Artificial intelligence (AI) is increasingly being integrated into healthcare systems; however, nurses' knowledge, attitudes, and perceived challenges play a crucial role in its adoption in patient care. This study aimed to assess nurses' knowledge, attitudes, and perceived challenges toward AI, examine the relationships among these variables, and explore their associations with demographic characteristics and prior AI training. A descriptive analytical cross-sectional study was conducted among 107 nurses working in intensive care, medical, and surgical units at Zagazig University Hospital. A purposive sampling technique was used. Data were collected over two months using structured instruments during morning shifts. Most participants were aged 25-34 years (55.1%), male (65.4%; reflecting the accessible sample composition), and held bachelor's degrees (68.2%), with nearly half (49.5%) having 5-10 years of clinical experience. Overall, 68.2% of nurses achieved satisfactory knowledge scores, whereas 88.8% demonstrated positive attitudes toward AI applications. Perceived challenges were mainly related to technical and ethical concerns, particularly the need for continuous system updates, cybersecurity risks, and implementation costs. A statistically significant weak negative correlation was found between nurses' knowledge and attitudes toward AI (r = -0.195, p = 0.044). No significant correlations were observed between knowledge and perceived challenges (r = -0.162, p = 0.095) or between attitudes and perceived challenges (r = 0.142, p = 0.145). Previous AI-related training was significantly associated with more positive attitudes toward AI (p = 0.019), whereas no significant associations were found with knowledge or perceived challenges. Educational level, workplace, and years of experience were not significantly associated with nurses' knowledge, attitudes, or perceived challenges. Nurses demonstrated a satisfactory knowledge and generally positive attitudes toward AI applications in patient care, while perceiving moderate implementation challenges. Although previous AI-related training was associated with more positive attitudes, no significant associations were found with knowledge or perceived challenges. The weak negative correlation between knowledge and attitudes suggests that greater awareness of AI may be accompanied by increased concerns regarding its use. Further educational initiatives are needed to enhance nurses' preparedness for AI integration in clinical practice.
Artificial intelligence is playing an increasingly important role in healthcare, particularly in diagnostics, clinical decision support, personalized medicine, robotics, administration, and medical education. At the same time, the clinical use of artificial intelligence raises not only technological opportunities but also ethical, data protection, and legal challenges. The aim of our study was to provide an integrated overview of the main benefits and risks of artificial intelligence applications in healthcare, with particular emphasis on liability-related issues. We conducted an interdisciplinary, narrative critical review of the literature. Scientific and regulatory sources were analyzed using content analysis, thematic analysis, and critical discourse analysis, with the integration of clinical, ethical, legal, and data protection perspectives. Based on the reviewed literature, artificial intelligence may improve diagnostic accuracy, support personalized decision-making, reduce administrative burden, contribute to better access to care, and create new opportunities in robotics and medical education. However, algorithmic bias, the lack of transparency resulting from the "black box" nature of many artificial intelligence systems, data protection and cybersecurity risks, as well as uncertainties related to social acceptance, represent major challenges. Our most important finding is that these issues converge in the question of clinical liability, while the traditional physician-centered model of responsibility appears increasingly insufficient. The use of artificial intelligence in healthcare can only be sustainable and legitimate within an integrated, liability-centered framework. Reconsidering the distribution of responsibilities among developers, healthcare institutions, and clinicians, as well as strengthening institutional guarantees of transparency, human oversight, patient autonomy, and data protection is essential for the safe implementation of artificial intelligence in healthcare. Orv Hetil. 2026; 167(27): 1079-1087. Bevezetés és célkitűzés: A mesterséges intelligencia egyre meghatározóbb szerepet tölt be az egészségügyben, különösen a diagnosztika, a döntéstámogatás, a személyre szabott medicina, a robotika, az adminisztráció és az orvosképzés területén. A mesterséges intelligencia klinikai alkalmazása ugyanakkor nemcsak technológiai lehetőségeket, hanem etikai, adatvédelmi és jogi kihívásokat is felvet. Tanulmányunk célja a mesterséges intelligencia egészségügyi alkalmazásainak fő előnyeit és kockázatait integráltan áttekinteni, különös tekintettel a felelősségi kérdésekre. Módszer: Interdiszciplináris, narratív jellegű kritikai irodalmi áttekintést végeztünk. A feldolgozott tudományos és szabályozási forrásokat tartalomelemzés, tematikus elemzés és kritikai diskurzuselemzés segítségével értékeltük, az orvosszakmai, etikai, jogi és adatvédelmi szempontok összekapcsolásával. Eredmények: A vizsgált szakirodalom alapján a mesterséges intelligencia javíthatja a diagnosztikai pontosságot, támogathatja a személyre szabott döntéshozatalt, csökkentheti az adminisztratív terheket, hozzájárulhat az ellátáshoz való hozzáférés javításához, valamint új lehetőségeket teremthet a robotika és az orvosképzés területén. Ugyanakkor az algoritmikus torzítás, a feketedoboz-jellegből fakadó átláthatatlanság, az adatvédelmi és kiberbiztonsági kockázatok, továbbá a társadalmi elfogadás bizonytalanságai jelentős akadályokat képeznek. Legfontosabb megállapításunk, hogy e tényezők a klinikai felelősség kérdésében összegződnek, miközben a hagyományos, orvosközpontú felelősségi modell egyre kevésbé elegendő. Következtetés: A mesterséges intelligencia egészségügyi alkalmazása csak integrált, felelősség-központú megközelítés mellett lehet fenntartható és legitim. A fejlesztők, az egészségügyi intézmények és a klinikusok közötti felelősségi viszonyok újragondolása, valamint az átláthatóság, az emberi kontroll, a betegautonómia és az adatvédelem intézményi garanciáinak megerősítése a biztonságos mesterséges intelligencia bevezetésének alapvető feltétele. Orv Hetil. 2026; 167(27): 1079–1087.
Perivascular epithelioid cell tumors (PEComas) are rare mesenchymal neoplasms composed of epithelioid cells that co-express melanocytic and smooth muscle markers. They can arise in various anatomic sites, most commonly the uterus, retroperitoneum, gastrointestinal tract, and liver. While most PEComas are sporadic and associated with TSC1/TSC2 mutations leading to mTOR pathway activation, a distinct molecular subset harbors TFE3 gene rearrangements, often exhibiting more aggressive clinical behavior. Given their rarity, the diagnosis and management of PEComas remain challenging and largely unstandardized. We report the case of a 37-year-old woman with no significant medical history who presented with fatigue, unintentional weight loss, and vomiting. Imaging revealed a large hepatic mass and pulmonary nodules. Histopathological and immunohistochemical evaluation confirmed a diagnosis of TFE3-rearranged PEComa involving the liver and left upper lung lobe. The patient underwent right partial hepatectomy with complete resection of the hepatic lesion. Subsequent disease progression was noted in the lung, lymph nodes, and bone despite treatment with an mTOR inhibitor. TFE3-rearranged PEComas represent a rare and aggressive molecular subset with limited therapeutic options. This case demonstrates resistance to mTOR inhibition, highlighting the critical importance of molecular subtyping to distinguish TFE3-rearranged from TSC1/TSC2-mutant disease and guide individualized management. Expanded molecular profiling is essential to refine treatment strategies for this uncommon entity.
This article examines the demographic resilience of the Republic of Adygea, which faces unique demographic and economic challenges due to its limited territory, distinct ethnocultural composition, and external migration flows. Given the transformation of the labor market driven by digitalization, an aging population, and structural changes in the economy, the region is forced to develop strategies to enhance demographic resilience. The authors analyze factors influencing the stability of Adygeas labor market, assesses current trends in employment, migration, and demographic dynamics, and proposes adaptation mechanisms aimed at mitigating the risk of labor shortages and ensuring economic growth. The studys findings substantiate the need for a comprehensive approach that includes human capital development, stimulating internal migration, and implementing flexible employment models. В статье рассматривается демографическая резильентность Республики Адыгея, сталкивающейся с уникальными демографическими и экономическими вызовами, обусловленными ограниченной территорией, спецификой этнокультурного состава и внешними миграционными потоками. В условиях трансформации рынка труда, обусловленной цифровизацией, старением населения и структурными изменениями в экономике, регион вынужден разрабатывать стратегии повышения демографической резильентности. Авторы анализируют факторы, влияющие на устойчивость рынка труда Адыгеи, даёт оценку текущим тенденциям в сфере занятости, миграции и демографической динамике, а также предлагает механизмы адаптации, направленные на снижение рисков дефицита кадров и обеспечение экономического роста. Результаты исследования обосновывают необходимость комплексного подхода, включающего развитие человеческого капитала, стимулирование внутренней миграции и внедрение гибких моделей занятости населения.
Ensuring adequate staffing levels for psychiatrists-narcologists and district psychiatrists-narcologists amid the observed shortage of healthcare personnel across all sectors and burnout among medical workers represents one of the primary pathways to improving the performance of psychoneurological services. Analysis of the new order from the Russian Ministry of Health on the «psychiatry-narcology» profile reveals that the document includes certain measures to strengthen preventive efforts by introducing the position of a medical psychologist in the office for the prevention of substance use disorders. However, in our view, certain provisions of the document require revision in the following directions: transitioning to commonly accepted indicators for labor norms in outpatient care, namely statistical data on population size and its contingents; and excluding staffing numbers from the normative provision for ensuring round-the-clock operations of medical personnel. Обеспечение должной численности врачей психиатров-наркологов и врачей психиатров-наркологов участковых в условиях наблюдаемого во всех сферах здравоохранения кадрового дефицита и выгорания медицинских работников является одним из основных путей совершенствования деятельности психо-наркологические службы. Анализ нового приказа Минздрава России по профилю «психиатрия-наркология» показывает, что документ содержит определенные меры по усилению профилактической работы путем дополнительного введения должности медицинского психолога в кабинет профилактики наркологических расстройств. Однако доработка отдельных положений документа должна быть проведена, на наш взгляд, по следующим направлениям: переход на общепринятые показатели для норм труда при оказании амбулаторной помощи, а именно на статистические данные по численности населения и его контингентов; исключение численности должностей из нормативной записи по обеспечению круглосуточной работы медицинского персонала.
As a detrimental and persistent criminal, social, and health issue, intimate partner violence (IPV) is a severe threat to the well-being of survivors. The healthcare system, specifically the emergency department, has provided access to services and supports for survivors of IPV when seeking healthcare. However, many survivors of IPV are unable to attend the hospital and access the corresponding services. Paramedics, versatile in-community service providers, could play a vital role in linking survivors to healthcare and support services. In-community IPV advocates understand the circumstances of survivors and have expert knowledge of services. To examine how the perspectives of IPV advocates can inform our understanding of paramedic services. Actioning an interpretive description approach in the context of paramedicine, IPV advocates in western Canada participated in semi-structured focus groups. Focus groups were transcribed verbatim and de-identified. De-identified transcripts were inductively analyzed (NVivo) for patterns. N = 17 IPV advocates (all women; age 42 ± 12) participated in focus groups. Participants indicated that primary and emergency healthcare, recognition of and validation for situations involving IPV, and the referral to specialized resources were desirable services paramedics could provide. Challenges for survivors accessing services through paramedics were paramedic conduct, paramedic capacity, paramedic service shortcomings, situational logistics, concurrent conditions, service access, and patient and perpetrator factors. Solutions for these challenges include adopting safe, equitable, and patient-centred practice, establishing and maintaining functional working capacities for paramedics, developing functional infrastructure and supporting policy, providing adaptable and versatile service options, avoiding biases and stereotypes, and considering holistic patient concerns, generating innovative methods to promote service access for all patients, and integrating techniques to facilitate patient engagement and mitigating perpetrator interference. Given the desired services from paramedics and the challenges identified for survivors, it is likely that a practice gap exists among paramedics and paramedic services. IPV advocate-derived solutions may help inform paramedics and paramedic services to address these challenges. If the best available evidence is utilized to develop positive change, paramedics could advance into specialist resources for survivors of IPV.
The article discusses the socio-legal aspects of the development mutual cooperation between Russia and China in the public health. This direction of the current Russian-Chinese political agenda is caused by some factors. One of them is the common nature of public health problems and challenges faced by the healthcare systems. Also the reason is the growth of cross-border mobility of the population of both countries, which necessitates coordination of efforts in the field of regulation, ensuring the quality of services, protecting patients rights and epidemiological control. In this regard, the objective of the study is to analyze the key areas, legal mechanisms and social challenges that influence the development of interaction between Russia and China in the field of public health. Based on the results of the study, the main vectors in the Russian-Chinese cooperation in the field of public health are defined. They include: 1) prevention and control of infectious diseases; 2) digital transformation of healthcare; 3) oncology and nuclear medicine; 4) medical education and science; 5) ethical problems. The main mechanisms of interaction between Russia and China in public healthcare are legal regulatory (bilateral agreements, interdepartmental protocols, harmonization of regulatory requirements) and projects in scientific and educational sphere. Overall, cooperation between Russia and China in healthcare is dynamically developing, multifaceted, and promising. However, there are a number of limitations and problems, including cultural barriers, legal restrictions and ethical challenges. To sum up, the Russian-Chinese cooperation in the field of public health has significant potential, but requires the development of a legal framework and a systematic approach. Одним из актуальных направлений в развитии отношений между Россией и Китаем на современном этапе является сотрудничество обоих государств в сфере общественного здравоохранения. Данный вектор российско-китайской политической повестки обусловлен рядом фактором, а именно: общим характером проблем здоровья населения и вызовами, с которыми сталкиваются системы здравоохранения, ростом трансграничной мобильности населения обеих стран, что вызывает необходимость координации усилий в области регулирования, обеспечения качества услуг, защиты прав пациентов и эпидемиологического контроля, которые обусловливают исследовательский интерес к изучению социально-правовых аспектов в развитии российско-китайского сотрудничества в сфере общественного здоровья. В этой связи цель данного исследования заключается в проведении анализа ключевых направлений, правовых механизмов и социальных вызовов, которые влияют на развитие взаимодействия между Россией и Китаем в сфере общественного здоровья. По результатам проведённого исследования на основе принципа методологической триангуляции были выявлены основные векторы в российско-китайском сотрудничестве в сфере общественного здоровья: 1) профилактика и борьба с инфекционными заболеваниями (в 2025 г. Россия и Китай подписали меморандум о сотрудничестве в области борьбы с инфекционными болезнями); 2) цифровая трансформация здравоохранения (в 2025 г. Минздрав России и Государственный комитет КНР по здравоохранению подписали Меморандум о взаимопонимании в области цифровой трансформации здравоохранения); 3) онкология и ядерная медицина; 4) медицинское образование и наука (образована Российско-Китайская ассоциация медицинских университетов, которая способствует обмену специалистами, разработке совместных образовательных программ и взаимному признанию дипломов о медицинском образовании). Основными механизмами взаимодействия России и Китая в сфере общественного здравоохранения выступают: нормативно-правовые (двусторонние соглашения, межведомственные протоколы, гармонизация регуляторных требований) и научно-образовательные (совместные исследования, обмен кадрами, образовательные программы). В целом, сотрудничество России и Китая в сфере здравоохранения можно охарактеризовать как динамично развивающееся, многогранное и перспективное. Однако есть ряд ограничений и проблем, включая культурные барьеры, правовые ограничения и этические вызовы. Сделан вывод о том, что российско-китайское сотрудничество в сфере общественного здоровья имеет значительный потенциал, но требует разработки правовой базы и системного подхода.
Tumor vasculature has traditionally been viewed as structurally and functionally abnormal and, therefore, is primarily targeted for inhibition. However, emerging evidence from vascular biology, regenerative medicine, and bioengineering challenges this paradigm, demonstrating that blood vessels actively instruct and shape the tumor microenvironment. Here, we propose that tumor vasculature functions as a dynamic and programmable interface that regulates cancer progression and define vascular reprogramming as a therapeutic strategy to actively redesign vascular structure, function, and signaling to control the tumor ecosystem. By integrating recent advances in endothelial cell heterogeneity, vascular niche biology, and multiscale modeling, we illustrate how tumor vessels govern cancer stemness, immune-cell trafficking, and metabolic adaptation, positioning the vasculature as a central regulatory hub rather than a passive conduit. We further highlight enabling technologies, including vascularized organoids, organ-on-a-chip systems, and iPSC-derived vasculature, that enable the precise reconstruction and manipulation of human vascular microenvironments, providing unprecedented opportunities to experimentally control vascular dynamics. Importantly, we distinguish vascular reprogramming from conventional anti-angiogenic and normalization strategies, emphasizing its potential to achieve sustained and integrative control of the tumor microenvironment. By modulating vascular permeability, perfusion, and immunoregulatory signaling, this approach enhances drug delivery, improves immune infiltration, and increases therapeutic sensitivity. Finally, we discuss the key challenges for clinical translation, including safety, scalability, and model limitations, and highlight future directions driven by spatial omics and artificial intelligence. Collectively, this framework establishes tumor vasculature as a designable therapeutic interface and advances a new paradigm in cancer therapy: not merely targeting the tumor microenvironment but engineering it through vascular control.
Institutional maternal and perinatal outcomes are highly specific to local contextualized conditions and are suited to inform local policy. As institutional delivery increases, maternal health events are more likely to occur in facilities than at home. This was a before-after impact evaluation study through the implementation of a 3-year quality improvement project undertaken in Central Region. The goal was to reduce institutional maternal mortality ratio and perinatal mortality rate over a 3-year period from 2021 to 2023 with 2020 as a baseline year. Baseline assessment was conducted by reviewing 2020 maternal death audit reports to identify key challenges associated with maternal deaths. Interventions were drawn to address identified challenges by key stakeholders. Sensitization meetings were held with stakeholders, health managers and health staff to discuss the interventions and solicited their support. Interventions implemented were life-saving skills and safe motherhood trainings for health staff across the region, introduction of maternal death tracker to improve surveillance on maternal death, clinical supervision of health staff at the peripheral level by specialist through telemedicine using WhatsApp platforms from 2021 to 2023. Baseline indicators were collected from the District Health Information Management System-2 (DHIM2) in 2020. The outcome indicators were improved family planning coverages, increased skilled delivery rates and reduction in maternal mortality ratio and perinatal mortality rates. Process indicators were proportion of practicing midwives and clinicians trained in life saving skills, number of health centers conducting basic emergency obstetric care signal functions, percentage of audited maternal deaths entered DHIMS2. Over the course of the project, 4,800 health staff were trained, skilled birth rate improved from 61.6 to 63.9%, family planning acceptor rate from 28.5 to 45.1% and reported maternal deaths audited improved from 78.7 to 100%. The implementation of institutional audit recommendations also improved from 20 to 72%. Institutional maternal mortality ratio declined by 25.3% and neonatal deaths by 45.2%. Quality improvement methods using the project approach to strengthen maternal health services can lead to improve mother and baby health outcomes. This approach when scaled up nationally may help increase the chances of meeting the sustainable development goal three, I recommend the implementation of the interventions to policymakers such as the Ministry of Health to support in reducing institutional maternal and perinatal mortalities.
Maritime service is a challenging profession. In addition to demanding physical labor under real risks to life and health, it requires seafarers not only to forgo many aspects of psychological well-being but also to embrace new digital challenges. Intensive work involving modern information technology is accompanied by a number of undesirable consequences (cognitive overload, emotional distress, the erosion of boundaries between work and personal life, etc.), which lead to decreased job satisfaction and pose risks to psychological health. In this article, the author explores the etymology of the concepts of «occupational stress» and «technostress,» identifies stress factors in seafarers professional activities, and identifies the main signs of psychological disorders associated with the development of advanced technologies. Based on the research results, practical recommendations for preventing the development of negative trends are formulated. Морская служба — это одна из сложных профессий. Помимо тяжёлого физического труда в условиях настоящей опасности для жизни и здоровья, она требует от моряков не только разлуки со многими составляющими психологического комфорта, но и принятия новых цифровых вызовов. Интенсивная работа, связанная с современными информационными технологиями, сопровождается рядом нежелательных последствий (когнитивная перегрузка, эмоциональный дистресс, разрушение границ между работой и личной жизнью и пр.), которые провоцируют снижение удовлетворённости работой и создают риски для психологического здоровья. В представленной статье автором раскрыта этимология понятий «профессиональный стресс» и «техностресс», выявлены стресс-факторы профессиональной деятельности моряков, а также установлены основные признаки проявления психологических расстройств в связи с развитием прогрессивных технологий. На основе результатов исследования сформулированы практические рекомендации по предупреждению развития негативных тенденций.
Macrophage lipid accumulation is a hallmark of atherosclerosis and other metabolic diseases. Toll-like receptor 4 (TLR4) signaling and cytoskeletal remodeling have each been implicated in this process, yet the mechanistic connections among these three elements remain incompletely defined. This review synthesizes current evidence for pathways in which TLR4 activation, via bifurcated signaling through MyD88/TRAM, SYK/Src, and integrins, engages small GTPases (Rac, Cdc42, Rho) and downstream effectors including cofilin and paxillin to drive cytoskeletal remodeling. These cytoskeletal changes facilitate lipid internalization through multiple routes, including macropinocytosis, receptor redistribution, and lysosomal synapse formation, and regulate lipid droplet dynamics, ultimately promoting foam cell formation. We also discuss the therapeutic potential and safety challenges of targeting cytoskeletal regulators in diseases such as atherosclerosis. The convergence of TLR4 signaling, cytoskeletal remodeling, and lipid metabolism represents a compelling mechanistic nexus for understanding foam cell formation. Elucidating the molecular details of this pathway-particularly the SYK/Src-cytoskeleton axis-may reveal macrophage-selective therapeutic targets that suppress pathological lipid accumulation while preserving host defense functions.
A comprehensive analysis of the situation is needed to effectively address Russias demographic problems. The aging population and low birth rate pose serious challenges for the country. The purpose of the study is to identify and analyze the social determinants that determine the choice of a small family model, followed by the development of recommendations for optimizing the demographic situation in the country. Для эффективного решения демографических проблем России необходим всесторонний анализ ситуации. Старение населения и низкая рождаемость представляют собой серьёзные вызовы для страны. Целью исследования является выявление и анализ социальных детерминант, обусловливающих выбор малодетной модели семьи, с последующей разработкой рекомендаций для оптимизации демографической ситуации в стране.
Honeybees, Apis mellifera, play a vital role as pollinators in global agricultural ecosystems. Nutrition, particularly dietary protein content, profoundly impacts honeybee health and reproduction. Yet, the molecular mechanisms connecting diet composition and gene expression in honeybee eggs remain underexplored. In this study, we investigate the intricate relationship between diet, gene expression, and honeybee egg development. Using RNA-seq analysis, we explore the effects of different protein-to-carbohydrate (P: C) ratios in honeybee diets on differential gene expression in the eggs laid by the queen and potential associated molecular responses. Our research identifies 1007 differentially expressed genes (DEGs) across various dietary conditions, highlighting the pivotal role of nutritional composition in shaping gene expression during egg development.Cluster analysis revealed two DEG profiles corresponding to low protein diets (LPD) and high protein diets (HPD). LPD conditions upregulate genes linked to protein catabolism, autophagy, and ubiquitin-mediated proteolysis, indicating potential cellular responses to nutritional stress. Conversely, HPD conditions upregulate genes related to RNA processing, spliceosome activity, and the MAPK signalling pathway, suggesting normal cellular development.Notably, the Hippo signalling pathway exhibits distinct gene regulation patterns under LPD and HPD conditions, potentially influencing cellular growth and differentiation in response to nutrient availability.Our findings underscore the critical role of nutrition in honeybee health and reproduction, providing insights into optimizing honeybee diets for colony health and resilience. As honeybee populations confront challenges from changing environmental conditions and resource availability, understanding these molecular responses is crucial for their effective management and conservation as essential pollinators. This study establishes a foundation for further investigations into the functional consequences of these molecular responses at the individual level and their broader implications for honeybee colony development and health.
Breast cancer remains the most prevalent malignancy among women worldwide, presenting significant clinical challenges due to tumor heterogeneity, multidrug resistance (MDR), and the severe systemic toxicity associated with conventional chemotherapy. In the rapidly evolving field of nanomedicine, Metal-Organic Frameworks (MOFs) have emerged as a superior class of porous nanomaterials with exceptional potential for oncology applications. Distinguished by their ultra-high surface area, tunable porosity, and biodegradable nature, MOFs offer a versatile platform for encapsulating chemotherapeutic agents, genetic materials, and photosensitizers. This review provides a comprehensive overview of the recent advancements in MOF-based nanoplatforms for the diagnosis and treatment of breast cancer. We critically analyze the synthesis and functionalization strategies that enhance the stability and targeting capability of MOFs in the physiological environment. Furthermore, we highlight the development of stimuli-responsive drug delivery systems that utilize the unique tumor microenvironment (pH, redox, and ATP) for controlled release. Finally, the review discusses the dual role of MOFs as theranostic agents integrating bioimaging (MRI, CT, and optical imaging) with therapeutic modalities (chemotherapy, photothermal, and photodynamic therapy) and outlines the future perspectives for their clinical translation.
The article presents the authors' hypothesis that sustainable human capital management systems in healthcare achieve maximum effectiveness when technological adaptability, geographically oriented workforce distribution, and comprehensive professional well-being support programs are integrated. The scientific novelty of the study lies in the development and validation of a conceptual model that combines three complementary components of sustainable human capital management in healthcare, with an emphasis on their synergistic interaction. The practical significance of the work consists in formulating recommendations for public healthcare authorities on the creation of sustainable human capital management systems capable of effectively responding to challenges associated with territorial vastness and demographic change. The results of the study may be used in the development of national strategies for strengthening the healthcare workforce and regional programs aimed at optimizing medical workforce management. В статье раскрывается предложенная авторами гипотеза о том, что системы устойчивого управления человеческим капиталом в здравоохранении достигают максимальной эффективности при условии синтеза технологической адаптивности, географически ориентированного распределения кадров и комплексных программ поддержки профессионального благополучия. Научная новизна исследования заключается в разработке и проверке концептуальной модели, объединяющей три взаимодополняющих компонента устойчивого управления человеческим капиталом в здравоохранении с акцентом на их синергетическое взаимодействие. Практическая значимость работы состоит в разработке рекомендаций для органов государственного управления здравоохранением по созданию устойчивых систем управления человеческим капиталом, способных эффективно реагировать на вызовы, связанные с географической протяжённостью территории и демографическими изменениями. Результаты исследования могут быть использованы при разработке национальных стратегий развития кадрового потенциала системы здравоохранения и региональных программ оптимизации управления медицинскими кадрами.
ConspectusThe innovative exploration of non-fullerene acceptors (NFAs) such as ITIC, Y6, and others, has boosted the power conversion efficiencies (PCEs) of organic solar cells (OSCs) surpassing 21%. However, organic photovoltaics still suffer from significant efficiency gaps compared to inorganic photovoltaics, particularly in open-circuit voltage under similar bandgaps. This notable disparity is largely driven by the stark difference in nonradiative recombination energy losses: OSCs typically incur losses exceeding 0.2 eV, whereas their inorganic counterparts suffer only minimal losses, ranging from a mere 0.03 to 0.04 eV. This insurmountable nonradiative recombination is closely associated with some intrinsic features of organic photovoltaic light-harvesting materials: relatively flexible molecular frameworks, loose and disordered molecular aggregates, large exciton binding energies, etc. Therefore, a multiscale regulation spanning single-molecular properties and aggregation behaviors in further molecular design is required, if a remarkable PCE improvement is expected.In this Account, we first present a brief review of the development of electron acceptor materials, with a focus on analyzing the prominent merits of current high-efficiency acceptor molecular skeletons (especially Y6 analogs) in terms of intermolecular packing modes, photodynamic, etc. Meanwhile, great challenges for further material design also arises from the quite limited structural optimization room for Y-series backbones. In order to break through the dilemma of molecular design, we developed CH-series NFAs with multi-functionalized central units and an "acceptor-donor-acceptor" architecture. Subsequently, a systematic discussion about CH-series NFAs will be made to reveal their advantages in (1) inducing a directional transformation of molecular packing mode toward a more favorable one, through multiple intermolecular weak interactions such as fluorine-hydrogen/sulfur/π bonds, thus rendering multidimensional long-range ordered molecular stacking to minimize energy loss pathways in OSCs; (2) breaking through the limitations of traditional dimeric/trimeric/polymeric acceptor design by pioneering the construction of relatively rigid central-units-linked dimeric/trimeric NFAs with multiple free terminals to enhance intermolecular packings; (3) proposing a novel "functional reconfiguration" strategy for the central units, aiming to explore new photoelectric conversion mechanisms in organic photovoltaic materials.Thus far, CH-series NFAs based binary OSCs have achieved the highest PCE of approaching 21%, ranking among the best NFAs. If further considering their great structural modification possibilities, CH-series NFAs hold exceptional promise as a versatile platform for developing OSCs with record-breaking PCEs. Therefore, we further propose some perspectives for CH-series NFAs, for example, more precise structural and packing optimization to reduce exciton binding energies and improve molecular packing ordering; further in-depth exploration of a "functional reconfiguration" strategy to apply new photoelectric conversion mechanisms, such as triplet excitons, singlet fission, etc.; extending the absorption edge of NFAs to near-infrared II region to harvest more low-energy photons, especially for tandem OSCs. These strategies may have the potential to overcome the critical challenge existing in OSCs and shrink the PCE gap comparing to inorganic platforms.
Electrochemical surface-enhanced Raman spectroscopy (EC-SERS) exploits the molecular specificity of Raman spectroscopy and controllable manipulation offered by electrochemical techniques. This integration enables selective enrichment of electrochemically active molecules at the electrode surface, which simultaneously serves as a nanoparticle-based SERS substrate. The enhanced Raman signal from target molecules located within plasmonic hotspots enables accurate analysis. EC-SERS applications in food analysis are emerging with research expanding to a wider range of contaminants. This review addresses a key gap in EC-SERS by combining analyte-electrode interactions, matrix interferences, and electrical double-layer modulation within a system, which directly connects the interfacial reaction to analytical performance in complex food matrices. To date, this technique has been primarily employed for detecting electroactive molecules, including pesticides, veterinary drugs, and phenolic compounds, in simple matrices such as tap water, juices, fruits, and vegetables. However, the inherent complexity of food matrices presents significant challenges, including electrode fouling, matrix interference, and modulation of the electrical double layer owing to the high salt content. Effective mitigation strategies require improved substrate and electrode designs, selective surface functionalization, and optimized pre-concentration approaches. Future research should focus on enhancing portability and validating the performance in real food samples to facilitate adoption across the supply chain.
Atopic dermatitis (AD) is a prevalent inflammatory skin disease and a major source of disease burden in children. Biomarker studies in childhood AD span genetic, immune, microbial and metabolic domains, but prior reviews have often focused on single molecular layers, specific sample sites or clinical classification. As a result, the field lacks an integrated, systems-level synthesis that compares and contextualizes biomarkers across domains while clearly distinguishing evidence strength. The rapid growth of literature in this field also poses practical challenges for traditional manual review workflows. To address these gaps, we conducted an AI-augmented, multi-domain review of childhood AD biomarkers. ASReview supported title and abstract screening, while ChatGPT assisted structured data extraction with human validation. Across 526 studies, we identified 141 genome, 95 immunome, 57 microbiome and 75 metabolome childhood AD biomarkers. The most frequently reported biomarkers included Filaggrin, IgE, CCL17, Staphylococcus, Bifidobacterium and vitamin D. Using a structured evidence-grading framework, eight biomarkers were categorized as having strong evidence: IgE, CCL17, CCL27, eosinophil cationic protein, eosinophil, IL-18, IL-31 and Escherichia. By synthesizing evidence across biomarker domains, we developed a systems-level, conceptual AD model in which barrier defects, Th2 inflammation, microbial dysbiosis and metabolic imbalance drive a self-perpetuating cycle of inflammation and barrier dysfunction. We also developed a web app for exploration of the biomarker findings: https://leejw.shinyapps.io/eczema_review_526/. This review provides a broad synthesis of childhood AD biomarkers and frames the evidence within an integrated, multi-domain conceptual model. The findings support the rationale for approaches that consider multiple biological nodes, including barrier repair, immune modulation, microbiome-directed strategies and metabolic factors, while underscoring the need for further validation before clinical implementation. Methodologically, the study illustrates how a hybrid human-AI review workflow can support scalable biomedical evidence synthesis without replacing human oversight.
ABSTARCTStarch-based delivery systems (SBDSs) have emerged as promising carriers for bioactive compounds (BCs) due to their biodegradability, low cost, and biocompatibility. However, the limited emulsifying capacity, poor physicochemical stability, and rapid digestibility of native starches restrict their applications. Yet critical gaps persist in understanding how starch modifications impact digestibility, release kinetics, and functional performance. This review critically evaluates how the modifications induce changes in molecular structure and supramolecular structure, which influence the encapsulation efficiency (EE), gastrointestinal (GI) release, and stability of BCs. A unified structure-property-function framework is provided by integrating parameters such as crystallinity, cross-link density, amphiphilicity, and digestibility fractions, including rapidly digestible starch (RDS), slowly digestible starch (SDS), and resistant starch (RS), with digestion behavior, release mechanisms, and bioaccessibility. The review further highlights emerging concepts such as digestion-tailored carrier engineering and synergistic dual-modification approaches. Additionally, it addresses key translation challenges, including clean-label requirements, regulatory constraints, scalability, process complexity, and inconsistencies between in vitro and in vivo performance. Overall, this review provides mechanistic and translation insights for designing advanced starch-based carriers with improved controlled-release performance and practical applicability.
The increasing prevalence of antifungal resistance necessitates the exploration of novel therapeutic agents from natural reservoirs. Bacteria derived from medicinal plants serve as an underexploited repository of biologically active secondary metabolites. This study investigated the chemical profile and antifungal potential of the cell-free supernatant (CFS) derived from Lactiplantibacillus plantarum (L. plantarum) strain isolated from the medicinal plant Pulicaria jaubertii (P. jaubertii) (Asteraceae) in Yemen. L. plantarum was isolated from surface-sterilized leaves of P. jaubertii and cultured to obtain CFSs. The chemical composition of the CFS was characterized using Fourier-transform infrared (FT-IR) spectroscopy. Antifungal efficacy was evaluated against clinically significant isolates of Aspergillus fumigatus (A. fumigatus) and Candida albicans (C. albicans) using agar incorporation and agar well-diffusion methods, respectively. FT-IR spectroscopy indicated that the CFS is a complex mixture containing functional groups of organic acids, peptides, and carbohydrates. It exhibited dose-dependent antifungal activity, achieving 71.9% and 90.0% growth inhibition against A. fumigatus and C. albicans, respectively, at 30% (v/v). Notably, a sharp increase in efficacy occurred between 20 and 25% (v/v). We hypothesize that this threshold effect may reflect a multi-mechanistic mode of action, potentially driven by the interplay between the acidic and peptidic constituents. These findings underscore the potential of L. plantarum CFS as a promising, sustainable source of multicomponent antifungal agents. This study highlights the value of integrating plant biodiversity with microbial chemistry to develop postbiotic interventions that address critical fungal challenges.