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South Korean public health doctors (PHDs) serve as frontline responders in underserved regions during national health crises, such as the COVID-19 pandemic. However, the system has not adapted to evolving healthcare needs and despite the essential roles of PHDs, little is known about the unique occupational stressors they face. We examined how work-related factors, especially national guidelines and policies, impact the mental health of PHDs during public health emergency deployments, providing evidence to inform policy and support systems for this workforce. An online cross-sectional survey of all PHDs serving between July and August 2021 was used to collect data on demographics, work-related stress, and mental health outcomes using validated questionnaires. Associations between work factors and mental health (depressive symptoms, embitterment, burnout) were analyzed using logistic regression. Among 269 PHDs (mean age 29.7 years), 27.1% reported depressive symptoms, 9.3% embitterment, and 45.4% burnout. Dissatisfaction with financial compensation was associated with higher risks of depressive symptoms (adjusted odds ratio [aOR], 2.481), embitterment (aOR, 3.695), and burnout (aOR, 2.997). Deployment of 3-6 months increased embitterment (aOR, 3.770) and burnout (aOR, 2.469). Job demands predicted all outcomes (aOR, 1.033-1.040). National guidelines/policies and concerns related to work and environment were associated with depressive symptoms (aOR, 1.138, 1.056) and burnout (aOR, 1.105, 1.042). This study highlights the need for adequate compensation, manageable deployment duration, and strong organizational support, including clear national guidelines and policies to mitigate mental health risks, among PHDs during public health emergency deployments.

Training pathways, such as MD-PhD-programs, have been established to increase the physician-scientist workforce. Still, MD-PhDs represent only a small fraction of the physician workforce worldwide. This is different in the Netherlands, where half of specialist physicians hold a PhD, but little is known about their careers. We aimed to explore the motivations of Dutch physicians to pursue a PhD, and investigate the proportion of MD-PhDs entering physician-scientist careers. In 2022, we conducted a survey study among all MD-PhDs in the Netherlands who obtained a PhD degree in the year 2008. Drawing on self-determination theory, we used the Motivation for PhD Studies Scale to assess respondents' motivations for pursuing a PhD. We defined a physician-scientist career as spending at least 20% of working hours on both research and clinical work. Of all 479 MD-PhDs, 240 completed the survey (response rate 56.6%). Motivation for a physician-scientist career appeared to be predominantly driven by autonomous motivation (including intrinsic and internalized forms of extrinsic motivation), rather than controlled motivation (reflecting external and internal pressures). Of all respondents, 67.5% reported a combination of clinical and research activities. One quarter (25.2%) met our criteria for a physician-scientist career, similar between men and women. Higher scores for autonomous motivation were associated with continued research activity, including a physician-scientist career and tenured appointment. The motivation to pursue research and having a scientific network or research collaborations were mentioned as supportive factors for continuing research after the PhD. The lack of dedicated time for research and a desire to spend more time with one's partner or family were the most important barriers against continued research activities. Autonomous motivation is more important than controlled motivation for Dutch physicians in pursuit of a PhD, and is associated with an increased likelihood of a subsequent physician-scientist career. Of the large proportion of MD-PhDs in the Dutch physician workforce, one fourth continues as physician-scientist.

Food and nutrient security are critical for population health and environmental sustainability. This study aimed to assess Taiwan's food and nutrient security and its alignment with the planetary health diet (PHD), integrating CO2 impact analysis. This study introduces the Food Security Index (FSI) and Nutrient Security Index (NSI) to assess Taiwan's food and nutrient security. It also examines adherence to the PHD and uses life cycle assessment to evaluate CO₂ emissions across regions/countries, offering a comprehensive view of environmental impacts. From 2017 to 2020, the Nutrition and Health Survey in Taiwan estimated the prevalence of undernourishment (PoU) for 12 120 participants using FAO methods. Additionally, the Food Insecurity Experience Scale (FIES) was calculated for 2879 participants in 2022-23 with FAO's RM.weights package. The FSI and NSI were derived from supply-to-needs (S-Nr) and intake-to-needs (I-Nr) ratios using NAHSIT and the food balance sheet (FBS). Moreover, PHD score (PHDS) was applied to assess PHD adherence and compare CO₂ emissions across 12 regions/countries using FBS. Taiwan with PoU below 2.5% (2017-20), FIES 1.1% (2022-23). FBS showed S-Nr 0.84 for vegetables, 0.77 for fruits, and 0.47 for dairy. I-Nr for calcium was 0.56, while NAHSIT S-Nr was 0.97 for cereals/roots, 0.36 for dairy, and 0.71 for vegetables/fruits, I-Nr 0.58 for fiber, 0.56 for calcium, and 0.49 for vitamin D. Taiwan achieved the highest PHDS (48.55%), while Brazil had the lowest (31.06%). A moderate negative correlation (r = -0.413) was found between PHDS and food-related CO₂ emissions. Despite high food security, targeted policies are needed to address nutrient imbalances and promote sustainable diets.

Cuproptosis, a newly identified form of copper-dependent programmed cell death, has emerged as a potential therapeutic strategy for cancer treatment. However, its antitumor efficacy was strictly limited by dysregulated glycolytic metabolism of tumor cells. Herein, we proposed multifunctional copper-based nano-PROTACs (CHNDs) to degrade hexokinase 2 (HK-2) and amplify cuproptosis for cancer therapy via dual mitochondrial energy depletion. Our initial evaluation indicated that polyethyleneimine (PEI)-based nano-PROTACs (PHDs) triggered HK-2 degradation via the ubiquitin-proteasome system (UPS). PHDs reduced HK-2 expression to 43.7% in 4T1 cells and 42.1% in CT26 cells, which consequently impaired glycolysis in tumor cells. Furthermore, copper ion release from CHNDs in a controlled manner and the glucose metabolism homeostasis interference by PHDs orchestrally induced effective cuproptosis and glycolysis inhibition for suppressing development and metastasis of tumor cells. Notably, CHNDs markedly inhibited the growth of murine colon and breast tumors by simultaneously disrupting mitochondrial respiration and glycolysis, resulting in tumor inhibition rates of 76.6% and 55.3%, respectively, and extending the median survival of CT26 tumor-bearing mice from 21 to 29 d. Our designed multifunctional engineered nanoparticle-based targeted protein degraders facilitated a new paradigm for precise oncology and proteolysis-targeting chimera (PROTAC) development.

Following Malaysia's transition to the endemic phase of COVID-19, primary healthcare doctors (PHDs) experienced a substantial increase in workload , which combined with workforce shortages and continued exposure to infection risk, contributed to sustained psychological distress among PHDs. Assessing the mental health status and coping strategies of healthcare professionals during the recovery phase is essential to ensure the continuity of national healthcare services. This cross-sectional study assessed the prevalence of stress, anxiety and depression among PHDs in private and public primary care clinics in Petaling, Selangor. It also analysed the relationship between these mental health conditions and coping mechanisms over 5 months. Selfadministered questionnaires containing sociodemographic items, as well as English versions of the Depression Anxiety Stress Scale-21 (DASS-21) and Brief COPE were utilised. Multiple logistic regression was applied to determine the associated factors of depression, anxiety and stress. A total of 230 participants were included. The median age was 35 years. The prevalence of depression, anxiety and stress was 28.7%, 23.0% and 20.4% respectively. Workplace conflict was significantly associated with higher odds of depression (AOR=2.497; 95% CI=1.230-5.070), anxiety (AOR=5.337; 95% CI=2.329-12.232) and stress (A0R=3.078; 95% CI=1.339-7.075). Avoidant coping strategies were associated with higher odds of depression (AOR=2.743; 95% CI=1.150-6.544) and anxiety (AOR=5.776; 95% CI=2.010-16.598). Current trends underscore the need to implement evidence-based coping strategies that directly address underlying factors contributing to depression and anxiety. Additional targeted interventions are required to improve the mental health of physicians post COVID-19 pandemic.

Doctoral research degrees, particularly Doctor of Philosophy (PhDs), are integral to advancing medical science, clinical research, and therapeutic practices in orthopedics. Despite their significance in fostering innovation and evidence-based medicine, prospective PhD scholars encounter numerous barriers and challenges. Institutional inaccessibility, logistical constraints, and geographical challenges in developing countries hinder the pursuit of advanced research education. In addition, the gap between clinical practices and research-based studies highlights the struggle of translating evidence-based medicine into routine care. Researchers face challenges like inadequate mentorship, disorganized feedback, insufficient preparatory guidance, and cultural differences, affecting both foreign and native scholars. Furthermore, balancing research responsibilities with clinical duties often leads to burnout, family disruptions, and compromised patient care standards. Mental health issues and lack of confidence are prevalent among PhD students, exacerbated by time management challenges and inadequate institutional incentives. Despite these obstacles, opportunities for interdisciplinary collaboration, bridging gaps between clinical and research practices, and adopting innovative methodologies have emerged. Technological advancements in orthopedics, such as robotics and artificial intelligence, are revolutionizing patient care and inspiring new research directions. PhDs contribute to career progression by equipping clinicians with advanced knowledge, fostering policy-making skills, and promoting specialization in fields like sports medicine and regenerative therapies. While challenges persist, the academic rigor and career incentives offered by PhDs create a promising pathway for orthopedic professionals to impact healthcare systems and patient experiences significantly. Continued focus on education, research methodologies, and interdisciplinary cooperation will ensure the integration of innovation and evidence-based practice for improved outcomes in orthopedics.

Physical activity is a modifiable health behavior influenced by neighborhood walkability. In-person field audits of pedestrian environment features of neighborhood walkability were conducted at the start of an ongoing multilevel, multicomponent physical activity promotion intervention called Community Walks, taking place in 12 low-income public housing developments (PHDs) in Boston, MA, USA. Following these audits, we then explored alternative, remote methods of walkability assessment. One option is the publicly available database of service requests submitted by individuals in municipalities across the U.S. by calling '311' to report problems that can present obstacles to physical activity (e.g., potholes, broken crosswalk signals). In this Community Case Study, we examined the cross-sectional relationship between pedestrian environment features and neighborhood walkability scores in the 12 low-income PHDs in Community Walks, and the frequency of 311 service requests within a 0.1-mile radius of each PHD's address. In adjusted analyses, a one-unit increase in the overall walkability score was associated with a 12% (95% CI: 1.03-1.22) increase in the frequency of 311 service requests. We then describe possible explanations of these findings and implications for community-based physical activity interventions. For example, pedestrian advocacy training is an intervention component that could raise residents' awareness of the 311 system and encourage its use to increase reporting of walkability concerns. This study represents an exploratory starting point for future multi-level physical activity interventions in which 311 data could inform intervention programming aimed at increasing health-promoting physical activity behaviors.

Chemotaxis to a moving potential mate that emits a volatile sex pheromone poses a navigation challenge requiring rapid, precise responses to maximize reproductive success. Volatile chemicals form gradients that differ from soluble compounds, potentially making navigation based on comparisons between spatially separated sensors unreliable for small-bodied animals. Here we show that, rather than a simple spatial comparison, Caenorhabditis elegans males employ an antagonistic strategy, comparing inputs from sex-shared head (AWA) and male-specific tail (PHD) sensory neurons with distinct response properties. Despite sharing a receptor, SRD-1, these detectors play different roles: AWAs promote forward movement and acceleration, while PHDs induce reversals and deceleration. In rising pheromone gradients, AWA activity dominates; in falling gradients, AWA inactivates, allowing PHD to correct trajectories. AWAs are essential for mate-searching, while PHDs are crucial for complex tasks. A minimal computational model reproduces these behaviors and infers how head-tail signals are combined. Thus, a sexually dimorphic, antagonistic sensory system enables adaptive navigation in dynamic environments.

<p>The present review provided a comprehensive exploration of the subtypes of prolyl hydroxylase domain (PHD) enzymes, with a focus on their localization, regulatory mechanisms and functional roles. Additionally, the development of pharmacological agents targeting PHDs and their crucial involvement in erythropoiesis were examined. Under hypoxic conditions, cells initiate a cascade of adaptive biological responses, numerous of which are governed by the transcriptional complexes of the hypoxia&#x2011;inducible factor (HIF) family. The intricate balance among HIF&#x2011;1&#x3b1;, HIF&#x2011;2&#x3b1; and HIF&#x2011;3&#x3b1; plays a fundamental role in orchestrating the transcription of genes involved in red blood cell production, angiogenesis, vascular homeostasis, metabolic regulation, and cellular proliferation and survival. HIF&#x2011;1&#x3b1; is rapidly upregulated in response to acute hypoxia and is particularly associated with erythropoietin production, whereas HIF&#x2011;2&#x3b1; predominantly regulates adaptive responses to chronic hypoxia. The hydroxylation of HIF&#x2011;&#x3b1; at two conserved prolyl residues by PHD1&#x2011;3 enables its recognition by the von Hippel&#x2011;Lindau tumor suppressor protein E3 ubiquitin ligase complex, leading to its polyubiquitination and subsequent proteasomal degradation. In humans, three PHD isoenzymes (PHD1&#x2011;3) and an asparaginyl hydroxylase known as factor&#x2011;inhibiting HIF have been identified, each exhibiting distinct substrate specificity and tissue distribution patterns. By modulating the hydroxylation of HIFs, PHDs serve as critical regulators of HIF activity, exerting influence over intracellular metabolism, reactive oxygen species, iron (Fe) bioavailability, nitric oxide signaling and redox equilibrium. These regulatory functions collectively shape a wide range of biological processes under hypoxic conditions. While HIF/PHD inhibitors have been successfully introduced into clinical practice, the development of HIF/PHD activators or functional restorers has faced considerable technical challenges. To date, no studies have reported the discovery of HIF/PHD activators. Nevertheless, targeting the HIF/PHD axis has already shown clinical value in treating anemia associated with chronic kidney disease, and ongoing research may expand its therapeutic potential to other hypoxia&#x2011;related disorders. Advancing research in this domain holds promise for pioneering novel therapeutic strategies, particularly for conditions such as polycythemia and chronic mountain sickness, where breakthroughs remain critically needed.</p>.

Innovation in psychiatry relies on laboratory-based neuroscience research using experimental animal models. How to best train and support investigators remains a critical question for the field. We examined how training background, operationalized as MD, PhD, or MD/PhD degree, is associated with National Institutes of Health (NIH) K-to-R01 transition, a key career benchmark. Understanding how clinical and research training impact early research success will inform strategies in medical education and physician-scientist training in psychiatry. This preregistered study used NIH RePORTER to identify recipients of NIH mentored-career-development K01 and K08 awards from neuroscience-focused NIH institutes. Projects using animal models to address a neuroscience question were identified by title-and-abstract review. R01 awards (1997-2024) were identified and linked to prior K awardees (1997-2016) to determine conversion rates. Among 758 awards (243 K01, 515 K08), 51% (388/758) converted to at least one R01. Conversion rates differed significantly by degree (p&#x2009;=&#x2009;0.035). MD-only investigators were less likely to convert (44%, 86/197) than MD/PhD (55%, 184/333) or PhD (52%, 118/228) investigators. Time to conversion also differed (p&#x2009;=&#x2009;0.032), with longer duration for MD-only investigators. In exploratory analyses, male PhDs converted more often than females (59% vs. 41%; p&#x2009;=&#x2009;0.024). No sex difference was found for MD and MD/PhD investigators. Lack of PhD-level research training was associated with reduced and delayed K to R01 transition for investigators using experimental animal models in neuroscience. Integrating PhD-style research training elements into psychiatry residency and faculty development programs may help close training-related gaps and address emerging sex disparities in research advancement.

Green chemistry is a set of principles for assessing, developing, and implementing methods that are safer, more efficient, and less detrimental to the environment. The analytical method greenness score (AMGS) is one of many metrics that attempt to evaluate traditional liquid chromatography (LC) based on the energy consumption of the instrument and the safety, health risks, and environmental impact of the solvents employed. Unfortunately, in practice, the AMGS is primarily focused on traditional separation methods in the pharmaceutical industry and is not amenable to cutting-edge separation science, including miniaturization. To broaden this scope, the unified Analytical Method Greenness Score (uAMGS) is presented here, which clarifies and expands on the underlying mathematics and incorporates both dimensional and uncertainty analysis, enabling its application to a broader range of analytical techniques. The uAMGS is used to compare the greenness of two distinct methods: single-molecule microscopy (SMM) and high-performance liquid chromatography (HPLC), which were used to collect equivalent data. uAMGS determines that SMM is significantly greener than HPLC due primarily to decreased solvent consumption. Overall, the uAMGS should allow chemists ranging from undergraduates to industrial PhDs to assess the greenness of a wide range of separations.

Operative triage of abdominal trauma, whether blunt or penetrating, remains a major challenge in emergency care. Although quantitative decision-support tools, such as Pediatric Emergency Care Applied Research Network (PECARN) rule, Focused Assessment with Sonography in Trauma (FAST), Shock Index, Pediatric Age-Adjusted (SIPA), and Blunt Abdominal Trauma Scoring System (BATSS), are widely used, they do not fully capture the complex clinical reasoning and experiential judgment required for real-world decision-making. This limitation is particularly important because blunt and penetrating abdominal trauma differ substantially in their pathophysiology, injury patterns, and management priorities. This qualitative study explored the patient-related factors influencing surgical prioritization (operative triage) of abdominal trauma from the perspectives of clinicians involved in trauma care. This qualitative study used a conventional content analysis approach. Ten clinicians with direct experience in abdominal trauma triage were purposively recruited from teaching hospitals affiliated with Dezful University of Medical Sciences, Iran. Participants included five specialist physicians (two anesthesiologists, one general surgeon, and two emergency medicine physicians) and five nursing and allied health professionals (two nurses with PhDs in Nursing, one nurse with a Master's degree, one surgical technologist with a Master's degree, and one Master's-level anesthesia professional). Data were collected through ten in-depth, semi-structured interviews and analyzed manually using the five-step content analysis method proposed by Graneheim and Lundman. Trustworthiness was established according to Lincoln and Guba's criteria. Analysis identified three main categories and ten subcategories influencing operative triage of abdominal trauma: physiological status (vital signs, respiratory distress, indicators of shock, level of consciousness, and associated neurological injury), individual and contextual characteristics (age, pregnancy, and comorbidities), and injury severity and pattern (limb injuries, extra-abdominal trauma, and head injury). Clinicians consistently distinguished between blunt and penetrating abdominal trauma during surgical prioritization. In blunt trauma, concealed hemorrhage, hemodynamic instability, and imaging findings suggestive of solid organ injury were the primary determinants of urgency. In penetrating trauma, injury trajectory, peritoneal violation, and the need for immediate surgical exploration were prioritized. Participants described operative triage as a dynamic process that integrates multiple clinical cues, contextual information, and professional experience rather than relying solely on algorithm-based protocols. Operative triage of abdominal trauma is a multidimensional clinical decision-making process that extends beyond standardized scoring systems and fixed numerical thresholds. Surgical prioritization requires the simultaneous integration of injury mechanism, physiological status, patient characteristics, and contextual clinical information. These findings underscore the importance of combining evidence-based protocols with experienced clinical judgment, particularly when managing patients with multisystem trauma, complex injuries, or atypical presentations. Incorporating these factors into trauma education, clinical training, and future decision-support systems may improve the accuracy, consistency, and timeliness of operative triage for patients with abdominal trauma.

Surgeon-Scientists in Otolaryngology-Head and Neck Surgery (OHNS) are critical to advancing clinical care through scientific innovation. However, extended training duration and challenges in research funding acquisition continue to hinder career advancement. Cross-sectional cohort study. Analysis of publicly available NIH RePORTER data and national survey of NIH-funded OHNS faculty across US academic medical institutions. Survey data was collected between October and December 2024. We identified NIH-funded OHNS faculty as of September 2024 using the NIH RePORTER database. We examined time to initial R01-equivalent funding and grant diversity by degree types (MD, PhD, or dual-degree). A survey was administered to the OHNS faculty to evaluate their training experiences, research productivity, and funding mechanisms. PhD faculty comprised the largest proportion of NIH-funded OHNS investigators (52%) and had greater grant diversity than MD and dual-degree counterparts (P&#x2009;<&#x2009;.0001). Furthermore, PhDs secured R01-equivalent grants earlier than MDs and dual-degree holders (7.5 vs 9.5 years posttraining, P&#x2009;=&#x2009;.04). However, MD and dual-degree faculty were more likely to obtain K awards and transition to R01 funding (P&#x2009;<&#x2009;.0001). Participation in T32/R25 residency programs was associated with a 2.5-year reduction in time to R01-equivalent grant (P&#x2009;=&#x2009;.037). Basic science researchers were 4 times more likely to obtain K awards (P&#x2009;=&#x2009;.04). While OHNS PhD faculty attain early and diverse funding, structured training programs and engagement in basic science research significantly enhance MD-degree faculty funding success. This study highlights institutional and training-level strategies that reduce the time to research independence and strengthen the OHNS surgeon-scientist pipeline.