Eighteenth-century medical texts document a formative period in the evolution of clinical reasoning, yet their integration into modern medical education is limited. The traditional approach to learning the history of medicine has naturally focused on passive reading, but new approaches using AI could enable learners to interrogate and simulate the historical diagnostic logic and therapeutic paradigms. More specifically, large language models (LLMs) offer an opportunity to create interactive simulations that allow experiential engagement with historical medical reasoning. We developed a historically constrained LLM-based educational platform designed to emulate the diagnostic reasoning, language, and conceptual frameworks of an 18th-century physician. A modern GPT architecture was customized using strict instruction-based constraints and limited exclusively to a curated corpus of six foundational 17th-18th century medical texts. Guardrails were implemented to prevent anachronistic terminology and modern medical concepts. Model outputs were evaluated qualitatively by comparing the model's diagnoses and treatment plans with published diagnoses and treatment from original 18 th century sources. We also applied the simulation to modern clinical vignettes for an illustrative contrast between modern and 18 th century approaches. The model generated responses that closely aligned with 18th-century medical and rhetorical style, as well as therapeutic reasoning. When presented with historical cases, the simulation demonstrated strong concordance with original diagnoses and management strategies. Secondly, when applied to modern cases, the model described period-appropriate reasoning, highlighting clear contrasts with contemporary biomedical reasoning. AI broadly, and more specifically LLMs configured as historically constrained simulators, can function as effective tools for learning in medical history. This approach could enable active engagement with historical clinical reasoning, fostering critical reflection on the contingent and evolving nature of medical knowledge. Such temporal simulations hold promise for medical humanities education and interdisciplinary teaching.
Cadmium sulfur selenide and cadmium zinc sulfide pigments have been widely employed by artists of the twentieth century. A deep knowledge of these artworks, also in view of their conservation and/or restoration, relies on comprehensive and robust databases of reference materials of the pigments to easily detect their composition and their tendency and routes to deterioration. In this work, we initiate the construction of such a database by applying exclusively non-invasive techniques-X-ray Fluorescence (XRF) and Fiber Optics Reflectance Spectroscopy (FORS) in the Vis-SWIR range-to two sets of historical pigments: a group of pure commercial tube paints and a mixed palette representative of artistic practice. To strengthen the interpretative framework, mock-up samples were prepared using modern Cd-based pigments. These reference materials were first analysed using the same non-invasive protocols to ensure full data compatibility. In addition, they were further characterized through synchrotron-based techniques, namely High-Resolution X-ray Powder Diffraction (HR-XRPD) and X-ray Absorption Spectroscopy (XAS), providing additional structural and phase information not accessible through laboratory non-invasive methods alone. The integration of non-invasive and synchrotron-based data on the modern reference materials enables a more rigorous interpretation of the spectra collected on historical pigments. This combined approach enhances phase discrimination, compositional assessment, and the understanding of pigment variability, thereby increasing the reliability and internal consistency of the historical database. The resulting dataset establishes a solid foundation for future non-invasive studies of twentieth-century Cd-based pigments in complex stratigraphic and binding media contexts.
Two century-old maleidrides 1 and 2 were found in the marine-derived fungus Talaromyces trachyspermus. Their structures were established by the analysis of spectroscopic data. Notably, their absolute configurations were unambiguously assigned by X-ray diffraction analysis. Interestingly, compound 1 showed antibacterial activity against Escherichia coli (IC50 = 103.6 mg/mL). This was the first report on the absolute configuration of compound 2, which has not been determined for near a century.
Sociological modernization theory predicts that rising meritocracy reduces the influence of family background on education while increasing the role of individual abilities. Sibling correlations are often used as omnibus indicators of family influence, but they reflect both shared environments and shared genetics, complicating interpretation over time. This study examines changes in the genetic and environmental components of educational attainment using administrative data on more than 13,000 Norwegian twin pairs born between 1915 and 1991. We apply a Bayesian hierarchical liability-threshold model to estimate heritability and shared environmental influences across birth cohorts, accounting for changes in educational systems and population distributions. For women, the heritability of educational attainment increased steadily across the twentieth century, while shared environmental influences declined, consistent with expanding educational opportunities and gender equality. For men, neither heritability nor shared environmental influences changed significantly over time. These findings clarify how genetic and environmental contributions to education vary across historical contexts, refining interpretations of long-term trends in family influence.
Citizen science plays an increasingly important role in generating scientific knowledge and supporting environmental and social action. However, its potential to address complex global challenges remains underutilised. This study explores how citizen science can be improved by involving the public in all stages of scientific research. Using participatory research methods, online surveys and group discussions were conducted with researchers, citizen scientists, and Indigenous participants. Thematic coding was used to identify key challenges, opportunities, and best practices to enhance citizen science initiatives. Additionally, nine case studies were reported using the Standardised Data on Initiatives (STARDIT) reporting tool. The study identified key strategies for improving involvement, engagement and retention in citizen science initiatives. Findings underscore the importance of inclusive, evidence-informed approaches such as targeted outreach, fair compensation, tailored support, and co-creation practices. Ensuring data quality and fostering trust require adherence to FAIR data principles (findable, accessible, interoperable and reusable), transparent validation and sharing processes, and establishing ethical research partnerships. Persistent challenges include short-term funding, which undermines long-term project sustainability, and the lack of centralised support for ethics and project management. Formal recognition of citizen scientists through co-authorship, standardised training, and professional development opportunities can further strengthen involvement and build capacity. Finally, emerging technologies, including artificial intelligence and open data platforms, present opportunities to scale and improve efficiency, provided they are implemented with appropriate ethical safeguards and investment. Drawing together these insights, we provide 10 actionable recommendations for citizen science in the 21st century. These highlight the importance of embedding citizen science in national research infrastructure, education, and policy, alongside consistent evaluation and reporting, to improve its inclusivity, longevity, and impact. We conclude by arguing that as the world confronts climate change, public health crises, and biodiversity loss, broader public involvement in science is key for equitable, efficient and evidence-informed responses.
In 2026, the American Chemical Society (ACS) is celebrating the 150th anniversary of its founding. The Perspective presents a historical account of the growth of the field of analytical chemistry and the journal Analytical Chemistry, as seen through the lens of the ACS. Beginning with the early influence of analytical chemists on ACS publications, leading to the creation of Industrial and Engineering Chemistry Analytical Edition in 1929, readers can follow the evolution of analytical chemistry, the fourth journal published by the ACS. Since its first volume, through 2026, the journal has seen continuous growth. Highlighting the impact of our seven Editors on the journal, this Perspective provides insight into our changing discipline through discussion of the most cited papers published in the journal. In a few years, analytical chemistry will mark its 100th anniversary. It is exciting to speculate about what changes are in store for the journal in the era of AI-enabled science, scientific writing, and publishing.
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This article presents KannadaLit4NLP, a large-scale, machine-readable corpus of Kannada literary texts designed to support natural language processing (NLP) research for a low-resource language. The dataset comprises 24,746 literary verses from three major Kannada literary traditions-Vachanas (11th-19th century), Tripadis (16th century), and Kagga (20th century)-along with 22,369 corresponding interpretations curated from scholarly sources. The corpus captures linguistic, stylistic, and semantic variations across historical periods and literary forms. The dataset was developed through a systematic pipeline that included source identification, digitisation via optical character recognition (OCR), manual verification, and structured annotation. Each entry is organised in a structured format that includes the original verse, metadata (literary form, author, and source), and associated interpretation(s), enabling its use in tasks such as semantic textual similarity, textual entailment, information retrieval, and generative modelling. KannadaLit4NLP addresses the limited availability of culturally grounded Kannada datasets by providing a resource that integrates classical and modern literary content with interpretative annotations. The dataset can facilitate the development and evaluation of NLP models in areas such as semantic understanding, translation, and knowledge representation, while also supporting computational studies of literary and cultural texts. The dataset is made publicly available to encourage further research and reproducibility in Kannada NLP.
The history of Greenland is marked by different waves of Paleo-Inuit immigration from North America from 2,500 BC to the 12th century and from the 10th to 15th century, Norse settlers immigrated from Northwest Europe and flourished in Southwest Greenland with the introduction of domestic livestock. The different Inuit and Norse cultures created middens by dumping and accumulating domestic waste; a latent source of microbes, including potential pathogens, that might have been preserved due to the general wet and cold conditions in the region. The aim of this study was to evaluate whether ancient Arctic settlements might be possible hot-spots for pathogenic agents that may spread to the surrounding environment because of current climate changes. Using metagenomics, we compared the microbial communities and resistomes of 78 samples from middens from different ages and locations in West and South Greenland (two Paleo-Inuit, four Norse and one early Colonial-time middens) to 143 soil samples from nearby surroundings. We found that the middens harbor a distinctive microbial signature enriched in human-associated bacteria. Those include opportunistic pathogens such as Clostridium perfringens and Paeniclostridium sordellii. In some early colonial midden layers, C. perfringens and Paraclostridium tenue together accounted for up to ~40%-50% of MetaPhlAn-derived relative abundance in individual samples. Antimicrobial resistance genes representing 17 resistance classes were detected across all sites, dominated by β-lactam and tetracycline resistance. Transect analyses across an actively eroding midden showed that midden-derived bacteria were confined to local erosion layers and were rapidly replaced by native marine communities, indicating limited environmental dispersal.
Vaccination is one of the most effective public health interventions in history, yet resistance to vaccines has persisted across centuries. This narrative historical review examines the evolution of vaccine hesitancy and anti-vaccine sentiment from the smallpox era to the COVID-19 pandemic. Sources were identified through PubMed and major public health organizations, including the World Health Organization and the U.S. Centers for Disease Control and Prevention, spanning the early 18th century through 2025. Across distinct historical periods, including early smallpox vaccination, mid-20th-century vaccine controversies, the 1998 Wakefield publication, and the COVID-19 pandemic, recurring themes emerge. Concerns regarding vaccine safety, distrust of institutions, and objections grounded in personal liberty have consistently shaped resistance. While these core arguments have remained stable, the mechanisms of dissemination have transformed dramatically. Modern digital platforms enable rapid, large-scale spread of misinformation, often amplified by algorithms that prioritize emotionally engaging content. The COVID-19 pandemic marked a critical inflection point, with vaccine hesitancy becoming increasingly politicized and, in some cases, economically incentivized through monetized online content. Historical examples demonstrate that both genuine safety events and misinformation can produce long-lasting effects on public trust, even after scientific refutation. This review highlights that vaccine resistance is not solely a deficit of scientific knowledge but a complex interplay of social, political, and cultural factors. Effective public health strategies must therefore extend beyond evidence dissemination to include trust-building, transparent communication, and engagement within modern information ecosystems. Sustaining vaccine confidence will require addressing both the historical roots and contemporary drivers of hesitancy.
Oncorhynchus mykiss is among the most extensively farmed fish species globally and simultaneously ranks as one of the most invasive aquatic taxa. Despite its non-native status in Europe, it remains a valued species in recreational fisheries and is frequently used to supplement streams with declining native Salmo trutta populations. In Slovakia, the presence of O. mykiss dates back to the late nineteenth century, with historical introductions into the Okna River basin and Lake Vihorlat occurring in the early twentieth century. Here, we present fish stock data and report the first documented occurrence of natural spawning redds of O. mykiss in the Okna River recorded in April 2025. This evidence confirms the existence of a self-reproducing, spring-spawning population, possibly descended from the original introductions. The spawning redds were located in gravel-sand substrates in shallow, low-flow areas after the period of rising water temperature and during stable discharge. Stock-assessment data indicate that O. mykiss is currently dominant over S. trutta, and comparisons with historical records suggest altered relative abundances of B. barbatula and Phoxinus sp. populations. These findings highlight, ongoing ecological interactions between non-native O. mykiss and native fish fauna in the Okna River.
Wide Awake Local Anesthesia No Tourniquet (WALANT) is often introduced as an anesthetic technique that avoids general anesthesia, regional blocks, sedation, and tourniquet discomfort. This description is accurate, but incomplete. The deeper significance of WALANT is that it restores living physiology to the operating theatre. For more than a century, reconstructive surgeons repaired tendons, transferred nerves, corrected deformities, balanced muscles, and reconstructed movement in patients whose physiology was temporarily silent. Tendon tension was estimated, nerve function was predicted, muscle balance was assumed, and the final judgment of success was delayed until rehabilitation revealed the truth. WALANT challenges this old paradigm by allowing movement, tension, balance, spasticity, sensory response, and patient-specific biomechanics to be observed during surgery itself. Its expanding role in tendon transfer, thumb reconstruction, peripheral nerve surgery, brachial plexus reconstruction, spasticity surgery, and ambulatory microsurgery suggests that its greatest contribution may not be anesthetic freedom, but the birth of physiology-guided reconstruction. This editorial argues that WALANT has moved beyond tendons and beyond anesthesia. It has become a new way of thinking about reconstructive surgery.
Movement of the mitral annulus toward the left ventricular (LV) apex during systole, termed atrioventricular plane displacement or mitral annular plane systolic excursion (MAPSE), was first observed by Leonardo da Vinci in the 15th century. MAPSE, a measure of longitudinal movement, shows good agreement between transthoracic echocardiography and cardiovascular magnetic resonance imaging and can also be measured by transesophageal echocardiography and cardiac computed tomography. Measurement is fast, simple, and easily automated. However, no major imaging guidelines advise routine measurement. We present a systematic review of studies appraising the diagnostic and prognostic performance of MAPSE from PubMed, Medline, Google Scholar, and Embase until September 2025 in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Studies assessing MAPSE in adult populations were included, and non-English publications, abstracts, and studies of congenital heart disease were excluded. Newcastle-Ottawa Scale assessed study quality. Correlation coefficients between MAPSE and markers of systolic function were pooled using Hunter-Schmidt meta-analysis. Heterogeneous diagnostic and prognostic outcomes were synthesized narratively. The review included 92 studies. MAPSE correlated with LV ejection fraction (r=0.64 [95% CI, 0.54-0.74]) and global longitudinal strain (r=0.53 [95% CI, 0.45-0.63]), showing a modest association with systolic function, particularly useful in patients with poor echocardiographic windows. MAPSE was frequently reduced despite preserved LV ejection fraction across multiple pathologies, enabling earlier detection of systolic impairment. MAPSE also demonstrated strong prognostic value, outperforming LVEF and global longitudinal strain in predicting adverse events in several studies. Overall, MAPSE has a clinically important role meriting integration into routine cardiac imaging and care.
Discovered in the late 19th century as a heat-sensitive plasma factor called "alexin", complement was first identified for its ability to work with antibodies to destroy microorganisms. Over the past two centuries, research advances have firmly established the complement system as a fundamental component of the immune system, with broader roles in immune surveillance, inflammation, and clearing immune complexes and apoptotic debris, while also bridging innate and adaptive immunity. Due to complement playing a central role in modulating biological processes on a system-wide scale, dysregulation or excessive activation can drive harmful inflammation and self-tissue damage. Despite some initial safety concerns and biological complexity, therapeutic targeting of the complement system has, over the past decade, emerged as a key strategy for controlling disorders in which its unregulated activation becomes pathogenic. However, inhibition of complement, particularly at the level of C3 or C5, predisposes patients to infections, most notably by encapsulated bacteria. These include a markedly increased risk of invasive infections caused by Neisseria meningitidis, as well as susceptibility to Streptococcus pneumoniae, Haemophilus influenzae, and other opportunistic viral and fungal pathogens. In this review, we aim to describe the infection risks associated with therapeutic complement inhibition and outline emerging approaches to mitigate their complications. These include optimised vaccination protocols, antimicrobial prophylaxis, patient education, and surveillance programs, as well as next-generation approaches such as pathway-selective inhibitors, personalised risk stratification, and adjunctive immune support. Enhancing these protective measures will be vital to optimising the therapeutic benefit of complement inhibition while reducing infectious morbidity and mortality.
For a half-century, the Efros-Shklovskii (ES) law has been a powerful framework for describing conduction in disordered systems featuring a Coulomb gap. Here, we examined the validity of the ES law at the ultimate 2D thickness limit by investigating the low-temperature transport of three single-atom-thick crystalline systems based on the √3×√3-Au reconstruction on a Si(111) surface. Structural disorder was represented by three distinct configurations: (i) random network of domain walls (α-Au phase), (ii) inhomogeneous Au-Cu solid solution, and (iii) random 2D gas of Tl adatoms atop the crystalline layer. We found that only the domain-wall-disordered α-Au phase exhibits temperature dependence of the conduction described by the ES law. In contrast, the other two configurations display typical metallic behavior.
Anaesthesia and surgery in the 21st century are the safest they have ever been, with over 300 million operations occurring worldwide every year. Mortality rates are consistently around 0.5-1% for elective non cardiac surgery; however, this commonly cited metric only describes part of the story. It is time for us to acknowledge, as many of our patients do, that mortality and length of hospital stay are useful but incomplete measures of perioperative success. Recently, there has been a shift in focus towards Value-Based HealthCare (VBHC), patient-centred outcome metrics (Patient-Reported Outcome Measures or PROMs) and Patient-Reported Experience Measures (PREMs) as markers of success. In this review, we examine the current state of patient-centred precision care (PC) with relevance to anaesthesia.
Human health and the health of our planet are inextricably linked. The accelerating loss of global biodiversity represents one of the most profound health threats of the 21st century. With species extinction rates estimated to be 10-100 times higher than natural baselines, biodiversity decline is no longer solely an environmental concern. This narrative review synthesizes evidence suggesting that biodiversity decline is increasingly relevant as a determinant of human health and survival rather than solely an environmental concern. The six pillars of lifestyle medicine, offer a coherent framework for interventions that can simultaneously prevent and improve lifestyle related illness outcomes while improving planetary health by reducing environmental pressures that drive species extinction and biodegradation. The review examines evidence synthesized from peer-reviewed databases (MEDLINE, PubMed, CINAHL, Joanna Briggs, SCOPUS, ScienceDirect, and GreenFILE), primarily 2010-2025, organized across seven thematic domains: infectious disease ecology, ecosystem services, microbiome dynamics, lifestyle medicine interventions, One Health integration, behavioural change, and clinical/policy implications. The review argues that lifestyle medicine must evolve from individual-focused clinical practice to also explicitly address structural drivers of ecological degradation, including food systems, transport, and urban design, thereby operationalizing planetary health principles in clinical care.
The early 20th-century discovery of heterosis and the establishment of heterotic groups transformed maize (Zea mays L.) into a keystone of global agriculture. However, maize breeding faces two significant challenges: the gradual decline of general combining ability (GCA) variance within heterotic groups and the impracticality of testing all possible single crosses in the early stages of a breeding program. Here, we developed genomic best linear unbiased prediction (GBLUP)-based multi-kernel models, using additive and two alternative non-additive genomic relationship matrices, to estimate the variance components associated with the GCA of Stiff Stalk (SS) and Non-Stiff Stalk (NSS) heterotic groups and the specific combining ability (SCA) arising from their crosses. We further applied these models to predict the performance of untested single-cross combinations under varying levels of parental information. We showed that the SS and NSS groups retained significant GCA variance across traits in both early- and late-maturity groups. The SS group, in contrast, exhibited no detectable GCA variance in grain yield for the intermediate-flowering subset of hybrids, highlighting a limitation for future genetic improvement. Furthermore, our results showed that GBLUP-based multi-kernel models effectively identified superior hybrids when parental information was available. In the absence of this information, however, these models underperformed compared to covariance-based approaches. Both non-additive matrices yielded similar results, indicating that they capture comparable genetic relationship patterns despite their distinct formulations. Overall, this study sheds light on the future use of US maize commercial germplasm and demonstrates how GBLUP-based multi-kernel models can improve the efficiency of hybrid breeding programs.
The Republic of Guinea has faced an important challenge with human African trypanosomiasis (HAT), which was endemic over the last century. After initial control in the 1960s-1970s, HAT resurged in the 1990s along the Guinean coast, driven by economic and demographic pressures on the mangrove ecosystem. In response, the Guinean government established a national control program in 2002, focusing on medical mass screenings. In 2012, vector control using tiny targets was introduced in the East Boffa focus to reduce fly density and human-vector contact. However, the Ebola epidemic from 2013 to 2016 disrupted these efforts, leading to a reliance on passive screening. Resuming screenings in 2016-2017 revealed increased cases in all foci except the East Boffa area, where vector control had been effective. Vector control continued during the SARS-CoV2 pandemic and at the same time targeted door-to-door screenings were introduced to target high-risk individuals. Since 2018, around 30,000 at-risk individuals have been screened annually. These strategies reduced the total number of new cases below 1 per 10,000 inhabitants in endemic areas over the period 2019-2023, allowing to validate the elimination of HAT as a public health problem. The Guinean team and partners then focused on systematic spatial monitoring of patients and community engagement in vector control. The program also integrates control of other neglected tropical diseases and addresses new research questions, especially about anatomical and animal reservoirs for parasites. These efforts, combined with implementation of improved diagnostic tests and new oral treatments, through active involvement in multiple clinical trials and studies, now aim to interrupt HAT transmission by 2030.
Cities worldwide face increasing threats from Extreme Climate Change, as hazards such as heatwaves, droughts, and floods pose growing risks to urban populations and infrastructure. However, global regional assessments of exposure to extreme climate hazards under worst-case scenarios remain limited. This study presents a global assessment of regional exposure to heatwaves, droughts, and floods by the end of the century using upper-quartile projections from 20 CMIP6 climate models under the SSP5-8.5 emissions scenario. Changes in these hazards were evaluated individually and in combination across thousands of cities. Results indicate heatwave frequency will increase by over 90% in many tropical and coastal urban areas, and temperature extremes up to 12.7 °C above historical values will occur in high-latitude cities. Over 120 cities are projected to exceed critical wet-bulb temperature thresholds for human health. Drought severity is projected to intensify significantly in South America, Africa, and Southeast Asia, becoming up to 3.2 times more severe than historical extremes. Flood risks, measured by river discharge, are projected to increase substantially in South America and Asia, with increases up to 85 times historical levels. Compound hazard analysis further identifies significant overlapping exposure in cities across Africa, Southeast Asia, and South America. These findings highlight substantial regional exposure to extreme climate hazards and emphasise the urgent need for targeted urban adaptation and resilience planning worldwide.