Seminatural streams and irrigation canals can act as important refuges for freshwater biodiversity in intensively managed landscapes, but they are also highly vulnerable to habitat degradation and biological invasions. In the northwestern Po Valley (Northern Italy), this secondary hydrographic network hosts the last remaining populations of Isoëtes malinverniana, a critically endangered endemic quillwort that has undergone a severe decline in recent decades. Despite the ecological relevance of benthic macroinvertebrates as indicators of habitat conditions, their communities have never been investigated in relation to the distribution of this species. We characterized macrobenthic communities in nine seminatural streams, including current and historical sites of I. malinverniana occurrence and one recent reintroduction site. Macroinvertebrates were sampled in spring 2025 together with basic physicochemical variables. Community composition, diversity patterns, and the occurrence of alien taxa were compared among streams to explore their relationship with the presence of I. malinverniana. Benthic assemblages were dominated by insects, particularly Chironomidae, while mollusks and crustaceans contributed less to total abundance. Only four alien taxa were recorded, yet their abundance varied markedly among streams. Streams hosting extant populations of I. malinverniana showed low levels of alien macroinvertebrates and environmental conditions indicative of limited disturbance, whereas historical sites of species loss and the reintroduction site exhibited higher proportions of alien taxa and signs of habitat alteration. Although overall macroinvertebrate diversity was higher where I. malinverniana is absent, this pattern was largely driven by alien species. These results indicate that macrobenthic community composition, particularly the presence of alien taxa, reflects environmental gradients critical for the persistence of I. malinverniana. Integrating macrobenthic assessments into monitoring programs may therefore support conservation and management actions for this critically endangered species.
Understanding how stand development is linked to soil multifunctionality (SMF) is essential for sustaining ecosystem functions in plantation forests. In this study, five stand age gradients (21, 26, 32, 37, and 47 a) of larch (Larix principis-rupprechtii) plantations were analyzed in northern China. SMF was quantified using a multithreshold approach, and a structural equation model was employed to resolve pathways through which stand age influences SMF via soil physicochemical properties, microbial diversity, and co-occurrence network. Soil organic carbon (SOC) and total nitrogen (TN) accumulated during early (21 and 26 a) to mid-aged stages (32 and 37 a). Specifically, SOC increased from 31.37 to 41.06 g·kg-1, while TN increased from 2.29 to 3.20 g·kg-1, before declining slightly in mature stands. Soil pH decreased from 6.67 to 6.31 along the stand age gradient, indicating intensified soil acidification. Microbial α-diversity increased from early to mid-aged stands and declined in mature (47 a) stands, with bacterial Chao1 index peaking at 37 a (P < 0.01) and fungal Chao1 index peaking at 32 a (P < 0.01). In contrast, microbial co-occurrence networks exhibited a continuous increase in structural complexity. SMF peaked in mature stands and was positively associated with SOC, TN, microbial α-diversity, and network complexity, but negatively associated with soil pH. Stand age influenced SMF primarily through indirect pathways. Specifically, SOC improved SMF mainly by promoting microbial α-diversity, whereas TN contributed primarily by strengthening bacterial network complexity. In contrast, soil pH exerted a persistent negative constraint on SMF by limiting microbial turnover. Notably, microbial network complexity explained variation in SMF more effectively than microbial diversity alone, particularly at higher multifunctionality thresholds. Overall, SMF in larch plantations was linked to a hierarchical, multi-pathway cascade in which soil nutrient dynamics structured microbial interaction networks, thereby amplifying functional integration, and informing stand age-specific management strategies.
Ceratonia siliqua is a nutritionally and economically important Mediterranean tree species whose natural stands in Morocco are increasingly threatened by habitat degradation and genetic erosion. However, the spatial organisation of genetic diversity across its natural range in Morocco remains insufficiently resolved. To support conservation and germplasm management initiatives, interpopulation genetic differentiation among Moroccan carobs populations was assessed using a pooled DNA sample and SSR markers analysed through three genotyping workflows: high-resolution melting (HRM), conventional PCR, and capillary electrophoresis. Genetic relationships among populations were evaluated using Neighbour-Joining (NJ) analysis, principal component analysis (PCA), and K-means clustering. Among the evaluated approaches, HRM provided the highest discriminatory resolution and generated the most informative polymorphism profiles across loci. All analytical frameworks consistently revealed substantial interpopulation differentiation and broad geographic grouping patterns. Southern populations formed genetically cohesive groups, whereas northern and central populations displayed more complex patterns of genetic similarity. K-means clustering supported the presence of four major population groups, while PCA identified a subset of highly discriminative SSR loci contributing to regional differentiation. Overall, the results reveal a genetically diverse and spatially differentiated Moroccan carob germplasm and demonstrate that SSR-HRM is a robust and cost-effective approach for population-level genetic screening. These findings provide useful genetic resources for future conservation, germplasm management, and breeding programmes in Moroccan carob.
Regenerative medicine is a dynamic, multidisciplinary area aimed at repairing and restoring the function of tissues and organs, incorporating diverse strategies like tissue engineering, bone regeneration, wound healing, and immunomodulation. In this field, biomaterials with exceptional physicochemical and biological properties-such as medical-grade metals, bioceramics, and polymers-play a crucial role. Among these, polydopamine (PDA) stands out as a highly promising material due to its straightforward synthesis, excellent biocompatibility, robust adhesive properties, ease of functionalization, high photothermal (PT) efficiency, and quenching capabilities. These qualities have sparked significant interest in PDA for regenerative medicine, where it acts as a versatile platform for surface modification, facilitating the development of multifunctional nanomaterials with extensive biomedical applications. This review offers a detailed examination of recent progress in PDA research, covering its synthesis processes, physicochemical properties, nanostructured forms, and diverse applications in regenerative medicine. Additionally, it critically assesses current challenges and provides insights into the future development of PDA-based nanoplatforms.
Precision medicine, which is based on the idea of tailoring health care for individual genetic, environmental, and lifestyle factors, is rapidly revolutionizing biomedical research and clinical practice across the world. Despite the progress across the world, Africa only has a limited representation in precision medicine research and implementation. This view looks at where Africa stands today in the precision medicine sphere and identifies gaps in genomic data, infrastructure, workforce capacity, and policy frameworks. It examines the implications of these gaps for health equity globally the potential dangers of growing health disparities if African populations are not included in research and innovation. Furthermore, it outlines the strategies to enhance Africa's involvement in precision medicine, such as capacity building, regional partnerships, investment in bioinformatics, and research policies to ensure inclusivity. Strengthening Africa's role in precision medicine is crucial not only for improving health at the local level but also for ensuring equitable health outcomes across the globe.
Research in child and adolescent mental health stands at an inflection point: the burden of psychiatric illness is global, heterogeneous, and dynamic, whereas our evidence base often remains limited and insufficiently responsive to patient needs. To meaningfully improve outcomes for youth and families globally and at scale, innovation in child and adolescent mental health research must extend beyond developing new treatments to encompass how we design, measure, and disseminate research. Continued innovation is essential to build on the existing corpus of knowledge and to ensure that research keeps pace with real-world clinical and public health priorities.
Montane moist temperate forests are structured by steep elevational and edaphic gradients that drive plant community turnover over short spatial scales. However, integrated evidence linking community structure, diversity, and species turnover to environmental gradients remains limited for the Hindu Kush-Western Himalayan region. This study aimed to characterize plant community organization, quantify alpha and beta diversity, and evaluate vegetation-environment relationships in the moist temperate forests of northern Pakistan. Vegetation was sampled during 2022-2023 across 50 representative stands selected to capture environmental heterogeneity using nested quadrats, and phytosociological attributes were recorded. Soil samples were analyzed for texture and key physicochemical properties. Plant species were grouped into communities, and alpha diversity, beta diversity, and multivariate ordination were applied to examine compositional patterns. A total of 70 plant species were recorded, with herbs and hemicryptophytes representing the dominant growth and life forms. Five distinct plant communities were identified, each defined by significant indicator species. Ordination separated communities clearly, with the first two axes explaining 72.31% of total compositional variation. Alpha diversity was highest in the BRI community and lowest, with greatest dominance, in the QCL community. Beta diversity was driven primarily by species turnover, including complete replacement between high- and low-elevation communities, whereas nestedness was minimal. Communities differed significantly in altitude and soil texture fractions and also varied in pH, electrical conductivity, organic matter, nitrogen, and phosphorus. Community composition was most strongly associated with clay, sand, and slope, while within-community diversity related mainly to soil texture and nutrient availability. These findings demonstrate that environmental filtering promotes strong species replacement across environmental gradients, underscoring the importance of conserving edaphically and topographically heterogeneous habitats.
Switching from transdermal fentanyl (TDF) to other opioids is clinically challenging because of the subcutaneous reservoir that delays drug elimination. This study compares the efficacy and safety of intravenous (IV) dose titration with morphine (MO) versus methadone (ME) as a "bridging" strategy to overcome this pharmacological lag. In this secondary analysis of an observational cohort study, patients who required an opioid switching from TDF (≥ 50 µg/h) to IV morphine or IV methadone were selected. As per protocol of the original study, patients were titrated with IV boluses of MO (n = 17) or ME (n = 22) until analgesia was achieved, followed by continuous infusion and subsequent oral conversion. The primary outcome was clinical stabilization; secondary outcomes included the comparison of final oral morphine equivalents (OME). Both groups achieved analgesia rapidly. The median IV dose required for stabilization was 10 mg for MO and 15 mg for ME (p = 0.152). Methadone demonstrated a significant "opioid-sparing" effect, allowing stabilization with equianalgesic doses (OME) significantly lower than those used in the morphine group and compared to baseline TDF. IV opioid dose titration is a safe and effective method for managing TDF switching effectively eliminating the "waiting period" associated with patch removal. While both drugs are effective, methadone stands out for its ability to significantly lower the total daily opioid requirement.
Radical fluoroalkylation via electron donor-acceptor (EDA) complex photochemistry stands out as a particularly attractive approach, owing to its mild conditions and the absence of an external metal photocatalyst or organic dye. Fluoroalkyl sulfones, valued for their stability, accessibility, and structural tunability, have emerged as versatile precursors for radical fluoroalkylation. Herein, we present a photocatalyst-free and straightforward method for direct fluoroalkylation through an EDA complex, utilizing inexpensive iodide anion as an electron donor and fluoroalkyl sulfones as acceptors. Upon visible light irradiation, the EDA complex undergoes single-electron transfer (SET) to generate fluoroalkyl radicals, which subsequently react with a diverse array of silyl enol ethers with high efficiency. The method features mild reaction conditions, broad functional group compatibility, and an extensive substrate scope that encompasses bioactive molecules and sterically demanding architectures. Mechanistic investigations indicate the involvement of an iodide-mediated EDA complex and support the proposed radical-generation pathway. This work establishes a practical and sustainable platform for fluoroalkylation, underscoring the utility of iodide in EDA-based photochemistry and broadening the scope of radical synthetic methods.
Flexible thermoelectrics convert body heat into electricity, offering a promising route towards self-powered wearable electronics while overcoming the limitations of conventional batteries. Among emerging flexible thermoelectric materials, silver selenide (Ag2Se) has attracted widespread attention because it combines outstanding near-room-temperature thermoelectric performance with low cost, excellent mechanical flexibility, and superior biocompatibility. Over the past five years, orientation engineering has emerged as an effective strategy for simultaneously enhancing carrier transport and suppressing carrier scattering, leading to remarkable improvements in both material properties and device performance. In this Perspective, we systematically review recent progress in highly oriented Ag2Se films, including deposited, nanowire-based, selenized, and free-standing architectures. We further propose film thickness together with near-room-temperature power factor as practical metrics for benchmarking their application potential. By correlating fabrication strategies, microstructural evolution, crystallographic orientation, and thermoelectric performance, we establish a unified framework for understanding orientation-dependent charge transport in Ag2Se films. Finally, we discuss the remaining scientific and technological challenges and highlight future opportunities for developing scalable, mechanically robust, and high-performance Ag2Se films for next-generation wearable thermoelectric energy harvesters and self-powered physiological monitoring systems.
Evidence on psychological, cognitive and functional outcomes of advanced diabetes technologies in older adults with long-standing type 1 diabetes (T1D) remains limited. We evaluated whether initiation of advanced hybrid closed-loop (AHCL) therapy was associated with changes in fear of hypoglycaemia, diabetes distress, psychological well-being, cognition, frailty-related measures and mobility-related function in adults aged ≥ 65 years with T1D. This prespecified, exploratory secondary analysis was conducted within a single-centre, open-label, randomised, controlled, parallel-group trial including adults aged ≥ 65 years with long-standing T1D. Participants were randomly assigned (1:1) to initiate AHCL therapy using the MiniMed 780G system or to continue standard diabetes treatment. The secondary outcomes included WHO-5, the 17-item Diabetes Distress Scale (DDS), Hypoglycemia Fear Survey-II (HFS-II), Montreal Cognitive Assessment, Digit Symbol Substitution Test, Fried frailty phenotype and performance-based functional measures. No formal sample-size calculation was performed for these secondary outcomes. Thirty-one participants were randomised and 29 completed 12 months of follow-up and were included in the treatment-effect analyses. In the baseline-adjusted primary analysis, AHCL therapy was associated with a lower HFS-II score than standard treatment (adjusted mean difference -18.9; 95% CI: -32.4 to -5.4; nominal p = 0.008), although this finding did not remain statistically significant after Holm correction (adjusted p = 0.104) or in an exploratory model additionally adjusted for sex (difference -13.6; 95% CI: -32.2 to 5.0; p = 0.145). Diabetes distress, psychological well-being, global cognition and processing speed did not differ between groups. In sex-adjusted sensitivity analyses, the between-group differences remained statistically significant for 6-min walk distance (92.6 m; 95% CI: 36.8 to 148.3; p = 0.002) and Timed Up and Go performance (-2.27 s; 95% CI: -4.28 to -0.27; p = 0.028), but not for gait speed (0.27 m/s; 95% CI: -0.05 to 0.59; p = 0.099). At 12 months, 12 of 14 AHCL participants were robust and 2 were pre-frail; in the control group, 11 of 15 were robust and 4 were pre-frail. No participant was classified as frail at follow-up. In this small, selected cohort, AHCL therapy was associated with a nominally lower fear-of-hypoglycaemia score and better performance on selected mobility-related tests over 12 months. The fear-of-hypoglycaemia finding did not remain statistically significant after correction for multiple comparisons or additional adjustment for sex. Six-minute walk distance and Timed Up and Go remained statistically significant in the exploratory sex-adjusted sensitivity analyses, whereas the gait-speed difference did not. No measurable between-group deterioration in global cognition or processing speed was observed. These exploratory findings require confirmation in larger studies with balanced representation by sex and direct measurement of physical activity. These findings also support a person-centred clinical message: older age alone should not be regarded as a barrier to AHCL when treatment is introduced with individualised education and appropriate ongoing support.
Particulate Matter (PM2.5) exposure contributes to the global disease burden, yet its monitoring remains sparse and uneven, with limited ground sensor infrastructure. Road-traffic proxy indicators can provide indirect estimates of PM2.5 where measurements are limited but require context-specific validation. We evaluated three PM2.5 road-traffic-related proxies: (i) population-Weighted Road Network Density (wRND), (ii) Euclidean (straight line) distance from highways (EH), and (iii) Euclidean distance from main roads (EM). We validated these proxies using high-resolution outdoor filtered PM2.5 personal exposure measurements collected over 1 year from 343 postpartum participants in The Gambia, Kenya, and Mozambique. Proxy-PM2.5 associations were assessed using Spearman correlation, and predictive utility was tested using country-specific and global Random Forest (RF) models (3-fold cross-validation), reporting R2, RMSE, and feature importance. Spatial mapping showed heterogeneous proxy-PM2.5 relationships across and within sites, with elevated PM2.5 occurring in both low- and high-proxy contexts. wRND-PM2.5 correlations were weak overall and statistically significant only in Mozambique (r = 0.351; p = 0.005), with non-significant associations in Kenya (r = - 0.041; p = 0.673) and The Gambia (r = - 0.020; p = 0.909). EH-PM2.5 correlations were positive in The Gambia (r = 0.335; p = 0.053) and Mozambique (r = 0.292; p = 0.020) but negative and significant in Kenya (r = - 0.224; p = 0.018). Single-variable RF models performed poorly across all countries (R2 < 0.45) and the Global model (R2 = 0.42). Combining proxies improved performance in Kenya (R2 = 0.52; RMSE = 31.7 µg/m3) and Mozambique (R2 = 0.60; RMSE = 8.9 µg/m3), Global R2 = 0.46; RMSE = 29.1 µg/m3), although in The Gambia, the combined model (R2 = 0.53; RMSE = 37.6 µg/m3) did not exceed the best single-proxy model. Road-network proxies provided limited but context-dependent signals of personal PM₂.₅ exposure. Their performance varied substantially across countries, indicating that road-based indicators should not be used as stand-alone exposure measures in heterogeneous sub-Saharan African settings. Instead, they are most defensible as locally validated components of hybrid exposure models that also incorporate meteorology, land use, biomass burning, household energy, and other non-traffic sources. The online version contains supplementary material available at 10.1007/s11869-026-02060-y.
Postoperative hydrocephalus is a common complication following posterior fossa tumor resection, affecting 7-40% of patients. Although preoperative cerebrospinal fluid (CSF) diversion may be required in selected patients with hydrocephalus, decisions remain individualized in routine neurosurgical practice. We therefore developed and externally validated a model to provide supplementary preoperative risk stratification using routinely available variables. We retrospectively analyzed 1,073 patients following resection of posterior fossa tumors (PFTs) treated at five tertiary centers between 2013 and 2024, dividing them into a development cohort (n = 854) and an external validation cohort (n = 219). We initially screened 30 perioperative variables from the multicenter dataset and then selected a clinically implementable model restricted to variables available before tumor resection. Feature importance was ranked using Shapley additive explanations (SHAP), and seven distinct machine learning (ML) algorithms were evaluated. Model performance was comprehensively measured using the area under the receiver operating characteristic curve (AUC), sensitivity, specificity, precision-recall curves, and decision curve analysis. The final clinically implementable model included three preoperative variables: Evans index, tumor-fourth ventricle relationship, and preoperative cerebrospinal fluid diversion status. In the external validation cohort, the support vector machine model showed good external discrimination, with an area under the receiver operating characteristic curve of 0.877, accuracy of 81.3%, sensitivity of 80.8%, and specificity of 81.7%. Logistic regression achieved comparable discrimination. Calibration assessment suggested dataset shift between the development and external validation cohorts, indicating that absolute predicted probabilities should be interpreted cautiously in populations with different baseline risks. A concise three-variable preoperative model showed good external discrimination for clinically relevant postoperative hydrocephalus after posterior fossa tumor resection. The model may support preoperative risk communication and postoperative surveillance planning, but should not be used as a stand-alone indication for cerebrospinal fluid diversion. Prospective validation and local recalibration are warranted before routine clinical implementation.
Miller Fisher syndrome (MFS) is an uncommon variant of Guillain-Barré syndrome (GBS) classically characterized by ophthalmoplegia, ataxia, and areflexia. Overlap forms with GBS are rare in early childhood and may be difficult to recognize, particularly in toddlers in whom neurological examination is limited. We report the case of a 20-month-old girl who presented with a seven-day history of progressive gait disturbance, repeated falls, refusal to walk, and convergent strabismus. Neurological examination showed severe axial ataxia, inability to sit or stand without support, generalized areflexia, symmetrical limb weakness, and right abducens nerve palsy. Brain and spinal magnetic resonance imaging (MRI) were normal. Cerebrospinal fluid (CSF) analysis showed mild albuminocytologic dissociation. Electroneuromyography demonstrated an acute motor-predominant polyradiculoneuropathy with preserved sensory responses. Anti-ganglioside antibody testing was positive for anti-ganglioside GQ1b (anti-GQ1b) and anti-ganglioside GT1a (anti-GT1a) immunoglobulin G (IgG) antibodies, supporting a diagnosis within the anti-GQ1b antibody syndrome spectrum. Campylobacter jejuni serology was positive despite the absence of preceding gastrointestinal symptoms, suggesting a possible antecedent exposure rather than a confirmed active infection. The diagnosis of MFS with GBS overlap was retained. The patient was treated with intravenous immunoglobulin at a total dose of 2 g/kg, with close respiratory, bulbar, and autonomic monitoring and early rehabilitation. The outcome was favorable, with recovery of independent walking at one month and complete neurological recovery at six months. This case highlights the importance of considering MFS with GBS overlap in very young children presenting with acute gait disturbance and ocular motor signs.
Myxedema coma is a rare endocrine emergency with high mortality that is typically associated with severe biochemical hypothyroidism. However, profound clinical decompensation may occur despite only modest abnormalities in thyroid function tests, making diagnosis challenging. We report the case of an 87-year-old woman with long-standing hypothyroidism, primary adrenal insufficiency, pituitary pathology, and ischemic heart disease who presented with an Escherichia coli urinary tract infection and subsequently developed profound hypothermia, severe bradycardia, hypotension, reduced consciousness, and gastrointestinal hypomotility despite appropriate antimicrobial therapy. Thyroid function tests demonstrated only mildly elevated thyroid-stimulating hormone with near-normal free thyroxine concentrations. Repeat clinical assessment revealed delayed relaxation of the ankle reflexes. Retrospective application of the Popoveniuc diagnostic scoring system gave a score of 105, providing strong support for the diagnosis of myxedema coma. The end-of-life care pathway was reversed, and treatment with intravenous hydrocortisone, intravenous levothyroxine, active warming, and supportive care resulted in marked clinical recovery. This case highlights the importance of recognizing myxedema coma as a clinical diagnosis, maintaining a high index of suspicion despite relatively mild biochemical abnormalities, and undertaking repeated clinical reassessments in elderly patients with impaired endocrine reserve.
Olfactory dysfunction (OD) is common in COVID-19, yet its relationship with pulmonary involvement remains inconsistent. We evaluated the association between CT-based lung involvement and OD in laboratory-confirmed COVID-19. In a prospective cross-sectional study (Yasuj University of Medical Sciences hospitals; December 26, 2021-May 22, 2022), OD was assessed using the CCCRC protocol and pulmonary involvement was categorized using a CT lung involvement score. Associations were examined using chi-square testing (categorical) and ANOVA where appropriate (α = 0.05). Among 120 patients (60 male/60 female; mean age 43.17 ± 14.76 years), 71 (59.2%) had hyposmia, and none had complete anosmia. CT pulmonary involvement was present in 40 (33.3%). OD category was significantly associated with the pulmonary involvement category (chi-square test; P value as reported in the Results section). OD was frequent and showed a statistically significant association with CT-based pulmonary involvement; however, OD severity alone should not be used as a stand-alone surrogate for pulmonary involvement. Larger multicenter studies are needed to clarify the observed pattern.
Standing balance is maintained through the integration of signals from the proprioceptive, visual, and vestibular systems. Galvanic vestibular stimulation (GVS) delivered through head-worn electrodes is increasingly used in clinical vestibular rehabilitation and immersive entertainment interfaces, but it is known to impact on-feet postural stability. Prior studies assessing balance and postural effects have predominantly focused on bilateral mastoid-based uniaxial GVS paradigms. Limited research has characterized balance metrics under multiaxial GVS configurations using four-electrode montages generating multiple directional stimulation paradigms. Standing balance was assessed in healthy participants with eyes closed using a dual force-plate system to record center-of-pressure (COP) dynamics. Participants were exposed to six randomized GVS stimulation conditions across four electrodes placed on the left and right mastoids, center forehead, and nape of the neck, while static, dynamic sway, and velocity-based COP features were extracted to characterize postural responses. GVS significantly altered static, dynamic sway, and velocity-based balance measures compared with the Null condition across six stimulation paradigms. All GVS stimulations increased COP displacement, sway length, sway area, and peak velocities, while reducing sway density metrics across mediolateral (ML) and anteroposterior (AP) axes. These findings provide an early quantitative characterization of postural responses to an unconventional GVS montage and create a foundation for predicting body motion during multiaxial vestibular stimulations. Such insights are important for the safe application of GVS in standing and ambulatory contexts, including clinical vestibular rehabilitation and immersive simulation environments.
Highly Superior Autobiographical Memory (HSAM) is the rare ability to recollect nearly all of one's past personal experiences with great detail and accuracy. When given a date, a person with HSAM can recall verifiable details about what they experienced that day. People with HSAM do not tend to stand out on standard neuropsychological assessments, common laboratory tasks, or other measures that assess intentional forms of memory. Some clues suggest that the superior autobiographical remembering of people with HSAM occurs involuntarily. In a newly identified case of a person with HSAM, we found evidence using the Involuntary Autobiographical Memory Inventory (IAMI) that the person's involuntary memory indeed stands out. This person's past-oriented Involuntary Autobiographical Memory (IAM) frequency was two standard deviations above the mean reported in previous research. while, in line with past research, her performance on standard neuropsychological batteries and laboratory tasks was unremarkable. We propose that these intrusive recollections facilitate the consolidation of memory for past events.
Bladder cancer is a long-standing clinical issue, with frequent recurrence and continuously disappointing results in patients, so that therapeutic development is primarily reliant on delineating the original molecular defects. Increasing interest has turned to the Kinesin Superfamily Proteins (KIFs), basic molecular motors that move along microtubule rails, and are now emerging as important key oncogenic derivers in bladder cancer pathogenesis. This review synthesizes available evidence indicating that several KIFs, specifically KIF4A, KIF14, KIF20A, and KIFC1, function as key oncogenic regulators and represent important prognostic biomarkers and therapeutic targets in bladder cancer. When KIF expression or activity is disrupted, it provides mechanical and signaling support for all the cancer hallmarks, facilitating cellular proliferation, invasion, metastasis, and resistance to highly effective cell death. Its oncogenic activity is generally facilitated by the activation of principal signaling pathways. A remarkable proportion of certain KIF isoforms are commonly overexpressed in cancer, and the scale of such overexpression increases with the severity of adverse clinical predictors, such as increasing disease stage, and patient survival worsens. This nuanced molecular image renders KIFs so highly promising targets for therapeutic intervention and prognostic stratification, and initial exploration of kinesin inhibitors is encouraging to abate chemoresistance, aside from optimizing the efficacy of current immunotherapies. Uncovering modalities that exploit the aggressive bladder cancer cell dependence on KIF motor activity is a highly promising path to clinical application.
Intervertebral disc degeneration (IVDD) is frequently implicated in low back pain (LBP), yet the severity of degeneration on imaging often fails to parallel pain intensity or functional limitation. Modic changes capture abnormal marrow signal at the disc-vertebral interface, but they primarily describe subendplate marrow signal rather than lesion continuity across the disc, cartilaginous endplate, and adjacent marrow. The disc-endplate-bone marrow complex (DEBC) classification provides a complementary lesion-level imaging framework that integrates disc signal, endplate integrity, and adjacent marrow response. By incorporating short tau inversion recovery (STIR) sequences, DEBC may help identify imaging features suggestive of edema-like lesion activity; however, STIR hyperintensity should not be interpreted as direct proof of inflammation, pain generation, or a specific molecular program. This narrative and critical review synthesizes imaging, mechanistic, omics, and translational evidence to evaluate the biological plausibility and current limitations of the DEBC framework. We argue that DEBC should not replace Modic classification, assign pain causality, or guide treatment as a stand-alone criterion. Rather, its current value lies in generating testable hypotheses, improving lesion-level stratification, and supporting future imaging-to-molecular validation. Longitudinal imaging, histopathology, spatial omics, and clinical outcome studies are needed to determine whether DEBC types correspond to reproducible lesion ecologies, pain-associated phenotypes, or treatment-response patterns.