搜索结果：Adapted

There is a critical lack of reliable, high-quality epidemiological data on mental health and/or social and emotional wellbeing (SEWB) outcomes for First Nations children, partly, due to the limited availability of culturally valid assessment tools. This review aims to assess the cultural validity of mental health and SEWB assessment tools used with First Nations children aged 4-12 years in Australia, and identify gaps, strengths, and opportunities for reform that enhance cultural safety, and self-determination in assessment practices. A systematic search of five electronic databases (Web of Science, PubMed, PsycINFO, Informit, and CINAHL) identified English-language studies (1980-2025) assessing mental health or SEWB in Aboriginal and/or Torres Strait Islander children aged 4-12 years. Data on assessment tools were extracted and their cultural validity analysed using the First Nations Cultural Validity Assessment Tool. Tools were classified, as bespoke, culturally adapted or generic, using the CBSPATSISP definitions. This review examined the cultural validity across 10 studies, including 11 unique tools and 16 assessments of cultural validity. Three tools were bespoke, eight culturally adapted, and five generic. Over three quarters of tools used to assess SEWB or mental health in First Nations children had poor or limited cultural validity. Two bespoke SEWB tools were identified, although none specifically targeted mental health. Culturally valid assessment tools for First Nations children remain limited, with research predominantly relying on inappropriate measures. Improving the measurement of mental health and SEWB outcomes requires a shift towards First Nations-led, co-designed tools grounded in Indigenous knowledges, strengths, and cultural frameworks. The evidence base was limited by reliance on published academic sources, which may have missed community-used assessment tools, a focus on cultural validity rather than broader study quality, and limited psychometric reporting for some First Nations-specific measures. PROSPERO (CRD42024542866). 13 May 2024. www.crd.york.ac.uk/PROSPERO/view/CRD42024542866.

Functional decline in activities of daily living (ADL) is considered a marker of ageing and Alzheimer's disease. However, there is a lack of performance-based instruments specifically designed to assess ADL in adults and older adults with Down syndrome. To describe the adaptation process of the Direct Assessment of Functional Status (DAFS) to assess the functional capacity of adults with Down syndrome. The Direct Assessment of Functional Status-Brazilian Version (DAFS-BR) was administered to 15 adults with Down syndrome (nine men and six women) who were divided into two diagnostic groups: stable cognition and suspected dementia or cognitive impairment. The process was conducted in two phases: phase one was characterized by an adaptation in the tasks. In phase two, (cultural and semantic) equivalences were verified, as well as structural aspects, including layout and instructions. This phase was essential for verifying the applicability and comprehensibility of newly adapted tasks. The DAFS-BR was adapted for the time orientation, communication (telephone use), moneyhandling skills, and shopping skills domains, considering the target population. The adaptation process of the DAFS-BR for people with Down syndrome was made considering linguistic, psychological, and cultural idiosyncrasies in the target population, with the input of experts with relevant experience in each domain. After psychometric studies, the Direct Assessment of Functional Status-Down Syndrome (DAFS-DS) could be considered the first ecological instrument for evaluating functional status in adults with Down syndrome in Brazil to enhance both clinical practice and research. O declínio funcional nas atividades da vida diária (AVD) é considerado um marcador do envelhecimento e da doença de Alzheimer. No entanto, há falta de instrumentos de avaliação baseados em desempenho especificamente desenhados para avaliar a AVD em adultos e idosos com síndrome de Down (SD). Descrever a adaptação da Avaliação do Estado Funcional (DAFS) para avaliar a capacidade funcional de adultos com síndrome de Down (SD). A DAFS-BR foi aplicada em 15 adultos com SD (nove homens e seis mulheres) divididos em dois grupos diagnósticos: cognição estável e suspeita de demência ou comprometimento cognitivo. O processo foi conduzido em duas etapas: na primeira, foram realizadas adaptações nas tarefas e, na segunda, foram verificadas equivalências (culturais e semânticas), aspectos estruturais, incluindo layout e instruções. Esta etapa foi essencial para verificar a aplicabilidade e a compreensibilidade das tarefas recém-adaptadas. A DAFS-BR foi adaptada nos domínios de orientação temporal, comunicação (uso do telefone), capacidade de gestão financeira e habilidades de compras, considerando a população alvo. O processo de adaptação da DAFS-BR para SD foi realizado considerando-se as particularidades linguísticas, psicológicas e culturais da população alvo, com a participação de especialistas com experiência relevante na área e em cada domínio. Após estudos psicométricos, o DAFS-SD poderá ser considerado o primeiro instrumento ecológico para a avaliação do estado funcional em adultos com síndrome de Down no Brasil, visando aprimorar tanto a prática clínica quanto a pesquisa.

Research suggests that approach and avoidance-decreasing or increasing self-stimulus distance, respectively-influence self-evaluation. However, this conclusion typically stems from examining approach and avoidance as a pair, while no empirical research has satisfactorily isolated the unique causal contribution of each behaviour. To address this gap, three experiments (N Total = 1929) used an adapted Manikin Task incorporating a proper control condition (i.e., no distance change) to first isolate the effect of approach, relying on both reaction time and self-report measures. Furthermore, by incorporating avoidance in the last experiment, this task allowed us to oppose model-based theoretical predictions. Results did not reveal any behaviour-specific effects. Nevertheless, the proposed methodology opens new avenues for investigating the behavioural determinants of self-construal.

Global agricultural productivity is increasingly destabilized by climate change-driven droughts, floods, extreme heat, and severe storms. Although the climate-smart agriculture (CSA) framework addresses these challenges, implementation has focused mainly on plant genetics and agronomic inputs, leaving the adaptive potential of the crop microbiome underexplored. Here, we examine the agricultural use of synthetic microbial communities (SynComs) through the "crop holobiont" concept, in which plants and their associated microbiota function as an integrated, responsive system rather than through plant genomes alone. Pioneer plants in extreme environments may serve as reservoirs of stress-adapted microbes and provide a strategic toolkit for advancing CSA. SynComs assembled from these microbes can act not only as nutrient suppliers but also as dynamic physiological modulators that enhance crop phenotypic plasticity under climatic stress. We propose a roadmap for crop microbiology that integrates synthetic ecological engineering, with broad implications for CSA.

Artificial intelligence (AI) is reshaping clinical practice, yet formal AI education in medical curricula has lagged significantly behind-a gap particularly acute in low- and middle-income countries (LMICs). This narrative review examines AI integration in medical education across LMICs, with primary contextual focus on sub-Saharan Africa and African health systems within this broader framing. Available evidence suggests that a substantial proportion of medical students globally may lack formal AI education despite growing clinical AI adoption among physicians, with LMICs and African contexts disproportionately underrepresented in AI-in-medical-education literature. African contexts face compounding implementation challenges-infrastructure deficits, data scarcity, algorithmic bias in externally designed tools, and regulatory gaps-yet possess distinctive contextual opportunities. Applying a structured critical counterargument analysis, the review interrogates both the rationale for integration and the strongest arguments for delay. The review's contribution lies in its LMICs-and-Africa-centred framing, its integration of three complementary theoretical frameworks, and its policy-oriented, phased implementation synthesis-dimensions not addressed in aggregate by existing reviews. AI integration in medical education in LMICs is a context-sensitive priority. The risks of unplanned inaction-widening competency gaps and forfeiture of iterative evaluation data-should be weighed against the risks of implementation, with careful, locally adapted, phased approaches offering the most defensible pathway forward.

Residents contribute substantially to clinical teaching; however, many lack formal preparation for their role as educators. Despite rising expectations within competency frameworks, evidence from multicultural, rapidly evolving training environments remains limited. This study aimed to assess residents' perceptions of their educator role, evaluate self-reported teaching competency and involvement, and identify learning needs to inform the development of a context-sensitive Residents-as-Teachers program. A cross-sectional needs assessment survey was conducted among all 322 medical and surgical residents in a large academic health system between May and July 2025. A validated, locally adapted questionnaire assessed perceptions, teaching involvement, and learning needs. Data were analysed using descriptive statistics, bivariate analyses, and multivariable linear regression to identify independent predictors of positive perceptions of the educator role. A total of 291 residents participated (response rate 90.4%), representing 18 specialties across medical and surgical disciplines. Residents reported spending a mean of 35.8% of their training time engaged in teaching activities. Overall perceptions of the educator role were positive (mean total score 49.99/60), while self-reported teaching competency was moderate. A consistent interprofessional teaching gap was identified, with nurses ranked least frequently taught by over 80% of residents and receiving the lowest competency rating. Residents expressed strong interest in structured teaching-skills training, preferring interactive instructor-led formats over online self-paced learning. In multivariable regression, interest in a future educator role (p <0.001) and competency in teaching medical students (p =0.038) were the strongest independent predictors of positive educator perceptions. These preliminary findings indicate that residents play a substantial yet underprepared role in clinical teaching. Results suggest that structured, contextually responsive Residents-as-Teachers programs prioritizing motivation, teaching competency, and interprofessional education may help address identified gaps and support the development of future clinician-educators. Longitudinal and implementation-focused research is needed to evaluate whether such programs improve observed teaching performance and learner outcomes in diverse postgraduate training environments.

Survivors of suicide loss (SLSs) represent a unique group that faces a heightened risk of developing complications related to grief, often characterized by ruminating on the reasons behind their loved one's suicide, which can affect their supportive social networks. Grief rumination is considered a transdiagnostic risk factor for mental health diseases, including prolonged grief. We evaluated the psychometric and reliability of the Iranian Utrecht Grief Rumination Scale (UGRS) among SLSs. This cross-sectional study, conducted between 2023 and 2024, investigated the psychometric properties of the Persian version of the UGRS. The scale was adapted for the Iranian population through a rigorous translation process encompassing forward translation, reconciliation, and back-translation. A sample of 170 suicide survivors, recruited via convenience and snowball sampling, completed a battery of instruments, including the UGRS, the Prolonged Grief Disorder scale - 13 (PG-13-R), the Hospital Anxiety and Depression Scale (HADS), and the Ruminative Response Scale (RRS). Confirmatory factor analysis (CFA), alongside assessments of concurrent, convergent, and divergent validity, was employed to evaluate the construct validity of the UGRS. Reliability was assessed using Cronbach's alpha and test-retest reliability over a 4-week interval. Data analysis was performed utilizing SPSS 26 (IBM, USA), Amos 26 (IBM, USA), and Mplus 8.3 (Muth&#xe9;n & Muth&#xe9;n, USA. The results of CFA showed that the second-order five-factor hierarchy had more appropriate fit indices than the five correlated factors in suicide survivors (&#x394;CFI = -0.014, &#x394;TLI = -0.021, &#x394;RMSEA = -0.012; &#x394;SRMR = -0.014). UGRS exhibited a moderate correlation with brooding, indicating a convergent validity, and an HTMT index of less than. 090 in all subscales, indicating its divergent validity. UGRS exhibited a positive correlation with prolonged grief and anxiety and depression, which confirms its concurrent validity. Internal consistency was supported by Cronbach's alpha and McDonald's omega for all subscales; test-retest reliability was also acceptable (ICC = 0.85). The Persian UGRS exhibited good psychometric properties, validating its application to assess grief rumination among suicide-loss survivors in both clinical and research contexts.

Background: The lack of child-friendly, second-line drug-resistant tuberculosis (DR-TB) medication in South Africa often leads to the use of adult formulations, which are not always suitable for children. Caregiver experiences in preparing and administering this treatment and the impact on parent-child relationships are poorly represented in the literature. Objective(s): To assess parental acceptability regarding the preparation and administration of DR-TB medications for young children, utilizing Wademan's acceptability framework. Methods: Seven caregivers of eight children who had been diagnosed with DR-TB between June 2019 and February 2022 and initiated treatment at a referral hospital in KwaZulu-Natal participated in the study. Individual in-depth interviews with three caregivers and one focus group discussion with four caregivers were used to gather data, which were analyzed using part of the acceptability framework for TB in children developed by Wademan et al. [1]. Findings: Despite challenges, caregivers were adept at navigating DR-TB medication regimens, highlighting their critical role in inventive preparation methods to enhance palatability and strategic administration practices for children. Adult medications were adapted where necessary, and caregivers employed various techniques to ensure adherence. The acceptability of treatment was affected by medication palatability, preparation and administration, appeal and side effects (usability), and the interface between caregivers and the healthcare system (integration). Staying engaged in care threatened not only family resources but also the parent-child relationship. The daily struggle was between children often resisting medication and caregivers needing to find ways for the children to take medication, for instance, by begging, reasoning with, threatening, and forcing them. Conclusions: Despite all formulations having adverse effects, caregivers and children preferred child-friendly formulations due to their ease of preparation and administration. Child-friendly formulations of DR-TB medications should be widely available and be the standard of care in all settings.

Objective: The MEchanick Transculturalization Research and Innovation ConSortium/Bernard Lown Scholars in Cardiovascular Health Program Consensus Conference on Dysglycemia-Based Chronic Disease (DBCD) Transculturalization in Chile convened on November 20, 2023, in Santiago, Chile. The conference generated affirmed and emergent concepts, key strategies, and specific implementation tactics to improve type 2 diabetes (T2D) care in Chile. Findings: Important affirmed concepts included: (1) implementing a comprehensive approach to T2D management beyond glycemic control; (2) addressing unique challenges for early detection and treatment of T2D; and (3) applying expanded roles of telemedicine. Important emergent concepts included: (1) adopting transculturalized chronic care models such as DBCD; (2) recognizing prediabetes as a critical DBCD target to prevent T2D and T2D complications, especially cardiovascular disease; and (3) implementation of the DBCD model for individual and population health. Key strategies included: (1) validation of culturally adapted T2D risk assessment tools; (2) integration of social determinants of health (SDOH) and ethnocultural factors into DBCD care strategies/tactics; and (3) promotion of equity in healthcare access for all people comprising diverse populations. Finally, specific implementation tactics included: (1) focusing on patient-centered public policies; (2) ensuring access to effective treatments; and (3) using culturally relevant resources for education and prevention. When coordinated, these strategies and tactics mitigate DBCD progression, thereby enhancing healthcare outcomes. Conclusions and recommendations: Expert consensus emphasizes the need for a comprehensive approach to T2D management in Chile, leveraging transculturalized lifestyle medicine, validated risk assessment tools, SDOH, and patient-centered public policies. This process should begin with incorporating eHealth technologies, validation studies, and then translation into clinical practice guidelines. As this templated methodology is applied to other regions of the world, the resulting compendium of concepts, strategies, and tactics can foment a more effective preventive health culture and optimize DBCD care across the ethnocultural spectrum.

Post-intensive care syndrome (PICS) involves cognitive, psychological, and physical impairments after ICU hospitalization. While extensively studied in general ICU populations, its impact on cardiac patients remains underexplored. This study examined the prevalence and severity of PICS-related symptoms among cardiac patients 2-4 weeks after ICU discharge and explored correlations with selected demographic and clinical factors. A cross-sectional correlational study was conducted with 100 post-ICU cardiac patients, assessed 2-4 weeks after ICU discharge, at a Critical Care Recovery Center (May-June 2024). Data were collected using a structured questionnaire and the Greek-adapted Healthy Aging Brain Care Monitor-Self Report (HABC-M SR). Non-parametric tests and Spearman correlations were applied (p&#x202f;<&#x202f;0.05). Clinically relevant PICS symptoms were identified in 68% of participants. The mean total HABC-M SR score was 41.4&#x202f;&#xb1;&#x202f;23.9, indicating moderate to severe symptom burden. Functional and psychological impairments were more prominent than cognitive deficits. Greater symptom burden correlated with older age, lower educational level, and male sex. PICS significantly influences the recovery of cardiac patients, affecting their physical, cognitive, and emotional well-being. Early identification of vulnerable groups is essential. Post-intensive care syndrome was highly prevalent among cardiac patients within the first month following ICU discharge, with functional and psychological impairments more pronounced than cognitive deficits. Older age, lower educational level, and male sex were correlated with greater symptom burden across PICS domains. These findings highlight the multidimensional impact of PICS in cardiac populations and underscore the need for early, structured screening and multidisciplinary follow-up during early recovery to support functional recovery and psychological well-being.

The shift from institutional care to community-based mental health services is critical for improving the outcomes of patients with severe mental illness. This study compared community-based mental health service models in Iran with those in Canada, Australia, Italy, Turkey, and South Korea to identify the best practices for improving mental health care in Iran. This descriptive-comparative study examined nine dimensions: policies and strategies, legal frameworks, service models, financing, workforce development, psychosocial interventions, information systems, civil society engagement, and research. Data were collected through a literature review of national and international databases. The findings revealed robust community-based strategies that demonstrated effective service delivery and integration practices in Canada, Australia, and Italy. In contrast, community mental health services in Iran are still developing and facing challenges such as limited resources, workforce shortages, and implementation barriers. To achieve effective community-based mental healthcare, Iran needs to strengthen its policies, increase funding, and develop its workforce. This study highlights the importance of adapting successful approaches from the countries reviewed, while addressing local challenges, improving mental health outcomes, and reducing stigma.

Helicobacter pylori (H. pylori) is one of the most common chronic infections worldwide and a primary cause of peptic ulcer disease and gastric cancer. Increasing antibiotic resistance has made eradication more difficult, emphasizing the need for new strategies. This narrative review summarizes the current evidence on H. pylori eradication, focusing on epidemiology, resistance, treatment regimens, adjunctive therapies, cancer prevention, and extra-gastric outcomes. We conducted a narrative literature search to identify current evidence on strategies for eradicating H. pylori. Both first-line and salvage regimens were considered, as well as adjunctive and novel approaches. The evidence was organized thematically. Over half of the world's population is infected with H. pylori, with the highest prevalence observed in Africa, South America, and Asia. Clarithromycin resistance exceeds 15%-20% in most regions, which diminishes the effectiveness of standard triple therapy. Current recommendations for first-line treatments in areas with high resistance include bismuth quadruple and concomitant regimens, which achieve eradication rates above 85%. Vonoprazan-based and high-dose dual therapies also show promise as alternative options. For second-line therapy, levofloxacin- and bismuth-based regimens remain effective, while rifabutin and susceptibility-guided approaches offer salvage options. Additionally, probiotics and N-acetylcysteine have been found to improve eradication rates and treatment tolerability. Successful eradication reduces the risk of gastric cancer, particularly in East Asia, and provides benefits for extra-gastric conditions such as iron deficiency anemia, idiopathic thrombocytopenic purpura, and pregnancy-related complications. Eradicating H. pylori is crucial for preventing gastric cancer and enhancing gastrointestinal and systemic health. Achieving success necessitates adapting treatment to resistance patterns, employing adjunctive strategies, using molecular antimicrobial sensitivity testing, and implementing eradication programs in areas with high prevalence.

The use of time-lapse electrical resistivity tomography (ERT) in environmental studies has increased considerably in recent years. This method serves to produce 2D or 3D images of the subsurface's electrical properties, making it possible to monitor the evolution of hydrologic or biogeochemical processes over time. However, the high cost and limited flexibility of commercial equipment has restricted its accessibility. OhmPi addresses these issues by offering a cost-effective, open hardware resistivity meter designed for laboratory and mid-scale field monitoring experiments. Since its launch in 2020, OhmPi has evolved significantly in response to user requirements. The latest version, OhmPi v2024, features a redesigned architecture with a new multiplexer and an upgraded measurement board. This improves performance and accuracy while maintaining affordability, with a price tag of under &#x20ac;1500 for 16 electrodes. The software has been completely redesigned to offer advanced features such as remote control via a graphical interface, and an integrated web server with MQTT protocol for network integration, ensuring flexibility and ease of use. Backward compatibility has been maintained to ensure a seamless transition for existing users. Extensive testing with ground analogue circuits and small-scale field experiments has confirmed OhmPi 's improved sensitivity, stability and robustness. These upgrades further establish OhmPi 's position as a reliable and adaptable tool for environmental ERT applications, providing an affordable alternative to commercial systems without compromising on quality.

Adapting the American Academy of Sleep Medicine (AASM) Guidelines for restless legs syndrome (RLS) to Latin America is a complex challenge, given the region's 33 countries and vast socioeconomic diversity. Such an endeavor requires comprehensive data and consensus from a broader representation of these populations. There is a need to assess the effect of social vulnerability on the prevalence of symptoms of periodic leg movements that may be erroneously called RLS and mimic the primary nosological diagnosis for itself. We aim to discuss the Asociaci&#xf3;n Lationoamericana de Sue&#xf1;o's (Latin American Sleep Association, ALADS, in Spanish) position statement to contextualize the 2025 AASM clinical practice guidelines for the treatment of RLS and periodic limb movement disorder. Their intention of advocating for future systematic studies employing standardized criteria in Latin America. While the Scientific Committee for Sleep Disorders of the Brazilian Academy of Neurology partially endorses those opinions, offering some counterpoints concerning, especially, the following issues: 1) challenges to the reportedly wide variability in Latin American RLS prevalence, with apparently very high prevalences exceeding the expected values in some locations; 2) the importance of complementing clinical history with structured RLS diagnostic questionnaires; and 3) amendments to the proposed summary of treatment recommendations, particularly regarding Iron supplementation. Finally, the presence of comorbidities and RLS in epidemiological studies must be considered and data from Latin America can contribute to the discussion on global criteria applied worldwide for RLS that need to be revised according to regional, social, and cultural issues.

Religion and spirituality play an important role in shaping attitudes, beliefs, social norms, and preventive behaviors related to Human Immunodeficiency Virus (HIV) prevention across diverse populations and cultural settings. This study aimed to synthesize the existing evidence regarding the effectiveness of faith-based interventions in influencing HIV preventive behaviors, examine how religious and spiritual factors contribute to stigma and community norm formation, and explore the mediating roles of gender, age, and psychosocial determinants. A systematic literature review integrated with bibliometric network analysis was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework. A structured search was performed in the Scopus database on 06 September 2025 using predefined Boolean strategies across titles, abstracts, and keywords. Bibliometric analysis of 438 publications was carried out using VOSviewer, OpenRefine, Tableau, and R Studio to identify publication trends, collaboration networks, thematic evolution, and institutional contributions. After screening and eligibility assessment, 48 empirical studies were included in the final review. The findings indicated that faith-based interventions generally demonstrated positive but heterogeneous effects on HIV preventive behaviors, particularly in improving condom use, promoting HIV awareness, and delaying sexual debut. Religious leaders' endorsement, theological framing, and faith-community social capital emerged as major pathways influencing stigma, discrimination, and social norms related to HIV prevention. Gender mediated intervention outcomes through masculinity and femininity norms, whereas age influenced prevention behaviors through peer interaction, parental influence, and professional socialization. Psychosocial mediators included stigma perception, self-efficacy, leadership authority, doctrinal orientation, and social support networks. Overall, religion and spirituality functioned as both facilitators and barriers depending on the sociocultural and theological context. The findings highlight the importance of multilevel and culturally adaptive HIV prevention strategies that actively engage faith communities, reduce stigma, and utilize digital platforms to improve intervention scalability and public health impact.

Reliable confidence estimation is essential for surgical visual question answering because overconfident errors may compromise clinical decision support in high-risk settings. However, existing methods typically model predictive uncertainty as a single global quantity, which fails to capture the hierarchical uncertainty arising from ambiguous objects, uncertain tool-tissue interactions, and complex scene context. To address this limitation, we propose a scene graph-guided framework that decomposes uncertainty into object-level, relation-level, and scene-level components and adaptively fuses them for confidence-aware surgical visual question answering. The framework further incorporates Dirichlet-based calibration to improve probabilistic quality and support selective answering. Experiments on the Surgical Scene Graph-Question Answering (SSG-QA) benchmark show that the proposed method achieves an overall accuracy of 63.58%, an Expected Calibration Error of 16.97%, and a Risk-Coverage AUC of 0.0861. Our SG-UD framework achieves competitive calibration performance, significantly improving Brier Score and NLL over baselines, while providing more granular uncertainty interpretability. Performance improves across all question types, with the largest gain observed for relation-type questions (+0.92% over MCAN). Ablation studies further show that uncertainty decomposition contributes most to answer accuracy (+0.70%), whereas Dirichlet calibration is critical for improving probabilistic quality. These findings indicate that explicitly modeling uncertainty across semantic levels can enhance the reliability and interpretability of surgical visual question answering and provide fine-grained confidence information for safer artificial intelligence-assisted surgical decision support.

Numerous ecologists have recently affirmed the vital role of field-based natural history for maintaining first-hand experience and knowledge of nature. These accounts are problematic, however, because they equate natural history with scientific study and assume a relatively stable Holocene context. The Anthropocene jettisons these and other assumptions about who naturalists are, the context in which they operate, and what they bring to society. In response, we synthesize and extend prior arguments to propose six ways for naturalists to adapt to an Anthropocene context: expanding the nature studied; questioning assumptions about data collection; consciously engaging with emotions; ensuring justice, equity, and diversity; critically navigating new technologies; and enlarging the ethical envelope. Through these practices, a sizable community of naturalists may emerge with a distinctive role in drawing attention to nature in peril.

Cold water immersion (CWI) and hot water immersion (HWI) are widely used recovery strategies in sports, yet their comparative efficacy remains unclear. This systematic review evaluates the effects of post-exercise CWI and HWI on performance recovery and physiological markers in athletes. Following PRISMA guidelines, a systematic search of Scopus, Web of Science, PubMed, and other databases was conducted up to December 2024. Randomized controlled trials and crossover studies comparing CWI, HWI, and control conditions in athletes or physically active individuals were included. Outcomes included perceptual recovery (DOMS, fatigue), biochemical markers (CK, cytokines), hormonal responses, and performance metrics. Eight studies were included. Neither CWI nor HWI consistently reduced DOMS or improved perceived recovery compared to control. However, HWI significantly improved sleep quality and acute anaerobic power, while CWI impaired immediate power output. Biochemically, chronic HWI reduced CK and increased testosterone, whereas CWI elevated HSP-72. Hormonal and inflammatory responses were modest, with no significant changes in cortisol or testosterone to cortisol ratio. The effects of water immersion are temperature and context dependent. HWI may benefit sleep and anaerobic performance, while CWI may hinder immediate power and induce cellular stress adaptations. Recovery strategy selection should align with specific athletic goals. https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD420251156387, CRD420251156387.

In preclinical research, agar-based tissue-mimicking phantoms have proven to be valuable tools for magnetic resonance imaging (MRI)-guided focused ultrasound (MRgFUS) evaluations. This study evaluates an agar-based silica-doped phantom for MRgFUS, examining main properties, MRI appearance, and thermal lesion formation in comparison with excised porcine tissue. The proposed agar/silica phantom was subjected to various single and grid sonication protocols in a 3T MRI scanner, with thermal effects monitored intraprocedurally through magnetic resonance thermometry and postsonication through T2-Weighted (T2-W) Turbo Spin Echo (TSE) imaging. The accuracy of lesion formation according to planned patterns and lesion visibility on T2-W TSE images were assessed. To establish the lesion detection threshold, phantom exposure was gradually increased, with identical sonication protocols repeated to assess repeatability. Grid sonications were also conducted on excised porcine tissue for comparison. The phantom facilitated lesion formation across various patterns and depths without significant shifting effects, exhibiting lesions with excellent contrast on T2-W images and adaptability to variations in power and pulse duration settings. In contrast, excised tissue exhibited abnormal temperature fluctuations during grid sonications and lesion shifting. The minimum focal temperature required to generate a measurable lesion on T2-W images was 39&#xb0;C (thermal dose threshold of 1.49 &#xd7; 10-4 CEM43&#xb0;C), with lesion sizes increasing proportionally to energy levels. A comparison of thermal profiling in repeated sonications demonstrated good repeatability. This study confirms that the agar/silica phantom provides a reliable, reproducible platform for MRgFUS assessment, improving lesion visualization, and calibration for preclinical studies.