum dots, and a kiwi-flesh like silica matrix. The MFS demonstrates heightened fluorescence brightness, swift magnetic response, excellent size uniformity, and dispersibility in water. Through liquid-phase capturing and fluorescence-enhanced signal amplification, as well as magnetic-enrichment sample amplification and magnetic-separation noise reduction, the MFS-based FLFIA is successfully applied to the detection of cardiac troponin I that achieved a limit of detection at 8.4 pg mL-1, tens of times lower than those of previously published fluorescent and colorimetric lateral flow immunoassays. This work offers insights into the strategic design of magneto-fluorescent synergetic signal amplification on LFIA platform and underscores their prospects in high-sensitive rapid and on-site diagnosis of biomarkers.

Synergistic Biofilter Tube for Promoting Scarless Tendon Regeneration.

Inspired by the imbalance between extrinsic and intrinsic tendon healing, this study fabricated a new biofilter scaffold with a hierarchical structure based on a melt electrowriting technique. The outer multilayered fibrous structure with connected porous characteristics provides a novel passageway for vascularization and isolates the penetration of scar fibers, which can be referred to as a biofilter process. In vitro experiments found that the porous architecture in the outer layer can effectively prevent cell infiltration, whereas the aligned fibers in the inner layer can promote cell recruitment and growth, as well as the expression of tendon-associated proteins in a simulated friction condition. It was shown in vivo that the biofilter process could promote tendon healing and reduce scar invasion. Herein, this novel strategy indicates great potential to design new biomaterials for balancing extrinsic and intrinsic healing and realizing scarless tendon healing.

Periodate oxidation-mediated nanocelluloses: Preparation, functionalization, structural design, and applications.

In recent years, the remarkable progress in nanotechnology has ignited considerable interest in investigating nanocelluloses, an environmentally friendly and sustainable nanomaterial derived from cellulosic feedstocks. Current research primarily focuses on the preparation and applications of nanocelluloses. However, to enhance the efficiency of nanofibrillation, reduce energy consumption, and expand nanocellulose applications, chemical pre-treatments of cellulose fibers have attracted substantial interest and extensive exploration. Various chemical pre-treatment methods yield nanocelluloses with diverse functional groups. Among these methods, periodate oxidation has garnered significant attention recently, due to the formation of dialdehyde cellulose derived nanocellulose, which exhibits great promise for further modification with various functional groups. This review seeks to provide a comprehensive and in-depth examination of periodate oxidation-mediated nanocelluloses (PONCs), including their preparation, functionalization, hierarchical structural design, and applications. We believe that PONCs stand as highly promising candidates for the development of novel nano-cellulosic materials.

Diatom Cribellum-Inspired Hierarchical Metamaterials: Unifying Perfect Absorption Toward Subwavelength Color Printing.

Diatom exoskeletons, known as frustules, exhibit a unique multilayer structure that has attracted considerable attention across interdisciplinary research fields as a source of biomorphic inspiration. These frustules possess a hierarchical porous structure, ranging from millimeter-scale foramen pores to nanometer-scale cribellum pores. In this study, this natural template for nanopattern design is leveraged to showcase metamaterials that integrates perfect absorption and subwavelength color printing. The cribellum-inspired hierarchical nanopatterns, organized in a hexagonal unit cell with a periodicity of 300 nm, are realized through a single-step electron beam lithography process. By employing numerical models, it is uncovered that an additional induced collective dipole mode is the key mechanism responsible for achieving outstanding performance in absorption, reaching up to 99%. Analysis of the hierarchical organization reveals that variations in nanoparticle diameter and inter-unit-cell distance lead to shifts and broadening of the resonance peaks. It is also demonstrated that the hierarchical nanopatterns are capable of color reproduction with high uniformity and fidelity, serving as hexagonal pixels for high-resolution color printing. These cribellum-inspired metamaterials offer a novel approach to multifunctional metamaterial design, presenting aesthetic potential applications in the development of robotics and wearable electronic devices, such as smart skin or surface coatings integrated with energy harvesting functionalities.

Enhancing Low-Frequency Microwave Absorption Through Structural Polarization Modulation of MXenes.

Two-dimensional carbon-based materials have shown promising electromagnetic wave absorption capabilities in mid- and high-frequency ranges, but face challenges in low-frequency absorption due to limited control over polarization response mechanisms and ambiguous resonance behavior. In this study, we propose a novel approach to enhance absorption efficiency in aligned three-dimensional (3D) MXene/CNF (cellulose nanofibers) cavities by modifying polarization properties and manipulating resonance response in the 3D MXene architecture. This controlled polarization mechanism results in a significant shift of the main absorption region from the X-band to the S-band, leading to a remarkable reflection loss value of - 47.9 dB in the low-frequency range. Furthermore, our findings revealed the importance of the oriented electromagnetic coupling in influencing electromagnetic response and microwave absorption properties. The present study inspired us to develop a generic strategy for low-frequency tuned absorption in the absence of magnetic element participation, while orientation-induced polarization and the derived magnetic resonance coupling are the key controlling factors of the method.

Segmenting and Predicting Musical Phrase Structure Exploits Neural Gain Modulation and Phase Precession.

Music, like spoken language, is often characterized by hierarchically organized structure. Previous experiments have shown neural tracking of notes and beats, but little work touches on the more abstract question: how does the brain establish high-level musical structures in real time? We presented Bach chorales to participants (20 females and 9 males) undergoing electroencephalogram (EEG) recording to investigate how the brain tracks musical phrases. We removed the main temporal cues to phrasal structures, so that listeners could only rely on harmonic information to parse a continuous musical stream. Phrasal structures were disrupted by locally or globally reversing the harmonic progression, so that our observations on the original music could be controlled and compared. We first replicated the findings on neural tracking of musical notes and beats, substantiating the positive correlation between musical training and neural tracking. Critically, we discovered a neural signature in the frequency range ∼0.1 Hz (modulations of EEG power) that reliably tracks musical phrasal structure. Next, we developed an approach to quantify the phrasal phase precession of the EEG power, revealing that phrase tracking is indeed an operation of active segmentation involving predictive processes. We demonstrate that the brain establishes complex musical structures online over long timescales (>5 s) and actively segments continuous music streams in a manner comparable to language processing. These two neural signatures, phrase tracking and phrasal phase precession, provide new conceptual and technical tools to study the processes underpinning high-level structure building using noninvasive recording techniques.

Recent advances in germinated cereal and pseudo-cereal starch: Properties and challenges in its modulation on quality of starchy foods.

Germination is an environmentally friendly process with no use of additives, during which only water spraying is done to activate endogenous enzymes for modification. Furthermore, it could induce bioactive phenolics accumulation. Controlling endogenous enzymes' activity is essential to alleviate granular disruption, crystallinity loss, double helices' dissociation, and molecular degradation of cereal and pseudo-cereal starch. Post-treatments (e.g. thermal and high-pressure technology) make it possible for damaged starch to reassemble towards well-packed structure. These contribute to alleviated loss of solubility and pasting viscosity, improved swelling power, or enhanced resistant starch formation. Cereal or pseudo-cereal flour (except that with robust structure) modified by early germination is more applicable to produce products with desirable texture and taste. Besides shortening duration, germination under abiotic stress is promising to mitigate starch damage for better utilization in staple foods.

Issues and Perspectives for the Study of Disruptive Clinician Behavior.

This article discusses issues and perspectives related to the study of disruptive clinician behavior (DCB) to improve patient safety and healthcare professionals' work environments. Multiple terminologies and ambiguous definitions have resulted in conceptual confusion in studies on DCB. In addition, subjective classifications have led the attributes of DCB to overlap and fluctuate. Therefore, we share Rosenberg's definition of DCB as "any inappropriate behavior, confrontation, or conflict, ranging from verbal abuse to physical and sexual harassment." It is recommended that DCB be understood as a hierarchical structure identified through statistical analysis of field survey data. Furthermore, a recurring list of items is duplicated across existing studies on DCB triggers, contributing factors, and influences. These items can be organized into separate path models based on their mutual relationships. Given these assumed models, we believe that further studies on DCB can shift toward elucidating the mechanisms of occurrence and impact. Finally, based on the path models, we recommend improving healthcare professionals' psychological and social states through a policy shift from "zero-tolerance" to "to err is human" as a priority issue for DCB prevention and countermeasures.

Residual Stress Mitigation in Perovskite Solar Cells via Butterfly-Inspired Hierarchical PbI2 Scaffold.

Residual stress in metal halide perovskite films intimately affects the photovoltaic figure of merit and longevity of perovskite solar cells. A delicate management of the crystallization kinetics is critical to the preparation of high-quality perovskite films. Only very limited methods, however, are available to regulate the residual stress of a perovskite film in a controllable manner, particularly for a perovskite film fabricated by a two-step method. Here, we demonstrate the construction of a hierarchical PbI2 scaffold inspired by Archaeoprepona demophon butterfly by combining an interlayer guided growth of porous structure and nanoimprinting. The hierarchically structured PbI2 that emulates the physical structure of the butterfly wing scale permits unimpeded permeation of organic amine salts and sufficient space for volume expansion during the crystallization process, accompanied by preferential perovskite growth of a defectless (001) crystal plane. The optimized perovskite film outperforms the control with reduced residual stress and defect density. Consequently, perovskite solar cells with a respectable power conversion efficiency reaching 23.4% (certified 23%) and an impressive open-circuit voltage of 1.184 V can be achieved. The target device can maintain 80% of initial efficiency after maximum power point tracking under illumination for 700 h. This work expands the range of engineering toward PbI2 by exploring a simultaneously tailored morphology and crystallinity and highlights the significance of a hierarchical PbI2 scaffold as an alternative choice to mitigate residual stress in a two-step processed perovskite active layer and boost the longevity of perovskite solar cells.

Utilization of reproductive health services among undergraduate regular class students in Assosa University, BGRS: a comparison among three varieties of multilevel binary logistic regression models.

INTRODUCTION: Reproductive health service (RHS) helps for people to have a delighted and safe sex through their life journey. It enables especially for women to go safely through pregnancy and childbirth and provide couples with the best chance of having a healthy infant. Therefore, this study aimed to identify the significant determinants of RHS utilization among undergraduate regular class students in Assosa University by using advanced methodology. METHODS: We used cross-sectional study design to collect RHS data from 362 students in Assosa University from 5 to 16, may 2021. These students were selected using stratified random sampling technique. We also used cross-tabulation to summarize the extents of RHS utilization across all predictors in terms of percentage and three varieties of multilevel binary logistic regression model to model the determinants of RHS. RESULTS: 42.27% of undergraduate regular class students in Assosa University utilize at least one type of RHS during their time at Assosa University whereas, 57.73% of undergraduate regular class students in this University are not utilized it. Among three varieties of multilevel binary logistic regression models, the random slopes two-level model was selected as a best fitted model for the datasets. At 5% level of significance, awareness about RHS, gender, preference of service fees and student's monthly average income were significant predictor variables in this model. In addition, the covariates; age, gender and preference of service fees have a significant random effects on utilization of RHS across all colleges/school. CONCLUSION: Students who; preferred service fee as usual rate, have awareness about RHS, are females and have high monthly average income were more likely to utilize RHS. RHS utilization among undergraduate regular students in Assosa University is likely to increase more effectively with interventions that address these factors.