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Zoonotic diseases pose significant threats to global health security, societal stability, and economic well-being by causing widespread illness, overwhelming healthcare systems, disrupting communities, and driving the majority of emerging infectious diseases. This editorial synthesizes key insights on surveillance and response to zoonotic diseases, arguing that current systems must evolve from fragmented, human-centric detection toward integrated, anticipatory platforms. The collected papers underscore that traditional surveillance fails to address the accelerating drivers of zoonotic emergence, such as climate change, agricultural intensification, and antimicrobial resistance. Instead, they advocate for a paradigm shift wherein genomics, artificial intelligence, and digital tools are leveraged to interpret risk signals across human, animal, and environmental domains-enabling early warning and source attribution. Critically, the issue emphasizes that technological advances alone are insufficient; effective response depends on embedding these tools within robust One Health governance, sustained cross-sectoral collaboration, and equity-focused investments. By framing surveillance as an action-oriented continuum, the contributions collectively assert that preventing future zoonotic crises requires transforming One Health from a conceptual ideal into an operational infrastructure capable of translating data into timely, context-specific interventions.

Social workers regularly encounter clients affected by substance use disorders (SUD), yet training in evidence-based assessment and interventions remains limited. In Sweden, municipal social workers have statutory responsibility for SUD assessment, intervention planning and client follow-up which underscores the need for targeted professional education. This study aimed to: (i) describe social workers' baseline self-assessed competence in evidence-based practices for SUD and its associations with demographic and professional characteristics, and; (ii) examine knowledge gains associated with completion of an evidence-based educational intervention. A non-randomized pre-post design included 173 municipal social workers recruited from 64 municipalities across five cohorts (2021-2023). Baseline self-assessed competence was analyzed using ordinal logistic regression, and knowledge gains were assessed using module-specific pre-post items with paired t-tests with Cohen's d. Baseline competence was rated as low to moderate, with professional experience predicting higher perceived competence. Substantial baseline knowledge gaps were observed, particularly in evidence-based psychosocial interventions and use of digital technology in assessment and planning of treatment. Knowledge increased significantly across all modules after training completion (d = 0.26-1.41). The largest knowledge gains were for modules on use of technology in the assessment and treatment-planning, biopsychosocial interventions, research-informed use of the assessment tool Addiction Severity Index (ASI), and the professional role in assessment and care planning. Score variability decreased across several modules. Completion of an immersive, online, evidence-based training was associated with meaningful improvements in social workers' knowledge related to substance use assessment, intervention planning, and use of technology. Although causal inference is limited by the non-randomized single-group pre-post design, the findings support the potential of scalable educational interventions to address competence gaps in substance use services even in organizations with high caseloads, workforce turnover, and limited training opportunities.

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Exercise in neurological rehabilitation is often prescribed to improve mobility, yet its influence extends to cognition through interacting peripheral, central, and behavioral pathways. This narrative review synthesizes evidence on how skeletal muscle activity can engage peripheral biomarkers and system-level interactions that become clinically meaningful only when translated into behaviorally relevant cognitive-motor integration (CMI). We examine neurotrophic, metabolic, immune, vascular, and endocrine relays, then consider central translation through synaptic plasticity, metabolic adaptation, neurovascular coupling, white matter integrity, and functional network reorganization. The central argument is that cognitive benefit cannot be inferred from biomarker change alone. Exercise is most likely to support recovery when biological pathway engagement is paired with attentionally demanding movement, dual-task control, gait automaticity, error-based adaptation, and context-sensitive learning. Research in stroke, Parkinson's disease, multiple sclerosis, and traumatic brain injury illustrates the heterogeneous benefits of exercise. This heterogeneity may be shaped by lesion topology, inflammatory activity, fatigue, autonomic stability, medication state, baseline fitness, and exercise tolerance, all of which alter the internal biological dose generated by a given external training prescription. Virtual reality, robotics, wearable sensing, and non-invasive brain stimulation may strengthen this framework when they manipulate task complexity, salience, repetition, feedback, and ecological monitoring for a defined mechanistic purpose. Current evidence supports exercise as a biologically and behaviorally meaningful adjunct in neurorehabilitation, but it cautions against uniform prescriptions and overly direct biomarker interpretations. A more precise next generation of trials should integrate exercise prescription, mechanistic readouts, technology-enabled assessment, and ecologically valid cognitive-motor outcomes within the same translational logic. Across the review, CMI is treated as the behavioral test of whether exercise-responsive biology has been recruited into adaptive function, rather than as a separate concept appended after conditioning.

Elevated circulating non-esterified fatty acids (NEFA), a hallmark of metabolic stress and negative energy balance, are increasingly associated with reduced female fertility. While most studies focus on late oocyte maturation, metabolic disturbances during follicular growth, particularly during the preantral - early antral transition, a critical window for establishing oocyte developmental competence may already impair oocyte quality. Here, we investigated whether sustained, physiologically buffered NEFA elevation during this stage affects oocyte developmental competence. Preantral follicles were cultured for 18 days in a three-dimensional ovine in vitro folliculogenesis system under physiological (70 μM) or moderately elevated (140 μM) NEFA conditions, with defined fatty acid composition and albumin buffering. The cytoprotective effects of the antioxidants Trolox and resveratrol were also evaluated. Chronic exposure to moderately elevated NEFA induced a pro-oxidant follicular microenvironment, characterized by reactive oxygen species (ROS) accumulation and oxidative DNA damage, including increased 8-OHdG and mtDNA D-loop oxidation. This stress impaired cumulus cell function and somatic-oocyte communication, reduced oocyte mtDNA copy number and mitochondrial activity, and compromised meiotic and developmental competence despite preserved follicular growth. Antioxidant treatment with Trolox restored mitochondrial function, normalized cumulus activity, and rescued blastocyst development, partially reversing the NEFA-induced phenotype. Prolonged moderate NEFA elevation during early folliculogenesis impairs oocyte competence despite preserved follicular morphology, identifying chronic lipotoxicity and redox imbalance as early and clinically relevant determinants of impaired fertility.

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Behavioral interventions for Tourette syndrome (TS) involve tic suppression and attention to premonitory urges. However, some patients believe that focusing on tic symptoms or urges may worsen symptoms, and that suppressing tics may exacerbate urges. Using a single experimental dataset with real-time urge monitoring, this study addressed two analytical aims. Aim 1 examined whether tic suppression worsens the intensity, frequency, and persistence of premonitory urges. Aim 2 examined whether sustained attention to urges increases tic frequency or worsens subjective urges. Ten adult men with TS and frequent tic symptoms (mean age=28.3 years, standard deviation=9.1 years) completed four 5-min conditions twice: rest, suppression, urge-reporting, and suppression+urge-reporting. In the urge-reporting conditions, participants used a handheld monitor to continuously report urges. The sessions were video-recorded, and tic frequency was coded. For Aim 1, the mean urge intensity, frequency of threshold-crossing urge episodes, and post-threshold persistence patterns were compared between the urge-reporting and suppression+urge-reporting conditions. For Aim 2, tic frequency and subjective states were compared between the conditions with and without urge-reporting. At the group level, tic suppression was not associated with consistent worsening of mean urge intensity, frequency of threshold-crossing urge episodes, or post-threshold persistence patterns. This overall pattern did not clearly differ by obsessive-compulsive symptoms, although participants with these symptoms showed larger and more persistent urge responses in the descriptive plots. Sustained urge-reporting was not associated with a consistent group-level increase in tic frequency; instead, marked individual variability was observed. Subjective urge intensity and fatigue were higher after suppression+urge-reporting condition than after suppression condition. Under short-term laboratory conditions, tic suppression was not associated with a consistent group-level worsening pattern in premonitory urge indices, and real-time urge reporting was not associated with a consistent group-level increase in tic frequency. However, individual variability was substantial; this variability may be partly related to obsessive-compulsive symptoms.

Artificial intelligence (AI), especially generative AI and large language models, is increasingly influencing higher education and health professions training. However, there is still limited empirical evidence about what veterinary students know about AI, how they use it, and how they perceive it. The aim of this study was to evaluate self-perceived AI-related knowledge, use, and attitudes among veterinary students in Spain and Portugal, and to analyze the influence of institutional context, prior AI training, and digital engagement. A cross-sectional survey was conducted during the 2023-2024 academic year with 340 undergraduate and postgraduate veterinary students from public and private institutions in Spain and Portugal. The questionnaire included sociodemographic questions and nine Likert-scale items assessing self-perceived AI knowledge, use, and attitudes. Composite scores were calculated and transformed using the Percentage of Maximum Possible (POMP) method (0-100 scale). Internal consistency of the instrument was high (&#x3c9;&#x202f;=&#x202f;0.842; &#x3b1;&#x202f;=&#x202f;0.835). Data was analyzed using MANOVA, one-way ANOVA, independent samples t-tests, and Pearson correlation analyses. Significant differences were observed between institutions in self-perceived AI knowledge, use, and attitudes. Students who had received prior AI training showed higher self-perceived knowledge and use scores (p&#x202f;<&#x202f;0.001) and more positive attitudes toward AI (p&#x202f;<&#x202f;0.001). Although formal AI training was limited in many institutions, students with any type of prior exposure-self-directed, university-based, or external-reported greater engagement and felt more prepared to use AI tools. Daily social media use showed a small but statistically significant positive correlation with self-perceived AI knowledge and use (r&#x202f;=&#x202f;0.115, p&#x202f;=&#x202f;0.034) and with positive attitudes (r&#x202f;=&#x202f;0.157, p&#x202f;=&#x202f;0.004). Categorized analyses showed a gradual increase in AI-related outcomes with higher levels of digital engagement. Veterinary students in the Iberian Peninsula are already using AI, mainly through informal learning pathways, while structured institutional integration remains uneven. Structured exposure to AI is consistently associated with higher self-perceived knowledge, greater use, and more positive attitudes. These results suggest that deliberate curricular integration and guided AI literacy initiatives are important to prepare future veterinarians for responsible and effective use of AI technologies.

Over the last decades alcohol intake has decreased among the Swedish men but been on the rise among the women, thus leading to an increased risk of alcohol dependence (AD) and related consequences among the Swedish women. The aim of this study was therefore to compare the mortality between women with AD and population-matched controls. Data were retrieved from the medical records of 2,037 women with AD at the Addiction Centre in Malm&#xf6; in 1970-2013 and followed up until 2019. They were matched by sex, age, and calendar year with a control group from the general population in Region Sk&#xe5;ne. For persons who died during follow-up, death certificates were obtained from the national registers to obtain time and cause of death. The mortality was compared between the groups as observed vs. expected, cumulative survival was assessed by comparing the survival rates of the women with AD to those of the control group. The cumulative survival was calculated as observed compared to expected. The cumulative survival and standardized life expectancy were significantly reduced for the women with alcohol dependence compared to the matched controls; T1/2 = 21 vs. 11, p < 0.05 and OR 1.9 CI 1.73-2.02, respectively. More women with alcohol addiction passed away due to accidental and intended causes of death (15.5% vs. 2.8%, p < 0.05). Their cause-specific mortality was significantly increased for mental health disorders, respiratory and digestive diseases, but significantly lower for cardiovascular and cancer diseases. This study showed that the mortality among Swedish women with long term alcohol dependence was significantly increased, thereby suggesting a need for a special focus on this group.

European Resuscitation Council (ERC) life support courses are delivered internationally to standardise resuscitation. Given advances in educational science, evolving learner needs, and rapid technological innovation, ongoing evaluation is required to ensure these courses continue to meet expectations. This study aimed to identify priorities for course delivery, teaching and assessment strategies, and to inform future course development. From May to June 2025, the ERC Course Strategy Taskforce conducted two web-based surveys among course participants and instructors (10 and 22 items, respectively). The surveys included single-response items, Likert-scale ratings, and open-text questions addressing teaching background, course delivery, assessment practices, and views on course structure and materials. Data were analysed using a mixed-methods approach, with descriptive statistics applied to quantitative data and inductive thematic analysis to qualitative responses. Responses from 13,989 participants and 1923 unique instructors across all ERC course types were analysed. Participant satisfaction was high (mean 9.13/10); 92.8% reported increased confidence in real-life resuscitation, and 99.5% rated the on-site component positively. Instructors favoured continuous assessment for evaluating technical skills (95.2%), non-technical skills (92.5%), and professional attitudes (96.2%), with 87.1% supporting its combination with a summative endpoint. Pre-course multiple choice question testing (85.7%) and mandatory instructor preparation (90.8%) were widely endorsed. Qualitative findings highlighted the need to further develop the ERC Course System, expand specialised content, and enable more personalised delivery formats. ERC courses are highly valued and should evolve towards competency-based assessment, structured faculty development, and enhanced digital infrastructure to maintain relevance, inclusivity, and educational impact.

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Childhood asthma remains a global public health challenge with suboptimal control, despite the availability of inhaled corticosteroids (ICS) as first-line therapy. Glucocorticoids suppress inflammation and protect the airway epithelial barrier (AEB) via genomic and nongenomic pathways. However, a significant subset of patients, particularly those with severe asthma, exhibits glucocorticoid resistance. Emerging evidence reveals a dual role of glucocorticoids on the AEB: beyond protection, they may inadvertently compromise barrier integrity by inducing epithelial apoptosis and dysfunction. This review synthesizes current knowledge on glucocorticoid mechanisms in asthma, focusing on the AEB as a critical interface between therapeutic efficacy and treatment failure. We show that AEB impairment serves as one of the key mechanisms underpinning glucocorticoid resistance and the progression to severe asthma, with heightened relevance in children due to the unique vulnerability of their developing airways. Furthermore, we examine how infections, nutritional factors (e.g.,&#xa0;vitamins A and D), and immune maturation intersect with AEB integrity and glucocorticoid responsiveness. By reframing the AEB as both a target and a determinant of glucocorticoid efficacy, this review highlights the urgent need for barrier-focused strategies to overcome resistance and improve outcomes in childhood asthma.