To use Google Trends to study whether public interest in meniscus surgery has increased during the last 15 years and after the COVID-19 pandemic, and to determine what specific topics regarding meniscus surgery the public is interested in. A longitudinal observational study was conducted between January 2010 and December 2024 on public interest in meniscus surgery utilizing Google Trends. Through establishing a focus group comprising two attending orthopaedic surgeons (sports-medicine fellowship trained), one orthopaedic surgery resident, and three medical students, and using ChatGPT, the 50 most commonly searched questions regarding meniscus surgery were identified. The mean relative search volume (RSV) was identified and compared for 50 search terms. RSV extends from 0 to 100, with 0 representing no public interest, and 100 representing maximal public interest. Analysis of variance tests compared means. Statistical significance was set at a P value less than .05. Between 2010 and 2024, the mean RSV for "meniscus surgery" increased significantly (2010: 40; 2024: 89; P < .001), after a transient decline during the COVID-19 pandemic. Among 50 topics regarding meniscus surgery, "recovery" and "pain" had the highest mean RSVs, while other topics including "arthroscopic meniscus surgery", "cost", "how long does meniscus surgery take", "therapy", "brace", "rehab", "swelling", and "arthritis" were also commonly searched (60 vs 25 vs 15 vs 9 vs 9 vs 6 vs 6 vs 5 vs 4 vs 2; P < .001). Patient interest in meniscus surgery has increased significantly during the past 15 years, and rebounded after the COVID-19 pandemic. Patients have interest in many topics regarding meniscus surgery, including recovery, pain, surgical length, cost, postoperative therapy, braces, and post-traumatic arthritis. This study showed that public interest in meniscus surgery has increased significantly in the last 15 years, and the various topics that are important to patients, as identified in this study, should be included in patient education materials.
Artificial intelligence (AI) possesses the transformative potential to reshape pediatric medicine, offering powerful tools for diagnosis, prognosis, and personalized therapy. This review focuses on three domains selected for their relative maturity in AI development and proximity to clinical translation-pediatric critical care, perinatal and neonatal medicine, and precision oncology-evaluating current evidence for clinical utility and outlining challenges to implementation. AI is demonstrating significant potential across these domains: in critical care, deep learning models outperform traditional scoring systems for dynamic prediction of adverse events; in perinatal and neonatal medicine, AI enhances prenatal ultrasonography and integrates multiomics data to guide complex therapies; and in oncology, radiomics, and genomic analysis enable non-invasive tumor characterization and personalized treatment strategies. However, significant hurdles remain. Foundational data challenges-including scarcity, heterogeneity, and limited sharing of pediatric data-are being addressed through transfer learning, federated learning, and synthetic data generation. Clinical translation is further impeded by algorithmic bias, the 'black box' problem, and the unique developmental physiology of children, which demands age-specific model validation. Future progress depends on multi-institutional collaboration, a research focus that extends beyond prediction to encompass causal inference and explainability, and the establishment of robust ethical, regulatory, and economic frameworks. Ultimately, responsible implementation of AI in pediatrics requires building systems that are not merely accurate but transparent, equitable, and trustworthy.
This article proposes an integrative map of mind designed to support whole-person, well-being coaching. It extends the author's 2013 hypothesis published in this journal, "Coaching the Multiplicity of Mind: A Strengths-Based Model," by aligning the author's nine science-informed capacities with Hartman's axiology, which describes three dimensions of value (Intrinsic, Extrinsic, and Systemic) and their 3×3=9 matrix of pairings. The nine pairings, referred to as nine value positions in this paper, are aligned with Self-Determination Theory, the Enneagram, Jung's cognitive functions, and the Big Five Ten Aspect personality traits. They are further organized into three functional bands (identity, stabilizing, and growth) with Confidence as the center, reflecting integration and wholeness. The nine value positions are recognizable as distinct ways people orient to experience through valuing, motivation, and attention, while remaining fluid, contextual, and interconnected in action. Organized into a map, they help coaches recognize which orientations are active, which are underrepresented, and where tensions between positions may call for self-awareness and integration. The integrative map is offered as a working hypothesis: a shared set of value positions that can align psychological frameworks commonly applied in coaching as a set of dimensions of each of the shared value positions. The map may allow coaches to (1) work from one map rather than holding many constructs and frameworks in parallel, (2) recognize which orientations a client is engaging and which are underrepresented, (3) approach tensions as integration opportunities.
NLRP12, a member of the NOD-like receptor family, has traditionally been regarded as an inflammasome-associated regulator of inflammatory signaling. However, accumulating evidence indicates that its role in cancer extends far beyond classical inflammasome biology. Recent studies show that NLRP12 exerts highly context-dependent functions across malignancies, acting as either a tumor suppressor or a tumor promoter depending on tumor type, cellular source, and dominant signaling environment. In inflammation-associated and epithelial malignancies such as colorectal cancer, hepatocellular carcinoma, and triple-negative breast cancer, NLRP12 suppresses tumor progression by restraining noncanonical NF-κB, Wnt/β-catenin, JNK, or canonical NF-κB signaling. In contrast, in gastric cancer, ovarian cancer, glioma, and macrophage-rich tumor ecosystems, NLRP12 has been linked to glycolytic remodeling, lactate-associated epigenetic adaptation, aggressive clinicopathological features, and immune suppression. Mechanistically, NLRP12 has emerged as a multifunctional signaling regulator that connects inflammatory control with oncogenic pathway modulation, metabolic rewiring, tumor-associated macrophage polarization, and PANoptosis-related stress responses. These findings position NLRP12 at the crossroads of tumor progression, immunity, metabolism, and inflammatory cell death. In this review, we summarize the molecular and functional landscape of NLRP12 in cancer, with emphasis on its dual roles in tumor biology, its context-specific mechanisms, and its potential clinical relevance as a biomarker and therapeutic reference point. A deeper cell-resolved and mechanism-oriented understanding of NLRP12 may help redefine this molecule from a conventional innate immune regulator to a context-dependent organizer of tumor ecosystems.
According to objectification theory, self-objectification adversely affects women's cognitive performance, leading to cognitive inhibition. However, results are inconsistent, and few studies have explored mechanisms and protective factors of cognitive inhibition. This study adopted a numerical Stroop paradigm with varying interference levels to investigate self-objectification's effect on women's cognitive inhibition, and highlights the role of interference level in understanding the effects of self-objectification on cognitive inhibition, revealing that self-objectification impaired cognitive performance primarily under the high-interference level. It also identifies appearance anxiety as a key mediator and self-compassion as a protective factor. By demonstrating that the effect of self-objectification on cognitive inhibition depends on interference level, this study resolves inconsistencies in previous research and extends objectification theory by identifying high cognitive load as a critical boundary condition and revealing self-compassion as a protective factor. These findings inform interventions to reduce self-objectification's cognitive impairment, particularly in high-demand tasks affecting women's performance.
To use Google Trends to assess whether interest in rotator cuff repair (RCR) has increased over the last 15 years and to identify the most frequently searched topics related to RCR. A retrospective longitudinal study was conducted on public interest in RCR using Google Trends. While using a focus group comprised of 2 sports-medicine fellowship-trained orthopaedic surgeons, 1 orthopaedic surgery resident, 3 medical students, and supplementing with ChatGPT, the 50 most commonly searched topics perioperatively regarding RCR were identified. The mean relative search volume (RSV) was obtained and compared for all 50 topics. Regarding RSV, which extends from 0 to 100, 0 represents no public interest, whereas 100 represents maximal public interest. Inclusion criteria for search topics included Google search terms concerning RCR which had a mean RSV available between January 2010 and December 2024. Analysis of variance tests were used to compare means. Statistical significance was set at a P value less than .05. Between January 2010 and December 2024, the mean RSV for "rotator cuff surgery" significantly increased (2010: 51; 2024: 90; P < .001), representing growing patient interest in rotator cuff surgery. Among the 50 perioperative topics, "recovery" and "pain" had significantly higher mean RSVs than other topics, whereas "sling," "therapy," "cost," "how long does rotator cuff surgery take," "arthroscopic surgery," "sleep," "rehab," and "healing" were also among the top ten topics with the highest mean RSV (79; 51; 20; 18; 14; 13; 9; 8; 7; 4; P < .001). Google searches for RCR have increased significantly during the past 15 years. Pain and recovery after RCR were the most frequently searched topics. This study investigates the public interest in RCR as indicated by Google search data. The level of interest has increased during the past 15 years, and the topics identified in this study should be included in patient education materials.
BRCA1-associated protein 1 (BAP1) is a deubiquitinase (DUB) localized in both the nucleus and cytoplasm and is widely recognized as a tumor suppressor. Germline and somatic alterations in BAP1 have been strongly associated with increased susceptibility to diverse cancer types and with adverse clinical outcomes. Although BAP1 is best known for its role in epigenetic regulation, particularly through the modulation of histone H2A monoubiquitination (H2Aub) and gene transcription, accumulating evidence suggests that its functional repertoire extends well beyond these canonical activities. BAP1 is increasingly viewed as a central molecular hub through which fundamental cellular processes are integrated and coordinated via its catalytic activity and dynamic protein interaction networks. In this review, the pleiotropic functions of BAP1 are systematically examined across several biological dimensions, including epigenetic regulation, genomic stability, cellular metabolism, and cell fate determination. Notably, BAP1-mediated regulation is highly context dependent, as cell type, differentiation status and tumor microenvironmental (TME) cues may shape its downstream effects and contribute to heterogeneous biological outcomes. By synthesizing these multidimensional regulatory mechanisms, this review provides an integrated overview of the molecular features and functional roles of BAP1, with particular emphasis on its impacts on the regulation of cell death including apoptosis, ferroptosis and disulfidptosis. Collectively, these insights underscore the evolving understanding of BAP1 biology over the past decade and highlight the need for renewed attention to this critical tumor suppressor and its therapeutic potential in cancer.
Parkinson's disease (PD) is characterized by progressive motor impairment and large-scale network dysfunction that extends beyond dopaminergic degeneration. Although rehabilitative exercise improves clinical outcomes, its capacity to induce structural brain plasticity remains incompletely understood. Here, we tested the hypothesis that forced (high-intensity) upper-limb exercise induces white matter microstructural remodeling in PD. Twenty-three patients with idiopathic PD (mean age 69.1 ± 6.5 years) were allocated to a forced exercise group (FE; n = 13) or a voluntary exercise group (VE; n = 10) and underwent an 8-week supervised upper-limb training protocol. Groups were matched for age, sex, and clinical severity. Assessment included diffusion tensor imaging (DTI) of cerebellar and thalamocortical tracts, computerized dynamic posturography (CDP), the motor section of the Unified Parkinson's Disease Rating Scale (UPDRS-III) and the Hoehn and Yahr scale. Significant Group  ×  Time interactions were identified in the inferior cerebellar peduncle mean diffusivity (MD), Axial Diffusivity, Radial Diffusivity (RD); all p < 0.001 and middle cerebellar peduncle (MDP) p = 0.021), confirming that microstructural changes were significantly larger in the FE group. Results for the anterior corticothalamic radiation represent exploratory trends (p ≈ 0.06 for the interaction) and should be interpreted with caution. Findings were accompanied by significant improvements in postural stability in the FE group. These findings identify exercise-induced plasticity within distributed motor-vestibular networks, supporting a systems-level compensatory mechanism. Our results provide in vivo evidence that targeted rehabilitation can reshape structural connectivity in PD, with implications for developing disease-modifying interventions.
Multienzyme cascades are emerging as alternatives to fermentation for converting biogenic feedstocks into value-added chemicals and fuels. A major bottleneck in redox transformations is the loss of costly and unstable cofactors in continuous-flow systems, typically necessitating co-immobilization and complex regeneration schemes. Self-sufficient biocatalytic nanomachines, created by fusing enzymes with tethered cofactors, offer a streamlined solution by enabling intramolecular cofactor retention and recycling. Here, we demonstrate that such nanomachines can be integrated into a complete redox-dependent cascade, exemplified by a 10-step glucose-to-isobutanol pathway. Oxidoreductases were fused into redox pairs using peptide linkers containing a single cysteine for covalent attachment of polyethylene glycol (PEG)-modified nicotinamide cofactors, with rational selection of monomeric enzymes ensuring structural compatibility and soluble expression. The resulting nanomachines remained catalytically competent and produced isobutanol in both batch and continuous-flow operation without the addition of free NAD+. A total turnover number of ∼1.4 × 104 was achieved for tethered PEG-NAD+, among the highest reported for immobilized nicotinamide cofactors. Use of the ultrastable analogue PEG-cNAD+ further demonstrates the modularity of the platform. Together, these results establish a proof-of-concept for cofactor-autonomous multienzyme redox cascades in continuous flow and define design principles for future cell-free synthesis systems.
Background: Poorly differentiated thyroid carcinoma (PDTC) is a rare, aggressive malignancy. Cardiac metastasis from PDTC is exceedingly uncommon. We report early cardiac metastasis occurring shortly after radical thyroidectomy to highlight atypical distant spread and management challenges. Case Description: A 62-year-old woman presented four months after thyroidectomy with progressive exertional dyspnoea, fatigue, productive cough, facial oedema, lip cyanosis, and dizziness. Postoperative pathology showed poorly differentiated thyroid carcinoma of the right lobe and isthmus (pT2N1bM0) with capsular and recurrent laryngeal nerve invasion. Transthoracic echocardiography revealed a right atrial mass that enlarged to 5.3 × 4.0 cm and extended toward the tricuspid orifice; imaging also demonstrated continuous tumor thrombus involving the right internal jugular vein, brachiocephalic vein, and superior vena cava. Cytology from internal jugular vein puncture showed malignant cells, supporting metastatic intraluminal tumor thrombus with intracardiac extension. After surgery, levothyroxine was initiated as thyroid hormone replacement and for gradual thyroid-stimulating hormone (TSH) suppression as tolerated. During cardiology admission, the patient received antimicrobial therapy, anticoagulation, thrombolysis, and cardiac workload reduction, with symptomatic improvement. She was discharged against medical advice before definitive oncologic treatment could be initiated and was subsequently lost to follow-up. Conclusions: In aggressive thyroid cancers such as PDTC, clinicians should remain vigilant for atypical distant metastases-including intracardiac extension via venous tumor thrombus-soon after surgery. Early multimodality imaging and coordinated multidisciplinary care are essential for individualized management.
BackgroundFollowing Hurricane Helene, our rural level 1 trauma center in Eastern Tennessee managed a sharp rise in tree-related injuries. We sought to determine whether post-disaster patients required greater inpatient resources than patients injured under baseline conditions, independent of presenting injury severity.MethodsThis IRB-approved (#0125.12) retrospective study identified adult patients with tree-related injuries from our trauma registry using ICD-10 E codes. We compared a pre-Helene cohort (January 2018-September 26, 2024; n = 176) to a post-Helene cohort (September 27-December 2024; n = 25). Outcomes included ICU admission, ICU length of stay, mechanical ventilation, operative intervention, and discharge disposition.ResultsPost-Helene patients required significantly more intensive care despite presenting with similar injury severity scores and initial physiologic parameters. Mechanical ventilation was needed in 24% of post-Helene patients vs 9.1% pre-Helene (OR 3.16, 95% CI: 1.10-9.04, P = 0.025). ICU length of stay was longer post-Helene (6 days [IQR 3-16] vs 3 days [IQR 2-7], P = 0.036). Discharge to extended care facilities was more frequent (36% vs 15.9%, OR 2.97, 95% CI: 1.20-7.39, P = 0.015). Post-Helene patients also carried a substantially higher burden of cardiopulmonary and renal comorbidities.ConclusionIn a rural disaster setting, tree-related trauma patients placed greater demands on critical care, ventilator, and post-acute resources than their initial presentations predicted. Hospital preparedness plans for rural level 1 trauma centers must account for this gap between triage acuity and downstream resource utilization.
This analysis was conducted to assess the risk of anemia in schizophrenia patients during long-term treatment with the glycine transporter-1 (GlyT1) inhibitor iclepertin. A population pharmacokinetic-pharmacodynamic (popPKPD) analysis to characterize the impact of iclepertin exposure on hemoglobin levels was performed using a sequential nonlinear mixed effects modeling approach. The effects of patient characteristics were investigated in a covariate analysis to identify vulnerable patient subgroups, and population simulations were conducted to evaluate different treatment scenarios. Simulations predicted a new, decreased hemoglobin steady state under chronic iclepertin treatment, reached after approximately 120 days. For a typical patient, the intended therapeutic dose of 10 mg iclepertin daily led to a 2% decrease of hemoglobin levels. In a potential extreme scenario of iclepertin exposure fivefold higher than the average exposure following a 10 mg dose (e.g., due to co-administration of a strong CYP3A4 inhibitor), a 7.6% decrease of hemoglobin levels was found. In both scenarios more than 97.5% of the virtual patients stayed above the drug discontinuation safety threshold of 100 g/L hemoglobin (Phase III trial drug discontinuation threshold defined by the patient safety team). Sex, race, age, body mass index and alanine transaminase levels were found to correlate with changes in hemoglobin levels. No correlation with kidney function could be identified. None of the investigated covariate effects were strong enough to raise any safety concerns during chronic treatment with 10 mg iclepertin daily. This work provides a generalizable modeling and simulation framework to assess the anemia risk in patients and vulnerable patient subgroups during chronic iclepertin treatment. The results of this analysis suggest that iclepertin drug effects on patient hemoglobin levels are small, reversible, and of limited significance, even under long-term treatment. This is the first model of the relationship between iclepertin exposure and hemoglobin levels, and, to our best knowledge, the first model to characterize a drug effect on hemoglobin levels over time that has been validated with clinical data that extend beyond the erythrocyte life span of ∼126 days.
Granular cell tumor (GCT) is a benign Schwannian neoplasm that only exceptionally arises in the pancreas. Because of its infiltrative growth pattern, pancreatic GCT may radiologically mimic pancreatic ductal adenocarcinoma (PDAC). A 38-year-old woman with Birt-Hogg-Dubé syndrome underwent magnetic resonance imaging as part of surveillance and was found to have an enhancing lesion causing ductal stricture at the junction of the pancreatic corpus and cauda. Computed tomography raised a strong suspicion of pancreatic ductal adenocarcinoma. The patient underwent distal pancreatectomy. Histologic examination revealed a 12-mm poorly circumscribed infiltrative tumor composed of sheets and nests of polygonal cells with abundant eosinophilic granular cytoplasm and small uniform nuclei. It extended along interlobular septa and encased small pancreatic ducts, providing a morphologic correlate for the ductal stricture seen on imaging. Periodic acid-Schiff with diastase (PAS-D) stain demonstrated diffuse intracytoplasmic diastase-resistant granules. Tumor cells showed diffuse expression of S100 protein, SOX10 and inhibin A, while neuroendocrine markers were negative. The findings were consistent with a granular cell tumor. Pancreatic granular cell tumor is a rare benign lesion that may present with imaging findings highly suspicious for PDAC. Its infiltrative growth pattern may closely mimic carcinoma on imaging and may lead to surgical resection for presumed malignancy. To our knowledge, pancreatic granular cell tumor has not previously been reported in association with Birt-Hogg-Dubé syndrome; whether this represents a coincidental finding remains uncertain.
Malignant gastrointestinal neuroectodermal tumor (GNET) is a rare and aggressive neoplasm that is characterized by EWSR1 rearrangements. Most patients present with metastatic disease. There are no established treatment guidelines, and systemic therapy options remain poorly defined. A woman in her late 30s presented initially with right upper quadrant pain and bloating. Endoscopic biopsy of a duodenal mass revealed a SOX10-positive malignant neoplasm. Molecular testing identified an EWSR1:CREB1 fusion, confirming GNET. Initial treatment with ipilimumab and nivolumab resulted in disease progression. Subsequent therapies included a selective interleukin-2 agonist clinical trial, nivolumab/relatlimab, and temozolomide, all associated with continued progression. Cabozantinib was initiated after further radiographic progression. Follow-up imaging demonstrated tumor regression, and the patient maintained stable disease for 15 months before mild progression. Metastatic GNET has a poor prognosis and lacks standardized systemic therapy. This case demonstrates durable disease stabilization with cabozantinib after progression on immunotherapy and chemotherapy. Tyrosine kinase inhibition may represent a promising therapeutic strategy in GNET and warrants further investigation. Malignant gastrointestinal neuroectodermal tumor (GNET) is a very rare and aggressive cancer. Due to the small number of cases that have been reported, there is no established standard of treatment. Patients are often treated with therapies used for other cancers, but the benefits of these treatments are not well known. In this report, we describe an adult patient with GNET who was treated with cabozantinib. Cabozantinib is a targeted therapy, so it blocks specific signals from the cancer cell. After starting treatment with cabozantinib, the patient’s cancer stopped growing for an extended period of time. This case suggests that cabozantinib may help control tumor growth in some patients with GNET. However, more research and additional patient cases are needed to better understand how effective this treatment may be.
Hereditary breast and ovarian cancer (HBOC) syndromes, responsible for 5%-10% of all breast and ovarian cancers in the general population, are largely associated with pathogenic variants of the BRCA1 and BRCA2 genes. Yet, the role of other cancer susceptibility genes highlights the genetic etiology of HBOC as complex, thus requiring thorough investigation beyond these main mutations, highlighting a need for a comprehensive genetic assessment in disease management strategies. In India, advances in genetic research and clinical management have significantly impacted the knowledge of HBOC. A definitive prevalence of BRCA1/2 mutations among Indian populations has catalyzed the adoption of genetic counseling for precision diagnosis and treatment strategies in recent times, with collateral support extended from communities among oncologists, geneticists, and reproductive medicine specialists. The integration of next-generation sequencing and multiplex gene panels creates a platform for identifying high-risk subjects, leading to individualized care pathways and enhanced disease management plans. These programs have increased access to essential services such as genetic counseling, multidisciplinary management, and fertility preservation to provide holistic care to HBOC patients. Future efforts should explore further the genetic heterogeneity of HBOC in Indian populations. There needs to be wider access to genetic testing and counseling services, and the implementation of strong, ethical policy guidelines for equitable use of genetic information. Through the creation of innovative, collaborative methods, these measures have tremendous potential to improve patient care, early detection, and outcomes for individuals affected by HBOC in India.
Microprocessor-controlled knees (MPKs) have meaningfully advanced the safety and confidence of many transfemoral prosthesis users, yet a persistent clinical paradox remains: improved device intelligence does not automatically translate into greater everyday activity or full functional recovery. This editorial argues that the value of an advanced prosthetic leg is realized not when the device assumes control on the user's behalf, but when it is coupled with the user's own voluntary control and human-device coordination. Drawing on evidence that objective activity does not consistently increase after MPK provision, that hip strength alone poorly predicts walking and balance, and that attention to the prosthesis increases with use, I propose that rehabilitation should invest in the human control loop as deliberately as in device technology. The microprocessor knee serves here as the representative case for a broader principle that may plausibly extend to microprocessor feet, hip disarticulation components, and powered limbs, though this extension is offered as a hypothesis for future investigation rather than an evidence-based conclusion. My organizing proposition is that, in the age of intelligent prostheses, the human remains the origin of control.
Extended X-ray absorption fine structure (EXAFS) is a widely used technique for atomic structure determination. Fourier transformation connects EXAFS in k space and R space. However, determining the appropriate k-range for the transformation can be challenging, but critical for the first-shell fit. In this study, we present an automatic method to determine the k-range using the Larch package and a Python program. The first step is to estimate spectral noise across a series of k-ranges with a fixed minimum value and identify the optimal maximum value in the k-range (k max ). The k max is determined by an empirical noise threshold that marks the point where the noise level in the Fourier transformed spectrum changes dramatically. Using the obtained k max value, the first shell is modeled to determine the minimum k value (k min ) by optimizing the background function through alignment of the spectrum with theory. The optimal k min corresponds to the point of the minimum R-factor, which quantifies the difference between the experimental and fitted spectrum. Our method was tested on various typical datasets and yielded suitable k-ranges for Fourier transformation and accurate first-shell fits. This approach helps avoid unreliable, irreproducible data analysis, especially for noisy data from diluted samples, and enables robust automatic first-shell EXAFS fitting.
Congenital radioulnar synostosis (CRUS) is an uncommon developmental defect caused by failure of segmentation between the radius and ulna during early embryonic life. Despite its rarity, it is the most prevalent congenital functional abnormality affecting the elbow. Clinical presentation varies widely, ranging from subtle cosmetic concerns to significant restriction of forearm rotation with consequent limitations in activities of daily living. A 4-year-old girl presented with inability to fully extend her left elbow since birth, accompanied by progressively worsening difficulty performing daily tasks involving the affected limb. There was also a history of absent left thumb noted at birth. Plain radiographs of the left forearm demonstrated symmetrical shortening of the radioulnar diaphysis, hypoplasia and posterior dislocation of the radial head, absence of the distal radial epiphysis, and osseous fusion of the proximal radius and ulna. Radiographs of both hands further revealed asymmetry of the left hand with aplasia of the first digit. A 13-year-old girl was evaluated for lifelong inability to extend both elbows, with increasing functional impairment of her forearms during routine activities. Plain radiographs of both forearms showed bilateral, symmetrical osseous fusion of the proximal radius and ulna with posteriorly dislocated radial heads. Additional findings included symmetrical bowing of the radial and ulnar shafts, penciling of the distal ulnar metaphysis, and positive ulnar variance. These cases demonstrate the diverse clinical spectrum of CRUS and emphasize the critical role of radiographic assessment in accurate classification and detection of associated anomalies. Prompt diagnosis and comprehensive functional evaluation are vital for optimal management planning.
This study uses density functional theory (DFT) calculations combined with molecular dynamics (MD) simulations to evaluate the water-splitting performance of the SrTiO3 perovskite improved through synergistic Si and As co-doping. While static DFT calculations capture only a single atomic configuration, MD simulations provide finite-temperature atomic ensembles, enabling realistic assessments of water adsorption, dissociation, and radical-formation processes. Pristine SrTiO3 shows pronounced thermal fluctuations, indicating weak thermal management, likely caused by limited generation of charge carriers and their rapid recombination. In contrast, the Si-doped, As-doped, and especially Si-As co-doped systems achieve faster thermal stabilization, suggesting enhanced charge-carrier dynamics and improved photocatalytic activity. Electronic analysis reveals significant band-gap narrowing in the doped structures due to the introduction of dopant-induced electronic states near the conduction band, increasing charge-carrier mobility. The band-gap trend-pure (2.12 eV) > As-doped (1.47 eV) > Si-As co-doped (1.50 eV) > Si-doped (1.28 eV)-extends absorption toward 570 nm, enabling visible-light-driven photocatalytic activity that is not exhibited by pristine SrTiO3. Overall, Si-As co-doping markedly enhances SrTiO3's water-splitting capability.
Over the past two decades, citizenship discourse has become an important framework within dementia studies, shifting attention from individualised and deficit-oriented understandings of dementia toward the socio-political, legal, institutional, cultural and relational conditions that shape everyday life. This editorial introduces a 2026 special issue on dementia citizenship that explores the growth of this important field of dementia studies since the landmark 2016 special issue on citizenship was published in Dementia: The International Journal of Social Research and Practice. Highlighted in the 2026 special issue are contributions that extend scholarship on agency, participation, embodiment, rights, collaboration and social justice for persons living with dementia across long-term care, community care-collectives, and volunteering among persons living with dementia. Together, the articles demonstrate how citizenship is enacted, constrained, and supported, and how institutional routines, professional practices, interdependence, and recognition shape opportunities for participation and flourishing. Finally, the editorial emphasizes the importance of experiential knowledge in the development and review of this special issue, and in the co-authorship of one of the contributions. Collectively this editorial and the special issue that it introduces aims to stimulate further critical inquiry and practice development to ensure that persons living with dementia have equal opportunities to participate in social life and to flourish.