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Return to preinjury level of activity after anterior cruciate ligament reconstruction (ACLR) in the general population has been widely studied in the literature. However, the rate of return to military duty (RTMD) after ACLR is still not well determined. Furthermore, reasons for not returning to the preinjury level of military duty remain uncertain. To determine (1) the rate of RTMD after ACLR and (2) factors associated with returning to the preinjury level of military duty after ACLR. Case series; Level of evidence, 4. Patients who have served and/or are currently serving in the military and who underwent a primary ACLR and were within 1 to 5 years postoperatively were eligible to participate in the study. All participants completed a questionnaire that inquired about patients' characteristics, including age, sex, tobacco usage, military rank, and preinjury military and physical activities. Return to preinjury level of military duty was determined by using a multidomain definition of RTMD that includes the type and frequency of military activities, as well as standing hours (defined as a continuous measure of total duration per duty day spent standing, walking, or moving). Individuals who did not return to their prior level of military duty were asked to report the reasons for not returning. A total of 94 male military personnel with a mean age of 30.3 ± 5.7 years participated in the study. Only 11 (11.7%) individuals returned to their preinjury level of military duty using the authors' comprehensive definition at a mean follow-up of 1.83 ± 0.76 years. Of the 94 participants, 51 (54.3%) returned to their preinjury standing hours, 32 (34.0%) to their preinjury type of military activity, and 30 (31.9%) to their preinjury frequency of military activity. Of those who did not RTMD, 83% reported fear of reinjury or lack of confidence as a reason for not returning, while 76% reported persistent knee problems. The rate of return to preinjury level of military duty in Jordanian military personnel after ACLR using a comprehensive definition for return to duty is only 11.7%. Fear of reinjury or lack of confidence in the injured knee and ongoing knee problems are the most commonly reported reasons for not returning to the prior level of military duty.

The TriService Nursing Research Program (TSNRP) has been a cornerstone of military nursing science for over three decades. Established in 1992, TSNRP has evolved from a visionary pilot project to the Gold Standard for the Joint Force, providing the empirical foundation for clinical practice guidelines used globally. With a focus on operational readiness, high-velocity science, and advanced professional development, TSNRP aims to bridge the cognitive and clinical strain on military nurses operating in contested environments. TSNRP's strategic trajectory has shifted towards addressing the complex physiological and environmental stressors inherent to modern warfare. Research initiatives have focused on warfighter health and performance, mental health and resilience, development of military nursing, and forward-looking broad research. The program has also expanded its reach through international collaboration, with the inaugural Global Tactical Nursing Research Symposium convening nursing professionals from across the globe. TSNRP's commitment to operational readiness is reflected in its strategic alignment with the National Defense Strategy and the Department of War. The program's funding priorities have shifted towards military operational research problems, recognizing that a sophisticated defense strategy requires a highly skilled and resilient nursing corps. TSNRP has also developed innovative training programs, such as the eCornell Leadership Certificate Program, to cultivate epistemic curiosity and critical thinking among nurses. With over $200 million in research funding and a legacy of publishing numerous studies and guidelines, TSNRP remains poised to meet the challenges of Large-Scale Combat Operations (LSCO). The program's dedication to evidence-based practice, international collaboration, and professional development ensures that military nurses are equipped with the most powerful weapon in medical science: rigorous, actionable, and life-saving knowledge. As the Military Health System confronts the daunting reality of LSCO, TSNRP stands ready to meet these challenges head-on, cementing its position as the leading authority on military nursing science.

Acute traumatic brain injury (TBI) in older veterans is an under-recognized public health emergency for the Veterans Health Administration (VHA). The fastest rising incidence of TBI in the United States is in older adults, who have higher mortality, lower rates of functional recovery, and higher risk for post-TBI dementia. Pre-existing TBI, medical/psychiatric conditions, and substance use-common in older veterans-are emerging risk factors for TBI and worse outcomes thereafter. There is an urgent need to characterize acute TBI in older veterans to inform effective interventions to optimize outcomes. We aim to characterize military, clinical, and biological features using a combination of TBI common data elements (CDEs) and validated dementia and geriatrics research assessments. This single-site, longitudinal, observational research study aims to enroll 70 older veterans with acute TBI who receive computed tomography in the emergency department and 30 matched non-neurotrauma controls who present to the San Francisco VA Medical Center within 14 days of their event. Participants and study partners complete pre-injury health/military relevant exposure assessments and multi-domain geriatric and TBI CDE follow-up assessments at 2 weeks, 3, 6, and 12 months. Blood for proteomic biomarkers is collected at baseline, 6 months, and 12 months. Willing participants also undergo magnetic resonance imaging at 2 weeks, 6 months, and 12 months. This study aims for comprehensive characterization of baseline and longitudinal endophenotypes of an intentionally heterogeneous, "real-world," population of older veterans presenting with acute TBI. Findings will inform the development of future studies focused on optimizing outcomes and evaluating interventions in TBI. This study will provide critical insights into the unique characteristics and the natural history of incident TBI in older veterans, paving the way for larger, Veteran Affairs-based, multicenter prospective studies of acute TBI to inform prevention, support correct diagnosis, and optimize short- and long-term recovery.

Military resilience programs have grown considerably over the past 2 decades since the Comprehensive Soldier Fitness Program was introduced. Although there is considerable positive evidence that supports the promotion of resilience in this population, there have also been concerns about dissemination, implementation, use of compulsory training and impact on the mission and the servicemember. Parallel civilian wellbeing and resilience programs have popularized psychological concepts such as grit and growth mindset with a patchwork of both positive and lackluster findings. More recently there has been recognition that "one-size-fits-all" resilience programs may be less effective and impactful than adaptations personalized for a specific subpopulation or community. The current study evaluated a tailored adaptation of resiliency programming within a military medical population. The study utilized the Kirkpatrick model for program evaluation, specifically focusing on level one (reaction). Participants were 156 first-year medical students across 5 cohorts who completed resilience training that consisted of 4&#xa0;hour-long modules. Data were collected via optional post-training surveys measuring perceived self-efficacy, perceived mental resilience, and willingness to recommend the training to peers. Qualitative themes were also extracted from open-ended responses regarding the students' "biggest takeaways." The results indicated a consistently positive response to the training across all cohorts, with no significant differences in ratings for perceived self-efficacy or mental resilience. Although most students recommended the program, the cohort that underwent training virtually during the COVID-19 pandemic showed a significantly lower willingness to recommend the program to peers (&#x3c7;2&#x2009;=&#x2009;26.41, P&#xa0;<&#xa0;.001) compared to in-person cohorts. Qualitative analysis revealed that students highly appreciated the acquisition of tangible skills (e.g., cognitive reframing, relaxation strategies), clarifying their values, and connecting with their peers. The "Grit and Growth" program provides a promising blueprint for adapting military resiliency training to specialized high-stress subpopulations. By successfully integrating individual psychological skills (grit and growth mindset) with systemic awareness and traditional Cognitive Behavioral Therapy models, the curriculum maintained high student satisfaction over 5&#xa0;years. Although limited by self-reported data, these findings offer a roadmap for future research to evaluate higher Kirkpatrick levels, such as behavioral changes and long-term academic or professional outcomes.

Aim: To conduct a comprehensive analysis of the legal guarantees for Ukrainian law enforcement officers performing their official duties in areas of military (combat) operations, and their impact on the preservation of mental and physical health. The research also aims to identify the relationship between the level of implementation of these guarantees, psycho-emotional state, occupational stress, and the risks of burnout among this category of personnel. Materials and Methods: The study was designed as an interdisciplinary empirical legal study combining legal, medico-social, and statistical methods. It included comparative legal analysis, an anonymous survey, and statistical processing of the data. The study involved 48 law enforcement officers with experience of service in combat zones or other high-risk conditions. The main research instrument was an adapted questionnaire assessing psychological competencies and the perception of legal guarantees. Results: The respondents highly rated the importance of psychological competencies for professional communication, while self-assessment of communicative skills was moderately high. At the same time, indicators of stress prevention, perception of legal guarantees, legal certainty, maladaptive behaviour risks, and mental health remained at an average level. The lowest scores were related to access to psychological assistance and access to rest and rotation. Correlation analysis showed that stronger legal guarantees were associated with lower occupational stress, while greater legal certainty was linked to better self-assessed mental health. Insufficient legal guarantees were significantly associated with emotional burnout. Conclusions: Legal guarantees for law enforcement personnel in combat conditions should be regarded not only as a formal element of service status, but also as a practical mechanism for preserving mental and physical health. Strengthening legal certainty, improving access to psychological and medical support, and ensuring effective rest and rotation mechanisms are essential for reducing stress and burnout and for enhancing professional resilience.

To determine whether publishing at a given institution is associated with matching there for orthopedic surgery residency, and whether this association reflects publication presence or sustained concentration of work at an institution, with exploratory analyses of publication network characteristics. Cross-sectional bibliometric analysis of the 2024 to 2025 NRMP and military match cycles using manually verified publication data with institutional affiliations. Primary analysis used chi-square tests and logistic regression with Bonferroni correction (&#x3b1;&#x202f;=&#x202f;0.025) to examine associations between institutional publication affiliations and match outcomes. Multi-institutional analysis of 221 ACGME-accredited orthopedic surgery residency programs across the United States. Of 954 matched first-year orthopedic surgery residents, with verified publication data obtained for 661 residents (69.3%) comprising 4077 PubMed-indexed publications classified by institutional affiliation as home or external with network characteristics. Among residents with verified publications (mean 5.92 publications per resident, median 3.0), 165 (25.0%) matched at an institution where they had previously published, compared with 3.8% expected by chance (&#x3c7;&#xb2;&#x202f;=&#x202f;178.3, p&#x202f;<&#x202f;0.001). To distinguish whether this association reflected publication presence or sustained engagement, we used the home institution-identifiable for every applicant-as a test case. Of 153 (23.1%) matched at home, but having a single home institution publication was not associated with home matching (19.6%&#x202f;vs 18.8%, p&#x202f;=&#x202f;0.865); however, the proportion of publications at the home institution was the strongest predictor of home matching (odds ratio&#x202f;=&#x202f;2.17, 95% confidence interval: 1.27-3.73, p&#x202f;=&#x202f;0.005). Publishing at a residency program was strongly associated with matching there, at a rate approximately 7 times higher than chance. The mere presence of a home institution publication did not predict home matching, but the proportion of publications concentrated at the home institution did. These findings suggest that sustained research engagement at target programs may be meaningfully associated with match outcomes.

Military operations expose service members to stressful environments, characterized by anxiety, sleep deprivation, and physical and cognitive fatigue. Readiness, defined as the ability to deploy and sustain operational missions, is critical to military effectiveness but remains difficult to measure and quantify. The Army's Holistic Health and Fitness (H2F) System emphasizes that physical and cognitive readiness contribute to mental toughness and performance, yet practical readiness assessment tools remain limited. Previous research demonstrated associations between self-perceived readiness, measured using the Acute Readiness Monitoring Scale (ARMS), and performance on discrete perceptual-cognitive tasks. This exploratory mixed-methods study investigated the relationship between self-perceived readiness, objective performance outcomes, and cadets' perceptions of readiness. The objectives were to: (1) explore cadets' perceptions of readiness and the dual-task treadmill protocol in relation to future military service; (2) determine whether self-perceived readiness was associated with cognitive and physical performance during the protocol; and (3) examine whether self-perceived readiness was associated with changes in perceptual-cognitive control following the protocol. We hypothesized that higher self-perceived readiness would be associated with enhanced perceptual-cognitive control and performance. Twenty-five physically active ROTC cadets (11 males, 14 females; mean age 19.5) from a large university participated. During a single visit, participants completed the 32-item ARMS, brief surveys assessing pain, stress, and mental fatigue, a dual-task treadmill protocol, and the Single Leg Memory Hop (SLMH) before and after treadmill testing. The treadmill protocol combined progressive physical exertion with 330 executive function tasks. Participants also completed semi-structured interviews exploring perceptions of readiness and the protocol experience. Quantitative data were analyzed using descriptive and correlational statistics, whereas qualitative data were analyzed using a constant comparison approach. Trustworthiness was maintained with peer debriefing, reflexive journaling, audit trail, triangulation, and member checking. Cadets demonstrated variable physical and cognitive performance during the dual-task treadmill protocol. Most maintained high cognitive accuracy (mean Stroop score 96.6%), but endurance declined as exercise intensity increased. Correlation analyses revealed few significant relationships between overall ARMS scores and objective performance outcomes, although several ARMS subscales demonstrated moderate associations with endurance and perceived exertion. Qualitative findings indicated that cadets viewed readiness as a multidimensional construct influenced by sleep, physical fitness, nutrition, emotional regulation, commitment, and mindset. Participants perceived the protocol as physically and cognitively demanding and believed it provided insight into readiness for future military service. Few significant relationships were observed between self-perceived readiness and objective performance measures. However, the qualitative findings suggest that cadets conceptualize readiness as a multidimensional construct extending beyond physical and cognitive performance alone. Together, the findings indicate that self-perceived readiness and objective performance may represent distinct but complementary aspects of military readiness. Additional research is needed to develop and evaluate readiness assessment approaches for future military leaders.

Emerging and re-emerging infectious diseases ranging from the 1918 H1N1 influenza pandemic to the recent SARS-CoV-2 and monkeypox virus outbreaks continue to pose profound threats to global public health. These crises underscore the critical need for high-fidelity and human-relevant infection models. Organoid technology has emerged as a cornerstone platform for pathogen research by faithfully recapitulating the 3-dimensional architecture and physiological microenvironment of native human tissues in&#xa0;vitro. This review systematically examines the development and structural refinement of organoid-based infection models with an emphasis on evidence-based strategies for stem cell source selection, extracellular matrix optimization, and dynamic culture system engineering. Such advancements enable the robust generation of multi-organ models including respiratory, intestinal, and neural organoids tailored for investigating viral tropism, spatiotemporal infection kinetics, and host immune responses. Furthermore, we evaluate the translational utility of organoids in high-throughput antiviral drug screening and preclinical vaccine assessment. To further enhance physiological relevance and functional fidelity, organoid platforms are being increasingly combined with advanced engineering strategies, including coculture approaches, CRISPR-Cas9-mediated genetic perturbation, engineered microphysiological systems (such as organ-on-a-chip), and 3D bioprinting. These integrated technologies improve biomimicry while expanding experimental controllability and scalability. In addition, we critically examine the major bottlenecks limiting clinical translation and discuss emerging frontiers driven by artificial intelligence and synthetic biology. Through iterative technological refinement and cross-disciplinary convergence, organoids have evolved beyond reductionist in&#xa0;vitro surrogates into physiologically informed and mechanism-driven platforms that advance our understanding of host-pathogen interactions while enhancing global preparedness against emerging pathogens.

Carlton George Smith, M.Sc., M.D., Ph.D., R.C.N.V.R. (1905-2003) was a Canadian anatomist and professor at the University of Toronto. He was highly regarded as an outstanding teacher, cutting-edge neuroscience researcher, and accomplished author. Dr. Smith became a member of the AAA in 1938 and joined the prestigious Cajal Club in 1950. In 1942, he joined the Naval Medical Research Unit in Halifax, eventually becoming its Commanding Officer, where he assisted with landmark research related to naval and military operational barriers during World War II. This research further bolstered his interests in the neuroanatomical bases of the special senses. Dr. Smith pioneered 3-dimensional (3D) teaching of neuroanatomy long before the era of technological advancement, using geometrical forms to describe the anatomical relationships between pathways and structures of the central nervous system. His innovative and evidence-based approaches, based on meticulous dissections, providing the foundation for both simple line drawings and detailed illustrations that were incorporated into several neuroanatomy books. He later developed a series of plaster models with his wife, Marguerite "Rita" Harland Smith, that highlight the complex 3D relationships of the human brain, head, and neck. Dr. Smith and Rita's legacy lives on through the models he donated to medical schools across Canada and at the University of Toronto through the endowment of scholarships and lectures. This article will include notable milestones in Dr. Smith's life with an emphasis on his scholarly and educational contributions to the field of neuroanatomy.

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Aim: To propose an indicative model of compulsory health insurance in the context of a significant deficit in budget financing of the healthcare sector and a decrease in the population's financial access to medical care. Materials and Methods: The search strategy involved the use of the keywords "health insurance", "health financing", "affordability", "patients", "healthcare", "insurance companies".The primary selection of materials was based on the analysis of the titles and abstracts of publications in accordance with the previously defined inclusion and exclusion criteria, formed according to the research topic. Of the 69 publications found, 21 were used. Methods used in the study: bibliographical, medical-statistical, analytical, graphical, functional-structural modelling, generalisation. The average salary "in hand" was calculated by subtracting from the average salary, according to official Ukrainian government sources (gov.ua, Ministry of Finance of Ukraine), personal income tax - 18.0% and military levy - 1.5% for the period until 01.12.2024; from 01.12.2024 the military levy increased to 5.0%. The real wage index, taking into account tax payments, was calculated according to the Methodology for calculating real wage indices. Conclusions: The proposed model is aimed at increasing the financial accessibility of medical care for the population, minimising the risks of inefficient use of resources, and strengthening the preventive component in health care. Its implementation requires further regulatory and organisational support.

By identifying which factors impact the physical function outcomes of pain therapies, health care providers can more effectively match therapies to individuals. This approach will ultimately improve the overall quality of pain management for diverse patient populations. The objective of this study was to test the following research question: Does the effectiveness of complementary and integrative health (CIH) versus standard rehabilitative care (SRC) in improving physical function differ on the basis of participant characteristics? The study design was a moderator analysis of data collected during a pragmatic clinical trial using a sequential multiple assignment randomized trial design. The setting was an interdisciplinary pain management center at a military medical center. The participants were a complete case sample of 249 active-duty service members with chronic pain. The interventions included a 3-week program of CIH therapies, consisting of twice-weekly chiropractic, acupuncture, yoga, and massage therapies, as well as a 3-week program of SRC, consisting of twice-weekly physical and occupational therapies. Functional measure t scores were calculated from a treadmill, lift, and carry battery. Multiple linear regression models showed that the effect of CIH versus SRC on the functional performance measure was moderated by race, pain impact, pain catastrophizing, and satisfaction with social roles. CIH interventions may be most effective for individuals who are non-Hispanic White, and SRC interventions may be more effective for individuals who are non-Hispanic Black. Psychosocial factors that may improve intervention effectiveness include lower baseline pain impact and pain catastrophizing and higher satisfaction with social roles. This research underscores the importance of tailoring interventions to the individual. By considering individuals' demographics as well as their psychological and social factors, health care providers can more effectively match individuals with the most appropriate treatment approach, ultimately improving outcomes across multiple dimensions of physical function.

Sex-based differences in treatment response to neuroprotective strategies during endovascular treatment (EVT) for acute ischemic stroke remain poorly understood. This study aimed to evaluate sex-specific effects of methylprednisolone on outcomes after EVT for acute ischemic stroke due to large vessel occlusion. Secondary analysis of the MARVEL (Methylprednisolone as Adjunct to Endovascular Thrombectomy for Large-Vessel Occlusion Stroke) randomized controlled trial. We compared outcomes following methylprednisolone versus placebo, stratified by sex. We also compared outcomes between women and men receiving methylprednisolone. The primary outcome was defined as the 90-day modified Rankin Scale score (mRS) ordinal shift. Secondary outcomes included mRS score of 0-4, 0-3, 0-2, 0-1 at 90 days. Safety outcomes included mortality within 90 days and symptomatic intracranial hemorrhage (sICH) within 48 hours. This study included 1680 patients (49.9% methylprednisolone, 56.7% men). Stratified by sex, among men, the methylprednisolone group was more likely to have a primary outcome compared with placebo [adjusted OR (aOR) 1.26 (1.00-1.59), P = 0.047] and reduce mortality (P < 0.01) and sICH (P = 0.031); among women, the primary outcome was similar between two treatment arms (P = 0.66), with similar findings for the safety outcomes. Additionally, stratified by different treatment arms, no significant difference was found in the primary outcome between men and women treated with methylprednisolone (P = 0.31) and placebo (P = 0.68). In this exploratory analysis, methylprednisolone appeared to be associated with better clinical outcomes in men compared with placebo. Nevertheless, the interaction between treatment and sex was not statistically significant. Furthermore, among patients receiving methylprednisolone, clinical outcomes did not differ significantly between men and women. ChiCTR.org.cn Identifier: ChiCTR2100051729. This study looked at whether an anti-inflammatory drug called methylprednisolone has different effects in men and women who had a severe stroke caused by a large blood clot in a brain artery and underwent a procedure called endovascular treatment to remove the clot. The research was based on data from a large clinical trial that included 1,680 patients. About half received methylprednisolone and the other half received a placebo. The researchers compared outcomes between men and women who received the drug versus placebo, and also directly compared men and women who received the drug. The results showed that among men, those who received methylprednisolone had better recovery of daily functions 90 days after the stroke compared to men who received placebo. They also had lower rates of death and symptomatic bleeding in the brain. Among women, however, there was no significant difference in recovery between those who received methylprednisolone and those who received placebo. When researchers directly compared men and women who both received methylprednisolone, their recovery outcomes were not significantly different. In summary, this study suggests that methylprednisolone may be more helpful for recovery in men with this type of stroke, while the benefit in women was less clear. These findings indicate that sex may be an important factor to consider when using this medication in future stroke treatment.

The polytrauma clinical triad (PCT)-co-occurring posttraumatic stress disorder (PTSD), traumatic brain injury (TBI), and chronic pain-is common among U.S. service members and veterans. While known to result in worse clinical outcomes, the effect of the PCT on suicide in military populations remains unknown. The current study examined the effect of the PCT on suicidal ideation and attempts in U.S. veterans and service members. In Study 1, veterans (N = 351) completed self-reports of PTSD symptoms and chronic pain and clinician interviews of TBI and suicidal ideation and attempts. In study 2, Army soldiers (N = 8558) completed self-reports of PTSD symptoms, chronic pain, TBI, and suicidal ideation and attempts across four assessments spanning from 1-month prior to deployment to 9-months post-deployment. The PCT was more prevalent in veterans (30.09%) than service members (2.51%), and was associated with greater odds of suicidal ideation in veterans (OR = 4.11) when compared with only two conditions. When compared with one or no conditions, the PCT was associated with greater odds of suicidal ideation (ORs = 2.06-2.94) and attempts (ORs = 4.06-4.40) in service members. PTSD seemed to drive this effect. Findings support the PCT as a potentially important risk factor for suicide in both current and former military members. Future research should attempt to understand the impact of the PCT on mechanisms of suicide risk and suicide risk screening should be prioritized in polytrauma clinics where patients with the PCT are likely to be seen.

This systematic literature review (SLR) aims to update the evidence regarding therapeutic strategies in difficult-to-treat rheumatoid arthritis (D2T RA), building on the previous SLR informing the European Alliance of Associations for Rheumatology (EULAR) points to consider for the management of D2T RA. Three research questions addressed efficacy or safety of treatments in patients with RA with (1) active disease and limited treatment options; (2) active disease with &#x2265;2 prior biologic/targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) and (3) poor health-related quality of life and low objective disease activity (non-pharmacological interventions). MEDLINE, Embase and Cochrane Library were searched until July 2025. Meta-analysis and meta-regression were conducted. We screened 8589 records and included 131 studies. For research question (RQ)1, evidence on DMARD efficacy and safety was synthesised across a wide spectrum of comorbidities including obesity, cardiovascular disease, history of malignancy and respiratory comorbidities. For RQ2, all b/tsDMARDs except otilimab demonstrated better efficacy than placebo (mostly high risk of bias). Meta-regression showed efficacy was maintained for Janus kinase inhibitors (JAKi) despite increasing number of prior bDMARD failures (1 to &#x2265;3). Safety results confirmed the increased occurrence of infection and malignancy with JAKi. For RQ3, limited evidence suggested orthopaedic surgical intervention as a potential non-pharmacological option in patients with D2T RA. This SLR summarised evidence supporting DMARD efficacy/safety across multiple comorbidities. In patients with active RA with &#x2265;2 prior bDMARDs, JAKi offer substantial clinical benefits but require careful risk stratification given cardiovascular and malignancy risks. Furthermore, standardised reporting and dedicated studies on non-pharmacological interventions are urgently needed. CRD42024593584.

Cancer centers are disproportionately vulnerable to large-scale crises-including pandemics, armed conflicts, cyberattacks, and supply chain failures-and while COVID-19 generated valuable crisis guidance for oncology, frameworks tailored to the specific structural vulnerabilities of GCC cancer systems have been limited. The Gulf Cooperation Council region illustrates this gap with immediate, real-time urgency. The ongoing 2026 regional military escalation has reportedly disrupted Strait of Hormuz shipping and Gulf air cargo routes-critical corridors for pharmaceutical cold-chain logistics across all six GCC states-posing risks to essential oncology pharmaceuticals, radioisotopes used in nuclear medicine, and CAR-T manufacturing supply chains. Cancer incidence across the GCC is projected to increase by 60% by 2040, and cancer care remains under-integrated into emergency preparedness frameworks globally. This Perspective proposes a six-pillar crisis leadership framework for cancer center directors and oncology leaders, organized across a four-phase crisis lifecycle (Prepare, Respond, Adapt, Recover), drawing on pandemic-era oncology evidence, international oncology society guidelines, and contextual analysis of the 2026 GCC crisis. The six pillars address the full operational spectrum of cancer center crisis management, from triage and pharmaceutical resilience to workforce wellbeing, digital health, and cross-border coordination. Three specific policy recommendations for GCC health systems are proposed: a formal GCC Oncology Crisis Network with a Regional Real-Time Pharmaceutical Dashboard and distributed reserve framework spanning UAE, Saudi Arabia, and Oman; domestic manufacturing investment for oncology essentials; and a GCC oncology resilience research agenda.

The use of specialized perturbation systems has become an increasingly popular approach for investigating walking stability. By accelerating or decelerating one belt, researchers can induce slip- and trip-like perturbations in a controlled laboratory setting. However, many existing studies rely on specialized perturbation systems that require expertise in device-specific software and handling of the equipment, limiting the accessibility of perturbation-based gait research to laboratories with access to such equipment. To address this limitation, we developed an open-source method capable of inducing slip- and trip-like perturbations using a standard split-belt treadmill. Here, we 1) describe the hardware and software components of the system, 2) validate the application's accuracy and precision, and 3) characterize the stability demands imparted by the perturbations with spatial stability measurements. Measured perturbation onset delay and duration were compared to the desired onset timing and programmed duration in addition to step length, step width, minimum mediolateral margin of stability, and sagittal-plane whole-body angular momentum range during the perturbed and recovery steps. Five participants with traumatic unilateral transtibial limb loss experienced perturbations consisting of brief, rapid increases or decreases in unilateral treadmill velocity, eliciting a "slip" or "trip". The mean (standard deviation) onset delay was 183.3 (9.7) ms, or 24.18% (1.91%) of stance duration. Mean perturbation duration was 239.90 (7.5) ms, 18.14% longer than the intended duration. The perturbations produced measurable changes in gait stability, such as increased step length during the perturbed step and step width during the subsequent recovery step in addition to increased minimum mediolateral margin of stability and sagittal whole body angular momentum. This open-source method successfully induced instability in individuals with impaired balance, demonstrating its feasibility as an accessible alternative to specialized perturbation systems. Future work will focus on refining both the software and hardware components to further improve timing, accuracy, and consistency.

To provide the public and non-specialist readers with clear insight, we re-evaluate a published study claiming that artificial intelligence (AI) software performs as accurately as orthodontist experts in identifying key points on dental X-ray images. Our analysis reveals flaws in the original research methods: inconsistent image processing led to unreliable measurements, and critical details about data sources were missing. Most importantly, when we repeated the experiment with new X-ray images and protocols, over 80% of the AI's landmark identifications showed significantly higher error rates than originally reported-contradicting the claim that AI matches expert accuracy. We urge methodological rigor in future studies on AI's role in dentistry.

Aim: This study set out to develop and substantiate the concept of blastotrauma as a distinct category of traumatic pathology, to introduce the Blast Trauma Severity Scale (BTSS) for evaluating the severity of explosion-related injuries, and to show how the scale can be applied clinically in patients with combat-related trauma. Materials and Methods: The study followed a retrospective observational design, drawing on archived clinical records of patients with combat-related injuries treated between 2023 and 2025. A total of 70 patients with blast and explosion-associated trauma qualified for inclusion. To enable consistent severity grading, the Blast Trauma Severity Scale (BTSS) was developed around five domains: soft tissue injury, bone injury, neurovascular injury, internal organ injury, and physiological response. Results: The study introduces blastotrauma as a complex pattern of morphological and physiological damage arising when explosive energy is transferred to human tissues. The BTSS delivers an integrated severity score from 0 to 20 points, organised into four grades. Assessment can be further refined by appending the dominant blast-injury mechanism descriptor (P/S/T/Q). Applying the scale to the study cohort confirmed that consistent, standardized stratification of blast injuries is achievable in clinical practice. Conclusions: The blastotrauma concept and the BTSS classification offer a practical framework for standardized description of explosion-related injuries, clinical stratification of patients, and continued research in trauma and military medicine.