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Background/Objectives: Skin cancer is one of the most common diseases worldwide, with a high mortality rate. Due to its ability to metastasize, the disease can progress to more serious stages over time. This article proposes a hybrid model based on feature engineering that will play a critical role in the early diagnosis of the disease. Methods: The developed model in this paper utilizes the well-known Vision Transformer (ViT) and Convolutional Neural Network (CNN) models for feature extraction from images in the dataset, while the FT-Transformer, Excel Former, SAINT, GRANDE, PTaRL, and TabTransformer architectures are used for feature extraction from clinical data. Furthermore, this study was developed using a very large pool of classifiers, including 13 classifiers. Fine-tuning was applied to improve the performance of the developed model. Channel attention mechanisms were incorporated into the study to ensure that the proposed model focuses on the diseased area. The PAD-UFES-20 dataset was used during the experiments. Class weighting was applied to the proposed model to prevent class-based imbalance in the PAD-UFES-20 dataset. Results: Six distinct CNN and four distinct ViT models were compared to the developed model. The developed model achieved a highly competitive Area Under the Curve (AUC) rate of 96.41%. The study was conducted using a dataset containing both clinical and imaging data. Conclusions: The proposed model is thought to help dermatologists diagnose skin cancer.

Systemic mastocytosis (SM) is a clonal mast cell (MC) neoplasm driven by somatically acquired activating mutations in the KIT receptor tyrosine kinase (CD117), resulting in pathological accumulation of morphologically atypical MCs in extracutaneous organs. The KIT D816V substitution is detectable in over 95% of cases by high-sensitivity next-generation sequencing (NGS) or allele-specific PCR. This gain-of-function variant confers ligand-independent receptor autophosphorylation, leading to constitutive activation of downstream signaling cascades that promote MC progenitor survival, clonal expansion, and resistance to apoptosis. Co-occurring somatic mutations in TET2, SRSF2, ASXL1, CBL, and RUNX1, increasingly identified in the context of clonal hematopoiesis of indeterminate potential, are associated with more aggressive phenotypes and independently confer adverse prognostic impact. The 2022 WHO classification delineates indolent forms from advanced-phase SM, aggressive SM, SM with an associated hematologic neoplasm (SM-AHN), and MC leukemia, which produce progressive end-organ damage through both neoplastic tissue infiltration and uncontrolled mediator release. Formal diagnosis requires integration of histological criteria (multifocal bone marrow MC aggregates of ≥15 cells), immunophenotypic aberrancies (CD25, CD2, and/or CD30 coexpression on MCs by flow cytometry or immunohistochemistry), biochemical markers (baseline serum tryptase ≥ 20 ng/mL), and molecular confirmation of KIT D816V or equivalent pathogenic KIT mutation. The development of type I KIT inhibitors with selectivity for the D816V-mutant conformation has fundamentally restructured the therapeutic field of advanced SM. This review provides a thorough synthesis of SM pathobiology, WHO-defined diagnostic and classification criteria, validated prognostic tools, and the developing landscape of KIT-directed and combination therapies, with direct translational relevance for specialist practitioners managing this heterogeneous myeloid neoplasm.

Microneedle systems are a promising category of devices used for various applications, such as drug delivery and diagnostics, offering benefits, including but not limited to, painless administration and improved patient experience and compliance. When combined with nanotechnology, these systems can offer improved therapeutic performance. This article analyzed the patent landscape related to technologies combining microneedles and nanotechnology. Patent documents were retrieved from the Espacenet database up to 2024. After applying predefined inclusion and exclusion criteria, 932 patents were selected from an initial set of 1,368 documents. The patents were categorized according to application field, publication year, country, origin of the invention (academic, industrial, independent, or other), type of nanotechnology used, and target substance. The results revealed an increasing global patent activity related to the integration of microneedles and nanotechnology. The patents covered diverse therapeutic and preventive applications and demonstrated the incorporation of multiple nanosystems, microneedle formats, and bioactive compounds. It is notable that this technological association has a multidisciplinary nature and is increasingly relevant to drug delivery innovation. The diversity of approaches reflects the potential of combining nanotechnology with microneedle systems to address different challenges in a wide number of health-related fields. Overall, the patent landscape indicates a growing global interest in microneedlenanotechnology integration. The findings may support technological assessment, research planning, and the identification of collaboration opportunities between academia and industry.

Background/Objectives: Hepatic fibrosis is a progressive pathological condition characterized by excessive extracellular matrix deposition in the liver, which may progress to cirrhosis and liver failure. Short-chain fatty acids (SCFAs) have demonstrated anti-inflammatory and anti-fibrotic properties; however, their therapeutic potential in hepatic fibrosis remains incompletely understood. This study aimed to evaluate the effects of acetate, propionate, and butyrate on carbon tetrachloride (CCl4)-induced hepatic fibrosis in Balb/C mice. Methods: Hepatic fibrosis was induced in Balb/C mice using CCl4, and the animals were treated with acetate, propionate, or butyrate administered via drinking water for four weeks. Biochemical parameters, histological alterations, and the expression of fibrogenic and inflammatory markers were evaluated and compared with a silymarin-treated group. Results: Treatment with SCFAs significantly reduced serum transaminase levels (AST and ALT) compared to the untreated fibrotic group. Histological analyses demonstrated the preservation of hepatic architecture and reduced inflammatory infiltrates, particularly in the butyrate-treated group. In addition, SCFAs significantly decreased the gene and protein expression of fibrogenic markers (ACTA2 and COL1A1) and inflammatory markers (NOS1, NF-κB, and IL-10), with propionate showing the most pronounced effects. Overall, the therapeutic effects observed with SCFAs were comparable or superior to those obtained with silymarin treatment. Conclusions: The findings suggest that SCFAs, especially butyrate and propionate, exert hepatoprotective, anti-inflammatory, and anti-fibrotic effects in CCl4-induced hepatic fibrosis. These compounds represent promising therapeutic candidates for the treatment of liver fibrosis.

Constipation is a frequent non-motor symptom in Parkinson's Disease (PD). Standard care includes dietary and lifestyle guidance or the use of laxatives. Diet represents a promising non-pharmacological approach, but its management in PD is complex and goes beyond simple dietary recommendations. This study protocol aims to examine whether nutritional counseling delivered by a dietitian is more effective than usual care in reducing constipation symptoms in PD patients. This 90-day randomized controlled superiority trial uses a parallel-group design. A total of 54 outpatients with PD without dementia and fulfilling the Rome IV criteria for functional constipation will be included. Baseline assessments comprise demographics, nutritional evaluation (anthropometric measurements and sarcopenia indicators), neurological assessment, and the Constipation Scoring System (CSS) scores. Participants will perform stool sample collection for microbiota analysis and will be requested to complete three 24-hour dietary recalls over the subsequent week. After baseline, participants will be randomly allocated to either the control group (usual care) or the intervention group (nutritional counseling delivered by a dietitian). At the first study visit, participants will deliver the stool sample and dietary recalls. The intervention will last for 90 days and will include one in person consultations and bi-weekly follow-up phone calls. Nutritional counseling will address four main topics: healthy eating, food processing, fiber and fluid intake, and levodopa interactions with diet. In addition, participants in the intervention group will receive an individualized diet plan. All baseline assessments will be repeated at the 90-day endpoint. The primary outcome is the change in weekly bowel movement frequency from baseline to day 90, measured through the stool diary. Secondary outcomes include CSS, changes in fecal gut microbiota, macronutrient distribution, diet quality, body composition and sarcopenia indicators. Trial registration number: NCT07213856.

Nipah virus (NiV) is a highly lethal zoonotic pathogen with significant pandemic potential, for which no approved antiviral therapies are currently available. Viral entry is mediated by the interaction between the NiV attachment glycoprotein (NiV-G) and host ephrin receptors, particularly ephrin-B2 (EFNB2) and ephrin-B3 (EFNB3), making this interface an attractive therapeutic target. In this study, we evaluated a set of structurally related flavonoids, apigenin, cynaroside, and lonicerin, as potential modulators of the EFNB2-NiV-G and EFNB3-NiV-G interactions. These compounds were selected based on their structural similarity, reported antiviral activity, chemical diversity, and favorable drug-like properties. Apigenin was employed as a reference scaffold due to its well-characterized pharmacological profile and its suitability for guiding analog-based compound selection. Apigenin served as a reference scaffold for selecting structurally related flavonoids, which were analyzed through density functional theory optimization, molecular docking, pharmacokinetic and toxicity predictions, molecular dynamics simulations, and binding free energy calculations. These flavonoids demonstrated high predicted affinity for both the EFNB2-NiV-G and EFNB3-NiV-G interfaces. According to results, these compounds consistently interacted with residues known to play a critical role in receptor recognition, with special emphasis on leucine and tryptophan residues within the G-H loop. These residues are well established as key determinants in the entry process of Nipah virus (NiV) into host cells, highlighting the potential relevance of these flavonoid-protein interactions. Molecular dynamics analyses indicated that flavonoid binding reduced the affinity and the conformational flexibility at the receptor-glycoprotein interfaces and decreased the stability of the complexes. Pharmacokinetic and toxicity predictions suggested favorable drug-like properties for the flavonoids, with apigenin displaying the most balanced profile. Collectively, these results support the potential of selected flavonoids as modulators of EFNB2-NiV-G and EFNB3-NiV-G interactions and provide a rationale for their prioritization in experimental studies aimed at developing scaffolds for the modulation of viral entry against Nipah virus.

Neonatal respiratory monitoring is essential for the early detection of clinical alterations, especially in preterm newborns. Conventional methods are limited by subjectivity and the use of contact sensors. This experimental technological development study was conducted according to the Standards for Reporting Diagnostic Accuracy Studies (STARD) guidelines. A computer vision-based system was developed: a fine-tuned YOLO11 model segmented the thoracoabdominal region of interest, the respiratory signal was extracted by optical-flow analysis of thoracoabdominal motion, and the respiratory rate was estimated by detrending and automatic peak detection; pose-based movement detection restricted the estimation to periods when the infant was still. The study was approved under protocols No. 4,744,993, 4,699,000, and 3,232,698 and classified as Technology Readiness Level (TRL) 5-6. Twenty-three neonatal recordings were included, comprising 3387 manually annotated frames for segmentation-model training and evaluation. At the time of recording, the newborns were between 3 and 15 days of postnatal age, had a postmenstrual age between 37 and 40 weeks, and were breathing spontaneously in room air. The sample consisted of neonates with a gestational age of 33 ± 1.76 weeks and weight of 1741.69 ± 393.97 g. Apgar scores were 7 ± 1.0 and 8 ± 1.0 at the 1st and 5th minutes, respectively. Fifty percent were female, and 75% were delivered by cesarean section. The system demonstrated robust thoracoabdominal segmentation with mean average precision (mAP) > 94% and continuous pose tracking. Respiratory dynamics analysis enabled respiratory-rate estimation during stable periods, with consistent performance supporting technical feasibility. The mean absolute error (MAE) was 2.1 breaths per minute (bpm) compared with the simultaneous clinical reference assessment.  The system demonstrated technical feasibility for automated thoracoabdominal segmentation and non-contact respiratory-rate estimation during periods of neonatal stability. Given the small, single-center sample and the inclusion of newborns breathing spontaneously in room air, prospective multicenter validation is required before clinical implementation. • Neonatal respiratory monitoring still relies mainly on contact sensors and subjective clinical assessment. • Artificial intelligence and computer vision have shown potential for noninvasive neonatal monitoring, but automated respiratory analysis systems remain limited. • An artificial intelligence-based video system integrating YOLO and respiratory-signal analysis enabled automated neonatal respiratory monitoring. • The system identified respiratory rate during periods of neonatal stability, supporting objective and noninvasive respiratory assessment.

We aimed to investigate the associations between Alzheimer's disease (AD)-related blood biomarkers and changes in brain volumes and cerebrovascular burden in community-dwelling older adults. We included 361 dementia-free participants with a Mini-Mental State Examination (MMSE) score ≥ 27 and without prior cerebrovascular events from a Swedish population-based study. Blood phosphorylated-tau217 (p-tau217), neurofilament light chain (NfL), and glial fibrillary acidic protein (GFAP) were measured at baseline. Brain magnetic resonance imaging (MRI) was performed at baseline and after 3 and/or 6 years. Linear mixed models were used to examine associations between AD-related blood biomarkers and changes in volumes of total brain tissue (TBTV), lateral ventricles, hippocampus, amygdala, and white matter hyperintensities (WMHs). During the follow-up, higher p-tau217 was associated with faster volume loss in the hippocampus (β*year = -0.047, 95% confidence interval [CI] = -0.077 to -0.018) and in the amygdala (β*year = -0.064, 95% CI = -0.105 to -0.022). Elevated GFAP was linked to faster TBTV decline (β*year = -0.040, 95% CI = -0.059 to -0.021), ventricular enlargement (β*year = 0.028, 95% CI = 0.013 to 0.042), and hippocampal shrinkage (β*year = -0.038, 95% CI = -0.064 to -0.013). Participants with higher NfL showed steeper TBTV decline, ventricular enlargement, hippocampal and amygdala shrinkage, and faster WMH accumulation. Results remained largely consistent after excluding participants with mild cognitive impairment at baseline. In cognitively unimpaired older adults, elevated blood p-tau217 was linked to faster shrinkage in AD-specific brain regions, whereas NfL and GFAP were associated with more widespread atrophy, with NfL also associated with accelerated WMH accumulation. These findings suggest that AD-related blood biomarkers may capture different dementia-related structural brain changes already at early stages. ANN NEUROL 2026.

Long-acting cabotegravir/rilpivirine (CARLA) is an effective treatment for HIV-1. However, concerns remain regarding potential pharmacodynamic interactions, particularly with intramuscular antibiotics used to treat sexually transmitted infections (STIs), which are common among people living with HIV (PLWH). The objective of this study was to assess whether concomitant intramuscular administration of CARLA and antibiotics affects antiretroviral control or impairs the syphilis serological response. A retrospective, monocentric cohort study was conducted. The first analysis compared PLWH receiving CARLA and intramuscular antibiotics (benzathine penicillin, ceftriaxone, or gentamicin) with those receiving only CARLA. HIV RNA levels were evaluated before and after injection. The second analysis evaluated the serological response to syphilis treatment in PLWH who received CARLA versus controls not treated with CARLA. Serological response was defined as a fourfold decrease in the rapid plasma reagin (RPR) titer. Statistical comparisons included non-parametric tests and Cox regression analysis. Among the 201 individuals included in the antiretroviral response analysis, no significant differences in HIV RNA suppression or blips were observed between the groups. Similarly, in 303 individuals assessed for syphilis response, the serological response rate and time to response were comparable. Adjusted Cox regression did not show an association between CARLA co-administration and delayed serological response (aHR 0.9, 95% CI 0.52-1.58, p=0.723). Concomitant intramuscular administration of CARLA and antibiotics does not appear to compromise HIV viral suppression or syphilis serological response. These findings support the co-administration of long-acting antiretrovirals and intramuscular antibiotics without compromising their effectiveness.

Secondary autoimmune and inflammatory diseases (SAIDs) are underrecognized and poorly described after allogeneic hematopoietic stem cell transplantation (allo-HSCT). The standardization of management is hindered by the scarcity of data on epidemiology, pathogenesis, and clinical outcomes. To improve the evidence base, we performed a retrospective multicenter EBMT database study of patients who underwent allo-HSCT between 2005 and 2019 for either hematological malignancy or severe aplastic anemia with available information on SAIDs. We included 129 cases of SAIDs and 14,617 controls. The 5-year incidence of SAIDs was 0.9% (95% confidence interval (CI): 0.7-1.1), and the 10-year incidence was 1.1% (95% CI: 0.9-1.3). The median time from allo-HSCT to the diagnosis of SAIDs was 442 days [interquartile range (IQR): 242-1082]. Overall survival after the onset of SAIDs was 83.4% (95% CI 74.6-89.3) at 2 years and 73.4% (95% CI: 62-82) at 5 years. In multivariate analysis, risk factors significantly associated with SAIDs were bone marrow failure (Hazard Ratio (HR): 3.41 [95% CI, 1.55-7.52], p = 0.002), female donor to male patient (HR 1.77 [95% CI, 1.15-2.73], p = 0.009), and the presence of chronic GvHD (HR 1.61 [95% CI, 1.04-2.51], p = 0.034). SAIDs after allo-HSCT are rare but clinically significant entities requiring further investigations, exploring treatment and prevention strategies, as well as improving diagnostic approaches.

Exertional dyspnoea is linked to inspiratory constraints to tidal volume expansion in chronic obstructive pulmonary disease (COPD). Dynamic assessment of these constraints via serial inspiratory capacity (IC) maneuvers across incremental cardiopulmonary exercise testing (CPET) might provide information regarding dyspnoea severity and exercise intolerance beyond the conventional peak IC-only approach. Pulmonary function tests and cycle ergometer CPET in 360 patients with COPD of varied severity. In addition to using peak-exercise cutoffs for critically high inspiratory constraints (CIC), a novel AI-based algorithm quantified dyspnoea and dynamic inspiratory constraints throughout progressively higher exercise intensities. Among the CIC variables, end-inspiratory lung volume (EILV)/total lung capacity (TLC) &#x2265; 0.9 correlated best with dyspnoea and exercise intolerance. CIC and dynamic constraints (&#x2264; 25th centile relative to sex- and age-adjusted norms) disagreed significantly: whereas &#x223c; a third of patients without CIC exhibited inspiratory constraints, &#x223c; a fifth of those with CIC did not (P < 0.05). Dynamic constraints, regardless of CIC, were significantly associated with abnormalities in submaximal mechanical-ventilatory responses, higher operating lung volumes, higher dyspnoea scores, and lower exercise tolerance. Of note, the prevalence of "high" dyspnoea-work rate and -ventilation (&#x2265; 75% centile) was more than fourfold higher in patients with dynamic constraints, regardless of CIC (P < 0.05). Clinicians interested in assessing the presence and severity of dyspnoea attributable to ventilatory responses to exercise should consider serial IC measurements in patients with COPD. Novel AI-based approaches to quantify these dynamic abnormalities are poised to increase the sensitivity of this analytical approach.

While functional mobility is known to deteriorate with age, the specific mechanisms driving this decline, along with potential differences between men and women, are not fully established. Therefore, the present study applied a moderated mediation framework to investigate whether lower limb strength and body mass index (BMI) mediate the relationship between aging and functional mobility, and to explore if sex acts as a moderator in these relationships. A cross-sectional design was used to evaluate 408 independent older adults (mean age: 71.9 &#xb1; 3.9 years; 273 females and 135 males). Assessments included the Timed Up and Go (TUG) for functional mobility, the 30 s Chair Stand for leg strength, alongside BMI calculations. Direct and indirect pathways were subsequently evaluated using a moderated mediation analysis. Lower limb strength and BMI significantly predicted functional mobility in both sexes (p < 0.05), with no significant moderation in the indirect pathways. Regarding conditional effects, advancing age predicted poorer functional mobility in females (p = 0.008) but not in males (p = 0.141), independent of the mediators. Strength and BMI appear to be correlates of functional mobility. However, since the age-by-sex interaction term was not statistically significant, the potential sex-specific direct effect of age must be interpreted with caution. While these findings hint at possible subtle differences in aging trajectories, future research is needed to confirm whether interventions for older women require addressing factors beyond strength and body composition.

Highly pathogenic avian influenza (HPAI) A(H5N1) viruses of clade 2.3.4.4b have recently spread across the Americas, prompting intensified surveillance efforts in Brazil aimed at early detection in wild birds. As part of these efforts, we identified a low pathogenic avian influenza A(H11N2) virus in a white-rumped sandpiper (Calidris fuscicollis) sampled at Lagoa do Peixe National Park (PNLP) in southern Brazil. Whole-genome sequencing revealed that seven of the eight gene segments shared high nucleotide similarity (approximately 98.8%) with viruses previously detected in shorebirds from Delaware Bay, North America. In contrast, the PB1 segment showed high nucleotide similarity (approximately 99%) to the PB1 lineage associated with clade 2.3.4.4b A(H5N1) genotype B3.2 viruses circulating in the Americas. Phylogenetic, nucleotide identity, and molecular clock analyses indicated that this lineage shares a recent common ancestor with North American LPAI viruses and was subsequently detected in distinct viral genetic backgrounds. Although no HPAI virus was identified in this study, the presence of a PB1 segment related to H5N1-associated lineages suggests that genetic components linked to these viruses were circulating among low pathogenic avian influenza viruses in South America. These findings highlight the importance of continued surveillance in migratory bird populations to improve understanding of avian influenza virus diversity and support epidemiological monitoring.

The topical application of ferulic acid (FA) is limited by its low solubility and high susceptibility to oxidation. To overcome these limitations, the multicomponent system Cicloferulic&#xae; (CF) was developed by mixing FA, hydroxypropyl &#x3b2;-cyclodextrin (HP&#x3b2;-CD), and polyvinylpyrrolidone K30 (PVP K30), which demonstrated greater safety and antioxidant efficacy than FA alone. The physicochemical characterization of FA, CF, and their components showed greater thermal stability and reduced crystallinity of CF, indicating the formation of the system. In cytotoxicity assays on HaCaT cells, FA maintained cell viability only up to 500 &#xb5;g/mL, while CF maintained viability even at 10.000 &#xb5;g/mL, demonstrating 20 times greater safety than FA. In cellular antioxidant activity assays, FA and CF showed similar effects at low concentrations. In the 1,1-diphenyl-2-picrylhydrazyl (DPPH) method, CF and FA reduced more than 70% of DPPH; however, CF contains only 12% FA, indicating an eightfold greater efficiency than FA. Formulations containing FA and CF increased the Sun Protection Factor (SPF) in vitro, even with a 50% reduction in UV filters. However, they did not stabilize formulations with intrinsically photolabile UV filters. In release studies, FA exhibited rapid flow, while CF promoted a modified release profile. Thus, CF stands out as an innovative, multifunctional system that can improve the stability, safety, and efficacy of FA for topical applications.

In modern sows, litter size often exceeds the number of functional teats. Therefore, many farms retain surplus piglets within the litter. The present study evaluated the effect of cross-fostering biological litters with up to two surplus piglets relative to functional teats, allowing piglet replacement until day three of lactation. Females were selected (n&#x2009;=&#x2009;201) at farrowing and evenly distributed among treatments: +0 (number of piglets equal to functional teats), +&#x2009;1 (one surplus piglet), and +&#x2009;2 (two surplus piglets). Biological litters were formed three to 12&#xa0;h after farrowing (day 0). Piglets that died or were removed (low viability) during the first three days of life were weighed and replaced. Piglets in the +&#x2009;2 group tended to have lower immunocrit values than those in the +&#x2009;0 group (P&#x2009;=&#x2009;0.06). Although the +&#x2009;2 group exhibited the highest overall piglet loss rate across lactation (P&#x2009;&#x2264;&#x2009;0.01), litter sizes in the +&#x2009;1 and +&#x2009;2 groups were larger than those in the +&#x2009;0 group (P&#x2009;<&#x2009;0.01). Piglets in the +&#x2009;2 group also had reduced average daily gain compared with piglets in the +&#x2009;0 and +&#x2009;1 groups (P&#x2009;<&#x2009;0.01). Facial and joint injuries were more frequent in the +&#x2009;1 and +&#x2009;2 groups on D5 (P&#x2009;<&#x2009;0.01). No differences among treatments were found in udder injury scores, number of functional teats, sow body condition at weaning, daily milk production, or subsequent reproductive performance (P&#x2009;&#x2265;&#x2009;0.10). Cross-fostering litters with up to two surplus piglets increased the number of piglets weaned without impairing sow performance, although individual piglet growth and early lesions were negatively affected.

Lumped-parameter cardiovascular models are computationally efficient and physiologically interpretable, but many still represent arterial compliance as linear and pressure-independent. Here, we introduce a nonlinear extension of a classical closed-loop Windkessel model by defining aortic compliance as an exponential function of aortic pressure. The heart, systemic circulation, and pulmonary circulation are represented as an RLC network with time-varying ventricular elastances, yielding a twelve-state formulation derived from Kirchhoff's laws. Under nominal conditions, the nonlinear model recovers the linear baseline, with near-superimposable pressure and flow waveforms and physiologically plausible steady-state indices. Away from the nominal operating point, the pressure-dependent law selectively modulates proximal pulsatility, while mean arterial pressure, stroke volume, and cardiac output remain comparatively preserved. Targeted parameter changes produce qualitative waveform and index-level signatures consistent with aortic regurgitation and arterial stiffening. The proposed formulation provides a compact, physiologically grounded platform for sensitivity analysis, pathological emulation, and early-stage evaluation of cardiovascular modeling scenarios.

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Abusive head trauma (AHT) is a major cause of infant morbidity and mortality but remains a challenging diagnose, as a clear history of trauma is often lacking and witnesses are usually limited to the perpetrator. Because several caregivers may attend to the same child, determining the timing of injury is crucial for identifying the offender. Among the approaches used to establish timing, the existence of a "lucid interval" between trauma and symptom onset remains controversial. To systematically reviewed the existing literature on the presence or absence of a lucid interval between AHT and symptom onset. Eligible studies included children evaluated for AHT in whom both the timing of trauma and the onset of symptoms were reported. MEDLINE, EMBASE and Google Scholar were systematically searched for articles published up to 2026. 16 studies were included: 5 case-reports or case-series, 10 retrospective studies and 1 systematic review published in 1995. Differences between studies mainly reflected how a lucid interval was defined. Studies reporting immediate symptoms defined the interval as the time to any symptoms, even nonspecific ones (e.g. vomiting, lethargy, irritability), whereas others often considered the delay to specific neurological signs such as seizures or loss of consciousness. Despite the low level of evidence of the included studies, this review suggests that symptoms occur immediately at the time of AHT, although early nonspecific signs may initially be overlooked. When combined with other methods, these findings may help experts determine the timing of AHT.

This study investigated the initial absorption dynamics and ultrastructural responses of soybean leaf tissue to foliar application of zinc-based (Zn2+) nanofertilizer, using brightfield light microscopy, electron scanning and transmission microscopy (SEM and TEM), and Raman spectroscopy. Anatomically, no relevant structural changes were detected in the roots or stems in any of the treatments. However, leaves treated with ionic Zn2+ (T1) exhibited thickening of the palisade parenchyma with Zn2+ accumulation in the adaxial epidermis. Samples treated with T2 and T3 revealed epidermal precipitates and intracellular deposits within leaf cells, as evidenced by brightfield optical microscopy and Raman spectroscopy. These aggregates were absorbed and subsequently dissolved, being no longer observed at the 30 min time point. Ultrastructural analysis confirmed the presence of nanofertilizers within the vacuoles and cytoplasm, suggesting absorption and translocation of Zn2+, reinforcing the ability of nano-enabled materials to overcome biological barriers. Our results indicate that zinc-based (Zn2+) nanofertilizers can alter cellular features without evident short-term phytotoxicity. Theoretically, this study provides mechanistic insights into nanoparticle dissolution dynamics, biological barrier penetration, and subcellular compartmentalization pathways in crop plants. From an applied perspective, the rapid absorption (<30 min) and preferential organelle targeting suggest potential for precision nutrient delivery systems, though long-term and efficacy evaluations are required before agricultural deployment can be recommended.