搜索结果：Science as culture

Citation analysis has emerged as a key area in scientometrics. However, the global movement toward open science, alongside the pervasive "publish or perish" culture, underscores the need to reevaluate the paradigm of citations as a measure of impact and quality. Brazil, a top 15 producer of scientific articles, has established the Lattes Platform, a comprehensive resource data on virtually active researchers in the country. Herein, the Brazilian scientific landscape was analyzed by integrating a widely used global ranking based on large-scale citation metrics with individual-level data from the Lattes Platform. The analysis assessed the impact, distribution, and disparities of Brazilian science across disciplines, geographic regions, and institutional affiliations from 2019-2023. Results showed that Brazilian researchers account for approximately 0.43% of the world's most cited scientists, a significant underrepresentation relative to Brazil's population share and scientific potential. Most highly cited scientists are concentrated in three states within the Southeast region, reflecting longstanding economic and infrastructural advantages. The majority of top Brazilian scientists work in Life Sciences, with particular representation in the subfields Zoology, Tropical Medicine, and Mycology & Parasitology. While Brazil's scientific output compares favorably with other South American and African countries, it remains behind nations with higher gross domestic products per capita and Human Development Index. Nonetheless, 73% of the most cited researchers receive national Research Productivity Grants, indicating a positive correlation between citation and qualified scientific excellence. These findings offer a deeper understanding of Brazilian scientific production from a citation perspective and advocate for strategic policy shifts.

Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide, with a rising burden. Patients are mainly older adults with limited self-management abilities due to low education and cognitive decline. Systematic health education is key to improving disease knowledge and self-management; however, current programs lack standardized content, delivery, and implementation. To systematically search, appraise, and synthesize the best evidence on COPD health education, providing healthcare professionals with a rational basis for improving patients' disease knowledge and home-based self-management. This study was registered with the Open Science Framework. Following the "6S" evidence pyramid model and a top-down principle, we systematically searched the following databases and websites from inception to November 18, 2025: BMJ Best Practice, UpToDate, Cochrane Library, National Institute for Health and Care Excellence, Registered Nurses' Association of Ontario, Medlive, Guidelines International Network, American Thoracic Society, European Respiratory Society, Global Initiative for Chronic Obstructive Lung Disease, China National Knowledge Infrastructure, Wanfang Data, VIP Database, Sinomed, PubMed, Embase, and Web of Science. We included clinical practice guidelines, systematic reviews, and expert consensus. Quality was assessed using the AGREE II and JBI checklists. Evidence levels and recommendations were determined using the JBI Pre-grading System (2014). Twenty-one publications were included (nine guidelines, eight systematic reviews, and four expert consensuses). Thirty-one evidence items were extracted and grouped into seven themes: educational principles, providers, recipients, methods, objectives, core content, and outcome assessment. Effective COPD health education should shift from one-way knowledge transfer to patient-empowerment-based, interactive models. The content must be tailored to local resources, culture, and health literacy. A closed-loop "education-assessment-feedback" system, multidisciplinary teams, and smart technologies are recommended. Future research should focus on resource-limited settings, multidisciplinary implementation strategies and long-term digital intervention outcomes.

Upper-limb dysfunction commonly occurs after breast cancer surgery and can impair the quality of life. Traditional Chinese exercises are a category of mind-body practices derived from traditional Chinese culture and exercise traditions. They involve physical postures, breathing techniques and mental focus and have the potential to improve postoperative upper limb function. This protocol outlines the methods used for a systematic review and meta-analysis evaluating traditional Chinese exercises for upper limb dysfunction following breast cancer surgery. Randomised controlled trials evaluating traditional Chinese exercises for upper-limb dysfunction among individuals following breast cancer surgery will be searched in MEDLINE (PubMed), Embase (Ovid), Cochrane Library (Wiley), Web of Science (Clarivate), China National Knowledge Infrastructure (CNKI), Wanfang Database (Wanfangdata), VIP Database (cqvip), and China Biology Medicine Database (Sinomed) from inception to April 2026. The search strategy combined terms for participants (eg, breast neoplasms), interventions (eg, Tai Chi, Baduanjin and Qigong) and study design (randomised controlled trials). The primary outcome is upper limb function, assessed using validated scales (eg, the Disability of the Arm, Shoulder and Hand questionnaire and its quick version and the Upper Extremity Functional Index). Secondary outcomes include shoulder range of motion (goniometry), pain intensity (Visual Analogue Scale and the Numeric Pain Rating Scale), upper limb circumference (cm), upper limb strength (dynamometers) and adverse events (haematoma, infection and lymphoedema). After study selection and data extraction, the risk of bias assessment will be performed using the Cochrane Risk of Bias Tool 2.0. Standard pairwise meta-analysis will be conducted using Stata V.16.0 software. Next, sensitivity and subgroup analysis will be performed. The Grading of Recommendations, Assessment, Development and Evaluation system will assess evidence quality for the primary outcome. This review may inform clinical decision-making on the rehabilitation of individuals following breast cancer surgery. Ethical approval is not required as study data will be drawn from published randomised controlled trials. The systematic review results will be published in a peer-reviewed journal. CRD420251143499.

Life expectancy is a key indicator of population health and an important guide for health policy1,2. Although Asia represents approximately 60% of the global population, studies of longitudinal trends in life expectancy and their underlying drivers across Asian countries remain limited, with most previous research focused on western or high-income settings3-6. Here we provide a comprehensive analysis of life expectancy, cause-specific mortality and risk factors in 1990-2023 across 34 Asian countries and territories, utilizing data from the Global Burden of Disease Study 20231,7. Life expectancy increased in all countries and territories between 1990 and 2023, with the largest annual gains observed in South Asia and the smallest annual gains in high-income Asia Pacific countries and territories. Reductions in cardiovascular disease mortality were the primary contributors to life expectancy gains in Central Asia, East Asia and high-income Asia Pacific, whereas declines in diarrhoeal diseases and tuberculosis contributed most in South and Southeast Asia. In 2019-2023, life expectancy declined in several Asian regions, largely driven by the COVID-19 pandemic, with a nearly two-year loss in the first year of the pandemic. The causes of changes in life expectancy and the contributing risk factors varied across regions and countries/territories. Therefore, under the principles of proportional universalism, proactive and effective policies at both regional and national levels are essential to reduce premature mortality and reduce life expectancy inequalities across Asia.

We aimed to describe the implementation process and provide a baseline characterization of suicidal behavior during the first year of implementing the Registered Nurses' Association of Ontario (RNAO) Best Practice Guideline (BPG) for suicide prevention in a tertiary occupational hospital in Santiago, Chile. A cross-sectional descriptive study was guided by the Knowledge-to-Action (KTA) framework. The implementation process included: 1) assessment of the local context; 2) adaptation of 26 RNAO BPG recommendations through the first four phases of the KTA cycle; and 3) use of institutional data from April 2024 to April 2025 to establish a baseline of suicidal behavior. Data sources included Emergency Department (ED) consultations, hospital admissions, liaison psychiatry referrals, patient safety reports, and staff training records. Data were analyzed using descriptive statistics. The preliminary assessment identified variable levels of compliance with the RNAO BPG recommendations, with 9 fully met, 12 partially met, and 4 unmet. Contextual analysis revealed key barriers and facilitators at the individual, team, and organizational levels, and identified priority stakeholders. Based on these findings, context-adapted strategies were developed, including protocol standardization, staff training, structured referral pathways, and environmental safety measures. Institutional data showed 7,936 ED consultations, of which 577 (7.3 %) involved suicidal behavior. Among 368 admitted patients with primary mental health diagnoses, 336 (91.3 %) were linked to suicide risk. Liaison psychiatry documented 7 cases from medical-surgical wards, while patient safety records identified three suicide-related sentinel events associated with mild to moderate harm. Implementation demonstrated that evidence-based nursing, guided by the KTA framework, supports standardized detection and management of suicide risk. These findings provide an initial characterization of suicidal behavior in an occupational health setting and underscore the importance of context-adapted strategies, continuous training, and institutional cultural change to support implementation.

Guidelines recommend ≥2 weeks of antifungal therapy after candidemia clearance and for invasive candidiasis (IC). This post-hoc analysis evaluates Day 7 pooled data from the phase 2 STRIVE and phase 3 ReSTORE trials to explore early antifungal activity. Adults with candidemia and/or IC received weekly rezafungin 400/200 mg or daily caspofungin 70/50 mg for ≤4 weeks. Efficacy was evaluated in the modified intent-to-treat population via all-cause mortality (ACM; primary endpoint; 20% noninferiority margin), mycological eradication, and time to negative blood culture (TTNBC) at days 7, 14, and 30 (TTNBC assessed only in patients with candidemia). Day 7 safety was evaluated in the safety population. Rezafungin was noninferior to caspofungin at each timepoint. Day 7 ACM rates were 7.9% (11/139) for rezafungin and 5.2% (8/155) for caspofungin (weighted difference [95% CI]: 3.0% [-3.7, 9.7]). Mycological eradication was similar between groups at all timepoints. Day 7 rates were 71.2% (99/139) and 65.2% (101/155), respectively (weighted difference [95% CI]: 6.6% [-4.0, 17.1]). Median (interquartile range) TTNBC was numerically shorter for rezafungin (22.3 [14.3-47.0] hours; caspofungin 26.3 [17.8-112.6] hours). Subgroup analyses suggested potential Day 7 benefits for rezafungin in patients with candidemia or C. albicans. Day 7 safety for rezafungin was consistent with previous reports. Rezafungin was noninferior to caspofungin in candidemia and/or IC from Day 7, with shorter TTNBC in patients with candidemia. Subgroup analysis suggested a potential early benefit with rezafungin in some patients. Trials exploring shorter treatment durations for some patients are warranted. NCT02734862 (STRIVE); NCT03667690 (ReSTORE).

This study aimed to explore the facilitators of and barriers to the clinical translation of evidence-based nursing guidelines. A convergent mixed-methods study design. First, 206 nurses from 12 hospitals were selected as study participants, and the Chinese version of the Organizational Readiness to Change Assessment (ORCA) scale was administered to assess the current readiness for guideline implementation. Subsequently, for the qualitative study, purposive sampling was used to select 15 nurses from the quantitative study sample for semistructured interviews. The framework analysis method was applied to code the transcribed texts using the Consolidated Framework for Implementation Research (CFIR), and thematic analysis was employed to identify facilitators and barriers to guideline implementation. Finally, all facilitating and barrier factors were systematically synthesized, and implementation strategies were matched using the Consolidated Framework for Implementation Research-Expert Recommendations for Implementing Change (CFIR-ERIC) tool. The organizational change readiness score was moderate-to-high (248.77 ± 33.35). The quantitative study identified 25 facilitating factors (such as the scientific rigor of guideline implementation and a positive departmental culture) and 16 barriers (including insufficient resources to address patient awareness or needs and inadequate communication among team members). The qualitative study identified 25 facilitating factors (such as high self-efficacy in evidence-based practice and leadership support) and 11 barriers (such as implementation complexity and resource constraints). From a mixed-methods analysis, the top three barriers were identified as a lack of incentives, insufficient resources, and interdepartmental communication barriers. Based on the CFIR-ERIC mapping, implementation recommendations targeting the main barriers were identified, including tailoring implementation strategies, modifying incentive mechanisms or compensation structures, and establishing communication networks among team members. This study systematically revealed, through a mixed-methods approach, the current status of nurses' readiness to participate in guideline implementation in China, as well as the facilitating factors and barriers. In the future, targeted strategies should be developed based on the identified barriers to promote the sustained implementation of guidelines.

The objective of this study was to evaluate the applicability of replicative DNA synthesis (RDS) in cultured human hepatocytes as an in vitro model to evaluate the carcinogenicity of nongenotoxic chemicals and species differences. Investigations were performed with 39 cryopreserved human hepatocyte preparations from predominantly Caucasian male and female donors aged 10 months to 80 years and were conducted by two separate laboratories, which employed different culture conditions and methodology for evaluating effects on hepatocyte RDS. For all male and female human hepatocyte preparations of all ages examined, treatment with either epidermal growth factor (EGF) and/or hepatocyte growth factor (HGF) resulted in a stimulation of RDS. In contrast, the treatment of human hepatocytes with the constitutive androstane receptor (CAR) activators phenobarbital and CITCO and the peroxisome proliferator-activated receptor alpha (PPARα) activator WY-14,643 did not result in any increases in RDS. These findings are in agreement with previous studies where, unlike EGF and HGF, nongenotoxic CAR and PPARα activators are mitogenic agents in rodent but not in human hepatocytes. While some donor to donor variability was observed, the qualitative inducibility of RDS by EGF and/or HGF in human hepatocytes was not sex-, age-, or, based on a limited number of samples examined, ethnicity-dependent. These studies demonstrate that cultured cryopreserved human hepatocytes are an established, reproducible and relevant in vitro test system for investigating the nongenotoxic carcinogenic potential of chemicals and species differences, and worth progressing to formal validation according to OECD principles.

Unhealthy 24-h movement behaviors, including insufficient physical activity, excessive sedentary behavior, excessive screen time, and inadequate sleep, are common among preschool children. However, evidence for the effectiveness of lifestyle interventions across these behavioral domains remains limited and inconsistent. This study aimed to evaluate the effects of lifestyle interventions on 24-h movement behaviors in preschool children. PubMed, SPORTDiscus, Scopus, Web of Science Core Collection, and CENTRAL were searched from inception to December 31, 2025. Randomized controlled trials involving children aged 2-6 years that evaluated structured lifestyle interventions targeting movement behavior domains were included. Random-effects meta-analyses were performed to estimate pooled mean differences (MDs) and 95% confidence intervals (CIs). Risk of bias was assessed using the Cochrane Risk of Bias 2 (RoB 2) tool, and certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. Forty-three trials from 16 countries were included, comprising 13,659 preschool children. Lifestyle interventions were associated with increases in moderate-to-vigorous physical activity (MD 5.77 min/day, 95% CI 2.27 to 9.28; I2 = 91%) and sleep duration (MD 0.18 h/day, 95% CI 0.01 to 0.35; I2 = 68%), and with reductions in sedentary behavior (MD - 7.62 min/day, 95% CI - 15.08 to -0.17; I2 = 63%) and screen time (MD - 0.33 h/day, 95% CI - 0.53 to -0.13; I2 = 95%). Effects on total physical activity and other intensity-specific physical activity outcomes remained uncertain. The overall risk of bias was rated as low in 2 trials, as having some concerns in 32 trials, and as high in 9 trials. The certainty of evidence was low for the primary outcomes, and small-study effects could not be ruled out for screen time. Lifestyle interventions were associated with modest improvements in several 24-h movement behaviors in preschool children. However, heterogeneity was substantial across outcomes, and the certainty of evidence was low. These findings should therefore be interpreted as favorable but uncertain directions of effect rather than precise estimates of intervention efficacy. Future trials should adopt more standardized measurement and reporting methods, include longer follow-up, and examine time reallocation within the 24-h movement composition. https://www.crd.york.ac.uk/PROSPERO/view/CRD420261332463, Identifier CRD420261332463.

The theme of pioneers charting new frontiers has long been a staple of scientific and technological discourse in the United States. Scientists, engineers and entrepreneurs perceived as doing groundbreaking work are lauded as pioneers in their fields. In recent years, the application of the pioneer label has expanded to include research participants in clinical trials for neurotechnologies such as Neuralink or other brain-computer interface (BCI) devices: 'BCI pioneers.' What might explain this new popular usage of the pioneer label? American science policy in the mid twentieth century drew on the mythos of the American frontier as a way of mobilizing public interest in scientific and technological innovation on a mass scale. One such way of mobilizing interest was to use frontier rhetoric to attribute novelty to scientific undertakings and technological developments: dubbed the new frontiers. A less explored aspect of this history is the application of the pioneer label to patients and research participants in scientific, mostly biomedical, studies. Through the use of frontier rhetoric, articulations of novelty can be attributed to patients and participants, and their participatory practices, including being the first to undergo a new medical procedure, as well as being explorers and trailblazers in their own right. Such rhetoric may be understood as mobilizing support for research participants by acknowledging their bravery, altruism and contributions to science, with implications for participatory science and scientific and technological innovation.

Climate change during the Holocene (5500-4000 year BP) transformed the altitudinal zonation of the northwestern Caucasus, affecting the development and distribution of prehistoric populations, whose specialized economic system were based on dry farming and cattle breeding. This study analyzes reliably dated palaeosols buried beneath Early Bronze Age Maikop culture kurgans, comparing these findings with palaeorecords from the Eastern Mediterranean-Black Sea-Caspian Corridor. Our results demonstrate that the forest-steppe boundary in the foothills (100-1100 m a.s.l.) is highly sensitive to climatic fluctuations. Palaeosol and palaeobotanical analyses show that, where luvisols under broadleaved forests are widespread in the foothills of the northwestern Caucasus today, between 5300 and 4900 year BP, Black Soil (Chernozem) under meadow and meadow-steppe ecosystems was present. The general cooling trend between 5000 and 4000 year BP, culminating in the '4.2 ka event', shifted the boundary between the broadleaved forests and the forest-steppes by 20 km northwards (descending from 800 to 400 m a.s.l.) while the meadow steppes retreated to the adjacent plains. Such a large-scale landscape restructuring has not been recorded in either the mountainous Caucasus or the East European Plain steppes. This forest expansion triggered persistent soil transformations, driving the evolution of Chernozems into Luvisols and establishing a new altitudinal zonation. The proposed reconstruction demonstrates that the '4.2 ka event', typically associated with cooling and aridification, can trigger differential responses across adjacent landscapes. While it caused intensified droughts and xerophytization in the southern East European Plain, the same cooling on the humid slopes of the northwestern Caucasus led to glacial expansion and a shift toward wetter forest landscapes. Taking these divergent landscape responses into account is essential to understanding how ancient populations of the northwestern Caucasus responded to the climatic changes of the Holocene.

The unfolded protein response (UPR) helps reinstate cellular proteostasis upon an accumulation of misfolded proteins in the endoplasmic reticulum (ER), in part through ER-associated degradation (ERAD). Ube2j2 is an ER-localized E2 ubiquitin-conjugating enzyme that participates in ERAD. We used mass spectrometry analysis of cultured U2OS cells to investigate how the loss of Ube2j2 affects the cellular proteome in response to tunicamycin-induced ER stress. We constructed a network of twelve statistically distinct modules of protein abundance profiles across conditions. We describe the gene ontology annotations for each module along with the "hub gene" proteins whose abundance levels most closely adhere to each module's protein abundance profile. Our analysis identifies known Ube2j2-associated pathways (eg the UPR and ERAD) and cellular functions that were previously unassociated with Ube2j2 (eg RNA metabolism, ER-Golgi transport, and cell-cycle progression). These data are available via ProteomeXchange with identifier PXD076153 and provide avenues for further investigation into the cellular functions of Ube2j2 under basal and ER-stressed conditions.

International evidence suggests that reducing user costs increases maternity care utilization but not necessarily care quality, underscoring the need for transparent, comparable measurement. In Japan, evidence-based maternity care for low-risk childbirth has not been systematically evaluated, and limited claims-data capture hinders assessment, benchmarking, and sustained quality improvement. We aimed to explore how determinants (facilitators and barriers) of implementing a multifaceted quality improvement intervention for low-risk childbirth emerge and evolve over time. This longitudinal qualitative study was performed at four facilities in the Kinki region of Japan using a process-evaluation approach. The intervention included quarterly performance-based audits and feedback to healthcare providers caring for low-risk women, multidisciplinary team-based quality improvement efforts, and educational sessions addressing care quality and organizational culture. Healthcare providers involved with low-risk childbirth participated in semi-structured interviews at the beginning and end of the intervention. Data were analyzed using directed content analysis, following the Consolidated Framework for Implementation Research (CFIR), to identify facilitators and barriers of the intervention, observe changes over time, and compare variations across facilities. Ethical approval was obtained from the Ethics Committee of Kyoto University (R2342 and R2344), and all interview participants provided written informed consent. Across 66 semi-structured interviews with 41 participants, four CFIR constructs-Champions, Key Stakeholders, Structural Characteristics, and Networks and Communications-transitioned from serving as facilitators to barriers during the intervention. In contrast, the Knowledge and Beliefs about the Intervention construct remained stable within each facility over time, although its valence differed across facilities. Facilities where Champions exhibited participatory leadership and effectively disseminated the intervention's positive value experienced greater stakeholder engagement and smoother implementation. In contrast, in facilities where the intervention was perceived as having low value, various context-driven factors hindered implementation. The role-related CFIR constructs, such as Champions and Key Stakeholders, exhibited more dynamic change over time, whereas perceptions of the intervention's value remained relatively constant. Consistently positive perceptions of value facilitated sustained participation despite the presence of additional barriers. These findings highlight temporal fluctuations in implementation determinants and underscore the importance of supporting key roles and offering phase-specific, contextually responsive implementation support over time.

BackgroundParkinson's disease is a progressive neurodegenerative disorder that contributes to the growing global health burden. YouTube has emerged as a ubiquitous source of health information among patients and their caregivers. Despite the increasing use of video-sharing platforms, the educational quality and reliability of Parkinson's disease-related videos remain unknown.MethodsThis cross-sectional study evaluated 147 Parkinson's disease-related YouTube videos. The research team collected general video information, and three instruments (Global Quality Score, modified DISCERN tool, and Patient Education Materials Assessment Tool) were applied to assess overall quality, reliability, and content understandability and actionability. Descriptive analyses were conducted overall, followed by detailed comparisons across the videos. Finally, using the Spearman correlation coefficient, we explored potential correlations between general video information and video quality and reliability.ResultsIn this study, we observed moderate overall quality and reliability when assessed using the Global Quality Score, modified DISCERN tool, and Patient Education Materials Assessment Tool instruments.ConclusionsOur findings demonstrated that YouTube contains substantial publicly available Parkinson disease-related content; however, the quality and reliability of the content varies and is generally inadequate to facilitate patient education. To better serve patients with Parkinson disease and their caregivers, multifaceted actions from healthcare professionals, science communicators, and internet platforms are necessary to elevate the quality and visibility of credible content.

The diagnosis of cancer results in psychophysiological distress in patients, significantly reducing quality of life (QoL). Currently, self-management interventions based on e-health have been used to improve QoL among cancer patients, but the overall effects remain inconsistent. To assess the impact of self-management interventions based on e-health on the QoL of cancer patients. Studies were retrieved from six databases up to November 6, 2024. The methodological quality assessment was performed via ROB 2. Data synthesis and subgroup analyses were performed in Review Manager 5.3. Meta-regression was conducted using Stata 15.0. Thirty RCTs were included. The results of meta-analysis revealed self-management interventions based on e-health significantly improved QoL (SMD&#x2009;=&#x2009;0.18, 95% CI: 0.08 to 0.28, p&#x2009;<&#x2009;0.01). Subgroup analyses showed that long-term, mixed-mode, theory-supported, or facilitator-supervised interventions were more effective, with greater improvements in QoL observed among patients with breast cancer than among other types. Self-management interventions based on e-health were valuable supplements for enhancing the QoL of cancer patients. Intervention duration, delivery modes, cancer types, theoretical frameworks, and facilitators' involvement should be considered in the design of future interventions. However, additional high-quality studies are needed to confirm these findings. The protocol was registered on PROSPERO (Registration number: CRD420251017709).

Migrants comprise over 17% of Norway's population and are at increased risk of limited health literacy, a key determinant of health. Health literacy is shaped by language, culture, social norms, discrimination, and health system responsiveness. Inflammatory rheumatic diseases are complex, chronic conditions requiring long-term, specialised care. Patients with these diseases and a migrant background, particularly those with limited proficiency in the dominant language, face additional barriers and poorer outcomes, yet their health literacy experiences remain underexplored. This study explored the experiences of patients with inflammatory rheumatic diseases, a migrant background, and limited language proficiency in accessing, understanding, appraising, and using health information and rheumatology services in Norway. Nineteen semi-structured, in-depth interviews were conducted with patients with a migrant background, and who used interpreters during consultations with health professionals. Participants were recruited from rheumatology departments at two Norwegian hospitals. Interviews were audio-recorded, transcribed verbatim and analysed using reflexive thematic analysis. Two patient research partners were involved throughout the study. Three main themes were generated. First, barriers to accessing and using health information and services were shaped by the interplay between language proficiency, digital literacy, and social support, which often compensated for system gaps. Health systems implicitly assumed a minimum level of linguistic and digital competence, creating mismatches between system demands and patients' abilities. Second, trust was foundational, shaping engagement and acceptance of treatment. Trust developed over time; length of residency did not necessarily equate to confidence in using services, and trust in health professionals often preceded trust in the wider system. Third, employment was an important factor shaping health literacy and disease management: while colleagues supported service navigation, physically demanding and precariat working conditions constrained access to care and self-management. Managing these conditions among migrants with limited language proficiency is shaped by interrelated individual, relational, and structural factors. Health literacy is co-constructed through social networks, trust, and contexts such as employment, while system assumptions about language and digital competence create fragmented access. Interventions should move beyond communication barriers to foster trust, support shared understanding, and address broader social and structural conditions influencing engagement with health services.

Aloe vera is an authentic medical plant abundant in aromatic polyketides, including the crucial hexaketides aloenin, aloesin, and barbaloin used in pharmaceuticals, yet the enzymatic basis of their biosynthesis remains incompletely understood. While it has been suggested that octaketide synthase (OKS) initiates anthraquinone biosynthesis, heterologous expression of OKS alone consistently produces shunt polyketide products, and the mechanism underlying this derailment was uncertain. To comprehend the proposed anthraquinone biosynthesis pathway, we combined biochemical constitution, structural characterization, and CRISPR/Cas9-mediated editing of key genes in Aloe vera. The results showed that the inclusion of a PKR (polyketide reductase) altered the reaction profile and supported the formation of a product spectroscopically consistent with 2-carboxy anthraquinone (C16H1205). ESI-MS analysis detected the molecular cation in [M]+ and [M&#xa0;+&#xa0;H]+ forms (m/z 284.2936 and 285.2421, respectively), while FTIR and 1H NMR analyses indicated the presence of characteristic anthraquinone, carboxyl, hydroxyl, and terminal methyl functionalities. The spectroscopic profile additionally distinguished the characterized product from compounds previously misannotated in the literature. Alongside, CRISPR/Cas9-based genome editing of candidate genes resulted in a significant reduction in aloin content in edited lines (OKS mutant: 2.54-fold, PKR mutant 1 and 2: 1.23 and 1.53-fold, respectively) compared to the non-edited control aloe line. Together, these findings support the involvement of tailoring enzyme ketoreductase for the efficient and appropriate formation of anthraquinones and provide functional insights into polyketide biosynthesis in aloe plants that sustain as an indigenous herb for mankind.

Global warming is altering carbon (C) cycling in terrestrial and inland aquatic ecosystems. Yet it remains unclear how experimental warming and elevation (natural temperature gradient) jointly regulate priming effects (PEs) on organic matter decomposition in soils and sediments and thereby influence CO2 and CH4 emissions. We investigated temperature-dependent priming induced by 13C-labelled glucose additions across a soil-sediment continuum in the Rongbuk River Basin on the Tibetan Plateau (3759-4550&#x2009;m&#x2009;a.s.l.). Soil and sediment samples were incubated under two temperatures (7&#xb0;C and 17&#xb0;C) to quantify PE for CO2 and CH4 (i.e., PE-CO2 and PE-CH&#x2084;). Labile C inputs induced consistently positive PE-CO2 in soils, with generally stronger responses in sediments. PE-CO2 ranged from 0.42 to 11&#x2009;mg CO2 g-1 SOC in soils and from 0.41 to 15&#x2009;mg CO2 g-1 SOC in sediments, whereas PE-CH4 ranged from -2.2 to 5.2&#x2009;&#x3bc;g CH4 g-1 SOC in soils and from 0.14 to 7.9&#x2009;&#x3bc;g CH4 g-1 SOC in sediments. Warming increased PE-CO2 but suppressed PE-CH4. Higher-elevation sites showed lower primed CO2 efflux but larger primed CH4 efflux than lower-elevation sites. This indicates that warming effects on priming depend on the balance between oxidative and reductive C processing. High-throughput amplicon sequencing targeting the 16S and ITS2 rDNA regions indicated specific effects on priming: bacterial community composition was closely correlated with rapid, substrate-driven CO2 priming, whereas fungal communities were indirectly linked to primed CH4 through their depolymerization of organic matter. Together, CO2 and CH4 released by priming of organic matter decomposition arise from distinct but coupled microbial pathways across soils and sediments, whereas sensitivity to temperature decreased along elevation. These findings highlight the need to explicitly account for oxidative and reductive priming related processes when predicting C turnover and greenhouse-gas feedbacks in high-elevation terrestrial-aquatic interface systems under climate change.

Diabetic retinopathy (DR) is associated with elevated dementia risk. However, no previous studies have quantified the strength or impact of this association. To address this, our study explored the relationship between DR and dementia. We searched Web of Science, Scopus, and PubMed for observational studies between January 1, 2000, and May 1, 2024, examining data showing an association between DR and dementia. No filters were used in these searches. Eligibility restrictions, including limitations in observational study designs and publications in English, were applied as pre-specified post-search screening steps. Pooled relative risk (RR) and 95% confidence intervals were estimated using the DerSimonian-Laird random-effects model. Nine observational studies including 2,887,409 patients were included. DR correlated with a significantly higher risk of all-cause dementia despite high inter-study heterogeneity. DR also correlated with an elevated risk of Alzheimer's disease, although this effect estimate and associated heterogeneity were dominated by a single large Korean cohort study and should be interpreted cautiously. The trim-and-fill-adjusted estimate suggested some overestimation of the primary pooled RR. No significant association with vascular dementia was found. Egger's test evaluated potential publication bias. The overall findings suggest a positive relationship between DR and dementia risk, specifically for all-cause dementia, although the evidence is limited by high heterogeneity, meaningful publication bias, and an observational study design that precludes causal inference. DR may indicate a clinical need for heightened cognitive surveillance in patients with diabetes. Future prospective studies with standardized dementia ascertainment and greater ethnic diversity are required to confirm these findings. PROTOCOL REGISTRATION: International Platform of Registered Systematic Review and Meta-analysis Protocols INPLASY202620035; https://doi.org/10.37766/inplasy2026.2.0035.