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Cultural safety requires the ongoing development of critical consciousness, addressing bias and prejudice, redressing power imbalance, committing to transformative change and ensuring that safe practice is determined by recipients of care. This paper presents a review and reflection of learnings, looking back over 2 years of implementing the Cultural Safety Training Plan for Vocational Medicine in Aotearoa. Looking forward, recommendations include the development of resources and assessment activities, training of trainers, broadening the scope of cultural safety, strengthening focus on college-level transformation, ensuring stronger communication and resource sharing across the colleges and continuing and expanding current implementation activities.
Our response to commentaries further clarifies the links between visual postdictive phenomena, conscious experience, reality monitoring, and planning. We also engage with suggestions about the limits and generality of our conclusions for other sensory modalities and visually guided behavior in aquatic organisms. We conclude that the role of sensory horizons in visual consciousness offers powerful constraints on theory and generates novel testable hypotheses for consciousness science.
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Shame serves as a crucial perspective for investigating individual sports withdrawal. Over the past two decades, this research topic has boomed rapidly in the field of social psychology of sport, with scholars conducting systematic explorations on its measurement tools, antecedent variables and action mechanisms. However, existing studies lack a systematic sorting and comprehensive understanding of its process mechanisms. First, this paper combs the research evolution of shame in sport, clarifies its evolutionary trends, and summarizes the limitations of existing measurement scales. Second, it generalizes the influencing factors of shame in sport from the perspectives of behavioral subjects and behavioral environments. Third, it clarifies the double-edged sword effect of shame on individuals in the field of sport and its contingency moderating factors. On this basis, the paper finally discusses the key problems and challenges faced by this research field, and focuses on the future research directions, aiming to theoretically deepen and expand the research content of shame in sport, and provide evidence-based references for improving sports participation and mental health in practice.
Internuclear ophthalmoplegia (INO) is a horizontal gaze disorder caused by medial longitudinal fasciculus lesions. INO of abduction is an exceptionally rare variant characterized by abduction limitation with preserved convergence and contralateral adduction nystagmus, with unclear pathophysiology, and only a limited number of cases have been reported. A 27-year-old man presented with headache, vomiting, seizures, and altered sensorium. Examination revealed bilateral disc edema and abduction restriction of the right eye, with contralateral adduction nystagmus, consistent with INO of abduction. Brain MRI showed no brainstem lesions, while MR venography demonstrated cerebral venous thrombosis of the superior sagittal, left transverse, and sigmoid sinuses. Vitamin B12 deficiency with hyperhomocysteinemia was detected. Treatment with anticoagulation and acetazolamide resulted in complete resolution of the ocular motility deficits. This case highlights a reversible form of INO of abduction associated with raised intracranial pressure in the absence of structural brainstem lesions, likely due to pressure-mediated disruption of inhibitory gaze pathways. INO of abduction is an ultrarare but clinically important sign. Its recognition in patients with intracranial hypertension and normal brainstem imaging may aid in localization and facilitate timely, reversible treatment.
Plants interact with a vast variety of microbes that inhabit both above- and belowground tissues. Through their effect on host physiology and growth, plant-microbe interactions define the success of a plant's life cycle. A key aspect of these interactions is the requirement for highly cell-type-specific responses from the plant, be it to form symbiotic structures in certain cells or to mount a highly localised immune response. There has been long-standing interest in uncovering the cell-specific transcriptomic changes that underpin these processes to better understand the establishment, functioning, and regulation of plant-microbe interactions. The recent optimisation of single-cell and spatial transcriptomics for plants now allows us to investigate these interactions in unprecedented detail. Here, we discuss how single-cell technologies can help unravel the many mysteries of plant-microbe interactions. We focus on the key lessons we have learned from recent single-cell studies in the field and highlight the current limitations of single-cell technologies. We also offer promising avenues for future exploration and conclude by suggesting experimental and bioinformatic considerations to maximise insights from past and future studies and help make the most of this new single-cell era in the field of plant-microbe interactions.
Forest management in North American montane and boreal biomes is facing multiple challenges, including climate change, wildfires and pest outbreaks. Mountain pine beetle (MPB, Dendroctonus ponderosae) is a notable example of a major threat to forest health in western North America whose impacts are compounded by warmer winters, which allowed it to establish further north and east of its historical distributional range. In western Canada, delimiting surveys and control of range-expanding MPB populations are managed through collaborative intergovernmental initiatives. While this approach has been shown to effectively slow MPB spread, these management efforts were planned without assessments of the long-term impacts of survey and control decisions on future rates of MPB spread. Here, we compared the current approach to managing MPB populations driven by recent detections and short-term forecasts against an optimisation-assisted approach that finds a MPB management strategy by factoring in the long-term impacts of survey and management decisions on future spread. We also evaluated a reduced-complexity approach where MPB spread forecasts are factored into decisions without tracking the long-term impacts from future management actions. We found that strategic long-term management could help reduce the future MPB-infested area by 65%-112% compared to the current short-term management strategy. Also, the reduced-complexity approach helped reduce the MPB-invaded area by 16%-77% compared to the conventional short-sighted approach. These results demonstrate the substantial benefits of incorporating longer-term pest spread forecasts and feedback from future management decisions into spatial prioritisations of MPB management efforts.
In airborne sensing applications, radar forward-looking imaging is a crucial technology for high-resolution ground mapping and terrain perception. Super-resolution deconvolution is key to overcoming the real-beam resolution limits of these airborne sensors. However, when utilizing phased array scanning radars for wide-swath ground mapping, the antenna pattern exhibits severe spatial variation at large scanning angles, which directly leads to model mismatch and degradation in super-resolution performance. To address this hardware-induced sensing limitation, this paper proposes a sparse super-resolution method tailored for forward-looking phased array scanning radar. Firstly, the causes of the spatial variation in antenna pattern are analyzed, and a modified antenna convolution matrix is derived to accurately model the scanning process. Secondly, the corresponding objective function is formulated under the assumption of target sparsity. Finally, an alternating direction method of multipliers (ADMM) solver based on reweighted strategy is employed to resolve the objective function. Experimental results demonstrate that the proposed method achieves approximately a 4 times increase in cross-range resolution and effectively enhances the observation capabilities within the radar forward-looking area.
Extracellular vesicles (EVs), naturally secreted by cells as nanoscale lipid bilayer structures, have become a research hotspot in biomedicine owing to their excellent biocompatibility, low immunogenicity, and inherent ability to cross biological barriers. This review systematically summarizes recent advances in EVs as natural nanomaterials. The biogenesis mechanisms of EVs are outlined, followed by a comparative analysis of the advantages and limitations of mainstream isolation and purification methods, including ultracentrifugation, size-exclusion chromatography, and microfluidic technologies. The core guiding role of the MISEV 2023 guidelines in standardizing EV characterization is highlighted. Engineering strategies to enhance EV therapeutic efficacy-including parental cell modification, post-isolation physicochemical tailoring, and hybrid vesicle construction-are then reviewed, followed by a comparative analysis of mainstream isolation technologies, emphasizing the trade-offs between purity and yield. Distinct from conventional descriptive reviews, this article establishes a strong biomimetic framework to scrutinize engineering strategies, including parental cell genetic modification, post-isolation physicochemical tailoring, and the fabrication of hybrid bio-synthetic vesicles. The design principles governing targeted delivery, drug-loading physics, and in vivo pharmacokinetic stability are critically evaluated through the lens of biomimetic nanotechnology. Furthermore, we identify critical research gaps and technical bottlenecks impeding clinical translation, offering a forward-looking perspective on the evolution of EVs from natural messengers into standardized precision medicine platforms.
Arthropod natural enemies-encompassing predators and parasitoids-form the backbone of sustainable agriculture, delivering irreplaceable ecosystem services via biological pest suppression. Driven by global demand for eco-friendly alternatives to synthetic pesticides, research in this domain has grown sharply over the past decade. Here, we report a systematic bibliometric analysis of 6515 Web of Science Core Collection papers focused on arthropod natural enemies in biological control (2016-2025), with the goal of charting the field's intellectual structure. Performance metrics confirmed an initial rapid increase from 2016 to 2019 followed by a plateau and a slight rise in 2025, with the US, China, and Brazil dominating output. Keyword co-occurrence networks pinpointed core themes, including conservation biological control, predatory mites, and integrated pest management (IPM). Temporal trends further revealed a pivot toward applied work on invasive pest systems. Co-citation analysis uncovered six foundational research clusters, while bibliographic coupling of 2021-2025 papers uncovered five active emerging subfields: landscape ecology and habitat manipulation, tri-trophic interaction mechanisms, high-impact invasive pest biocontrol, non-target risk assessment for introduced agents, and fall armyworm integrated management. We synthesize cross-cutting implications and outline future priorities-including AI-enabled rearing systems, functional biodiversity boosting, climate adaptation, and multifunctional landscape tuning. By consolidating historical progress and forward-looking directions, this framework empowers researchers, extension practitioners, and policymakers to scale sustainable pest management worldwide.
Background/Objectives: Given the limited evidence internationally, this qualitative study employed discovery interviews to explore the lived experience of patients who developed Hospital-Acquired Malnutrition (HAM) and that of their carers. Methods: Seven (two patients [(n = 1 female] and five carers [n = 3 female]) completed discovery interviews with an experienced independent interviewer. Carers were either spouses or parents. Responses were thematically analyzed using a constant comparative approach. Results: A key theme was 'It's not about the food, it's the hospital system' with the needs of the system dominating, including when patients were feeling at their worst. Subthemes were 'integration of care' and 'patient acuity', including symptoms that impacted food intake. Another theme was 'Who is looking out for the patient?', exploring 'reliance on carer advocacy', and 'variation in staff involvement'. One carer said, "… the girl that delivered the meal tray was the only one in our hospital stay who actually said to [the patient], 'I'm so glad you're sitting up. I was worried about you because you hadn't eaten for so long?" A persistent but comparatively less strong theme was 'When it is about the food' which explored 'the quality of the food' and 'receiving information on eating and drinking'. Conclusions: The three key themes identified from carers and patients were hospital system impacts, care co-ordination and, less strongly, experiences with food quality and information. The key opportunities to prevent, or better support the nutritional care of patients with, HAM may be through improving systems and care co-ordination.
A comprehensive policy framework constitutes a crucial institutional foundation for the sustainable development of healthcare systems and quantitative evaluation of public policies offers a scientific basis for policy refinement and optimization. Amid ongoing healthcare reform and profound shifts in the structure of demand for medical resources, systematically assessing the textual quality of national-level medical resource allocation policies, together with examining of their structural characteristics and evolutionary trajectories, carries considerable practical significance. Through a systematic screening process, 16 national-level policy documents on medical resource allocation were identified. Text-mining techniques were applied to extract high-frequency keywords and build a keyword co-occurrence network, after which the PMC-index model was then used to quantitatively assess the overall quality of these policies. Heterogeneity analyses were then conducted across policy quality grades and time periods to reveal structural differences and evolutionary patterns. The average PMC-index across the 16 policies was 6.67, suggesting that China's medical resource allocation policies are generally of relatively high quality. However, the analysis revealed several structural weaknesses, including limited predictive and forward-looking content, insufficient medium- to long-term planning, and an under-supply of higher-level policy instruments. Temporal analysis showed that the PMC-index increased from the Exploration Stage to the Deepening Stage before declining modestly in the Focus Stage. China's medical resource allocation policies are of relatively high overall quality, yet further improvements remain necessary. Future policy efforts should focus on three priorities: optimizing the hierarchical structure of the policy system, strengthening policy predictability and medium- to long-term planning orientation, and refining policy content and implementation mechanisms. Together, these efforts would enhance the systematization, stability, and governance effectiveness of the policy framework.
Memories of pain can last a lifetime, preventing future injuries, but this comes at the expense of remembering other concurrent experiences. When pain is chronic, pain memory benefits are limited and may contribute to maintenance of the disorder. Here we investigated two hypotheses, (1) pain takes up slots in working memory or (2) pain induces arousal above optimum levels at high task difficulty, leading to decreased performance. We used the Sternberg Task of working memory, in which the participant plays repeated trials where they are shown different sets of numbers and then asked to identify whether a 'probe number' was in the set or not. The Sternberg Task is ideal for testing the two hypotheses by looking at pain-related changes in accuracy and response time. There was a replication of the response time increase with set size, as well as the effect of older age on working memory and pain threshold. However, we saw no pain effect on either response time, accuracy, or the relationship between these parameters and set size with an acute painful thermal stimulus or in students with self-reported chronic pain. Together, this suggests that pain does not impair working memory in the Sternberg Task.
coexistence of anemia and undernutrition is a major public health concern among children in Mali. However, there is a lack of study looking into the relationship between undernutrition and anemia among children in Mali. Therefore, this study was conducted by using multilevel analysis to identify significant factors associated with the coexistence of anemia and undernutrition among children. A cross-sectional design was conducted from Mali Demographic and Health Survey data from 2023/24. STATA 17 was used for data summarization and analysis. The model was evaluated using the intra-class correlation coefficient (ICC), median odds ratio (MOR), likelihood ratio (LR), and deviance. Variables with a p-value less than 0.2 in the bi-variable logistic regression analysis were taken into account for the next multilevel analysis. In the multilevel analysis, significant factors were presented using the Adjusted Odds Ratio (AOR) along with the 95% Confidence Interval (CI). The prevalence of the coexistence of anemia and undernutrition among children was 26.3% (CI: 25.2%, 27.4%). According to the multilevel logistic regression result, mothers aged 25-34 years (AOR = 1.41; 95% CI: 1.01, 1.96), no education (AOR = 1.51; 95% CI: 1.19, 1.91), primary education (AOR = 1.39; CI: 1.05, 1.84), not covered by health insurance (AOR = 2.18; 95% CI: 1.05, 2.47), rural residents (AOR = 1.46; 95% CI: 1.16, 1.84), and short maternal stature (AOR = 1.83; 95% CI: 1.49, 2.27) were associated with an increased odds of the coexistence of anemia and undernutrition among children. In contrast, tall maternal stature (AOR = 0.29; 95% CI: 0.22, 0.36) and children aged 37-47 months (AOR = 0.70; 95% CI: 0.50, 0.96) were associated with decreasing the odds of the coexistence of anemia and undernutrition among children. In Mali, the coexistence of anemia and undernutrition contributes to mortality and related complications among children. The finding from this study revealed that children whose mothers were aged 25-34, mothers without formal education, mothers without primary education, mothers whose health was not covered by health insurance, children who lived in rural areas, and maternal short stature were associated with increased odds of the coexistence of anemia and undernutrition among children. In contrast, tall maternal stature and children aged 37-47 were associated with decreasing the odds of the coexistence of anemia and undernutrition among children.
We examined infants' expectations about caregivers' comforting behavior at 6, 9, and 12 months and assessed associations with maternal depressive symptoms. One hundred thirteen infants (47% female; 72% White, 13% Asian, 6% Black, 6% Latinx, 3% more than one race) and their mothers participated at one or more time points. In a violation-of-expectation task, infants watched video vignettes in which a caregiver either interrupted her household chore to comfort a crying baby (comfort event) or continued her work and ignored the baby (ignore event). Infants' looking times were coded offline. Mothers reported on their depressive symptoms. Bootstrapped analyses of variance indicated that infants, on average, looked longer at the ignore than at the comfort event, suggesting that they expected the caregiver to engage in comforting behavior. Path analyses revealed concurrent associations, such that higher levels of maternal depressive symptoms at a given time point predicted lower expectations about comforting behavior at the same time point. The magnitude of these associations did not differ by time point. In sum, our results contribute to a growing literature on infants' expectations about caregiving and provide the first evidence for maternal depressive symptoms as a concurrent predictor of poorer performance on a laboratory task assessing infants' expectations about caregivers' comforting behavior. Two possible mechanisms for this association are discussed. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
Hepatitis B and D display a distinctive epidemiological pattern in the Western Amazon, disproportionately affecting Indigenous peoples and riverine populations across Brazil, Peru, Colombia, Venezuela, and Ecuador. Despite more than three decades of universal hepatitis B vaccination, moderate endemicity and a high burden of chronic carriers persist in the region. In the state of Amazonas, Brazil, the Fundação de Medicina Tropical Dr. Heitor Vieira Dourado (FMT-HVD) has played a pivotal historical and contemporary role in the recognition, diagnosis, clinical management, surveillance, and research of HBV and HDV infections, serving as a major reference center for the region. The local health-care network is aligned with national policies but faces substantial challenges related to the vast geographic territory, strong centralization of specialized services in Manaus, and limited availability of trained professionals in endemic and remote areas. Logistical, socioeconomic, and cultural barriers continue to restrict timely access to diagnosis and treatment, while universal vaccination, widespread rapid testing, and ongoing decentralization efforts represent key facilitating factors. Looking ahead, the proposed research agenda emphasizes integrated surveillance, genomic and clinical-epidemiological studies, evaluation of the care cascade, and strengthening of primary health care as essential strategies to reduce regional inequalities and accelerate progress toward the elimination of viral hepatitis by 2030.
The urgent demand for energy-efficient CO2 separation technologies has propelled significant advancements in polymer-based CO2 separation membranes over the past decade. This review systematically examines three primary classes of these membrane materials: conventional dense polymer membranes, microporous polymer membranes, and mixed matrix membranes (MMMs). We analyze their distinct transport mechanisms, advantages, and the persistent challenges of permeability-selectivity trade-offs, physical aging, and scalability that have hindered widespread industrial adoption despite significant laboratory advances. Furthermore, we offer a forward-looking perspective on critical research directions, including the molecular design of stable microporous polymers, the evolution of MMMs towards continuous hybrid architectures, and the development of scalable ultrathin membrane fabrication techniques. By integrating materials innovation with engineering practicality, polymer-based membranes are poised to play a transformative role in sustainable carbon management.
The integration of AI into the workplace is advancing rapidly, necessitating robust metrics to evaluate its tangible impact on the labor market. Existing measures of AI occupational exposure focus primarily on the theoretical potential of AI to substitute or complement human labor based on technical feasibility, offering limited insights into actual adoption. To address this gap, we introduce the AI Startup Exposure (AISE) index, a novel metric based on O*NET occupational descriptions and AI applications developed by venture backed startups worldwide. Our findings indicate that even though white-collar high-skilled occupations are theoretically highly exposed, they are heterogeneously targeted by AI startups. Roles involving routine organizational tasks, such as data analysis and office management, show significant exposure, while occupations involving tasks that are tied to ethical or high-stakes considerations-such as judges or surgeons-present lower AISE scores, despite technical feasibility for automation. Our approach challenges the conventional assumption that high-skilled jobs uniformly face high AI risks, highlighting instead societal desirability and market-oriented choices as critical determinants of AI exposure. Contrary to fears of widespread job displacement, our findings suggest that AI adoption will be gradual and shaped by social factors as much as the technical feasibility of AI applications. This framework provides a forward-looking tool for policymakers to monitor the evolving impact of AI and navigate a fast changing labor market landscape.
The selection of biomaterial is crucial for the long-term success of implants. Materials that perform an adequate function and reduce negative biological responses should be taken. Due to their good mechanical strength, stainless steel, titanium, and Co-based alloys have been utilized for implant purposes; however, their permanent nature and very low corrosion rates may lead to long-term clinical complications. Researchers are looking for biomaterials that combine suitable mechanical properties with controlled and uniform degradation behavior. In the last decade, magnesium and iron-based alloys have been seen as a good alternative and examined as promising biodegradable metals for implant applications. However, their excessively rapid corrosion (Mg) or extremely slow degradation (Fe) imposes significant limitations on their clinical applicability. In recent times, zinc-based alloys have been seen as new materials that will challenge magnesium and iron-based alloys. Zn2+ ions released from zinc metal corrosion play a crucial role in bone metabolism, enzymatic activity, and cellular proliferation. However, the low mechanical strength and limited ductility of pure zinc restrict its direct utilization in load-bearing implants. Therefore, the fabrication of high-strength and ductile zinc-based alloys while maintaining biocompatibility and suitable corrosion rate remains a main research challenge. This article critically assesses and compares the mechanical properties, corrosion behavior, and biocompatibility of magnesium-, zinc-, and titanium-based alloys, and inspects the impact of advanced fabrication methods, particularly additive manufacturing, on microstructure evolution and implant performance.
Objectives: Endocrine neoplasms, as a general rule, show systemic, neuro-inflammatory and metabolic consequences, known as paraneoplastic syndrome. The comorbidity of thyroid tumors with neurological and autoimmune diseases prompt looking for common neuro-immuno-endocrine mechanisms of these disorders. While most TCs are well described, there is a gap in the literature after the isolation of oncocytic/Hürthle cell carcinoma (HCC), as a unique type due to immunoendocrine and metabolic features (low TSH-receptor expression and radioiodine avidity). The aim of this study was to collect clearly defined reports of HCC (as a separate entity) and to attempt determining common clinical symptoms and the usefulness of various diagnostic techniques (comprehensive critical review). This may be an introduction to modern treatment (patient-centered care) since the main cause of mortality is not local progression or metastases. Results: Until now, due to misnomenclature and data misinterpretation, HCC has been treated according to general standards (with overuse of TSH-ST and RIA). High thyroglobulin level, decreased total thyroxin (with normal FT3 and spontaneous decrease in TSH), hypercalcemia, as well as the "reverse flip-flop" phenomenon, as common symptoms, indicate the neuroendocrine origin of HCC. Sparse, well-documented lymph node metastases are another feature, although from few studies. Most studies omit the N stage. Whole-body 131iodine and 18F-fluorodeoxyglucose scintigraphy may be useful before FNAB. Fine-needle aspiration biopsy (FNAB), as a "gold standard" in early diagnosis of thyroid nodules, delays HCC diagnosis because of the inability to determine a benign/malignant nature. Conclusions: Final HCC outcome may be affected by various overlapping immunoendocrine factors (paraneoplastic effects). Due to very few thyroid function tests performed in HCC, we have proposed a set of basic laboratory analyses, core biopsy in HCC differentiation, and diagnostic chain for standardization. According to the review, adaptation and treatment of HCC based on existing standards for other thyroid cancers seem to be insufficient, and the risks outweigh the benefits. The key recommendations resulting from the 5th edition of the WHO Classification of Endocrine Neoplasms are only the beginning of refuting many myths and biases.