Childhood obesity is a public health challenge, with 26.1% of Australian children aged between 2 and 17 years classified as overweight or obese in 2022. General practitioners (GPs) are the most frequently accessed healthcare providers for children. This project aims to provide a contemporary insight into current childhood obesity management practices among Australian GPs, including perceived barriers and enablers. A 20-question survey was developed by a multidisciplinary team including a paediatric endocrinologist, GP registrar, paediatric registrar and medical student. The HealthMap database distributed the survey to registered Australian GPs using a Quality Audit Reporting System. Free-text responses were thematically analysed using Braun and Clarke's qualitative descriptive methodology. Ethics approval was granted by the Nepean Blue Mountains Local Health District Human Research Ethics Committee. There were 199 responses, of which 92% (n = 183) were GP Fellows. Most respondents were from New South Wales (34.7%, n = 69) and Victoria (27.6%, n = 55). A majority (60.3%, n = 120) practised in major cities, with 18.1% (n = 36) based in outer regional areas. Thematic analysis identified key barriers to obesity management: difficulty engaging families, limited referral pathways for multidisciplinary care, inadequate public health interventions and underutilisation of national resources. Participating Australian GPs identified significant challenges in managing childhood obesity, particularly limited awareness of available resources and referral pathways. Improving the dissemination of existing services, strengthening clinical support and enhancing multidisciplinary care pathways may help support GPs in delivering effective, obesity-targeted care.
Sports nutrition experts are commonly employed by professional collision sports teams to provide nutrition support to athletes, including guidance related to concussions and repeated head impacts. At present, there are limited clinical guidelines on which to base dietary advice regarding concussions, which may result in differing management approaches. This study aimed to explore the practices and perspectives of sports dietitians working in professional-level Australian collision sports (Australian Rules Football, Rugby League, and Rugby Union) regarding nutrition strategies for concussion management. Online semistructured interviews were conducted with 14 accredited sports dietitians. A qualitative, descriptive, and methodological approach guided data collection and analysis, with structured content analysis used to identify key categories. Quantitative summaries of supplement practices were also reported. Five categories were identified: 1) the dietitian's role in concussion management-dietitians considered themselves integral to multidisciplinary concussion management and were primarily involved after concussion; 2) nutrition strategies for concussion, which included dietary adjustments to manage symptoms and supplementation with fish oil and creatine monohydrate (93% of participants, respectively) to mitigate potential neurological sequelae; 3) confidence in management of concussion-dietitians felt confident in recommending strategies for concussion that were commonly used for other indications (e.g., creatine monohydrate supplementation for performance enhancement) but were less certain when providing tailored/individual recommendations, particularly in complex cases; 4) barriers to and enablers of recommendations that spanned from individual level (e.g., symptoms affecting dietary intake) to organizational level (e.g., financial resourcing to support supplementation protocols); and 5) differences in care between squads and codes and in care received by female and academy squads compared with their professional-level male counterparts. Sports dietitians in Australian collision sports actively contribute to concussion management, despite limited clinical guidelines. Further clinical research and the development of evidence-informed guidelines are critical to enhance the integration of nutrition into multidisciplinary concussion management and ensure optimal recovery for athletes.
To examine longitudinal associations between type 2 diabetes mellitus (T2DM) and work participation among Australians. Adults (≥18 years) from the Household, Income and Labour Dynamics in Australia Survey were followed from 2013 to 2017 and 2021. The exposure was T2DM status: prevalent (T2DM at baseline and follow-up), incident (no diabetes at baseline; T2DM at follow-up), or no diabetes. Outcomes were changes in work participation (transition out of or into employment) and patterns of weekly working hours (including persistent non-employment). Survey-weighted Poisson regression estimated adjusted incidence rate ratios (IRR); group-based trajectory modelling examined working hours patterns. Over four years, prevalent (adjusted IRR 1.57, 95%CI 1.09-2.25) and incident T2DM (adjusted IRR 1.59, 95%CI 1.12-2.25) were associated with transition out of employment, and incident T2DM with reduced transition into employment (adjusted IRR 0.22, 95%CI 0.09-0.56). These associations were no longer significant over eight years of follow-up. Prevalent T2DM was associated with persistent non-employment (adjusted odds ratio 2.04, 95%CI 1.44-2.88), and incident T2DM with lower odds of increasing working hours (adjusted odds ratio 0.44, 95%CI 0.22-0.88). T2DM is associated with reduced work participation, particularly immediately following diagnosis, highlighting the importance of early, targeted workplace support.
General practitioners (GPs) are central to the treatment and management of injured workers. Australian workers' compensation funds GP consultations for work-related injuries. Almost all other GP consultations are subsidised by public healthcare insurance (Medicare Benefit Scheme). This study aimed to examine changes in publicly-insured GP consultations before and after injury for injured workers with long-duration claims, focusing on consultation duration types and GP-provided mental health and chronic diseases management plans. This retrospective cohort study using interrupted time series analysis included 3,755 injured workers and 10,113 community individuals with injury/index date between 2006 and 2016. We compared monthly changes in rates (per 1000 workers) of six GP consultation types for 12-month before and 24-months after injury. Acute and long-term changes were examined both overall (combining all consultation types) and separately by consultation type. Consultation types include four duration-based levels: A (0-6 min), B (6-20 min), C (20-40 min), and D (40-60 min), and two types describing mental health and chronic disease management plans. After injury, injured workers received an additional 1,600 Medicare-subsidised GP consultations per 1,000 workers per year compared to the community group. Post-injury, the largest increase in monthly consultation rates was observed for Level D consultations (IRR: 2.37, 95% CI: 1.35, 4.20), while the smallest increment was observed for Level B consultations (IRR: 1.45, 95% CI: 1.32, 1.59). Monthly GP mental health care and chronic disease development plan rates increased by 84% (IRR: 1.84, 95% CI: 1.17, 2.93) and 20% (IRR: 1.20, 95% CI: 0.78, 1.86) post injury, respectively; however, the monthly rates of these consultations were small (maximum 25/1000 workers) Following these initial increases immediately post-injury, monthly consultation rates decreased by 3% to 9% and by 24-months post-injury had returned to levels observed in the comparison group. All six types of publicly insured GP consultations increased temporarily in the initial months following injury, regardless of worker's compensation status. These consultations remained elevated above pre-injury levels for over 12 months, likely reflecting delayed claim acceptance or increased care needs. These findings highlight the need of a comprehensive, whole-person approach to recovery that addresses both immediate and broader healthcare needs.
Doubled haploid (DH) technology can rapidly deliver fixed lines for breeding and research purposes, especially in crops like wheat (Triticum aestivum L.). In Western Australia, we have developed an anther culture protocol that generates more than 12,000 bread wheat DH lines annually. Key aspects of the protocol include the growth conditions of donor plants, microspore developmental stage, stress pretreatment, induction and regeneration medium and culture conditions. Using controlled environment rooms for donor plant growth is important in Australia, enabling year-round production of high-quality plants. We select spikes for anther culture when microspores are at the mid-late to late uninucleate stage. Several stress pretreatments are applied to excised anthers to reprogram microspores from a pathway of gametogenesis to embryogenesis and plant development. We use a combination of mannitol and n-butanol stress pretreatments to induce embryogenesis and these are critical steps in our protocol. Following stress pretreatments, anthers are coincubated with ovaries in a liquid induction medium (LIM) for 4-6 weeks. The inclusion of ovaries during the induction phase is another important step. Resulting embryos are then transferred to a solid regeneration medium for shoot and root development. Plants are subsequently transferred to a soil medium and grown to maturity. We rely on spontaneous chromosome doubling to restore fertility in our wheat DH lines.
Intestinal failure-associated liver disease (IFALD) is a recognized complication of long-term parenteral nutrition (PN), with reported prevalence ranging from 25-85%, reflecting heterogeneity in patient populations, diagnostic criteria, and PN practices. We aimed to estimate the prevalence of IFALD in Australian adults receiving long-term home-PN (HPN), describe its biochemical and elastographic features, and identify predictors of IFALD. This was a single-centre, cross-sectional observational study in an Australian tertiary centre. Adults currently receiving long-term HPN (>12 weeks) or had received HPN within the previous decade were included. Patients with malignancy or pre-existing liver disease were excluded. IFALD was defined as persistent, unexplained elevation of liver function tests after exclusion of alternative causes of liver injury. Vibration controlled transient elastography (VCTE) was performed in all patients. Univariate logistic regression was used to evaluate associations between IFALD, nutritional, and biochemical variables. 24 patients were included. The median (inter-quartile range) duration of HPN was 42.5months (15.8-62.3); and weekly calories were 6647 kilocalories (3476.3-8471.3). 15 (62.5%) patients had IFALD. Cholestasis was the predominant biochemical pattern (80%). VCTE demonstrated significant fibrosis (≥ 8 kPa) in 20% and significant steatosis in 40% of IFALD patients. Ongoing HPN was the only variable significantly associated with IFALD on univariate analysis (OR=8, p=0.03). IFALD was highly prevalent and manifested as cholestatic liver injury, with a subset demonstrating elastographic evidence of fibrosis. Ongoing HPN was the main predictor, suggesting potential reversibility with PN cessation. Larger, multicentre studies are needed to identify any clinical predictors of IFALD.
A variant of spontaneous movements "fidgety-like movements" has been described, but its prevalence and clinical relevance remain unclear. To describe the prevalence of "fidgety-like movements" at 3-5 months corrected age (CA), its relation to major cerebral lesions, and neurodevelopmental outcome in children born extremely preterm (EPT; <28 weeks gestation). A retrospective re-analysis was conducted using three General Movement Assessment datasets, including Motor Optimality Score-Revised (MOS-R) at 3-5 months CA, in 402 infants born EPT from cohorts in the Netherlands, Sweden and Australia. Follow-up age ranged 1-8 years. Neurodevelopmental outcomes were assessed using standardized assessments and ICD-10, and classified as typical or adverse. Twenty-six of 402 infants (7%; range 5-8%) (mean gestational age ± SD, 25.1 ± 1.4 weeks; birth weight 780.1 ± 202.1 g) showed "fidgety-like movements". Median (IQR) MOS-R was 22 (21-24). Eighteen (69%) were boys, 18 (69%) had bronchopulmonary dysplasia and two (8%) had severe brain lesions. Follow-up data were available for 25 children (96%): 12 (48%) had typical and 13 (52%) adverse outcomes. Of those with adverse outcomes, most were motor delay (n = 6, 24%), language delay (n = 5, 20%) and ADHD (n = 4, 16%) or combined, with only one case of CP (4%). Fifty-four percent of children had MOS-R < 23 (below cut-off for high risk of NDD). The rate of "fidgety-like movements" was 7% in infants born EPT. Only one infant developed CP; however, more than half of infants with "fidgety-like movements" had adverse outcomes and reduced MOS-R scores highlighting need for careful follow-up.
Microplastics and their associated toxic chemical compounds pose significant risks to both terrestrial and aquatic ecosystems. Risk evaluation commonly relies on three indices: the Pollution Load Index (PLI), Polymer Hazard Index (PHI), and Potential Ecological Risk Index (PERI), with each providing valuable yet isolated insight into different aspects of microplastics risk. The study areas included three urban creeks located in Southeast Queensland, Australia. Based on data obtained from individual sampling sites and multiple sampling rounds, PLI, PHI and PERI hotspot locations were identified. PHI and PERI values indicated a strong influence of hazardous polymer composition on toxicity-weighted ecological risk. Site-level Spearman correlation analysis showed that industrial, commercial, and residential land uses are positively associated with PLI, PHI, and PERI, whereas natural land use showed a negative correlation. A risk-zoning framework was developed based on elbow and silhouette analyses, which identified k = 3 as the optimal number of clusters, defining low, medium, and high-risk groups. Eight risk categories were then derived from these groups for finer operational risk classifications. These were expressed using a consistent hexadecimal colour scale derived from the 40 possible index-combination permutations. The resulting two-dimensional (2D) risk-zoning plots visualise how sediment microplastics are distributed across the combined risk space. Film and foam were identified as the most dominant shape compositions across all risk categories. The proposed innovative methodology offers a practical approach for identifying microplastic hotspots, interpreting risk-driving mechanisms, and supporting decision-making and policy formulation for targeted microplastics management and ecological protection strategies.
To examine global research trends in delirium prevention through a bibliometric analysis and provide a structured overview of its development and emerging directions. A bibliometric analysis. Data were retrieved from the Web of Science Core Collection, focusing on publications between January 1, 2015, and December 31, 2024. The analysis utilized VOSviewer, CiteSpace, and the Bibliometrix R package to evaluate publication trends, contributing countries, institutions, authors, and research focus areas. Annual publication output increased steadily from 2015 to 2024, indicating a growing research interest in postoperative delirium. The United States contributed the largest share of publications (26.8%), followed by China (12.1%), Japan (8.5%), and Australia (6.7%). Harvard University and Harvard Medical School were the most productive institutions. Inouye SK and Ely EW were the most prolific authors. International collaboration was centered on a network involving the United States, China, and Germany. The most-cited article was by Su X et al in The Lancet (2016; 512 citations), and the most locally cited reference was Inouye SK's Confusion Assessment Method (1990; 268 citations). Keyword analysis identified 11 major research themes, including postoperative delirium, cognitive impairment, dexmedetomidine, nursing-led nonpharmacological interventions, dementia, advanced age, machine learning, electroencephalogram monitoring, neuroinflammation, intensive care unit, cardiac surgery, and hip fracture. Research on postoperative delirium prevention has increased steadily over the past decade, with the United States and leading academic institutions contributing substantially to the field. Current research has focused on major risk factors and preventive interventions, while emerging topics such as machine learning, electroencephalogram monitoring, and neuroinflammation suggest new directions for future studies. Further research should address nonsurgical populations, integrated intervention strategies, long-term outcomes, and mechanistic pathways to support more precise and multidisciplinary prevention approaches.
As climate extremes intensify, interactions among environmental drivers are expected to alter soil respiration (SR) and its response to rewetting, increasing uncertainty in carbon-climate feedbacks. However, the interactive effects of drought and warming, two commonly studied climate stressors, on SR remain elusive due to limited research and a lack of high-resolution data. This study investigated overall SR (SRoverall, encompassing both drying and rewetting phases) and rewetting-induced respiration pulses (SRpulse), along with their apparent sensitivity to temperature and moisture under factorial combinations of rainfall and warming treatments in a field-based climate-manipulation experiment conducted in a temperate pasture system in southeastern Australia. Rainfall extremes were derived from 30 years of regional climate records, while warming was imposed as a continuous, year-round increase of +3°C. An automated flux monitoring system was deployed to measure hourly SR across eight campaigns from October 2023 to November 2024. The drivers of SRoverall and SRpulse were identified by analyzing climatic variables together with soil parameters from rhizosphere and non-rhizosphere zones. Drought and warming consistently suppressed SRoverall but amplified SRpulse and moisture sensitivity. The interactive effects of both treatments on SRoverall varied seasonally, shifting from additive in spring to antagonistic in summer and autumn, and synergistic in winter. Drought suppressed apparent temperature sensitivity (Q10), but warming effects on Q10 varied with moisture conditions. Soil temperature, moisture, and extractable C:N ratio from across rhizosphere and non-rhizosphere soil were consistent predictors of SRoverall and SRpulse but exerted opposing effects on the two components. These findings advance our understanding of how drought-warming interactions shape both overall and pulse-driven SR, providing a process-based foundation for improving predictions of carbon-climate feedbacks under intensifying climate extremes.
Global population ageing continues to place pressure on health and care systems. In Australia, the increasing integration of health and aged care systems is a rising policy approach to alleviating the burden on the health system and improving the quality of care for older people. Preference-based instruments (PBMs) have become increasingly important as a tool to enable quality assessment and economic evaluation of both health and aged care services. Given the changing policy context towards more integrated services and older peoples' frequent movement across both health and aged care settings, it is important that PBMs are applicable across different care settings. This literature review aimed to assess the application of generic PBMs with older people across health and aged care settings. A systematic search of three databases for studies utilising PBMs with older people in health or aged care settings resulted in 204 articles included for review. The EQ-5D instruments were the most frequently utilised instrument across studies, followed by the Quality of Life-Aged Care Consumers (QOL-ACC). Most instruments were applied in either health or aged care settings, with few being used across both. The measurement of quality of life in older people across these settings using PBMs requires consideration of several issues particularly pertinent to this population, including the appropriateness, relevance and comprehensiveness of dimensions, the use of a suitable recall period and enabling self-report for people with cognitive impairment.
Core domains recommended for assessing low back pain (LBP) include pain, function, and health-related quality-of-life. The 9-item questionnaire, derived from PROMIS-29 Impact score, was proposed by the National Institute of Health task force as a comprehensive yet concise measure of LBP impact. However, its psychometric properties have not been widely evaluated. The objectives were to evaluate convergent validity, responsiveness and minimal clinically important difference of the Impact score (total and domains) compared with established measures: Oswestry Disability Index, Numerical Rating Scale, EuroQol 5-Dimension 5-Level, the Patient-Specific Functional Scale, and the Global Perceived Effect Scale (GPE). A secondary analysis was conducted using data of WELBack RCT of 372 participants with chronic non-specific LBP. Outcomes were collected at baseline and 2-months follow-up. Convergent validity was assessed via correlations between the Impact score and legacy measures and one-tailed hypothesis testing. Responsiveness was analyzed using distribution-, construct-, and criterion-based approaches. The MCID estimate was derived using the GPE as an anchor. The questionnaire demonstrated high convergent validity, meeting 80% of predefined hypotheses. Our analyses demonstrated moderate responsiveness, with a large effect size (0.8), 60% of hypotheses were met in construct-based approach, and an acceptable area under the curve (0.73) in criterion-based evaluation. MCID was estimated at 6 points. In conclusion, the Impact score, which captures a construct of LBP impact, reflecting multiple health domains, demonstrated high convergent validity and acceptable responsiveness in patients with chronic LBP. Its brevity and psychometric robustness support its use in clinical practice and research. PERSPECTIVES: This article evaluated the convergent validity, responsiveness and minimal clinical important difference of the Impact score to evaluate low back pain impact. The results demonstrate good validity, responsiveness and an MCID of 6 which supports the use of this short and easy to apply questionnaire.
Experimental and clinical evidence continues to accumulate, supporting the critical role of dysregulated inflammation, immunity, and redox signaling in the pathophysiology of various age-related cardiometabolic and neurodegenerative diseases. While ongoing research is investigating novel anti-inflammatory and immunomodulatory therapies for such conditions, available antirheumatic drugs may serve a similar purpose. One such drug, methotrexate, has been successfully used at high doses since the 1940s as an anticancer agent and, more recently, at lower doses in patients with autoimmune diseases. Although the effects of methotrexate have traditionally been attributed to its antiproliferative activity via folic acid modulation, additional targets have been identified, including AMP-activated protein kinase, Janus kinase/signal transducer and activator of transcription, high mobility group box 1 protein, the gut microbiota, and additional pharmacological effects of adenosine, a key mediator of methotrexate. The beneficial effects of modulating these targets on downstream inflammatory and immune pathways, cellular senescence, and vascular, metabolic, and brain homeostasis have been increasingly investigated in experimental models. Furthermore, studies conducted over the past 20 years suggest an association between low-dose methotrexate and a decreased risk of certain age-related cardiometabolic and neurodegenerative diseases, particularly in patients with autoimmune conditions. The results of these studies support the potential protective role of methotrexate against age-associated cardiometabolic and neurodegenerative diseases through multiple mechanisms, unlike targeted immunomodulatory and anti-inflammatory drugs, thereby providing a robust framework for investigating its repurposing in future intervention studies. SIGNIFICANCE STATEMENT: New treatments are essential to address the burden of age-related diseases. The important roles of dysregulated inflammation, immunity, and redox signaling in these conditions have spurred research into developing new therapies or repurposing existing drugs to target these dysfunctions. The disease-modifying antirheumatic drug methotrexate has shown potential protective effects against cellular senescence and certain age-related cardiometabolic and neurodegenerative diseases. This knowledge will encourage further research into the repurposing of methotrexate for the treatment of these diseases.
Real-world data demonstrate that patients hospitalised with non-acute severe UC (NASUC) experience intravenous corticosteroid (IVCS) failure rates approaching those of ASUC, yet no dedicated management guidelines exist. We aimed to determine whether inpatient medical therapy and colectomy risk differ between TWC-positive ASUC, compared to hospitalised patients who did not meet TWC (NASUC), and evaluate if a reduced CRP threshold (≥ 12 mg/L) improves case capture of high-risk patients. We analysed 503 consecutive acute UC admissions to a tertiary IBD centre (2015-2024). Patients not meeting TWC for ASUC were classified as NASUC. Propensity score matching (PSM) compared colectomy risk between ASUC and NASUC after adjustment for gender, endoscopic severity, disease extent and therapy on admission. A total of 145 (29%) acute UC admissions did not meet TWC for ASUC. The predominant NASUC phenotype was stool frequency ≥ 6/24 h without systemic toxicity (77%). Lowering the CRP threshold to ≥ 12 mg/L would have reclassified 26% of NASUC patients as ASUC, capturing 43% (6/14) of patients who required colectomy within 1-year. After PSM, there was no significant difference in colectomy between ASUC and NASUC at 30-days (9% vs. 5%, p = 0.367), 90-days (11% vs. 5%, p = 0.158) or 1-year (18% vs. 13%, p = 0.479) and until last follow-up (p = 0.77). NASUC is not a benign clinical entity. Colectomy risk were comparable between ASUC and NASUC inpatients when matched for objective disease severity and treatment exposure. A reduced CRP threshold (≥ 12 mg/L) improves identification of high-risk patients currently missed by the standard TWC.
The biopsychosocial (BPS) model is widely endorsed as best practice in musculoskeletal (MSK) physiotherapy. However, its implementation often remains constrained by biomedical assumptions, with psychosocial approaches primarily used to improve adherence, reduce symptoms, or restore function. As a result, contemporary BPS practice risks becoming "biomedical-plus" care rather than a genuinely integrated approach. We argue that physiotherapists can move toward a more authentic application of the BPS model through three interconnected foundational conditions - the 3Cs: professional Confidence, role Clarity, and Compassionate communication. Together, these foundational conditions support physiotherapists in engaging with the emotional, relational, and social dimensions of pain. Many physiotherapists report uncertainty when addressing trauma, psychological distress, or social determinants of health, often due to limited training, lack of supervision, and fragmented interdisciplinary systems. Rigid professional boundaries may discourage meaningful engagement with psychosocial and social contributors to pain, while entrenched patient expectations for biomedical explanations and passive treatments can make person-centred BPS conversations challenging. Addressing these barriers requires a shift from viewing psychosocial care as an "add-on" toward understanding pain within broader relational and social contexts. Authentic BPS physiotherapy requires educational reform, interdisciplinary collaboration, supportive service structures, and communication approaches that validate lived experience while promoting meaningful participation. By strengthening Confidence, Clarity, and Compassion, physiotherapists are well positioned to support not only physical recovery but also self-management, social connection, autonomy, and engagement in valued life roles.
To investigate the effect of peripheral scleral lens landing zone modifications upon short-term regional variations in corneal oedema. Nine healthy participants wore different scleral lens designs ((1) spherical landing zone, (2) toric landing zone, (3) peripheral notches, and (4) peripheral channels) in a randomised order on four separate days for 100 min. Stromal oedema was quantified using high-resolution optical coherence tomography across the central, mid-peripheral, and peripheral cornea with the lens in situ. Eye Surface Profiler (ESP) images were also captured following the application of 10 μL of 2% sodium fluorescein, over a period of 100 min. Central and peripheral fluorescent intensity data were extracted from the ESP images and analysed using customised software to quantify tear exchange. The channel lens design displayed less central oedema compared to the toric design (1.57 ± 0.45% less oedema, p = 0.04). In the corneal periphery, the magnitude of oedema was less for both the toric lens (2.66 ± 0.66% less oedema, p = 0.02) and the channel design (3.39 ± 0.97% less oedema, p = 0.04) in comparison to the spherical lens design. A highly significant correlation was observed between the magnitude of peripheral tear exchange after 90 min of lens wear and the magnitude of peripheral oedema (r = -0.61, p < 0.001). Scleral lenses with either a toric landing zone or peripheral channels exhibited less peripheral corneal oedema than a spherical landing zone design, due to enhanced peripheral tear exchange.
MXenes are a rapidly expanding family of two-dimensional transition-metal carbides, nitrides, and carbonitrides whose physicochemical behavior in aqueous and biological environments is dominated by their surface terminations (e.g., -O, -OH, and -F), rendering them intrinsically active solid-liquid interfaces. These terminations regulate interfacial charge distribution, hydration structure, adsorption equilibria, and colloidal stability, positioning MXenes as dynamic interfacial systems rather than passive nanomaterials. Rational control of surface termination chemistry therefore represents a central strategy for governing MXene interactions with electrolytes, proteins, and biological media. This review provides a comprehensive and critical analysis of recent advances in MXene surface-termination engineering from the perspective of interfacial and colloidal science, with emphasis on etching routes, post-synthetic modification, dimensional tailoring (2D, 3D, and emerging 4D architectures), and characterization approaches relevant to interfacial behavior. We examine how termination chemistry controls key interfacial properties, including zeta potential, dispersion stability in physiological electrolytes, hydration-mediated wetting, and protein corona formation, and how these interfacial factors collectively shape biological responses such as cytotoxicity, inflammatory signaling, antibacterial activity, and reactive oxygen species generation. Particular attention is devoted to termination-driven charge regulation and coordination chemistry at solid-liquid interfaces, which govern adsorption-desorption dynamics, molecular loading, and stimulus-responsive release, as well as the modulation of optical and magnetic responses. By critically comparing reported systems and explicitly addressing unresolved challenges related to termination heterogeneity, interfacial aging, and scalability, this review clarifies structure-interface-function relationships that underpin MXene performance in complex environments. Finally, we identify emerging strategies and open questions for designing surface-terminated MXenes with predictable and controllable interfacial behavior, highlighting their broader relevance as model systems for dynamic solid-liquid interfaces with bio-functional implications.
Zearalenone (ZEN) is a mycotoxin that widely contaminates human food supplies. In animal models, exposure to ZEN has extensive impacts on reproduction and pregnancy including contributing to early parturition. Here, we translate that research to humans by examining gestational exposure to ZEN in relation to the timing of birth and placental corticotropin releasing hormone (pCRH), a hormone that regulates the timing of parturition. Utilizing data from a pregnancy cohort (UPSIDE; Rochester, NY; n=299), we investigated exposure to ZEN and its metabolites in relation to: 1) gestational age at birth; and 2) pCRH across pregnancy. Adjusted linear regression models were fitted to examine gestational age at birth and pCRH in relation to three maternal urinary mycoestrogen measures in each trimester: (1) ZEN; (2) its metabolite, α-zearalenol (aZOL); and (3) the sum of ZEN and its five metabolites (∑mycoestrogens). For models examining pCRH, we additionally fitted linear mixed effects models to account for repeated measures. All models were refitted stratified by fetal sex. Mycoestrogens were detected in over 90% of samples in each trimester. Sex-stratified analyses showed distinct sex differences in trimester 2 in relation to exposure, with higher gestational age at birth in males (β:2.35 days, 95%CI:0.14, 4.56) and lower gestational age at birth in females (β:-1.70 days, 95%CI:-3.35, -0.07). In linear mixed effects models examining pCRH, ZEN was positively associated with pCRH concentrations: ZEN (%Δ:5.17, 95%CI:1.09, 9.36). Mycoestrogen exposure may be associated with sex-specific changes in gestational age at birth and higher pCRH, a risk factor for preterm birth.
Adversities in early life compromise children's nurturing care and impact their development. This study explored the biopsychosocial conditions associated with electroencephalography (EEG)-based brain activity in children living in rural Bangladesh, a setting with high rates of malnutrition and suboptimal psychosocial stimulation. In a substudy of the Benefits and Risks of Iron Supplementation in Children (BRISC) study in Bangladesh, we recorded resting EEG brain activity in a random subsample of 440 children at 11 months and 594 children at 20 months of age. EEG band power measures were derived for delta, theta, alpha, and beta power bands. Validated tools were used to assess maternal depression, household food insecurity, and psychosocial stimulation. Children's anthropometry, venous hemoglobin and ferritin concentrations, and inflammation were also measured. Linear regression analyses were conducted to identify the concurrent and lagged biopsychosocial conditions associated with EEG-based brain activity. Growth, nutritional status, psychosocial stimulation, and household food security were associated with concurrent and lagged brain activity. The direction of association differed by EEG frequency band, but the majority of biopsychosocial conditions were positively associated with activity in the higher frequency bands and negatively with lower frequency bands. Our findings indicate that brain activity in children can be influenced by a range of biopsychosocial adversities. Children's nutrition, quality and quantity of psychosocial stimulation, and food security influence their current and later brain activity in this resource-limited setting in South Asia. TRIAL REGISTRATION: ACTRN12617000660381.