United States national guidelines around infant feeding in the setting of maternal HIV were updated significantly in 2023. The updated guidelines encourage evidence-based counseling and emphasize shared decision-making around infant feeding, supplanting a blanket recommendation for replacement feeding. This scoping review seeks to capture the shift in clinical practices and perspectives of people living with HIV and their healthcare providers since 2023. Our review followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) extension for scoping reviews. We conducted a search of articles published in or after 2023 and focused on infant feeding guidelines in the setting of HIV or the infant feeding experiences of people living with HIV and providers that care for individuals with HIV in the peripartum and postpartum periods. We excluded studies that were not published in English. We searched MEDLINE, Embase, Cochrane's CENTRAL, CINAHL Ultimate, and Web of Science Core Collection and included all years from 2023 to the final date of search on January 6, 2026. Our search yielded qualitative studies on both provider and patient experiences, protocols for implementation of the new guidelines, quantitative studies on HIV transmission in breastfeeding people living with HIV, and opinion pieces rooted in evidence. Our review found emergent safety data on breastfeeding among people living with HIV. Studies on provider experiences demonstrated variability in experience and comfort around breastfeeding, exacerbated by a lack of institutional guidelines on breastfeeding. Our review both highlighted evidence and expert opinion that counselling on infant feeding should be conducted by a multidisciplinary care team and tailored to the individual patient. Patient experiences highlighted that infant feeding decisions among people living with HIV are shaped by sociocultural contexts, personal motivations to breastfeed, patient knowledge on breastfeeding safety, and communication with their healthcare provider. Recommendations to optimize counseling and care around infant feeding include an approach that is evidence-based, culturally sensitive, and free from bias. Areas for continued work include research on the optimal frequency of maternal and infant testing in the postpartum period and efforts to implement infant feeding guidelines in a clear and consistent manner across institutions and healthcare practices.
Metabolic dysfunction-associated kidney disease (MDAKD), encompassing diabetic kidney disease (DKD), obesity-related glomerulopathy (ORG), and hyperuricemic nephropathy (HN), has emerged as a major global health challenge alongside the increasing prevalence of metabolic syndrome. The development and progression of MDAKD are driven by a complex pathogenic network involving metabolic dysregulation, gut microbiota imbalance, oxidative stress, mitochondrial dysfunction, chronic inflammation, and renal fibrosis. Although previous reviews have focused on individual pathogenic mechanisms or specific disease subtypes, comprehensive syntheses integrating distinct MDAKD subtypes within a unified framework while systematically elucidating the multidimensional regulatory mechanisms of natural products remain limited. Natural products have attracted growing attention owing to their multi-component and multi-target pharmacological properties. Increasing evidence suggests that their therapeutic potential extends beyond the modulation of individual pathogenic pathways, encompassing the coordinated regulation of multiple interconnected pathological networks. Diverse bioactive constituents, including polysaccharides, flavonoids, phenolic acids, triterpenes, alkaloids, and saponins, have demonstrated considerable renoprotective effects. Compared with conventional single-pathway interventions, the multi-target regulatory characteristics of natural products, together with their generally favorable safety and tolerability profiles, make them particularly suited to the multifactorial nature of MDAKD. This review systematically summarizes the key pathogenic mechanisms underlying MDAKD and comprehensively discusses recent advances in natural product-based interventions from both mechanistic and pharmacological perspectives. Current evidence indicates that natural products exert renoprotective effects through the coordinated modulation of multiple interconnected pathological processes, thereby establishing a multidimensional regulatory pattern that closely aligns with the complex pathophysiology of MDAKD. Despite challenges related to limited bioavailability, incompletely characterized pharmacokinetic properties, insufficient safety evaluation, and the lack of high-quality clinical evidence, natural products remain promising candidates for the integrated management of MDAKD. Accordingly, this review proposes a multidimensional regulatory framework for natural product-mediated interventions in MDAKD, providing a theoretical basis for future mechanistic studies, drug development, and clinical research.
An estimated 1.3 billion people and over one-fifth of women globally live with a disability (1). Women with disabilities face lower rates of preventative care and higher rates of morbidity and premature mortality compared to persons without a disability. Obstetrics and gynecology care providers (OB/GYN providers) deliver longitudinal care to women across the lifecycle and serve as important stakeholders for bringing clarity and context to conversations about health care accessibility for patients with disabilities (patients), while patients and their advocates are critical contributors, to ensure that information obtained reflects lived experiences. The aim of this study was to compare the experiences and perceptions of patients, OB/GYN providers, and advocates regarding accessibility of OB/GYN care. A quantitative, descriptive, cross-sectional study was conducted using an online survey distributed to patients, OB/GYN providers, and advocates through professional networks, advocacy groups, and social media from August 2024-April 2025. Surveys gathered demographic data as well as perceptions of barriers and facilitators to care and related outcomes. Thematic analysis of open-ended questions was also conducted. A total of 369 participants completed surveys. Most patients had physical (74.4%) or cognitive disabilities (48.2%). Compared to patients, OB/GYN providers and advocates were more likely to report care delays (23.5 vs. 50.7 vs. 30.8%) and rescheduled appointments (18.0 vs. 22.1 vs. 19.4%) and less likely to report appointment cancellations (15.7 vs. 10.2 vs. 12.9%), due to unmet accommodation needs (all p < 0.001). Patients reported wait times of 1 month to 1 year to have a canceled appointment rescheduled; many OB/GYN providers (62.5%) reported rescheduling wait times of < 2 weeks. Most patients (86.7%) reported not receiving needed care when their appointments were canceled without rescheduling, while 14.3% of OB/GYN providers and 50.0% of advocates reported that patients never received care (p < 0.001). Nearly all care providers (94.2%) believed that OB/GYN teams make the effort to prioritize comfort and safety for disabled patients. One-third of providers were unaware of what accommodations their offices provided. Patients identified physical barriers (51.9%) and social barriers (29.2%) as primary factors negatively impacting care in both questionnaire and open-ended responses. Discordant perceptions exist between patients, OB/GYN providers and advocates regarding the prevalence and impact of disruptions in OBGYN care for patients with disabilities and OB/GYN provider sensitivity and care quality provided to affected patients. Engaging key stakeholders with different and valuable perspectives in conversations helps establish a critical framework from which to develop harmonious solutions that can reduce care gaps and improve OBGYN care for patients with disabilities.
Ulcerative colitis (UC) is a chronic, idiopathic inflammatory bowel disease characterized by continuous mucosal erosions and ulcers in the colon. In recent years, biologics and small-molecule agents have revolutionized UC management; however, these therapies may be limited by risks such as infections, secondary loss of response, or intolerance. Granulocyte and monocyte adsorptive apheresis (GMA), developed in Japan, offers a non-pharmacologic and selective immunomodulatory approach by removing activated myeloid cells and modulating the inflammatory milieu. In this review, we summarize the mechanisms of action of GMA, including its effects on proinflammatory cytokines and regulatory T-cell responses. We also examine the clinical evidence, from randomized controlled trials and observational studies, that supports its efficacy, particularly in steroid-dependent and elderly patients. While mucosal healing rates with GMA may be lower than those achieved with biologics, its favorable safety profile may support its use as an adjunctive or bridging strategy in selected patients. However, evidence supporting these roles remains limited and is derived mainly from observational studies. Future directions include integration with personalized medicine, biomarker development and global expansion. GMA remains a viable option in the therapeutic landscape of UC.
LSD1 is a key epigenetic eraser that demethylates the histone proteins and regulates transcription. Overexpression of LSD1 drives the development of multiple cancers, such as prostate, breast, gastric, lung, colorectal cancers, and acute myeloid leukemia. Although several LSD1 inhibitors have shown promise for cancer therapy, monotherapy faces challenges such as low selectivity, high toxicity, and drug resistance. To overcome these drawbacks and achieve synergistic anticancer effects, researchers have focused on dual inhibitors that target LSD1 along with other oncogenic partners, including HDAC, EGFR, EZH2, tubulin, ERα, G9a, JmjC, DCN1, and SMOX. This review aims to provide recent design strategies and SAR for LSD1-based dual inhibitors, emphasizing the fusion of different LSD1 pharmacophore (tranylcypromine, pargyline, pyridine, 5-cyano-3-phenylindole, indole, benzyl/aryl piperazine, triazole-dithiocarbamate and substituted triazole scaffold) with various heterocyclic and zinc-binding cores such as hydroxamic acids, bipyridine, hydroxy quinoline to generate hybrids capable of inducing apoptosis, blocking cell-cycle, differentiation. This review explores the pharmacological role of LSD1 in oncogenesis and offers structural and SAR insights to guide the design of LSD1-based dual inhibitors.
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Hair regeneration depends on a complex interplay between the activation of hair follicle stem cells (HFSCs), maintenance of inductive capacity in the dermal papilla (DP), and the re-establishment of immune microenvironmental homeostasis. Collectively, this interplay underlies a fundamental 'restart' of a multicellular regenerative network. In their role as post-transcriptional regulators, micro-RNAs (miRNAs) exert network-level control over cell fate transitions, paracrine signaling, inflammatory thresholds, and fibrotic processes via the RNA-induced silencing complex (RISC). For this reason, miRNAs have emerged in recent years as key targets for hair regenerative therapies. Recent studies indicate that miRNAs enhance HFSC entry into the active growth phase (i.e., anagen) through pro-regenerative signaling pathways such as Wnt/β-catenin and Sonic hedgehog (Shh), while also mediating the initiation of catagen phase via TGF-β/BMP signaling, extracellular matrix remodeling, and androgen receptor (AR)-associated regressive signaling. In some immune-mediated alopecias (e.g., alopecia areata), miRNA regulation of inflammatory axes, including IFN-γ/JAK-STAT and NF-κB, provides additional therapeutic targets that could potentially be exploited to restore hair follicle immune privilege. In this context, miRNA mimics and inhibitors (e.g., antagomirs and locked nucleic acids, LNAs) enable gain-of-function or blockade, respectively, providing tools that can be used individually or as combined regimens to stimulate regeneration simultaneous with anti-regression/immune remodeling. Recent developments using chemical modifications (e.g., 2'-O modifications, 2'-F, and LNA) improve nucleic-acid stability and modulate RISC loading. From a delivery standpoint, lipid nanoparticles, polymeric nanocarriers, exosome mimetics, and physical enhancement strategies such as microneedles and iontophoresis may help overcome the skin barrier and exploit the follicular "reservoir effect" for localized targeting. Major barriers to clinical translation remain, however, including off-target and network side effects arising from miRNAs' multi-cellular roles in vivo, risk of local immunogenicity and inflammation, alignment of dose-schedule with the hair cycle, and batch consistency with CMC/quality-control requirements for delivery systems. This review summarizes recent developments in understanding the mechanisms, delivery platforms, and translational challenges of miRNAs and their mimics in hair regeneration. It further proposes a translational roadmap centered on modular pathway-guided combinatorial nucleic-acid strategies, follicle-targeted delivery, and standardization of efficacy endpoints to inform future clinical development in this area.
Family-integrated care (FIC), grounded in the principles of family-centered care (FCC), has become an important approach for supporting children and families during pediatric intensive care. Although post-intensive care syndrome in pediatrics (PICS-p) provides one important rationale for family engagement, the scope of FIC extends beyond PICS-p to include bedside participation, communication, shared decision-making, rehabilitation, psychosocial support, and transition planning. This narrative review aims to synthesize current applications, reported benefits, implementation barriers, and future priorities for FIC in the pediatric intensive care unit (PICU). We conducted a narrative review of literature on FIC/FCC in pediatric critical care. Searches were performed in PubMed/MEDLINE, CINAHL, Embase, Web of Science, and the Cochrane Library, with emphasis on contemporary literature from 2015 to April 2026 and inclusion of selected foundational papers when conceptually necessary. Eligible evidence included observational, qualitative, mixed-methods, quality-improvement, pre-post, interventional, guideline, and review literature relevant to family participation in PICU care. The review identifies several recurring themes: the transition from restricted visitation to partnership-based care; practical family participation in routine care, communication, shared decision-making, rehabilitation, and end-of-life contexts; patient- and family-centered outcomes; structural, cultural, linguistic, and resource-related barriers; and the role of interdisciplinary teams, institutional policy, staff education, and digital tools in supporting implementation. Current evidence suggests that FIC may improve family experience, communication, parental confidence, and selected psychosocial outcomes, while its effects on long-term child outcomes and PICS-p require further pediatric-specific evaluation. Future work should prioritize clearer definitions, standardized implementation models, inclusive study designs, and pragmatic outcome measures that reflect both child and family priorities.
Spontaneous or primary intracerebral hemorrhage (ICH) is considered the most severe form of stroke. Previous studies have focused mostly on local and perilesional changes in hematomas while paying less attention to damage in distant neural tissue. With the widespread use of magnetic resonance imaging (MRI) technology, an increasing number of studies have revealed that diffusion-weighted imaging (DWI) hyperintense lesions with low apparent diffusion coefficient (ADC) hypointensity can appear in remote areas away from the hematoma after ICH, indicating the presence of ischemic injury. However, the mechanism underlying their development remains unclear, and there is currently a lack of systematic reviews on the factors influencing remote DWI (R-DWI) lesions and their relationship with ICH prognosis. Additionally, some research findings are contradictory. Therefore, this review aims to systematically summarize the factors influencing R-DWI lesions after ICH and explore their predictive indicators, prognostic associations, and potential mechanisms.
Obesity is a metabolic disorder characterized by excessive accumulation of adipose tissue and is a recognized risk factor for numerous chronic diseases. Effective non-pharmacological management of obesity is essential for reducing obesity-related health risks. Hypoxia, defined as insufficient oxygen supply to tissues and cells, is associated with pathological and pathophysiological conditions. In recent years, intermittent hypoxic conditioning (IHC), a potential non-pharmacological intervention under controlled hypoxic conditions, has gained increasing popularity. Recent studies suggest potential benefits of IHC in improving disease-related outcomes. A growing body of research supports its feasibility as an intervention for obesity, highlighting its emerging potential in the treatment of this condition. This review critically discusses the effects of IHC on obesity, with a focus on both animal and human evidence, underlying mechanisms, and safety considerations. By synthesizing current findings, it aims to clarify the state of knowledge and research limitations, and to provide an objective assessment of the applicability of IHC in obesity management.
Heart failure with preserved ejection fraction (HFpEF) constitutes a growing burden worldwide, with hyperuricemia emerging as a prominent comorbidity. This review explores the prevalence, pathophysiological mechanisms, and therapeutic implications of hyperuricemia in HFpEF. Epidemiological studies consistently demonstrate that elevated serum uric acid (SUA) levels are associated with an increased risk of cardiovascular events, hospitalizations, and mortality. Mechanistic insights highlight endothelial dysfunction, oxidative stress, myocardial fibrosis, and systemic inflammation as key contributors linking hyperuricemia to adverse cardiac remodeling. Pharmacological interventions, including xanthine oxidase inhibitors, uricosuric agents, and SGLT2 inhibitors, show promise in mitigating hyperuricemia and improving HFpEF outcomes. Despite emerging evidence, critical knowledge gaps persist regarding causality, therapeutic efficacy, and optimal patient selection. Future research should focus on targeted interventions, dynamic SUA monitoring, and the interplay between hyperuricemia, diabetes, and left ventricular dysfunction to enhance the management of HFpEF patients.
Airway management remains a critical component of anesthetic practice, and failure to anticipate a difficult airway may result in significant morbidity and mortality. Conventional airway assessment tools demonstrate limited predictive accuracy and are often influenced by operator subjectivity. Recent advances in artificial intelligence (AI), particularly machine learning (ML) and deep learning (DL), have introduced novel approaches to airway assessment, prediction, procedural guidance, and education. This review aims to provide a comprehensive overview of the current applications of AI in airway management, evaluate the emerging evidence, discuss existing challenges, and explore future directions for clinical implementation. A narrative review of the literature was conducted using the PubMed, Scopus, and Google Scholar databases. Relevant studies, review articles, and guidelines published in English were screened to identify evidence related to AI-based airway assessment, difficult airway prediction, video laryngoscopy, airway imaging, simulation-based education, and emerging airway technologies. AI has demonstrated promising applications across multiple domains of airway management. ML and DL models have shown improved performance in predicting difficult airways compared with conventional bedside assessment methods by incorporating clinical variables, facial image analysis, voice characteristics, and imaging data. AI-assisted ultrasound interpretation and videolaryngoscopy have enabled real-time anatomical recognition, procedural guidance, and automated performance assessment. Furthermore, AI-enhanced simulation and educational platforms have facilitated personalized training and objective competency evaluation. Despite these advances, challenges related to dataset quality, external validation, algorithm transparency, ethical considerations, and clinical integration remain significant barriers to widespread adoption. AI has the potential to transform airway management through enhanced prediction, decision support, procedural guidance, and education. While current evidence is encouraging, further multicenter studies, regulatory oversight, and the development of explainable AI systems are required before routine clinical implementation. AI should be considered a complementary tool that augments clinical expertise rather than a replacement for clinician judgment.
Waterfowl circovirus (WFCV) is an important member of the genus Circovirus within the family Circoviridae, encompassing duck circovirus (DuCV) and goose circovirus (GoCV). As a pathogen that poses a serious threat to the global waterfowl industry, WFCV induces significant immunosuppression in its hosts, leading to growth retardation, feather abnormalities, and increased susceptibility to other pathogens. Consequently, it results in markedly elevated mortality rates among affected birds and causes substantial economic losses. In recent years, with the advancement of molecular biology techniques, notable progress has been made in research on waterfowl circoviruses. This review aims to systematically consolidate current findings on the genomic characteristics, pathogenic mechanisms, and clinical manifestations of WFCV while also summarizing the existing detection technologies and the status of vaccine development. Future research directions and prevention strategies are proposed, with the goal of providing a scientific reference for the effective control of this disease.
Chest X-rays (CXRs) are the most commonly performed imaging investigation. In the UK, many centers experience reporting delays due to radiologist workforce shortages. Artificial intelligence (AI) tools capable of distinguishing "normal" from "abnormal" CXRs have emerged as a potential solution. If "normal" CXRs could be safely identified and reported without human input, a substantial portion of radiology workload could be reduced. This article examines the feasibility and implications of autonomous AI reporting of "normal" CXRs, using the United Kingdom as an example setting. Key issues include defining "normal," ensuring generalizability across populations, and managing the sensitivity-specificity trade-off. It also addresses legal and regulatory challenges, such as compliance with IR(ME)R and GDPR, and the lack of accountability frameworks for errors. Further considerations include the impact on radiologists practice, the need for robust post-market surveillance, and incorporation of patient perspectives. While the benefits are clear, adoption must be cautious, with strong governance, legal clarity, and rigorous clinical validation to ensure safe and sustainable use.
Persistent gaps remain in the training of physicians and midwives in sexual and reproductive health in Chile, despite overall advances in the field. These shortcomings affect equitable access to care and contribute to stigma surrounding sexual and reproductive rights. A multicenter study involving over 2,500 students and 57 professors from Chilean universities identified uneven curriculum implementation and disparities between secular and religious institutions. This policy brief proposes evidence-based interventions, including comprehensive sexuality education; integration of gender and human rights perspectives; explicit inclusion of abortion, conscientious objection, and confidentiality; incorporation of these topics into national assessment requirements; and strengthening faculty competencies. The proposed actions aim to improve healthcare quality and align with standards set by the WHO, FIGO, and other international organizations.
Wildfire activity in the United States is increasing due to climate change, land management practices, and human ignitions, reversing decades of air quality progress. Wildfire is an essential process in fire-adapted ecosystems, but fine particulate matter (PM2.5) from wildfire smoke poses significant health risks both near the fire source and in communities far from fire-prone areas. Public health and forest management are often viewed as having conflicting goals-reducing smoke exposure versus restoring fire to ecosystems-but opportunities for collaboration exist. We analyzed an interdisciplinary panel discussion from the 2024 Rocky Mountain Wildfire Smoke Symposium (RMWSS) using thematic analysis and the RADaR technique to identify such opportunities. Four major themes emerged: (a) coordinated communication between stakeholders, (b) barriers and facilitators to bridge building across disciplines, (c) impacts of climate change and (d) priorities and perspectives across disciplines. Additionally, we synthesized the panel discussion and audience polling data into a figure that categorizes solutions by perceived investment, impact, and stakeholder responsibility. High impact objectives included advancing climate resilient community infrastructure, expanding resource sharing, and securing full-time equivalent (FTE) funding for smoke specialists and communication liaisons. Collaboration across disciplines, combined with long-term policy that reduces barriers for safe fire management while investing in clean air will be critical to addressing the wildfire crisis. Wildfires are becoming more frequent and intense and smoke from these fires can harm people's health—even in communities far from the flames. At the same time, fire is important in maintaining healthy forests. Balancing forest management and public health requires stronger coordination across disciplines. We examined a discussion among experts in public health, forest management, and fire science to identify ways to better prepare for a future with more fire and smoke. The conversation highlighted common challenges, including gaps in communication, limited coordination across agencies, and a lack of resources. It also highlighted ways to build bridges across disciplines including consistent public messaging, better access to clean indoor air spaces, and policy investments that support both healthy forests and clean air.
Immune checkpoint inhibitors (ICIs) have been one of the important therapeutic approaches for patients with advanced malignancies; nevertheless, their clinical efficacy remains limited in many patients. Recently, the contribution of intestinal microbiota to improved antitumor immune responses has gradually been recognized. A comprehensive literature search was conducted in PubMed, Embase, and the Cochrane Library to identify relevant studies published up to June 15, 2026. We evaluated the influence of microbiota interventions with respect to efficacy and survival in cancer patients receiving ICIs from three perspectives: antibiotics, probiotics, as well as fecal microbiota transplantation (FMT). The main endpoint was objective response rate (ORR), and secondary endpoints were overall survival (OS) and progression-free survival (PFS). The final analysis comprised 106 studies and categorized them into three groups: antibiotics (76 studies), probiotics (15 studies), and FMT (15 studies). Antibiotic use was correlated with compromised immunotherapy efficacy and unfavorable survival outcomes. In particular, antibiotics exposure was linked to a reduced ORR (Odds Ratio, OR = 0.60, 95% Confidence Interval, CI = 0.46-0.77, p < 0.001), shorter OS (Hazard Ratio, HR = 1.56, 95% CI = 1.44-1.69, p < 0.001), and shorter PFS (HR = 1.50, 95% CI = 1.32-1.70, p < 0.001). In contrast, probiotics showed a supportive and positive effect on immunotherapy outcomes, with improved ORR (OR = 1.95, 95% CI = 1.46- 2.62, p < 0.001) and better OS (HR = 0.56, 95% CI = 0.41- 0.78, p < 0.001) and PFS (HR = 0.53, 95% CI = 0.38-0.74, p < 0.001). FMT combined with immunotherapy achieved a favorable ORR of 0.30 (95% CI = 0.16-0.45, p < 0.001). This meta-analysis synthesized evidence from studies on antibiotics, probiotics, and FMT use, suggesting gut microbiota offering potential approaches to enhance immunotherapy treatment effectiveness and clinical efficacy in individuals with advanced-stage solid cancers.
Although ethical decision-making in rehabilitation is increasingly complex, physical therapy remains marginal in mainstream philosophical bioethics. This paper critically interrogates the normative limitations of principlism, particularly the framework articulated by Beauchamp and Childress, in addressing moral dilemmas within physical therapy practice, especially in contexts characterized by systemic inequities, cultural plurality, and hierarchical institutional structures. Drawing upon my clinical experience as a licensed physical therapist in both the Philippines and the United States, I analyze ethically charged scenarios involving premature discharge, coerced consent, and institutional practices that undermine therapeutic justice. While principlism offers a widely accepted ethical schema, its abstraction and proceduralism often render it inadequate in morally ambiguous and relationally complex clinical situations. To respond to these limitations, I propose a more context-sensitive and philosophically robust framework by integrating Hare's two-level utilitarianism, Habermas's discourse ethics, feminist care ethics, and Kohlberg's theory of moral development. These perspectives collectively reconceptualize ethical reasoning as dialogical, developmental, and attentive to the affective and political dimensions of care. Through philosophical analysis, narrative reflection, and engagement with lived clinical experience, I argue that physical therapists must be recognized not merely as technical practitioners, but as moral agents engaged in situated ethical judgment. This paper contributes to the evolving discourse on bioethics in allied health professions by foregrounding moral ingenuity, structural critique, and relational accountability as essential to ethical excellence in rehabilitative practice.
Human brain organoids (HBOs) are three-dimensional structures derived from human stem cells that model aspects of brain development and function, offering potentially unprecedented opportunities for studying neurological disorders and for developing treatments. This consensus paper presents recommendations from the Asia Pacific Neuroethics Working Group, developed through interdisciplinary collaboration among scientists, bioethicists, philosophers, and legal scholars who convened in Singapore in November 2024. We provide a comprehensive analysis of the ethical, legal, and sociocultural dimensions of HBO research, addressing both current realities and future possibilities. The paper examines key ethical considerations, including the potential moral status of HBOs, particularly regarding sentience and consciousness, while identifying and dispelling common misconceptions and "ethical red herrings" arising from sensationalized portrayals. We analyze consent frameworks for cell donation, privacy concerns, dual-use risks, and questions of distributive justice. Legal challenges are explored, including the categorical ambiguity of HBOs within existing regulatory frameworks, intellectual property issues, and cross-border inconsistencies in standards. Sociocultural perspectives emphasize the importance of public understanding, cross-cultural engagement, and empirical research on diverse community attitudes toward HBO research. In our recommendations, we advocate for evidence-based ethical discussions, anticipatory frameworks addressing potential future developments, contextualized analysis comparing HBOs to related experimental models, robust informed consent processes, proportionate responses to consciousness concerns, development of adaptive regulatory frameworks, responsible science communication to manage public expectations, and sustained interdisciplinary collaboration. We emphasize a balanced approach that promotes scientific innovation while maintaining rigorous ethical oversight, recognizing HBOs' significant potential for advancing neuroscience and medicine. This represents the first comprehensive ethical framework for HBO research from the Asia Pacific region, helping to establish foundational principles for responsible development of this rapidly advancing field.