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Circadian disruption, a common consequence of shift work, is associated with neuropsychiatric disorders and cognitive impairment. However, existing occupational studies lack generalizability and the underlying structural mechanisms remain unclear. The present study aimed to investigate the relationships between circadian disruption, cognitive impairment and hippocampal white matter integrity, as well as their changes following circadian rhythm restoration. We analyzed UK Biobank longitudinal cohort data, comparing cognitive performance (including reaction time, numeric memory, fluid intelligence, and prospective memory) and structural connectivity derived from diffusion magnetic resonance imaging (MRI) between shift and non-shift workers. Mouse models of chronic circadian disruption and recovery were established to complement the human findings. Compared with non-shift workers, shift workers exhibited cognitive impairment, with a maximum decrease of 14.81% in fluid intelligence scores; notably, their cognitive performance remained lower than that of never-shift workers even after ceasing shift work, with a maximum reduction of 7.73% in fluid intelligence. Higher Criticism analysis indicated alterations in whole-brain structural connectivity in shift workers, including the hippocampus, with approximately 90% of structural connectivity in the bilateral hippocampi showing a decrease (Cohen's d&#x202f;<&#x202f;0). Murine models of 8-week circadian disruption confirmed cognitive impairment and myelin loss; furthermore, mice with 8&#x202f;weeks of circadian rhythm restoration following chronic circadian disruption also displayed hippocampus-related cognitive function inferior to that of controls, as well as slow-to-recover myelin structure. This study indicates that circadian disruption induces slow-to-recover cognitive impairment; this impairment is hippocampus-associated, and the myelin architecture of the hippocampus also exhibits a slow-to-recover pattern.

This study investigates how Chinese breast cancer survivors reconstruct damaged identities and negotiate cultural norms to build resilience within a specific socio-cultural context. Using narrative inquiry and a life-course perspective, in-depth interviews were conducted with 15 female breast cancer survivors in Beijing. The study employed thematic narrative analysis to identify cross-cutting patterns while preserving individual story integrity. Rigor was ensured through data saturation and member checking. Resilience is manifested as a transformative narrative practice across three dimensions: (1) body narrative, survivors transition from chaos narratives to quest narratives, reclaiming identities by ascribing meaning to physical scars; (2) relational narrative, survivors negotiate the tension between Confucian gender expectations and self-care, shifting from stoic endurance to accepting vulnerability; and (3) social narrative, survivors bridge the gap between "silent island" of isolation and collective empowerment by establishing narrative communities that challenge social stigma. These findings reveal a duality of resilience-constrained by cultural structures yet empowered with agency. This study proposes a tripartite social work interventions framework, recommending that social workers act as narrative witnesses, cultural mediators, and community architects. By integrating local cultural wisdom with narrative techniques, social workers can effectively facilitate identity reconstruction and the social integration of breast cancer survivors.

As the primary living environment for disabled older adults, families play a crucial role in disease prevention and maintaining their health. However, research has found that both disabled older adults and their family members experience numerous physiological, psychological, and social adaptation problems when adjusting to the changes brought by disability, severely impacting the overall health status of the family. Therefore, guided by the ERG (Existence-Relatedness-Growth) theory, this study aims to understand the family health needs of families with disabled older adults in the community, providing a basis for improving the health level of these families and developing targeted intervention programs. From December 2024 to February 2025, this study employed purposive and snowball sampling to select 12 pairs of disabled older adults and their primary caregivers from communities under the jurisdiction of Zhengzhou City, Henan Province for semi-structured interviews. Thematic analysis was applied to organize and analyze the interview data. Deductive analysis indicated that the famliy health needs of families with disabled older adults in the community can be summarized into the following three themes: existence needs (daily living needs, economic support needs, environmental modification needs), relatedness needs (family communication needs, social resource connection needs, social participation needs), and growth needs (autonomy and dignity maintenance needs, family development needs, demand for technology-enabled solutions). The results show that the family health needs of families with disabled older adults in the community are unique and diverse. Community health workers and social workers can develop and implement effective strategies based on the different levels of family needs to promote the health level of families with disabled older adults and improve the overall quality of life of these families.

There is increasing recognition that individuals of all ages with life-limiting conditions benefit from palliative care. Despite a preference for dying at home, most patients still spend their final days in hospital. The WHO encourages member states to integrate palliative care across all levels of their health system. This study aims to explore how home care services in a Norwegian municipality implement practices that enable patients to die at home, and how healthcare professionals experience these practices. A secondary analysis was conducted using qualitative data originally collected in May 2024 for the evaluation of a structured care model for days at home and home death. The dataset comprised four focus groups, one with members of the project team who had developed the model, one with home care unit managers, and two with healthcare workers involved in applying the structured care model in practice. The secondary analysis was conducted between May and August 2025, using Braun and Clarke's thematic analysis. The analyses resulted in the following three themes, which describe how home care services implement practices enabling patients to die at home, as well as their experiences of this practice: T1) Advancing palliative care through focused projects: enhancing competence and addressing challenges; T2) Spending the final days at home: identifying patients with palliative care needs and providing compassionate and effective care, and, T3) Sharing responsibility versus reducing the workload. Fostering knowledge and support in home-based palliative care. Overall, the findings showed that a recently implemented care model improved focus, procedures and collaboration, but also revealed organizational weaknesses. Palliative home care was seen as a nuanced, nonlinear process shaped by patient and family wishes, and end-of-life meetings with patients and families were described as complex, requiring both skilled care and emotional support. Yet some nurses felt insecure and called for more colleagues with whom they could share their experiences, knowledge, and responsibilities. Supported by a newly implemented structured care model, the home care services worked systematically and purposefully to improve the quality of care for patients with palliative needs. However, the data revealed weaknesses in the system, such as a lack of clear reporting guidelines and unclear roles among collaborating healthcare services. Healthcare workers were engaged and described their work as complex and unpredictable, thus underlining the need for confidence, competence, and support from colleagues. Overall, the study demonstrates that palliative home care is enhanced by clearly articulated goals and a comprehensive understanding of the requirements needed to deliver high-quality care.

BackgroundVirologic failure in children is a significant public health concern in sub-Saharan Africa. This study aims to assess the incidence rate of virologic failure and its predictors among children undergoing first-line antiretroviral therapy (ART) in Ethiopia.MethodsA multicenter retrospective follow-up study was conducted in HIV-infected children on first-line ART from January 1, 2013, to December 31, 2022, in Ethiopia. A simple random sampling method was employed to select the sample. Data entry was performed using EpiData, and analysis was conducted using STATA version 14. Kaplan-Meier curves and log-rank tests were utilized for survival analysis.ResultAmong 537 HIV-infected children followed over the study period, 12.29% developed virologic failure, yielding an incidence rate of 17 per 10&#x2005;000 person-month observations (95% confidence interval [CI]: 13.4, 21.7). Factors independently associated with an increased risk of virologic failure included poor ART adherence (adjusted hazard ratio [AHR]&#x2009;=&#x2009;2.63; 95% CI: 1.38, 4.97), advanced World Health Organization (WHO) Treatment (T) stages III and IV (AHR&#x2009;=&#x2009;2.71; 95% CI: 1.15, 6.37), no history of regimen change (AHR&#x2009;=&#x2009;5.88; 95% CI: 3.23, 10.71), and age at ART initiation above 10 years (AHR&#x2009;=&#x2009;2.97; 95% CI: 1.30, 6.78). In contrast, having a caregiver younger than 40 years was associated with a significantly lower risk of virologic failure (AHR&#x2009;=&#x2009;0.42; 95% CI: 0.25, 0.72). These findings emphasize the importance of monitoring adherence, providing closer follow-up for children in advanced treatment stages, and considering caregiver-related factors to reduce virologic failure.ConclusionsVirologic failure among HIV-infected children on first-line ART in Northwest Ethiopia was a relatively low incidence. Interventions targeting poor adherence, children with advanced WHO Treatment (T) stage, older age at ART initiation, and those with no history of regimen change are essential. Additionally, caregiver characteristics, such as age below 40 years, play a protective role and should be considered when designing adherence support and monitoring strategies to further reduce the risk of virologic failure. How Often HIV Treatment Fails and Why Among Children Receiving First-Line Antiretroviral Therapy in Northwest EthiopiaPlain Language SummaryChildren living with HIV need lifelong treatment to keep the virus under control. Antiretroviral therapy (ART) helps reduce the amount of HIV in the body, allowing children to grow and live healthier lives. However, in some children, the treatment stops working well. This is known as virologic failure, meaning the virus is no longer adequately suppressed.This study looked at how often virologic failure occurred and what factors were linked to it among children receiving first-line ART in several health facilities in Northwest Ethiopia. We reviewed the medical records of children who had been on ART for a period of time and followed their treatment outcomes.We found that a notable number of children experienced virologic failure while on first-line treatment. Several factors were linked to a higher risk of treatment failure. These included poor adherence to medication, advanced stage of HIV disease at the start of treatment, low immune status, and treatment-related factors such as drug substitutions and missed clinic visits.Understanding why HIV treatment fails in children is important because early identification of these risk factors can help healthcare providers intervene sooner. Improving medication adherence, providing close follow-up for high-risk children, and strengthening routine viral load monitoring may help prevent treatment failure.The findings of this study can support healthcare workers, program managers, and policymakers in improving pediatric HIV care and strengthening treatment programs, especially in resource-limited settings like Ethiopia.

Adolescent peer navigation is a promising strategy to improve engagement and health outcomes among adolescents living with HIV (ALHIV), yet youth-focused models remain underdeveloped and poorly documented, particularly in low- and middle-income countries. The Moi Teaching and Referral Hospital (MTRH) Rafiki Centre in Eldoret, Kenya-one of Africa's largest adolescent health centers-employs young adults living with HIV as peer navigators to support clients aged 14-24. Peer navigators meet defined eligibility criteria, including secondary school completion, ART adherence, and viral suppression, and are employed until age 25. Their compensation is supported primarily by USAID/PEPFAR-funded annual stipends, placing them outside formal health workforce structures and limiting access to employment benefits. This study addresses a critical evidence gap by providing an in-depth analysis of the structure, functioning, and perceived impact of this adolescent peer navigator model. In June 2024, we conducted semi-structured qualitative interviews with 23 participants: eight current peer navigators, six former navigators, and nine health care workers who supervise or collaborate with peers. Interviews explored peer roles, training, supervision, program strengths and challenges, and perceived effects on adolescent outcomes. Audio-recorded interviews were transcribed and analyzed using reflexive thematic analysis, combining deductive codes based on interview domains with inductively generated themes. Participants described peer navigators as central to adolescent engagement, trust-building, and improved clinical and psychosocial outcomes. Shared lived experience allowed peers to normalize HIV, promote adherence, reduce stigma, facilitate disclosure, and strengthen adolescents' self-acceptance and coping. Peer navigation functioned as a bidirectional bridging mechanism: peers guided adolescents through clinical and social systems while conveying youth realities back to providers, enhancing responsiveness and equity. Peers, however, reported significant emotional burden, safety concerns during community visits, and challenges maintaining boundaries with clients. Structural vulnerabilities were prominent; reliance on donor-funded stipends without formal recognition, living wages, or benefits created job insecurity, undermined professional legitimacy, and threatened program sustainability. The Rafiki Centre's program demonstrates how adolescent peer navigation can advance youth-friendly HIV care by integrating lived experience into health systems in ways that improve adherence, reduce stigma, and enhance psychosocial well-being. Yet the same features that make peer navigation effective also create vulnerabilities that require institutional support. Strategic frameworks and institutional structures that allow timely and honorable entry and exit of peer roles, support in transitioning to other opportunities, and protections for physical, emotional and financial safety are essential for sustaining and scaling this developmentally attuned, equity-promoting model of adolescent HIV care.

This paper explores the connection between caring for the land and caring for ourselves, specifically as a response to, and within the context of, adverse mental health among Hawaiian farmers. After providing a brief, empirically informed overview of the farmer mental health crisis, we turn our attention to the native Hawaiians' rich and sophisticated tradition of environmental philosophy, which is underpinned by the land-care ethic of m&#x101;lama '&#x101;ina. We show that the Hawaiian environmental ontology is relational, in that nature and people are intimately and metaphysically interconnected, and we argue that because of this metaphysical embeddedness of people within the land, in the Hawaiian worldview there is no clear distinction between land-care, community-care, and self-care. Moreover, we posit that traditional Hawaiian thought frames agricultural economics, ecology, and wellbeing as complementary concepts, rather than mutually exclusive modalities. We aim to illustrate that this holistic approach to land and community care means that Hawai'i is perhaps uniquely positioned to address the present farmer mental health crisis and, consequently, we conclude that the reintegration of native Hawaiian philosophy into contemporary Hawaiian society would be likely to precipitate improvements in the mental health outcomes of (native and non-native) Hawaiian agricultural workers, and Hawaiian society at-large.

To provide a conceptual overview of how female healthcare staff experience menopause transition in the workplace via a critical interpretive meta-synthesis. Search strategy - Seven electronic databases were searched systematically using keywords and subject headings within the core review concepts of menopause, healthcare staff and workplace. Inclusion criteria - Primary, qualitative research published in English reporting on healthcare staff experiences of the menopause transition. Data extraction and synthesis - Data were extracted from seven eligible papers with constructs extracted and synthesised via reciprocal translational analysis. Three interrelated themes were identified: Distress in the workplace; Fear of judgement; and Pressure to perform. Menopause significantly affects female healthcare workers' wellbeing and performance, and appears to be worsened by stigma, lack of support and gender dynamics. Systemic changes, including more organisational awareness, appear warranted to enhance and sustain female employees at work.

Canada is committed to supporting internationally educated nurse (IEN) integration into the healthcare system, as a strategy to address post-pandemic nursing shortages. The province of Nova Scotia has emerged as a Canadian exemplar with the development of NICHE (Nova Scotia's International Community of Healthcare Workers Engagement) programme, which anchors intersectoral collaboration between the government, the nursing regulator and healthcare systems in service of streamlining IEN integration. We conducted a province-wide realist evaluation of the integration of IENs into the Nova Scotia healthcare system and community. We collected data from interviews with 24 participants, comprised of IENs and stakeholders at meso- and micro-healthcare system levels. We used a theory-driven approach to data analysis which utilised elements of content analysis, reflective dialogue and the construction of CMOCs (context-mechanism-outcome configurations). We constructed three main CMOCs which highlight facilitators for IEN integration related to (1) the development of adaptive programme pathways for IENs, (2) the critical role of IEN allies and advocates within healthcare systems, and (3) the shift in focus from recruitment to retention. The study findings describe the contextual factors and key mechanisms that promote 'successful' IEN integration which may be useful for leaders and policymakers integrating IENs into their local health human workforce. The findings raise important questions about supporting IEN retention, consistent with the vision for a healthy and sustainable nursing workforce. The findings from this study underscore the need for further evaluation research in on the topic of IENs.

Social vulnerability (SV) influences rehabilitation and postoperative care for patients with hip fracture. However, most previous work relies on area-level measures that overlook interindividual variation. The recent adoption of ICD-10 Z-codes allows clinical identification of patient-level SV and may offer a better understanding of its impact. This study aimed to evaluate healthcare utilization, including readmissions, discharge disposition, and length of stay (LOS) in surgically treated hip fracture patients with and without clinically acknowledged SV. Adults surgically treated for hip fracture between 2016 and 2020 were included from the Nationwide Readmissions Database. SV was defined as having at least one documented relevant ICD-10 Z-code. Primary outcome measures included complications, LOS, discharge disposition, and 30- and 90-day readmissions, stratified by SV and evaluated using chi-square analyses. Multivariable logistic regression assessed long LOS (&#x2265;&#x2009;5 days) and discharge to home, adjusting for age, insurance/income status, and substance use. Patients with SV were younger (35.6% with SV vs. 50.1% without SV were 81+), had a lower median household income (38.8% with SV vs. 25.7% without SV were in the lowest quartile), and were more often insured by Medicaid (19.3% vs. 3.8%). Alcohol/drug use disorders were significantly more prevalent in patients with SV (18.5% vs. 4.5%). SV was associated with 47% higher odds for long LOS (1.47, 1.41-1.54) and 23% higher odds for discharge to home (1.23, 1.16-1.30) but comparable 90-day readmissions (21.2% vs. 19.8%). Among surgically treated hip fracture patients, SV was associated with higher odds of long LOS and discharge to home but no meaningful difference in readmissions. The small number of patients with clinically documented SV highlights the limited reporting by healthcare workers. This analysis of a nationwide all-payer database highlights the need to identify these higher risk patients and implement appropriate care pathways to reduce healthcare utilization.

Nuclear medicine is a diagnostic and therapeutic medical specialty based on the administration of radiopharmaceuticals emitting ionizing radiation (IR). In this context, healthcare professionals are exposed to low doses of radiation during their activity. This review aims to provide an up-to-date overview of occupational exposures in nuclear medicine in France, based on data from the 2023 IRSN and 2024 ASN reports, and to put them into perspective with those of other medical or industrial sectors, as well as with natural background exposure. Occupational exposures in nuclear medicine remain very low: in 2023, the average annual dose for workers was 0.78 mSv, which is about three times lower than the average natural exposure in France. No regulatory exceedance was observed, either for external exposure, extremities of the limbs doses, or eye lens doses. Most reported significant radiation protection events are minor and without clinical consequence. Furthermore, this article recalls the historical background of the concept of maximum permissible dose and the principles of radiation protection, highlighting the limitations of the linear no-threshold (LNT) model applied to low doses on which these principles are based. Finally, it describes the organizational, technical, and individual measures implemented in nuclear medicine departments to maintain these low levels of exposure. These data confirm that this medical specialty remains one of the least exposed to occupational risks in the hospital environment.

The aim of this study is to understand the factors contributing to patients' non-adherence to lifestyle modification plans among visitors of the Lifestyle Clinics in King Abdul-Aziz Medical City, Jeddah. Adherence to these plans is crucial for improving health outcomes and preventing chronic diseases. A cross-sectional study was conducted at the Lifestyle Clinics within the Primary Healthcare department of King Abdulaziz Medical City, Jeddah. Participants were adults referred for weight reduction. Data were collected using a questionnaire covering sociodemographic characteristics, adherence to lifestyle modifications, and barriers to adherence. The adherence level was assessed using a validated 13-item questionnaire, and the data were analyzed using IBM SPSS Statistics. A total of 380 participants were included, with a median age of 42 years (IQR: 32-50 years). Approximately 45.5% were adherent to the lifestyle modification plan, while 54.5% were non-adherent. Significant positive correlations were found between age and adherence (Correlation Coefficient=.205, p<.001), with healthcare workers showing higher adherence levels (p=0.027). Common barriers to adherence included lack of willpower (74.5%), energy (70.8%), and time (68.9%). Statistically significant associations were identified between lack of energy (p=0.019) or time (p=0.023) and non-adherence. This study identified key factors associated with non-adherence to lifestyle modification plans, particularly younger age, non-healthcare occupations, and perceived barriers such as lack of energy and lack of time. Despite high levels of knowledge regarding healthy lifestyle practices, adherence remained suboptimal, highlighting the gap between awareness and behavioral implementation. Addressing practical barriers through targeted, behavior-focused interventions may improve adherence and long-term health outcomes.

Advance care planning (ACP) is a vital tool to align patients' goals and values with their medical care; however, ACP has low completion rates. Barriers to ACP include lack of continuity across care settings, consistent documentation, electronic health record (EHR) accessibility to ACP information, and need for clinician education. To address these barriers, system-wide healthcare initiatives are needed. Examine a health system-wide approach to improve ACP completion and continuity among adult patients within an academic medical center. Retrospective cohort study PARTICIPANTS: A total of 34,268 patients aged 65&#xa0;years or older receiving healthcare at a single academic medical center. A multimodal initiative across care settings (ambulatory, transition of care, and emergency department/hospital) was implemented to include patient cohort identification, EHR enhancements, addition of ACP dedicated social workers to enhance continuity, and clinician education. ACP completion was the primary outcome and defined as (1) completion of a Medical Orders for Life-Sustaining Treatment (MOLST) or Advance Healthcare Directive document, (2) identification of a surrogate decision maker, or (3) documentation of conversations regarding ACP goals. Fifty-one percent of the cohort completed ACP during the study (Feb. 2021-Jan. 2024). ACP completion likelihood increased among patients with a positive surprise question screen (adj IRR 4.56, [CI 3.52, 5.90]) and those diagnosed with dementia (adj IRR 1.59 [CI 1.47, 1.72]), advance cancer (adj IRR 1.37 [CI 1.19, 1.58], and heart failure (adj IRR 1.11 [Cl 1.04, 1.19]. Compared to baseline, ACP completion increased during both operational implementation periods: first period adj IRR 1.24 (CI 1.16, 1.32) and second period adj IRR 3.54 (CI 3.38, 3.70). This multipronged approach to a system-wide ACP implemented across care settings at an academic medical center led to an increase in ACP completion and provides a framework for other academic medical centers.

Indigenous peoples experience significant health inequities compared to non-Indigenous peoples. The reasons for this are multi-faceted. Access to healthcare for marginalised Indigenous peoples is made more difficult by living rurally; urban counterparts have improved healthcare access and health outcomes. This review aimed to further understand the healthcare experiences of rural Indigenous peoples residing in New Zealand (Aotearoa), Australia, Canada or the United States of America (USA). Participants were required to self-identify as Indigenous consumers of healthcare aged 18&#x2009;years or older, with personal or family experiences of receiving healthcare. Contextually, rural healthcare service access in any healthcare setting was chosen. The countries chosen for inclusion were New Zealand, Australia, Canada, and the USA. Exclusion criteria included studies with non-Indigenous participants with healthcare experiences that were unable to be isolated and extracted, as well as studies involving both rural and urban healthcare experiences where the urban experiences were unable to be isolated and removed. The electronic databases Scopus (Elsevier), CINAHL Complete (EBSCOhost) and Medline (OVID) were searched. Articles were screened by one author (TC) to identify primary research studies that reported patient lived experiences and included Indigenous participants who live rurally. Searches were completed in June 2024 and limited to full text, English language and date limited to 2004-2024. Articles were then analysed via thematic analysis. Seven articles were analysed. The articles were located in Aotearoa, Australia, and Canada. No suitable studies from the USA were identified or included. Five themes were identified as having impacted the healthcare experiences of Indigenous peoples: distance to care; quality of care and racism; support from and impact on, wh&#x101;nau (family); health professional communication and knowledge sharing; and Indigenous solutions and holistic care. Ensuring that patient-centred care also involves wider family members has been shown to be beneficial, as has the engagement of Indigenous health professionals and health workers in providing culturally inclusive healthcare. Health professionals should consider language and communication techniques when engaging with people seeking healthcare and not make assumptions, for example around health knowledge.

Using 2015 and 2018 China Health and Retirement Longitudinal Study data and a two-way fixed-effects difference-in-differences design, this study examines how China's Long-Term Care Insurance (LTCI) affects the mental health of older adults who are not directly insured. Among 1,899 non-beneficiaries in pilot and non-pilot cities, LTCI improved health-related quality-of-life trajectories, with stronger spillovers for mental than physical health. Pilot-city residents reported greater vitality, social functioning, and fewer role-emotional limitations, suggesting mediation through structural, cognitive, and relational social capital. These findings highlight LTCI reforms as opportunities for gerontological social workers to strengthen community networks, outreach, and psychosocial support.

Metal additive manufacturing (AM) relies on alloy feedstock powders that may come into contact with the workers' skin during handling, yet skin-relevant data on metal release and biological reactivity remain limited. Here, we assessed the cutaneous bioactivity of the fine particle fraction of four gas-atomized Fe-based AM powders (316L stainless steel, Fe-powder A, and tooling steels B and C). Powders were sieved to <10 &#x3bc;m and characterized by scanning electron microscopy and X-ray photoelectron spectroscopy before and after incubation in artificial sweat (ASW). Metal biodissolution was quantified in ASW and keratinocyte culture medium using atomic absorption spectrophotometry. Cellular responses were evaluated in HaCaT keratinocytes using Cell Painting-based phenomics and multiplex cytokine/chemokine profiling and in an ex vivo full-thickness human skin explant model, including superficial barrier disruption, IL-8/CXCL8 quantification, and histological assessment. ASW exposure induced marked shifts in the outermost surface composition across powders, indicating sweat-driven surface transformation. Biodissolution was low and medium-dependent, with Fe dominating the release in ASW, and with an overall metal release remaining limited in cell culture medium. In HaCaT cells, MCP-1/CCL2, IL-6, and IL-8/CXCL8 were quantifiable but showed no significant changes following powder exposure. Cell Painting revealed subtle, shared phenotypic signatures, primarily involving mitochondrial-associated features, without evidence of broad cellular stress. In the ex vivo skin model, AM powders did not increase IL-8/CXCL8 secretion, the particles remained localized to the skin surface without detectable penetration, and coexposure with Staphylococcus epidermidis did not enhance bacterial colonization or induce inflammation. To the best of our knowledge, this is the first study that applies a human skin explant model to evaluate dermal responses to metal AM powders. Overall, the tested AM powders showed low short-term cutaneous reactivity under skin-relevant conditions, providing human-relevant evidence to inform occupational risk assessment in AM environments.