OpenWorld Role-Playing Games (OWRPGs) differ from other video game genres in that they offer players vast digital landscapes and significant freedom: they can fight, use diplomacy, play stealthily, or pursue activities like farming or trading. This player autonomy creates a space rich in unintended consequences, incidental learning being just one. A study of higher education (HE) students explored this phenomenon. While existing research on incidental learning in games focuses mainly on language acquisition, the current study argues that commercial OWRPGs have the same educational power as purpose-built learning games, and that the scope of incidental learning is far broader than previously examined. Using a constructivist grounded theory (CGT) approach, 25 semi-structured interviews were conducted and written gaming journals collected from 11 additional participants. All 36 participants played OWRPGs in their leisure time. The analysis identified 34 distinct forms of incidental learning, with language acquisition being just one. These were grouped into three categories: self-improvement, academic, and employability skills, with considerable overlap between each. This study shows that OWRPGs can act as a setting for incidental learning in skills over and above lexical improvement. As a result, it is suggested that future research analyse in further depth the skills this research has discovered, looks for further skills that may be honed via incidental learning, and examine other video game genres to highlight any forms of incidental learning that occur.
Treatment outcomes and satisfaction improve when healthcare decisions align with patient preferences. However, little is known about general health preferences in older adults, and eliciting patient preferences is time consuming. To describe the distribution of preferences for healthcare in general, and associations between preferences and patient characteristics in adults aged 50 years and over in England. Data were collected in wave 8 (2016/2017) of the English Longitudinal Study of Ageing (ELSA), a biennial longitudinal survey of people aged 50 and over living in private households in England that began in 2002/2003 and is designed to be nationally representative. Data were collected from ELSA participants using face-to-face interviews and a short self completion questionnaire. Amongst other items, the questionnaire contained six measures of general healthcare preferences that had not been asked in previous ELSA waves: risk aversion, future orientation, quality or length of life, body function compared to looks, openness to experimental treatments, and preference to leave treatment decisions to a doctor. Healthcare preferences varied substantially, with some systematic patterns by age and sex: women were less likely than men to want to delegate decisions to doctors, and more likely to prioritise quality of life over length of life; participants aged over 75 years were more likely than younger participants to want to delegate decisions to doctors, and more likely to want to avoid risks. The systematic sex and age differences offer a useful starting point for eliciting healthcare preferences in a busy clinical environment, but cannot replace asking about individual preferences.
As semiconductor packaging technology evolves from two-dimensional to three-dimensional integration, the through-glass via (TGV) technique, as a core interconnect method in advanced packaging, is emerging as a strong candidate to replace through-silicon vias (TSVs) and plated through-holes (PTHs) in organic substrates. Glass substrates offer excellent electrical insulation, low dielectric loss, tunable thermal expansion coefficients, and the potential for large-scale panel-level manufacturing. However, issues related to TGV hole quality, metallization uniformity, and thermomechanical reliability remain key bottlenecks limiting their large-scale industrialization. This investigation provides a comparative review of non-laser and laser machining for TGVs to address the above problems. First, the technical background and core advantages of TGVs are outlined. Second, this study details non-laser processing methods, including sandblasting erosion, mechanical drilling, the photosensitive glass method, electrochemical discharge machining (ECDM), deep reactive ion etching (DRIE), and others. Third, laser processing methods, covering laser ablation drilling, laser-induced deep etching (LIDE), femtosecond laser-assisted wet etching and others, are given focus. Moreover, this study analyzes typical applications of TGVs in 3D/2.5D packaging, MEMS devices, optoelectronic integration, and others. In addition, the machining processes of non-laser and laser-based TGVs, such as mechanical machining, ECDM, and LIDE, are compared, and key process challenges, technical trade-offs, and reliability failure mechanisms are discussed. Finally, this review looks ahead to future trends, aiming to provide a systematic technical reference for researchers in the TGV field.
Bunyaviricetes, including highly pathogenic members such as Severe Fever with Thrombocytopenia Syndrome Virus, Crimean-Congo Hemorrhagic Fever Virus, and Rift Valley Fever Virus, pose significant global health threats characterized by high mortality rates and a lack of approved specific therapeutics. Drug repurposing provides pharmaceutical companies with cost-effective and expedited strategies to discover innovative treatment options for patients. Given the issue of antiviral drug resistance and the high cost of developing new antiviral drugs, drug repurposing offers enormous potential for expanding the repertoire of available therapeutics. This paper reviews the progress made in developing candidate drugs against bunyaviruses through high-throughput screening and drug repurposing methods, summarizes the mechanisms of action of candidate drugs targeting viruses and host cells, and looks ahead to future trends in the development of small-molecule antiviral drugs, with the aim of providing a reference for promoting the development of new bunyavirus drugs.
Pediatric inflammatory diseases, such as neonatal necrotizing enterocolitis (NEC), juvenile idiopathic arthritis (JIA), and asthma, pose numerous challenges in clinical treatment due to their complex pathogenesis and the still-developing stage of children's immune systems. These challenges include poor precision, strong toxic and side effects, and unclear long-term biological safety. In recent years, the development of nanozymes has provided new opportunities to address these issues. This review systematically summarizes the latest research progress of nanozymes in the diagnosis and treatment of pediatric inflammatory diseases. Firstly, we focus on the rational design principles of nanozymes tailored to the physiological characteristics of children, including the regulation of their catalytic activity and strategies for optimizing biocompatibility. Subsequently, we deeply analyze the core roles of these antioxidant nanozymes in breaking the vicious cycle of oxidative stress and reshaping the inflammatory microenvironment through multiple mechanisms, such as scavenging reactive oxygen species (ROS), regulating macrophage polarization, and inhibiting the pro-inflammatory protein (NLRP3 inflammasome). Moreover, we detail the successful applications of nanozymes in various typical pediatric inflammatory disease models and emphasize their potential as a multifunctional theranostic platform in achieving synergistic antioxidant, antibacterial, and targeted drug delivery. Finally, this article prospectively discusses the key challenges that nanozymes must address in the process of clinical translation for children, including long-term biological safety, precise dose control, and individualized drug delivery, and looks forward to the development of intelligent responsive and biodegradable nanozymes. This review aims to provide theoretical basis and reference ideas for the in-depth exploration and clinical application of nanozymes as innovative nanomedicines in the field of pediatric precision medicine in the future.
Train-the-Trainer (TTT) models can scale parent-mediated interventions (PMIs) in public health care, yet evidence on large-scale implementation remains limited. This study reports the implementation of an adapted TTT model for the WHO Caregiver Skills Training (CST) within the Italian National Health Service, evaluating adoption, acceptability, feasibility and sustainability. Twenty-eight clinicians from 10 Regions undertook the four-phase TTT. A mixed-methods design combined surveys with focus groups, analyzed using the Consolidated Framework for Implementation Research (CFIR). Twenty trainees (71%) qualified as Master Trainers (MTs), and 17 of these (85%) trained facilitators; 60% of MTs achieved full fidelity within the expected timeline. Satisfaction ratings were high, whereas feasibility ratings were mid-range. Implementation inhibitors clustered in the CFIR Inner setting (available resources, leadership engagement), Outer setting (lack of formal recognition), and Process (training model's intensity structure) domains. Accelerators included Characteristics of individuals (motivation, readiness to change), Intervention characteristics (responsiveness to families' needs, accessibility) and Inner Setting features (integration within existing care pathways). Overall, the adapted TTT was acceptable and supported early adoption and fidelity; however, lower feasibility for select capacity-building components and multilevel barriers indicate that sustained integration will require stronger organizational support and policy endorsement. Proposed adaptations offer an adaptable framework for global efforts to expand caregiver support within public health systems.Lay AbstractFamilies of autistic children often benefit from programs that teach caregivers practical skills to support their child's development. However, these programs can be hard to implement in public health systems due to a shortage of trained professionals and because interventions may not align with existing service structures. To overcome these challenges, the Italian National Institute of Health has implemented the World Health Organization's Caregiver Skills Training (CST) program through initiatives funded by the National Autism Fund. To ensure the program could be effectively adopted within the Italian public health context, we applied a "Train-the-Trainer" model. This approach trains experienced clinicians to become "Master Trainers," who in turn train other professionals to deliver the program to families, supporting scalability and sustainability within the system. In our study, 28 clinicians from 10 regions of Italy took part in a four-step training process. Most (20 trainees) completed the program successfully, and many (17 trainees) went on to train facilitators. Surveys and focus groups examined how well the program was taken up, how acceptable it felt, how doable it was in routine services, and what might help it last. Trainers reported high satisfaction with the program, although some faced difficulties such as limited institutional support. Factors that helped implementation included strong motivation and the program's perceived usefulness for families. Barriers included organizational challenges and the need for formal recognition of the program. Overall, this approach looks promising for bringing CST into public services, but durable, wider use will require stronger organizational support and policy endorsement. The proposed adjustments offer a practical path to expand caregiver support and offer methods that can be transferred to public health systems in other countries.
Colorectal cancer is the fourth most common cancer and the second most common cause of cancer deaths in England. Most cases of colorectal cancer arise from a prior adenomatous polyp in the bowel lining. Colonoscopy is the gold standard investigation for people with symptoms suggestive of colorectal cancer. During a colonoscopy, polyps can be removed or a biopsy can be taken. However, waiting times for colonoscopy can be long and the procedure can be unpleasant. Colon capsule endoscopy may provide an alternative diagnostic procedure to rule out polyps or colorectal cancer. To evaluate the clinical effectiveness, acceptability and cost-effectiveness of colon capsule endoscopy using PillCam COLON 2 for detecting colorectal polyps and colorectal cancer. A systematic review searched six bibliographic databases and eight conference proceedings in August 2024. Studies of PillCam COLON 2 in symptomatic or polyp surveillance patients were included if they were randomised controlled trials, or if they reported data on diagnostic test accuracy, yield or patient preference. Bayesian pooling of sensitivity and specificity was performed. The economic analysis included a review of existing models and development of an independent model to assess the cost-effectiveness of colon capsule endoscopy versus colonoscopy and computed tomography colonography in three main populations (symptomatic patients with a faecal immunochemical test score of 10-100 μg/g, symptomatic faecal immunochemical test < 10 μg/g and surveillance patients). Subgroup analyses were conducted in patients who are able and willing to undergo colonoscopy and those who are not (denoted 'COL-eligible' and 'COL-ineligible'). Among the diagnostic test accuracy studies (11-64% patients 'in-scope'), for polyps of any size (two studies), ≥ 6 mm (four studies) and ≥ 10 mm (four studies), pooled sensitivities were 0.78 (95% credible interval 0.51 to 0.90), 0.83 (95% credible interval 0.70 to 0.91) and 0.85 (95% credible interval 0.70 to 0.94), respectively. Specificities were 0.60 (95% credible interval 0.27 to 0.88), 0.69 (95% credible interval 0.52 to 0.81) and 0.90 (95% credible interval 0.82 to 0.95), respectively. Among yield studies, colonoscopy was spared in 37-50% of symptomatic patients (three studies). Data on colonoscopy spared in surveillance patients were available from one study; however, these data are confidential and cannot be reported here. In patients unwilling/unable to undergo colonoscopy, colon capsule endoscopy completed 70-98% of incomplete colonoscopies. Patient preference studies indicated general satisfaction with PillCam COLON 2, but some conflicting information on patient preference for colon capsule endoscopy compared to colonoscopy and computed tomography colonography. For colonoscopy-eligible patients, within all three main analysis populations, the External Assessment Group's model suggests that colon capsule endoscopy is expected to lead to small quality-adjusted life-year losses and higher costs than colonoscopy; hence, colon capsule endoscopy is dominated by colonoscopy. For colonoscopy-ineligible patients, colon capsule endoscopy either dominated by computed tomography colonography or has an incremental cost-effectiveness ratio which is markedly higher than £30,000 per quality-adjusted life-year gained. Despite these findings, colon capsule endoscopy is predicted to lead to substantial reductions in the number of colonoscopies required, particularly for symptomatic patients who are able to undergo colonoscopy. The generalisability of the diagnostic test accuracy data to symptomatic and polyp surveillance patients was unclear. Colon capsule endoscopy is expected to be less effective and more expensive than colonoscopy. However, it could help to free up constrained colonoscopy services, particularly in people with symptoms suggestive of bowel cancer. The systematic review protocol is available on the PROSPERO website (registration number CRD42024586405). This award was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme (NIHR award ref: NIHR136010) and is published in full in Health Technology Assessment; Vol. 30, No. 58. See the NIHR Funding and Awards website for further award information. Bowel cancer is the fourth most common cancer in England. Most bowel cancers start as small growths on the bowel lining called polyps. Some polyps can become cancerous over time. If polyps are found and removed before they become cancerous, bowel cancer can be prevented. People with symptoms of bowel cancer are usually sent for a procedure called a colonoscopy, where a small camera with a light is inserted into the colon through the anus. Polyps can be removed, or a tissue sample can be taken. However, waiting times for colonoscopy are long and the procedure is unpleasant. Also, some people may need a different investigation if they are frail, have other illnesses or refuse colonoscopy. PillCam COLON 2 is an alternative procedure which involves swallowing a capsule containing two tiny cameras and a light. It takes pictures inside the bowel and sends them to a computer. However, people may still need to have a colonoscopy afterwards if polyps are found or if PillCam COLON 2 does not fully work. This assessment looks at PillCam COLON 2 as an alternative to colonoscopy and another procedure called computed tomography colonography. We looked for best available evidence on the accuracy and acceptability of PillCam COLON 2. We also looked at studies which have used this test in practice. Our review found that PillCam COLON 2 might miss some polyps compared to colonoscopy, but it can avoid further investigations in some patients. Some patients preferred PillCam COLON 2, but others preferred different procedures. We also looked at whether PillCam COLON 2 represents good value for money for the NHS through cost-effectiveness analyses. The analyses suggest that it is less effective and more expensive than colonoscopy. However, it could help free up constrained colonoscopy services, particularly in people with symptoms of bowel cancer.
Ultrafine particles (UFPs) are ubiquitous in the atmosphere and occur at high number concentrations. Despite their ability to penetrate deep into the respiratory system, their harmfulness remains insufficiently studied, primarily due to the lack of reliable standardised and harmonized long-term global exposure data. In this study, we applied an ecological approach to provide an exploratory assessment of the long-term exposure to UFPs from 2010 to 2019 in high-income countries (HICs) in relation to cardiovascular disease (CVD) risk using publicly available country-level aggregate data. To minimize social and demographic confounding factors and use reliable UFP estimation, we focus exclusively on HICs and the findings should not be generalized globally. Using a newly developed global UFP data set, we estimated population-weighted exposure (PWE) over the past decade. These estimates were combined with CVD aggregate data to identify statistically significant co-occurrences between PWE of UFPs and three health outcomes: disability-adjusted life years (DALYs), years of life lost (YLLs), and years of life lived with disability (YLDs). The findings suggest consistent patterns between long-term exposures to UFPs and CVDs. Aligning with the current literature, we suggest that further research into possible effects on CVDs due to long-term UFPs exposure is needed. Coherent with the last EU directives, our findings highlight the relevance of monitoring UFPs as a public health priority even when PM 2.5 mass-based standards are met. While our conclusions are limited to group level associations, our ecological analysis could serve as a preliminary step toward establishing consistent UFP exposure-response relationships. Ultrafine particles are extremely small particles that exist in very high numbers in the air and can travel deep into the lungs. Unlike larger particles, their long‐term health effects are not well understood because standardized global exposure data have only recently become available. We performed an ecological analysis of the long‐term exposure to ultrafine particles between 2010 and 2019 in relation to cardiovascular disease in high‐income countries. Using a newly developed global data set of ultrafine particles and country‐level public health data, we looked for patterns between ultrafine particles exposures and measures of disease burden. Countries with higher exposure to ultrafine particles generally had a greater burden of cardiovascular disease. Our findings call for further research into possible effects on cardiovascular diseases due to long term exposure to ultrafine particles. We suggest that ultrafine particles deserve attention in air‐quality regulations and public health policy, even where existing air quality standards for fine particulate matter are met.
Burnout among family medicine residents remains a significant challenge, often exacerbated by electronic health record (EHR) documentation burden.1 Emerging technologies such as ambient artificial intelligence (AI), may reduce clinical documentation time while simultaneously enhancing work satisfaction. We looked to evaluate the impact of ambient AI on resident well-being, satisfaction, and documentation time. This prospective pilot study was conducted at two community-based family medicine residency programs. Sixteen third-year residents were invited to participate in the study. Residents used ambient AI software for outpatient clinical documentation. Pre- and postintervention data included objective EHR usage metrics and well-being assessments using the Mini ReZ survey. Primary outcomes included subjective well-being, changes in documentation time per patient, and total EHR time. Fifteen residents enrolled in the study and 13 completed pre/postsurveys. The documentation time per patient decreased significantly postintervention (-3.09 min, P = .002). The overall EHR time also decreased though not significantly (P = .760). Survey data showed a significant improvement in the total Mini ReZ score (P = .012; Holm-adjusted P = .037), and improvements in subscales related to work pace/EHR stress (P = .0032; Holm-adjusted P = .013) and resident experience (P = 0.024; Holm-adjusted P = .048). The use of ambient AI software in a family medicine resident population was associated with improved well-being, satisfaction, and documentation efficiency. This study indicates that a larger study focused on resident efficiency and subsequent satisfaction is warranted.
The latest drug-eluting stents (DESs) are the gold standard for patient treatment during percutaneous coronary intervention (PCI). The latest advancements in DES innovation have resulted in the development of new stent technologies with reduced thickness in the struts. The new DES design, ultrathin-strut DESs, features struts measuring less than 70 μm in thickness. The evidence for these devices is derived from observational studies, extensive meta-analyses, and randomized trials with long-term outcomes. The investigation is focused on determining the comparative performance of ultrathin-strut DESs and conventional new-generation DESs across various clinical settings and patient lesion profiles. The objective of the seminar is to examine recent advancements in the use of very thin DESs and the potential of computational modeling in coronary arteries during PCI. An analysis of the mechanical performance of ultrathin DESs has been conducted in terms of radial expansion and stresses within the stent-vessel system. Residual stresses generated by the crimping process will also be considered.
The main objective of this study is to characterize self-medication Pharmaceutical Interventions (PI) carried out between 2017 and 2025. A descriptive study was conductive in 201 community pharmacies. Data were collected using GIPAMED notification grid. This study looked at 3366 PIs involving selfmedication. The main reason for requesting drug by the patient or their representative, leading to an PI, was pain (in nearly one-third of cases). The molecules that caused the highest number of PIs were ibuprofen, paracetamol, oxomemazine, pheniramine in combination, and fosfomycin. The main reasons for PIs were "non-compliance with regulations: request for a prescription drug only", "contraindication with the pathophysiological condition," "non-indication with regard to the symptoms," and "need for a medical consultation: limits of pharmacy advice." The dispenser referred the patient for a consultation in 38.1% of cases. The solution proposed by the pharmacist was accepted by the interlocutor in more than 90% of cases. The overall characterization of PIs provided a descriptive basis for identifying the most common types of PIs, the molecules involved, and how they are resolved. This data highlights areas requiring vigilance when dispensing nonprescription drugs. The prospective PI database developed has thus made a significant contribution to primary care research and, more specifically, to community pharmacy research.
Plant tissue culture is a crucial part of biotechnology that supports crop improvement, plant conservation, and other related fields. Although tissue culture has been successfully used in many plants, low regeneration and transformation rates still exist in some species. Agrobacterium-mediated transformation is commonly used in genetic engineering, but its effectiveness depends heavily on establishing a reliable in vitro regeneration system through organogenesis or somatic embryogenesis. Over the past decade, substantial progress has been made in understanding the molecular basis of regeneration; however, most reviews have focused on individual aspects such as hormone regulation or transcription factor networks in isolation. In contrast, this review provides a comprehensive and integrated framework that systematically links four critical layers-wound signaling, hormonal regulation, developmental regulators, and epigenetic modifications-into a unified regulatory network governing plant regeneration. Furthermore, we highlight recent cutting-edge advances, including artificial intelligence-assisted prediction, single-cell and spatial transcriptomics, epigenome editing, and CRISPR-based activation systems, and we discuss their transformative potential in overcoming genotype-dependent recalcitrance. By synthesizing classical regulatory mechanisms with emerging technologies, this review offers a forward-looking perspective that distinguishes it from earlier publications and provides both theoretical foundations and practical strategies for improving plant regeneration and genetic transformation.
Next generation of Theranostics studies are looking at novel combinations with radiation sensitizers to enhance PRRT's efficacy. Here, we present safety and efficacy data from a multi-center phase 1 study of a [¹⁷⁷Lu]lutetium-dotatate -triapine combination in patients with GEP-NETs. The study consisted of two phases (dose escalation and expansion) administering the recommended phase 2 doses (RP2D) for the two agents. All patients received 200 mCi of [¹⁷⁷Lu]lutetium-dotatate on day 1 of four 8-week cycles, in combination with oral triapine administered at assigned dose levels (100 mg, 150 mg or 200mg) from days 1 to 14 of each cycle. A total of 31 (A: 15 ; B: 16 ) patients received treatment. Nine patients experienced dose-limiting toxicities; Grade 3 anemia (n=1), Grade 5 cardiac arrest (n=1), and Grade 4 neutropenia (n=7). Based on the overall safety and pharmacokinetics data, a [¹⁷⁷Lu]lutetium-dotatate (200 mCi) plus triapine (150 mg) dose was selected as the RP2D for the expansion phase. Grade ≥3 treatment related adverse events were observed in 77% patients: anemia (23%), nausea and vomiting (3% ), lymphopenia ( 58%), neutropenia ( 35%) and leukopenia ( 39%). The majority of cytopenias were transient and resolved within two weeks. Among the 28 evaluable patients, the objective response rate (ORR) was 21.4% and the median progression-free survival (mPFS) has not been reached (median follow-up period: 23.7 months). The combination of [¹⁷⁷Lu]lutetium-dotatate (200 mCi) and oral triapine (150 mg D1-14) was well tolerated and demonstrated preliminary activity in patients with well-differentiated GEP-NETs. (NCT04234568).
State legislative initiatives that were started in 2023 to streamline the licensing of internationally trained physicians (ITPs) have garnered bipartisan interest and support across the country. The new approach, more broadly applicable than previous efforts, precludes a requirement for Accreditation Council for Graduate Medical Education-accredited graduate medical education conducted in the United States. The change is the most recent development in our nation's long and winding history of licensing international medical graduates (IMGs). At the turn of the 20th century, only about 100 IMGs presented to state medical boards each year for licensure. Medical graduates around the world who sought quality postgraduate training opportunities, including those from the United States, looked to Europe. Nativist sentiment and state and federal laws in the 1920s discouraged or prohibited immigration for many internationally educated or trained physicians. That changed substantially during and after World War II when a population surge, an increase in physician refugees, and, later in the 1960s, relaxed immigration laws combined with a robust expansion of hospitals to shift the medical regulatory landscape. The result was greater receptivity to IMGs, with concerns about prevailing credentialing models predicated on recognition by state medical boards of "approved" international medical schools. The establishment of the Educational Commission for Foreign Medical Graduates in the 1950s mirrored a broader shift toward evaluation of persons and their capabilities. Recent demographic pressures (for example, a growing and aging patient population and a maldistributed and insufficient physician workforce) are prompting a flurry of state legislative initiatives to improve access to care and welcome more IMGs, especially ITPs, in a trend that runs counter to growing federal restrictions on immigrants and international workers.
Hollow Syndrome is a prevalent psychological adjustment problem in medical students, while the mechanism underlying the association between negative perfectionism (a common personality trait in medical education) and this condition remains unclear. A total of 2977 medical students from a medical university in Shandong, China were recruited via cluster sampling. Data were collected using the Chinese Hollow Syndrome Questionnaire (CHQ), Chinese Frost Multidimensional Perfectionism Scale (CFMPS), Self-Esteem Scale (SES), Achievement Motivation Scale (AMS), and Subjective Well-being Scale for Chinese Citizens (SWBS-CC20). Serial mediation and moderated mediation analyses were conducted using SPSS 26.0 and the PROCESS macro. Negative perfectionism was significantly negatively associated with Hollow Syndrome symptom scores (lower scores indicate more severe symptoms). Self-esteem and achievement motivation mediated the association through three distinct pathways, with the total indirect effect accounting for 74.26% of the total effect; the direct effect of negative perfectionism was not statistically significant after including the mediators, indicating a full mediation pattern. Subjective well-being significantly moderated both the pathway from self-esteem to Hollow Syndrome and the pathway from achievement motivation to Hollow Syndrome, with the strength of all three indirect effects decreasing as subjective well-being increased. Negative perfectionism is associated with more severe Hollow Syndrome among medical students, mainly through reduced self-esteem and achievement motivation, and subjective well-being acts as a protective buffer against this adverse association. These findings provide clear, actionable targets for mental health interventions among medical students, and offer an empirical basis for alleviating Hollow Syndrome by protecting self-esteem, enhancing achievement motivation, and fostering subjective well-being. Medical students face intense academic and career pressure. Many hold extremely high standards for themselves and often struggle with feelings of emptiness and unclear life goals. We explored the links between strict self-expectations and such feelings, and looked for factors that support students’ mental health. We worked with nearly 2,900 medical students at a Chinese university. We asked them about their self-confidence, study motivation, sense of well-being, and experiences of inner emptiness. We found that overly high self-standards are linked to stronger feelings of emptiness, and this connection relates to lower confidence and weaker drive. Students with stronger well-being show a weaker link between high self-standards and emptiness. These findings offer practical guidance for supporting medical students. Schools can help students build confidence, set clear goals, and foster positive feelings in daily life. These steps help students stay motivated and mentally healthy throughout their medical training.
Liquid metals, particularly gallium-based alloys, uniquely combine fluidic compliance with metallic conductivity, which makes them ideal candidates for biomimetic design. Rather than treating biomimicry as the mere imitation of biological forms, we argue that liquid metal biomimicry should be understood as the realization of biological strategies through the intrinsic physics of fluidity and interfacial dynamics. This review organizes existing research within a hierarchical framework that couples physical liquidity, interface biology analogy, and functional emergence to explain how adaptive behaviors naturally arise from dynamic liquid metal systems. We examine representative systems across morphological and functional dimensions and contend that their true significance lies not in replicating nature but in addressing problems that conventional rigid materials cannot solve. Looking forward, we identify several transformative directions that collectively chart a roadmap toward truly intelligent and autonomous bioinspired systems. By bridging the physics of fluidity with the principles of biological adaptability, liquid metal biomimicry holds transformative potential for soft robotics, wearable electronics, neuromorphic computing, and biomedical engineering.
Seasonal epidemics and high variability of influenza viruses pose a severe threat to global public health security. Neuraminidase, a key functional enzyme in the life cycle of influenza viruses, represents an important target for anti-influenza drug development. Given the continuous emergence of drug-resistant strains against first-line clinical neuraminidase inhibitors (NAIs) such as oseltamivir, there is an urgent need to develop novel, broad-spectrum, and resistance-overcoming NAIs. Natural products, characterized by structural diversity and a wide range of biological activities, provide abundant resources for the discovery of new NAIs. Recent advances in computer-aided drug design, intelligent analytical platforms, and modern screening technologies have accelerated the identification of natural product-derived NAIs. In particular, biosensor-based strategies, including electrochemical, fluorescence, bioluminescence, and surface-enhanced Raman scattering biosensors, have demonstrated significant advantages in sensitivity, selectivity, rapid response, and high-throughput screening. In combination with computational methods and experimental approaches such as affinity ultrafiltration and activity-guided separation, these technologies have promoted the development of intelligent, precise, and multimodal screening platforms. Looking forward, the integration of biosensor-based high-throughput screening platforms with artificial intelligence algorithms is expected to drive the next generation of natural product screening platforms and facilitate the efficient discovery and clinical translation of novel NAIs. This paper systematically reviews the research progress of screening strategies for natural product-derived NAIs; introduces representative natural active NAIs, including phenols, terpenoids, and alkaloids; and prospects future development directions, aiming to provide a scientific reference for the efficient discovery of NAIs from natural products.
Conductive polymers (CPs) have emerged as a versatile material platform for addressing the critical challenges of aqueous zinc-ion batteries (AZIBs), yet a comprehensive understanding of their multifunctional roles across the full battery system remains lacking. This review provides a systematic, mechanism-driven overview of CP applications in AZIBs from a holistic "cathode-electrolyte/separator-anode" chain perspective. Firstly, we establish the structural characteristics and synthesis methods of CPs, followed by a summary of zinc storage mechanisms in cathode systems. The multifaceted roles of CPs in cathodes are then comprehensively analyzed, including their functions as surface coatings, interlayer intercalants, standalone active materials, and carbon-based composites, with detailed discussion on how they address the intrinsic limitations of inorganic cathodes and optimize organic electrode performance. Subsequently, CP-driven strategies in electrolyte and separator engineering are critically evaluated, covering interfacial modification, electrolyte additives, gel/solid polymer electrolytes, and functional separators. For zinc anode stabilization, two complementary mechanisms are established: interfacial chemical environment reconstruction coupled with solvation behavior regulation, and interfacial electric field homogenization integrated with selective ion transport. Finally, we summarize the core advantages of CPs in AZIBs and identify unresolved challenges, including controllable synthesis, quantitative mechanistic understanding, advanced characterization techniques, and industrial scalability, offering forward-looking perspectives to bridge the gap between laboratory research and practical commercialization of high-performance CP-integrated AZIBs.
People who experienced COVID-19 may have purpose disruption, which is important to health and wellbeing. This study examined three dimensions of the feasibility of a purpose renewal intervention (Compass Course): acceptability, implementability, and preliminary efficacy. This study used a prospective pretest-posttest design with people who experienced COVID-19. Intervention consisted of 8-group sessions (n = 27). Standardized measures of meaning and purpose at pretest, posttest, and 2-month follow-up were collected. The intervention was implemented as planned. Those who completed the sessions (n = 16) reported high levels of satisfaction with the intervention (median overall satisfaction rating of 9.5/10). Participants made statistically significant pre-post changes in two measures of purpose in life and one measure of post-traumatic growth, but not self-efficacy. Results suggest that implementation of the Compass Course was feasible and acceptable, and further studies related to purpose renewal for persons after COVID-19 are warranted. A study to explore the feasibility of a treatment for people who have had COVID that addresses purpose/direction in everyday lifePeople who experienced COVID-19 may struggle with a sense of purpose/direction in their life, which is important to health and wellbeing. This study looked at a group-based treatment purpose renewal intervention, the Compass Course, to see if it was feasible and acceptable to the participants, and if it had the potential to be effective. The Compass Course had eight sessions in which 27 participants were initially enrolled. Participants completed assessments on purpose in life, post-traumatic growth, and self-efficacy before the first session, after the last session, and again after 2 months. The course was implemented as planned and successfully completed by 16 participants. Those who completed the course reported high levels of satisfaction. Participants made significant changes in three of the six outcome measures. Results indicate that the Compass Course was feasible and acceptable, and further research is warranted for COVID survivors.
Pharmacists play a key role in managing and mitigating mpox through clinical care, pharmacovigilance, vaccine management, and resilient supply chains. Management focuses on supportive care, infection prevention, and accurate diagnosis, with pharmacists ensuring the availability and rational use of vaccines, disinfectants, laboratory reagents, and personal protective equipment. They also promote vaccine equity, community engagement, pharmacovigilance, and efficient production and distribution of health commodities. In Africa, where 1.2 billion people lack access to mpox vaccines, pharmacists help address inequities through community outreach and trust-building. They further strengthen supply chains using inventory management, local production, and technologies such as artificial intelligence, blockchain, and continuous manufacturing. Pharmacists support humanitarian supply chains by promoting rational medicine use, preventing antimicrobial resistance, and supporting adherence. However, their impact is limited by vaccine inequities, varying clinical authority, inadequate training, and limited involvement in outbreak planning. Expanding their roles in surveillance, pharmacoeconomics, and real-world evidence is crucial to improve outcomes and cost-effectiveness. Looking ahead, pharmacists are essential in smallpox and mpox vaccine research, contributing to safety and efficacy through involvement in drug development and clinical trials. This narrative review employs a thematic synthesis to evaluate the pharmacist's role in the global mpox response. By analyzing literature from major databases (PubMed, Scopus, and Google Scholar) and technical reports, it identifies systemic opportunities and structural challenges within the pharmaceutical lifecycle. Integrating pharmacists into multidisciplinary teams and enhancing their training in pharmacovigilance and infectious disease management are critical to achieving sustainable outbreak preparedness. Empowering pharmacists through structural reforms can enhance health system resilience, optimize cost, and safeguard public health in current and future pandemics.