Thymoma is associated with various immunological abnormalities, most notably Good syndrome; however, the full spectrum of immune dysfunction in these patients remains unclear. To evaluate the clinical and immunological characteristics of patients with thymoma and to identify occult immunodeficiency as well as associated autoimmune, infectious, and allergic conditions. In this retrospective single-center study, 37 adult patients with thymoma who had undergone thymectomy were evaluated at least one year after surgery. Clinical data, autoimmune and allergic comorbidities, infection history, and immunological parameters including immunoglobulin levels and lymphocyte subsets were analyzed. Good syndrome was identified in 2 patients (5.4%). However, additional immunological abnormalities were observed, including NK cell deficiency (16.2%), B cell lymphopenia (5.4%), isolated IgM deficiency (5.4%), and IgG subclass deficiency in 1 patient (2.7%). Recurrent infections were reported in 67.6% of patients. Autoimmune diseases were present in 86% and allergic diseases in 43.2% of patients. Patients with immunological abnormalities tended to have a higher frequency of recurrent infections. Our findings suggest that immune dysfunction in patients with thymoma may extend beyond classical Good syndrome and may involve a broader spectrum of immunological abnormalities. Systematic and long-term immunological evaluation may be important for the early detection and management of these conditions.
Patients who have undergone Roux-en-Y gastric bypass (RYGB) no longer have anatomy that is amenable to trans-oral endoscopic retrograde cholangio-pancreatogram (ERCP). Laparoscopic-assisted ERCP (LA-ERCP), which combines laparoscopic and endoscopic techniques to access the patient's biliary tree, is a possible solution. Historically, there have been concerns about the safety and feasibility of this procedure. The aim of this case series is to explore the outcomes of LA-ERCP at a single high-volume centre. This is a retrospective case series of all patients undergoing LA-ERCP at a single high-volume UK centre between 2015 and 2024. A total of 17 patients underwent 19 LA-ERCPs during the above time period. Of the 19 LA-ERCPs, 16 were completed successfully with no complications and the majority of patients were discharged home within four days post-procedure. This is the largest reported UK cohort of patients who have undergone LA-ERCP. LA-ERCP is an effective, safe and viable option for patients who are unable to undergo trans-oral ERCP.
Valid data on behavioral determinants are essential to enhance adherence to injury prevention (IP) programs. This study reports the development and validation of the Sports Injury Prevention Behavior Determinants Questionnaire for youth handball and football players (12-17 years) and their coaches. Using the Health Action Process Approach framework, we followed consensus-based guidelines, including conceptualisation, focus groups, cognitive interviews, and a cross-sectional study for both players and coaches. Confirmatory factor analysis (CFA), reliability testing, and principal component analysis (PCA) were performed for the coach questionnaire only. Focus groups identified training load management, pain and injury management, and injury prevention training as key IP elements. These were integrated with relevant HAPA constructs during item development and refined through cognitive interviews. A cross-sectional study (337 coaches, 528 players) and CFA informed the final coach version, which was subsequently evaluated using a test-retest design. PCA included 59 coaches while the reliability analysis included 45 due to drop out. Intraclass correlation coefficients indicated good reliability (> 0.75) for all constructs in the coach questionnaire, although self-efficacy constructs showed small systematic differences (≤ 0.04; 95% CI 0.00 to 0.06). PCA led to minor refinements of the questionnaire. The Sports Injury Prevention Behavior Determinants Questionnaire is the first validated tool to assess IP behavioral determinants in youth handball and football coaches, with applicability across team sports. The player version followed the initial steps to ensure good face and content validity but requires refinement based on CFA and further reliability testing and PCA.
There are few screening tools for intellectual disabilities that have been developed and used within Africa. This study aimed to examine the psychometric properties of the English version of the adolescent Screener for Intelligence and Learning Disabilities (SCIL) when used with Nigerian adolescents and young people. Two hundred nine adolescents and young people (aged 11-26 years) completed the SCIL and took part in an assessment of their level of general intellectual functioning and adaptive behaviour. Initially, principal components analysis was used to determine whether SCIL items should be retained or removed. Discriminative and convergent validity were then examined, along with the sensitivity, specificity, positive predictive (PPV) and negative predictive (NPV) values, using adjusted and nonadjusted diagnostic criteria for intellectual disability. The diagnostic criteria were adjusted because Western intelligence tests were not developed for use within Africa, and their use without adjustment remains contentious. All SCIL items were retained. The SCIL had good internal consistency, discriminative and convergent validity. Using adjusted diagnostic criteria, a SCIL cutoff score of 10 revealed sensitivity = 0.66, specificity = 1, PPV = 1 and NPV = 0.83 for identifying those with an intellectual disability. AUC was 0.91. Unadjusted diagnostic criteria and the original SCIL cutoff score of 15, revealed sensitivity = 0.67, specificity = 0.98, PPV = 0.96 and NPV = 0.82 with an AUC of 0.96. The SCIL has good psychometric properties when used with Nigerian adolescents. Further factor analytic work is needed.
To examine factors related to early access and adherence to physiotherapy services among children with cerebral palsy (CP) in Cameroon. A cross-sectional mixed retrospective and prospective study was conducted in Douala, Cameroon. Children aged 3 to 60 months diagnosed with CP from a tertiary referral center were included. Data were collected through structured caregiver interviews and medical record reviews. Early access was defined as initiating physiotherapy before 5 months of age, and good adherence was defined as completing ≥50% of prescribed sessions. Out of 94 children, 36 (38.3%) accessed physiotherapy early, and 36 (38.3%) showed good adherence. Factors significantly linked to early access included CP subtype, neonatal jaundice, and having more than 7 risk factors. Poor adherence was significantly associated with parental discouragement due to lack of improvement and canceled appointments due to the physiotherapist's unavailability. Early physiotherapy access and adherence remain inadequate in this Cameroonian setting, with clinical severity prompting earlier referrals.
A complementary dual-mode biosensor was constructed for determination of chlorpyrifos (CP) using a multifunctional composite consisting of MnO2@thionine/ZIF-8 (MnO2@Thi/ZIF-8). This composite synergistically combines the good oxidase-mimetic activity of MnO2 dispersed on the surface of ZIF-8 with the stable electroactivity of thionine (Thi) encapsulated within detachable ZIF-8 framework, enabling dual-mode detection of CP. In the presence of acetylcholinesterase (AChE) and its substrate acetylthiocholine (ATCh), enzymatic hydrolysis quantitatively produces acetic acid (HAc) and thiocholine (TCh). TCh acts as a reducing agent to convert MnO2 to Mn2+, leading to diminished oxidase-mimetic activity of MnO₂ and a subsequent decrease in the oxidation of 3,3',5,5'-tetramethylbenzidine (TMB) to oxidized TMB (oxTMB). Concurrently, HAc induces the hydrolysis of ZIF-8, resulting in the release of encapsulated Thi, generating electrochemical current. Upon CP addition, AChE activity is selectively inhibited, reducing the production of both TCh and HAc. The complementary dual-mode sensor exhibits good analytical results (electrochemical mode: 0.1-60 ng/mL; colorimetric mode: 0.5-60 ng/mL) and satisfactory performance in real-sample analysis. This study not only provides an effective strategy for sensitive and accurate monitoring of OPs through the synergistic integration of inorganic oxides with metal-organic frameworks (MOFs) but also offers new insights into the design of multifunctional nanozymes for multimodal sensing platforms.
Osteoporosis is a systemic bone disease characterized by low bone mass and destruction of bone microstructure, which is prone to fractures. It is more common in the elderly. Against the context of global population aging, osteoporotic fractures have become a major public health burden. To construct and validate a nomogram model for predicting osteoporosis risk in elderly individuals aged ≥60 years based on National Health and Nutrition Examination Survey (NHANES) data. This cross-sectional study included 3,422 participants aged ≥60 years from the NHANES database (2017-March 2020). Osteoporosis was defined as a dual-energy X-ray absorptiometry (DXA) T-score ≤ -2.5. Demographic characteristics, biochemical indicators, anthropometric measurements, and inflammation-related indices were collected. Univariate and multivariate logistic regression analyses were used to identify independent predictors of osteoporosis. The dataset was randomly divided into a training set (70%) and a validation set (30%). A nomogram model was then developed and validated using area under the curve (AUC), calibration curves, and decision curve analysis (DCA). The results showed that female gender (5.92[3.21,10.91], P < 0.001), age (1.06[1.03,1.09], P < 0.001), height (0.94[0.91,0.96], P < 0.001), BMI(0.97[0.95,1], P = 0.038), drinking history (1.78[1.02,3.12], P = 0.043), history of kidney disease (1.96[1.06,3.62], P = 0.033), previous hypercholesterolemia (1.47[1.03,2.09], P = 0.036), and difficulty falling asleep (1.6 [1.12,2.28], P = 0.010) were independent predictors of osteoporosis in the elderly. The nomogram demonstrated its good discrimination ability with AUC values of 0.806 in the training set and 0.793 in the validation set. Calibration curves showed good agreement between predicted and observed outcomes, and DCA confirmed clinical applicability. This study developed a clinically applicable prediction model to identify elderly individuals at high risk of osteoporosis, aiding early intervention and reducing adverse outcomes.
Identifying vulnerabilities in older patients through comprehensive geriatric assessment is crucial but resource-intensive. This prospective study validated shorter tools- Onco-multidimensional prognostic index (MPI) and Geriatric-8 (G8) for predicting 2-year mortality in breast cancer patients and developed a nomogram using significant clinical predictors. The geriatric assessment was done in newly diagnosed treatment-naïve breast cancer patients with age ≥65 years. Overall survival was analysed by Kaplan-Meier test; univariate and multivariate analyses done to determine predictors of survival using Cox-proportional hazards model. A nomogram was constructed based on multivariate model and validated using calibration curve. Among 300 patients (median age 70 years, IQR 67-74), 95.6% had ECOG-PS 0-1. High-grade histology and lympho-vascular invasion (LVI) positivity were seen in 77% and 30%, respectively. Most patients (77.6%) were non-metastatic. Luminal, HER2+ and triple negative subtype was present in 70%, 10.3% and 18.7% tumours. Rate of non-compliance to treatment was 25%. At median follow-up of 28.8 months, 2-year survival was 78%. The 2-year mortality for Onco-MPI categories was 13.36% (low-risk), 25.9% (medium-risk) and 29.8% (high-risk); high versus low-risk showed statistical difference (HR 2.68, 95% CI 1.13, 6.37; p = 0.026). G8 scores ≤14 and ≤12 both significantly predicted survival (p = 0.001; p = 0.005). On multivariate analysis, higher nodal stage, metastatic status, triple negative breast cancer subtype and LVI positivity independently predicted poorer survival. G8 score remained a significant predictor at both cut-offs (≤14 and ≤12) compared to Onco-MPI. A nomogram integrating nodal stage, metastatic status, LVI and G8 predicted 1- and 2-year survival with a C-index of 0.75 (95% CI: 0.65-0.84) and demonstrated good calibration at 12 and 24 months. In elderly breast cancer patients, G8 score was a stronger predictor of survival, outperforming onco-MPI. The nomogram combining conventional prognostic factors with G8 showed good discrimination for pre-treatment prognostication.
This work presents a novel dual-mode sensing platform based on a hydrogen-bonded organic framework/covalent organic framework heterojunction (Namely HOF/COF) for tannic acid (TA) detection. The platform ingeniously integrates the fluorescence recognition capability of HOF with the photoresponsive nanozyme activity of COF. The HOF component introduces abundant hydrogen-bonding sites, enabling specific TA recognition and modulating fluorescence signal through synergistic mechanisms of dynamic quenching, photoinduced electron transfer (PET), and inner-filter effect (IFE). The COF component provides a stable porous framework and exhibits both photoresponsive oxidase-like and peroxidase-like activities, facilitating colorimetric detection. The formation of heterojunction induces significant interfacial synergy, which enhances both detection sensitivity and selectivity. The dual-mode output of fluorescence and colorimetry allows for mutual signal validation, thereby significantly improving the reliability of the assay. The developed sensor demonstrates good performance in the detection of TA in real Rosa roxburghii, teas, and environmental water samples, with good agreement to HPLC method.
India experiences a high degree of tobacco industry interference. The World Health Organization Framework Convention on Tobacco Control, in its Article 5.3, requires members to protect their policies from tobacco industry influence. Despite the global guidance, the implementation of the Article 5.3 of the convention remains far from desired. We study implementation processes concerning the Article 5.3 policies in 17 of the 19 Indian states that had adopted such policies by 2023. We first conducted an online survey to understand the nature and enforcement of Article 5.3 policies. We then conducted focus group discussions engaging representatives from governments and civil society. The inquiry focused on understanding the prevailing policies, perceived challenges, and good practices in policy implementation as well as the perceived policy impacts. We used reflexive thematic analysis of the qualitative data. There were 17 respondents for the survey, and a total of 258 participants in 17 focus group discussions across study states. Major perceived challenges in the implementation of Article 5.3 policies included limited dissemination/awareness about these policies, suboptimal functioning of the committees overseeing implementation, low priority accorded to these policies, and interference by the tobacco industry. Several government departments were perceived vulnerable to industry interference, with the departments of education, health, and municipal administration perceived as the most vulnerable. A few states adopted practices that facilitated Article 5.3 policy implementation, including display of policy signage/declarations, issue of policy orders/notifications by non-health departments, and setting up a complaints mechanism and norms to avoid sponsorships by private entities. These policies were perceived to have reduced visible interference from the industry and enabled some of the government agencies to refuse funding/partnerships with the tobacco industry. The sub-national Article 5.3 policies in India have a promise to reduce tobacco industry interference. However, implementation of these policies ought to be strengthened.
Descending necrotizing mediastinitis (DNM) is a rare but life-threatening infection originating from odontogenic, tonsillopharyngeal, or deep cervical sources, and propagating through the cervical fascial planes into the mediastinum. Despite advances in cross-sectional imaging, thoracic surgery, intensive care medicine, and antimicrobial therapy, DNM remains associated with mortality ranging from 11 to 40% across contemporary series. The evidence base is fragmented and lacks a unified framework integrating anatomical, physiological, microbiological, and critical care dimensions. The aims of this study are to map the DNM literature across five predefined age and host-status subgroups, to synthesize differences in source infection, diagnostic pathway, mediastinal extent, treatment phases, ICU burden, microbiological evolution, and outcomes, to appraise methodological quality, and to identify future research priorities. A scoping review was conducted in accordance with PRISMA-ScR, with incorporation of a prespecified illustrative institutional case for contextual comparison and pregnancy subgroup representation. Structured searches of PubMed/MEDLINE, Scopus, and Web of Science were supplemented by systematic citation chaining and revised eligibility criteria, allowing the inclusion of mixed infectious mediastinitis studies when the DNM subgroup could be clearly distinguished, yielding 18 studies (881 patients) in the final synthesis. A prospectively documented institutional case of DNM in pregnancy was analyzed separately from the PRISMA-tracked literature and used only to contextualize the pregnancy subgroup and to compare the proposed phase-based framework with a high-complexity observed clinical course. The methodological quality of the PRISMA-tracked studies was predominantly Fair to Good; the illustrative institutional case was appraised separately as Fair. The reviewed literature suggested a hypothesis-generating, generally recurrent, phase-based clinical trajectory across subgroups. The institutional case was broadly consistent with the literature-derived pattern in seven of eight phases and differed mostly in the degree of multidrug-resistant microbiological complexity during Phase 7, an exploratory finding that may extend, rather than contradict, the proposed framework. Six recurrent adverse inflection points were identified, while evidence density varied across phases. DNM may be more usefully interpreted as a staged infectious syndrome rather than as an exclusively anatomical or surgical entity. The proposed phase-based framework, derived from structured synthesis of heterogeneous literature and contextualized by a prospectively documented severe case, should be interpreted as a conceptual, hypothesis-generating complement to existing anatomical staging systems rather than as a validated clinical model. Prospective multicenter registries, standardized reporting frameworks, and reproducibility testing should be regarded as the highest-priority research needs.
Glutathione-S-transferase pi (GSTP1), overexpressed in cancer cells, is known to inactivate many electrophilic anticancer drugs by glutathionylation. While NBDHEX is a potent and selective inhibitor of GSTP1 with good anticancer activity, it suffers from poor aqueous solubility and bioavailability. Herein, we report the reactive oxygen species (ROS)-responsive fluorogenic prodrug RK-251 of NBDHEX, by coupling it to a dual positively charged NIR fluorophore (QCy7) and a ROS-responsive unit. ROS-mediated activation of RK-251 in aqueous medium resulted in rapid uncaging of NBDHEX, with turn-on NIR fluorescence and potent GSTP1 inhibition. Moreover, RK-251 exhibited potent anticancer activity against triple-negative breast cancer (MDA-MB-231) cells compared with nonmalignant cells, with the modulation of key cancer marker genes. Endogenous ROS-mediated activation of RK-251 led to the turn-on red fluorescence, which was further validated in developing zebrafish embryos, confirming the concomitant release of QCy7 without any noticeable abnormalities or acute toxicities, supporting the translational potential of the prodrug.
To evaluate the diagnostic performance of left ventricular (LV) volumetric parameters derived from routine abdominal MRI for detecting left ventricular hypertrophy (MRI-LVH) in patients with autosomal dominant polycystic kidney disease (ADPKD) who were previously diagnosed with LVH by echocardiography (Echo-LVH). This retrospective study reviewed 156 ADPKD patients (27 with LVH). The LV wall (LVW) and cavity were manually segmented on T2-weighted abdominal MRI images to calculate 3 height-adjusted parameters: LV wall volume (ht-LVWV), LV cavity volume (ht-LVCV), and total LV volume (ht-LVV). Diagnostic performance was assessed using receiver operating characteristic curve analysis, with Echo-LVH as the reference standard. Subgroup analyses were performed across sex, chronic kidney disease stage, Mayo Imaging Classification, and blood pressure status. Sensitivity analysis was adjusted for body surface area, age, sex, and systolic blood pressure. Ht-LVWV demonstrated high diagnostic accuracy for Echo-LVH, with an area under the curve (AUC) of 0.82 (95% CI: 0.74-0.90), sensitivity=92%, and specificity=64% at a threshold of 60 mL/m. Ht-LVV also showed good performance (AUC=0.70), while ht-LVCV had inadequate diagnostic performance (AUC=0.61). Ht-LVWV maintained robust performance across all clinical subgroups. After adjusting for confounders, the AUC for ht-LVWV improved to 0.92 (95% CI: 0.85-0.98). Ht-LVWV measured on routine abdominal MRI is a promising biomarker for detecting LVH in ADPKD patients, with performance independent of key clinical variables. These findings support the potential for a diagnosis of MRI-LVH from standard ADPKD abdominal imaging protocols that are obtained routinely in the evaluation of ADPKD for renal and cardiovascular risk assessment in ADPKD.
Over the years, the application of ultrasound as a non-invasive diagnostic tool has become increasingly widespread in clinical practice. Additionally, the incidence of hypoxemia is relatively high among patients undergoing painless gastroscopy. The primary objective of the present study was to predict the occurrence of hypoxemia in painless gastroscopy by measuring the anatomical parameters of the upper respiratory tract using ultrasound. The present single-center, prospective, observational study included 218 patients. Before anesthesia, basic information (age, sex, BMI) was collected. Preanesthetic ultrasound examined upper airway parameters, including distance from the skin to the hyoid bone (DSH), distance from the skin to the epiglottis (DSE), distance from the skin to the anterior commissure of the vocal cords (DSAC), tongue thickness (TT), hyoid-mental distance (HMD) and anterior condylar translation (ACT). Binary logistic regression was applied to identify independent predictors, and the predictive performance of each variable and a combined model was evaluated using the area under the receiver operating characteristic curve (AUC), calibration analysis and decision curve analysis (DCA). A total of 218 patients were analyzed in the present study. A binary logistic regression model identified BMI, DSH, DSE, DSAC, TT and ACT as the independent indicators associated with hypoxemia in painless gastroscopy. A novel combined predictive model equation was derived: logit(P)=1.053 x BMI + 1.363 x DSH + 1.658 x DSE + 1.839 x DSAC + 1.075 x TT-0.894 x ACT. The model demonstrated excellent discrimination with an AUC of 0.989, 95% CI: 0.979-0.999, significantly outperforming individual predictors (AUC range: 0.775-0.879). Calibration curves confirmed good agreement between predicted and observed risk, and DCA indicated clinical utility of the model. In conclusion, BMI, DSH, DSE, DSAC, TT, ACT and the novel combined predictive model incorporating aforementioned parameters are potentially valuable predictors fort the occurrence of hypoxemia in painless gastroscopy. This study was registered at the Chinese Clinical Trial Registry (trial registration no. ChiCTR2500109627; registered on 23 September 2025).
Left atrial appendage aneurysm is a rare clinical entity that may cause arrhythmias and thromboembolism. We present the case of a 36-year-old man with atrial fibrillation and left atrial appendage aneurysm the size of 60 × 40 mm, who underwent surgery with aneurysmectomy and concomitant cryoablation (Cox-Maze IV). The patient had transient episodes of atrial flutter postoperatively, but otherwise an uneventful postoperative course and made a good recovery. This case demonstrates the benefits of concomitant aneurysmectomy and surgical ablation in patients with left atrial appendage aneurysm and atrial fibrillation. It reinforces the need for individualized management and supports the use of adjunct surgical ablation in appropriately selected patients. Left atrial appendage aneurysm is strongly associated with atrial arrhythmias and thromboembolism. Although surgery with resection and ablation is beneficial, long-term rhythm surveillance and research are required to better define arrhythmia mechanisms in these patients.
Penile squamous cell carcinoma is a rare malignancy that may require radical surgery in advanced stages. We report a 66-year-old male with a one-year history of a penile lesion diagnosed as verrucous squamous cell carcinoma, staged as T3N2M0 (clinical stage IIIB) based on magnetic resonance imaging findings. The patient underwent total penectomy with scrotal flap phalloplasty and perineal urethrostomy, followed by robotic inguinal lymphadenectomy, which revealed no metastatic involvement (pN0). Postoperative outcomes were favorable, with good flap viability and satisfactory urinary function. This case highlights a practical reconstructive approach and the importance of histopathological confirmation of nodal disease.
Patients with traumatic brain injury (TBI) are at a greater risk of subsequent violent victimisation, and a prognostic model can assist in identifying those at highest risk who can benefit from targeted interventions. We aimed to develop and internally validate a clinical prediction model to estimate the risk of violent victimisation following TBI in adolescence. We investigated a cohort of adolescents aged 10 to 24 exposed to TBI between 2009 and 2023, using data from a linked register, covering 86% of the population in Wales, the Secure Anonymised Information Linkage (SAIL) Databank. We fitted a multivariable Cox regression model for the association between predictors and time to violent victimisation identified in medical records, with optimism-corrected bootstrapping for internal validation. Key performance measures, including discrimination and calibration, were examined at 1 and 3 years post-TBI. The cohort included 34 092 adolescents, of whom 332 (1.0%) were violently victimised within 1 year and 701 (2.1%) within 3 years of the TBI. The final model included a range of predictors including calendar age, sex at birth, substance misuse, psychiatric conditions, neurological conditions, conduct disorder, learning difficulties and a history of victimisation or self-harm. The clinical prediction model showed good calibration and moderate discrimination at 1 (area under the curve (AUC)=0.72) and 3 years (AUC=0.67) post-TBI. This brief, scalable and evidence-based prediction model showed moderate predictive performance at internal validation. External validation is necessary to test the model's transportability. A large population-based sample was used to identify risk factors for violent victimisation and develop a novel clinical prediction model for use in adolescents with TBI.
Hormonal intrauterine device (IUD) is an effective contraceptive method with high user satisfaction rates. To guide the introduction of hormonal IUD into the public sector in Tanzania, an operational research study was conducted to assess client acceptability of hormonal IUDs. To explore clients' perspectives on contraceptives and experiences with hormonal IUDs. This observational mixed-methods study (2023-2024) used focus group discussions with current or future contraceptive users (N = 58, baseline), plus facility register reviews, a structured quantitative survey (N = 100, endline) and semi-structured in-depth qualitative interviews (N = 18 at midline 2, N = 15 at endline) with hormonal IUD clients. Register and survey data were analysed for descriptive statistics. Qualitative data was analysed thematically and triangulated with quantitative data. In total, 1,198 clients chose hormonal IUD during the eight-month study. At baseline, women had limited knowledge and several concerns about IUDs and emphasised the importance of good contraceptive counselling. Client satisfaction with hormonal IUD at six months post-insertion was high (93% were strongly or somewhat satisfied). Most (92%, 83% and 100%) clients were strongly satisfied with the counselling, follow-up care and removal services received, respectively. Hormonal IUD clients found the characteristic of localised release of hormones possibly offering a better side-effect profile than other hormonal methods appealing. Hormonal IUD clients showed high satisfaction with the method and care received throughout the study. The authors recommend introduction of hormonal IUD into the public sector in Tanzania, with investments in community awareness, male engagement, and strengthening the quality of contraceptive counselling and side effects management. Main findings: Hormonal intrauterine devices were highly acceptable to women accessing family planning services at primary health care level in TanzaniaAdded knowledge: While other studies have found high acceptability of hormonal intrauterine device across several settings, this was the first such study conducted in Tanzania. It strengthens the evidence base that hormonal intrauterine devices are acceptable to clients across different contexts and adds new insight into features of hormonal intrauterine devices that women in Tanzania found appealing or concerning, which can help tailor counselling materials and provider training materials.Global health impact for policy and action: This study contributes to the global literature supporting high acceptability of hormonal intrauterine devices among women across a range of contexts and provides insights on how to align comprehensive counselling on contraceptive options with women’s needs.
The Expert Panel for Cosmetic Ingredient Safety (Panel) assessed the safety of 8 Melaleuca alternifolia (tea tree)-derived ingredients as used in cosmetic formulations; 5 of these ingredients are reported to function in cosmetics as skin-conditioning agents. Because final product formulations may contain multiple botanicals, each containing the same constituents of concern, formulators are advised to be aware of these constituents and to avoid reaching levels that may be hazardous to consumers. Industry should use good manufacturing practices to minimize impurities that could be present in botanical ingredients. The Panel noted that oxidized tea tree oil could be a sensitizer, and stated that industry should employ methods to minimize oxidation of the oil in the final cosmetic product. The Panel considered all the data and concluded that these ingredients are safe in cosmetics in the present practices of use and concentration described in this safety assessment when formulated to be non-sensitizing.
The analysis of metabolic profiles using high resolution mass spectrometry (MS) data provides deep insights into biological processes. In metabolomics, MS analysis generates a large number of features that represent metabolites. However, identifying specific metabolites from these features can be challenging. One of the major bottlenecks in the metabolomics field is the identification of MS features, which is a prerequisite for any biochemical interpretation. By identifying similarities and differences within a metabolite family (mFam), evaluating MS features at the metabolite family level can help assigning functional roles to individual MS features. These data can help interpreting metabolic pathways and processes within a biological system. For the assignment of metabolite families to MS features, it is important to have good quality, reliable, and comprehensive spectral libraries. We initiated a global effort to collect high-resolution MS/MS spectra of metabolites from labs working in different fields, including metabolomics of animals, microorganisms, and plants. The mFam-MS/MS collection delivers valuable training data to assign machine-readable classified information on the unknown metabolites. The mFam collaboration used a standardized metadata template and has developed a globally curated MS/MS spectral library of 7,872 spectra with 2,126 unique metabolites. This library was compiled from 47 datasets contributed by 25 laboratories measured on 12 instrument types, including QTOF, Orbitrap, and Ion Mobility-QTOF systems. It comprises 4,646 spectra in positive mode and 3,226 in negative mode. This standardized resource significantly enhances metabolite identification capabilities, supports the development of machine learning-based annotation tools, and accelerates the discovery of novel metabolites. All spectra are available under the collective contributor label mFam in the MassBank system, including the web interface and the 2025.10 data release available at GitHub and Zenodo.