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Invasive ants often exert strong negative effects on native ant assemblages and other invertebrates through strong resource monopolization and chemical defense. Removal of an invasive ant may therefore promote recovery of local biodiversity. However, evidence for such effects is mixed, and often taxon-specific. In this study, we experimentally removed Pheidole megacephala (Hymenoptera: Formicidae) from 2 secondary forest sites at located at Taiping (TP) (herein referred to as TP1 and TP2) and examined the taxon-specific responses of native ants, beetles, and spiders under field conditions. Removal of P. megacephala had limited effects on ant species richness and Shannon diversity. In contrast, beetle family richness at TP1 increased significantly during the first year of posttreatment compared with pretreatment levels. Several native ant species (eg Carebara diversa, Recurvidris recurvispinosa, and Solenopsis indagatrix) and predatory beetle taxa (Harpalinae, Cetoniinae, Paederinae, and Staphylininae) that were absent before treatment were detected following P. megacephala removal. Spider family richness declined during the second year of posttreatment at TP2, whereas the activity density of hunting spiders, particularly Ctenidae, Oonopidae, and Salticidae, increased approximately 2-fold at TP1 after removal. These native ants, predatory beetles, and hunting spiders that responded positively to removal share similar food resources or overlapping nesting and foraging habitats with P. megacephala. Our results suggest that removal of this invasive ant may have facilitated partial recovery of the local invertebrate community, particularly taxa that are ecologically and behaviorally similar to P. megacephala, likely by releasing food and spatial resources.

This study presents a sustainable approach to utilizing marble dust waste by producing bifunctional metakaolin-based geopolymers via a synchronized hot-pressing technique. In this study, the environmental footprint was minimized by designing mixtures in which marble waste constituted 50% of the total volume. Three stoichiometric series were investigated by varying the activator modulus (SiO2/Na2O = 3 and 4) and the Si/Al ratio (2 and 3) under two curing temperatures (150 and 300 °C) and three compaction stresses (5, 25, and 50 MPa). Thus, a high-volume industrial byproduct was transformed into a functional component. In this context, it investigated the transformation of industrial products into next-generation materials by using them to produce cementless composite geopolymers for civil engineering and to adsorb heavy metal (Cu2+). As a result of the research, an early compressive strength of 58 MPa was obtained through heat treatment and pressing applied at 300 °C and 50 MPa. This optimum strength was achieved in the SiO2/Na2O = 3, Si/Al = 3 series, whereas excess silica (SiO2/Na2O = 4) and excess aluminum (Si/Al = 2) limited the strength to 16.8 and 35.2 MPa, respectively. Microstructural analyses (SEM/EDS and FT-IR) revealed that marble dust was used as a filler material in the microstructure to produce an N-A-S-H-containing matrix. The produced materials were then ground after their service life and used to purify water containing heavy metals. More than 99.75% of Cu2+ was removed through ion exchange between copper ions used as heavy metals. The residual Cu2+ concentration fell below 0.25 mg/L from an initial concentration of 100 mg/L, and the released Na+-to-adsorbed Cu2+ molar ratio of approximately 1.8-2.3 confirmed an ion-exchange-dominated uptake mechanism. This structural and environmental impact demonstrates that marble waste, which is otherwise discarded as waste, is considered inert, offering an alternative model for the circular economy and environmental applications.

Reproductive trade-offs are fundamental to life history evolution, yet their expression is often obscured by individual variation in quality. Symbionts represent a critical environmental factor that may alter these trade-offs, but their impact on the link between reproductive effort and somatic maintenance remains poorly understood. Using burying beetles (Nicrophorus nepalensis) and their phoretic mite (Poecilochirus carabi), with a split-brood design to control for genetic background, we show that mite presence shapes both the magnitude and success of reproductive attempts. Brief physical exposure to mites alone was sufficient to trigger a plastic shift toward higher fecundity, even when mites are subsequently removed, producing brood sizes matching those of permanently mite-associated females. Crucially, survival analysis revealed that mites unmasked a latent trade-off between reproduction and longevity. These findings demonstrate how symbiotic interaction can both induce anticipatory life history shifts and reveal reproductive costs that remain hidden.

Upper tract urothelial carcinoma (UTUC) is a relatively uncommon malignancy, and radical nephroureterectomy (RNU) is the standard treatment for high-risk disease. However, management becomes challenging in patients with a solitary kidney, as radical surgery may result in dialysis dependence. Recently, enfortumab vedotin combined with pembrolizumab has shown promising efficacy in advanced urothelial carcinoma. A 74-year-old man with a history of right radical nephroureterectomy for UTUC developed a tumor in the contralateral ureter accompanied by progressive renal dysfunction. Ureteroscopic biopsy demonstrated low-grade non-invasive urothelial carcinoma, however, imaging and endoscopic findings raised suspicion of clinically invasive disease (suspected cT2N0M0). Because radical surgery would likely have resulted in dialysis dependence, treatment selection was challenging. A ureteral stent was placed to relieve obstruction, and systemic therapy with enfortumab vedotin plus pembrolizumab was initiated after multidisciplinary discussion and detailed informed consent. After ten cycles of therapy, radiologic and endoscopic findings demonstrated marked tumor regression, and ureteroscopic biopsy revealed no definite residual malignancy. The ureteral stent was subsequently removed, and renal function remained stable. The patient has since remained free of disease progression without additional treatment during follow-up. We report a clinically challenging case of contralateral ureteral tumor in a solitary kidney that showed a favorable clinical course following treatment with enfortumab vedotin plus pembrolizumab. This case highlights the importance of individualized multidisciplinary decision-making in complex clinical situations.

Penile strangulation is a rare urological emergency that may lead to ischemia or gangrene if not promptly treated. We report a case of a 52-year-old man with schizophrenia who presented 36 h after placing a metallic ring at the base of his penis for sexual stimulation. Physical examination revealed marked distal penile edema without evidence of necrosis. Initial attempts at manual removal were unsuccessful due to severe swelling. The device was subsequently removed safely using a modified string method combined with needle puncture for decompression. This approach enabled reduction in penile volume and facilitated successful removal without complications or the need for surgical intervention. The modified string method represents a minimally invasive, effective, and safe technique for the management of rigid constriction devices, particularly in cases of low-grade penile strangulation.

This scoping review examined the literature on the roles of healthcare professionals involved in multidisciplinary team (MDT) management of pressure injuries (PIs), as well as the barriers and facilitators influencing team-based care. Pressure injuries represent a significant global disease burden with physical and psychological impacts on individuals, requiring coordinated management from multiple disciplines. Understanding MDT composition, roles, and care delivery is essential to optimise patient outcomes and team performance across the care continuum. Eligible English-language papers on multidisciplinary PI care in hospital and community settings were identified through searching CINAHL, Cochrane, Embase, MEDLINE, and Scopus. After duplicates were removed, the remaining articles were independently screened by two reviewers, with discrepancies resolved by consensus. Data from 41 eligible papers were extracted and analysed thematically. MDT roles spanned wound care, rehabilitation, education, nutritional support, and care coordination, with substantial interdisciplinary overlap. Key facilitators included dedicated leadership, regular meetings, shared documentation, and ongoing training, while barriers encompassed unclear role definitions, inconsistent guidelines, poor hospital-to-community integration, and patient complexity. Critical gaps remained in psychosocial support, telehealth, and care for diverse populations. Multidisciplinary teams must be adaptable, holistic, and guided by patient experiences to optimise both healing and long-term prevention.

In this study, Egyptian sodium bentonite (NaB) was modified with the cationic surfactant benzalkonium chloride (BAC) to prepare organo-modified bentonite (OMB), which altered the surface chemistry and introduced positively charged adsorption sites, thereby enhancing the adsorption performance. NaB and OMB were characterized by (FTIR), (XRD), (BET), and zero charge point (pHpzc) measurements. After the modification, the OMB was used to remove highly toxic Cr(VI), commonly found in industrial effluents, from aqueous solutions via batch adsorption. The impacts of BAC loading, pH, exposure time, clay dose, initial Cr(VI) concentration, temperature, and shaking speed were systematically investigated in relation to the sorption process. The optimal conditions for removal were found to be 150% BAC loading (w/w relative to NaB), pH = 2, clay dose = 4 g L- 1, 60 min contact time for NaB and 70 min for OMB, 10 mg L- 1 initial concentration of Cr (VI) ions, and shaking speed of 200 rpm. Under these conditions, OMB achieved 99.6 ± 0.4% removal ([Formula: see text] ≈ 2.27 ± 0.05 mg g- 1), whereas NaB removed only 6.6 ± 0.06% of Cr(VI) ions. Adsorption kinetics followed the pseudo-second-order model, while equilibrium data followed the Langmuir isotherm, indicating surface interactions on the clay surface. Thermodynamic parameters indicated that Cr(VI) adsorption on NaB was endothermic and nonspontaneous, whereas adsorption on OMB was spontaneous and exothermic. These results demonstrate that BAC-modified bentonite is an efficient and low-cost adsorbent for Cr(VI) removal from heavy metal-contaminated water.

Cervical collars have traditionally been applied routinely in adult trauma to reduce the risk of secondary cervical spinal cord injury. Increasing evidence, however, supports selective spinal motion restriction and earlier collar removal when instability has been adequately excluded. This narrative review evaluates current evidence on collar application, avoidance, clearance, and continued use after confirmed cervical fracture. A structured literature search was conducted across major biomedical databases and guideline sources, with the synthesis guided by the Scale for the Assessment of Narrative Review Articles. In blunt trauma, collar use should be based on clinical risk, examination reliability, mechanism of injury, and phase of care. Routine collaring is generally unsupported in isolated penetrating trauma and may delay time-critical management. In evaluable patients, validated decision rules and high-quality computed tomography (CT) support early clearance when appropriate. In adults with impaired consciousness, collar removal after a negative high-quality CT should be individualized according to neurological findings, clinical context, examination reliability, institutional protocols, and the presence or absence of radio-clinical discrepancy. After fracture confirmation, continued collar use should be individualized according to stability, frailty, treatment goals, and tolerance. Collar-related harms should be incorporated into repeated reassessment. The proposed Four-Domain Trauma Collar Framework organizes these decisions across application, clearance, continuation, and de-escalation but remains a conceptual, unvalidated model. Cervical collars limit neck movement while possible cervical spine injury is assessed after trauma. Although once applied routinely, collars are not necessary for every injured adult, and prolonged use can cause pressure injuries, swallowing or breathing problems, and other harms. This review examines when collars should be applied, avoided, removed, or continued. After blunt trauma, collars are most appropriate when an unstable neck injury is a credible concern. Routine use after isolated penetrating trauma is generally unhelpful and may delay airway management or bleeding control. In awake adults who can be examined reliably, clinical decision rules and modern computed tomography (CT) can support early collar removal. In adults with impaired consciousness, a normal high-quality CT may support (but does not automatically justify) removal; scan quality, neurological findings, clinical context, examination reliability, and local protocols must also be considered. Further assessment may be needed when imaging and clinical findings do not agree. The proposed Four-Domain Trauma Collar Framework organizes these decisions but is conceptual rather than a validated guideline.

Gas-solvent partition constants for varied compounds were assembled from multiple sources for 53 organic solvents and water. The solvation parameter model was used to determine five solvent parameters (system constants) obtained from calibration models for the gas-solvent partition constants and subsequently used as variables for solvent classification. The system constants describe the solvents capability to enter into interactions with polarizable lone pair electrons, e system constant, interactions of a dipole-type (induction and orientation), s system constant, the solvent's hydrogen-bond basicity and acidity, a and b system constants, and the opposing contribution of solvent cohesion (cavity formation) and solute-solvent dispersion interactions, l system constant. The organic solvents are assigned to eight groups with similar solvation properties using hierarchical cluster analysis with the five system constants as variables. Water is identified as a singular solvent and excluded from the classification. Diisopropyl ether is also identified as a singular solvent but has properties not far removed from those of other oxygen-containing solvents (esters, cyclic ethers, aliphatic ketones, etc.) Within group variation of solvent properties indicates a general lack of solvents with duplicate properties with each group comprised of solvents with a narrow range of system constants. In preliminary work, compound descriptors were assigned for 19 further compounds and updated for a further 61 with all compounds compliant with the WSU-2025 descriptor database. These compounds facilitated the construction of calibration models for an additional 20 organic solvents that could then be merged with a database of system constants for 33 organic solvents and water.

Solar-driven photothermal evaporation has emerged as a low-carbon, energy-efficient approach for environmental remediation, but its application to volatile organic contaminants in soils remains challenged by rapid volatilization and limited mass transfer within soil matrices. Here, we present a biochar-supported NiO/TiO₂/polyvinyl alcohol/gelatin evaporator (BNT-H) that integrates evaporation-driven extraction with interfacial catalytic degradation for in situ phenol removal from soil. Under 1 kW m⁻² irradiation, BNT-H achieved an evaporation rate of 2.45 kg m⁻² h⁻¹. By controlling light intensity in a closed system, phenol was continuously transported to the photocatalytically active interface, where it was catalytically degraded. Volatile compounds not fully degraded were condensed and returned to the soil, re-entering the evaporation-catalysis cycle. This closed-loop process of evaporation, condensation, and reprocessing effectively minimized uncontrolled VOC emissions. Outdoor experiments demonstrated that the BNT-H system removed over 99% of phenol from soil with an initial concentration of 17.0 mg kg⁻¹ within seven days. Wheat germination in the remediated soil reached 97%, indicating substantial alleviation of phenol-induced phytotoxicity. Overall, this work presents a low-carbon strategy that shows potential for scale-up in VOC-contaminated soil remediation and provides mechanistic insights into coupling photothermal evaporation with interfacial catalysis for pollutant control.

We reported the clinical records of 2 patients each with a foreign body in the urinary bladder admitted to Qingdao Central Hospital, University of Health and Rehabilitation Sciences. The size and shape of each foreign body in the urinary bladder were different, thus we chose different surgical approaches to remove them. Case 1 was a 21-year-old male patient. He presented to the outpatient service with urodynia. The patient currently complained of urodynia, and narrated that a foreign body was self-inserted via the urethra 2 days before. Physical examination revealed suprapubic pain. Ultimately he was admitted to the Department of Urology with a diagnosis of "bladder foreign body". A computed tomography (CT) scan of the pelvis was performed and the results demonstrated a linear metallic structure, mea-suring 4.2 cm in length, within the urinary bladder. Under general anesthesia, the patient was placed in lithotomy position and a rigid cystoscope was inserted into the bladder via urethra. The foreign body was a metal tubular structure and was located within the urinary bladder. Removal by foreign body forceps was attempted and long axis of the foreign body should be parallel to cystoscope. Removal was carefully performed after several attempts due to the smooth surface of the metal foreign body. Case 2 was a 42-year-old male patient. He presented to the outpatient service with dysuria and urodynia and was admitted to the Department of Urology. The patient narrated that a foreign body was self-inserted via the urethra 1 day before, and currently complained of dysuria, urodynia, and slight hematuria. A CT scan of the urologic system was performed and the results demonstrated a metal tubular structure, measuring 21.5 cm in length. The length of the foreign body was long (from top of iliac crest to perineum) and both ends were sharp, thus bladder perforation could not be excluded. Besides, with smooth metal surface, it was difficult to remove via cystoscopy and the risk of iatrogenic bladder perforation would increase simultaneously. Therefore, laparoscopic surgery was chosen to detect whether there would be a bladder perforation and could remove the foreign body. Under general anesthesia, the patient was placed in supine position and supraumbilical incision of 1 cm was performed. Pneumoperitoneum needle was used to establish a pneumoperitoneum and insufflation CO2 pressure was maintained at 12 mmHg. The peritoneum was accessed and a 10-mm trocar and laparoscopic camera were inserted. A 5-mm trocar was inserted at 2 cm below the umbilical level of lateral margin of left rectus abdominis muscle. While a 12-mm trocar was inserted at symmetrical site of his right rectus abdominis muscle. Under laparoscope, dome of the bladder was lifted into the abdominal cavity by the foreign body, then the bladder wall was incised to expose the foreign body. We pushed the bottom of the foreign body from the perineum extracorporally and removed the foreign body from the supraumbilicus trocar.

Conductive hydrogels have emerged as promising materials for soft tissue interfacing by combining tissue-like mechanical compliance with electrical conductivity, thereby enabling improved electrical communication with electroactive biological tissues. This work presents an electroconductive composite hydrogel fabricated via light-based vat-polymerization by integrating a choline-based bio-ionic liquid (IL) with gelatin methacryloyl (GelMA). The resulting hydrogels demonstrate tunable conductivity, structural integrity, and high print fidelity when fabricated using digital light processing (DLP) light-based 3D printing. Electrical conductivity was optimized at 20% v/v IL concentration, with the hydrogels demonstrating stable performance for over 28 days. A food-grade photoabsorber was integrated into the formulation to improve DLP resolution and was effectively removed after printing process. The hydrogels supported the human mesenchymal stem cells' viability and proliferation, confirming their cytocompatibility. They also promoted enhanced maturation of primary neurons, demonstrating a supportive microenvironment for neural cells. In vivo implantation of indocyanine green-loaded hydrogels exhibited sustained stability and robust retention of signal over a period of 4 weeks, with histological analysis indicating seamless integration with surrounding tissues. Impedance spectroscopy at both gut and spinal cord interfaces illustrated that GelMA/IL composites achieved the lowest impedance across a range of frequencies, outperforming both GelMA-only and tissue-only conditions. Collectively, these findings position light-based vat-polymerized electroconductive composites as a promising platform for the development of anatomically conformal materials tailored for soft tissue interfacing.

NovoSorb® Biodegradable Temporising Matrix (BTM) is a synthetic polyurethane bilayer matrix, used in trauma and burns reconstruction. However, there is little evidence of its use for paediatric limb ischaemia. We present a review of literature and three paediatric cases of sepsis-induced ischaemic limb injuries, reconstructed using BTM. Data were collected on demographics, management and outcomes of three patients cared for by the senior author and plastic surgery service. The operative regimen and challenges faced are discussed.Three children, aged 1-8 years, were managed between 2022 and 2024. The first case had an immune-mediated reaction after bronchiolitis, and two cases had group A streptococcus sepsis. The first case required debridement of both lower limbs, covered with BTM, to improve scar quality and limb length. The second child had bilateral upper limb ischaemia, necessitating left below-elbow and right trans-metacarpal amputations, with BTM applied bilaterally to optimise residual limb length and stump quality. The third child underwent a right above-knee amputation and had significant soft tissue necrosis from the plantar surface of the left foot to the knee; BTM was applied to the left leg as a limb-salvage strategy. All cases required multiple surgical debridements, followed by early BTM application and subsequent split-thickness skin grafting. Follow-up of 1 year showed good outcomes in scar quality and preservation of limb length. BTM has not been reported in wounds of this aetiology in the paediatric population. These cases demonstrate BTM as a valuable adjunct in reconstruction of complex wounds secondary to sepsis-induced critical limb ischaemia. Occasionally, serious infections in children can severely reduce blood flow to parts of the arms or legs. This can cause tissue damage, often leading to amputations. Treating these injuries is difficult, especially when the aim is to save as much of the limb as possible. NovoSorb® Biodegradable Temporising Matrix (BTM) is a man-made dressing that helps the body form and organise new tissue before a skin graft is applied. It is already used for burns and other injuries, but its use in children with infection-related limb damage has been rarely reported.Question: Can BTM help rebuild and maintain residual length in children's limbs after severe infection causes loss of blood supply?Work conducted: This study reported three children, aged 1-8 years, treated between 2022 and 2024.What we did: Each child had life-threatening infections that damaged parts of their arms or legs. Surgeons removed the dead tissue in stages, utilised BTM early to protect the wounds and help new tissue organise, then later added thin skin grafts. After at least one year, all children had good scar quality and movement of the limb, and, where possible, preserved more of the affected limb.Learning points of this study: We saw promising results using BTM in these rare and complex cases. It appeared to achieve good healing and maintain residual limb length, but we do not know for sure how it compares to other treatments. Larger studies are needed to confirm these findings and guide best practice.

The use of cover crops (CCs) is increasingly promoted to diversify cropping systems and advance agricultural sustainability. Yet, CC adoption can involve context-dependent trade-offs, including resource competition and elevated greenhouse gas (GHG) emissions. In this opinion article, we propose enhanced rock weathering (ERW) as a complementary strategy to improve biogeochemical synchrony within CC systems. By synthesizing emerging evidence, we show how CC-ERW interactions can synergistically enhance carbon sequestration, nutrient cycling, GHG mitigation, and soil food-web functioning, mainly via root-driven weathering processes and soil feedbacks. We further outline opportunities for application across diverse agroecosystems and highlight key challenges for scaling, including weathering thresholds, potential metal risks, and governance constraints. Overall, harnessing the CC-ERW nexus offers a promising pathway toward climate-resilient and multifunctional agriculture.

The trillion-dollar drug development industry depends on high-quality data to guide decision making processes. Many drug candidates work by targeting specific biological sites within disease-causing cells, often entering via passive diffusion through the cell membrane(s). We have previously developed a solution-state 1H NMR spectroscopy assay that calculates comparative membrane adhesion and permeation factors for a drug candidate, aiding the design of effective, selective drugs that demonstrate minimal off-target (side) effects. However, the uptake of this assay into standardized drug development processes is limited because of the lengthy specialist manual workflows required to process the raw spectral data. Herein, we automate and validate the analysis of this assay, outputting high-quality data to remove this limitation, improving data accessibility, increasing assay throughput, experimental reproducibility, and interoperability with other workflows.

The plastic crisis is omnipresent, ranging from plastic littering to microplastics found in every niche of the planet, including the human body. To achieve higher recycling quotas, especially for mixed plastic waste, pyrolysis is a viable option. However, plastic pyrolysis oil waste (PPOW) poses significant challenges for valorization due to its extreme molecular heterogeneity. To reduce this molecular heterogeneity, we artificially compounded, monitored, and optimized a bacterial consortium capable of tolerating organic pollutants and utilizing them as carbon and energy sources. Additionally, a back-propagation (BP) neural network was applied to evaluate O2 consumption as an indicator of microbial activity and to build a predictive model for process optimization. The primary constituents of the PPOW were alkanes and ε-caprolactam. Within 7 days, the bacterial community demonstrated remarkable efficacy, degrading alkanes (C10-C28) at rates of 71-100% and achieving complete removal of ε-caprolactam (8,032 mg/mL) and naphthalene. The AI model predicted O2 consumption with high accuracy (R2 > 0.99). This AI-driven approach significantly reduces experimental iterations and operational costs for future process optimization. These results are discussed in the context of a developing open circular plastic economy.

Short peripheral catheters (SPCs) are the most frequently used vascular access devices in neonates but are associated with complications and limited dwell times. International guidelines recommend using the smallest appropriate catheter gauge, yet 24G SPCs remain the default choice in many neonatal intensive care units (NICUs) while 26G SPCs are less often used because of concerns about flow adequacy particularly during blood transfusions. Evidence directly comparing these gauges in neonates is limited. We conducted a retrospective cohort study in a tertiary NICU and national referral centre for high-risk neonatal care in Doha, Qatar. Data were collected between 1 August 2018 and 31 December 2023. Eligible participants were neonates (0-28 days) who received at least one SPC insertion. Data extracted included demographics, catheter characteristics, dwell time, complications and reasons for removal. Analyses were performed at the catheter episode level. Dwell times were analysed using Kaplan-Meier survival curves with log-rank testing, and group comparisons were performed with parametric or non-parametric tests as appropriate. A total of 45&#x2009;753 SPC episodes were analysed: 10&#x2009;531 (23.0%) 24G and 35&#x2009;222 (77.0%) 26G. Baseline characteristics were comparable between the groups. The mean dwell time was slightly longer for 26G than for 24G (35.1 vs 32.6&#x2009;hours, p<0.001), although the absolute difference was small. Therapy completion rates were nearly identical (42.6% vs 42.0%, p=0.286). First-attempt success was higher with 26G (79% vs 74%, p<0.001), representing a clinically relevant improvement. The complication profile showed a trade-off: 26G SPCs had fewer leaks (11.9% vs 14.4%, p<0.001) and occlusions (4.0% vs 4.8%, p<0.001), but a slightly higher rate of phlebitis (4.6% vs 4.2%, p<0.001). Severe infiltration and extravasation rates were comparable. Overall complication rates were not significantly different between the groups. In the transfusion subgroup, 26G SPCs were used most frequently, and outcomes were not clinically different from those of 24G, with no excess complications observed, supporting their clinical feasibility for blood administration. In this large neonatal cohort, 26G SPCs were associated with a statistically longer dwell time than 24G SPCs, although the absolute difference was small. Therapy completion and complication rates were comparable between the groups, whereas first-attempt insertion success rates were higher with 26G SPCs.

Web-based surveys involving self-reported questionnaires are vulnerable to fraudulent responses. Advancements in artificial intelligence and bots have introduced additional challenges to preventing and identifying fraudulent responses to online questionnaires. This study aimed to describe our experiences with fraudulent responses, strategies for preventing and identifying fraudulent responses, lessons learned when conducting a web-based survey with adults living with Long COVID, and recommendations for web-based survey research. The Long COVID and Episodic Disability Study is an international community-engaged study among adults living with Long COVID in Canada, Ireland, the United Kingdom, and the United States. We conducted a longitudinal web-based survey, with online administration of a self-reported questionnaire at 2 timepoints (Time 1 and Time 2), 1 week apart. We recruited through Long COVID community groups using social media, emails, and word of mouth. The survey was disrupted by fraudulent responses, including bots. To defend data integrity, we implemented the following strategies: (1) pausing our initial launch (Wave 1), (2) developing and implementing screening criteria to identify fraudulent responses, and (3) relaunching the web-based survey (Wave 2) with revised recruitment strategies and questionnaire design to prevent and identify fraudulent responses. We received 4663 responses for Time 1 and 1281 responses for Time 2, of which we retained 798 of 4663 (17%) responses and 629 of 1281 (49%) responses. Strategies for preventing fraudulent responses included enabling survey protection features in survey software, shutting down compromised survey links, avoiding recruitment via public social media groups, and removing mention of a financial incentive from recruitment materials. Strategies for identifying fraudulent responses included monitoring response completion times, start and end time stamps, geolocation, and screening for suspicious email address characteristics and duplicates. Our lessons learned fell into the following three areas: (1) survey-design and implementation to prevent and identify fraudulent and bot-generated responses, (2) recruitment strategies to mitigate the risk of disruption by bots, and (3) responding to disruptions caused by fraudulent and bot responses. We recommend the following tactics to prevent and mitigate the risks of fraudulent and bot responses when administering online web-based questionnaires: (1) review current literature and connect with researchers and Research Ethics Boards about strategies before launching, (2) invest in survey software with rigorous information security technology, (3) use bot-detection features available in survey software before launching, (4) design questionnaire items to identify bots and fraudulent actors, (5) tailor criteria for identifying fraudulent and bot responses to the characteristics of the target population, (6) avoid recruitment in public social media groups, (7) engage community leaders in tailored and targeted recruitment, (8) avoid advertising incentives, (9) shut down compromised links rapidly, (10) communicate with the Research Ethics Board about disruptions, and (11) combine automated and manual methods to identify potentially fraudulent responses on time.

Flat head/neck pigmented macules can be diagnostically challenging. To assess the impact of reflectance confocal microscopy (RCM) integration to dermoscopic triage of equivocal lesions. Prospective multicentre study of equivocal flat macules. Lesions suspicious or discordant were biopsied/excised; double-negative lesions were followed &#x2265;1 year. Histopathology served as reference standard. A total of 2006 lesions from 801 patients (mean age 66.2 years) were evaluated. After dermoscopy-RCM integration, 236/2006 (11.8%) lesions were managed as malignant (226 biopsied/excised; 10 noninvasively treated [8 BCC, 2 LM]). Twenty-six lesions changed at follow-up and were removed, with 4 malignancies (0.4%; 3 LM, 1 BCC). Histology (n=252) confirmed 114 malignancies (62 LM/LMM; 52 BCC/SCC). Dermoscopy detected 54.8% of LM/LMM and 90.4% of BCC/SCC; RCM correctly diagnosed 91.9% of LM/LMM and 94.2% of BCC/SCC. Verification and selection biases and follow-up losses. Integrating RCM significantly improves LM/LMM sensitivity detection, and specificity for benign lesions compared to dermoscopy alone, minimizing overtreatment and missed malignancies. Although a small residual risk of missed malignancy persists, the combined approach offers a highly safe, non-invasive pathway for managing equivocal lesions in cosmetically sensitive areas.