Klinik für Allgemein‑, Viszeral‑, Gefäß- und Transplantationschirurgie, Universitätsklinikum Magdeburg A. ö. R., Leipziger Str. 44, 39120, Magdeburg, Deutschland. kilian.dossow@med.ovgu.de.
Klinik für Allgemein‑, Viszeral‑, Gefäß- und Transplantationschirurgie, Universitätsklinikum Magdeburg A. ö. R., Leipziger Str. 44, 39120, Magdeburg, Deutschland.
Klinik für Gastroenterologie, Hepatologie und Infektiologie, Universitätsklinikum Magdeburg A. ö .R., Magdeburg, Deutschland.
Klinik für Hals‑, Nasen- und Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Magdeburg A. ö .R., Magdeburg, Deutschland.
Klinik für Radiologie und Nuklearmedizin, Universitätsklinikum Magdeburg A. ö .R., Magdeburg, Deutschland.
[Increasing infection parameters after initiation of nasal tube feeding].

Klinik für Augenheilkunde, Medizinische Fakultät, Universitätsklinikum Düsseldorf, Heinrich-Heine-Universität Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland. MarcGerd.Sieradzki@med.uni-duesseldorf.de.
[Severe, acute, purulent conjunctivitis after glaucoma surgery].

The ability to drive after lower limb injuries or operations is usually temporarily impaired. Before deciding when a patient can safely drive again, legal, medical and safety-related issues must be clarified.The current literature was reviewed and summarized.The study situation is heterogeneous; often only individual aspects of the complex ability to drive a car are examined. Many factors have an influence on this, including the type of injury or operation, the affected limb, the use of aids, immobilization or the use of painkillers and central medication.It is, therefore, important that doctors inform and advise affected patients individually, with the patient ultimately taking responsibility for the decision. The information provided by the doctor and any recommendations given on how to return to driving safely must be documented in the medical records. Missed or undocumented information can have legal consequences, for example in the event of an accident. In cases of doubt or for professional drivers, a formal driving test may be required. In the case of permanent restrictions, a traffic medical assessment is required. The driving license authority decides whether and when this is necessary.The patient must ensure that they are sufficiently functionally recovered to be able to control the vehicle without being restricted by pain or medication. Our recommendations, based on an extensive literature review, support orthopaedic and trauma surgeons in advising their patients, who ultimately have to make the decision to drive again independently.
© 2025. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.
Abteilung für BG-Rehabilitation, BG-Unfallklinik Murnau, Professor-Küntscher-Str. 8, 82418, Murnau, Deutschland. stefan.simmel@bgu-murnau.de.
Abteilung für BG-Rehabilitation, BG-Unfallklinik Murnau, Professor-Küntscher-Str. 8, 82418, Murnau, Deutschland.
HINTERGRUND: Die Fahrtüchtigkeit nach Verletzungen oder Operationen im Bereich der unteren Extremität ist meist vorübergehend eingeschränkt. Vor der Entscheidung, wann ein Patient wieder sicher Auto fahren kann, müssen rechtliche, medizinische und sicherheitsrelevante Fragen geklärt werden. Die aktuelle Literatur wurde gesichtet und zusammengefasst. Die Studienlage ist heterogen, oft werden nur einzelne Aspekte der komplexen Fähigkeit, ein Auto zu führen, untersucht. Viele Faktoren haben hierauf einen Einfluss, darunter die Art der Verletzung oder Operation, die betroffene Extremität, der Einsatz von Hilfsmitteln, eine Ruhigstellung oder die Einnahme von Schmerz- und zentralwirksamen Medikamenten. AUFKLäRUNG: Es ist deshalb wichtig, dass Ärzte betroffene Patienten aufklären und individuell beraten, wobei der Patient letztlich selbst die Verantwortung für die Entscheidung übernimmt. Die ärztliche Aufklärung sowie gegebene Empfehlungen zur sicheren Rückkehr zum Autofahren müssen in der Krankenakte dokumentiert werden. Eine versäumte oder nicht dokumentierte Aufklärung kann rechtliche Konsequenzen haben, etwa im Falle eines Unfalls. In Zweifelsfällen oder bei Berufskraftfahrern kann ein formeller Fahrtest erforderlich werden. Bei dauerhaften Einschränkungen ist eine verkehrsmedizinische Begutachtung erforderlich. Die Fahrerlaubnisbehörde entscheidet, ob und wann diese notwendig ist. Der Patient muss sicherstellen, dass er ausreichend funktionell erholt ist, um das Fahrzeug kontrollieren zu können, ohne durch Belastungsgrenzen, Schmerzen oder Medikamente eingeschränkt zu sein. Unsere Empfehlungen, basierend auf einer umfangreichen Literaturrecherche, unterstützen OrthopädInnen und UnfallchirurgInnen in der Beratung ihrer Patienten, die letztendlich die Entscheidung wieder Auto zu fahren selbstständig treffen müssen.
[Ability to drive after surgery and trauma to the lower limb : When can I drive again?]

Considering regional impacts on downstream communities and ecosystems is challenging in impact assessments. We suggest that environmental and cultural flows have the potential to be applied to protect water more comprehensively in assessment but are currently underutilized. Environmental and cultural flows refer to adequate water quantity and quality for the environment and Indigenous rights. Through interviews and a scoping review of legislation and assessments, we address how these concepts are and could be embedded within Canadian impact assessments. To date, environmental flows have been considered in assessments involving dams, oil and gas, and mining, and the focus has been on fish and habitat, rather than Indigenous rights and cumulative withdrawals. We propose Regional Readiness through water councils, change, and consensus (three Cs) to prepare watershed actors to protect environment and cultural flows in impact assessments. The three Cs are: (1) Advisory councils dedicated to creating regional objectives and rules for ecosystem and rights-based needs, (2) Assessing hydrologic and water quality change with regional data and relationships to water, and (3) Building consensus on the cultural and ecological significance and sensitivity of water bodies. Development of this framework follows examples from Canadian water-related assessments and initiatives: Wolastoq Ecological Limits of Hydrological Alteration, Athabasca Chipewyan and Mikisew Cree assessments, Yinka Dene Water Management Policy, Grand Council Treaty #3 Nibi Declaration, Slave Watershed Environmental Effects Program, and Strategic Assessment of Wood Buffalo National Park. These cases demonstrate how the inclusion of environmental and cultural flows processes in assessment could enable greater water protection.
School of Environment, Resources and Sustainability (SERS), University of Waterloo, Waterloo, ON, Canada. ntbergbu@uwaterloo.ca.Canadian Rivers Institute, Fredericton, NB, Canada. ntbergbu@uwaterloo.ca.
School of Environment, Resources and Sustainability (SERS), University of Waterloo, Waterloo, ON, Canada.Canadian Rivers Institute, Fredericton, NB, Canada.
Canadian Rivers Institute, Fredericton, NB, Canada.Institut National de la Recherche Scientifique, Québec City, QC, Canada.
School of Environment, Resources and Sustainability (SERS), University of Waterloo, Waterloo, ON, Canada.
Canadian Rivers Institute, Fredericton, NB, Canada.School of Environment and Sustainability, University of Saskatchewan, Saskatoon, SK, Canada.
Centring Water in Impact Assessment: Reconsidering Environmental and Cultural Flows in Development Decision-Making in Canada.

Immune checkpoint inhibitors (ICI) lead to immune-mediated toxicity, so-called immune-related adverse events (irAE) in nearly all patients treated. These also include exacerbations of pre-existing autoimmune diseases. This update focuses on the evidence for and the management of rheumatic irAEs, which occur in patients with an underlying rheumatic disease. Despite the existing gaps in evidence and knowledge, it is highlighted that in rheumatological patients a thorough interdisciplinary consideration and planning of the baseline and irAE medications can be decisive for the outcome. From the current literature and also own experience in the MalheuR project, it can be derived that in general ICI treatment can be carried out even in patients with pre-existing rheumatic diseases with acceptable safety and good efficacy. The present update and the advisory service of the MalheuR project aim to increase the number of patients with pre-existing rheumatological diseases who receive the possibility of a (successful) ICI treatment in an interdisciplinary setting.
Innere Medizin V, Sektion Rheumatologie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Deutschland. karolina.gente@med.uni-heidelberg.de.
Immuncheckpointinhibitoren (ICI) führen bei fast allen behandelten Patienten zu immunvermittelten Toxizitäten, sog. „immune-related adverse events“ (irAEs). Dazu gehören auch Schübe bereits bestehender Autoimmunerkrankungen. Dieses Update konzentriert sich auf die Evidenz und das Management von rheumatischen irAEs, die als Exazerbation einer vorbestehenden rheumatologischen Grunderkrankung auftreten. Trotz der noch bestehenden Evidenz- und Wissenslücken ist anzunehmen, dass bei rheumatologischen Patienten eine sorgfältige interdisziplinäre Abwägung und Planung der Baseline- und irAE-Medikation von entscheidender Bedeutung für das Outcome sind. Aus der aktuellen Fachliteratur als auch aus eigener Erfahrung im MalheuR-Projekt ist abzuleiten, dass die ICI-Therapie im Allgemeinen auch bei Patienten mit rheumatischen Vorerkrankungen mit akzeptabler Sicherheit und guter Wirksamkeit durchgeführt werden kann. Das vorliegende Update sowie das Beratungsangebot des MalheuR-Projekts zielen darauf ab, die Anzahl der Patienten mit rheumatologischen Vorerkrankungen zu erhöhen, die die Möglichkeit einer (erfolgreichen) ICI-Therapie in interdisziplinärer Zusammenarbeit erhalten.
[Update on the treatment of rheumatic immune-related adverse events under immune checkpoint inhibition].

The efficacy of hypnotic drugs for sleep-wake state discrepancy remains unclear.This study evaluated the efficacy of lemborexant in improving sleep-wake state discrepancy in insomnia disorder and its associations with sleep quality and daytime functioning.Twenty-nine participants diagnosed with insomnia disorder were treated with lemborexant for 12 weeks. Objective sleep parameters were measured using a home electroencephalography device, and subjective parameters were obtained from electronic sleep diaries. Sleep-wake state discrepancy indices, including discrepancies of sleep onset latency (disSOL), wake after sleep onset (disWASO), total sleep time (disTST), and sleep efficiency (disSE), were calculated as objective minus subjective sleep parameters. The Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS) were used to assess sleep quality and daytime sleepiness. Linear mixed-effects models were used for data analysis.Both subjective and objective sleep parameters were improved at 12 weeks after lemborexant administration. The disTST decreased significantly at 4 and 12 weeks. The disSOL increased and disSE decreased significantly by 12 weeks. Participants with defined sleep-wake state discrepancy (disTST > 0 min) showed greater decreases in these indices, whereas minimal changes were observed in those without. The disWASO did not change significantly among baseline and 4 and 12 weeks. The improvement in disTST demonstrated a significant association with the reduction of ESS scores (p = 0.008), whereas there was no substantial effect on PSQI scores.The present findings suggest that lemborexant treatment reduces sleep-wake state discrepancy, which may be associated with improved daytime functioning in patients with insomnia disorder.
Department of Psychiatry, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Aichi, Japan.
Department of Psychiatry, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Aichi, Japan. iwamoto.kunihiro.z4@f.mail.nagoya-u.ac.jp.
Medical Headquarters, Eisai Co., Ltd., Tokyo, Japan.
Brain and Mind Research Center, Nagoya University, Nagoya, Japan.Pathophysiology of Mental Disorders, Nagoya University, Graduate School of Medicine, Nagoya, Japan.
Department of Psychiatry, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Aichi, Japan.Ascent Development Services, Tokyo, Japan.
Department of Advanced Medicine, Nagoya University Hospital, Nagoya, Japan.
Pathophysiology of Mental Disorders, Nagoya University, Graduate School of Medicine, Nagoya, Japan.
Psychopharmacology (Berl). 2025-06-24;():.
Effect of lemborexant on sleep-wake state discrepancy in participants with insomnia disorder.

Intensifying forest management or reducing harvest levels are proposed as alternative strategies for mitigating climate change. Today, scientific disagreement over which approach is more effective impedes the development and implementation of effective climate change mitigation policies. In this paper we review studies of the climate impact of Swedish forestry to clarify the conceptual and methodological differences that underly the disagreement. To examine how assumptions concerning crucial parameters contribute to differing conclusions, we simulated various management scenarios for Gävleborg County in central Sweden. We find that support for either side in the debate can be obtained by adjusting assumptions about substitution levels and the design of management interventions. Studies favoring intensified management over reduced harvesting assume relatively high substitution levels and implement intervention levels - such as increased fertilization or expanded stump harvest - which are considerably higher (2.4-17.7 times) than the levels recommended by the Swedish Forest Agency. Conversely, when using recommended intervention levels and substitution levels based on current usage of forest biomass, reduced harvest strategies show greater climate benefits than intensified management. These findings emphasize the need to focus the scientific discussion on i) the empirical evidence for various substitution levels and ii) the relevance of alternative management scenarios for the development of effective climate change mitigation policies.
Umeå University, Department of Ecology, Environment and Geoscience, Umeå, Sweden. goran.englund@umu.se.
Swedish University of Agricultural Sciences, Department of Forest Resource Management, Umeå, Sweden.
Mid Sweden University, Department of Natural Sciences, Design and Sustainable Development, Sundsvall, Sweden.Swedish University of Agricultural Sciences, Department of Wildlife, Fish & Environmental Studies, Umeå, Sweden.
Swedish University of Agricultural Sciences, Department of Energy & Technology, Uppsala, Sweden.Wageningen University and Research, Wageningen Environmental Research (WENR), Wageningen, The Netherlands.
Mid Sweden University, Department of Ecotechnology & Sustainable Building, Östersund, Sweden.
Why We Disagree about the Climate Impact of Forestry - A Quantitative Analysis of Swedish Research.

Congenital nasal pyriform aperture stenosis is a rare neonatal condition that causes respiratory distress and potentially requires surgery. Current diagnosis relies on clinical assessment and manual computed tomography (CT) measurements of the pyriform aperture width, which may not fully capture obstruction severity.To evaluate the severity of pyriform aperture stenosis using automatic three-dimensional (3-D) analysis and identify parameters discriminating between conservative and surgical cases.This retrospective study analyzed CT scans of neonatal airways using a novel automated 3-D segmentation algorithm. We collected 22 CT scans (2010-2022) of newborns aged 0-35 days: 12 controls, four moderate cases treated conservatively, and six severe cases requiring surgery. The algorithm measured pyriform aperture width, nasal volumes, surface area, and cross-sectional areas.The algorithm achieved high accuracy (Dice coefficient, 0.961 ± 0.005) and aligned well with manual measurements of the pyriform aperture (average difference, -0.05 ± 0.77 mm, -0.7 ± 9.1%). All cases with stenosis showed anterior narrowing, while only severe cases exhibited stenosis along the entire mid-nasal cavity. Mid-nasal cavity volume, surface area, and cross-sectional areas at 50% and 75% of the mid-nasal cavity emerged as potential surgical predictors, with cross-sectional area at 75% being the most discriminating (moderate, 68.6 ± 7.5 mm2; severe, 33.5 ± 13.7 mm2; P<0.01).Automated 3-D CT analysis quantifies pyriform aperture stenosis severity by measuring nasal airway dimensions. The study suggests objective parameters that may assist in surgical decisions and highlights the importance of considering the entire 3-D nasal cavity when planning surgical interventions. A multi-center study with a larger cohort is recommended to validate these findings.
Jerusalem College of Technology, Jerusalem, Israel. yeshua@g.jct.ac.il.
Jerusalem College of Technology, Jerusalem, Israel. yoavhodbh@gmail.com.Hebrew University of Jerusalem, Jerusalem, Israel. yoavhodbh@gmail.com.
Hebrew University of Jerusalem, Jerusalem, Israel.Shaare Zedek Medical Center, Jerusalem, Beyth St 12, 9103102, Israel.
Jerusalem College of Technology, Jerusalem, Israel.
Hebrew University of Jerusalem, Jerusalem, Israel. elib@szmc.org.il.Shaare Zedek Medical Center, Jerusalem, Beyth St 12, 9103102, Israel. elib@szmc.org.il.
Automated three-dimensional computed tomography analysis for surgical decisions in congenital nasal pyriform aperture stenosis.

To evaluate the feasibility and safety of distal radial artery (DRA) catheterization compared to conventional radial artery (CRA) catheterization for invasive arterial pressure monitoring in intensive care unit (ICU) patients.This single-center, prospective, randomized controlled study enrolled 197 ICU patients requiring invasive arterial pressure monitoring between May 2024 and March 2025. Patients were randomly assigned to either the DRA group (n = 99) or CRA group (n = 98). Primary outcome was first-attempt puncture success rate. Secondary outcomes included final success rate, catheterization time, compression time for hemostasis, abnormal waveform frequency, unplanned removal rate, and complications.The DRA group demonstrated significantly lower first-attempt puncture success rates compared to the CRA group (68.69% vs. 82.65%, P = 0.022). With ultrasound assistance, final success rates were comparable between groups (98.99% vs. 97.96%, P = 0.993). Total catheterization time (133.61 ± 35.82s vs. 126.50 ± 36.99s, P = 0.175) and abnormal waveform frequency were similar between groups. The DRA group exhibited significantly shorter hemostasis times (224.45 ± 55.25s vs. 417.56 ± 71.32s, P < 0.001). Both groups had low complication rates with no statistically significant differences (1.01% vs. 3.06%, P = 0.621).Despite lower first-attempt success rates, DRA catheterization provides equivalent monitoring stability to CRA with significantly reduced hemostasis time and comparable safety profiles. DRA represents a viable alternative for invasive arterial pressure monitoring in ICU patients, particularly those requiring rapid hemostasis, preservation of forearm radial artery integrity, and patients in special positioning.
© 2025. The Author(s), under exclusive licence to Springer Nature B.V.
Department of Cardiology, The First Affiliated Hospital of Ningbo University, Ningbo, China.
Department of Intensive Care Unit, The First Affiliated Hospital of Ningbo University, Ningbo, China.
Department of Intensive Care Unit, Rushan People's Hospital, Rushan, 264500, Shandong Province, China.
North China University of Science and Technology Health Science Center, Tangshan, Hebei Province, China.
Department of Intensive Care Unit, Rushan People's Hospital, Rushan, 264500, Shandong Province, China. 110qiuxiaowen@163.com.
Journal of clinical monitoring and computing
Feasibility and safety analysis of distal radial arterial catheterization for arterial pressure monitoring in ICU.

Lymphoproliferation can represent the first or leading disease sign in different inborn errors of immunity (IEI), which include autoimmune lymphoproliferative syndrome (ALPS), common variable immunodeficiency (CVID), combined immunodeficiencies, activated phosphoinositide 3-kinase δ syndrome (APDS), Epstein-Barr (EBV)-related disorders, and others. The genetic and molecular background and the clinical implications of IEI presenting with lymphoproliferation are partly unexplored. Therefore, the diagnosis and clinical management of this category of patients is particularly challenging. As treatments targeting the specific genetic defect are available for some of the IEIs associated with lymphoproliferation, identifying the molecular diagnosis is of great clinical relevance and could significantly improve the patient's long-term outcome. To this purpose, a first-level immunological assessment is strongly recommended in patients with persistent or recurrent unexplained lymphoproliferation, and specific second-level analysis can orient towards the correct clinical suspicion. The mechanisms responsible for polyclonal, benign lymphoproliferation in IEI also cause an increased susceptibility to clonal, malignant lymphoproliferation. Therefore, a careful follow-up is recommended in all the patients with IEI and polyclonal lymphoproliferation, to promptly identify the development of clonality. Moreover, as malignant lymphoproliferation can be the first disease sign of some IEI, there is increasing interest in the possibility of recognizing IEIs in patients presenting with lymphoid malignancies. This work, by describing some relevant case studies, reviews the role of lymphoproliferative features in three of the most paradigmatic conditions, particularly ALPS, CVID, and APDS, and provides an updated discussion on the diagnosis, treatment, and follow-up of patients with IEI and lymphoproliferative features.
Section of Pediatric Hematology and Oncology, Azienda Ospedaliero- Universitaria Pisana, Pisa, Italy.
Department of Experimental and Clinical Biomedical Sciences Mario Serio , University of Florence, Florence, Italy. filippo.consonni@unifi.it.Division of Pediatric Oncology/Hematology, Meyer Children's Hospital IRCCS, Florence, Italy. filippo.consonni@unifi.it.
Clinical Immunology Unit, Department of Internal Medicine, University of Pisa, Pisa, Italy.
Section of Clinical and Laboratory Immunology, Pediatric Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
Division of Pediatric Oncology/Hematology, Meyer Children's Hospital IRCCS, Florence, Italy.Department of Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Florence, Italy.
Inborn errors of immunity presenting with lymphoproliferation: lessons from a case series.

Allogeneic stem cell transplantation (alloSCT) remains a potentially curative treatment for patients with hematologic malignancies. Nevertheless, relapse and graft failure continue to be major barriers to long-term success. In these high-risk situations, a second alloSCT may represent the only curative option, although outcomes are frequently compromised by high non-relapse mortality and disease progression. Despite improvements in conditioning regimens, donor availability, and supportive care strategies, clinical results remain suboptimal and underscore the importance of careful patient selection.In this study, we report the 15-year experience of our institution-a national reference center for alloSCT in Spain-in managing patients undergoing a second alloSCT. Our objective is to evaluate relevant clinical and transplant-related factors associated with survival outcomes. Ultimately, we aim to enhance the selection process and contribute to a more personalized approach to 2nd-alloSCT, helping clinicians make better-informed decisions about which patients are most likely to benefit from this high-risk but potentially life-saving procedure.
Hematology Department, University Hospital Marqués de Valdecilla, IDIVAL, Av. Valdecilla, 25, Santander, 39008, Spain. rodrigo.cantera.estefania@navarra.es.
Hematology Department, University Hospital Marqués de Valdecilla, IDIVAL, Av. Valdecilla, 25, Santander, 39008, Spain.
Faculty of Medicine and University Hospital Cologne, Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany.Faculty of Medicine, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), University Hospital Cologne, University of Cologne, Cologne, Germany.German Centre for Infection Research (DZIF), Partner Site Bonn- Cologne, Cologne, Germany.
Hematology Department, University Hospital Marqués de Valdecilla, IDIVAL, Av. Valdecilla, 25, Santander, 39008, Spain.University of Cantabria, Santander, Spain.
Prognostic factors of survival in second allogeneic hematopoietic transplantation.

The increasing prevalence of methamphetamine and cocaine in postmortem toxicology casework has placed significant demands on forensic laboratories. This study introduces and validates a streamlined method using salt assisted liquid-liquid extraction (SALLE) coupled with liquid chromatography-tandem mass spectrometry (LC-MS/MS) to improve the efficiency and reliability of detecting amphetamine-type stimulants (ATS) and cocaine metabolites in forensic toxicology.A new SALLE method was developed to analyze a panel of drugs, including amphetamine, methamphetamine, phentermine, 3,4-methylenedioxymethamphetamine (MDMA), 3,4-methylenedioxyamphetamine (MDA), pseudoephedrine, cocaine, cocaethylene, and benzoylecgonine (BZE). Calibration models, bias, precision, recovery, matrix effects, interferences, limits of detection (LOD) and quantitation (LOQ), dilution integrity, carryover, and sample stability were evaluated following AAFS standard 036 guidelines. The method was applied to over 150 postmortem and human performance toxicology cases and compared with the traditional gas chromatography-mass spectrometry (GC/MS) approach.The SALLE-LC-MS/MS method exhibited high accuracy, with all analytes meeting bias and precision criteria (< 20%). Percent recovery values exceeded 80%, while matrix effect values (ion suppression/enhancement) remained below 20%. LODs ranged from 5-25 µg/L, and LOQs ranged from 10-50 µg/L across analytes. Processed samples were stable for up to 8 days. Analysis of 150 cases showed strong agreement with the GC/MS method, with average percent differences ranging from 5.4 to 19.4% for most analytes. The new method reduced sample preparation time by 67% and data-processing time by 80%, resulting in overall time savings of 8 h per batch.The resulting validated SALLE procedure represents a significant advancement in the analysis of stimulant drugs within forensic toxicology. Its adoption at the Georgia Bureau of Investigation not only addresses current analytical challenges but also sets a precedent for the development of more efficient and reliable methods in the field.
© 2025. The Author(s), under exclusive licence to Japanese Association of Forensic Toxicology.
Georgia Bureau of Investigation Division of Forensic Sciences, P.O. Box 370808, Decatur, GA, 30034, USA. Jon.Stephenson@gbi.ga.gov.
Georgia Bureau of Investigation Division of Forensic Sciences, P.O. Box 370808, Decatur, GA, 30034, USA.
Quantitative analysis of stimulants in whole blood using an evaporation free precipitation salt assisted liquid-liquid extraction (SALLE) sample preparation approach.

Department of Neonatology, The First Affiliated Hospital With Nanjing Medical University, Jiangsu Province, Nanjing, P.R. China, 210000.
Department of Neonatology, Danyang Maternal and Child Health Hospital, Jiangsu Province, Zhenjiang, P.R. China, 210000.
Department of Neonatology, The First Affiliated Hospital With Nanjing Medical University, Jiangsu Province, Nanjing, P.R. China, 210000. pjj86961@163.com.
Department of Neonatology, Children's Hospital of Nanjing Medical University, Jiangsu Province, Nanjing, P.R. China, 210008. yy860507@126.com.
Correction: Risk factors of acute kidney injury in extremely low gestational age neonates (ELGANs) - a retrospective case-control study.

At 2 years and 4 months old, a girl presented with microscopic hematuria, mild edema, and nephrotic-range proteinuria with hypoalbuminemia and hypercholesterolemia without other extrarenal manifestations. She had a family history of microscopic hematuria. Kidney biopsy revealed a glomerular basal membrane of uneven thickness combined with podocytopathy. Genetic testing revealed a heterozygous c.3499G > A (p.Gly1167Arg) variant in COL4A3, which has been reported as a pathogenic variant of autosomal dominant Alport syndrome; this variant was inherited from her father. Treatment with steroids and immunosuppressants was effective. Podocytopathy should be considered in Alport syndrome patients with a young age of onset and nephrotic-range proteinuria. Electron microscopy plays an important role in diagnosis.
© 2025. The Author(s), under exclusive licence to International Pediatric Nephrology Association.
Department of Nephrology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing, China.
School of Pediatrics, Capital Medical University, Beijing, China.
Department of Pathology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.
Department of Nephrology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China. wanghui@bch.com.cn.Department of Nephrology, Baoding Hospital of Beijing Children's Hospital, Capital Medical University, Regional Center for Children's Health, Hebei, China. wanghui@bch.com.cn.Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing, China. wanghui@bch.com.cn.Key Laboratory of Basic and Clinical Pediatric Nephrology, Hebei, China. wanghui@bch.com.cn.
Alport syndrome complicated with steroid-sensitive nephrotic syndrome: a case report.

Ethylene glycol (EG) is a typical antifreeze compound and a significant analyte in forensic toxicology. Current EG analytical method for biological samples in forensic toxicology employ liquid chromatography-tandem mass spectrometry (LC-MS/MS), however, they exhibit low sensitivity and reliability. Therefore, in this study, we aimed to establish a highly sensitive, selective, and reliable EG assay system for human serum analysis using a hydroxyl derivatization-aided LC-MS/MS technique.p-Toluenesulfonyl isocyanate (PTSI) was applied for precolumn derivatization of EG in human serum, to enhance the sensitivity of LC-MS/MS for EG detection.The optimal derivatization conditions were 200 µL/mL PTSI in acetonitrile at 25 °C for 10 min. A highly sensitive and reliable LC-MS/MS detection of EG in human serum was achieved, with the calibration curve exhibiting a good linearity (r > 0.999, 10-1000 µg/mL of EG). The proposed PTSI-derivatization-LC-MS/MS method exhibited high reliability (1.4-1.8%) for the intra-day and inter-day repeatability (%RSD), and accuracy (96.7-102.4%), with the limits of detection and quantification in human serum being 0.023 µg/mL (S/N = 3) and 0.077 µg/mL (S/N = 10), respectively.A novel PTSI derivatization-aided LC-MS/MS method was developed, offering a highly sensitive, selective, and reliable analytical tool for EG quantification in human serum for forensic toxicology applications.
Department of Bioscience and Biotechnology, Faculty of Agriculture, Graduate School of Kyushu University, Kyushu University, 744 Motooka, Nishi-ku, Fukuoka, 819-0395, Japan. s.ogawa.hrk@gmail.com.Forensic Science Laboratory, Fukuoka Prefectural Police Headquarters, 7-7 Higashikoen, Hakata-ku, Fukuoka, 812-8576, Japan. s.ogawa.hrk@gmail.com.
Forensic Science Laboratory, Fukuoka Prefectural Police Headquarters, 7-7 Higashikoen, Hakata-ku, Fukuoka, 812-8576, Japan.
Department of Bioscience and Biotechnology, Faculty of Agriculture, Graduate School of Kyushu University, Kyushu University, 744 Motooka, Nishi-ku, Fukuoka, 819-0395, Japan. tmatsui@agr.kyushu-u.ac.jp.
Quantitative analysis of ethylene glycol in human serum by liquid chromatography-tandem mass spectrometry with p-toluenesulfonyl isocyanate derivatization.

Federal University of Ceará, Fortaleza, Brazil.
Associação de Psiquiatria do Estado do Ceará, Fortaleza, Brazil.
Federal University of Ceará, Fortaleza, Brazil.Associação de Psiquiatria do Estado do Ceará, Fortaleza, Brazil.
Federal University of Ceará, Fortaleza, Brazil. lwbisol@ufc.br.Associação de Psiquiatria do Estado do Ceará, Fortaleza, Brazil. lwbisol@ufc.br.
Eur Child Adolesc Psychiatry. 2025-06-24;():.
Which second generation antipsychotic is more associated with metabolic syndrome?

Previous meta-analyses have shown that psychotic experiences are a potential clinical risk marker for self-injurious thoughts and behaviors. However, it is unclear whether hallucinations and delusions have different effects on self-injurious thoughts and behavior. The study was to provide an updated meta-analysis of the associations between different types of psychotic experiences and self-injurious thoughts and behaviors in children and adolescents. Fifteen cross-sectional and twenty-one longitudinal studies were included after searching for articles published before January 2025 according to PRISMA guidelines. This study was registered with PROSPERO (CRD42024523854). Random-effect models were used to obtain estimates of effect sizes and study quality was rated. Results showed that children and adolescents with psychotic experiences were more likely to engage in self-injurious thoughts and behaviors, with a 3.00-fold (95% CI: 2.15-4.20) and a 2.18-fold (95% CI: 1.92-2.46) increase in cross-sectional and longitudinal studies. After adjusting for co-occurring psychopathology, psychotic experiences still remained to be significant in cross-sectional (OR = 2.52, 95% CI: 1.94-3.28) and longitudinal studies (OR = 1.60, 95% CI: 1.30-1.97). Hallucinations (OR = 2.07, 95% CI: 1.90-2.25) were significantly more strongly associated with an increased risk of self-injurious thoughts and behavior compared to delusions (OR = 1.70, 95% CI: 1.51-1.92) in longitudinal studies. These findings highlighted the importance of assessing hallucinations as part of suicide prevention strategies in children and adolescents.
© 2025. Springer-Verlag GmbH Germany, part of Springer Nature.
Xiangya School of Public Health, Central South University, Changsha, China.Shanghai Changning Mental Health Center, Affiliated Mental Health Center of East China Normal University, 299 Xiehe Road, Changning District, Shanghai, 200335, China.
Shanghai Changning Mental Health Center, Affiliated Mental Health Center of East China Normal University, 299 Xiehe Road, Changning District, Shanghai, 200335, China.
Shanghai Changning Mental Health Center, Affiliated Mental Health Center of East China Normal University, 299 Xiehe Road, Changning District, Shanghai, 200335, China.Shanghai Key Laboratory of Mental Health and Psychological Crisis Intervention, Affiliated Mental Health Center (ECNU), School of Psychology and Cognitive Science, East China Normal University, Shanghai, China.
Shanghai Changning Mental Health Center, Affiliated Mental Health Center of East China Normal University, 299 Xiehe Road, Changning District, Shanghai, 200335, China. wolaiye1974@163.com.
Xiangya School of Public Health, Central South University, Changsha, China. 351239334@qq.com.
An update meta-analysis on the relationship between psychotic experiences and self-injurious thoughts and behaviors in children and adolescents.

Although recent studies have examined the impacts of maternal work-family conflict (WFC) on child development, the cognitive domain remains underexplored. This study investigates the longitudinal relationship between maternal WFC and children's executive function (EF) difficulties in South Korea, with an emphasis on the asymmetric effects and potential heterogeneity by the child's sex. Utilizing four waves from the Panel Study on Korean Children, this study focused on employed mothers and their school-age children (N = 1,054). Asymmetric fixed effects (FE) models were used to estimate the differential impacts of increasing versus decreasing maternal WFC while controlling for unobserved individual-level confounders. Moreover, sex-stratified analyses were performed to examine the differential patterns based on the child's sex. Asymmetric FE models revealed that the estimated effects of increasing maternal WFC on EF difficulties (β = 0.050, p < 0.001) are statistically significant and larger in magnitude than those of decreasing WFC. These differential impacts were more pronounced among boys than girls. Stratified by child's sex, the effects of increasing maternal WFC on EF difficulties were statistically significant in boys (β = 0.090, p < 0.001) but not in girls. The findings of this study suggest that the detrimental influences of increasing WFC on children's EF difficulties may not be counterbalanced by the benefits of decreasing WFC. These insights should guide policymakers to consider strategies aimed at reducing work demands and providing targeted support to families, thereby alleviating the negative consequences of maternal WFC on children's cognitive development.
Department of Health Policy and Management, Korea University, Room 367, B-dong Hana-Science Building 145 Anam-ro, Seongbuk-gu, Seoul, Republic of Korea.Interdisciplinary Program in Precision Public Health, Korea University, Seoul, Republic of Korea.
George Warren Brown School of Social Work, Washington University in St. Louis, St. Louis, MO, USA.
Department of Health Policy and Management, Korea University, Room 367, B-dong Hana-Science Building 145 Anam-ro, Seongbuk-gu, Seoul, Republic of Korea. jinho_kim@korea.ac.kr.Interdisciplinary Program in Precision Public Health, Korea University, Seoul, Republic of Korea. jinho_kim@korea.ac.kr.Center for Demography of Health and Aging, University of Wisconsin- Madison, Madison, WI, USA. jinho_kim@korea.ac.kr.
The differential impact of increasing and decreasing maternal work-family conflict on children's executive function difficulties in South Korea.

Occasionally, tinea is a differential diagnostic option in lesions of nummular atopic eczema. Mycological diagnostics can yield quite unexpected results.Evaluation of the detection of rare geophilic dermatophytes on atopic eczema, using mycological data and its clinical interpretation.Detailed conventional and genetic mycological work-up of scales collected from atopic eczema; correlation of the findings with the clinical context and the pertinent literature.On a lesion of nummular atopic dermatitis two rare geophilic dermatophytes were detected synchronously: Arthroderma (A.) onychocola and A. quadrifidum. This was only the third isolation of A. onychocola ever and the first one on glabrous skin and in Germany. The strain grew on human stratum corneum and perforated hair. A. quadrifidum did not show unusual features. No pathogenetic relevance of this twofold colonization was noted regarding the atopic eczema.Obviously, A. onychocola is more prevalent than has been assumed up to now. Geophilic dermatophytes detected on atopic dermatitis are not necessarily pathogenetically relevant for eczema-such a colonization needs to be critically interpreted in relation to its clinical context. The determinants that allow geophilic dermatophytes to persist on human skin are still not understood.
Klinik für Dermatologie, Venerologie und Allergologie, Mykologisches Labor, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Schwanenweg 20, Haus U27, 24105, Kiel, Deutschland. jbrasch@dermatology.uni-kiel.de.
Klinik für Dermatologie, Venerologie und Allergologie, Mykologisches Labor, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Schwanenweg 20, Haus U27, 24105, Kiel, Deutschland.
HINTERGRUND: Differenzialdiagnostisch muss bei nummulären Herden eines atopischen Ekzems gelegentlich auch an eine Tinea gedacht werden. Die mykologische Diagnostik kann durchaus überraschende Ergebnisse zeigen. Vorgehen zur Einordnung eines Nachweises seltener geophiler Dermatophyten auf einem atopischen Ekzem anhand der Mykologie und ihre klinische Interpretation. Dargestellt werden die detaillierte konventionelle und genetische mykologische Aufarbeitung von Schuppenmaterial eines atopischen Ekzemherds sowie der Abgleich der Befunde mit dem klinischen Kontext und der relevanten Literatur. Auf dem nummulären Herd eines atopischen Ekzems wurden synchron 2 seltene geophile Dermatophyten nachgewiesen: Arthroderma (A.) onychocola und A. quadrifidum. A. onychocola wurde damit überhaupt erst zum dritten Mal isoliert und erstmals in Deutschland und von freier Haut. Der Stamm zeigte Wachstum auf humanem Stratum corneum und Haarperforation. A. quadrifidum ließ keine Besonderheiten erkennen. Eine pathogene Relevanz der Doppelbesiedlung für das atopische Ekzem war nicht erkennbar. A. onychocola ist offenbar weiter verbreitet, als bislang vermutet. Auf atopischem Ekzem nachgewiesene geophile Dermatophyten sind nicht zwingend pathogenetisch ekzemrelevant – eine solche Besiedlung bedarf einer kritischen Interpretation im klinischen Kontext. Die Faktoren, die geophilen Dermatophyten einen Verbleib auf menschlicher Haut ermöglichen, sind noch unklar.
[Arthroderma onychocola plus Arthroderma quadrifidum on atopic eczema : An exceptional constellation that warrants interpretation].

Diabetes prevalence among individuals of Chinese background in Australia is about three times higher than the general population.The aim of this study was to identify specific barriers and enablers of medication-taking among adults of Chinese background living with type-2 diabetes mellitus (T2DM) in Australia.Qualitative semi-structured interviews were conducted with: (1) adults (18 + years) with T2DM of Chinese heritage currently prescribed diabetes medications; (2) health professionals involved in the care of people with T2DM of Chinese heritage. Participants were recruited from a national registry and single specialist clinic. Interviews were audio-recorded, transcribed verbatim, and analyzed using deductive content analysis based on the 14 domains of the Theoretical Domains Framework (TDF). The most relevant TDF domains were identified based on frequency counts across cohorts.A total of 25 people living with T2DM (60% male; age range: 31-72), and 11 healthcare professionals (5 endocrinologists; 5 pharmacists; 1 credentialled diabetes educator; 10 of Chinese background) participated. Barriers and enablers influencing medication-taking behaviors were identified across 13/14 TDF domains (except for 'Reinforcement'). Relevant domains most frequently identified were: Social Influences; Environmental Context and Resources; Beliefs About Consequences, and Behavioral Regulation.Drawing on the TDF, potential targets for future interventions aimed at improving the uptake and maintenance of medication-taking behavior among adults with T2DM of Chinese heritage were identified. These data may support the development of culturally relevant and theoretically informed healthcare professional strategies and diabetes education programs, and ultimately, improve health outcomes for individuals with T2DM.
School of Nursing and Midwifery and Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, Geelong, 1 Gheringhap St, Geelong, VIC, 3220, Australia. m.omonaiye@deakin.edu.au.Deakin University Centre for Quality and Patient Safety Research-Eastern Health Partnership, Eastern Health, Box Hill, VIC, Australia. m.omonaiye@deakin.edu.au.
School of Nursing and Midwifery and Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, Geelong, 1 Gheringhap St, Geelong, VIC, 3220, Australia.
Eastern Health Clinical School, Monash University, Box Hill, VIC, Australia.
School of Psychology, Deakin University, Geelong, Australia.The Australian Centre for Behavioural Research in Diabetes (ACBRD), Diabetes Victoria, Carlton, Australia.Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, VIC, Australia.
School of Nursing and Midwifery, Monash University, Clayton, VIC, Australia.
School of Nursing and Midwifery and Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, Geelong, 1 Gheringhap St, Geelong, VIC, 3220, Australia.Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, 2200, Copenhagen, Denmark.Faculty of Health Sciences, University of Southern Denmark, 5230, Odense, Denmark.
Deakin Rural Health, Deakin University, Geelong, VIC, Australia.
School of Nursing and Midwifery and Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, Geelong, 1 Gheringhap St, Geelong, VIC, 3220, Australia.Deakin University Centre for Quality and Patient Safety Research-Eastern Health Partnership, Eastern Health, Box Hill, VIC, Australia.
International journal of clinical pharmacy
Barriers to, and enablers of, medication taking among Chinese adults living with type 2 diabetes mellitus in Australia: a qualitative study.

The growing prevalence of resistant dermatophyte isolates, particularly from Trichophyton indotineae (synonym: T. mentagrophytes ITS genotype VIII) but also from T. rubrum may lead to increasing numbers of difficult-to-treat dermatomycoses. Terbinafine resistance in T. indotineae or T. rubrum is caused by point mutations that alter specific positions in the Erg1 gene encoding squalene epoxidase, thereby, preventing effective binding of terbinafine to the enzyme. In T. indotineae, two different forms of genomic amplification of Erg11B that lead to azole resistance have been identified. Like Erg11A, Erg11B encodes a form of sterol-14-α-demethylase, whose enzymatic activity is inhibited by azole binding. In T. indotineae as well as in T. rubrum, point mutations in Erg11B have been identified that result in altered amino acid sequences and prevent binding of specific classes of azoles. Another resistance mechanism involves increased expression of transporter proteins responsible for drug efflux. The combination of these various mechanisms presents a major challenge for diagnostics and requires adaptation of both the diagnostic approach and the subsequent therapeutic strategies.
Dermatologisches Forschungslabor, Laborleitung Dermatomykologische Diagnostik, Klinik für Hautkrankheiten, Universitätsklinikum Jena, Dermatologisches Forschungslabor Gebäude F2, Am Klinikum 1, 07747, Jena, Deutschland.
Dermatologisches Forschungslabor, Laborleitung Dermatomykologische Diagnostik, Klinik für Hautkrankheiten, Universitätsklinikum Jena, Dermatologisches Forschungslabor Gebäude F2, Am Klinikum 1, 07747, Jena, Deutschland. C.Wiegand@med.uni-jena.de.
Die zunehmende Anzahl schwierig zu behandelnder Dermatomykosen beruht auf der gestiegenen Anzahl resistenter Isolate, insbesondere durch Trichophyton (T.) indotineae (syn. T. mentagrophytes ITS Genotyp VIII), aber zunehmend auch durch T. rubrum. Terbinafin-Resistenz in T. indotineae oder T. rubrum beruht auf Punktmutationen, die bestimmte Positionen im Erg1-Gen für die Squalen-Epoxidase ändern und die effiziente Bindung von Terbinafin an das Enzym verhindern. In T. indotineae wurden 2 verschiedene Formen der genomischen Amplifikation von Erg11B gefunden, die zur Azol-Resistenz führen. Erg11B kodiert wie Erg11A für eine Form der Sterol-14-α-Demethylase, die durch die Bindung von Azolen in ihrer Enzymaktivität gehemmt wird. In T. indotineae wie auch in T. rubrum wurden Erg11B-Punktmutationen identifiziert, die zu veränderten Aminosäuresequenzen führen und die Bindung von Azolen bestimmter Substanzklassen verhindern. Ein weiterer Weg zur Resistenz wird durch die Expressionssteigerung von Transportern ermöglicht, die am Efflux der Medikamente beteiligt sind. Die Kombination der verschiedenen Mechanismen bedeutet für die Diagnostik eine große Herausforderung und erfordert eine Anpassung sowohl des diagnostischen Regimes als auch der daraus abzuleitenden Therapie.
[Development of resistance in skin fungi : Molecular mechanisms, antifungal resistance assays, risk factors, and diagnostic regime-challenges for medical treatment].

A growing role for the skeleton in human health and longevity emerged recently. However, knowledge regarding the effects of new risk factors, linked to modern life, for bone diseases is not documented satisfactorily. Micro- and nanoplastics (MPs) are environmental and health concerns due to their widespread detection in the human surrounding environment. This narrative review aims to critically summarize current knowledge on the effects of MPs on bone and bone marrow and to explore potential links to human bone diseases, such as osteoporosis. Worryingly, MPs were recently detected in human bone tissue. In the last years, in vitro studies have shown that MPs affect cell viability, induce cell senescence, alter adipogenic cell differentiation, modify gene expression, increase reactive oxygen species production, trigger inflammatory responses, and promote osteoclastogenesis. MPs have also been associated with the impairment of the bone marrow mesenchymal stromal cell differentiation potential. Experimental animal studies indicated that MPs ingestion disturbs gut microbiota and reduces white blood cell counts, suggesting compromised bone marrow function. MPs have been detected in bone tissue following intragastric administration and were shown to affect various blood cells. Additionally, MPs accumulation in bones reduced their growth and impaired trabecular microarchitecture likely due to the osteoblasts' decreased osteogenic function. Although numerous in vitro and in vivo studies have described the effects of MPs on cells and bone tissue using animal models, the mechanistic impact of MPs accumulation in human bones or bone marrow remains largely unexplored.
© 2025. The Author(s), under exclusive licence to the International Osteoporosis Foundation and the Bone Health and Osteoporosis Foundation.
Laboratory for Evaluation of Mineral and Bone Disorders in Nephrology (LEMON), School of Medical Sciences, State University of Campinas (Unicamp), Campinas, São Paulo, Brazil.
Centro de Tecnologia da Informação Technology Renato Archer, CTI, Campinas, São Paulo, Brazil.
Laboratory of Bioenergetics and Cell Metabolism (LABIME), School of Medical Sciences, State University of Campinas (Unicamp), Campinas, São Paulo, Brazil.
Laboratório de Fisiopatologia Renal, Hospital das Clínicas da Faculdade de Medicina da USP -HCFMUSP, Universidade de São Paulo, LIM 16, São Paulo, Brazil.
Faculty and Department of Medicine, Endocrinology and Nephrology Axis, CHU de Québec Research Center, L'Hôtel-Dieu-de-Québec Hospital, Laval University, Quebec City, Canada.
MP3CV Laboratory, UPJV UR7517, University of Picardie Jules Verne, Avenue Laennec, Amiens, France.
MP3CV Laboratory, UPJV UR7517, University of Picardie Jules Verne, Avenue Laennec, Amiens, France.Department of Biochemistry, Picardie University Medical Center, Amiens, France.
Laboratory for Evaluation of Mineral and Bone Disorders in Nephrology (LEMON), School of Medical Sciences, State University of Campinas (Unicamp), Campinas, São Paulo, Brazil. rbo@unicamp.br.Division of Nephrology, Internal Medicine Department, School of Medical Sciences, State University of Campinas (Unicamp), Rua Tessália V. de Camargo, Cidade Universitária Zeferino Vaz. 126, Campinas, São Paulo, 13083-033, Brazil. rbo@unicamp.br.
Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA
Effects of microplastics on the bones: a comprehensive review.

Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Leipzig, Philipp-Rosenthal-Str. 23, 04103, Leipzig, Deutschland. conrad.hempel@medizin.uni-leipzig.de.
Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Leipzig, Philipp-Rosenthal-Str. 23, 04103, Leipzig, Deutschland.

Aim of the study to determine the validity and reliability of the Turkish version of the Back-Health-Related Postural Habits In Daily Activities Questionnaire (BEHALVES-T). 162 adolescents were included in the study. Test-retest method and internal consistency analysis were used for reliability. The validity was determined using the Back Pain and Body Posture Evaluation İnstrument (BackPEI). When Test-retest values for BEHALVES-T was examined, it was seen that using a bag, carrying weight, reaching and the total score of the scale were consistent (ICC > 0.70). Standing and sitting posture sub-dimensions were found to be borderline consistent (p < 0.01). Examining the scale's internal consistency showed that the sub-dimensions' consistency levels were low, but the total value scale's internal consistency was medium. The relationship between BEHALVES-T, BACKPEI (r = -0.238) was found to be weak. The content validity index was found to be 0.98. According to the results of this study, the Turkish version of the BEHALVES is a valid and reliable questionnaire for adolescents.
Ministry Of Health Etlik City Hospital, Physical Therapy and Rehabilitation Hospital, Ankara, Turkey.
Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Ankara Yıldırım Beyazıt University, Ankara, Turkey. fztsaniye1982@gmail.com.
Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Balıkesir University, Balıkesir, Turkey.
European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
Investigation of the validity and reliability of the Turkish version of Back-Health-Related postural habits in daily activities questionnaire.

For both native speakers and second language (L2) learners, variation in the relative order of acquisition of inflectional morphemes has been shown in the literature. Previous studies employing the simple lexical decision task have also shown effects of suffixal characteristics on word recognition of both derived and inflected words such that some inflectional suffixes trigger whole-word processing while others contribute to decomposition. Additionally, evidence from the masked priming paradigm shows that suffixal characteristics affect the efficiency of morphological decomposition of derived words during early-stage processing. However, very little work has systematically examined the early stages of processing inflected words with different suffixes, leaving our understanding of the factors that impact the early-stage processing of inflected words incomplete at best. We argue that the overwhelming focus on the past tense -ed suffix in previous L2 studies risks exacerbating already serious generalizability issues in the realm of L2 research. Future studies would therefore do well to include and compare a wider range of inflectional suffixes, which may well require looking beyond English. This is essential for the field to make progress toward a more complete understanding of the processing of morphologically complex words.
© 2025. The Author(s), under exclusive licence to Marta Olivetti Belardinelli.
School of English and International Studies, Beijing Foreign Studies University, No. 2 North Xisanhuan Road, Haidian District, Beijing, 100089, China. wuzhaohong@bfsu.edu.cn.
Department of Linguistics, University of Pittsburgh, Pittsburgh, USA.
The generalizability issue in studying inflectional processing in real time: the potential effects of suffixal characteristics.

No studies have elucidated the dynamic spinal balance in patients with dropped head syndrome (DHS) categorized by global spinal alignment. We investigated the differences in dynamic spinal balance and corresponding muscle activity during prolonged walking in patients with DHS based on their global spinal alignment.Three-dimensional gait analysis combined with electromyography was conducted to evaluate kinematic spinal parameters during walking, including the sagittal vertical axis (SVA) in the cervical (C-SVA), thoracic (T-SVA), and lumbar (L-SVA) regions, along with the muscle activity. Patients were divided into two groups based on C7 SVA from standing whole spine radiographs: SVA + and SVA-. Parameter changes were compared between the first and final laps of prolonged walking in each group.Twenty-eight patients were included (11 in the SVA + group and 17 in the SVA- group). In the SVA + group, prolonged walking caused a significant increase in T-SVA and L-SVA (P = 0.002, 0.014), with no compensatory increase in paraspinal muscle activity. In the SVA- group, C-SVA and T-SVA increased significantly (P = 0.002), with a decrease in cervical paraspinal muscle activity (P = 0.009).Three-dimensional gait analysis with electromyography highlighted the distinct pathophysiological mechanisms in patients with DHS, as determined by their global spinal alignment. In the SVA + group, gait-induced thoracolumbar imbalance increased without compensatory activation of the lumbar paraspinal muscle. Conversely, in the SVA- group, gait-induced cervicothoracic imbalance increased without compensatory activation in cervical paraspinal muscle activity. These findings suggest that although DHS presents with similar symptoms, it may involve different underlying pathophysiologies depending on the global spinal alignment.
© 2025. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
Department of Orthopaedic Surgery, Institute of Medicine, University of Tsukuba, Tsukuba, Japan. k.sakashita715@gmail.com.
Department of Orthopaedic Surgery, Institute of Medicine, University of Tsukuba, Tsukuba, Japan.
Three-dimensional gait analysis reveals differences in spinal balance and muscle activity during prolonged walking in patients with dropped head syndrome based on global spinal alignment.

We propose a novel intraoperative landmark for decompression during anterior cervical discectomy and fusion (ACDF), referred to as the inflection point of the uncinate process (IPUP). Its safety and efficacy were systematically assessed through comprehensive radiographic analyses and clinical investigations during ACDF.Computed tomography (CT) scan data from 135 patients were analyzed retrospectively. Eight imaging parameters were evaluated: inflection point of uncinate process (IPUP) distance, medial wall of the transverse foramen (MTF)-IPUP distance, anterior wall of the transverse foramen (ATF)-IPUP distance, posterior wall of the transverse foramen (PTF)-IPUP distance, the intervertebral foraminal decompression line(IFDL)-MTF distance, the intervertebral foraminal decompression (IFD) distance, the intervertebral foraminal decompression (IFD) angle, and the maximum decompression angle. A retrospective analysis was conducted on the radiographic data of 87 patients with cervical spondylosis who underwent ACDF between January 2020 and January 2023. Patients were divided into two groups: the IPUP group and the non-IPUP group. Three postoperative radiographic parameters were evaluated: the decompression width, the effective rate of intervertebral foraminal decompression, and the transverse diameter of the spinal cord at the surgical level.The IPUP distance gradually increased from C3 to C6. The minimal MTF-IPUP distance and PTF-IPUP distance were observed at C5, while the minimal ATF-IPUP distance occurred at C4. The shortest MTF-IFDL distance was observed at C5, while it exceeded 2 mm across all cervical levels. The IFD distance and IFD angle both decreased from C3 to C6, whereas the maximum decompression angle increased. Postoperatively, the decompression width in the IPUP group exceeded the transverse diameter of the spinal cord in all patients and was significantly greater than that in the non-IPUP group at all levels except C3.Using the IPUP as an intraoperative decompression landmark during ACDF can safely achieve broader spinal cord and nerve root decompression. Vertical decompression confined within the medial borders of the bilateral IPUPs is generally sufficient in most cases. In patients with foraminal stenosis, additional safe neural decompression can be accomplished either by oblique decompression at an 11° lateral deviation from the IPUP or by extending 3 mm laterally at the base of the intervertebral foramen.
Medical College, Wuhan University of Science and Technology, Wuhan, Hubei, China.Department of Orthopaedic, General Hospital of Central Theater Command, Wuhan, Hubei, China.
Medical College, Wuhan University of Science and Technology, Wuhan, Hubei, China.
Department of Orthopaedic, General Hospital of Central Theater Command, Wuhan, Hubei, China. flygalle@hotmail.com.Trauma and Microscopic Orthopaedics, Zhongnan Hospital of Wuhan University, Wuhan, Hubei Province, People's Republic of China. flygalle@hotmail.com.
Medical College, Wuhan University of Science and Technology, Wuhan, Hubei, China. kanghuispine@163.com.Department of Orthopaedic, General Hospital of Central Theater Command, Wuhan, Hubei, China. kanghuispine@163.com.
Positioning and clinical application of the inflection point of the uncinate process in anterior cervical discectomy and fusion (ACDF): a retrospective study.

A fully automated personal identification method is crucial for mass disaster response. This study evaluated an approach using shape-based radiomic features of thoracic vertebral bodies on CT scans. This retrospective study included 66 individuals with both antemortem and postmortem CT scans (2007-2014) and 1018 antemortem cases from the Lung Image Database Consortium image collection. Thoracic vertebral bodies (T1-T12) were segmented, and 14 shape-based radiomic features were extracted. Outlier detection using the Mahalanobis distance excluded vertebral bodies with atypical feature distributions. Personal identification was performed using Euclidean distance-based similarity scores, ranking the ten most similar antemortem cases for each postmortem case. The Mann-Whitney U test compared similarity scores, and the Youden index determined the optimal similarity score threshold for one-to-one verification. Of the 66 individuals, five cases were excluded due to outlier detection. A top-1 match rate of 98.4% (60/61) was achieved for the remaining 61 postmortem cases. Similarity scores for the top-1 rank (median [interquartile range], 0.910 [0.899-0.918]) were significantly higher than those for the top-2 rank (0.834 [0.819-0.853], P < 0.001). The area under the receiver operating characteristic curve was 0.99938, with an optimal similarity score threshold of 0.832, enabling clear differentiation between matches and nonmatches. An automated identification method using shape-based radiomic features of thoracic vertebral bodies on CT scans achieved near-perfect top-1 accuracy, demonstrating its potential for victim identification in mass disasters.
© 2025. The Author(s) under exclusive licence to Society for Imaging Informatics in Medicine.
Department of Radiological Technology, Graduate School of Health Sciences, Niigata University, 2-746 Asahimachi-Dori, Chuo-Ku, Niigata, 951-8518, Japan. ichikawa@clg.niigata-u.ac.jp.Institute for Research Administration, Niigata University, 8050 Ikarashi 2-No-Cho, Nishi-Ku, Niigata, 950-2181, Japan. ichikawa@clg.niigata-u.ac.jp.
Department of Radiological Technology, Graduate School of Health Sciences, Niigata University, 2-746 Asahimachi-Dori, Chuo-Ku, Niigata, 951-8518, Japan.
Journal of imaging informatics in medicine
Radiomic Fingerprints: Automated Personal Identification in Mass Disasters Using Shape-Based Features of Thoracic Vertebral Bodies on CT.

There has been a shift of dynamic in the relationship between technology and healthcare, with technological advancements progressively driving change in the delivery of care and, at times, causing disruption to the traditional doctor/patient partnership. This shift is significant in the context of medical devices. Increasingly complex devices are being introduced which require a level of technical expertise outside of the scope of the traditional training of doctors, with this knowledge gap progressively filled by medical device representatives (MDRs), a role that began as devoted to sales and has now expanded to that of adviser and trainer. This change in role represents a blurring of lines between sales and support and has potentially flourished within a regulatory gap. This paper addresses the challenge of the evolving relationship between MDRs, surgeons and patients and is based on the findings of a broader project Support or Sales? Medical device representatives in Australian hospitals . It provides an overview of the outcomes of a series of interviews with stakeholders highlighting their perceptions and experiences at this point of intersection between care and sales. It then examines the existing regulatory framework and considers whether there is a real or perceived regulatory gap. This analysis of current regulatory measures in areas such as hospital safety, privacy and professional regulation and conflicts of interests, leads to a conclusion that the evolving relationship between MDRs and surgeons has not taken place in a regulatory vacuum and sufficient frameworks are in place to protect the public. However, they rely heavily on translation into local policies and concurrent adaptations to best practice behaviour which does appear to be lagging, resulting in insufficient transparency and recognition of emerging contexts requiring novel applications. This lag could threaten patient safety and patient trust in the healthcare system.
Academy for Medical Education, Medical School, The University of Queensland, 288 Herston Rd, Herston, QLD, 4006, Australia. bernadette.richards@uq.edu.au.
Private Researcher, Not affiliated with any institution, Adelaide, Australia.
Philosophy Department, Faculty of Arts, Macquarie University, Michael Kirby Building, 17 Wally's Walk, Macquarie Park, NSW, 2109, Australia.
Device reps in theatre: blurred boundaries or regulatory gaps?

Presbycusis is a common disease in the elderly linked to cognitive decline. Studies have shown structural alterations in brain regions associated with hearing and cognitive function in presbycusis patients. However, the neural mechanisms linking brain structure with hearing loss and cognitive impairment remain unclear. This study investigated neuroanatomical alterations associated with auditory and cognitive functions. A total of 67 presbycusis patients and 68 normal-hearing controls underwent magnetic resonance imaging, auditory assessment, and cognitive assessment. Presbycusis patients were divided into presbycusis cognitive preservation (presbycusis-CP) and presbycusis cognitive impairment (presbycusis-CI) subgroups according to Montreal Cognitive Assessment scores. Atrophy of gray matter volume (GMV) was observed in presbycusis patients. The results indicated that GMV of the hippocampus, superior frontal cortex (SFC), and posterior cingulate cortex (PCC) mediated the connection between hearing loss and cognitive impairment. Interestingly, the hippocampus mediated the relationship between the GMV of the SFC and PCC in presbycusis and with the strongest mediating effect (56.14%) in presbycusis-CI patients. Notably, this was not valid in normal-hearing controls and presbycusis-CP patients. Overall, patients with presbycusis, especially presbycusis-CI patients, exhibit a distinct reorganization pattern in auditory and cognitive-related brain areas, with the hippocampus potentially being a key target for presbycusis-related cognitive impairment.
© 2025. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
Department of Biomedical Engineering, School of Life Sciences, Tiangong University, Tianjin, China.Tianjin Key Laboratory of Optoelectronic Detection Technology and System, Tianjin, China.School of Precision Instruments and Optoelectronics Engineering, Tianjin University, Tianjin University, Tianjin, China.
Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Shandong University, Jinan, China.
Department of Biomedical Engineering, School of Life Sciences, Tiangong University, Tianjin, China.
Department of Otolaryngology, the Central Hospital of Jinan City, Cheeloo College of Medicine, Shandong University, Jinan, China.
Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China.Department of Radiology, Shandong Provincial Hospital, Shandong University, Jinan, China.
Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China.
Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China. fuyanli1234@sina.com.
Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Shandong University, Jinan, China. whboto11@163.com.
Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China. feigao@email.sdu.edu.cn.
Brain structural reorganization mediates the relationship between hearing loss and cognitive impairment.

The advent of artificial intelligence (AI) is radically transforming healthcare by introducing innovative tools that enhance diagnosis, personalized therapies, and medical training. However, this technological progress raises ethical and social questions, particularly regarding the centrality of human relationships in care. Medical Humanities (MH), a field combining the humanities and medicine, provide a critical framework to balance technological innovation and empathy. Through interdisciplinary approaches, MH fosters healthcare education that integrates technical expertise with humanistic sensitivity, preventing the dehumanization of care. In this context, narrative medicine emerges as a vital tool to emphasize patients' individual stories, with AI amplifying its impact through advanced data analysis. This article offers a conceptual analysis examines the dialogue between AI and MH, highlighting the challenges and opportunities of this synergy. It also discusses strategies to mitigate algorithmic biases and ensure an ethical and inclusive approach, envisioning a future where technology and humanity coexist harmoniously in medical practice. This integration is key to promoting patient-centered care while preserving the core values of therapeutic relationships.
© 2025. The Author(s) under exclusive licence to Monash University.
University of Foggia, Foggia, Italy. marco.paglialonga@unifg.it.
Beyond the algorithm: the importance of medical humanities in the age of AI.

In this study, we present a reversible, fluorescence turn-on sensor for noninvasive detection of serine using copper-cobalt nanoclusters (Cu-CoNCs) quenched by Cu2+ ions. The Cu2+ ions suppress the intrinsic fluorescence of Cu-CoNCs primarily through static quenching and the inner filter effect (IFE), both of which contribute to the observed fluorescence suppression. Serine chelates Cu2+ through its amine and hydroxyl groups, sequestering the quencher and reinstating the excited-state properties of the nanoclusters. Fluorescence lifetime measurements, spectral analysis and Stern-Volmer plots support the proposed mechanism. The sensor demonstrates strong selectivity and specificity toward serine in biological matrices such as saliva and urine, where fluorescence recovery is both significant and reproducible. Optimal performance was observed at a near neutral to slightly basic pH, with extreme acidic or alkaline conditions adversely affecting sensor response. Real sample analysis confirms high 92-101% recovery rates from spiked saliva samples. This economical, portable sensing platform provides a promising route for point of care diagnostics. The approach underscores the potential of serine as a noninvasive biomarker for cancer and related metabolic disorders, paving the way for early screening using easily accessible biological fluids.
Department of Biotechnology, Faculty of Applied Sciences and Technology, University of Kerala, Kariavattom Campus, Thiruvananthapuram, 695581, Kerala, India.
Department of Chemistry, School of Physical and Mathematical Sciences, University of Kerala, Kariavattom Campus, Thiruvananthapuram, 695581, Kerala, India.
Department of Chemistry, School of Physical and Mathematical Sciences, University of Kerala, Kariavattom Campus, Thiruvananthapuram, 695581, Kerala, India. emailtosony@gmail.com.Department of Chemistry, International Inter University Centre for Sensing and Imaging (IIUCSI), University of Kerala, Kariavattom Campus, Thiruvananthapuram, 695581, Kerala, India. emailtosony@gmail.com.
Copper Nanocluster-Enabled Fluorescent Sensing of Serine: A Strategy for Noninvasive Cancer Biomarker Detection.

This study presents a rapid, green, and highly sensitive fluorescence-based method for detecting urea in soil using nitrogen-doped carbon dots (CDs) synthesized via a microwave-assisted process. Citric acid and urea were used as carbon and nitrogen precursors, respectively, with optimal synthesis achieved at a 1:1 weight ratio and 9 min of microwave irradiation. The structural properties of nitrogen-doped carbon dots (CDs) were studied using X-ray Diffraction (XRD). Transmission Electron Microscopy (TEM) technique was used to observe the shape and size of the CDs, providing insight into their morphology. To understand the chemical composition, bonding states, and surface functionalities, X-ray Photoelectron Spectroscopy (XPS) and Fourier Transform Infrared Spectroscopy (FTIR) analyses were carried out. The performance of the nitrogen-doped-CDs in detecting urea, including their sensitivity and selectivity, was evaluated using fluorescence spectroscopy. The resulting CDs exhibited enhanced fluorescence properties and a limit of detection (LOD) as low as 143 mg/gm. The method demonstrated high selectivity toward urea even in the presence of interfering metal ions, and its effectiveness was validated in soil samples under varying pH conditions. This approach provides a cost-effective, scalable, and environmentally friendly solution for real-time monitoring of soil nutrients, supporting sustainable agricultural practices through improved nitrogen management.
Center for Advanced Materials, Qatar University, P.O. Box 2713, Doha, Qatar.
Department of Mechanical and Industrial Engineering, Qatar University, P.O. Box 2713, Doha, Qatar.
College of Arts and Sciences, Qatar University, Doha, P.O. Box 2713, Qatar.
Center for Advanced Materials, Qatar University, P.O. Box 2713, Doha, Qatar. kishorkumars@qu.edu.qa.Department of Mechanical and Industrial Engineering, Qatar University, P.O. Box 2713, Doha, Qatar. kishorkumars@qu.edu.qa.
Microwave-Assisted Synthesis of Nitrogen-Doped Carbon Dots for Sensitive Fluorescence-Based Urea Detection in Soil.

School of Medical Technology and Information Engineering, Zhejiang Chinese Medical University, Hangzhou, China.
The First Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China.
Department of Clinical Laboratory, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, China. zhangzhezhong@zcmu.edu.cn.
Impact of Tele-Kangaroo Mother Care (KMC) Clinics on the Respiratory Outcomes of Newborns: Correspondence.

Pulmonary sequestration (PS) is a rare congenital lung malformation often requiring surgical resection due to recurrent infections or hemoptysis. Traditionally treated via open thoracotomy, recent advancements have made minimal-invasive approaches like robotic-assisted thoracoscopic surgery (RATS) increasingly viable. This study compares outcomes between RATS and open resection for PS in a high-volume center.In this retrospective cohort study, 23 adult patients who underwent surgical resection of PS between 2010 and 2023 were analyzed. Fifteen patients were treated via open thoracotomy (THKT), while eight underwent RATS using the DaVinci-X system. We compared preoperative findings, intraoperative variables, and postoperative outcomes.The patients in the RATS group were younger (median age: 36 vs 47 years) and had a shorter median hospital stay (5 vs 10 days, p < 0.001) compared to the THKT group. The RATS group also experienced earlier chest drainage removal (3 vs. 4 days, p = 0.016). However, the median duration of surgery was longer for RATS (118 vs. 75 min, p = 0.018). A trend towards less postoperative complications was observed in the RATS group (33% vs. 0%).RATS provides a safe and effective alternative to open surgery for PS resection, with benefits including reduced hospital stay and earlier chest tube removal. Despite longer operative times, the minimally invasive approach may offer enhanced recovery and fewer complications. Continued accumulation of experience with RATS is likely to improve operative efficiency, making it a valuable option in the surgical management of pulmonary malformations.
Department of Thoracic Surgery, Thoraxklinik, Heidelberg University Hospital, Roentgenstraße 1, 69126, Heidelberg, Germany.
Department of Thoracic Surgery, Thoraxklinik, Heidelberg University Hospital, Roentgenstraße 1, 69126, Heidelberg, Germany.Thoracic Surgery Unit, Cardiovascular and Thoracic Department, University and Hospital Trust-Ospedale Borgo Trento, Verona, Italy.
Translational Lung Research Center Heidelberg, German Center for Lung Research (DZL), Heidelberg, Germany.Section Translational Research (STF), Thoraxklinik, Heidelberg University Hospital, Heidelberg, Germany.
Translational Lung Research Center Heidelberg, German Center for Lung Research (DZL), Heidelberg, Germany.Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany.
Department of Thoracic Surgery, Thoraxklinik, Heidelberg University Hospital, Roentgenstraße 1, 69126, Heidelberg, Germany.Translational Lung Research Center Heidelberg, German Center for Lung Research (DZL), Heidelberg, Germany.
Department of Thoracic Surgery, Thoraxklinik, Heidelberg University Hospital, Roentgenstraße 1, 69126, Heidelberg, Germany. martin.eichhorn@med.uni-heidelberg.de.Translational Lung Research Center Heidelberg, German Center for Lung Research (DZL), Heidelberg, Germany. martin.eichhorn@med.uni-heidelberg.de.
General thoracic and cardiovascular surgery
Gen Thorac Cardiovasc Surg. 2025-06-24;():.
Robotic-assisted versus open resection of pulmonary sequestration: a retrospective cohort study. RATS surgery for pulmonary sequestration.

Mobile X-ray radiography is crucial for imaging patients with limited mobility; however, radiological technologists (RTs) may be positioned closer to patients and thus be at risk of harmful radiation doses owing to scattered radiation. As X-ray systems transitioned from digital computed radiography (CR) to flat panel detector (FPD) systems, we studied the RTs' eye lens and neck radiation doses over 2 years. Three RTs participated in measurements using a CR system, and five RTs participated in measurements using a FPD system. We measured radiation exposure with neck dosimeters (glass badges) and lens dosimeters (DOSIRIS®). The results showed a 66% reduction in lens dose after switching from the CR system to the FPD system. Comparisons of specific RT members also revealed significantly lower doses for the FPD system than for the CR system. Two main factors contributed to this decrease: the FPD system used a virtual grid instead of a scatter removal grid, and the RTs' awareness of radiation exposure increased with experience. Although the lens dose was significantly reduced, RTs should still wear protective eyewear and equipment when frequent imaging is expected or when working close to patients.
© 2025. The Author(s), under exclusive licence to Japanese Society of Radiological Technology and Japan Society of Medical Physics.
Department of Radiological Technology, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba, Sendai, 980-8575, Japan.Department of Radiology, Miyagi Cancer Center, 47-1, Medeshima, Natori, Miyagi, 981-1293, Japan.
Department of Radiological Technology, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba, Sendai, 980-8575, Japan.
Department of Radiological Technology, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba, Sendai, 980-8575, Japan.Department of Radiology, Sendai Kosei Hospital, 4-15, Hirose-Machi, Aoba-Ku, Sendai, Miyagi, 980-0873, Japan.
Department of Radiology, Sendai Kosei Hospital, 4-15, Hirose-Machi, Aoba-Ku, Sendai, Miyagi, 980-0873, Japan.
Department of Radiological Technology, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba, Sendai, 980-8575, Japan. chida@med.tohoku.ac.jp.Division of Disaster Medicine, International Research Institute of Disaster Science, Tohoku University, 6-6-4, Aoba, Sendai, 980-8579, Japan. chida@med.tohoku.ac.jp.
Assessment of lens absorbed dose by radiological technologists during mobile X-ray radiography: a comparison between computed radiography and flat panel detector systems.

Previously, we demonstrated the therapeutic effects of intranasal administration of human HSP70 and YB-1 proteins in various models of AD, including olfactory bulbectomized (OBX) mice. Herein, we investigated the effect of these two stress proteins on transcription in the hippocampus and cortex of OBX mice. Despite different structures, both proteins frequently caused pronounced normalizing changes in the transcription of the same genes. Thus, the genes that normalized their expression due to the action of recHSP70 or recYB-1 coincide by 61%. More than 60% of these common target genes exhibited complete restoration to a pattern similar to that of the control sham-operated mice. Notably, the number of genes with altered expression after administration of the proteins was twice as high in the hippocampus as in the cortex. In the brain of OBX mice, the protein application led to a normalization of the expression of many genes related to AD pathogenesis, including genes that participated in the metabolism of Aβ and tau proteins. Importantly, the normalized genes also include loci involved in ribosome biogenesis, as well as genes responsible for neurotransmitter transport, cognition, apoptosis, mitochondrial functions, and protection from oxidative stress. A significant positive effect of both proteins was demonstrated in all six cell types studied in the brain of OBX mice, with the most pronounced effect observed in the astrocytes. Besides AD-related genes, both proteins normalized the expression of several genes implicated in the development of major depression and other neurodegenerative diseases.
Institute of Cell Biophysics, Russian Academy of Sciences, Federal Research Center, Moscow Region, Puschino, 142290, Russian Federation.
Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, 119991, Moscow, Russian Federation.
National Medical Research Center for Obstetrics, Gynecology and Perinatology Named After Academician V.I. Kulakov, Moscow, 117997, Russian Federation.
Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, 119991, Moscow, Russian Federation. misha672011@yahoo.com.Institute of Evolution, University of Haifa, 3103301, Haifa, Israel. misha672011@yahoo.com.
Similar Normalizing Effect of HSP70 and YB-1 Stress Proteins on the Brain Transcription of a Mouse Model of Alzheimer's Disease.

Magnetic resonance imaging (MRI) is time-consuming, posing challenges in capturing clear images of moving organs, such as cardiac structures, including complex structures such as the Valsalva sinus. This study evaluates a computed tomography (CT)-guided refinement approach for cardiac segmentation from MRI volumes, focused on preserving the detailed shape of the Valsalva sinus. Owing to the low spatial contrast around the Valsalva sinus in MRI, labels from separate computed tomography (CT) volumes are used to refine the segmentation. Deep learning techniques are employed to obtain initial segmentation from MRI volumes, followed by the detection of the ascending aorta's proximal point. This detected proximal point is then used to select the most similar label from CT volumes of other patients. Non-rigid registration is further applied to refine the segmentation. Experiments conducted on 20 MRI volumes with labels from 20 CT volumes exhibited a slight decrease in quantitative segmentation accuracy. The CT-guided method demonstrated the precision (0.908), recall (0.746), and Dice score (0.804) for the ascending aorta compared with those obtained by nnU-Net alone (0.903, 0.770, and 0.816, respectively). Although some outputs showed bulge-like structures near the Valsalva sinus, an improvement in quantitative segmentation accuracy could not be validated.
School of Management and Informatics, University of Shizuoka, 52-1 Yada, Suruga-ku, Shizuoka, Shizuoka, 422-8526, Japan. hoda@u-shizuoka-ken.ac.jp.
Kobe Digital Labo Incorporated, Shin Crescent Bldg., Chuo-ku, Kobe, Hyogo, 650-0034, Japan.
Department of Cardiac Surgery, Nagoya University Hospital, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8560, Japan.iCorNet Laboratory, 2-22-8 Chikusa, Chikusa-ku, Nagoya, Aichi, 464-0858, Japan.
Refining cardiac segmentation from MRI volumes with CT labels for fine anatomy of the ascending aorta.

Few studies have addressed the impact of COVID-19 on mental health in low resource settings. This study examines the association of COVID-19-related stressors with psychological distress in older adults in Puerto Rico. Data are from a 2021 Knowledge, Attitudes and Practices survey about COVID-19 with adults aged 60 + in Puerto Rico (n = 213). We used the Self-Reporting Questionnaire-20 (SRQ-20) to assess distress. Stressors included COVID-19 diagnosis, hospitalization, or death of someone close, treatment delays, and loneliness. We used negative binomial regression with a log linear link function to model the effects of demographics and pandemic-related social and health stressors on distress. Almost one-third (31%) of participants reported clinically significant distress; 44.3% reported a loved one diagnosed with COVID-19, 32.4% had lost someone close, 25.8% reported treatment delays, and 39.4% experienced loneliness. A COVID-19 diagnosis of someone close without hospitalization [Adjusted Incidence Rate Ratio (AIRR) = 1.55; 95% CI 1.08, 2.22] and loneliness [AIRR = 1.20; 95% CI 1.09, 1.32] were associated with greater SRQ-20 scores. We consider the nexus of cultural and contextual factors (e.g., outmigration, under-resourced healthcare system, fatalism etc.) that are likely to influence short- and longer-term effects of COVID-19-related distress among older adults in Puerto Rico. Interdisciplinary collaborations are needed to enhance Covid-19-related support and to implement culturally appropriate and contextually feasible evidence-based interventions that will reduce high rates of mental health challenges and prevent their long-term effects.
Department of Disability and Human Development, University of Illinois, 1640 Roosevelt Road #712, Chicago, IL, 60608, USA. dc1981@uic.edu.
School of Social Work, University of North Carolina at Chapel Hill, 325 Pittsboro Street, Chapel Hill, NC, 27599, USA. morganmr@unc.edu.School of Social Work, Virginia Commonwealth University, 1000 Floyd Avenue, Richmond, VA, 23284, USA. morganmr@unc.edu.
School of Social Work, University of Maryland, 525 Redwood Street, Baltimore, MD, 21201, USA. juliavazquez@umaryland.edu.
Weill Cornell Medicine Center on Aging and Behavioral Research, Division of Geriatrics and Palliative Medicine at Weill Cornell Medicine, 420 East 70th Street 3rd Floor, Suite B, New York, NY, 10021, USA.
School of Social Work, Virginia Commonwealth University, 1000 Floyd Avenue, Richmond, VA, 23284, USA. jdburnette@vcu.edu.
Psychological Distress in Older Adults Living in Puerto Rico during COVID-19.

Metal-organic frameworks (MOFs) are highly versatile porous crystalline polymers with diverse structural compositions, high porosity, and biocompatibility, which guarantees their significant potential in various biomedical applications, including drug delivery, magnetic resonance imaging (MRI), and biosensing. However, despite these promising features, MOFs' application is considerably hindered by main challenges such as toxicity and biocompatibility. This review aims to provide a comprehensive understanding of MOF-associated toxicity, and the challenges involved in their biomedical applications. We first addressed the different routes of MOFs exposure, such as oral ingestion, inhalation, skin, and intravenous routes, and their potential contribution to MOF-associated toxicity. Further, we focused on drug delivery systems, MRI contrast agents, and biosensors, along with their key challenges, like how toxicity issues affect their efficacy and safety. The key biological mechanisms involved in MOF-induced toxicity were also critically examined, such as oxidative stress, mitochondrial dysfunction, and autophagy disruption. Moreover, we evaluated how MOFs' toxicity prolife is influenced by their physicochemical properties such as MOFs' composition, size and shape, surface characteristics, biodegradability, and stability. The current advancements were also illustrated to address these challenges and to minimize the toxicity with enhancement in therapeutic performance, such as the development of stimuli-responsive drug delivery systems and MOF-based composites with better biocompatibility and efficacy. Overall, this review enlightens the need for novel strategies to overcome the current challenges in MOFs' biomedical applications. Future research should focus on the evaluation of systematic toxicity and development of novel, suitable MOF-based composites to ensure their safety and efficacy.
National Reference Laboratory of Veterinary Drug Residues (HZAU) and MAO Key Laboratory for Detection of Veterinary Drug Residues, Wuhan, 430070, Hubei, China.
Key Laboratory of Prevention & Control for African Swine Fever and Other Major Pig Diseases, Ministry of Agriculture and Rural Affairs, Wuhan, 430070, Hubei, China.
Department of Pharmacology, Faculty of Pharmacy, The University of Lahore, Defense Road, Lahore, Pakistan.
National Reference Laboratory of Veterinary Drug Residues (HZAU) and MAO Key Laboratory for Detection of Veterinary Drug Residues, Wuhan, 430070, Hubei, China. dmchen1027@163.com.
National Reference Laboratory of Veterinary Drug Residues (HZAU) and MAO Key Laboratory for Detection of Veterinary Drug Residues, Wuhan, 430070, Hubei, China. snxsy1@126.com.Key Laboratory of Prevention & Control for African Swine Fever and Other Major Pig Diseases, Ministry of Agriculture and Rural Affairs, Wuhan, 430070, Hubei, China. snxsy1@126.com.Hubei Hongshan Laboratory, Wuhan, 430070, Hubei, China. snxsy1@126.com.
Toxicity Challenges and Current Advancement in Metal-Organic Frameworks (MOFs) for Biomedical Applications.

Endarterectomy, typically in patients with peripheral artery disease, involves arteriotomy closure with a 'patch.' One of its most common long-term complications is restenosis due to arterial wall hyperplasia induced by excessive mechanical stimulation. Methods to reduce surgically induced stress to promote positive long-term outcomes remain an open question.In this work, an arterial 'punch' approach is proposed to alleviate the stress concentration in arterial walls around the incision/patch anastomotic interface. Intraoperatively, coronary vascular punches are used to create proximal and distal circular arteriotomies for patients undergoing femoral endarterectomy. The surgical procedure is numerically simulated by first opening the vessel wall and subsequently adjusting the boundary condition of the incision to consider the patch's effect. An optimization study is performed by investigating the impact of incision/patch combinations on arterial wall stresses. The optimal punch tip size is identified by obtaining the minimum in-plane principal stress in the arterial wall. A beveled punched hole is also considered to optimize the stress field.Simulation results show that the stress magnitude in the arterial wall with a punched hole is significantly lower than that in an artery with a sharp vertex. The stress exponentially declines with increasing punch diameter. A beveled hole can further reduce the stress values and the number of high-stress regions.The arterial punch method can effectively alleviate stress concentration in arterial tissues. Importantly, stress concentration is shown to be sensitive to punched hole size and shape, suggesting potential practical implications for surgical techniques and patient outcomes.
Department of Surgery, The University of Chicago, Chicago, USA.
Department of Physics of Complex Systems, Weizmann Institute of Science, Rehovot, Israel.
Department of Surgery, The University of Chicago, Chicago, USA. lpocivavsek@bsd.uchicago.edu.
Numerical assessment of arterial punch method and arterial reconstruction in femoral endarterectomy.

Stem cell therapy has emerged as a promising approach for treating severe chronic liver diseases, including decompensated liver cirrhosis (DLC) and liver failure(LF), with mesenchymal stem cells (MSCs) being the most extensively investigated cell type in both preclinical and clinical trials.To summarize the research progress in clinical studies of stem cells therapy for chronic liver diseases, providing a comprehensive overview of current knowledge.Research on stem cell therapy for liver diseases was searched from databases such as PubMed, Web of Science, Google Scholar, and ClinicalTrials.gov.As of March 31, 2025, over 110 clinical trials investigating stem cell therapies for chronic liver diseases have been registered, predominantly in Phase I and Phase II stages. MSCs derived from umbilical cord, bone marrow, or adipose tissue representing the primary cellular sources. Stem cell therapy has demonstrated favorable safety profiles in the treatment of liver diseases. Concurrently, emerging evidence highlights its preliminary efficacy in enhancing patient survival rates and promoting hepatic functional recovery. However, challenges remain, such as inconsistent efficacy across trials, the absence of standardized protocols, and unresolved safety concerns. Emerging technologies, including stem cell-derived exosomes, gene-edited stem cells, and 3D liver organoids, show promising preclinical potential but require further validation.Stem cell therapy holds great potential for liver disease treatment. Although not yet a mainstream clinical option, continuous research may lead to effective, widely applicable treatments in the future.
© 2025. Asian Pacific Association for the Study of the Liver.
Department of Infectious Diseases, The Fifth Medical Center of Chinese PLA General Hospital, 100 Western 4 Ring Road, Beijing, 100039, China.
Department of Infectious Diseases, The Fifth Medical Center of Chinese PLA General Hospital, 100 Western 4 Ring Road, Beijing, 100039, China.Chinese PLA Medical School, Chinese PLA General Hospital, Beijing, 100085, China.
Department of Infectious Diseases, The Fifth Medical Center of Chinese PLA General Hospital, 100 Western 4 Ring Road, Beijing, 100039, China. fswang302@163.com.Chinese PLA Medical School, Chinese PLA General Hospital, Beijing, 100085, China. fswang302@163.com.
Stem cells therapies for liver diseases: for current practice and future goals.

To compare the quality of intraoral radiographic images of two types of dental detectors using wall-mounted and handheld dental X-ray units.Six intraoral dental radiographic images of a Dental Digital Quality Assurance radiographic phantom (Dental Imaging Consultants LLC, San Antonio, TX) were acquired with two types of dental receptors: photostimulable phosphor (PSP) receptor (CS 7600 digital system, Carestream Dental, Rochester, New York, United States) under two conditions, filtered and unfiltered; and a complementary metal oxide semiconductor (CMOS) sensor (RGV 6200, Carestream Dental, Rochester, New York, United States) using handheld (Nomad Pro 2; Kavo Kerr, Biberach, Germany) and wall-mounted (Midmark Preva DC Intraoral X-ray, Midmark Corporation, Illinois, United States) dental X-ray units. Spatial and contrast resolutions and percentage of radiographic contrast were evaluated. Then, radiographic images of an acrylic block were obtained under the same conditions and brightness, noise, and uniformity were assessed. Values were compared between the devices and the digital systems with Analysis of Variance (P < 0.05).There were no differences in spatial and contrast resolutions between dental X-ray units and detectors. Handheld dental X-ray units provide significantly higher radiographic contrast (P < 0.001) and lower brightness, noise, and uniformity (P < 0.001) regardless of the digital system used.Compared to a wall-mounted dental X-ray unit, the handheld device provides higher radiographic contrast and lower brightness, noise, and uniformity regardless of the digital system used.
© 2025. The Author(s) under exclusive licence to Japanese Society for Oral and Maxillofacial Radiology.
Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Av. Limeira, 901, Areião, Piracicaba, SP, 13414-903, Brazil. ruiz03338@gmail.com.
Department of Diagnosis & Oral Health, University of Louisville School of Dentistry, 501 South Preston Street, Louisville, KY, 40202, USA.
Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Av. Limeira, 901, Areião, Piracicaba, SP, 13414-903, Brazil.
Comparison of image quality between intraoral radiographic images using wall-mounted and handheld dental X-ray units.

The skin is a pivotal organ that serves as a physical barrier, protecting the body from harmful substances such as pathogens, allergens, and other environmental irritants. Chronic inflammation in the skin, along with the anthropogenic effects, can cause reactive oxygen species (ROS) overproduction. Prolonged exposure to elevated ROS levels and inadequate antioxidant defenses in the skin can contribute to the onset of various skin disorders. The nuclear factor erythroid 2-related factor-2 (Nrf-2) signaling pathway plays a key role in enhancing antioxidant capacity by promoting the production of antioxidant and detoxifying molecules. Consequently, pharmacological activation of the Nrf-2 pathway may help restore the oxidant-antioxidant balance, thereby improving therapeutic outcomes for chronic skin disorders. This study aimed to investigate the potential effect of novel agent: (5-((4-(4-(methoxycarbonyl)-2-oxopyrrolidin-1-yl)phenyl)carbamoyl)benzene-1,2,3-triyl triacetate (LN-53), synthesized based on the structure of previously developed by our team lead compound SK-119, on Nrf-2 signaling pathway in human epidermal keratinocytes (HEKs) at mRNA and protein level.The cytotoxicity of LN-53 was evaluated by MTT, LDH, live/dead cell staining, and caspase-3,-8,-9 multiplex activity assays. Intracellular ROS production was assessed by DCFH-DA staining. The Nrf-2 gene was silenced by transient transfection using human Nrf-2 siRNA. Nrf-2 and related factors (heme oxygenase-1 (HO-1) and NAD(P)H dehydrogenase: quinone-1 (NQO1)) were evaluated at the mRNA level by qPCR and protein level in nuclear and cytosolic fractions by Nrf-2 activation assay and Western blot. The levels of inflammatory cytokines (IL-6 and IL-8) in supernatants were determined by ELISA.Our results indicate that LN-53 effectively reduces intracellular ROS production triggered by tert-butyl hydroperoxide (TBHP), without leading to any noticeable cell damage. It promoted the nuclear translocation of Nrf-2 and induced the production of Nrf-2, HO-1, and NQO1 at both the mRNA and protein levels. LN-53-mediated alterations in antioxidant gene expressions were blocked by Nrf-2 knockdown. LN-53 treatment also suppressed the release of IL-6 and IL-8 cytokines mediated by TBHP exposure. Additionally, novel compound LN-53 was found to be more stable than the parent compound SK-119.LN-53 can effectively induce antioxidant mechanisms by promoting Nrf-2 nuclear translocation and suppressing ROS production in human epidermal keratinocytes. These data may suggest that LN-53 can contribute to maintaining redox balance and homeostasis in the skin.
Department of Biology, Molecular Biology Section, Faculty of Science, Hacettepe University, Beytepe Campus, Cankaya/Ankara, 06800, Turkey.
Department of Chemistry, Faculty of Exact Sciences, Bar-Ilan University, Ramat-Gan, 5290002, Israel.
Department of Chemistry, Faculty of Exact Sciences, Bar-Ilan University, Ramat-Gan, 5290002, Israel. aric-lev.gruzman@biu.ac.il.
Department of Biology, Molecular Biology Section, Faculty of Science, Hacettepe University, Beytepe Campus, Cankaya/Ankara, 06800, Turkey. cagatayk@hacettepe.edu.tr.
A novel 2-oxopyrrolidine derivative (LN-53) efficiently induces Nrf-2 signaling pathway activation in human epidermal keratinocytes.

Atypical sensory processing has been recognized as a notable characteristic in individuals with autism spectrum disorder (ASD). While visual global-local processing in ASD has been widely studied, understanding of auditory processing across global and local levels remains less defined. To clarify the mixed findings in the literature, we conducted a systematic review with meta-analysis and searched for potential factors that might explain the heterogeneity of previous studies. Our thorough search across four electronic databases up to 2025 identified 25 eligible studies for quantitative synthesis, focusing on comparisons of auditory global-local pitch processing between individuals with ASD and typically developing peers. Our findings indicated that the pooled effect size (Hedges' g = -0.05) for global pitch processing was not statistically significant, whereas there was a significant, albeit modest, pooled effect size (Hedges' g = 0.29) for local pitch processing. Significant moderators influencing global pitch processing included the number of answer choices, language typology, and participants' vocabulary size, while inconsistencies in local pitch processing outcomes were associated with the vocabulary size of autistic participants and variations in task paradigms employed. Overall, this meta-analysis supports the notion that individuals with ASD tend to prefer local pitch processing without apparent deficits in global processing abilities, aligning with the Enhanced Perceptual Functioning model. These findings contribute to our understanding of auditory processing differences in ASD, and offer implications for targeted interventions and further research directions.
School of Foreign Languages, Hunan University, Changsha, Hunan Province, China.
School of Foreign Languages, Hunan University, Changsha, Hunan Province, China. chenfeianthony@gmail.com.
College of Foreign Languages and Literature, Fudan University, Shanghai, China.
Faculty of Arts and Sciences, Beijing Normal University, Zhuhai, China.
Journal of autism and developmental disorders
Auditory Global-Local Processing in Autism Spectrum Disorder: A Systematic Review and Meta-Analysis.

Schizophrenia is a mental disorder with multifactorial etiology including positive, negative and cognitive symptoms. Nitric oxide (NO֗)-related biochemical pathways significantly contribute to the disease's pathophysiology and subsequent antipsychotic treatment. Recently, metabotropic glutamatergic (mGlu) or muscarinic (M) receptors have been considered as potent antipsychotics with the potential to reverse cognitive symptoms. The aim of this study was to investigate how selected mGlu or muscarinic receptor ligands regulate the most important aspects of NO֗-related neurotransmission.In this study, MK-801-the tool compound that induces schizophrenia-related changes-was used alone or with mGlu or muscarinic receptor ligands. Positive allosteric modulators (PAM) of mGlu2 (LY487379), mGlu5 (CDPPB), M1 (VU0357017) and M4 (VU0152100) receptors were administered. cGMP levels, superoxide dismutase (SOD) activity, nitrite and GLT-1 s-nitrosilation processes were investigated in mouse brain and plasma samples, while oxidative stress was measured in vitro with the use of mouse or human astrocytic cell lines.MK-801 did not change cGMP levels, while a decrease was observed in mice treated with VU0357017 or LY487379 in parallel. Increased SOD activity was observed in the cortex of MK-801-treated mice, and the compounds, with the exception of CDPPB, prevented this effect. The investigated compounds also prevented an MK-801-induced increase in plasma nitrite levels. GLT-1 protein was decreased after MK-801 treatment which was not evident in mice administered with muscarinic or mGlu ligands. GLT-1 S-nitrosilation was increased in all groups. In vitro studies revealed the potency of these compounds in counteracting MK-801-induced oxidative stress.The present data confirm that both mGlu and muscarinic receptor ligands may exert antipsychotic effects through biochemical pathways regulated by NO֗, in particular by decreasing oxidative stress indicators.
Maj Institute of Pharmacology Polish Academy of Sciences, 12 Smętna Street, Kraków, 31-343, Poland.
Department of Medical Laboratory Diagnostics- Fahrenheit Biobank BBMRI.pl, Medical University of Gdańsk, 7 Dębinki Street, Gdańsk, 80-211, Poland. leszek.kalinowski@gumed.edu.pl.BioTechMed Center, Department of Mechanics of Materials and Structures, Gdańsk University of Technology, 11/12 Narutowicza Steet, Gdańsk, 80-223, Poland. leszek.kalinowski@gumed.edu.pl.
Maj Institute of Pharmacology Polish Academy of Sciences, 12 Smętna Street, Kraków, 31-343, Poland. wierons@if-pan.krakow.pl.
The impact of muscarinic and mGlu receptors modulators on MK-801-induced impairments in NO-dependent processes both in vitro and in vivo.

Center for Mind and Brain, University of California, Davis, Davis, CA, USA. patrick.dwyer@latrobe.edu.au.Department of Psychology, University of California, Davis, Davis, CA, USA. patrick.dwyer@latrobe.edu.au.MIND Institute, UC Davis Health, Sacramento, CA, USA. patrick.dwyer@latrobe.edu.au.Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Bundoora, VIC, Australia. patrick.dwyer@latrobe.edu.au.
Center for Mind and Brain, University of California, Davis, Davis, CA, USA.
Laboratoire de Neurosciences Cognitives, Centre National de la Recherche Scientifique, Aix-Marseille University, Marseille, France.Sonova AG, Stäfa, Switzerland.
Laboratoire de Neurosciences Cognitives, Centre National de la Recherche Scientifique, Aix-Marseille University, Marseille, France.
Center for Mind and Brain, University of California, Davis, Davis, CA, USA.MIND Institute, UC Davis Health, Sacramento, CA, USA.
Center for Mind and Brain, University of California, Davis, Davis, CA, USA.Department of Psychology, University of California, Davis, Davis, CA, USA.MIND Institute, UC Davis Health, Sacramento, CA, USA.Department of Psychology, University of Maryland, College Park, MD, USA.
Using Psychoacoustic Tasks and Multidimensional Questionnaires to Characterize Auditory Hyperreactivity in Autistic Young People.

Autistic children face challenges in communication, verbal skills, and emotional abilities, which, along with their special-care needs, place additional pressure on families, leading to difficulties in maintaining family balance and parental management. Therefore, the present study aimed to design and develop an integrated developmental model of autistic children based on parent-child adaptation within the family system. This qualitative research was conducted using a grounded theory approach. The population consisted of parents of autistic children in Tehran, from whom 14 parents (both men and women) were selected through purposive and theoretical sampling at the Masir Center and were interviewed, adhering to ethical considerations, lasting approximately 50 to 60 min. Following the interviews, the findings were coded using Strauss and Corbin's method at three levels: open coding, axial coding, and selective coding. The findings of this research were discussed within the framework of underlying factors (enriching children's experiences), predisposing factors (environmental supports), mediating factors (organizational supports), growth-oriented coping strategies (implementation of an integrated development education program), and consequential outcomes (integrated developmental transformation of autistic children). Findings revealed the impact of collaboration and coordination within the support and therapeutic system on effective adaptation and development in autistic children. Therefore, attending to a multifaceted and integrated perspective in the development and adaptation processes of these children within the family system is required when interacting with them and designing educational programs.
Department of Counseling, Faculty of Education and Psychology, Alzahra University, Tehran, Iran.
Department of Counseling, Faculty of Psychology and Educational Sciences, Allameh Tabataba'i University, Tehran, Iran.
Department of Clinical Psychology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran. maryammaadi@sbmu.ac.ir.
Development of an Integrated Developmental Model for Adaptation with Autistic Children in Family System.

Department of Psychoeducation and Psychology, Université du Québec en Outaouais (UQO), Campus de Saint- Jérôme, 5 rue Saint-Joseph, Saint-Jérôme, Québec, J7Z 0B7, Canada. christophe.maiano@uqo.ca.Substantive-Methodological Synergy Research Laboratory, Department of Psychology, Concordia University, Montreal, Canada. christophe.maiano@uqo.ca.Cyberpsychology Laboratory, Department of Psychoeducation and Psychology, Université du Québec en Outaouais (UQO), Saint-Jérôme, Canada. christophe.maiano@uqo.ca.
Substantive-Methodological Synergy Research Laboratory, Department of Psychology, Concordia University, Montreal, Canada.Optentia Research Unit, North-West University, Vanderbijlpark, South Africa.
Department of Physical Activity Sciences, Université du Québec à Trois-Rivières, Trois-Rivières, Canada.
School of Education, Translational Health Research Institute, Western Sydney University, Sydney, Australia.
Institute for Positive Psychology and Education, Australian Catholic University, Sydney, Australia.
Profiles of Physical Fitness Among Youth with Intellectual Disabilities: A Longitudinal Person-Centered Investigation.

To identify the underlying mechanism by which quercetin (Que) alleviates sepsis-related acute respiratory distress syndrome (ARDS).In vivo, C57BL/6 mice were assigned to sham, cecal ligation and puncture (CLP), and CLP+Que (50 mg/kg) groups (n=15 per group) by using a random number table. The sepsisrelated ARDS mouse model was established using the CLP method. In vitro, the murine alveolar macrophages (MH-S) cells were classified into control, lipopolysaccharide (LPS), LPS+Que (10 μmol/L), and LPS+Que+acetylcysteine (NAC, 5 mmol/L) groups. The effect of Que on oxidative stress, inflammation, and apoptosis in mice lungs and MH-S cells was determined, and the mechanism with reactive oxygen species (ROS)/p38 mitogen-activated protein kinase (MAPK) pathway was also explored both in vivo and in vitro.Que alleviated lung injury in mice, as reflected by a reversal of pulmonary histopathologic changes as well as a reduction in lung wet/dry weight ratio and neutrophil infiltration (P<0.05 or P<0.01). Additionally, Que improved the survival rate and relieved gas exchange impairment in mice (P<0.01). Que treatment also remarkedly reduced malondialdehyde formation, superoxide dismutase and catalase depletion, and cell apoptosis both in vivo and in vitro (P<0.05 or P<0.01). Moreover, Que treatment diminished the release of inflammatory factors interleukin (IL)-1β, tumor necrosis factor-α, and IL-6 both in vivo and in vitro (P<0.05 or P<0.01). Mechanistic investigation clarifified that Que administration led to a decline in the phosphorylation of p38 MAPK in addition to the suppression of ROS expression (P<0.01). Furthermore, in LPS-induced MH-S cells, ROS inhibitor NAC further inhibited ROS/p38 MAPK pathway, as well as oxidative stress, inflammation, and cell apoptosis on the basis of Que treatment (P<0.05 or P<0.01).Que was found to exert anti-oxidative, anti-inflammatory, and anti-apoptotic effects by suppressing the ROS/p38 MAPK pathway, thereby conferring protection for mice against sepsis-related ARDS.
© 2025. The Chinese Journal of Integrated Traditional and Western Medicine Press and Springer-Verlag GmbH Germany, part of Springer Nature.
Department of Emergency Medicine, the Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu Province, 221002, China.Department of Emergency Medicine, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, 210002, China.Department of Emergency Medicine, Jinling Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing, 210002, China.
Department of Emergency Medicine, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, 210002, China.Department of Emergency Medicine, Jinling Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing, 210002, China.Department of Emergency Medicine, Xuzhou Municipal Hospital Affiliated to Xuzhou Medical University, Xuzhou, Jiangsu Province, 221000, China.
Intensive Care Unit, Suqian First Hospital, Suqian, Jiangsu Province, 223800, China.
Department of Emergency Medicine, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, 210002, China.
Department of Emergency Medicine, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, 210002, China.Department of Emergency Medicine, Jinling Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing, 210002, China.
Department of Emergency Medicine, the First Affiliated Hospital of Wannan Medical College (Yijishan Hospital of Wannan Medical College), Wuhu, Anhui Province, 241000, China.
Department of Emergency Medicine, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, 210002, China. sunzhr84@163.com.Department of Emergency Medicine, Jinling Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing, 210002, China. sunzhr84@163.com.
Quercetin Confers Protection against Sepsis-Related Acute Respiratory Distress Syndrome by Suppressing ROS/p38 MAPK Pathway.

To investigate the effects of acupuncture on the neurotransmitter levels and gut microbiota in a mouse model of Tourette syndrome (TS).Thirty-six male C57/BL6 mice were randomly divided into 4 groups using a random number table method: 3,3'-iminodipropionitrile (IDPN) group, control group, acupuncture group, and tiapride group, with 9 mice in each group. In the IDPN group, acupuncture group, and tiapride group, mice received daily intraperitoneal injections of IDPN (300 mg/kg body weight) for 7 consecutive days to induce stereotyped behaviors. Subsequently, in the acupuncture intervention group, standardized acupuncture treatment was administered for 14 consecutive days to IDPN-induced TS model mice. The selected acupoints included Baihui (DU 20), Yintang (DU 29), Waiguan (SJ 5), and Zulinqi (GB 41). In the tiapride group, mice were administered tiapride (50 mg/kg body weight) via oral gavage daily for 14 consecutive days. The control group, IDPN group, and acupuncture group received the same volume of saline orally for 14 consecutive days. Stereotypic behaviors were quantified through behavioral assessments. Neurotransmitter levels, including dopamine (DA), glutamate (Glu), and aspartate (ASP) in striatal tissue were measured using enzyme-linked immunosorbent assay. Dopamine transporter (DAT) expression levels were additionally quantified through quantitative polymerase chain reaction (qPCR). Gut microbial composition was analyzed through 16S ribosomal RNA gene sequencing, while metabolic profiling was conducted using liquid chromatography-mass spectrometry (LC-MS).Acupuncture administration significantly attenuated stereotypic behaviors, concurrently reducing striatal levels of DA, Glu and ASP concentrations while upregulating DAT expression compared with untreated TS controls (P<0.05 or P<0.01). Comparative analysis identified significant differences in Muribaculaceae (P=0.001), Oscillospiraceae (P=0.049), Desulfovibrionaceae (P=0.001), and Marinifilaceae (P=0.014) following acupuncture intervention. Metabolomic profiling revealed alterations in 7 metabolites and 18 metabolic pathways when compared to the TS mice, which involved various amino acid metabolisms associated with DA, Glu, and ASP.Acupuncture demonstrates significant modulatory effects on both central neurotransmitter systems and gut microbial ecology, thereby highlighting its dual therapeutic potential for TS management through gut-brain axis regulation.
Acupuncture and Moxibustion Department, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, 510000, China.the Second Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, 510000, China.
the Seventh Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, 510000, China.
the Second Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, 510000, China.
Acupuncture and Moxibustion Department, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, 510000, China.
Acupuncture and Moxibustion Department, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, 510000, China. fuwenbin@139.com.FU Wenbin Guangdong Province Famous Traditional Chinese Medicine Inheritance Studio, Guangzhou, 510000, China. fuwenbin@139.com.Situ Ling lnheritance Studio of Lingnan Acupuncture School, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, 510000, China. fuwenbin@139.com.
Acupuncture as A Potential Therapeutic Approach for Tourette Syndrome: Modulation of Neurotransmitter Levels and Gut Microbiota.

Electronic cigarettes (ECs) differ from traditional tobacco smoke but may contribute to cardiopulmonary remodeling. Pulmonary hypertension (PH), characterized by pulmonary artery and right ventricle remodeling, poses a significant risk of mortality in infants, children, and adolescents. However, the impact of maternal EC exposure on PH development in offspring remains unclear. To address this, we established a PH rat model with maternal EC exposure.Maternal EC exposure was initiated on gestation day 12 via electronic nicotine delivery systems. Offspring were administered monocrotaline (MCT) at 6 weeks of age (6-wo) to induce PH. Mechanistic experiments were conducted at 10-week-old (10-wo). Protein expression of NADPH oxidases, DNA methyltransferases, and autophagy-related markers was analyzed by Western blot. Morphological changes and the severity of PH were evaluated via hematoxylin and eosin (HE) staining and echocardiography, respectively. Furthermore, the involvement of the oxidative stress/DNA methylation/autophagy axis in response to maternal EC exposure was confirmed through a combination of ELISA, Western blot, HE staining, and echocardiography. Additionally, ATG5 mRNA expression was measured by qRT-PCR.Compared with control conditions, maternal EC exposure significantly worsened MCT-induced PH in male offspring. This was associated with increased oxidative stress, DNA hypomethylation, and anomalous autophagy in the offspring. In vivo treatment with chloroquine inhibited autophagy and ameliorated PH development in offspring exposed to maternal EC. Furthermore, N-acetylcysteine (NAC), an antioxidant, attenuated maternal EC exposure-induced oxidative stress, DNA hypomethylation, and excessive autophagy, thereby improving PH. DNA hypermethylation also reversed PH development, accompanied by reduced oxidative stress and suppressed autophagy. ATG5, a key regulator of autophagy, was identified as a potential therapeutic target, as its repression mitigated PH in maternal EC-exposed offspring.Maternal EC exposure induces oxidative stress and DNA hypomethylation in offspring, leading to anomalous autophagy and exacerbation of PH development. Targeting ATG5-mediated autophagy may represent a novel therapeutic approach for improving PH outcomes in offspring exposed to maternal EC.
Department of Cardiac Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, China.
Department of Pediatric Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, China.
Department of Cardiac Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, China. drwenss@outlook.com.
Maternal Electronic Cigarette Exposure Induces Dysregulation of Autophagy via Oxidative Stress/DNA Methylation in Pulmonary Hypertension Offspring.

Sleep is fundamental to the physical and mental health of both the general population and pregnant women. Most studies have focused on the impact of certain trimester sleep behaviors on gestational complications and birth outcomes. This study aimed to explore the association between maternal sleep duration and fetal growth development from as early as 23 gestational weeks to birth.A total of 803 pregnant women were prospectively enrolled. The self-reported maternal nocturnal sleep duration during all 3 trimesters was recorded. The outcome measures were reference-population-based Z-scores of fetal biometric measurements obtained through routine ultrasonographic examination.Using multiple linear regression, a marginally significant negative association was observed between second-trimester sleep duration and second-trimester fetal head circumference (HC) and third-trimester fetal biparietal diameter (BPD). Then the associations of long sleep duration in each trimester with fetal biometry extreme values were evaluated. A significant impact of second-trimester long sleep duration on the second-trimester BPD below the 10th percentile of the reference population was observed. Longitudinal analysis reported similar results for BPD and HC.Overall, a negative association between sleep duration and fetal biometric measurements was observed. Long sleep durations in the second trimester might negatively impact fetal growth, particularly brain parameters, including BPD and HC.
© 2025. The Author(s), under exclusive licence to Huazhong University of Science and Technology.
Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, 110004, China.
Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China. yefang@hust.edu.cn.Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China. yefang@hust.edu.cn.
Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China. tjdengdongrui@126.com.
Long Sleep Duration Is Associated with Fetal Brain Parameter Extreme Values: A Prospective Cohort Study.

Percutaneous coronary intervention (PCI) after transcatheter aortic valve replacement (TAVR) is technically challenging because of the presence of the transcatheter heart valve (THV), which complicates coronary artery engagement. Owing to their flexibility, diagnostic catheters (DCs) facilitate coronary access, but require subsequent exchange to guiding catheters (GCs) for PCI. The feasibility of using an extension wire (EW) to facilitate DC-to-GC exchange in this context remains unexplored. A retrospective analysis was conducted at our institution, examining 11 PCI cases performed after TAVR between January 6, 2020, and June 1, 2024, in which an EW was employed to transition from a DC to a GC. Clinical, angiographic, and procedural data were reviewed. Procedural success was defined as a successful DC-to-GC exchange and completion of PCI. DC-to-GC exchange using an EW was successfully achieved in all 11 cases (100%). Revascularization was achieved in 10/11 cases (91%). The lesions were uniformly classified as American College of Cardiology/American Heart Association Type B2/C. The GCs included Judkins-type in 7/11 cases (64%) and backup-type in 4/11 cases (36%). The THV types included SAPIEN in 6/11 cases (55%), Evolut in 3/11 cases (27%), and Navitor in 2/11 cases (18%). A 6Fr GC was utilized in 10/11 cases (91%), and rotational atherectomy was performed in 1/11 cases (9%). The use of an EW to facilitate the transition from DC to GC in PCI after TAVR resulted in high procedural success, providing a feasible approach for addressing complex lesions and optimizing procedural outcomes.
© 2025. The Author(s) under exclusive licence to Japanese Association of Cardiovascular Intervention and Therapeutics.
Department of Cardiovascular Medicine, Sendai Kousei Hospital, 1-20 Tsutsumidori-Amamiya, Aoba Ward, Sendai, Miyagi, 9810914, Japan.
Department of Cardiovascular Medicine, Sendai Kousei Hospital, 1-20 Tsutsumidori-Amamiya, Aoba Ward, Sendai, Miyagi, 9810914, Japan.Department of Laboratory Medicine, The Jikei University School of Medicine, Tokyo, Japan.
Department of Cardiovascular Surgery, Sendai, Miyagi, Japan.
Department of Cardiovascular Medicine, Sendai Kousei Hospital, 1-20 Tsutsumidori-Amamiya, Aoba Ward, Sendai, Miyagi, 9810914, Japan. noriotada@hotmail.com.
Cardiovascular intervention and therapeutics
Feasibility of guiding catheter exchange using extension wire in percutaneous coronary intervention after transcatheter aortic valve replacement.

Developing effective adsorbents for the recovery of noble metals from secondary resources is of considerable environmental significance. In this study, a metal-organic framework, UiO-66-2,5-dimercapto-1,3,4-thiadiazole (DMTD), was synthesized as a promising adsorbent for gold (Au) recovery from solid wastes. Initially, UiO-66-NH2 was functionalized with four different thiadiazole derivatives, containing thiol, amine, and methyl functional groups at the 2' and 5' positions. Among these, DMTD was selected due to its superior sorption efficiency. The synthesized UiO-66-DMTD exhibited exceptional selectivity and sorption efficiency during repeated addition of spent adsorbent, even in the presence of competing ions, within a pH range of 1 to 6. Au(III) appears to interact with S = C, S-H, and N = C groups on thiadiazole through reductive chelation, resulting in 53% Au(0), 26% Au(I), and 21% Au(III), based on the X-ray photoelectron spectroscopy results. To obtain pure Au(0), tin chloride solution was reacted following the Au sorption by UiO-66-DMTD, and as a result, Au(0) nanoparticles with 200-500 nm size range were recovered. Overall, the consecutive reaction of the leaching solution with UiO-66-DMTD and tin chloride is an effective method for the selective recovery of Au(0) nanoparticles from secondary resources.
Department of Environment and Energy Engineering, Gwangju Institute of Science and Technology, Gwangju, 61005, Republic of Korea.Research Center for Innovative Energy and Carbon Optimized Synthesis for Chemicals (Inn-ECOSysChem), Gwangju Institute of Science and Technology, Gwangju, 61005, Republic of Korea.
Department of Civil and Environmental Engineering, National Laboratory Astana, Nazarbayev University, Astana, 010000, Republic of Kazakhstan.
Department of Environment and Energy Engineering, Gwangju Institute of Science and Technology, Gwangju, 61005, Republic of Korea. shan@gist.ac.kr.Research Center for Innovative Energy and Carbon Optimized Synthesis for Chemicals (Inn-ECOSysChem), Gwangju Institute of Science and Technology, Gwangju, 61005, Republic of Korea. shan@gist.ac.kr.
Environmental science and pollution research international
Environ Sci Pollut Res Int. 2025-06-24;():.
Selective recovery of Au(0) nanoparticles from solid wastes using dimercaptothiadiazole-functionalized UiO-66-NH2 and tin chloride.

Age-related macular degeneration (AMD) is the leading cause of irreversible vision loss among the elderly in developed countries, manifesting in two primary forms: neovascular (wet) AMD and non-neovascular (dry) AMD. Current treatments, such as anti-VEGF therapy, offer limited efficacy, particularly for dry AMD, highlighting the urgent need for alternative strategies. Advancements in contemporary treatment strategies for these eye conditions are a pressing medical concern. Stem cell-based therapies have emerged as a promising approach for retinal regeneration due to their capacity for self-renewal and differentiation into retinal cell types, including retinal pigment epithelial (RPE) cells and photoreceptors, two key cell populations damaged in AMD. Among the various sources, pluripotent stem cells such as human embryonic stem cells (hESCs) and induced pluripotent stem cells (iPSCs) show significant potential in generating functional RPE cells and restoring retinal architecture and function. Preclinical and early clinical studies have demonstrated promising outcomes, including improved visual acuity and anatomical integration. However, challenges such as immune rejection, tumorigenicity, limited long-term integration, and ethical concerns continue to impede clinical translation. This review critically evaluates current stem cell-based therapeutic strategies for AMD, including advances in mesenchymal stem cells, retinal organoids, and combinatorial approaches with gene and nanotherapy. Furthermore, this review outlines the translational bottlenecks and future directions required to advance these therapies toward clinical application.
Department of Zoology, Seethalakshmi Ramaswami College (Autonomous), Affiliated to Bharathidasan University, Tiruchirappalli, Tamilnadu, India.
Department of Ophthalmology, Bern University Hospital, University of Bern, Bern, Switzerland.Department of Biomedical Research, University of Bern, Bern, Switzerland.
Aravind Medical Research Foundation, Aravind Eye Hospital, Madurai, Tamilnadu, India.
Department of Biochemistry and Molecular Biology, Pondicherry University, Puducherry, 605014, India.
Department of Biotechnology, Rathinam College of Arts and Science, Coimbatore, 641021, Tamil Nadu, India.
Centre for Excellence in Nanobio Translational Research, Department of Pharmaceutical Technology, University College of Engineering, Anna University- BIT Campus, Tiruchirappalli, Tamilnadu, India. annadurai.t@aubit.edu.in.
Age-Related Macular Degeneration: Therapeutic Strategies Based on Stem Cells.

Environmental pollution remains a critical barrier to sustainable societal development. In this context, the present work explores a sustainable approach to environmental remediation through the mechanochemical synthesis of bismuth oxychloride (BiOClm) immobilized on waste stainless-steel slags (SSS) at varying proportions. This strategy exemplifies the principles of circular economy by transforming industrial waste into a high-value, photocatalytically functionalized material. The composites were thoroughly characterized in terms of their physicochemical and optical properties, and their photocatalytic activity was evaluated through nitrogen oxide (NOx) abatement under UV and visible light. Although the absolute photocatalytic activity of the composites was lower than that of pure BiOClm, their efficiency per unit of BiOClm was higher, indicating improved utilization of the active phase. This enhancement is attributed to a slight semiconductor behavior of SSS metallic constituents, as confirmed by photocurrent measurements. The coupling between BiOCl and the metal-rich support results in an upward shift of the band energy positions, thereby encompassing the energy of oxygen conversion to superoxide. Thus, the superior photocatalytic activity (normalizes to the photocatalyst mass) of BiOClm supported on SSS is attributed to the BiOCl-metal-support interactions, which facilitate charge separation and enhance redox performance. The results indicate that BiOCl/SSS composites with BiOCl contents between 20 and 40% exhibit the most effective photocatalytic performance, achieving a maximum NOx removal efficiency of 1.49% per gram, compared to 0.8% for pure BiOCl. According to the results, a proportion of SSS in the range 60-80% would be the optimum to be used as an active support for BiOClm. Overall, this work offers a promising route for the valorization of industrial waste into functional materials for air pollution control.
Institute of Construction Science Eduardo Torroja, IETcc-CSIC, Madrid, Spain.
Institute of Construction Science Eduardo Torroja, IETcc-CSIC, Madrid, Spain. eva.jimenez@csic.es.
Institute of Construction Science Eduardo Torroja, IETcc-CSIC, Madrid, Spain.Escuela Técnica Superior de Ingenieros Industriales, Universidad Politécnica de Madrid (UPM), Madrid, Spain.
Bismuth oxychloride anchored on waste stainless-steel slag: preliminary assessment of its potential as an active photocatalytic support.

Lead (Pb) is a prevalent toxic metal in contaminated ecosystems, posing a real threat to living organisms. Although birds are highly sensitive to Pb, there is little information on its impact on the avian digestive system. This study was designed to compare the effects of chronic Pb exposure (for 15 and 30 days) on the activities of digestive enzymes-aminopeptidase-N (APN), maltase-glucoamylase (MG), and sucrase-isomaltase (SI)-between eared doves (Zenaida auriculata) and house sparrows (Passer domesticus). Our results showed that Pb-exposed sparrows exhibited inhibited digestive enzyme activities compared to the control, while treated doves did not show significant changes in enzyme activity. This difference in sensitivity between sparrows and doves may be due to physiological differences and water consumption. In conclusion, this study provides the first evidence of inhibited APN, MG, and SI activity in sparrows as a result of chronic Pb exposure through drinking water. Furthermore, our work contributes to the understanding of Pb toxicology in the digestive system of birds and its effect on the acquisition of energy, which should be considered when evaluating the impact of environmental pollutants on wildlife.
Laboratorio de Biología Integrativa, Instituto Multidisciplinario de Investigaciones Biológicas de San Luis (IMIBIO-SL), Universidad Nacional de San Luis (UNSL) & Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Av. Ejército de Los Andes 950, D5700, San Luis, Argentina.
Laboratorio de Biología Integrativa, Instituto Multidisciplinario de Investigaciones Biológicas de San Luis (IMIBIO-SL), Universidad Nacional de San Luis (UNSL) & Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Av. Ejército de Los Andes 950, D5700, San Luis, Argentina.Facultad de Química, Bioquímica y Farmacia, Universidad Nacional de San Luis, San Luis, Argentina.
Laboratorio de Biología Integrativa, Instituto Multidisciplinario de Investigaciones Biológicas de San Luis (IMIBIO-SL), Universidad Nacional de San Luis (UNSL) & Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Av. Ejército de Los Andes 950, D5700, San Luis, Argentina. fabricio.cid@gmail.com.Facultad de Química, Bioquímica y Farmacia, Universidad Nacional de San Luis, San Luis, Argentina. fabricio.cid@gmail.com.
First evidence of lead-induced impairment of intestinal digestive enzyme activity in birds.

Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Hospital, 2-5-1 Shikata-Cho Kita-Ku, Okayama, 7008558, Japan. pc4x4onk@s.okayama-u.ac.jp.
Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Hospital, 2-5-1 Shikata-Cho Kita-Ku, Okayama, 7008558, Japan.
The Sakakibara Heart Institute of Okayama, Okayama, Japan.
Department of Cardiovascular Therapeutics, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan.
Iatrogenic laceration of the atrial septum during catheter ablation for atrial fibrillation in a patient with multiple atrial septal defects.

The toxicity of chromium, in its hexavalent form (Cr(VI)), is extremely harmful to living organisms owing to its potent oxidizing properties. The present research focused in exploring the hexavalent chromium induced bioaccumulation, oxidative responses and histological anomalies in widely cultured freshwater carp Labeo rohita. Fingerlings of L. rohita were exposed to four sub-lethal waterborne concentrations of 96 h LC50 (1/40th, 1/20th, 1/10th and 1/5th) of the Cr(VI). The impact of chromium was assessed in 5, 15 and 30 days exhibiting significant accumulation (P < 0.05) in the fish tissues (gill > kidney > liver > muscles) with increasing concentration. The bioaccumulation factor (BAF) also exhibited the highest in the liver tissue and least in muscle. Antioxidant enzymes like superoxidase dismutase (SOD) in the gill, liver and kidney increased significantly with the concentrations, while catalase (CAT) activity was found to fluctuate along different concentrations. Significant reduction in growth performance i.e. SGR and reduced feeding intensity was also observed after 30th day. The histopathological examination revealed epithelial hyperplasia in the gill tissues and vacuolization and shrinkage of hepatocytes in the liver tissues. Chromium toxicity-induced alterations in kidney tissues were also characterized by glomerular shrinkage and an increase in Bowman's space. Overall, the study demonstrated that hexavalent chromium exerts significant impact on accumulation, oxidative stress, and histological anomalies, particularly at higher concentrations, in the fingerlings of L. rohita. Therefore, effective treatment of wastewater below the studied concentrations from anthropogenic sources prior to its release into aquatic environments is vital to avert pollution and safeguard the sustainability of aquatic life.
Department of Zoology, Raiganj University, Raiganj, West Bengal, 733 134, India.
Department of Zoology, Raiganj University, Raiganj, West Bengal, 733 134, India. drdebashrimondal@gmail.com.
Department of Aquatic Animal Health, West Bengal University of Animal and Fishery Sciences, Kolkata, 700 094, India.
Biometals : an international journal on the role of metal ions in biology, biochemistry, and medicine
Hexavalent chromium induced bioaccumulation, oxidative responses and histological anomalies in freshwater carp Labeo rohita (Hamilton, 1822).

Curdlan, an exopolysaccharide, has gained sufficient attention in recent years due to its potential health benefits. Its unique physico-chemical and rheological properties create an appropriate substitute for diverse applications in agriculture, food, and pharmaceutical industries. This review begins with an overview of bioactive properties, structural characteristics, curdlan biosynthesis, and its production technologies. Curdlan is useful in the modulation of immune responses and as an effective agent against diseases like malaria, cancer, dengue, and COVID-19. This review also expounds on the potential role of curdlan in the food industry as a thickener, texture modifier, stabilizer, and emulsifier. This biomolecule holds promise for functional food development due to its prebiotic properties. Research on curdlan has proved its potential role in the biomedical sector, and it acts positively in drug delivery and tissue engineering practices. Thus, curdlan offers a potential remedy in response to growing environmental concerns and the urgent demand for environment-friendly substitutes for synthetic polymers.
© 2025. The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature.
Department of Botany, Dayanand Girls P.G. College, Kanpur Nagar, 208001, UP, India.
Department of Botany, Pt. Prithi Nath P.G. College, Kanpur, 208001, UP, India.
Department of Botany, Faculty of Science, University of Allahabad, Prayagraj, 211002, UP, India. pradeepiitkgp.yadav@gmail.com.
Department of Industrial Biotechnology, Gujarat Biotechnology University, GIFT City, Gandhinagar, 382355, Gujarat, India. sudhir.singh@gbu.edu.in.
Department of Botany, Dayanand Girls P.G. College, Kanpur Nagar, 208001, UP, India. jsjdgpg2017@gmail.com.
Curdlan: a microbial biopolymer of multifarious applications for a sustainable environment.

A contemporary issue arising from global industrial and economic development over the past few decades is the pollution of the environment. Chromium (Cr) is a heavy metal used in numerous industries that can build up in the surrounding ecosystem due to improper disposal techniques. Chromium pollution can cause toxicity in both the local flora and fauna. Bioremediation is perceived as an alternative to conventional treatments to mitigate chromium pollution and has thus been extensively developed in recent years. Among the various biological organisms, bacteria possesses desirable characteristics and can be cost effective while treating the pollutants. Numerous mechanisms have been evolved by bacteria to combat toxicity triggered by chromium exposure. Plant growth promoting bacteria have also evolved with mechanisms that impart resistance to susceptible plants upon chromium exposure. Large scale chromium remediation requires the use of bioreactors that can effectively utilize bacteria and nullify the toxic form of Cr. The robustness of these techniques can be increased by combining them with conventional techniques such as precipitation, filtration, etc. Case studies have also been discussed to determine their relevance in the bioremoval of Cr. The future aspects of chromium bioremediation in accordance to the omics approach has been discussed so as to understand the fate of Cr upon treatment using biological methods. This review highlights the various toxic effects that have been observed in various flora and fauna while providing insights into bacterial mechanisms that could resist Cr toxicity and their possible applications defined in terms of robustness in ex situ as well as in situ remediation technologies.
School of Bio Sciences and Technology, Vellore Institute of Technology, Vellore, Tamil Nadu, 632014, India.
School of Biosciences Engineering and Technology, VIT Bhopal University, Sehore, Madhya Pradesh, 466114, India.
School of Bio Sciences and Technology, Vellore Institute of Technology, Vellore, Tamil Nadu, 632014, India. jabez.vit@gmail.com.
Review on the robustness of technologies and strategies in removal of hexavalent chromium: a biological perspective.

In 1986, Japanese macaques of the Arashiyama B group fissioned, with high-ranking females forming the dominant E group and the middle- and low-ranking females forming the subordinate F group (Suzuki et al. in Primates 64:79-90. https://doi.org/10.1007/s10329-022-01024-x , 2023). In 1988, we recorded the dominant-subordinate interactions among adult females in both groups and analyzed them to clarify how they reorganized their dominance relations. The two groups showed contrasting results. Two years after group fission, the past dominance relations among female kin-groups had been largely maintained in E group, whereas the dominance relations among females in F group had been significantly reorganized, with the females from some kin-groups dispersing into various rank positions within the group. In both the E and F groups, the kin-related dyads within the 2nd degree of maternal relatedness (consanguinity) (r ≥ 0.25) tended to follow Kawamura's principles (Kawamura in Primates 1:149-156, 1958), but a considerable number of dyads did not. Such deviations from the principles seemed to derive from multiple factors: past rank reversals between the mothers and daughters, social influences from high-ranking males, and changes in the membership of kin-related females following group fission; for example, disappearances of or separations from mothers. Once rank changes were fixed, however, the relations of the newly emerged mother-daughter and sister dyads again reflected Kawamura's principles.
© 2025. The Author(s), under exclusive licence to Primate Society of Japan.
Museum of Nature and Human Activities, Hyogo, Sanda, 669-1546, Japan.
Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan.Department of Anthropology, University of Sri Jayewardenepura, Gangodawila, Nugegoda, Sri Lanka.
School of Policy Studies, Kwansei Gakuin University, 2-1 Gakuen, Sanda, 669-1337, Japan. ytakahataz96014@gmail.com.
Reorganization of female dominance relations after group fission of Japanese macaques (Macaca fuscata) in Arashiyama based on Kawamura's principles.

Plant viruses use the plasmodesmata and vascular systems to spread systemically in a plant, which may influence the translocation of exogenous transgene products in genetically modified (GM) plants. Transgrafting is a technique that involves the use of GM plants as grafting partners for non-GM plants, and yields non-GM edible harvests from transgrafted crops; thus, there is potential for its distribution as a non-GM product. However, when growing in agricultural fields, transgrafts are exposed to biotic stresses, such as plant virus infections. In this study, we investigated the influence of a plant virus infection on translocation of transgene products between GM and non-GM parts of transgrafts. We generated homo- and hetero-transgrafts of green fluorescent protein (GFP)-expressing GM tomatoes and GM Nicotiana benthamiana rootstocks with non-GM tomato scions and infected them with cucumber mosaic virus (CMV), a major plant virus, and analyzed the translocation of GFP protein in transgrafts. The results showed that CMV infection did not promote GFP transfer from GM rootstock to non-GM scions.
Graduate School of Agriculture, Osaka Metropolitan University, 1-1 Gakuen-cho, Naka-Ku, Sakai, Osaka, 599-8531, Japan. tomochi@omu.ac.jp.Graduate School of Life and Environmental Sciences, Osaka Prefecture University, 1-1 Gakuen-cho, Naka-ku, Sakai, Osaka, 599-8531, Japan. tomochi@omu.ac.jp.Osaka International Research Center for Infectious Diseases, Osaka Metropolitan University, Sakai, Osaka, 599-8531, Japan. tomochi@omu.ac.jp.
Graduate School of Agriculture, Osaka Metropolitan University, 1-1 Gakuen-cho, Naka-Ku, Sakai, Osaka, 599-8531, Japan.Graduate School of Life and Environmental Sciences, Osaka Prefecture University, 1-1 Gakuen-cho, Naka-ku, Sakai, Osaka, 599-8531, Japan.
Graduate School of Life and Environmental Sciences, Osaka Prefecture University, 1-1 Gakuen-cho, Naka-ku, Sakai, Osaka, 599-8531, Japan.
Graduate School of Horticulture, Chiba University, 1-33 Yayoi-cho, Inage-ku, Chiba, 263-8522, Japan.
Cucumber mosaic virus infection does not increase the translocation of the green fluorescent protein from GM rootstock to non-GM scion in transgrafted plants.

In the year 2022, the outbreak of monkeypox virus (MPXV) occurred in the various countries of Africa, particularly Central and West Africa, North America, South America, Europe, and other countries. Without any delay it spread across more than 100 countries infecting around 116,015 people causing around 255 deaths. Monkeypox is a major public health issue, and it is important to search for new therapeutic approaches. This review article is a review of molecular docking studies to identify possible protein inhibition approaches against Monkeypox virus. The exploration on the molecular architecture of the main viral proteins and their relationships with the host cell, emphasizing how these interactions are important in the viral cycle. By gathering data from multiple molecular docking studies, the evaluation of how effective different structural elements are in disrupting these protein interactions is conducted. The results of the analysis reveal how narrowed the focus of molecular interventions is, which holds the promise for the development of antiviral therapies for Monkeypox (Mpox). Not only does this review update the current understanding of the pathophysiology of Monkeypox, but it also provides a basis for more research to deal with this new viral threat. It will be important for the design of inhibitors that can block the replication and dissemination of MPXV to understand the mechanisms of action of the viral proteins and their interactions with the host cell.
Department of Biotechnology, Microbiology and Forensic Science, School of Sciences, Noida International University (NIU), Uttar Pradesh, Gautam Budh Nagar, 201312, India.
Amity Institute of Forensic Sciences, Amity University, Noida, Uttar Pradesh, 201303, India.
Department of Biotechnology, Microbiology and Forensic Science, School of Sciences, Noida International University (NIU), Uttar Pradesh, Gautam Budh Nagar, 201312, India. shilpy.singh24@gmail.com.
Targeting monkeypox virus (MPXV): strategies for molecular docking studies on protein inhibition.

Haptic feedback could improve the efficiency of needle insertion procedures by providing surgeons with enhanced sensing and guiding capabilities. A framework has been developed to provide physicians with enhanced haptic feedback during CT-guided needle insertion procedures in oncology.The physicians encountered needle-tissue interaction and guidance forces with visual feedback to accurately reach the tumor. The force feedback to users was enhanced by amplifying several parameters in the feedback model, such as tip forces and radial forces. The study evaluated the effect of multiple haptic and visual feedback algorithms on user performance in efficiently inserting the needle. In this experimental pilot study, 12 participants including three interventional radiologists engaged in five experimental scenarios simulating a needle insertion.The results showed that enhanced force feedback for tumor perception reduced tumor targeting error and trajectory deviation, compared to natural force feedback. This was also the case when tumor perception and haptic guidance were both enhanced. Additionally, real-time visual feedback and enhanced force feedback for guidance reduced the duration to finish the task significantly. Participants still preferred real-time visual feedback over enhanced haptic feedback cues.On average, small tumors (around 3mm in diameter) can be successfully targeted with enhanced haptic feedback in the radial and axial directions. Additionally, critical regions, such as veins within the liver, can be avoided more effectively as users maintain the desired trajectory with greater accuracy.
Robotics and Mechatronics, University of Twente, Enschede, The Netherlands. m.s.selim@utwente.nl.
Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands.
Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.
Robotics and Mechatronics, University of Twente, Enschede, The Netherlands.
Robotics and Mechatronics, University of Twente, Enschede, The Netherlands.Department of Medical Imaging, Radboud University Medical Center, Nijmegen, The Netherlands.
International journal of computer assisted radiology and surgery
Int J Comput Assist Radiol Surg. 2025-06-24;():.
Experimental evaluation of virtual needle insertion framework with enhanced haptic feedback.

Automating suturing in robotic-assisted surgery offers significant benefits including enhanced precision, reduced operative time, and alleviated surgeon fatigue. Achieving this requires robust computer vision (CV) models. Still, their development is hindered by the scarcity of task-specific datasets and the complexity of acquiring and annotating real surgical data. This work addresses these challenges using a sim-to-real approach to create synthetic datasets and a data-driven methodology for model training and evaluation.Existing 3D models of Da Vinci tools were modified and new models-needle and tissue cuts-were created to account for diverse data scenarios, enabling the generation of three synthetic datasets with increasing realism using Unity and the Perception package. These datasets were then employed to train several YOLOv8-m models for object detection to evaluate the generalizability of synthetic-trained models in real scenarios and the impact of dataset realism on model performance. Additionally, a real-time instance segmentation model was developed through a hybrid training strategy combining synthetic and a minimal set of real images.Synthetic-trained models showed improved performance on real test sets as training dataset realism increased, but realism levels remained insufficient for complete generalization. Instead, the hybrid approach significantly increased performance in real scenarios. Indeed, the hybrid instance segmentation model exhibited real-time capabilities and robust accuracy, achieving the best Dice coefficient (0.92) with minimal dependence on real training data (30-50 images).This study demonstrates the potential of sim-to-real synthetic datasets to advance robotic suturing automation through a simple and reproducible framework. By sharing 3D models, Unity environments and annotated datasets, this work provides resources for creating additional images, expanding datasets, and enabling fine-tuning or semi-supervised learning. By facilitating further exploration, this work lays a foundation for advancing suturing automation and addressing task-specific dataset scarcity.
Department of Surgical Sciences, Università degli Studi di Torino, Corso Dogliotti 14, 10126, Turin, TO, Italy.DIBRIS, Università degli Studi di Genova, Via all'Opera Pia 13, 16145, Genoa, GE, Italy.
Department of Surgical Sciences, Università degli Studi di Torino, Corso Dogliotti 14, 10126, Turin, TO, Italy.
Department of Surgical Sciences, Università degli Studi di Torino, Corso Dogliotti 14, 10126, Turin, TO, Italy.DIMEAS, Politecnico di Torino, Corso Duca degli Abruzzi 24, 10129, Turin, TO, Italy.
DIBRIS, Università degli Studi di Genova, Via all'Opera Pia 13, 16145, Genoa, GE, Italy.
Robotics and Mechatronics, University of Twente, Drienerlolaan 5, 7522, Enschede, NB, Netherlands. g.dagnino@utwente.nl.Department of Surgical Sciences, Università degli Studi di Torino, Corso Dogliotti 14, 10126, Turin, TO, Italy. g.dagnino@utwente.nl.
A reproducible framework for synthetic data generation and instance segmentation in robotic suturing.

Cardiovascular diseases are the leading cause of mortality globally. Advances in interventional radiology and endovascular devices have made endovascular procedures effective alternatives to traditional open surgery, leading to their routine application in clinical practice. Within this framework, novel technologies, including robotic platforms and navigation software, have been developed to assist clinicians in executing endovascular interventions with improved dexterity, enhanced guidance, and superior clinical training, ultimately yielding better patient outcomes.This study aims to develop a model-based simulation environment within the SOFA framework, to enable shape and force sensing for endovascular robotic procedures. The vascular catheter was modeled using beam theory, and realistic interactions between the catheter and vascular models were established using the finite element method (FEM) with both linear elastic and nonlinear hyper-elastic models. Experiments measured contact forces and positional changes during catheter insertion, comparing anatomical deformations with simulation results.Experimental tests validated the simulated force and displacement measurements. The catheter contact force showed an absolute error of 0.0371 N (30.45%). Catheter tip displacement averaged 3.1 mm, and the proximal segment's Fréchet distance averaged 3.6 mm. For the anatomical model, the elastic FEM model performed best, with deformation measurement errors of 34%, 19%, and 59% across three different force scenarios.The results indicate that the integration of advanced physical modeling, realistic human-robot interactions, and enhanced computational capabilities will facilitate the development of innovative solutions, enabling clinicians to achieve greater accuracy and reliability in minimally invasive surgical (MIS) applications, particularly in endovascular interventions.
Politecnico di Torino, Turin, Italy.Università degli Studi di Genova, Genoa, Italy.Università degli Studi di Torino, Turin, Italy.
University of Twente, Enschede, The Netherlands.
University of Twente, Enschede, The Netherlands.Fraunhofer Research Institution for Individualized and Cell-Based Medical Engineering, Lübeck, Germany.
Università degli Studi di Genova, Genoa, Italy.
University of Twente, Enschede, The Netherlands. g.dagnino@utwente.nl.Università degli Studi di Torino, Turin, Italy. g.dagnino@utwente.nl.
A simulation environment for robot-assisted endovascular interventions.

Although studies have investigated the effects of adverse childhood experiences (ACEs) on binge drinking, few studies have investigated the moderating effects of race/ethnicity on the association between ACEs and binge drinking among adults. The objectives of this study were to examine the association between ACEs and binge drinking, and whether this association is dependent on race/ethnicity. Data for this study were obtained from the 2019-2022 Behavioral Risk Factor Surveillance System survey. An analytic sample of 204,858 adults aged 18-69 (50.9% female) was analyzed using binary logistic regression. Of the 204,858 respondents, 18.2% engaged in binge drinking, 32.7% had no ACEs, and 21.5% had four or more ACEs. We found that race/ethnicity moderated the association between ACEs and binge drinking. Odds were 1.67 times higher for non-Hispanic Blacks who experienced four or more ACEs (AOR = 1.67 p < .001, 95% CI = 1.31-2.14) and 1.39 times higher for Hispanics who experienced four or more ACEs (AOR = 1.39 p < .05, 95% CI = 1.05-1.83) to engage in binge drinking when compared to their non-Hispanic White counterparts who experienced four or more ACEs. Other factors associated with binge drinking include younger age, higher income, higher education, not being married, poor mental health, and cigarette smoking. Females had lower odds of engaging in binge drinking. The association between ACEs and binge drinking varies based on race/ethnicity. The findings of this study underscore the importance of developing race-specific screening and intervention strategies to support individuals exposed to multiple ACEs and potentially mitigate binge drinking later in life.
© 2025. W. Montague Cobb-NMA Health Institute.
School of Social Work, The University of Texas at Arlington, Arlington, USA. philip.baiden@uta.edu.Department of Kinesiology, The University of Texas at Arlington, Arlington, USA. philip.baiden@uta.edu.Department of Applied Health Science, Indiana University School of Public Health, Bloomington, USA. philip.baiden@uta.edu.
School of Social Work, The University of Texas at Arlington, Arlington, USA.Department of Kinesiology, The University of Texas at Arlington, Arlington, USA.Department of Applied Health Science, Indiana University School of Public Health, Bloomington, USA.
Journal of racial and ethnic health disparities
J Racial Ethn Health Disparities. 2025-06-24;():.
Association between Adverse Childhood Experiences and Binge Drinking among Adults: The Moderating Effect of Race/Ethnicity.

African American men bear an unequal proportion of metastatic prostate cancer burden. The utilization of second-generation anti-androgens like abiraterone with androgen deprivation therapy (ADT) has become a standard therapy for metastatic prostate cancer. Thus, we aimed to examine the utilization of abiraterone with ADT in African American men with metastatic disease and determine whether disparities in its use exist.This is a retrospective study, using a multi-institutional regional collaborative prostate cancer database. We compared the use of ADT with abiraterone between African American men and non-African American men diagnosed with distantly metastatic prostate cancer from July 2015 to August 2022, using logistic regression and negative binomial regression.We identified 201 men with metastatic prostate cancer and of those, 28% were African American men. African American men were younger (47% vs. 27.8%, ≤ 69 years, p = 0.002), and younger men experienced a longer time between diagnosis of metastatic disease and receipt of ADT with abiraterone compared to older men (mean 125 vs. 14 days, p = 0.038). While African American and non-African American men had similar rates of ADT use with abiraterone, African American men experienced longer times between documented metastatic disease and initiation of ADT with abiraterone (mean 187 vs. 79 days, p = 0.042).The initiation of ADT with abiraterone was delayed by 3 months in African American men. This discrepancy warrants an investigation of system level barriers to the timely initiation of abiraterone in African American men given its known oncologic benefits.
Division of Urologic Oncology, Department of Urology, University of Virginia, 500 Ray C. Hunt Drive, Charlottesville, VA, 22903, USA. ci5d@uvahealth.org.
Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA.
Division of Urology, Cooper University Health Care, Camden, NJ, USA.
Department of Urology, Einstein Healthcare Network, Philadelphia, PA, USA.
Division of Urologic Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA.
Department of Urology, Geisinger Health System, Danville, PA, USA.
Division of Urology, University of Pennsylvania, Philadelphia, PA, USA.
Division of Urology, MidLantic Urology/Main Line Health, Bala Cynwyd, PA, USA.
Division of Urology, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, USA.
Department of Urology, Temple University, Philadelphia, PA, USA.
Department of Urology, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
Department of Urology, University of Pittsburgh, Pittsburgh, PA, USA.
Division of Urology, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA.
Department of Urology, MedStar Health Georgetown, Washington, DC, USA.
Health Care Improvement Foundation, Philadelphia, PA, USA.
Investigating the Usage of Abiraterone in African American Men with Metastatic Prostate Cancer.

The built environment and food environment have been well documented as correlated factors of obesity, but literature has paid less attention to how these environments interact with racial and ethnic composition to affect obesity. This study examines the racial-ethnic context of obesity concerning the built environment and food environment in a racially segregated city, Chicago.The obesity data was sourced from the Healthy Chicago Survey, which gathered information through landline and cell phone interviews with adults aged 18 years or older. The built environment was measured by density, diversity, and design: the density was measured in 1000 residents per square mile within a community; the design of the built environment was measured by the intersection density; and the diversity was measured by the entropy index for land use mix. Spatial statistics were used to identify local clusters and outliers of built environments. We used the North American Industry Classification System codes to distinguish different types of food stores. We used ordinary least squares regression models to examine the effects of the built environment on the obesity rate and included interaction terms to investigate how the built environment interacts with racial composition to impact the obesity rate.Our results show that population density had a positive association with obesity rates when the African American population percentage increased. Both intersection density and the land use mix were negatively associated with obesity rates. However, as the percentage of the African American population increased, the magnitude of the negative association between the intersection density and obesity rate decreased, while the magnitude of the negative association between the land use entropy index and obesity rate increased. Besides, built environments are more important than food environments in reducing the obesity rate, although grocery stores showed negative effects on obesity while restaurant establishments showed positive effects on obesity.We provide suggestive evidence that improving urban planning and design to increase the intersection density and land use diversity might significantly reduce the obesity rate, although race was significant in the obesity rate, and the magnitudes of effects of intersection density and land use diversity on the obesity rate differed in African American communities. This evidence highlights the importance of considering demographic factors in designing and planning urban environments to promote public health. Race significantly influenced the obesity rate, with varying effects observed in African American communities. Our findings suggest that tailored urban planning strategies might be necessary to effectively address obesity in different populations.
Department of Social Sciences, Lewis College of Science and Letters, Illinois Institute of Technology, 3301 S Dearborn St, Siegel Hall 116H, Chicago, IL, 60616, USA. hhuang48@illinoistech.edu.
Department of Urban and Regional Planning, School of Architecture and Planning, University at Buffalo, The State University of New York, South Campus, Hayes Hall 331, Buffalo, NY, 14214, USA.
Assessing Obesity Risk: The Interaction of the Built and Food Environments with African Americans in Chicago.

Solid pseudopapillary neoplasm (SPN) of the pancreas is a rare tumor with low malignant potential, though 10-15% may show invasive or metastatic behavior. This study aimed to evaluate the safety and efficacy of endoscopic ultrasound-guided ethanol ablation (EUS-EI) in patients with SPN who were not surgical candidates.Four patients with SPN who declined or were ineligible for surgery underwent EUS-EI at Aichi Cancer Center. Technical and clinical outcomes, as well as adverse events, were assessed.Technical success was achieved in all patients (100%). Clinical success was observed in three patients (75%), including two with complete ablation and one with significant tumor reduction. No major adverse events or tumor recurrence occurred during follow-up.EUS-EI may be a safe and effective alternative for managing SPN in non-surgical candidates.
© 2025. The Author(s), under exclusive licence to Japanese Society of Gastroenterology.
Department of Gastroenterology, Aichi Cancer Center, 1-1 Kanokoden, Chikusa-ku, Nagoya, 464-8681, Japan.
Department of Gastroenterology, Aichi Cancer Center, 1-1 Kanokoden, Chikusa-ku, Nagoya, 464-8681, Japan. khara@aichi-cc.jp.
EUS-guided ethanol ablation in patients with solid pseudopapillary neoplasm: a four-case series.

This systematic review aims to evaluate the impact of mind maps and Concept Maps on academic performance among undergraduate medical students in the preclinical stage.Our protocol was registered on PROSPERO (CRD42024529458). We followed PRISMA guidelines in conducting our systematic review. We searched PubMed, Scopus, Google Scholar, and Cochrane Library from inception to June 2024. We included only randomized controlled trials (RCTs) that involved undergraduate medical students in the preclinical stage, evaluated mind mapping and Concept Maps as the intervention, and compared it to traditional methods or no intervention, with academic performance as the primary outcome. A qualitative synthesis of the results was conducted, and where possible, effect sizes (e.g., Cohen's d) were calculated to quantify the impact of mind maps and concept maps on academic performance. The risk of bias was assessed using the Cochrane Risk of Bias tool. The risk of bias was assessed using the Cochrane Risk of Bias tool.A total of six RCTs were included. Four studies reported significantly higher assessment scores with the use of mind maps or concept maps. Teli et al. (Indian Journal of Clinical Anatomy and Physiology 7(2):243-246, 2020) observed a significant improvement in knowledge retention in the intervention group (mean score: 82.4% vs. 69.8%, p < 0.0001). Concept maps demonstrated moderate-to-large effect sizes, with Ho et al. (Medical Education 48(7):687-697, 2014) reporting Cohen's d = 0.7-0.8 for improved test scores. Two studies found no significant differences in performance (p > 0.05), but students consistently expressed a preference for these methods due to their utility in understanding and summarizing information. Overall, mind maps and concept maps prove to be effective tools for enhancing academic performance, especially in terms of knowledge retention and comprehension.This systematic review shows that mind maps and Concept Maps are effective methods in helping undergraduate preclinical medical students achieve better performance, especially in terms of knowledge retention and comprehension. While not all studies showed significant differences, the overall preference for these methods indicates their potential as valuable learning tools. We recommend integrating these tools into preclinical curricula and providing training sessions to enhance their effectiveness.
Faculty of Medicine, Yarmouk University, Irbid, Jordan.
Department of Ophthalmology, Hamad Medical Corporation, Doha, Qatar. Habuserhan@hamad.qa.
Advances in health sciences education : theory and practice
Adv Health Sci Educ Theory Pract. 2025-06-24;():.
Efficacy of mind maps and concept maps in enhancing academic performance among undergraduate medical students in the preclinical stage: a systematic review.

Prenatal care (PNC) is a core element of preventive care and is vital in identifying and managing conditions that can put maternal and fetal health at risk. However, not all women benefit from this basic healthcare service. This study explores trends in access to PNC amidst racial inequities and challenges among social determinants of health. To examine the study aim, we analyzed birth records from the North Carolina Pregnancy Risk Assessment Monitoring System from 2017 to 2021. The primary outcome of interest was the adequacy of PNC, using the Kotelchuck Prenatal Care Index. One-way analysis of variance, chi-square, and logistic regression models were employed to address the study objective. The study included 587,028 women; White women had higher adjusted odds (aOR 1.33 to 1.18; p < .001) of receiving adequate PNC compared to other groups. Black women had lower odds of receiving adequate PNC (aOR = 0.75 to 0.85; p < .001) during the study period. While trends suggested the odds of Black women receiving adequate care are improving over time (p < .001), they remain lower than those of White and Hispanic women. Factors associated with inadequate access to PNC included having less than a high school diploma (p = .004), being unmarried (p < .001), and having Medicaid coverage (p < .001). Equitable prenatal care is essential to reducing maternal health disparities among women of color. This requires diverse healthcare staffing, implicit bias training, technology-supported care options, and addressing social determinants of health.
School of Global Health Management and Informatics, University of Central Florida, Orlando, FL, USA. Cynthia.williams@ucf.edu.
College of Business and Economics, Department of Management, California State University, Los Angeles, CA, USA.
School of Global Health Management and Informatics, University of Central Florida, Orlando, FL, USA.
North Carolina Trends in Prenatal Care: The Need for Greater Equity in Prenatal Care Access for Women of Color.

We report the case of a patient with anaplastic carcinoma of the pancreas derived from an intraductal papillary mucinous neoplasm. A 51-year-old man was reported to have an enlarged cystic lesion in the pancreatic head. Contrast-enhanced computed tomography revealed a multifocal cystic lesion with an internal contrasted nodule. The patient was diagnosed with IPMN with high-risk stigmata and underwent pylorus-preserving pancreaticoduodenectomy. The pathological diagnosis was anaplastic carcinoma of the pancreas, classified as pleomorphic type, derived from intraductal papillary mucinous neoplasm. Based on the morphological features and immunohistochemical reactivity for MUC1, MUC2, MUC5AC, and MUC6, the intraductal papillary mucinous carcinoma was classified as pancreatobiliary type. Immunostaining for tumor-suppressor genes CDKN2A(p16), TP53, SMAD4, and STK11 was performed; aberrant expression of p53, Smad4, and STK11 was observed in intraductal papillary mucinous carcinoma and anaplastic carcinoma. The patient's postoperative course was uneventful; however, para-aortic lymph node metastasis was observed 10 months postoperatively. Immunohistochemical analysis of intraductal papillary mucinous neoplasm subtypes and tumor-suppressor genes may contribute to predicting prognoses in such cases.
Department of Gastroenterological and Pediatric Surgery, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama-machi, Yufu, Oita, 879-5593, Japan. komorin@oita-u.ac.jp.
Department of Gastroenterological and Pediatric Surgery, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama-machi, Yufu, Oita, 879-5593, Japan.
Department of Diagnostic Pathology, Faculty of Medicine, Oita University, Yufu, Oita, Japan.
Anaplastic carcinoma of the pancreas derived from an intraductal papillary mucinous neoplasm: a case report.

A growing number of police departments in the United States have adopted specialized training models to handle situations involving people with mental illness (PWMI), including the Crisis Intervention Team (CIT) model and other models with reduced training hours (OMRTH). However, research on police chiefs' attitudes toward these training models, especially those working in rural areas, remains limited. To address this gap in the literature, this study explored the attitudes of rural police chiefs across two states regarding two categories of police training models (the CIT model and OMRTH) and examined factors influencing their viewpoints. The results revealed that chiefs in rural areas demonstrated favorable attitudes toward the CIT model but negative attitudes toward OMRTH. Policy implications and suggestions for future research are discussed.
School of Criminal Justice, University of Central Oklahoma, Edmond, OK, 73034, USA. cseo@uco.edu.
School of Criminal Justice, University of Central Oklahoma, Edmond, OK, 73034, USA.
Community Ment Health J. 2025-06-24;():.
Exploring Police Training Models for Addressing Mental Illness in Rural Communities.

Australia's National Disability Insurance Scheme (NDIS) provides individualised funding to eligible people with disability to purchase required services and supports. However, people with psychosocial disability have experienced challenges in accessing these supports. In response, the NDIS introduced psychosocial recovery coaching as a 'recovery oriented' support for people with psychosocial disability. This study, based on research undertaken with an Australian organisation providing psychosocial recovery coaching, aims to identify outcomes of this support and how these relate to the CHIME-D recovery framework and broader evidence on peer-delivered mental health support. The study shows that overall, participant experiences and outcomes of psychosocial recovery coaching align strongly with the CHIME-D recovery framework, and with the NDIS stipulated goals and responsibilities of psychosocial recovery coaching service delivery. This paper contributes new knowledge on the outcomes of psychosocial recovery coaching and suggests that future iterations of NDIS psychosocial supports should align with personal recovery outcomes-including those identified by people with psychosocial disability.
The Centre for Social Impact, School of Business, Law and Entrepreneurship, Swinburne University of Technology, Mail H25, Cnr John and Wakefield Streets, PO Box 218, Hawthorn, Vic, 3122, Australia.
The Centre for Social Impact, School of Business, Law and Entrepreneurship, Swinburne University of Technology, Mail H25, Cnr John and Wakefield Streets, PO Box 218, Hawthorn, Vic, 3122, Australia. rccampain@swin.edu.au.
Psychosocial Recovery Coaching and the National Disability Insurance Scheme: Outcomes and their Alignment with the CHIME-D Recovery Framework.

Holmium laser enucleation of the prostate (HoLEP) is an effective treatment for benign prostatic hyperplasia (BPH). This study aimed to assess the impact of catheterization duration on postoperative outcomes, focusing on re-catheterization rates and associated risk factors.A retrospective analysis was conducted on patients who underwent HoLEP at our institution (June 2022-August 2024). Starting in November 2023, we decided to attempt catheter removal the morning after the procedure unless contraindicated. Patients were categorized into two groups based on catheterization duration: > 1 day (Group A) and ≤ 1 day (Group B). Perioperative variables, functional outcomes, and re-catheterization rates were compared between the groups. Multivariable logistic regression models were used to identify independent predictors of re-catheterization.258 patients were analyzed. Baseline characteristics, including age, BMI, IPSS, Qmax, and PSA, were comparable between groups. Median prostate volume was larger in Group A (85 vs. 70.5 mL, p = 0.06) -though the difference bordered on statistical significance. Enucleation time was significantly longer in Group A (80 vs. 55 min, p < 0.001). Patients in Group A experienced higher re-catheterization rates (21.9 vs. 1.5%, p < 0.001) and longer hospitalization (2 vs. 1 day, p < 0.001). Multivariable analysis confirmed catheterization duration as the sole independent predictor of re-catheterization (p < 0.001). Factors such as prostate volume, post-void residual volume, and enucleation time were insignificant. Most re-catheterizations were due to urinary tract infections (16/30, 53%).Early catheter removal after HoLEP is safe and effective, reducing re-catheterization risk without compromising outcomes. Early removal may also enhance postoperative recovery by minimizing infections.
Department of Urology, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy.
Residency Program in Health Statistics and Biometrics, University of Verona, Verona, Italy.
Department of Urology, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy.University of Verona, Verona, Italy.
Department of Urology, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy. riccardogiuseppe.bertolo@univr.it.University of Verona, Verona, Italy. riccardogiuseppe.bertolo@univr.it.
One-night catheter stay after Holmium laser enucleation of the prostate: a single-center comparative study.

Patient-reported outcome measures (PROMs) evaluate how patients feel and function. While several prior studies have explored barriers and facilitators to integrating PROM data collection in clinical workflows from patient perspectives, research on this topic remains limited for transgender and gender-diverse (TGD) patients seeking gender-affirming surgery. The objective of this qualitative study was to identify barriers and facilitators to collecting PROM data in TGD patients undergoing surgery from the patient perspective.Interpretive descriptive approach was used. In-depth semi-structured interviews were conducted with adult TGD patients who were seeking or had undergone gender-affirming surgery at a single academic tertiary center to understand barriers and facilitators to completing PROMs related to their care. All interviews were audio-recorded, transcribed verbatim and analyzed using content analysis.A total of 14 interviews were completed with participants (median age 32.5 years, range 21-60 years), of whom nine were assigned female at birth and five were assigned male at birth. Eight participants identified as men, five identified as women, and one identified as non-binary. Nine participants received masculinizing and five participants received feminizing procedures. Barriers to completing PROMs were organized into four sub-domains of difficulty engaging with content (e.g., uncomfortable questions, unclear or not inclusive questions), mode of administration (e.g., delivery method, location and environment of completion), concerns about privacy and confidentiality (e.g., mistrust of source, data privacy concerns), and fear of negative impact on care (e.g., fear of losing medical care). Facilitators were organized into four subdomains of altruism (e.g., importance of TGD-specific research, desire to give back to prospective patients), belief in research value (e.g., ensure accurate data, sense of social responsibility), desire to improve medical care and programs (e.g., reduce healthcare-related microaggressions), and access to gender-affirming care.Adult TGD patients have multiple barriers and facilitators to completing PROMs. Healthcare providers and systems should address barriers to create safe spaces that ensure sustained engagement of TGD individuals in PROM data collection efforts.
© 2025. The Author(s), under exclusive licence to Springer Nature Switzerland AG.
Patient-Reported Outcomes, Value and Experience (PROVE) Center, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA.
Division of Plastic Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA.
Department of Urology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA, 02115, USA.
Patient-Reported Outcomes, Value and Experience (PROVE) Center, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA.Division of Plastic Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA.
Patient-Reported Outcomes, Value and Experience (PROVE) Center, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA. mkaur17@bwh.harvard.edu.
Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation
Collecting patient-reported outcomes data in transgender and gender diverse adults seeking surgery: barriers and facilitators from the patient perspective.

The aim of this study was to compare Wafi ileostomy to Brooke ileostomy in patients undergoing elective resection for stage 3 rectal cancer in terms of ileostomy creation and reversal-related complications. This was a prospective cohort study enrolling consecutive patients with stage 3 distal rectal cancer undergoing elective TME with Wafi or Brooke ileostomy at a median 8-week interval following neoadjuvant chemoradiation in two institutions. Wafi ileostomy was defined as the insertion of a soft polyvinylchloride spiral endotracheal tube into the afferent limb of the terminal ileum with a flexible rubber band passed behind the backwall of its efferent limb to occlude. Brooke ileostomy was defined as the exteriorization of the terminal ileum afferent limb through the abdominal wall (then everted and sutured to the skin) with the efferent limb acting as mucous fistula. Propensity score matching with a 1:1 ratio was employed to compare diagnosis-matched patients for age, gender, and American Society of Anesthesiologists score. During 5 years, 110 patients underwent TME with Wafi ileostomy, whereas 116 patients underwent TME with Brooke ileostomy. Propensity score matching left 99 Wafi and 99 Brooke comparable patients. Wafi ileostomy was reversed (tube removed at bedside) at median postoperative day (POD) 14 (same hospital stay) as compared to 150 days of ileostomy reversal (second surgery) in the Brooke ileostomy group (p < 0.001). Ileostomy-related overall complication rates were significantly lower in Wafi ileostomy patients (6% vs. 24%, p = 0.001). On multivariable logistic regression, dehydration was found to be associated with increased emergency room visits and readmissions in Brooke ileostomy patients (OR = 1.24 (1.03, 3.92); p = 0.044). Compared to Brooke, Wafi ileostomy with its reversal at bedside without need for a second surgery was associated with fewer complications.
Department of Surgery, Marmara University, Istanbul, Turkey.
Section of Colorectal Surgery, Westchester Medical Center, New York Medical College, Valhalla, NY, USA.
Section of Colorectal Surgery, Westchester Medical Center, New York Medical College, Valhalla, NY, USA. rcmbergamaschi@gmail.com.Jacobi Medical Center, Suite 610, 1400 Pelham Parkway South, New York, NY, 10461, USA. rcmbergamaschi@gmail.com.
Comparing Wafi ileostomy to Brooke ileostomy in stage 3 rectal cancer: a prospective cohort study.

The detection rate of congenital morphological abnormalities during ultrasound examinations in early pregnancy is not sufficient with B-mode alone due to the small size of the target. This study aimed to evaluate the effectiveness of routine color Doppler mode compared to B-mode alone in the early detection of congenital heart disease (CHD) during first-trimester screening.A before-after clinical study was conducted at Showa University Hospital between January 2012 and May 2023. In April 2018, the protocol was modified to incorporate routine color Doppler mode. We compared detection rates, specificity, positive predictive values (PPV), and negative predictive values (NPV) between the B-mode only group and the B-mode with routine color Doppler group.Among the 12,321 fetuses screened, 5,907 were screened with B-mode only and 6,414 with routine color Doppler mode. The detection rate for CHD was significantly higher with color Doppler mode (29.26% vs. 64.15% for all CHDs, p < 0.001; 48% vs. 85.71% for major CHDs, p = 0.001) without impairing the specificity (99.96% vs. 99.98%) or PPV (94.44% vs. 92.31%).Routine use of color Doppler mode in first-trimester CHD screening significantly increases detection rates while maintaining high specificity and PPV. This protocol supports early CHD diagnosis, facilitating timely prenatal counseling and management.
© 2025. The Author(s), under exclusive licence to The Japan Society of Ultrasonics in Medicine.
Department of Obstetrics and Gynecology, Showa University Hospital, Tokyo, Japan. cera.mein7.sus@gmail.com.Department of Obstetrics and Gynecology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan. cera.mein7.sus@gmail.com.
Department of Obstetrics and Gynecology, Showa University Hospital, Tokyo, Japan.
Color doppler in first-trimester congenital heart disease screening: A decade of clinical insights.

University of Padua, Padua, Italy. michele.carron@unipd.it.
Enhanced Recovery After Bariatric Surgery and Admission to the Intensive Care Unit: A Potential Paradox.

One anastomosis gastric bypass (OAGB) is gaining increasing acceptance worldwide. Pregnancy outcomes after OAGB have been understudied. We aimed to examine associations of OAGB with maternal and perinatal outcomes.The study group comprised women who delivered after OAGB during 2017-2024 in a university hospital. A control group was established by matching preoperative body mass index, age, delivery history, and delivery year.Overall, 50 OAGB and 50 matched control parturients were included. In the OAGB group, rates of gestational hypertensive disorders (2.0% vs. 10.0%, P = 0.008) and gestational diabetes mellitus (4.0% vs. 18.0%, P = 0.05) were significantly lower compared with the control group. For the OAGB group, hemoglobin levels were lower at both early pregnancy (11.5 vs. 13.1 g/dL, P < 0.001) and pre-delivery (10.4 vs. 10.9 g/dL, P = 0.008), with a higher proportion of patients requiring intravenous iron supplementation (24.0% vs. 2.0%, P = 0.002). Rate of induction of labor was lower within the OAGB group (12.5% vs. 36.1%, P = 0.03), while gestational age at delivery and mode of delivery were similar between the groups. For the OAGB group, birthweight was significantly lower (2900 vs. 3392 grams, P < 0.001) with a higher proportion of small-for-gestational-age infants (28.0% vs. 6.0%, P = 0.006) and a lower proportion of large-for-gestational-age infants (2.0% vs. 24.0%, P = 0.002).OAGB was associated with reduced rates of gestational diabetes mellitus, gestational hypertensive disorders, excessive fetal growth, and induction of labor; and an increased rate of small-for-gestational-age infants. Hemoglobin levels were lower throughout pregnancy among OAGB patients, with a higher incidence of intravenous iron supplementation.
Department of Obstetrics & Gynecology, Edith Wolfson Medical Center, Holon, Israel. amichaimd@gmail.com.Gray Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel. amichaimd@gmail.com.Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Zucker School of Medicine at Hofstra/Northwell, New York, NY, USA. amichaimd@gmail.com.
Department of Surgery, Hadassah-Hebrew University Medical Center, Ein-Kerem Campus, Jerusalem, Israel.
School of Public Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel.
Department of Nutrition Sciences, School of Health Sciences, Ariel University, Ari'el, Israel.Department of Nutrition, Tel-Aviv Assuta Medical Center, Tel-Aviv, Israel.
Department of Surgery, Hadassah-Hebrew University Medical Center, Mount Scopus Campus, Jerusalem, Israel.
Pregnancy Outcomes After One Anastomosis Gastric Bypass.

Department of Surgery, Minimally Invasive Surgery Research Center, Division of Minimally Invasive and Bariatric Surgery, Hazrat-E Fatemeh Hospital, Iran University of Medical Sciences, Tehran, Iran. mkermansaravi@yahoo.com.Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran. mkermansaravi@yahoo.com.
Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran.
Digestive Disease Institute, Cleveland Clinic, Cleveland, OH, USA.
Brigham and Women's Hospital, Division of General and Gastrointestinal Surgery, Boston, USA.
The Centre for Obesity and Diabetes, Hospital Alemao Oswaldo Cruz, São Paulo, Brazil. ricardo.cohen@prestador.haoc.com.br.
Collaborative Intelligence in Metabolic and Bariatric Surgery: Integrating Human Expertise and Artificial Intelligence for Better Outcomes.

Weight loss and improvement in health-related quality of life (HRQoL) following metabolic bariatric surgery (MBS) are well documented. However, there is varied and inconclusive data on postoperative gastrointestinal symptoms.A prospectively maintained database of patients in a regional hospital undergoing laparoscopic sleeve gastrectomy (LSG), Roux-en-Y gastric bypass (RYGB) and one-anastomosis gastric bypass (OAGB) between March 2018 and August 2019 was retrospectively analysed. Gastrointestinal symptoms and HRQoL were measured over 2 years using the Structured Assessment of Gastrointestinal Symptoms Scale (SAGIS) and Short Form 36 (SF-36) standardised health questionnaires, respectively.A total of 203 patients were included for analysis. There was an improvement in median total symptom burden score from 5.5 to 4.0 at 24 months (p = 0.010). Constipation scores did not change. Nausea and vomiting worsened in the first 6 months (p < 0.001) and then improved back to baseline by 24 months (p = 0.003). Diarrhoea and discomfort scores improved from baseline to 24 months (p = 0.022). Epigastric pain improved from baseline to 24 months (p = 0.021). Median reflux score did not change between 0 and 6 months and then improved to significantly better than baseline at 24 months (p = 0.040). All three surgeries demonstrated sustained weight loss to 24 months. Overall HRQoL and each of the eight domains significantly improved post-surgery.There was an overall improvement in gastrointestinal symptoms post-surgery. The data reaffirmed sustained weight loss and improvement in HRQoL post MBS.
Wagga Wagga Base Hospital, Wagga Wagga, Australia. lees.kyang@gmail.com.
Wagga Wagga Base Hospital, Wagga Wagga, Australia.
Rural Clinical School, University of Notre Dame, Wagga Wagga, Australia.
Wagga Wagga Base Hospital, Wagga Wagga, Australia.Calvary Riverina Hospital, Wagga Wagga, Australia.
Wagga Wagga Base Hospital, Wagga Wagga, Australia. nick@hwpconsulting.com.au.Rural Clinical School, University of Notre Dame, Wagga Wagga, Australia. nick@hwpconsulting.com.au.Calvary Riverina Hospital, Wagga Wagga, Australia. nick@hwpconsulting.com.au.
Gastrointestinal Symptoms and Health-Related Quality of Life Following Metabolic Bariatric Surgery: A Prospective Cohort Study.

With the increasing use of contrast-enhanced CT, optimizing the iodinated contrast medium (ICM) dose while maintaining diagnostically adequate image quality is essential to mitigate potential adverse effects on patients, the environment, and public health, as well as to reduce medical costs and address potential supply shortages. Multi-energy CT technologies including dual-energy CT and photon-counting detector CT enable data acquisition at multiple energy spectra, allowing for material characterization beyond the capabilities of conventional single-energy CT. Recent technical advancements and the growing adoption of these technologies in clinical practice have enhanced patient care across various diagnostic tasks. Among the spectral-based imaging options offered by multi-energy CT, virtual monoenergetic imaging holds significant promise for substantial ICM dose reduction due to the drastic improvement in iodine contrast at lower energy levels. This article aims to provide an overview of multi-energy CT technology and its utility for ICM dose optimization across various clinical indications, while also discussing current issues and related topics.
Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto, 860-8556, Japan. y.nagayama1980@gmail.com.
Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto, 860-8556, Japan.
Department of Diagnostic Radiology, Kumamoto Chuo Hospital, 1-5-1 Taishima, Minami-ku, Kumamoto, 862-0965, Japan.
Department of Diagnostic Radiology, Graduate School of Biomedical and Health Science, Hiroshima University, 1-2-3 Kasumi, Minamiku, Hiroshima, 734-8551, Japan.
Imaging Research Center, Takatsuki General Hospital, 1-3-13 Kosobe-cho, Takatsuki, Osaka, 569-1192, Japan.
Department of Radiology, Jichi Medical University Saitama Medical Center, 1-847 Amanuma-cho, Omiya-ku, Saitama, 330-8503, Japan.
Department of Radiology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Chuo-ku, Hamamatsu, Shizuoka, 431-3192, Japan.
Department of Medical Information and Communication Technology Research, Graduate School of Medicine, St. Marianna Univereity School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan.
Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
Department of Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
Contrast medium dose optimization in the era of multi-energy CT.

Nanostructured lipid carriers (NLCs) decorated with sulfhydryl-modified surfactants have recently gained attention for delivering BCS Class IV drugs. However, the impact of the chain-length of these surfactants on the permeation and bioavailability properties of NLCs is still unknown. Therefore, this study investigates the effect of surfactant chain-length on the mucoadhesive, permeation, and bioavailability properties of NLCs. For this purpose, short- and long-chain sulfhydryl-modified polyethoxylated surfactants were generated to develop mucoadhesive NLCs and loaded with the model drug aprepitant (APT). NLCs were characterized and assessed for comprehensive physicochemical and biological evaluations. Moreover, in-vivo studies were performed for proof-of-concept to show enhanced oral drug bioavailability. NLCs showed particle size under 200 nm with 6.9 and 6.7% drug loading and 85 and 84% drug entrapment for short- and long-chain surfactants, respectively. The drug-loaded NLCs were safe and stable, and short- and long-chain surfactants containing NLCs exhibited 11.6- and 9.6-fold enhanced mucoadhesion, respectively. Moreover, in comparison to long-chain sulfhydryl-modified surfactant, short-chain surfactant is transported into deeper segments of mucus due to less interaction with the mucus. Similarly, short-chain sulfhydryl-modified surfactants showed significantly enhanced cellular permeation across Caco-2 cell lines. Furthermore, the long-chain sulfhydryl-modified surfactants showed 4.38-fold enhanced Cmax, whereas due to better diffusion and mucoadhesion properties, the short-chain surfactants exhibited 5.38-fold enhanced Cmax. Similarly, 34.8% relative bioavailability was attained for short-chain surfactants and 24.8% for long-chain surfactants. These results suggest short-chain sulfhydryl surfactants are promising candidates for improving the oral delivery of poorly soluble drugs and warrant further investigation for clinical translation.
College of Pharmacy, University of Sargodha, Sargodha, Punjab, 40100, Pakistan.Lahore College of Pharmaceutical Sciences, Raiwind road, Lahore, 54000, Pakistan.
iBB- Institute for Bioengineering and Biosciences, Department of Bioengineering, Instituto Superior Técnico, Universidade de Lisboa, Av. Rovisco Pais 1, Lisboa, 1049-001, Portugal.Associate Laboratory i4HB-Institute for Health and Bioeconomy, Instituto Superior Técnico, Universidade de Lisboa, Av. Rovisco Pais, Lisboa, 1049-001, Portugal.
School of Pharmacy, Monash University Malaysia, Bandar Sunway, Subang Jaya, Selangor, Malaysia.
Doctor's Institute of Health Sciences, Sargodha, 40100, Pakistan.
College of Pharmacy, University of Sargodha, Sargodha, Punjab, 40100, Pakistan. alia.erum@uos.edu.pk.
ILM College of Pharmaceutical Sciences & Sargodha College of Medical Sciences, Sargodha, 40100, Pakistan.
College of Pharmacy, University of Sargodha, Sargodha, Punjab, 40100, Pakistan.
College of Pharmacy, University of Sargodha, Sargodha, Punjab, 40100, Pakistan. mulazim.hussain@uos.edu.pk.
iBB- Institute for Bioengineering and Biosciences, Department of Bioengineering, Instituto Superior Técnico, Universidade de Lisboa, Av. Rovisco Pais 1, Lisboa, 1049-001, Portugal. prfonte@ualg.pt.Associate Laboratory i4HB-Institute for Health and Bioeconomy, Instituto Superior Técnico, Universidade de Lisboa, Av. Rovisco Pais, Lisboa, 1049-001, Portugal. prfonte@ualg.pt.Department of Chemistry and Pharmacy, Faculty of Sciences and Technology, University of Algarve, Gambelas Campus, Faro, 8005-139, Portugal. prfonte@ualg.pt.Centro de Ciências do Mar do Algarve (CCMAR/CIMAR LA), Universidade do Algarve, Campus de Gambelas, Faro, 8005-139, Portugal. prfonte@ualg.pt.
Drug delivery and translational research
Impact of chain-length of sulfhydryl-modified surface-decorated surfactants on mucoadhesive nanostructured lipid carriers.

The use of drugs with psychedelic and dissociative effects for the treatment of psychiatric illnesses has become increasingly popular in recent years. However, few trials have been conducted to determine the efficacy of these agents in the specific setting of treatment-resistant major depressive disorder (MDD) in older adults. In this paper, we review notable aspects of treatment-resistant MDD in older adults, review classical and nonclassical psychedelic agents and dissociative agents presently being trialed mostly in younger populations for the treatment of depression, and review what is known about trialing these agents in older adults with treatment-resistant MDD. Given the limitations to extant standard treatment and the potential risks associated with first-line pharmacological agents such as selective serotonin reuptake inhibitors (SSRIs) in this population, psychedelic-assisted psychotherapy may offer an important alternative for managing treatment-resistant MDD in older adults. This subset of patients is understudied and stands to benefit significantly from improved treatment regimens. The limited research available that details psychedelic-assisted treatment in this specific group is promising. Here we focus on reviewing those agents with the most controlled data available, beginning with the dissociative anesthetic ketamine/esketamine, and the hallucinogenic agent psilocybin, and concluding with a brief review of related substances including lysergic acid diethylamide (LSD), N,N-dimethyltryptamine (DMT), ayahuasca, ibogaine, 3,4-methylenedioxymethamphetamine (MDMA), and mescaline. Treatment-resistant MDD is highly prevalent among older adults, and while preliminary findings seem promising regarding the safety and tolerability of psychedelics, concerns remain owing to insufficient data, and therefore further research is crucial to establish the safety, efficacy, and applications of psychedelic therapy in this population.
Division of Geriatric Psychiatry, Department of Psychiatry & Behavioral Neuroscience, Saint Louis University School of Medicine, St. Louis, MO, USA. Lindsay.vinarcsik@health.slu.edu.
Division of Geriatric Psychiatry, Department of Psychiatry & Behavioral Neuroscience, Saint Louis University School of Medicine, St. Louis, MO, USA.
Use of Psychedelic Agents in Older Adults with Treatment-Resistant Major Depressive Disorder: What the Evidence Shows.

Robotic microsurgery enhances the dexterity and stability of the surgeon to perform precise and delicate surgical procedures at microscopic level. Accurate needle pose estimation is critical for robotic micro-suturing, enabling optimized insertion trajectories and facilitating autonomous control. However, accurately estimating the pose of a needle during manipulation, particularly under monocular vision, remains a challenge. This study proposes a convolutional neural network-based method to estimate the pose of a suture needle from monocular images.The 3D pose of the needle is estimated using keypoints information from 2D images. A convolutional neural network was trained to estimate the positions of keypoints on the needle, specifically the tip, middle and end point. A hybrid dataset comprising images from both real-world and synthetic simulated environments was developed to train the model. Subsequently, an algorithm was designed to estimate the 3D positions of these keypoints. The 2D keypoint detection and 3D orientation estimation were evaluated by translation and orientation error metrics, respectively.Experiments conducted on synthetic data showed that the average translation error of tip point, middle point and end point being 0.107 mm, 0.118 mm and 0.098 mm, and the average orientation angular error was 12.75 ∘ for normal vector and 15.55 ∘ for direction vector. When evaluated on real data, the method demonstrated 2D translation errors averaging 0.047 mm, 0.052 mm and 0.049 mm for the respective keypoints, with 93.85% of detected keypoints having errors below 4 pixels.This study presents a CNN-based method, augmented with synthetic images, to estimate the pose of a suture needle in monocular vision. Experimental results indicate that the method effectively estimates the 2D positions and 3D orientations of the suture needle in synthetic images. The model also shows reasonable performance with real data, highlighting its promise for real-time application in robotic microsurgery.
Graduate School of Engineering, The University of Tokyo, 7-chōme-3-1 Hongō, Bunkyo, Tokyo, 113-8656, Japan. wang-yifan971125@g.ecc.u-tokyo.ac.jp.
Graduate School of Medicine, The University of Tokyo, 7-chōme-3-1 Hongō, Bunkyo, Tokyo, 113-0033, Japan.
Graduate School of Engineering, The University of Tokyo, 7-chōme-3-1 Hongō, Bunkyo, Tokyo, 113-8656, Japan.Graduate School of Medicine, The University of Tokyo, 7-chōme-3-1 Hongō, Bunkyo, Tokyo, 113-0033, Japan.
Monocular suture needle pose detection using synthetic data augmented convolutional neural network.

Osteochondral (OC) diseases, which usually occur as a result of the sedentary life brought by today's conditions, lead to a painful and uncomfortable life, especially in later ages. Although there are many non-invasive and invasive methods for the elimination of osteochondral damage, none of them provide full recovery. For this reason, approaches that include advanced tissue engineering techniques are being put forward for the permanent treatment of damage by mimicking the natural tissue architecture. This chapter highlights preclinical and clinical advancements in OC tissue regeneration mainly focused on 3D printing. First, the cellular structure and composition of OC tissue are explained. Next, current strategies for the fabrication of 3D-printed scaffold OC tissue are discussed. Finally, the clinical applications of 3D-printed scaffolds are presented.
© 2025. The Author(s), under exclusive license to Springer Nature Switzerland AG.
Center for Nanotechnology and Biomaterials Applications & Research (NBUAM), Marmara University, Istanbul, Türkiye.Department of Metallurgical and Materials Engineering, Faculty of Technology, Marmara University, Istanbul, Türkiye.
Center for Nanotechnology and Biomaterials Applications & Research (NBUAM), Marmara University, Istanbul, Türkiye. aceren@marmara.edu.tr.Department of Metallurgical and Materials Engineering, Faculty of Technology, Marmara University, Istanbul, Türkiye. aceren@marmara.edu.tr.
Advances in experimental medicine and biology
Advances in Clinical Implications of 3D Printing for Osteochondral Regeneration.

Mechanical Processing Division, ICAR-National Institute of Natural Fibre Engineering and Technology, Kolkata, 700040, West Bengal, India. sourav.omprakash@gmail.com.Agricultural and Food Engineering Department, Indian Institute of Technology Kharagpur, Kharagpur, 721 302, West Bengal, India. sourav.omprakash@gmail.com.
Agricultural and Food Engineering Department, Indian Institute of Technology Kharagpur, Kharagpur, 721 302, West Bengal, India.
Probiotics Antimicrob Proteins. 2025-06-24;():.
Correction: Optimisation of Process Parameters for Development of Probiotic-GABA Enriched Nutri Bar by Response Surface Methodology (RSM) and Modelling Using Artificial Neural Networks (ANN): Characterisation and Sensory Evaluation by Fuzzy Logic Analysis.

The dog with chronic atrioventricular block (CAVB) combines a number of risk factors associated with Torsade de Pointes (TdP) arrhythmias. Nevertheless, approximately 33% of the animals are resistant to dofetilide-induced TdP arrhythmia. Of a group of 78 experimentally identical CAVB dogs, we compared TdP inducible vs. non-inducible animals for a set of basic, and cardiac electrical and mechanical parameters. Body weight, but not sex or age, is associated with TdP inducibility. Of the cardiac parameters, longer ventricular repolarization duration and increased contractility at baseline are associated with dofetilide-induced TdP arrhythmias. Differences in cardiac parameters disappeared upon dofetilide infusion. We discuss that prolonged repolarization and increased contractility may be early indications of calcium-mediated early after depolarization that may develop into TdP arrhythmias.
Department of Medical Physiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands.
Department of Medical Physiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands. m.a.g.vanderheyden@umcutrecht.nl.
Arrhythmia Inducibility in the CAVB Dog Model, A Critical Analysis on Underlying Factors.

Incidence of early-onset (< 40 years) type 2 diabetes (T2D) is increasing. While multiple risk factors have been identified, particularly obesity and low socioeconomic status, early-life factors are hypothesised to play a role via fetal programming. We investigated sociodemographic and early-life factors in relation to early-onset T2D using a family-based design that accounts for shared genetic and environmental factors. We included 1,814,062 individuals born in Sweden 1983 to 2002 with follow-up data until 2020, and identified early-onset (age 19-39) T2D cases (n = 3505) through National Diabetes, Patient and Prescribed Drug Registers. Perinatal and sociodemographic factors were retrieved from registers. We used a cohort and sibling design, with multivariable-adjusted Cox proportional hazards regression. Sociodemographic factors associated with early-onset T2D included low parental education, single parenthood, younger parental age and non-Swedish origin. The latter association did not remain after mutual adjustment. Regarding perinatal factors, a higher incidence was noted in relation to lower birth weight (hazard ratio 2.38 [95% confidence interval: 1.98-2.87] and 1.43[1.33-1.54] for < 2500 g and 2500-3500 g, respectively, vs 3500-4500 g), small-for-gestational-age (SGA) (2.24[1.96-2.56]), large-for-gestational-age (LGA) (1.19[1.01-1.39]), and maternal obesity (2.34[2.04-2.69]), diabetes (1.59[1.36-1.85]), smoking (1.59[1.48-1.71]), and infection (1.21[1.03-1.41]) during pregnancy. In the sibling analysis, only low birth weight and SGA remained associated with early-onset T2D. Early-onset T2D is associated with sociodemographic and multiple perinatal factors; only growth restriction likely reflects fetal programming, while other perinatal-related associations might involve confounders. This study highlights the need for early-life, targeted strategies to prevent T2D and reduce health inequities.
Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden. coralie.amadou@chsf.fr.Sud-Francilien Hospital, Paris-Saclay University, Corbeil-Essonnes, France. coralie.amadou@chsf.fr.
Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
Abdominal Centre/Endocrinology, Helsinki University Hospital, Helsinki, Finland.Folkhalsan Research Center, Helsinki, Finland.Institute for Molecular Medicine Finland FIMM, University of Helsinki, Helsinki, Finland.Lund University Diabetes Center, Malmo, Sweden.
Fetal programming of early-onset type 2 diabetes: a Swedish nationwide cohort and sibling analysis.

This study aimed to develop a deep learning (DL) model based on three-dimensional multi-parametric magnetic resonance imaging (mpMRI) for preoperative assessment of lymph node metastasis (LNM) in rectal cancer (RC) and to investigate the contribution of different MRI sequences.A total of 613 eligible patients with RC from four medical centres who underwent preoperative mpMRI were retrospectively enrolled and randomly assigned to training (n = 372), validation (n = 106), internal test (n = 88) and external test (n = 47) cohorts. A multi-parametric multi-scale EfficientNet (MMENet) was designed to effectively extract LNM-related features from mpMR for preoperative LNM assessment. Its performance was compared with other DL models and radiologists using metrics of area under the receiver operating curve (AUC), accuracy (ACC), sensitivity, specificity and average precision with 95% confidence interval (CI). To investigate the utility of various MRI sequences, the performances of the mono-parametric model and the MMENet with different sequences combinations as input were compared.The MMENet using a combination of T2WI, DWI and DCE sequence achieved an AUC of 0.808 (95% CI 0.720-0.897) with an ACC of 71.6% (95% CI 62.3-81.0) in the internal test cohort and an AUC of 0.782 (95% CI 0.636-0.925) with an ACC of 76.6% (95% CI 64.6-88.6) in the external test cohort, outperforming the mono-parametric model, the MMENet with other sequences combinations and the radiologists.The MMENet, leveraging a combination of T2WI, DWI and DCE sequences, can accurately assess LNM in RC preoperatively and holds great promise for automated evaluation of LNM in clinical practice.
Digital Medical Research Center, School of Basic Medical Sciences, Fudan University, Shanghai, China.Shanghai Key Laboratory of Medical Image Computing and Computer Assisted Intervention, Shanghai, China.
Department of Colorectal Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.
Digital Medical Research Center, School of Basic Medical Sciences, Fudan University, Shanghai, China. chenxizhang@fudan.edu.cn.Shanghai Key Laboratory of Medical Image Computing and Computer Assisted Intervention, Shanghai, China. chenxizhang@fudan.edu.cn.
Department of Colorectal Surgery, Zhongshan Hospital, Fudan University, Shanghai, China. xujmin@aliyun.com.
Preoperative Assessment of Lymph Node Metastasis in Rectal Cancer Using Deep Learning: Investigating the Utility of Various MRI Sequences.

Type 1 diabetes mellitus (T1DM) is due to the autoimmune destruction of pancreatic β-cells. Biomarkers of early diagnosis of T1DM are important to improve treatment and prevent complications. β-catenin, a key effector of the WNT signaling pathway, plays a critical role in the development of pancreatic β-cells. This study investigates the association between serum β-catenin protein and T1DM and evaluates its diagnostic performance compared to routine markers.The study included 50 patients with T1DM aged 15-25 years and 30 healthy age- and gender-matched subjects (HS). All participants were evaluated with full history taking, thorough clinical examination, and laboratory evaluation of biochemical tests and glycemic markers. Serum β-catenin was measured using an enzyme-linked immunosorbent assay.There were significant differences in the concentration of β-catenin between T1DM and HS (P < 0.001). Gender, HbA1c, BU, and lipid profile were found to be significantly independently related to β-catenin levels (P < 0.05). β-catenin showed excellent discriminatory ability (AUC 1.0); the results revealed that the best cut-off value of β-catenin levels to predict T1DM was > 1.81 ng/ml.The results show that the concentration of β-catenin has the potential to diagnose T1DM. Further, larger studies are needed on whether β-catenin has a therapeutic role in T1DM.
© 2025. The Author(s), under exclusive licence to Royal Academy of Medicine in Ireland.
National Diabetes Center, Mustansiriyah University, Baghdad, Iraq. baydaaahmed.ndc@uomustansiriyah.edu.iq.
Department of Studies and Planning, the University Presidency, Mustansiriyah University, Baghdad, Iraq.
Department of Chemistry, College of Science for Women, University of Baghdad, Baghdad, Iraq. noorulhuda.g@csw.uobaghdad.edu.iq.
Department of Chemistry, College of Science for Women, University of Baghdad, Baghdad, Iraq.
National Diabetes Center, Mustansiriyah University, Baghdad, Iraq.
Enhanced diagnostic accuracy of type 1 diabetes mellitus through the combined use of serum β-catenin and HbA1c.

Department of Surgery, Hoag Memorial Hospital Presbyterian, Newport Beach, CA, USA. Melsilver9@gmail.com.Department of Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA. Melsilver9@gmail.com.
Department of Radiation Oncology, Hoag Memorial Hospital Presbyterian, Newport Beach, CA, USA.
Department of Surgery, Hoag Memorial Hospital Presbyterian, Newport Beach, CA, USA.
ASO Visual Abstract: Intraoperative Radiation Therapy (IORT) for Breast Cancer: The Final Analysis of a Prospective Cohort of 1828 Cases.

Certain patients with stage IIIA-N2IIIB non-small cell lung cancer (NSCLC) have surgical opportunities after induction therapy. Two to four cycles of neoadjuvant chemoimmunotherapy (NCIT) are commonly used. However, whether the number of cycles of NCIT has an impact on the pathological response has not been extensively investigated. The intent of this study was to explore the impact of the number of NCIT cycles on the pathological response of patients with stage IIIA-N2IIIB NSCLC.This retrospective single-center study reviewed patients with stage IIIA-N2IIIB NSCLC without positive driver genes who received two to four cycles of NCIT followed by complete resection. The primary endpoint was the major pathological response (MPR) rate. Univariate and multivariate logistic regression analyses were performed to explore the risk factors for the MPR. The objective response rate (ORR) was also compared between different cycles of NCIT.Among the 170 patients included in our final analysis, the MPR rate was 58.24%, and the pathological complete response (pCR) rate was 37.06% in the overall cohort. The MPR rates were 58.97%, 62.50%, and 50.00% in the two-, three- and four-cycle NCIT groups, respectively. Multivariate regression analysis revealed that preoperative assessment of the radiographic response to NCIT, partial response/complete response (PR/CR), was the only independent prognostic factor for the MPR (p < 0.001).We confirmed that preoperative PR/CR was important in predicting the MPR, whereas the number of cycles of NCIT did not influence the MPR rate in patients with stage IIIA-N2IIIB NSCLC.
Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China.Lung Cancer Center/Lung Cancer Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Lung Cancer Center/Lung Cancer Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, China.Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China. cheguoweixw@126.com.Lung Cancer Center/Lung Cancer Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, China. cheguoweixw@126.com.
Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China. prof_qh_zhou@126.com.Lung Cancer Center/Lung Cancer Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, China. prof_qh_zhou@126.com.
Influence of Cycles of Neoadjuvant Chemoimmunotherapy on Treatment Response in Stage IIIA-N2IIIB Non-small Cell Lung Cancer: Experience from a Large-Volume Center.

Department of Surgical Specialties, Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia. warrenscy@gmail.com.JBI, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia. warrenscy@gmail.com.Department of Surgery, Colorectal Unit, Royal Adelaide Hospital, Adelaide, SA, Australia. warrenscy@gmail.com.
Department of Surgical Specialties, Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia.Department of Surgery, Colorectal Unit, Royal Adelaide Hospital, Adelaide, SA, Australia.
Department of Surgical Specialties, Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia.JBI, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia.
JBI, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia.
ASO Visual Abstract: Compliance and Toxicity of Total Neoadjuvant Therapy in Locally Advanced Rectal Cancer: A Systematic Review and Network Meta-analysis.

The comprehensive complication index (CCI) reflects the overall patient complication burden on a 0-100 scale. This single-institution retrospective analysis explores the accuracy of CCI in describing complications following cytoreductive surgery for advanced high-grade ovarian carcinoma (HGOC) and aims to identify predictive factors of high complication burden.In total, 304 patients who underwent cytoreductive surgery for FIGO stage IIIA-IVB HGOC at our institution from 2015 to 2023 were analyzed. Each complication's severity was graded using the Clavien-Dindo classification. The CCI was used to quantify the global complications burden, and patients were stratified into three groups: CCI-low (< 26.2), CCI-intermediate (26 ≤ CCI < 33.7), and CCI-high (≥ 33.7).Of the 200 patients (65.8%) with at least one complication, 127 (41.8%) were CCI-low, 32 (10.5%) CCI-intermediate, and 41 (13.5%) CCI-high. Median hospitalization duration (p < 0.0001) and readmission rates (p < 0.0001) correlated with CCI categories, reflecting increased CCI scores with greater surgical complexity, as assessed by the Aletti surgical complexity score (SCS). Univariate analysis showed a significant association between CCI-high and FIGO stage, surgical complexity, diaphragmatic procedures, multiple bowel resections, length of surgery and intraoperative blood loss. Multivariate analysis confirmed FIGO stage (odds ratio [OR] 2.57), multiple bowel resections (OR 5.61), and blood loss (OR 1.93) as independent risk factors for high complication burden.The CCI is a good descriptor of postoperative complications in patients undergoing cytoreductive surgery for advanced HGOC by integrating both the severity and number of complications into a single, easily usable, and intuitive quantitative score. FIGO stage, multiple bowel resections, and blood loss-but not surgical timing-are independent predictors of a high complication burden.
Department of Medicine and Surgery, University of Milano-Bicocca, Milano, Italy.UO Gynecology, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy.
UO Gynecology, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy.
Medical Physics, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy.
UO Surgery, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy.
Department of Medicine and Surgery, University of Milano-Bicocca, Milano, Italy. robert.fruscio@unimib.it.UO Gynecology, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy. robert.fruscio@unimib.it.
Postoperative Complications After Cytoreductive Surgery for Advanced Ovarian Carcinoma: A Single-Center Analysis Exploring the Value of the Comprehensive Complication Index and the Predictors of High Complications Burden.

Faculty of Education, Guidance and Psychological Counseling Program, Recep Tayyip Erdogan University, Rize, 53200, Turkey. mehmet.avci@erdogan.edu.tr.
Rest Intolerance, Emotional Distress, Insomnia, and Adaptive Coping Strategies: A Validation and Serial Mediation Analysis Study.

Screening recommendations for early onset prostate cancer (EOPC) vary significantly across countries and regions, with differences in the recommended starting age and screening frequency. Given these variations, a comprehensive global analysis of EOPC epidemiology and disease burden is essential to inform evidence-based, region-specific screening and intervention strategies.Using data from the Global Burden of Diseases Study (1990-2021), we analyzed EOPC incidence, mortality, and disability-adjusted life-years (DALYs) across 204 countries, stratified by Sociodemographic Index (SDI) levels. Age-standardized rates and trends were assessed through estimated annual percentage change values. Risk factors, including smoking, milk intake, and calcium intake, were evaluated. Frontier analysis identified regions needing urgent intervention, while Bayesian age-period-cohort modeling projected EOPC trends through 2040.In 2021, there were 58,694 new EOPC cases and 7927 related deaths globally. The highest burden was observed in high-SDI regions. Incidence, mortality, and DALYs increased across most SDI regions, except for a decline in mortality in high-SDI areas. Age-specific analysis showed rising EOPC burden across all age groups from 1990 to 2021, with the sharpest increases in the 45-49 and 50-54 years age groups. Risk factor analysis attributed 1% of DALYs to smoking, while low milk and calcium intake were protective (-10.2 and -2.8%, respectively). Projections indicate a continued rise in global EOPC burden through 2040.This study provides critical insights into the global burden of EOPC, emphasizing the need for region-specific screening and prevention strategies to mitigate its impact.
Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.
Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China. 1019056315@qq.com.
Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China. xierh23@mail.sysu.edu.cn.
Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China. huangh9@mail.sysu.edu.cn.Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China. huangh9@mail.sysu.edu.cn.Department of Urology, Qingyuan People's Hospital, The Sixth Affiliated Hospital of Guangzhou Medical University, Qingyuan, China. huangh9@mail.sysu.edu.cn.Guangdong Provincial Clinical Research Center for Urological Diseases, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China. huangh9@mail.sysu.edu.cn.
Epidemiology of Early Onset Prostate Cancer: Global Patterns, Risk Factors, and Projections Through 2040.

Department of Otolaryngology-Head and Neck Surgery, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Respiratory and Critical Care Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
International forum of allergy & rhinology
Int Forum Allergy Rhinol. 2025-06-24;():e23631.
Subjective Sleep Gains in Empty Nose Syndrome: A Cautionary Note on the Need for Objective Validation.

To evaluate the impact of chronic diabetes on 42-day hospital readmission rates and hospitalization costs following hospital delivery discharge.Using 2016-2019 data from the Hospital Cost and Utilization Project Nationwide Readmissions Database, we conducted a propensity score matched analysis comparing individuals with and without chronic diabetes. Given the strong relationship between severe maternal morbidity and readmission, we used an exact match for severe maternal morbidity during the delivery hospitalization. The study evaluated three outcomes: (1) readmission rates within 42 days of discharge from the delivery hospitalization, (2) total hospitalization costs during the delivery and readmissions within 42 days, and (3) total hospitalization costs for readmission hospitalizations.Adjusted analyses showed 61% [adjusted Odds Ratio: 1.61; Confidence Interval: (1.52, 1.71)] higher rates of postpartum hospital readmission within 42 days (4.49% vs. 2.85%; p < 0.001) and 24% higher total delivery hospitalization costs plus the cost of readmission among individuals with chronic diabetes relative to individuals without diabetes ($9,047 vs. $7,296; p < 0.001). Hospital readmissions costs were higher for individuals with diabetes compared with individuals without diabetes at the time of delivery ($9,136 vs. $8,363; p = 0.03).Continued efforts to prevent and control chronic diabetes may be important for prevention of postpartum hospital readmissions and increased associated costs.
¹University of Arkansas for Medical Sciences Fay W. Boozman College of Public Health, Little Rock, AR, USA.
University of Arkansas for Medical Sciences College of Nursing, Little Rock, AR, USA.
¹University of Arkansas for Medical Sciences Fay W. Boozman College of Public Health, Little Rock, AR, USA. CCBrown@uams.edu.
Association of Chronic Diabetes with 42-Day Readmission after Delivery Hospitalization.

Department of Biomedical, Metabolic, and Neural Sciences, University Hosptals of Modena, Modena, 41010, Italy. giulianagalassi@alice.it.
Department of Biomedical, Metabolic, and Neural Sciences, University Hosptals of Modena, Modena, 41010, Italy.
Respiratory Disease Unit, University Hospitals of Modena, Modena, Italy.
Division of Pathology, University Hospitals of Modena, Modena, Italy.
Tackling paraneoplastic and non-paraneoplastic Lambert-Eaton myastenic syndromes: when timing is key. Comment on schőn et al. report.

The objective of this study was to ascertain the prevalence of trauma symptoms in individuals residing within the seismic region 18 months after the February 6th 2023, Maras earthquake, and to examine the factors contributing to these symptoms. The study included 339 participants who experienced the earthquake. The participants were administered sociodemographic data form, Traumatic Stress Symptom Checklist (TSSC), Coping with Earthquake Stress Scale (CESS), and Psychological Well-Being Scale (PWBS). According to the TSSC, 20.1% of the 339 participants were determined to have probable PTSD (pPTSD). In the pPTSD group, rate of destruction in the home, rate of women, rate of loss of life in relatives, rate of property loss, and rate of receiving psychiatric support were significantly higher. The pPTSD group demonstrated significantly lower positive reappraisal, seeking social support, and PWBS scores compared to the non-PTSD group. TSSC scores were negatively correlated with sub-scores of the CESS and PWBS among all participants. Regression analyses revealed that the presence of long-term pPTSD was predicted with being female, loss of life in relatives, property loss, and the need for psychiatric support. Additionally, positive reappraisal and seeking social support coping mechanisms were shown to decrease the risk of developing pPTSD. Current research suggest that traumatic symptoms may persist long after major natural disasters. Consequently, the provision of psychological support services, the enhancement of social support networks, and the dissemination of stress management methods following disasters such as earthquakes should be sustained over an extended period in high-risk regions. It is anticipated that the findings of this study will serve as a guide for researchers, clinicians, and policy-makers, facilitating the development of effective strategies for the management of post-disaster mental health needs.
Department of Psychiatry, Faculty of Medicine, Necmettin Erbakan University, Yunus Emre Mah., Beyşehir Cad. No:281,Meram, 42090, Konya, Türkiye. hasanbakay@gmail.com.
Department of Psychiatry, Faculty of Medicine, Necmettin Erbakan University, Yunus Emre Mah., Beyşehir Cad. No:281,Meram, 42090, Konya, Türkiye.
Predictors of Persistent Post-Traumatic Stress Symptoms After 2023 Maras Earthquake: The Impact of Gender, Loss, and Coping Strategies.

Syphilis and HIV are closely linked infections with shared transmission routes and risk factors. Despite effective screening and treatment options, the prevalence of syphilis remains high among people living with HIV (PLWH), especially in middle-income countries like Türkiye.To investigate the seroprevalence of syphilis among PLWH using centralized laboratory data and to assess its distribution by age and sex.A retrospective cross-sectional study was conducted by reviewing data derived from blood specimens submitted to our laboratory for routine CD4⁺ T cell enumeration, ultimately analyzing 2,768 PLWH between January 2022 and December 2024. Syphilis seropositivity was defined by concurrent positivity in both VDRL and TPHA tests. Demographic and clinical variables were analyzed using SPSS v.22.0.Syphilis seropositivity was detected in 923 patients (33.3%). The prevalence was significantly higher among males (37.0%) compared to females (6.1%) (p < 0.001). The highest seroprevalence was observed in patients aged 31-40 years (37.4%). There was no significant difference in mean age between syphilis-positive and syphilis-negative groups (p > 0.05).This study reveals a high burden of syphilis among PLWH in Türkiye, particularly in younger male populations. The findings underscore the necessity for routine syphilis screening, targeted prevention strategies, and integrated STI care within HIV programs.
Flow Cytometry Laboratory, Ümraniye Training and Research Hospital, Istanbul, Türkiye.
Department of Medical Microbiology, Biruni University School of Medicine, Istanbul, Türkiye.Biruni Research Center, Biruni University, Istanbul, Türkiye.
Department of Medical Microbiology, Istanbul Medipol University School of Medicine, Istanbul, Türkiye. okanaydogan@medipol.edu.tr.Research Institute for Health Sciences and Technologies (SABITA), Istanbul Medipol University, Istanbul, Türkiye. okanaydogan@medipol.edu.tr.
European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology
Eur J Clin Microbiol Infect Dis. 2025-06-24;():.
Burden of syphilis among people living with HIV: a large cross-sectional study from Türkiye.

Artificial intelligence (AI) is a disruptive technology that is currently finding widespread application after having long been confined to the domain of specialists. In urology, in particular, new fields of application are continuously emerging, which are being studied both in preclinical basic research and in clinical applications. Potential applications include image recognition in the operating room or interpreting images from radiology and pathology, the automatic measurement of urinary stones and radiotherapy. Certain medical devices, particularly in the field of AI-based predictive biomarkers, have already been incorporated into international guidelines. In addition, AI is playing an increasingly more important role in administrative tasks and is expected to lead to enormous changes, especially in the outpatient sector. For urologists, it is becoming increasingly more important to engage with this technology, to pursue appropriate training and therefore to optimally implement AI into the treatment of patients and in the management of their practices or hospitals.
Klinik für Urologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3, 24105, Kiel, Deutschland. severin.rodler@uksh.de.
Klinik für Urologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3, 24105, Kiel, Deutschland.
Klinik für Strahlentherapie, Universitätsklinikum Schleswig-Holstein, Kiel, Deutschland.
Künstliche Intelligenz (KI) ist eine disruptive Technologie, die aktuell breite Anwendung findet, nachdem sie lange Zeit in Händen von Spezialisten war. Auch in der Urologie zeigen sich immer neue Anwendungsfelder, die aktuell sowohl in den präklinischen Grundlagen- als auch der klinischen Anwendungsforschung untersucht werden. Anwendungsbeispiele sind die Bilderkennung im Operationssaal oder von Radiologie- und Pathologiebildern, das automatische Ausmessen von Harnsteinen oder die Strahlentherapie. Einzelne Medizinprodukte, v. a. im Bereich der KI-basierten prädiktiven Biomarker, haben bereits Einzug in internationale Leitlinien erlangt. Daneben spielt KI eine immer wichtigere Rolle bei administrativen Aufgaben und wird hier insbesondere im ambulanten Bereich massive Veränderungen mit sich bringen. Für Urologen ist es zunehmend wichtig, sich mit dieser Technologie auseinanderzusetzen, sich entsprechend fortzubilden und damit KI optimal für die Behandlung der eigenen Patienten als auch für das Management der eigenen Praxis oder Klinik einzusetzen.
[Practical artificial intelligence for urology : Technical principles, current application and future implementation of AI in practice].

Exploring the mechanisms underlying willingness to buy (WTB) will help us identify neural indicators for predicting the performance of innovative products. Using functional magnetic resonance imaging, we asked participants to view products created by combining two components, including high applicability new combinations (HANCs), which provide a novel and practical application; and low applicability new combinations (LANCs), which provide no additional value. First, we found that WTB generally involves activation of the parahippocampal gyrus. For HANC, activation in the pars opercularis of the inferior frontal gyrus (IFG oper) is associated with WTB. Second, representational similarity analysis revealed that for HANC, the interrelation between the elements and combinations in the IFG oper predicts WTB. Third, multivoxel pattern analysis found that classification accuracy in the IFG oper predicts the difference in WTB between HANCs and LANCs. In conclusion, WTB requires default mode network-based associative processing. For HANC products, executive control network-based processes are necessary for value construction.
© 2025. Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences.
Beijing Key Laboratory of Learning and Cognition, School of Psychology, Capital Normal University, Beijing, 100048, China.
School of Design, Hunan University, Changsha, 410000, China.
Beijing Key Laboratory of Learning and Cognition, School of Psychology, Capital Normal University, Beijing, 100048, China. luoj@psych.ac.cn.
From Brain to Shopping Cart: Neural Signals of Willingness to Buy Innovative Products.

The realities of ecosystem breakdown and climate change pose a significant threat to the health of individuals around the world, disproportionately affecting poor and vulnerable populations. Every sector in society, including healthcare, needs to be engaged in the tremendous collective effort and transformational change needed to limit global warming. We see priority setting as having a key role to play in reallocating existing budgets within healthcare systems whilst at the same time being used to facilitate sustainable and more efficient resource allocation across countries. Priority setting looks to fairly distribute resources with the goal of improving patient and population health outcomes. However, these goals can be broadened to include consideration of environmental impact based on our understanding of the necessity of emissions reduction to address the climate crisis and promote population health. In this paper, we introduce key concepts of priority setting and identify the interplay between priority setting and the realities of resource scarcity in the realm of planetary healthcare. We propose that applying priority-setting principles could serve at least three goals; (1) protect and improve health outcomes; (2) limit unnecessary and marginal care; and (3) facilitate a just transition to a sustainable healthcare system.
Centre for Clinical Epidemiology and Evaluation, University of British Columbia, Vancouver, Canada.
Bergen Centre for Ethics and Priority Setting in Health (BCEPS), University of Bergen, Bergen, Norway.
University of Tasmania, Hobart, Tasmania, Australia.
Deakin Health Economics, Deakin University, Melbourne, VIC, Australia.
Yale School of Medicine, New Haven, CT, USA.
Centre for Clinical Epidemiology and Evaluation, University of British Columbia, Vancouver, Canada. craig.mitton@ubc.ca.
Applied health economics and health policy
Appl Health Econ Health Policy. 2025-06-24;():.
Priority Setting in the Context of Planetary Healthcare.

Living kidney transplantation is an established treatment for end-stage kidney disease (ESKD). While rare, the donors may develop de novo glomerular diseases post-donation. We report a case of membranous nephropathy (MN) in an 80-year-old male, diagnosed 9 years post-donation. The patient had a history of early gastric cancer treated with endoscopic submucosal dissection one year post-donation. Routine follow-up revealed asymptomatic proteinuria (4.27 g/gCr). The kidney biopsy demonstrated MN with IgG1/IgG3-dominant deposits and NELL-1 positivity. Recent evidence suggests NELL-1-positive MN may occur independently of malignancy in older individuals. Notably, MN developed 8 years after cancer remission with no evidence of recurrence. The patient achieved complete remission with conservative therapy consisting of an angiotensin receptor blocker and dietary modification. This case underscores the need for vigilant long-term follow-up in older kidney donors and illustrates how early proteinuria detection facilitates timely management of de novo glomerulopathies.
© 2025. The Author(s), under exclusive licence to Japanese Society of Nephrology.
Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Shimotsuke, Tochigi, Japan.
Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Shimotsuke, Tochigi, Japan. e-hishida@dokkyomed.ac.jp.Department of Nephrology and Hypertension, Dokkyo Medical University, Shimotsuga, Tochigi, Japan. e-hishida@dokkyomed.ac.jp.
Department of Pathology, Dokkyo Medical University, Shimotsuga, Tochigi, Japan.Department of Nephrology and Hypertension, Saitama Medical Center, Kawagoe, Saitama, Japan.
NELL-1-positive membranous nephropathy following gastric cancer in an older living kidney donor: a case report.

The ultimate goal of regenerative medicine is to restore damaged tissues to a healthy state in the body. Direct reprogramming, also referred to as transdifferentiation, holds significant therapeutic potential by converting abundant somatic cells, such as fibroblasts, into functionally distinct cell types for tissue regeneration. Despite its potential applications in regenerative medicine, direct reprogramming faces major challenges, including low efficiency and poor In vivo applicability. In this study, we propose a novel therapeutic strategy for osteoporosis based on In vivo direct reprogramming using a stepwise delivery approach that first enhances cellular stemness and subsequently induces osteogenic transdifferentiation. Enhancing stemness in lineage-committed cells facilitates their conversion into other functional cell types.To investigate the efficiency of direct reprogramming via stepwise delivery, we utilized valproic acid (VPA) and tauroursodeoxycholic acid (TUDCA) as reprogramming and bone-stimulating factors, respectively. VPA increased the expression of stemness genes, including Oct4, Nanog, and Sox2, and subsequent treatment of TUDCA enhanced the expression of osteogenic genes in the mouse fibroblast. Targeted delivery of these factors to fibroblasts surrounding bone tissue, enabling subsequent direct reprogramming into osteoblasts, was achieved using bisphosphonate (BP)-conjugated lipid nanoparticles as carriers.Our findings demonstrate that sequential induction of cell reprogramming and tissue regeneration through stepwise administration of VPA and TUDCA significantly enhances therapeutic efficacy in a mouse model of osteoporosis compared to their simultaneous administration.This stepwise bone-targeted drug delivery system presents a promising strategy for osteoporosis treatment via In vivo direct reprogramming.
© 2025. Korean Tissue Engineering and Regenerative Medicine Society.
Department of Biomedical Engineering, Dongguk University, Seoul, South Korea.
Department of Research & Development Team, ATEMs, Seoul, Republic of Korea.
Department of Biomedical Engineering, Dongguk University, Seoul, South Korea. ruddov@gmail.com.
Department of Biomedical Engineering, Dongguk University, Seoul, South Korea. soohong@dongguk.edu.
Tissue engineering and regenerative medicine
Stepwise Administration of Bone-Targeted Lipid Nanoparticles Encapsulating Valproic Acid and TUDCA Facilitates In Vivo Direct Reprogramming for Osteoporosis Treatment.

Following myocardial infarction (MI), endothelial cell proliferation drives neovascularization to support cardiac regeneration. While myeloid-derived growth factor (Mydgf) is known to promote cardiac repair post-injury, yet its mechanism in angiogenesis remained unclear. In this study, we found that myeloid-derived growth factor knockout (Mydgf-KO) reduced endothelial cell proliferation during early postnatal cardiac angiogenesis and impaired neovascularization post-MI, leading to exacerbated cardiac dysfunction. Recombinant MYDGF therapy reversed these deficits. Liquid chromatography mass spectrometry analysis (LC-MS) analysis of cardiac ECM in Mydgf-KO mice revealed FGF1 as a critical downstream effector of Mydgf in angiogenesis. Administration of recombinant FGF1 protein significantly promoted endothelial cell proliferation and tube formation in human coronary artery endothelial cells. These findings establish the Mydgf-FGF1 axis as a critical regulator of cardiac angiogenesis and unveil its promise as a therapeutic target to promote vascular repair in ischemic heart disease.
Department of Biochemistry and Molecular Biology, Shanxi Medical University, Taiyuan, 030001, China.
State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China.
Department of Physiology & Pathophysiology, School of Basic Medical Sciences, Capital Medical University, Beijing, 100069, China.
State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China. nieyuniverse@126.com.National Health Commission Key Laboratory of Cardiovascular Regenerative Medicine, Fuwai Central-China Hospital, Central China Branch of National Center for Cardiovascular Diseases, Zhengzhou, 450046, China. nieyuniverse@126.com.Shenzhen Key Laboratory of Cardiovascular Disease, Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen, 518057, China. nieyuniverse@126.com.
State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China. bailina0520@163.com.
Journal of cardiovascular translational research
J Cardiovasc Transl Res. 2025-06-24;():.
Mydgf Enhances Cardiac Angiogenesis by Upregulating FGF1.

Stigmatization in MS patients is an important problem that affects social interaction, work life and daily life. In this study, we investigated the prevalence, severity and especially the effects of stigmatization on work life in MS patients.A cross-sectional study of 420 people living with MS (PwMS) assessed stigma using the NeuroQoL Stigma Short Form and a direct stigma survey. Demographic, clinical, workplace, and social data were collected through an online survey. Statistical analyses were performed.Stigma was prevalent, with 77% reporting stigma in direct surveys and 67.6% scoring > 8 on the NeuroQoL Stigma Short Form. Stigma was more severe in patients with progressive MS and higher EDSS scores. The most disturbing symptoms were fatigue (73.3%), imbalance (46.7%) and attention deficit 50.5%). The most prominent complaint affecting work life was fatigue (41.2%). Only 7.3% of the patients had sought psychological support for this issue. 57.4% of patients had disclosed their illness to their employer and 68.1% to their coworkers.Stigma in MS is pervasive, linked to clinical severity, workplace challenges, and social withdrawal. Interventions targeting stigma's psychological and social dimensions, along with workplace education and support are essential.
© 2025. The Author(s) under exclusive licence to Belgian Neurological Society.
Department of Neurology, University Of Health Sciences, Sultan Abdulhamid Han Research and Training Hospital, Istanbul, Turkey. nzl.gmzb@gmail.com.
Faculty of Medicine, Department of Neurology, Sakarya University, Sakarya, Turkey.
Faculty of Medicine, Department of Neurology, Kocaeli University, Kocaeli, Turkey.
Department of Neurology, Sancaktepe Şehir Prof Dr İlhan Varank Research and Training Hospital, University Of Health Sciences, İstanbul, Turkey.
Department of Neurology, Bursa Yüksek İhtisas Research and Training Hospital, University Of Health Sciences,, Bursa, Turkey.
Faculty of Medicine, Department of Neurology, Çanakkale Onsekiz Mart University,, Çanakkale, Turkey.
Department of Neurology, Şişli Hamidiye Etfal Research and Training Hospital, University Of Health Sciences, İstanbul, Turkey.
Department of Neuropsychology, Sultan Abdulhamid Han Research and Training Hospital, University Of Health Sciences, İstanbul, Turkey.
Department of Neurology, Sakarya Training and Research Hospital, Sakarya, Turkey.
Department of Neurology, University Of Health Sciences, Sultan Abdulhamid Han Research and Training Hospital, Istanbul, Turkey.
Understanding stigma in multiple sclerosis: workplace discrimination, social challenges and psychological impacts.

The visual cortex is an essential part of the brain for processing visual information. It exhibits structural and functional plasticity, which is crucial for adapting to complex visual environments. The quintessential manifestation of visual cortical plasticity is ocular dominance plasticity during the critical period, which involves numerous cellular and molecular events. While previous studies have emphasized the role of visual cortical neurons and their associated functional molecules in visual plasticity, recent findings have revealed that structural factors such as the extracellular matrix and glia are also involved. Investigating how these molecules interact to form a complex network that facilitates plasticity in the visual cortex is crucial to our understanding of the development of the visual system and the advancement of therapeutic strategies for visual disorders like amblyopia.
Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin Eye Institute, Tianjin Eye Hospital, Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, 300020, China.
State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Institutes of Brain Science, Fudan University, Shanghai, 200032, China. guyu_@fudan.edu.cn.
Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin Eye Institute, Tianjin Eye Hospital, Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, 300020, China. shixf_tmu@163.com.Institute of Ophthalmology, Nankai University, Tianjin, 300020, China. shixf_tmu@163.com.
Recent Advances in the Molecular Mechanisms of Ocular Dominance Plasticity in the Visual Cortex.

Hospital at home (HaH) is an internationally evaluated and widely established model of care in many countries. HaH is an acute clinical service that provides personnel, equipment, technology, medications, and skills that are typically available in hospitals, and delivers hospital-level care for selected individuals in their own homes or in nursing facilities. An interprofessional team consisting of nurses, therapists, and physicians treats patients-who would otherwise be cared for in a conventional hospital bed-in their own beds at home. Patients receive needs-based nursing and medical visits several times a day, and the team is available 24 h a day, 7 days a week. The average duration of treatment is similar to that of a conventional inpatient stay, ranging from 3-9 days. In current pilot projects in Switzerland, patients with internal medicine or palliative acute conditions are predominantly being treated. A Cochrane review based on 20 randomized studies on HaH shows high patient safety, lower complication rates compared to the traditional inpatient setting, lower treatment costs, and high patient satisfaction.
Klinik Arlesheim, Pfeffingerweg 1, 4144, Arlesheim, Schweiz. severin.poechtrager@hospitales.ch.
Hospital at Home (HaH) ist ein international evaluiertes und in vielen Ländern etabliertes Versorgungsmodell. HaH ist eine akute klinische Dienstleistung, die Personal, Ausrüstung, Technologien, Medikamente und Fähigkeiten, die normalerweise in Krankenhäusern zur Verfügung gestellt werden, übernimmt und die Krankenhausversorgung für ausgewählte Menschen in ihrem Zuhause oder in Pflegeheimen erbringt. Ein interprofessionelles Team aus Pflegefachpersonen, Therapeut:innen und Ärzt:innen behandelt Patient:innen, die sonst in einem konventionellen Krankenhausbett behandelt werden, in ihrem eigenen Bett zu Hause. Die Patient:innen werden bedarfsorientiert mehrmals täglich pflegerisch und ärztlich visitiert und das Team ist 24 h am Tag und 7 Tage die Woche verfügbar. Die durchschnittliche Behandlungsdauer ist analog eines konventionell stationären Aufenthalts zwischen 3 und 9 Tagen. In den Pilotprojekten in der Schweiz werden aktuell vorwiegend Patient:innen mit internistischen oder palliativen Akutsituationen behandelt. Eine Cochrane Review, basierend auf 20 randomisierten Studien zu HaH, weist eine hohe Patient:innensicherheit, niedrigere Komplikationsraten als im klassisch stationären Setting, geringere Behandlungskosten und eine hohe Patient:innenzufriedenheit aus.
[Healthcare without boundaries: revolution in cross-sector healthcare delivery].

The prognostic significance of the neutrophil-to-lymphocyte ratio (NLR) in relation to albumin levels for acute ischemic stroke (AIS) remains unclear. This study examined the correlation between inflammatory markers and nutritional status to predict 90-day outcomes in patients with AIS. A total of 5855 patients with acute cerebral infarction admitted to the Stroke Center at Jiangsu Province Hospital of Chinese Medicine between June 2017 and September 2023 were retrospectively analyzed. The NLR, SIRI, SII, and NLR-ALb were calculated using peripheral venous blood indicators obtained 24 h post-admission. All patients were followed up 90 days after discharge, and their prognosis was evaluated using the modified Rankin Scale (mRS). Logistic regression analysis, receiver operating characteristics, and Kaplan-Meier survival curves were used to explore the association between inflammatory markers and 90-day outcomes in patients with AIS. In conclusion, higher levels of NLR, SIRI, SII, and the NLR-ALB ratio are associated with poor outcomes following AIS.
Department of Neurology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, 210029, China.Department of Neurology, Jiangsu Province Hospital of Chinese Medicine, Nanjing, 210029, China.
Department of Neurology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, 210029, China. yfy120@njucm.edu.cn.Department of Neurology, Jiangsu Province Hospital of Chinese Medicine, Nanjing, 210029, China. yfy120@njucm.edu.cn.
Department of Neurology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, 210029, China. yfy0069@njucm.edu.cn.Department of Neurology, Jiangsu Province Hospital of Chinese Medicine, Nanjing, 210029, China. yfy0069@njucm.edu.cn.
Department of Neurology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, 210029, China. zy1987424@163.com.Department of Neurology, Jiangsu Province Hospital of Chinese Medicine, Nanjing, 210029, China. zy1987424@163.com.
Correlation Between NLR to Albumin Ratio and 90-day Prognosis After Treatment for Acute Ischemic Stroke.

Non-invasive screening tools for Alzheimer's disease (AD) risk are needed. Decline in episodic memory and subjective cognitive impairment (SCI) are both associated with elevated AD risk. We investigated associations between three cognitive domains (episodic memory, executive function, and working memory) and motor speech performance in older adults with healthy cognition (HC) or SCI. In total, 1014 community-dwelling participants (cross-sectional sample: 843 HC, mean 66.9 years, 72.8% female; 171 SCI, mean 66.3 years, 70.8% female) remotely completed cognitive tests (Paired Associates Learning and Spatial Working Memory from the Cambridge Neuropsychological Test Automated Battery) and motor speech tests (Tasmanian [TAS] Test). We evaluated whether acoustic motor speech features extracted from 10-s tests of pa, ta, or ka syllable repetition improved episodic memory, executive function, and working memory regression models over age, sex, education, anxiety, and depression (ΔAIC > 2). Motor speech features improved estimation of cognitive scores over fixed demographic and clinical variables in each group and cognitive domain. In summary, we found associations between motor speech performance and cognition in older adults. Short motor speech tests demonstrate potential for non-invasive, cost-effective AD risk screening. Longitudinal research is needed to investigate relationships between individual motor speech features and cognitive changes confirmed to result from the progression of AD.
Wicking Dementia Research and Education Centre, College of Health and Medicine, Medical Science Precinct, Medical Sciences 1, University of Tasmania, Level 4, 17 Liverpool St, Hobart, TAS, 7000, Australia.
Audiology and Speech Pathology, The University of Melbourne, 550 Swanston St, Parkville, VIC, 3010, Australia.Redenlab Inc. Australia, 585 Little Collins St, Suite 669, Melbourne, VIC, 3000, Australia.Tasmanian School of Medicine, Medical Science 1, University of Tasmania, Level 1, 17 Liverpool St, Hobart, TAS, 7000, Australia.
School of Information and Communication Technology, Centenary Building, University of Tasmania, Grosvenor St, Sandy Bay, TAS, 7005, Australia.
Wicking Dementia Research and Education Centre, College of Health and Medicine, Medical Science Precinct, Medical Sciences 1, University of Tasmania, Level 4, 17 Liverpool St, Hobart, TAS, 7000, Australia. jane.alty@utas.edu.au.Tasmanian School of Medicine, Medical Science 1, University of Tasmania, Level 1, 17 Liverpool St, Hobart, TAS, 7000, Australia. jane.alty@utas.edu.au.Neurology Department, Royal Hobart Hospital, 48 Liverpool St, Hobart, TAS, 7000, Australia. jane.alty@utas.edu.au.
Rapid repetitive syllable sounds associate with episodic memory, executive function, and working memory in cognitively healthy and subjectively impaired older adults.

The P2Y12 receptor (P2Y12R) is a G-protein-coupled receptor whose expression level is directly correlated to microglial activation. Herein, we report on the design of a series of new P2Y12R ligands and the radiolabeling and characterization of two positron emission tomography (PET) tracers, [11C]37 and [18F]41. These compounds were evaluated by autoradiography studies on rat brain slices exhibiting overexpression of human P2Y12Rs (AAV-hP2Y12R). Metabolism and biodistribution of [18F]41 were evaluated ex vivo in healthy rats and indicated good metabolic stability with 41% of unchanged radioligand 1 h post injection and a limited crossing of the blood-brain barrier with a brain uptake of 0.02%ID/g 1 h post injection. In vivo PET imaging performed in the AAV-hP2Y12R rat model confirmed this low brain uptake, and no significant difference was found in the transfected (SUVmean 0.14 ± 0.01) versus contralateral (SUVmean 0.13 ± 0.01) striatum of the AAV-hP2Y12R model. Similar results were observed in healthy rats and in nonhuman primates. Additional studies in the presence of tariquidar led to a 3-4-fold increase in the [18F]41 brain concentration, suggesting that [18F]41 is a P-glycoprotein substrate. Future work will focus on improving radioligand design to enhance blood-brain barrier permeation and to reduce efflux transport.
Paris-Saclay University, CEA, CNRS, Inserm, BioMaps, SHFJ, 91401 Orsay, France.
Paris-Saclay University, CEA, CNRS, MIRCen, Laboratoire des Maladies Neurodegeneratives, 92265 Fontenay-aux-Roses, France.
PharmaCenter Bonn, Pharmaceutical Institute, Department of Pharmaceutical & Medicinal Chemistry, University of Bonn, 53121 Bonn, Germany.
Université Claude Bernard Lyon 1, Centre de Recherche en Neurosciences de Lyon, Inserm U1028, CNRS UMR5292, BIORAN, Groupement Hospitalier Est, 69677 Bron, France.
Synthesis, Labeling, and Biological Evaluation of P2Y12 Receptor Radioligands for Positron Emission Tomography Imaging of Neuroinflammation.

Postoperative delirium (POD) is a common and severe complication following cardiac surgery, with an incidence of about 65% in older patients. This study aimed to develop a predictive model for POD in patients aged ≥ 18 years, to enhance early detection and intervention. A retrospective analysis was performed on the data collected from 825 patients who underwent cardiac surgery at Nanjing First Hospital (May 2021-July 2022). POD was diagnosed using the Confusion Assessment Method for the ICU (CAM-ICU). We used LASSO regression and multivariate logistic regression to identify key predictors for the nomogram. The incidence of POD was 23.6%, with significant predictors including head CT findings, hyperlactatemia before extubation, APACHE II score, ASA score, and length of hospital stay. The model demonstrated strong predictive ability (AUC: 0.922 training, 0.896 validation). A web-based calculator ( https://baozexiang.shinyapps.io/dynnomapp/ ) was developed to enhance clinical risk assessment and patient outcomes.
School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, Jiangsu, China.Department of Pharmacy, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China.
Department of Anesthesiology, Perioperative and Pain Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China.
Department of Anesthesiology, Perioperative and Pain Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China. siyanna@163.com.
Department of Anesthesiology, Perioperative and Pain Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China. tracy_kelvin@njmu.edu.cn.
Department of Pharmacy, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China. zoujianjun100@126.com.
Development of a Nomogram Model to Predict the Risk of Postoperative Delirium in Cardiac Surgery Patients.

We aimed to report the 5-year efficacy and safety data of suture trabeculotomy ab interno (SLOT ab interno) in patients with primary open-angle glaucoma and exfoliation glaucoma.Single-centre, three-arm randomised trial.Ninety-nine eyes of 99 patients were randomly assigned to one of three groups: the 360° (n = 34), upper-180° (n = 34), and lower-180° (n = 31) groups. We evaluated intraocular pressure (IOP), medication use, and visual field progression. Surgical success (with or without medication) was defined as IOP ≤21 mmHg with a ≥20% reduction (criterion A) or IOP ≤15 mmHg with a ≥ 20% reduction (criterion B). Visual field progression was assessed by MD values at fixed postoperative time points and by the MD slope (dB/year).Fifty-six of 99 eyes (56.5%) completed 5 years of follow-up. At 5 years, the mean IOP decreased from 18.8 ± 5.7 to 13.5 ± 3.1 mmHg (28% reduction, p<0.001), with medication use decreasing from 3.3 ± 1.1 to 2.0 ± 1.7 (p=0.005) and a mean MD slope of -0.2 dB/year. No significant differences in surgical success rates (criteria A and B), MD values, or MD slopes were observed among the groups.The extent of Schlemm's canal incisions (360°, upper-180°, or lower-180°) during SLOT ab interno has no significant effect on IOP reduction or medication use over 5 years.
© 2025. Japanese Ophthalmological Society.
Sato Eye Clinic Kumamoto, 1st Floor, JR Kumamoto Kasuga North Building, 3-24-1 Kasuga, Nishi-ku, Kumamoto, 860-0047, Japan. zxsato@gmail.com.
Sato Eye and Internal Medicine Clinic, Kumamoto, Japan.
Outcomes of a randomised trial comparing 360° and 180° schlemm's canal incisions in suture trabeculotomy ab interno for primary open-angle glaucoma and exfoliation glaucoma: a 5-year analysis.

Psoriasis is a chronic immune-mediated skin disease with known physical and mental health comorbidities, such as cardiovascular disease, depression, and anxiety. Psoriasis also has a significant impact on quality of life and sleep due to factors like itch and pain. This study aims to assess the relationship between sleep quality, mental health, and psoriasis, and specifically investigate the impact of poor sleep quality on mental health outcomes within participants with psoriasis.In this cross-sectional study, we enrolled 556 participants into two cohorts: 487 participants were enrolled into the psoriasis cohort, and 69 were enrolled into the healthy control cohort. The demographics, disease severity, family history, sleep quality (PROMIS 8a, PROMIS 8b, and Insomnia Severity Index), and mental health (Patient Health Questionnaire-8 and Generalized Anxiety Disorder-7) of participants were assessed. Descriptive analysis and logistic regression models were employed to examine sleep and mental health, adjusting for potential confounders like demographics and comorbidities.A comparison of patients with psoriasis and healthy controls revealed worsened sleep and mental health outcomes in patients with psoriasis. Among participants with psoriasis, greater sleep impairment (Patient-Reported Outcomes Measurement Information System (PROMIS) 8a), sleep disturbance (PROMIS 8b), and insomnia were significantly associated with anxiety (ORa 1.22; 95% confidence interval (CI) 1.16, 1.30; ORa 1.26; 95% CI 1.16, 1.80; ORa 5.13; 95% CI 2.91, 9.33; respectively) and depression (ORa 1.42; 95% CI 1.32, 1.56; ORa 1.16; 95% CI 1.08, 1.26; ORa 7.04; 95% CI 4.01, 12.77; respectively).These findings underscore the importance of recognizing how psoriasis can impact mental health and sleep. Building a collaborative relationship between patients with psoriasis and their providers is essential to improve overall sleep and life quality.
Department of Dermatology, University of California San Francisco, 2340 Sutter St N414, San Francisco, CA, USA. Andrea.Leung@ucsf.edu.
Department of Dermatology, University of California San Francisco, 2340 Sutter St N414, San Francisco, CA, USA.
Department of Dermatology, University of California San Francisco, 2340 Sutter St N414, San Francisco, CA, USA.Institute for Human Genetics, University of California San Francisco, San Francisco, CA, USA.
Dermatol Ther (Heidelb). 2025-06-24;():.
The Impact of Psoriasis on Sleep Quality: Examining the Relationship Between Psoriasis, Sleep, and Mental Health.

Current evidence on the association between metabolic dysfunction-associated steatotic liver disease (MASLD) phenotypes to carotid artery plaque (CAP) remains limited. This study aims to investigate both the association and the potential mediating effects of MASLD phenotypes on the risk of CAP.In this cross-sectional study, 8644 participants were categorized into five groups based on hepatic steatosis and cardiometabolic criteria: Non-hepatic steatosis, Dysglycemia-MASLD, Overweight-MASLD, Lean-MASLD, and other hepatic steatosis. Multivariable logistic regression analysis was conducted to evaluate the association between MASLD phenotypes and CAP. Mediation analyses were performed to evaluate the mediating effect of dysglycemia and body mass index (BMI) on the relationship between MASLD and CAP.The Dysglycemia-MASLD group exhibited the highest prevalence of CAP of 26.28%, followed by the Lean-MASLD (18.55%) and Overweight-MASLD (14.39%) groups. After adjusting for covariates, Dysglycemia-MASLD patients had a significantly higher risk of CAP, with an OR of 1.599 (95% CI 1.348, 1.896). Notably, individuals under 45 in the Dysglycemia-MASLD and Lean-MASLD subgroups had more than a two-fold increased risk of CAP compared to the Non-hepatic steatosis group, with ORs of 2.393 (95% CI 1.660, 3.416) and 2.724 (95% CI 1.002, 6.221), respectively. Mediation analysis indicated that dysglycemia and BMI mediated 30.86% and 24.49% of the association of MASLD with CAP.The risk of developing CAP varies across MASLD phenotypes, with Dysglycemia-MASLD and Lean-MASLD patients exhibiting the highest risk. Therefore, personalized health management strategies are essential for different MASLD phenotypes.
© 2025. Associazione Medici Diabetologi / Association of Diabetologists (AMD), Societa Italiana di Diabetologia / Italian Society of Diabetology (SID).
Central Laboratory of Yongchuan Hospital, Chongqing Medical University, Chongqing, China.Department of Laboratory Medicine, Key Laboratory of Laboratory Medical Diagnostics, Ministry of Education, Chongqing Medical University, Chongqing, China.Department of Health Management Center, Clinical Medical College and Affiliated Hospital of Chengdu University, Chengdu, Sichuan, China.
Department of Health Management Center, Clinical Medical College and Affiliated Hospital of Chengdu University, Chengdu, Sichuan, China.
Department of Central Laboratory, Clinical Medical College and Affiliated Hospital of Chengdu University, Chengdu, Sichuan, China.
Shuangliu District Center for Disease Control and Prevention, Chengdu, Sichuan, China.
General Medicine of Yongchuan Hospital, Chongqing Medical University, Chongqing, China.
Institute of Basic Medicine and Forensic Medicine, North Sichuan Medical College, Nanchong, Sichuan, China.
Central Laboratory of Yongchuan Hospital, Chongqing Medical University, Chongqing, China. liubeizhong@cqmu.edu.cn.Department of Laboratory Medicine, Key Laboratory of Laboratory Medical Diagnostics, Ministry of Education, Chongqing Medical University, Chongqing, China. liubeizhong@cqmu.edu.cn.
Associations between MASLD phenotypes and the risk of carotid artery plaque: a cross-sectional study among railway workers.

Institute of Cytology of the Russian Academy of Sciences (RAS), St. Petersburg, Russia.Personalized Medicine Centre, Almazov National Medical Research Centre, St. Petersburg, Russia.
Personalized Medicine Centre, Almazov National Medical Research Centre, St. Petersburg, Russia.
Polenov Neurosurgical Institute, Almazov National Medical Research Centre, St. Petersburg, Russia.
Institute of Cytology of the Russian Academy of Sciences (RAS), St. Petersburg, Russia.
Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry Russian Academy of Sciences (RAS), Moscow, Russia.
Personalized Medicine Centre, Almazov National Medical Research Centre, St. Petersburg, Russia.Polenov Neurosurgical Institute, Almazov National Medical Research Centre, St. Petersburg, Russia.
Institute of Cytology of the Russian Academy of Sciences (RAS), St. Petersburg, Russia. maxim.shevtsov@tum.de.Personalized Medicine Centre, Almazov National Medical Research Centre, St. Petersburg, Russia. maxim.shevtsov@tum.de.Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany. maxim.shevtsov@tum.de.
Glioblastoma cell motility and invasion is regulated by membrane-associated heat shock protein Hsp70.

Biomolecular Systems Department, Max-Planck-Institute of Colloids and Interfaces, Am Mühlenberg 1, 14476, Potsdam, Germany. maurice.michel@ki.se.Department of Biology, Chemistry and Pharmacy, Freie Universität Berlin, Arnimallee 22, 14195, Berlin, Germany. maurice.michel@ki.se.Department of Oncology and Pathology, Science for Life Laboratory, Karolinska Institutet, Tomtebodavägen, Stockholm, 23A, 17121, Sweden. maurice.michel@ki.se.
Laboratory of Cellular and Molecular Immunology, Brussels Center for Immunology (BCIM), Vrije Universiteit Brussel, Brussels, 1050, Belgium.Myeloid Cell Immunology Laboratory, VIB Center for Inflammation Research, Brussels, 1050, Belgium.
Biomolecular Systems Department, Max-Planck-Institute of Colloids and Interfaces, Am Mühlenberg 1, 14476, Potsdam, Germany.Department of Biology, Chemistry and Pharmacy, Freie Universität Berlin, Arnimallee 22, 14195, Berlin, Germany.
Biomolecular Systems Department, Max-Planck-Institute of Colloids and Interfaces, Am Mühlenberg 1, 14476, Potsdam, Germany. daniel.varon@fhnw.ch.Department of Biology, Chemistry and Pharmacy, Freie Universität Berlin, Arnimallee 22, 14195, Berlin, Germany. daniel.varon@fhnw.ch.School of Life Sciences FHNW, Institute for Chemistry and Bioanalytics, Muttenz, 4132, Switzerland. daniel.varon@fhnw.ch.
Detection of antibodies against the African parasite Trypanosoma brucei using synthetic glycosylphosphatidylinositol oligosaccharide fragments.

To review the spectrum of clinical and imaging features of nodular fasciitis, emphasizing those most characteristic of this diagnosis.A retrospective review of our institutional pathology and imaging databases from 2006 to 2024 identified 89 patients with confirmed nodular fasciitis pathology and imaging evaluation. For the purpose of analysis, lesions were subdivided into 2 basic groups: superficial and deep. Superficial lesions were defined as those involving the skin, superficial fascia, subcutaneous fat, and/or extending to the deep fascia. Deep lesions were defined as those localized to the deep fascia or extending deep to the deep fascia, as well as those that were intermuscular or intramuscular. There were 45 females and 44 males with an overall average age of 37.3 years (range 1.5-84 years; 68.5% between 20 and 60 years). There were 30 superficial lesions (33.7%) and 59 (66.3%) deep lesions. Deep lesions were on average 65% larger than those located superficially and patients with deep lesions were on average 7.2 years older than those with superficial lesions. While there are no pathognomonic imaging features, careful attention to the relationship of the lesion to the adjacent fascia, as well as to the identification of characteristic time-dependent lesional MR signal changes can be useful aids in identifying this lesion.While nodular fasciitis is often considered to be an uncommon soft tissue tumor, it is recognized as the third most common benign soft tissue lesion. Knowledge of the spectrum of lesion characteristic locations and appearances will facilitate definitive diagnosis.
© 2025. The Author(s), under exclusive licence to International Skeletal Society (ISS).
Department of Radiology, Mayo Clinic, 5777 E Mayo Boulevard, Phoenix, AZ, USA. kransdorf.mark@mayo.edu.
Department of Pathology, Mayo Clinic, 5777 E Mayo Boulevard, Phoenix, AZ, USA.
ACR Institute for Radiologic Pathology (AIRP), 1100 Wayne Avenue, Suite 1020, Silver Spring, MD, 20910, USA.Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA.Department of Radiology, Walter Reed National Military Medical Center, 8901 Wisconsin Ave., Bethesda, MD, 20889, USA.
Department of Radiology, Mayo Clinic, 5777 E Mayo Boulevard, Phoenix, AZ, USA.
Imaging features of nodular fasciitis: a review of 89 cases.

This study aims to investigate the role of TREM1 in necrotizing enterocolitis (NEC).A mouse model of NEC was established through artificial feeding combined with hypoxia-cold stress. Intestinal injury was assessed via H&E staining. Inflammatory cytokines were measured by ELISA, and reactive oxygen species (ROS) activity was evaluated using DHE staining. Intestinal permeability was determined by the fluorescein-isothiocyanate-dextran (FITC-dextran) method. Tight junction proteins were analyzed through immunohistochemistry and western blotting. The expression of CD86 and CD206 in M1 and M2 macrophages was assessed by immunofluorescence, and the mRNA levels of M1 and M2 markers (CD86, iNOS, CD206, and Arg-1) were detected by RT-qPCR. Proteins involved in ER stress were analyzed using western blotting.Inhibition of TREM1 was found to reduce intestinal injury, inflammation, and oxidative stress, improve intestinal barrier function, suppress M1 macrophage polarization, and attenuate ER stress in NEC mice. Moreover, we found that treatment with the ER stress inducer tunicamycin reversed these protective effects of TREM1 inhibition.TREM1 inhibition protects against intestinal injury, inflammation, oxidative stress, intestinal barrier damage, and M1 macrophage polarization in NEC mice by suppressing ER stress.
Department of Neonatology, The Third Affiliated Hospital of Wenzhou Medical University, 108 Wansong Road, Rui'an, Wenzhou, 325200, Zhejiang, China.
Department of Neonatology, The Third Affiliated Hospital of Wenzhou Medical University, 108 Wansong Road, Rui'an, Wenzhou, 325200, Zhejiang, China. huangjinruian@wmu.edu.cn.
Targeting TREM1 Ameliorates Necrotizing Enterocolitis in Neonatal Mice by Inhibiting Endoplasmic Reticulum Stress and Regulating Macrophage Polarization.

Prophylactic endoscopic submucosal dissection (ESD) defect closure has been suggested to reduce delayed adverse events (DAE) associated with ESD but the data are limited. We aim to study the effect of prophylactic rectal ESD defect closure on post-ESD outcomes.An international multicenter retrospective cohort study was performed between 2016 and 2023 involving patients who underwent rectal ESD without intraprocedural perforations and had follow-up data available for at least 2 weeks post-ESD. Delayed adverse events (DAE) defined as bleeding and perforation within 2 weeks of ESD and post-procedure hospitalization or observation rates were compared between the two groups - ESD defects closed (closure group) and ESD defects open (open group).A total of 385 patients were included. Complete closure of ESD defects was performed in 166 (43%) patients. DAE were observed in 21 (5.5%) patients. On logistic regression analysis, anticoagulant use, NICE3 lesions and incomplete resections had significantly higher rate of DAE. In these high-risk groups, defect closure had a numerically lower rate of DAE without statistical significance. While defect closure did not significantly reduce the rate of overall DAE (p = 0.16), there were no delayed perforations in the closure group compared to 3 (1.3%) in the open group. A significantly lower number of patients were kept for post-ESD overnight hospital observation in the closure group compared to the open group (17% v 37%, p < 0.01).Prophylactic closure of rectal ESD defects leads to significantly less overnight hospital observation. Anticoagulant use, NICE 3 lesions and incomplete resections had significantly higher DAE within 2 weeks. While defect closure did not significantly reduce the overall DAE, selective prophylactic defect closure in high-risk groups will need to be studied in larger samples.
Division of Gastroenterology and Hepatology, Thomas Jefferson University Hospital, Philadelphia, PA, USA. Anand.Kumar@jefferson.edu.
Drexel University, Philadelphia, PA, USA.
Division of Gastroenterology and Hepatology, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
Johns Hopkins University, Baltimore, MD, USA.
Division of Gastroenterology & Hepatology, Johns Hopkins Medicine, Baltimore, MD, USA.
Division of Gastroenterology, Kingston Health Sciences Center, Queen's University, Kingston Ontario, Canada.
Division of Gastroenterology and Hepatology, Stony Brook University Hospital, Stony Brook, NY, USA.
Division of Gastroenterology, University of California Irvine, Orange, CA, USA.
Division of Gastroenterology and Hepatology, University of Pennsylvania, Philadelphia, PA, USA.
Institute for Liver & Digestive Health, UCL (University College London), The Royal Free Hospital, London, UK.
Digestive Endoscopy Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, and Center for Endoscopic Research Therapeutics and Training (CERTT), Università Cattolica del Sacro Cuore, Rome, Italy.
Digestive Endoscopy Unit, Ospedale Isola Tiberina - Gemelli Isola, Rome, Italy.
Division of Gastroenterology and Hepatology, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
Division of Gastroenterology, Minneapolis VA Medical Center, University of Minnesota, Minneapolis, MN, USA.
Division of Gastroenterology, University of Washington, Seattle, WA, USA.
Division of Gastroenterology, University of California Davis, Davis, CA, USA.
Prophylactic Rectal ESD (Endoscopic Submucosal Dissection) Defect Closure and Post-ESD Clinical Outcomes: An International Multi-Center Study (with Video).

Glioblastoma (GBM) is the most aggressive brain cancer with poor prognosis, even with current treatments combining surgery, chemotherapy, and radiation. Despite initial tumor removal, recurrence is common and driven by altered genetic profiles. MicroRNAs (miRNAs), small non-coding RNAs with regulatory roles, are implicated in GBM progression through their influence on key hallmarks such as angiogenesis, proliferation, immune evasion, and resistance to therapy. This review systematically analyzed peer-reviewed literature from 2019 to 2025 to evaluate recent findings on miRNAs in GBM pathogenesis. Studies reveal differential miRNA expression in GBM models and their involvement in tumor biology via modulation of target genes. Understanding miRNA networks, along with the tumor microenvironment and immune interactions, may enable the identification of diagnostic and therapeutic biomarkers. Targeting both tumor and associated immune components presents a promising direction for future GBM therapies.
© 2025. The Author(s), under exclusive licence to Federación de Sociedades Españolas de Oncología (FESEO).
Department of Neurosurgery, University of Florida, Gainesville, FL, 32608, USA. siddharth.dr99@gmail.com.Department of Neurosurgery, RCSM Government Medical College, Kolhapur, 316013, India. siddharth.dr99@gmail.com.
Apollo Institute of Medical Sciences and Research, Hyderabad, 500090, India.
RCSM, Government Medical College, Kolhapur, 316013, India.
Department of Neurosurgery, University of Florida, Gainesville, FL, 32608, USA.
Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico
Recent advances in molecular mechanisms of microRNAs in pathogenesis and resistance of treatment in glioblastoma.

Department of General Surgery, the Third People's Hospital of Chengdu, Chengdu, China. wangpin109@126.com.Center of Breast and Thyroid Surgery, the Third People's Hospital of Chengdu, Chengdu, China. wangpin109@126.com.
Letter to the editor: Reflections on idiopathic granulomatous mastitis.

The Spielberger State-Trait Anxiety Inventory (STAI) is the most cited measure of state and trait anxiety, and is routinely employed in a variety of research and clinical contexts. Here, we investigate the temporal stability as well as the convergent and discriminant validity of the German version of the STAI trait scale (STAI-T) across multiple time points in two independent samples (105 and 120 Caucasians). We observed temporal stabilities of .42-.67 for intervals between 20 and 41 months and from .81-.87 for intervals of five to 12 months, with decreasing stability as the time interval increased. Temporal stability estimates of the STAI-T were similar to those of related constructs. Additionally, examining the relationships within a nomological network support the recent conclusion that the STAI-T also shares substantial variance with questionnaires measuring negative emotionality such as depression, and hence does not measure anxiety specifically - despite its name. These results provide further psychometric information on what the STAI-T actually measures and to what extent STAI-T scores are expected to be stable across longer time intervals. This is of relevance for researchers aiming, for example, to use the STAI-T scale for predicting symptom trajectories and evaluating the effectiveness of therapeutic interventions.
Institute of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.Institute of Psychology, Biological Psychology and Cognitive Neuroscience, University of Bielfeled, Bielefeld, Germany.
Institute of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Department of Psychology, Kiel University, Kiel, Germany.
Institute of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.Department of Psychology, University of Würzburg, Würzburg, Germany.
Institute of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center Mainz, Mainz, Germany.Leibniz Institute for Resilience Research (LIR), Mainz, Germany.
Assessing the Long-Term Stability of the Spielberger State-Trait Inventory Trait Scale over 3.5 Years.

BackgroundTibiotalocalcaneal (TTC) nails are commonly used implants for hindfoot arthrodesis. This study evaluated the relationship between the sagittal placement of the nail-specifically, more anterior versus more posterior positioning within the talus-and patient outcomes following surgery.MethodsWe conducted a retrospective, single-center study involving patients aged 18 years and older who underwent hindfoot nail fusion. Variables analyzed included smoking status, body mass index (BMI), diabetes mellitus (DM) status, age, cause of surgery, surgical complications including nonunion, and need for revision surgery. Postoperative X-rays were assessed to calculate the talar-to-nail ratio (tnR), defined as the distance between the anterior margin of the talus and the center of the hindfoot nail (nL) relative to the total length of the talus (tL), expressed as tnR = nL/tL.ResultsThe study included 53 patients (24 male, 29 female) aged 18-92 years. The mean tnR was 54.635% (SD = 9.925), with a range from 23.89% to 76.71%. Bivariate analysis showed no significant relationship between the analyzed variables and nonunion or revision surgery, with the exception of tnR, which was significantly positively associated with revision surgery (59.130 ± 8.253 vs 51.912 ± 9.967, P = .009). In multivariable logistic regression, while DM and age were not significantly associated with revision surgery (P > .05), tnR demonstrated a significant association, with an odds ratio of 1.093 (95% CI: 1.017-1.193) and a P-value of .026.ConclusionMore posterior nail placement, as indicated by a higher tnR, is significantly associated with an increased likelihood of revision surgery, potentially due to an increased foot lever arm. These findings suggest that more anterior nail placement may lead to improved surgical outcomes in TTC arthrodesis.Level of Evidence:Level III, Prognostic.
John Sealy School of Medicine, The University of Texas Medical Branch, Galveston, Texas.
Department of Internal Medicine, University of Miami, Miami, Florida.
Department of Orthopaedic Surgery, The University of Texas Medical Branch, Galveston, Texas.Department of Biostatistics & Data Science, The University of Texas Medical Branch, Galveston, Texas.
Department of Orthopaedic Surgery, The University of Texas Medical Branch, Galveston, Texas.
Sagittal Position of Nail in Talus Affects Tibiotalocalcaneal Arthrodesis Outcomes.

Women are more often prescribed antibiotics than men for a number of health conditions. Adults' behaviours in engaging with healthcare for themselves, especially when attending appointments with a child with a respiratory tract infection for whom they provide care, may contribute to the gender differences in antimicrobial use. This study aimed to evaluate gender differences in caregivers' attendance at healthcare visits for children with respiratory tract infections, their behaviours in engaging with healthcare for themselves and their children, and associated antibiotic prescriptions.An online survey was conducted among Japanese caregivers, asking about children's healthcare visits and prescriptions for antimicrobials associated with respiratory tract infections, who accompanied them and whether the caregiver attended a simultaneous healthcare visit for themselves. We used multivariable logistic regression analysis to evaluate factors associated with caregivers' attendance at children's healthcare visits and responders' simultaneous healthcare visits.Among the 1664 participants, 1091 accompanied their children to healthcare visits. Female responders were significantly more likely to accompany their child (adjusted odds ratio (aOR) 6.76 [95% confidence interval (CI) 5.00-9.15], p < 0.001). Participants with higher education levels were less likely to require a simultaneous healthcare visit (aOR 0.56 [95% confidence interval (CI) 0.33-0.94], p = 0.029). Other covariates, including participants' gender, were not significantly associated with simultaneous healthcare visits.Women were more likely to accompany a child to a healthcare visit for a respiratory tract infection. However, they were no more likely to require a simultaneous healthcare visit, or receive antibiotics at those simultaneous visits.
AMR Clinical Reference Center, National Center for Global Health and Medicine, Japan Institute for Health Security, Tokyo, Japan.
AMR Clinical Reference Center, National Center for Global Health and Medicine, Japan Institute for Health Security, Tokyo, Japan.Disease Control and Prevention Center, National Center for Global Health and Medicine, Japan Institute for Health Security, 1-21-1 Toyama, Shinjuku-ku, Tokyo, Japan.
AMR Clinical Reference Center, National Center for Global Health and Medicine, Japan Institute for Health Security, Tokyo, Japan. tsuzuki.s@jihs.go.jp.Disease Control and Prevention Center, National Center for Global Health and Medicine, Japan Institute for Health Security, 1-21-1 Toyama, Shinjuku-ku, Tokyo, Japan. tsuzuki.s@jihs.go.jp.Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium. tsuzuki.s@jihs.go.jp.
Gender Differences in Antibiotic Prescriptions and Healthcare Visits Among Caregivers Accompanying Children with Respiratory Tract Infections: A Cross-Sectional Study.

College of Information Science and Technology, Qingdao University of Science and Technology, Qingdao, 266100, China.
College of Information Science and Technology, Qingdao University of Science and Technology, Qingdao, 266100, China. songtq@qust.edu.cn.
Office of the Dean, The Affiliated Hospital of Qingdao University, Qingdao, 266000, China.
Physical and engineering sciences in medicine
Fetal arrhythmia detection method based on QCNN-BiLSTM.

Productivity is utilised inconsistently in value assessment and poses methodological and conceptual challenges for estimation. This systematic literature review aims to understand how productivity gain/loss for patients and caregivers was measured in health economic evaluation, identify the preferred instruments to capture productivity gain/loss and assess their properties.A systematic literature review was conducted using PubMed, Ovid MEDLINE, Embase, Japan-specific (J-STAGE and Ichushi Web) and economic literature databases (Cost-Effectiveness Analysis (CEA) Registry, Paediatric Economic Database Evaluation (PEDE) and National Health Service Economic Evaluation Database (NHS EED)). Additional relevant data were identified using clinical trial registries and grey literature searches. Studies published between January 2021 and December 2023 which presented economic evaluations with outcomes relevant to productivity measures were included. Instruments were selected for practical relevance and frequent use in studies, while research-specific and single-study questionnaires were excluded.Among 1431 published health economic evaluations with productivity in the assessment, 152 were included in this review. These studies were almost equally distributed over the 3-year period, with a slightly higher number in 2023 versus 2021 [54 (35.5%) versus 48 (31.6%)]. In total, 118/152 studies reported patient measures only, 14/152 reported caregiver measures only and 20/152 reported both patient and caregiver measures. Based on the inclusion criteria, 20 of the 88 identified instruments were further investigated in this review. The Work Productivity and Activity Impairment Questionnaire (WPAI) [23 (15.1%)], Institute for Medical Technology Assessment (iMTA) Productivity Cost Questionnaire (iPCQ) [23 (15.1%)] and Trimbos/iMTA Questionnaire for Costs associated with Psychiatric Illness​ (TIC-P) [(8 (5.3%)] were the most commonly used instruments. All three instruments were reported as valid and reliable. All three instruments reported absenteeism, presenteeism and overall work impairment. WPAI additionally included information on daily activity impairment. The human capital approach (n = 18) and the friction cost approach (n = 17) were utilised to assign monetary value to the lost productivity.This review identified a significant number of health economic evaluations between 2021 and 2023, which included productivity loss in the assessment. Various instruments were used to measure productivity loss in these studies, while a few instruments were commonly used across studies. To ensure consistent measurement of productivity, it is crucial to establish a standard tailored to a country or region, considering differences across countries or regions. Furthermore, necessary adaptations should be made on the basis of the specific health intervention being studied. Last, maintaining transparency in all productivity evaluations is vital.
Department of Pharmaceutical Sciences, International University of Health and Welfare, Narita city, Chiba, Japan.
Value, Evidence and Access Department, Integrated Market Access, Johnson and Johnson, Tokyo, Japan. KWattan1@ITS.JNJ.com.
Value, Evidence and Access Department, Integrated Market Access, Johnson and Johnson, Tokyo, Japan.
Asia Pacific Regional Market Access, Johnson and Johnson, Singapore, Singapore.Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.School of Pharmacy, Faculty of Health and Medical Sciences, Taylor's University Malaysia, Subang Jaya, Malaysia.
Policy Department, Integrated Market Access, Johnson and Johnson, Tokyo, Japan.
Department of Health Economics and Outcomes Research, The University of Tokyo, Bunkyō, Tokyoō, Japan.
Including Productivity as an Element to Reflect Value of the Treatment: A Systematic Review of Published Health Economic Evaluations.

Center for Molecular Oncology, Frontiers Science Center for Disease-related Molecular Network, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, 610041, China.
Center for Molecular Oncology, Frontiers Science Center for Disease-related Molecular Network, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, 610041, China. yongpeng@scu.edu.cn.
Antibody-based targeted protein degradation for membrane and extracellular proteins: emerging strategies and breakthroughs.

The optimal duration of immunotherapy (ITH) remains undefined for patients with metastatic melanoma, and debates on de-escalation strategies are ongoing. Patients in the pivotal KEYNOTE and CheckMate trials who experienced a complete response (CR) on ITH had long-term responses, even after treatment was terminated early because of toxicity or at the physician's discretion.Our study explores the duration of planned ITH drug holidays-intentional ITH suspension until disease progression off treatment-in patients with unresectable and metastatic melanoma treated for at least 6 months with ITH.We enrolled 222 patients who received anti-programmed cell death protein-1-based ITH, experienced stable disease, partial response, or complete response during ITH, and had no treatment-limiting toxicities.At a median follow-up of 63 months since the first ITH cycle, median overall survival after the drug holiday start (OS3) was not reached, and the 5-year OS3 rate was 79.3%. Median progression-free survival since the start of drug holiday (PFS3) was not reached, with a 3-year PFS3 rate of 65% for all patients, and the highest rate was in the complete response group (72.3%). After the drug holidays, upon disease progression off treatment, the objective response rate to ITH reintroduction was 58.9%. Again, durable, ongoing objective responses were achieved on ITH reintroduction after drug holidays. The best radiological response achieved before drug holidays correlated with the duration of ITH drug holidays, with the longest duration of disease control without treatment for complete responders.Drug holidays in patients with unresectable and metastatic melanoma after an objective response or prolonged disease stabilization during ITH result in durable control of the disease, particularly in patients with complete response.
Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Roentgena 5 Street, 02-781, Warsaw, Poland. AnnaMalgorzata.Czarnecka@nio.gov.pl.Department of Outpatient Chemotherapy, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland. AnnaMalgorzata.Czarnecka@nio.gov.pl.
Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Roentgena 5 Street, 02-781, Warsaw, Poland.Department of Computational Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland.
Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Roentgena 5 Street, 02-781, Warsaw, Poland.
Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Roentgena 5 Street, 02-781, Warsaw, Poland.Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland.
Department of Medical and Experimental Oncology, Institute of Oncology, Poznan University of Medical Sciences, Poznań, Poland.
Department of Clinical Oncology, Holy Cross Cancer Center, Kielce, Poland.
Department of Clinical Oncology, Lower Silesian Oncology, Pulmonology and Hematology Center, Wroclaw, Poland.Department of Surgical Oncology, Lower Silesian Oncology, Pulmonology and Hematology Center, Wroclaw, Poland.
2nd Department of Radiotherapy and Chemotherapy, Maria Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, Gliwice, Poland.
Department of Clinical Oncology, Lower Silesian Oncology, Pulmonology and Hematology Center, Wroclaw, Poland.Department of Surgical Oncology, Lower Silesian Oncology, Pulmonology and Hematology Center, Wroclaw, Poland.Department of Hematology and Oncology, Faculty of Medicine, Wroclaw University of Science and Technology, Wroclaw, Poland.
Department of Medical and Experimental Oncology, Institute of Oncology, Poznan University of Medical Sciences, Poznań, Poland.Department of Cancer Diagnostics and Immunology, Greater Poland Cancer Center, Poznań, Poland.
Department of Clinical Oncology, Lower Silesian Oncology, Pulmonology and Hematology Center, Wroclaw, Poland.Department of Surgical Oncology, Lower Silesian Oncology, Pulmonology and Hematology Center, Wroclaw, Poland.Department of Oncology, Wroclaw Medical University, Wroclaw, Poland.
Department of Bone Marrow Transplantation and Oncohematology, Skin Cancer and Melanoma Team, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice, Poland.
Discontinuation of Immune Checkpoint Inhibition in Patients with Advanced Unresectable Melanoma Achieving CR, PR, or SD.

Atherosclerotic cardiovascular disease (ASCVD) continues to increase globally as the most common cardiovascular disease. Lifestyle and metabolic risks are major contributors to the increase in the burden of ASCVD. However, the epidemiological characterization of the burden of ASCVD due to lifestyle and metabolic risks has not been adequately documented. We analyzed data from the 2021 Global Burden of Disease Study to assess the disability-adjusted life years (DALYs) and age-standardized DALY rate (ASDR) attributed to ASCVD induced by lifestyle and metabolic risks. This study also analyzes temporal trends and inequalities in disease burden. Lifestyle and metabolic risks led to an increase in the DALYs and a decrease in the ASDR for ASCVD. High systolic blood pressure (SBP) was the primary contributor to the burden of ischemic heart disease (IHD) and ischemic stroke (IS), whereas high fasting plasma glucose (FPG) was the primary contributor to the burden of peripheral artery disease (PAD). High FPG and high body mass index (BMI) are primary risk factors that contribute to a more rapid increase in the burden of ASCVD. Over 32 years, high SDI regions reduced ASCVD burden linked to lifestyle and metabolic risks, while low SDI regions saw increases. ASCVD attributable to lifestyle and metabolic risks remains a major global public health concern. Although the burden of ASCVD caused by lifestyle and metabolic risks has improved in developed countries, developing countries still need to take effective measures to reduce the disease burden. Furthermore, while high SBP remains the leading contributor to the ASCVD burden, it is also crucial to recognize that high FPG and high BMI are becoming significant drivers of the growth in the ASCVD burden. This highlights the need for a paradigm shift in ASCVD prevention and control strategies-from single risk management to comprehensive metabolic network regulation.
National Clinical Research Center for TCM Cardiology, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, 100091, China.The Second Department of Geriatrics, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, 100091, China.Key Laboratory of Disease and Syndrome Integration Prevention and Treatment of Vascular Aging, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, 100091, China.
National Clinical Research Center for TCM Cardiology, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, 100091, China.
The Second Department of Geriatrics, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, 100091, China. dr.xufengqin@hotmail.com.Key Laboratory of Disease and Syndrome Integration Prevention and Treatment of Vascular Aging, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, 100091, China. dr.xufengqin@hotmail.com.
National Clinical Research Center for TCM Cardiology, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, 100091, China. liuyueheart@hotmail.com.Key Laboratory of Disease and Syndrome Integration Prevention and Treatment of Vascular Aging, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, 100091, China. liuyueheart@hotmail.com.
Global burden of atherosclerotic cardiovascular disease attributed to lifestyle and metabolic risks.

Deoxynivalenol (DON) is a prevalent mycotoxin in animal feed that particularly impacts weaned piglets, causing liver damage, growth retardation, and posing significant public health risks. However, the precise mechanisms underlying DON-induced liver damage and optimal treatment approaches remain unclear. The pregnane X receptor (PXR) holds a pivotal position in hepatic xenobiotic elimination and drug metabolism. This research aimed to explore the involvement of PXR in DON-induced liver injury and evaluate the potential of the PXR agonist, 3-indolepropionic acid (IPA), to alleviate liver damage and associated diarrhea in weaned piglets under practical farming conditions. The results demonstrated that DON initiates p53-mediated hepatocyte apoptosis in weaned piglets. RNA-seq and hepatocyte-specific PXR knockout (PXR-HKO) mice revealed PXR's regulatory role in DON-induced hepatocyte apoptosis. IPA reduces DON-induced hepatocyte apoptosis in piglets, mice, and hepatocyte cell lines by enhancing PXR expression and facilitating nuclear translocation. Furthermore, AlphaFold3 predictions and Co-IP assays demonstrate that DON diminishes PXR-p53 binding, thereby amplifying p53-mediated apoptotic transactivation. In conclusion, this study elucidates a novel mechanism by which PXR decreases its binding to p53 upon DON exposure, thereby promoting hepatocyte apoptosis. Additionally, it validates the positive impact of IPA in mitigating liver damage and diarrhea caused by DON in weaned piglets.
State Key Laboratory of Animal Nutrition, College of Animal Science and Technology, China Agricultural University, Beijing, 100193, China.College of Animal Sciences, Fujian Agriculture and Forestry University, Fuzhou, 350002, China.
State Key Laboratory of Animal Nutrition, College of Animal Science and Technology, China Agricultural University, Beijing, 100193, China.
State Key Laboratory of Animal Nutrition, College of Animal Science and Technology, China Agricultural University, Beijing, 100193, China. maxi@cau.edu.cn.
3-Indolepropionic acid confers PXR-p53 binding to mitigate deoxynivalenol-induced hepatocyte apoptosis.

Human embryonic stem cells (hESCs) can be classified as having naïve and primed pluripotency states. While several studies have reported different gene expression networks between these two pluripotency states, the role of alternative splicing (AS) in regulating these differences has not been well characterized. In this study, we performed RNA sequencing and identified differential AS events in 784 genes between naïve and primed hESCs. Among these, KIAA1522, whose function has not been well studied, has state-specific isoforms regulated by alternative first exon (AFE). This splicing event resulted in isoforms with distinct N-terminal domains and subcellular localization. Notably, the sequences and alternative isoform patterns of KIAA1522 were conserved between humans and mice. Further investigation using cleavage under targets and tagmentation (CUT&Tag) experiments in cells with specific-isoform overexpression or knockdown revealed the opposite activity of long terminal repeat retrotransposons (LTR-RTs) and motif enrichment profiles. The naïve-specific (N-P) isoform upregulated naïve marker gene expression and preferentially activated LTR-RTs by binding to the motifs enriched for POU and FOX family transcription factor binding sites. Conversely, the primed-specific (P-P) isoform promoted primed marker gene expression and suppressed LTR-RTs activity by binding to the motifs enriched for zinc finger protein binding sites. Collectively, KIAA1522 regulates the balance between naïve and primed pluripotency states through isoform-specific regulation of LTR-RTs activity and collaboration with distinct transcriptional regulators. In summary, our results characterize the splicing atlas of hESCs in naïve and primed states and reveal the regulatory function and mechanism of AFE usage by KIAA1522.
State Key Laboratory of Organ Regeneration and Reconstruction, Institute of Zoology, Chinese Academy of Sciences, Beijing, 100101, China.University of Chinese Academy of Sciences, Beijing, 100864, China.
State Key Laboratory of Organ Regeneration and Reconstruction, Institute of Zoology, Chinese Academy of Sciences, Beijing, 100101, China.Beijing Institute for Stem Cell and Regenerative Medicine, Beijing, 100101, China.
State Key Laboratory of Organ Regeneration and Reconstruction, Institute of Zoology, Chinese Academy of Sciences, Beijing, 100101, China.College of Life Science, Northeast Agricultural University of China, Harbin, 150030, China.
State Key Laboratory of Organ Regeneration and Reconstruction, Institute of Zoology, Chinese Academy of Sciences, Beijing, 100101, China.University of Chinese Academy of Sciences, Beijing, 100864, China.Beijing Institute for Stem Cell and Regenerative Medicine, Beijing, 100101, China.
State Key Laboratory of Organ Regeneration and Reconstruction, Institute of Zoology, Chinese Academy of Sciences, Beijing, 100101, China. wanghaoyi@ioz.ac.cn.University of Chinese Academy of Sciences, Beijing, 100864, China. wanghaoyi@ioz.ac.cn.Beijing Institute for Stem Cell and Regenerative Medicine, Beijing, 100101, China. wanghaoyi@ioz.ac.cn.
State Key Laboratory of Organ Regeneration and Reconstruction, Institute of Zoology, Chinese Academy of Sciences, Beijing, 100101, China. fenggh@ioz.ac.cn.Beijing Institute for Stem Cell and Regenerative Medicine, Beijing, 100101, China. fenggh@ioz.ac.cn.
KIAA1522 isoform switching regulates LTR-RTs activity in distinct pluripotency states of hESCs.

In the real-world POLARIS study, patients with hormone receptor-positive (HR+)/human epidermal growth factor receptor 2-negative (HER2-) advanced/metastatic breast cancer (ABC) who had received palbociclib + endocrine therapy (ET) had a median real-world progression-free survival (rwPFS) of 20.9 months in the first line of therapy (1LOT) and 13.5 months in second or later LOTs (≥ 2LOT).The aim of this study is to assess the relationship of prior anticancer treatments with clinical outcomes.Kaplan-Meier estimates of rwPFS and overall survival (OS) are described by prior anticancer treatments in patients with HR+/HER2- ABC who received palbociclib + ET.A total of 1250 patients received ≥ 1 palbociclib dose (1LOT: 901 [72.1%]; ≥ 2LOT: 349 [27.9%]). In the 1LOT group, 563 (62.5%) had received prior (neo)adjuvant treatments: 24.3% ET alone, 26.6% chemotherapy alone, 45.5% ET + chemotherapy, and 3.6% other treatments; both median rwPFS and OS were numerically longer in patients who had received ET alone (30.4 months and not reached, respectively) and had had no prior treatment (23.7 and 53.3 months, respectively) than in patients with prior chemotherapy alone (15.9 and 38.4 months, respectively). In the ≥ 2LOT group, patients with prior ET alone (21.5%; 19.8 months) or chemotherapy alone (16.6%; 15.5 months) in the (neo)adjuvant and/or metastatic setting had numerically longer median rwPFS than those with prior ET + chemotherapy (41.3%; 11.6 months); OS was comparable regardless of prior treatment.Patients with HR+/HER2- ABC who had received ET alone prior to palbociclib tended to have better clinical outcomes, while those with prior chemotherapy had less clinical benefit.ClinicalTrials.gov, NCT03280303.
Division of Hematology/Oncology, Department of Medicine, University of Alabama at Birmingham, 1720 2nd Avenue South, Birmingham, AL, 35294, USA. grocque@uabmc.edu.
Texas Oncology-Baylor Charles A. Sammons Cancer Center, Dallas, TX, USA.
Hematology/Oncology, Health Partners Institute, Saint Paul, MN, USA.
St. Luke's Hospital Koontz Center for Advanced Breast Cancer, Kansas City, MO, USA.
Mid-Illinois Hematology and Oncology Associates, Normal, IL, USA.
Medical Oncology, Hematology, Novant Health Cancer Institute, Winston-Salem, NC, USA.
Oncology Pfizer Biopharma, Pfizer Inc, New York, NY, USA.
Oncology Clinical Statistics, Pfizer Inc, La Jolla, CA, USA.
Pfizer Inc, South San Francisco, CA, USA.
Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Relationship of Prior Anticancer Treatments with Palbociclib Clinical Outcomes in Patients with HR+/HER2- Advanced Breast Cancer in Real-World Settings.

Posterior spinal instrumentation and fusion (PSF) is the gold standard for severe adolescent idiopathic scoliosis (AIS), yet instrumentation strategies vary widely, often leading to suboptimal results. Deep learning's potential in AIS planning is underexplored.This study trained and validated an artificial neural network multi-task learning model (NNML) using preoperative clinical and radiographic data from 189 AIS patients with Lenke 1A and 2A curves enrolled in the MIMO Clinical Trial (NCT01792609). The model mimics experienced spine surgeons' decision-making for selecting the upper and the lower instrumented vertebrae (UIV, LIV), determining rod curvature, and predicting screw density based on the study's randomized allocation. Models were trained with data from 179 patients, utilizing tenfold cross-validation, and externally validated on 10 patients from a separate hospital and surgeons outside the training set. For UIV and LIV selection, accuracy within the top two predictions was used as a classification performance metric, ensuring that other clinically relevant alternatives were considered.The NNML, which comprised 83 inputs and multiple hidden layers, led to significant gains over ST-NN and proved more robust during the internal validation (loss 6.2 vs. 9.3; p ≤ 0.01). It showed 82-95% and 80-100% accuracy for UIV and LIV predictions and 70-90% accuracy for predicting the rod curvatures ± 5°. The RMSE for the screw density and rod curvature predictions was 0.2-0.3 and 3.7-5.6°, respectively.An NNML can better use the features of relevant AIS patients for mixed task prediction pertinent to PSF surgery planning than ST-NN. In addition, NNML was capable of mimicking experienced spine surgeons' decision-making process when designing the instrumentation.
© 2025. The Author(s), under exclusive licence to Scoliosis Research Society.
Department of Orthopedic Surgery, Mayo Clinic, 200 1 st Street Southwest, Rochester, MN, 55905, USA. caroline.constant@uzh.ch.Polytechnique Montréal, 2500 Chemin de Polytechnique, Montréal, H3 T 1 J4, Canada. caroline.constant@uzh.ch.Centre Hospitalier Universitaire (CHU) Sainte-Justine, 3175 Ch. Côte Sainte-Catherine, Montréal, H3 T 1 C5, Canada. caroline.constant@uzh.ch.AO Research Institute Davos, Clavadelerstrasse 8, CH 7270, Davos, Switzerland. caroline.constant@uzh.ch.
Department of Orthopedic Surgery, Mayo Clinic, 200 1 st Street Southwest, Rochester, MN, 55905, USA.
Department of Orthopedic Surgery, University of Minnesota, Minneapolis, MN, USA.
Polytechnique Montréal, 2500 Chemin de Polytechnique, Montréal, H3 T 1 J4, Canada.Centre Hospitalier Universitaire (CHU) Sainte-Justine, 3175 Ch. Côte Sainte-Catherine, Montréal, H3 T 1 C5, Canada.
Minimize Implants Maximize Outcomes Study Group
Neural network-based multi-task learning to assist planning of posterior spinal fusion surgery for adolescent idiopathic scoliosis.

Sarcopenia (loss of muscle strength/mass) reduces physical performance (walking, strength, mobility) and is common in Parkinson's disease (PD), but data on newly diagnosed, untreated patients ( de novo ) are scarce. Fatigue is frequent in PD and linked to physical decline and malnutrition, key sarcopenia risk factors. We aimed to describe sarcopenia prevalence, malnutrition risk, and fatigue in de novo PD and explore differences based on fatigue presence.Participants (n = 49) underwent physical tests [chair stand test (CST), hand grip strength, gait speed, Timed Up and Go test (TUG)] to assess sarcopenia. Malnutrition risk and fatigue were assessed using the Nutrition Form version 2 (MEONF-II) and the 16-item Parkinson's Disease Fatigue Scale (PFS-16).Twenty (40.8%) showed probable sarcopenia. Eight (16%) had fatigue, and 8 (19%) were at risk of malnutrition. No significant differences in sarcopenia indicators were found between groups, but those with fatigue had lower physical performance (CST, p = 0.033; TUG, p = 0.011), slower gait speed (p = 0.050), and poorer appetite (p = 0.003).A substantial proportion of de novo PD presented probable sarcopenia. Fatigue was associated with poorer physical performance and appetite but not sarcopenia. Whether fatigue increases risk of future malnutrition/sarcopenia is unclear due to cross-sectional study design. It should be further explored using a longitudinal study design.
Department of Neurology, Rehabilitation Medicine, Memory Disorders and Geriatrics, Skåne University Hospital Malmö, Malmö, 205 02, Sweden. Beata.Lindholm@med.lu.se.Cognitive Disorders Unit, Department of Clinical Sciences Malmo, Lund University, Malmo, 205 02, Sweden. Beata.Lindholm@med.lu.se.
Department of Neurology, Rehabilitation Medicine, Memory Disorders and Geriatrics, Skåne University Hospital Malmö, Malmö, 205 02, Sweden.
The PRO-CARE group, Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden.Department for Research, Development and Education, Management for Psychiatry and Habilitation, Region Skåne, Lund, Sweden.
Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.Medical Unit Allied Health Professionals, Women's Health and Allied Health Professionals Theme, Karolinska University Hospital, Stockholm, Sweden.
Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology
Sarcopenia, malnutrition, and fatigue in de Novo Parkinson's disease- support for early rehabilitation.

Nanomedicines hold great promise for the treatment of osteoporosis, while their nonspecific accumulation in the liver typically reduces the drug delivery efficacy. Herein, we report bone-targeted liposomes encapsulated with arginine and metformin for the treatment of osteoporosis. These liposomes are functionalized with alendronate to enhance the bone-targeting capability. The delivered agents directly modulate osteoblasts, osteoclasts, and osteocytes, promoting bone formation and inhibiting bone resorption to counteract osteoporotic bone loss. In addition to targeted bone delivery, the inevitable hepatic accumulation of liposomes is strategically utilized to stimulate the hepatic secretion of lecithin-cholesterol acyltransferase (LCAT), which, in turn, promotes bone remodeling by engaging the liver-bone axis. This dual mechanism, which combines targeted bone delivery with beneficial off-target hepatic effects, synergistically enhances therapeutic outcomes. Our findings highlight a promising nanomedicine-based strategy that takes advantage of interorgan communication to optimize osteoporosis treatment.
Department of Orthopedics, Qilu Hospital of Shandong University, Jinan, Shandong 250014, China.
Department of Hematology, Qilu Hospital of Shandong University, Jinan, Shandong 250014, China.
Key Laboratory of Colloid and Interface Chemistry of the Ministry of Education, School of Chemistry and Chemical Engineering, Shandong University, Jinan, Shandong 250100, China.
Department of Orthopedics, Qilu Hospital of Shandong University, Jinan, Shandong 250014, China.Shandong Key Laboratory of Magnetic Field-Free Medicine & Functional Imaging, Research Institute of Magnetic Field-free Medicine & Functional Imaging, National Medicine-Engineering Interdisciplinary Industry-Education Integration Innovation Platform, Shandong University, Jinan, Shandong 250012, China.
Key Laboratory of Colloid and Interface Chemistry of the Ministry of Education, School of Chemistry and Chemical Engineering, Shandong University, Jinan, Shandong 250100, China.Shandong Key Laboratory of Targeted Drug Delivery and Advanced Pharmaceutics, Shandong University, Jinan, Shandong 250100, China.
Integration of Bone-Targeted Delivery and Crosstalk Modulation of Liver-Bone Axis for Improved Osteoporosis Therapy.

Novel theories have emerged in the past decade pertaining to how the brain processes internal body sensations and how such processes underpin not only perception but also how we act in the world. These neuroscientific advances offer new perspectives for research and practice allied to medicine, sport and exercise science. The construct of perceived fatigue has been understudied until recent recognition of its prevalence and influence on perceptions and behaviours in health, diseases and performance. The aim of the present perspective piece is to propose a theoretical and conceptual framework for understanding perceived fatigue and its emergence during exercise. We encourage the use of the definition proposed by Micklewright et al. (2017), that is a feeling of diminishing capacity to cope with physical or mental stressors, either imagined or real , from a critique of contemporary taxonomies and a distinction made with other key percepts in the field of medicine, sport and exercise. We also offer some methodological considerations for its measure. We then succinctly describe a neurobiologically plausible mechanistic underpinning of exercise-induced perceived fatigue based on the theory of predictive processing applied to homeostatic regulation through allostatic control and metacognition. Finally, we position the model of perceived fatigue through Metacognitive Inference of Dyshomeostasis (MID) within the wider corpus of knowledge. We first contrast the MID model with the most dominant biology-grounded models of perceived fatigue proposed in the literature to then provide preliminary evidence in support of the MID model and suggest some testable predictions for future research.
Fatigue and Exercise Laboratory, Centre for Lifelong Health, School of Education, Sport and Health Sciences, University of Brighton, Brighton, UK. j.dekerle@brighton.ac.uk.
Department of Family Practice, Faculty of Medicine, University of British Columbia, British Columbia, Canada.
Fatigue and Exercise Laboratory, Centre for Lifelong Health, School of Education, Sport and Health Sciences, University of Brighton, Brighton, UK.Cognitive Neuroimaging Unit, INSERM, CEA, CNRS, NeuroSpin Centre, Université Paris-Saclay, Gif-Sur-Yvette, France.Institut de neuromodulation GHU Paris, psychiatrie et neurosciences, centre hospitalier Sainte-Anne, pôle hospitalo-universitaire 15, Université Paris Cité, Paris, France.
A New Framework to Understand and Study Exercise-Induced Perceived Fatigue as a Metacognitive Inference of Dyshomeostasis.

Online molecular characterization of atmospheric aerosols using advanced mass spectrometry techniques has revolutionized our understanding of aerosol chemistry but faces significant challenges from instrumental background. Two powerful techniques, Filter Inlet for Gases and AEROsols coupled to Chemical Ionization Mass Spectrometry (FIGAERO-CIMS) and Extractive Electrospray Ionization Time-of-Flight Mass Spectrometry (EESI-TOF), particularly suffer from memory effects and system contamination. These background interferences mask atmospheric signals and necessitate intensive maintenance, including ion source and sampling system cleaning, thereby limiting long-term field applications. Here, we present the SMART-PMF framework (Synchronous Mass-Spectral Analysis and Background Removal Treatment) that applies positive matrix factorization directly to near-raw mass spectral data, utilizing distinct temporal patterns to separate atmospheric signals from instrumental background. Applied to FIGAERO-CIMS and EESI-TOF data, this approach successfully extracts atmospheric signals, reduces maintenance needs, and enables simultaneous background correction and atmospheric source apportionment. By simplifying spectral complexity via factor-specific separation and chemical characterization, SMART-PMF enhances the accuracy of peak fitting and molecular formula assignments. Validation against colocated Aerosol Mass Spectrometer (AMS) measurements confirms reliable background correction and methodological complementarity, offering robust support for long-term, molecular-level aerosol measurements. This systematic approach has broad applicability for addressing background interference across diverse online mass spectrometry applications.
Joint International Research Laboratory of Atmospheric and Earth System Research, School of Atmospheric Sciences, Nanjing University, Nanjing 210023, China.National Observation and Research Station for Atmospheric Processes and Environmental Change in Yangtze River Delta, Nanjing 210023, China.
State Environmental Protection Key Laboratory of Formation and Prevention of Urban Air Pollution Complex, Shanghai Academy of Environmental Sciences, Shanghai 200233, China.
National Observation and Research Station for Atmospheric Processes and Environmental Change in Yangtze River Delta, Nanjing 210023, China.Nanjing-Helsinki Institute in Atmospheric and Earth System Sciences, Nanjing University, Nanjing 210023, China.
Joint International Research Laboratory of Atmospheric and Earth System Research, School of Atmospheric Sciences, Nanjing University, Nanjing 210023, China.National Observation and Research Station for Atmospheric Processes and Environmental Change in Yangtze River Delta, Nanjing 210023, China.Now at National Satellite Meteorological Center, China Meteorological Administration, Beijing 100081, China.
Joint International Research Laboratory of Atmospheric and Earth System Research, School of Atmospheric Sciences, Nanjing University, Nanjing 210023, China.National Observation and Research Station for Atmospheric Processes and Environmental Change in Yangtze River Delta, Nanjing 210023, China.Now at Hubei Province Academy of Eco-Environmental Sciences, Wuhan 430072, China.
A Novel Analytical Framework for Simultaneous Background Correction and Chemical Characterization in Aerosol Molecular Composition Online Mass Spectrometry.

This study explored the perceptions and experiences of children with obesity and their parents regarding childhood obesity based on the Information-Motivation-Behavioral Skills model. This qualitative study used focus group interviews with 20 participants (10 children with obesity or overweight, and 10 of their parents) to explore their information, motivation, and behavioral skills regarding childhood obesity. Participants displayed significant knowledge gaps regarding the causes and consequences of childhood obesity, necessitating accurate information dissemination. Motivations for addressing obesity individual motivations, such as health concerns, appearance, self-esteem, and social motivations encompassing personal experiences, peer influence, family dynamics, and the importance of positive role models. Parents and children demonstrated various behavioral skills to combat obesity, including portion control and engagement in physical activities. However, failures at both individual and environmental levels were identified, highlighting challenges in maintaining healthy habits. Addressing these challenges through tailored strategies and supportive environments is crucial for effective obesity management.
Nursing Department, Daejin University, Pocheon-si, Republic of Korea.
College of Nursing, ShinHan University, Dongducheon-si, Republic of Korea.
Uijeongbu West Elementary School, Uijeongbu-si, Republic of Korea.
Exploring Information, Motivation, and Behavioral Skills on Childhood Obesity Through Focus Group Interviews With Parents and Children.

To evaluate the impact of first-trimester screening for preeclampsia (PE) and its association with adverse perinatal outcomes.A retrospective cohort study was conducted in women with (Group I) or without (Group II) first-trimester screening for PE between 11 and 13 + 6 weeks using maternal characteristics, mean arterial pressure, and uterine artery Doppler. Women were classified as low and high risk using a cut-off value of 1:150 according to the Fetal Medicine Foundation guidelines.A total of 2442 pregnant women were analysed, 988 in Group I and 1434 in Group II, of whom 204 were at high risk and 1230 at low risk for PE. Group II had higher maternal age (28.0 vs. 26.0 years, p < 0.001), Apgar score at the 1st minute (9.0 vs. 8.0, p < 0.001), Apgar score at the 5th minute (9.0 vs. 8.0, p < 0.001) and lower gestational age at delivery (39.1 vs. 39.4 weeks, p < 0.001) than Group I. Group II was found to have a lower risk of gestational hypertension (p < 0.001), higher risk of delivery < 34 weeks (p = 0.06), and lower risk of spontaneous delivery < 37 weeks (p < 0.001). Women at high risk of PE had a higher risk of delivery < 34 weeks (6.9% vs. 1.2%, p < 0.001), delivery < 37 weeks (16.7% vs. 8.0%, p < 0.001), PE < 34 weeks (2.9% vs. 0.5%, p = 0.005), PE < 37 weeks (4.9% vs. 1.0%, p = 0.0007) and PE > 37 weeks (2.9% vs. 0.5%, p = 0.005). Among women at high risk of PE, 61.3% (125/204) used aspirin (ASA) 100 mg by 37 weeks' gestation. The ASA use was associated with a lower risk of PE > 37 weeks' gestation (0.8% vs. 6.3%, p = 0.033).First-trimester screening for PE did not reduce the risk of preterm or term PE. First-trimester screening was associated with a lower risk of gestational hypertension and preterm PE. High risk pregnancies had a higher risk of preterm and term PE and of preterm and term delivery. ASA use was associated with lower risk of term PE.
© 2025. Società Italiana di Ultrasonologia in Medicina e Biologia (SIUMB).
Gynecology and Obstetrics Service, Mario Palmério University Hospital - University of Uberaba (UNIUBE), Uberaba, MG, Brazil.
Albert Einstein Israelite College of Health Sciences, Albert Einstein Israelite Hospital, São Paulo, SP, Brazil.
Department of Radiology, Federal University of Triângulo Mineiro (UFTM), Uberaba, MG, Brazil.Sabin Diagnostic Medicine, Uberaba Unit, Uberaba, MG, Brazil.
Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), Rua Belchior de Azevedo, 156 apto. 111 Torre Vitoria, São Paulo, SP, 05089-030, Brazil. araujojred@terra.com.br.Discipline of Woman Health, Municipal University of São Caetano do Sul (USCS), São Caetano do Sul, SP, Brazil. araujojred@terra.com.br.
Gynecology and Obstetrics Service, Mario Palmério University Hospital - University of Uberaba (UNIUBE), Uberaba, MG, Brazil.Sabin Diagnostic Medicine, Uberaba Unit, Uberaba, MG, Brazil.Department of Obstetrics and Gynecology, Federal University of Triângulo Mineiro (UFTM), Uberaba, MG, Brazil.
First-trimester screening for preeclampsia between 11 and 13 + 6 weeks of gestation and adverse perinatal outcomes.

Metabolic dysfunction-associated steatotic liver disease (MASLD)-related cirrhosis has become an important global public health concern, particularly in certain vulnerable populations, with its incidence continuing to rise. This study aims to systematically analyze the epidemiological trends of MASLD-related cirrhosis and predict future incidence rates. The findings will provide critical scientific evidence to inform effective prevention and intervention strategies to address the public health challenges posed by this disease.The burden of MASLD-related cirrhosis globally, regionally, and by country was analyzed from 1990 to 2021, stratified by age, sex, and socio-demographic index. Age-period-cohort (APC) models were used to analyze trends in different age groups, time periods, and birth cohorts. Health inequalities were measured using the inequality slope index and concentration index. The frontier analysis was conducted based on development levels to estimate achievable outcomes. The ARIMA model was used to predict future incidence and mortality rates.Compared to 1990, the global burden of MASLD-related cirrhosis increased by 2021, with the number of cases reaching 1.267 billion (95% UI: 1.158 to 1.380 billion) and global deaths at 97,400 (95% UI: 69,500 to 130,200). The risk of developing MASLD-related cirrhosis increased with age, peaking in middle-aged and older adults, and then gradually declining with further aging. Frontier analysis revealed that countries with low or low-middle Socio-Demographic Index (SDI), such as Somalia, Niger, Papua New Guinea, Yemen, and Timor-Leste, experienced heavier disease burdens with limited control measures. ARIMA predictions indicated that the incidence of MASLD-related cirrhosis will continue to rise, while mortality rates will remain stable.MASLD-related cirrhosis has become a significant global public health challenge. In recent years, the global burden of the disease has been increasing due to changes in lifestyle and the rising burden of chronic diseases, particularly in low- and middle-income countries. Health disparities remain prominent, highlighting the need for targeted interventions to mitigate the impact of this disease across diverse populations.
Guizhou University of Traditional Chinese Medicine, Guiyang, 550000, China.
The First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang, 550000, China.
The Second Affiliated Hospital of Guizhou, University of Traditional Chinese Medicine, Guiyang, 550000, China.
The First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang, 550000, China. anzhenxiang057@gzy.edu.cn.
Guizhou University of Traditional Chinese Medicine, Guiyang, 550000, China. 363110152@qq.com.
Journal of endocrinological investigation
Time trends and health inequalities of cirrhosis caused by metabolic Dysfunction-associated steatotic liver disease from 1990 to 2021: A global burden of disease study.

A microwave-assisted intramolecular dehydrogenative coupling reaction for the construction of novel γ-carbolines was established. Following Pd(II)/Cu(II)-catalyzed C-H activation, intramolecular cyclization provided γ-carbinone derivatives with various substituents in 57-85% yield. The rapid synthesis of γ-carbolines and wide functional group tolerance are among the advantages of this microwave-assisted approach.
School of Chemistry and Chemical Engineering, Zhejiang Key Laboratory of Alternative Technologies for Fine Chemicals Process, Shaoxing University, Shaoxing 312000, Zhejiang Province, P. R. China.
Microwave-Assisted Intramolecular Dehydrogenative Coupling Reaction: Access to γ-Carboline Derivatives.

Expanding tumor antigen-specific T-cells in vivo remains a major challenge in developing effective cancer immunotherapeutics. Artificial antigen-presenting cells (aAPCs) have the potential to overcome this challenge, but formulating aAPCs without correlating the in vivo dynamics of T-cell expansion often leads to suboptimal T-cell responses. Here, we have defined the critical effect of the peptide-major histocompatibility complex (p-MHC) valency displayed along with co-stimulatory molecules on iron-oxide nanoparticle-based aAPCs in vivo and demonstrated that the functionality of these aAPCs is governed by the p-MHC valency. Nanoscale aAPCs engage cognate CD8+ T-cells directly to induce the formation of T-cell receptor (TCR) microclusters, leading to nuclear translocation of nuclear factor of activated T-cells (NFAT) in a p-MHC valency-dependent manner. Nanoscale aAPCs, presenting p-MHCs above the threshold valencies, promoted the expansion and tumor infiltration of adoptively transferred and endogenous tumor-specific CD8+ T-cells in tumor situations. The treatment effectively inhibited tumor growth, highlighting the importance of defining the threshold valency of p-MHC in developing aAPCs for effective immunotherapies.
Nano-Biotechnology Laboratory, National Institute of Immunology, Aruna Asaf Ali Marg, New Delhi 110067, India.
Department of Electrical Engineering, National Institute of Technology-Durgapur, Mahatma Gandhi Avenue, Durgapur, West Bengal 713209, India.
TANLUN Medical Research and Innovation Inc., #6, XIERQIZHONGLU, Haidian District, Beijing 80086, China.
Defining the Critical Valency of Peptide-MHC on Nanoscale Artificial Antigen Presenting Cells for Expanding Endogenous Tumor-Specific T-cells In Vivo.

Acute rhinosinusitis is one of the most prevalent diseases seriously affecting the well-being and quality of life. To address this condition, a novel intelligent liposome nanoparticle (BHL@IR780@LNP) was constructed by coloading the photosensitizer IR780 and a nitric oxide donor (l-arginine-loaded biguanide chitosan-hyaluronic acid composite nanoparticles, BHL) onto liposome nanoparticles composed of cholesterol and soybean phospholipids. Under irradiation with an 808 nm near-infrared laser, BHL@IR780@LNP was able to generate heat and reactive oxygen species, resulting in the precise release of nitric oxide, which effectively killed 97.5% of Escherichia coli and 99.2% of Staphylococcus aureus, respectively. Furthermore, in vivo findings demonstrated that BHL@IR780@LNP+L could effectively eliminate 99.5% of S. aureus at the nasal mucous membrane and significantly reduce inflammatory markers. Overall, this study demonstrates a highly effective antibacterial nanoformulation (BHL@IR780@LNP+L) that innovatively integrates the synergistic effects of heat, reactive oxygen species, and nitric oxide to combat acute rhinosinusitis.
State Key Laboratory of Chemical Engineering, Tianjin University, Tianjin 300072, P. R. China.
Department of Oncology, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, P. R. China.
State Key Laboratory of Chemical Engineering, Tianjin University, Tianjin 300072, P. R. China.Haihe Laboratory of Sustainable Chemical Transformations, Tianjin 300192, P. R. China.
Synergistic Nitric Oxide Therapy and Phototherapy Using a Novel Bacteria Scavenger for Treatment of Acute Rhinosinusitis.

Ulcerative colitis (UC), a chronic inflammatory bowel disease with limited therapeutic options, necessitates novel treatments targeting its complex pathophysiology. This study identified FHND5032, a novel small-molecule miR-124 inducer, as a potent therapeutic candidate for UC. We found that FHND5032 significantly upregulated miR-124 expression in macrophages, surpassing the clinical-stage comparator ABX464 in vitro and in vivo. Mechanistically, miR-124-5p directly targeted PIK3R2, suppressing the PI3K/Akt pathway and decreasing proinflammatory cytokines while promoting M2 macrophage polarization. In dextran sodium sulfate-induced mouse colitis, FHND5032 markedly reduced the disease activity index, restored colon length, preserved mucosal architecture, and repaired intestinal barrier integrity. Additionally, FHND5032 reversed gut dysbiosis by reducing Proteobacteria and enriching beneficial Firmicutes, outperforming ABX464 in microbiome modulation. Safety assessments confirmed no organ toxicity or biochemical abnormalities. Collectively, FHND5032 exerted multifaceted anticolitis effects by targeting the PIK3R2/PI3K/Akt axis, restoring immune homeostasis, and modulating gut microbiota, positioning it as a promising therapeutic agent for UC.
Jiangsu Province Key Laboratory for Molecular and Medical Biotechnology, College of Life Sciences, Nanjing Normal University, Nanjing 210046, China.
Division of Spine Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing 210046, China.
Jiangsu Chia Tai Fenghai Pharmaceutical Co., Ltd., Nanjing 210046, China.
Jiangsu Province Key Laboratory for Molecular and Medical Biotechnology, College of Life Sciences, Nanjing Normal University, Nanjing 210046, China.Jiangsu Chia Tai Fenghai Pharmaceutical Co., Ltd., Nanjing 210046, China.
Novel Small-Molecule miR-124 Inducer Acts as a Physiological Brake of Inflammation in Ulcerative Colitis by Targeting the PIK3R2/PI3K/Akt Axis.

Assembling 2D ultrathin nanosheets into vertical heterostructures offers significant potential for advanced energy storage due to enhanced active sites, improved ion diffusion, and increased electrical conductivity, leading to superior ion/electron transport, higher energy density, and improved rate performance. However, breaking crystal symmetry and fostering the anisotropy in crystal growth is critical in non-layered materials. In case of transition metal hydroxides, to overcome with challenges such as random assembly, complex synthesis, instability, and poor interfacial contact is critical. This study synthesizes large area, ultrathin, 2D Nickel/Cobalt hydroxide vertical heterostructures achieving 32% higher areal charge storage compared to cobalt/nickel hydroxide vertical heterostructures and 57% and 330% better than individual Ni(OH)2 and Co(OH)2. The synergistic interaction between nickel and cobalt hydroxides contributes to a high volumetric capacity (710 mAh cm-3) and energy density (285 mWh cm-3) in symmetric devices. The flexible micro-supercapacitor retains 75% capacitance after 15,000 cycles and demonstrates stability under bending up to 135°, with a volumetric capacity of 393 mAh cm-3. DFT simulations complement experiments, revealing interaction energy and electronic state redistribution near the Fermi level. This integrated approach serves as a guide for enhancing electrochemical properties in 2D heterostructures, aiding in the development of next-generation, high-performance energy storage materials.
JAIN (Deemed-to-be-university), Centre for Nano and Material Sciences, Others, INDIA.
JAIN (Deemed-to-be-university), Centre for Nano and Material Sciences, Banglore, Banglore, INDIA.
SRM University AP, Department of Physics, INDIA.
Unité de Catalyse et Chimie du Solide: Unite de Catalyse et Chimie du Solide, CNRS, UMR 8181-UCCS-12, 59000, Lille, FRANCE.
JAIN (Deemed-to-be-university), Centre for Nano and Material Sciences, INDIA.
Universite de Lille, CNRS, MREI 1 - 145 Avenue Maurice Schumann, Dunkirk, 59375, Dunkirk, FRANCE.
JAIN (Deemed-to-be-university), Centre for Nano and Material Sciences, Kanakapura road, 562112, Bangalore, INDIA.
Ultrathin 2D Ni/Co Hydroxide Heterostructures for High Energy Density Flexible Micro-supercapacitor.

Correction to: Genome-wide association mapping dissects the selective breeding of determinacy and photoperiod sensitivity in common bean (Phaseolus vulgaris L.).

Globalization and climate change may be driving the spread of the quarantine fruit fly, Bactrocera carambolae, highlighting the need for ecofriendly control methods like the Sterile Insect Technique (SIT), which relies on releasing sterile males to reduce wild populations. However, developing effective strains through genetic manipulation of sex-determination genes remains challenging due to limited knowledge of this pathway in B. carambolae. In this study, the structures of three key orthologous genes-transformer (tra), transformer-2 (tra-2), and doublesex (dsx)-were characterized and compared with those of other Bactrocera species. These genes were found to share conserved structures, following a bottom-up pattern from Bcardsx to Bcartra-2 and Bcartra, with intron retention observed in Bcartra as a structural variation. Developmental expression analysis revealed that the splicing patterns of Bcartra first appeared at 6 hours post oviposition (hpo), with sex-specific patterns established by 10 hpo. The expression profiles in B. carambolae were similar to those in the closely related species B. dorsalis, although gene expression occurred later in B. carambolae. RNAi knockdown of Bcartra resulted in nearly all phenotypic males, supporting the role of BcarTRA in controlling the sex-specific splicing of Bcartra itself and the downstream genes doublesex and fruitless. Additionally, in silico predictions of protein interactions (TRAF, TRA-2, and RBP1) and putative cis-regulatory elements on Bcartra pre-mRNA suggested specific binding events occur at these conserved sites. These findings contribute to the development of potential genetic tools for pest control and provide insights into the evolutionary relationships among these orthologous genes.
© 2025 Institute of Zoology, Chinese Academy of Sciences.
Regional R&D Training Center for Insect Biotechnology (RCIB), Faculty of Science, Mahidol University, Nakhon Pathom, Thailand.Department of Biotechnology, Faculty of Science, Mahidol University, Bangkok, Thailand.
Department of Pathobiology, Faculty of Science, Mahidol University, Bangkok, Thailand.
Molecular characterization of transformer, transformer-2, and doublesex genes in the carambola fruit fly, Bactrocera carambolae, revealing potential for genetic pest management.