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Food as Medicine initiatives integrate healthy food resources, including medically tailored meals and produce prescriptions, into clinical care to manage and prevent chronic conditions. This field is evolving rapidly, as states shift toward sustainable reimbursement models through health plan benefits or Medicaid waivers. This article presents the proceedings and findings from a regional Food as Medicine convening in Los Angeles County. In 2025, The Los Angeles County Department of Public Health convened 74 multi-sector partners, including health plans, clinical providers, community-based organizations, farms, and local food hubs, to align Food as Medicine initiatives with the region's food system infrastructure. The resulting synthesis of event proceedings and attendee survey data provides a collective framework for scaling Food as Medicine interventions, serving as a potential playbook for advancing local and national policy integration. A local health department, university, managed care plan, and retail-based produce prescription program shared their promising models of Food as Medicine implementation. Case examples from California and those from other states showed how these entities leveraged Medicaid to build organizational capacity, drive local economies, and bolster their food system structure to procure and distribute affordable, healthy foods. During roundtable discussions, attendees agreed that a more centralized food handling system can help streamline and meet food system needs. Likewise, greater investment in data infrastructure can help track and demonstrate health and economic impacts associated with these initiatives. Post-event evaluations showed >90% of attendees were "very" or "extremely interested" in expanding Food as Medicine within their organizations. Two central priorities emerged-a need to further: (i) cultivate strategic partnerships that align with regional food system objectives, and (ii) integrate local and state regenerative and/or organic sourcing preferences into institutional procurement practices. Attendees recommended a centralized regional hub as a promising vehicle for accomplishing these goals.

Predicting a diagnosis of pre-eclampsia is based on a combination of clinical assessment of blood pressure, presence of protein in the urine, symptoms and laboratory test abnormalities. Accurately detecting pre-eclampsia is important to avoid false-positive diagnoses which could lead to unnecessary antenatal admissions and/or preterm delivery. Four blood tests that measure the biomarkers of placental growth factor or the ratio of soluble fms-like tyrosine kinase-1 to placental growth factor are available (known as Triage, Elecsys, DELFIA Xpress, and BRAHMS Kryptor tests). Abnormal measurements of these biomarkers can be used as an aid to predict a diagnosis of pre-eclampsia and maternal and fetal outcomes. To evaluate the test accuracy, clinical effectiveness and cost-effectiveness of placental growth factor -based tests used in conjunction with standard clinical assessment for predicting pre-eclampsia and maternal and fetal outcomes in pregnant women who are referred to secondary care with suspected pre-eclampsia in weeks 20-37 of pregnancy. A systematic review of the diagnostic/prognostic accuracy and clinical effectiveness of placental growth factor-based tests with standard clinical assessment. Database included MEDical Literature Analysis and Retrieval System, Excerpta Medica dataBASE and Cochrane Library. Other sources searched included relevant conference proceedings and websites, grey literature and research in progress. The most recent date of searching was 18 March 2021. An independent economic analysis was conducted using a decision tree model. The model includes short-term costs and quality-adjusted life-years for the management of women, maternal and neonatal outcomes and long-term outcomes for severe neonatal complications. The model compared the use of the test alongside standard clinical assessment to standard clinical assessment only. Two different estimates of standard clinical assessment were included, from the INSPIRE study and from National Institute of Health and Care Excellence Diagnostic Guidance 23. Seventeen studies were included in the systematic review. Two large, randomised trials provided the best available evidence to inform the economic model: The PARROT trial (Triage test) and the INSPIRE trial (Elecsys test). When used as rule-out tests for pre-eclampsia (with neonatal outcomes included), all four tests produced higher quality-adjusted life-years and higher costs than both types of standard clinical assessment. The incremental cost per quality-adjusted life-year ranged from &#xa3;637 (DELFIA test vs. standard clinical assessment from INSPIRE) to &#xa3;47,393 (Triage test vs. standard clinical assessment from diagnostics guidance 23) per quality-adjusted life-year. Incremental costs and quality-adjusted life-years were always very small, with incremental costs always less than the cost of the test and incremental quality-adjusted life-years always <&#x2005;0.006. Although the evidence for placental growth factor-based tests is advancing, there remains uncertainty for key parameters, such as diagnostic sensitivity and specificity. This particularly affects the Elecsys test. Despite uncertainties from lack of data, and heterogeneity across studies, the use of placental growth factor-based tests to rule out and rule in pre-eclampsia has the potential to provide improved outcomes at reduced cost when compared with standard clinical assessment. Future research priorities include more rigorous evaluation of the DELFIA and BRAHMS placental growth factor-based tests, more evidence for Triage and Elecsys as rule-in tests, and greater focus on Black, and Asian and Mixed ethnicity groups. This study is registered as PROSPERO CRD42020227085. This award was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme (NIHR award ref: NIHR132386) and is published in full in Health Technology Assessment; Vol. 30, No. 54. See the NIHR Funding and Awards website for further award information. Pre-eclampsia is a condition that affects some pregnant women and, if not detected or left untreated, can cause serious health complications for the mother and/or the baby. Four tests are now available (Triage, Elecsys, BRAHMS and DELFIA) that can detect abnormal levels of certain proteins in the blood indicating that a pregnant woman may have pre-eclampsia. We investigated the use of these tests in addition to the usual tests done by doctors to diagnose pre-eclampsia. Results of the tests determine whether someone with suspected pre-eclampsia should be admitted to hospital or can be safely monitored as outpatients. We carried out expert medical evidence searches to update our knowledge of the accuracy and cost of these tests and to find out if the tests can help doctors correctly recommend the best form of treatment for each woman. make the best decisions or impact on delivery-related outcomes for mother and baby. We developed an economic computer model that estimated costs of treatment and benefits to the mother and baby, to predict whether the tests would be good value for money for the NHS. Economic modelling shows that placental growth factor-based tests are cost-effective compared with standard clinical assessment when used to help diagnose (rule in) or exclude (rule out) preterm pre&#x2011;eclampsia. Cost-effectiveness reflects the amount of money the NHS is willing to pay for health gain. These tests would be useful to help plan safe care and a safe birth for women with pre-eclampsia, and also to identify those unlikely to develop pre-eclampsia, and therefore reduce unnecessary hospitalisation. The tests may work differently in people who are pregnant with more than one baby. There is uncertainty about how effective two of the tests are (the BRAHMS and DELFIA tests) due to lack of research, and on the usefulness and costs of testing women more than once if the previous test was negative but they still have symptoms of pre-eclampsia.

The 1910s were a complex and rapidly changing decade in mental hygiene, marked by institutional innovation, professional development, and the expanding reconceptualization of mental disease and maladjustment. This growth frequently generated friction between practical clinical sciences, particularly psychiatry and consulting clinical psychology. After years of mounting tension, the National Research Council convened a joint conference in 1921 on the "Relations of Psychiatry to Psychology," bringing together 12 representatives to debate and draft resolutions intended to harmonize collaboration. Despite being the first coordinated effort of its kind in the United States, the meeting has been largely overlooked by historians. Yet the conference, especially its unpublished 43-page stenographic transcript and related correspondence, offers a rare window into the conflicts of the 1920s, capturing the tone, immediacy, and strategic maneuvering that more polished publications sideline or obscure. Drawing on these proceedings alongside contemporary publications and archival materials, this article reconstructs the meeting, its background, and its immediate repercussions. I argue that the conference revolved around four intertwined points of contention: (a) the definition and scope of core concepts such as "disease," "diagnosis," and "medical"; (b) psychologists' freedom to conduct clinical research without psychiatric supervision; (c) the hierarchical relationship and division of labor between the professions; and (d) the organization, administration, and authority of psychological clinics. Ultimately, the 1921 meeting saw psychologists pressing for clearer definitions, research autonomy, and practical authority, whereas psychiatrists defended broad conceptual frameworks and professional precedence that confined psychologists to experimental work and narrowly defined psychometric consultation. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

This paper summarises the proceedings from two symposia (IUNS-ICN, 2025 and a FENS Task Force Northern Europe Networking webinar, 2025) convened to discuss the status of data sharing in nutritional science, with a focus on the challenges, opportunities, and solutions for achieving future best practice and available nutrition-related data and exemplar collaborations. Improved data sharing practices offer the potential to enhance research efficiency and impact. Despite this, data sharing is constrained by structural, cultural, and methodological barriers. Challenges include institutional/geographical data fragmentation, dataset heterogeneity, time- and resource-intensive requirements, GDPR/consent considerations, and publication-focused academic incentives over data stewardship. Opportunities include the exploration of new research questions, reduced data duplication, and more robust, conclusive, and equitable science. Transitioning toward effective data sharing practices will require coordinated action across academic institutions, the research community, funders, and publishers, including clear training, incentives, policies, and an overall cultural shift toward open science.

Medical malpractice occurring in primary health care settings may have significant consequences for patient safety, quality of care, and the legal liability of health care professionals. This study aimed to retrospectively examine malpractice cases alleged to have occurred in primary health care institutions in T&#xfc;rkiye and adjudicated by the Court of Cassation, in order to describe the types of errors, case outcomes, characteristics of the judicial process, and decision patterns. Using the official decision search system of the Presidency of the Court of Cassation of the Republic of T&#xfc;rkiye, 22 decisions meeting the inclusion and exclusion criteria were identified and included. Data were evaluated with respect to the type of action (civil compensation vs. criminal), the profession of the defendant, the alleged type of error, the outcome of the incident, the status of the expert report, and judicial decisions. Statistical analyses were performed using IBM SPSS Statistics for Windows, Version 22.0 (IBM SPSS Corp.; Armonk, NY, USA). Of the decisions reviewed, 54.5% concerned compensation claims and 45.5% were criminal proceedings. Nurses constituted the most frequently prosecuted professional group (40.9%), and the most common malpractice allegation was incorrect injection administration (31.8%). The vast majority of incidents occurred in health centers/family health centers. In primary health care, medical malpractice allegations primarily cluster around nursing practices and injection procedures. Strengthening training, supervision, record-keeping systems, and intra-team allocation of responsibilities will play a critical role in reducing malpractice in primary care. Cite this article as: Sanc&#x131; GT, Sanc&#x131; A, Vural T. Evaluation of medical malpractice in primary healthcare: A 20-year retrospective analysis of supreme court decisions. Eurasian J Med. 2026, 58(3), 1360, doi: 10.5152/eurasianjmed.2026.261360.

Tissue biopsy specimens, both remnant diagnostic specimens and those collected for ancillary study, are an invaluable resource for clinical oncology research. However, using biopsy specimens for molecular research is associated with innate challenges, such as insufficient tissue and/or tumor content, and low nucleic acid yields as well as analyte degradation due to suboptimal preanalytical workflows. The National Cancer Institute's Biorepositories and Biospecimen Research Branch convened a meeting that included expert-guided discussions that centered on strategies to mitigate these challenges and their effects on molecular analysis. Participants, who included medical oncologists, interventional radiologists, pathologists, and molecular biologists, offered best practice guidance on biopsy collection, preservation, storage, and extraction techniques. Their recommendations were largely based on the optimized workflows that were implemented at their respective institutions, which improved the likelihood of producing reproducible molecular data. Pre- and postcollection techniques, such as clear cross-team communication, prebiopsy scoring based on lesion- and patient-specific criteria, biopsy collection and handling practices, and tumor enrichment options, were also discussed. The proceedings revealed that increasing awareness of the challenges associated with research use of tissue biopsies is key to developing assay-specific strategies that ensure sufficient tumor specimens are available for molecular oncology research. The lessons shared here from large-scale and multicenter trials will, ideally, inform the design of new cancer research studies, thereby harnessing the full potential of valuable clinical biopsy specimens.

Congenital Disorder of Glycosylation type Ib (MPI-CDG) is a rare autosomal recessive metabolic disorder caused by deficiency of mannose-6-phosphate isomerase, resulting in impaired N-glycosylation. Unlike other CDG subtypes, MPI-CDG is not associated with neurodevelopmental impairment and is effectively treated with oral D-mannose supplementation. However, evidence guiding management during pregnancy is scarce, and D-mannose is generally avoided due to limited safety data. We describe the long-term course and pregnancy outcomes of a woman diagnosed with MPI-CDG in infancy. She was treated with oral D-mannose throughout childhood with good clinical response but demonstrated intermittent non-compliance in adulthood, complicated by hepatic fibrosis, protein-losing enteropathy, osteoporosis, anaemia, and musculoskeletal manifestations. She had two pregnancies without D-mannose supplementation. The first pregnancy was complicated by microcytic anaemia, hypoalbuminemia, pregnancy-induced cholestasis, and emergency caesarean section. A male infant was delivered and later diagnosed with Hirschsprung disease, requiring surgical correction with good outcome. Postpartum assessment of the mother demonstrated progression of liver disease to cirrhosis (F4). The second pregnancy proceeded with fewer complications and resulted in emergency caesarean delivery of a healthy female infant with normal postnatal glucose control and growth. This case contributes to the limited literature on pregnancy in MPI-CDG and illustrates that successful pregnancies are possible despite advanced multisystem disease and cessation of D-mannose therapy. It highlights the importance of multidisciplinary care, close hepatic and nutritional monitoring, and the need for further studies to clarify the safety and role of D-mannose supplementation during pregnancy.

Fibrous adhesions of the peroneal tendons can occur at the retromalleolar space and around the lateral malleolar tip with different peroneal pathology or after operations at this region, especially open surgery. This can cause tightness and pain at the posterolateral ankle. Surgery is indicated if symptoms persist after physiotherapy. Whenever possible, endoscopic adhesiolysis is preferable to open surgery because less extensive dissection and small surgical incisions allow immediate vigorous mobilization of the foot and ankle. Previous report of endoscopic adhesiolysis of peroneal tendons utilized proximal and distal coaxial portals. This is not suitable if the retromalleolar space is filled up with dense fibrous adhesions. The purpose of this technical note is to describe the details of endoscopic adhesiolysis of peroneal tendons via distal portals. Adhesiolysis can be started in the relatively spacious area distal to the superior peroneal retinaculum and proceeded proximally.

ConspectusThe quest for sustainable alternatives to precious transition metals has driven a paradigm shift toward main group redox catalysis. Among p-block elements, low-valent group 14 compounds (such as tetrylenes and tetryliumylidenes) are particularly attractive because their ambiphilic nature, featuring a lone pair of electrons and vacant p-orbital, closely mimics the electronic configuration of transition metals. Despite their well-established ability to activate inert bonds in stoichiometric reactions, translating this reactivity into genuine catalytic redox cycles has remained a formidable challenge. The primary obstacle lies in the often prohibitive reductive elimination from the high-valent state, which precludes catalyst turnover.Over the past three years, we have addressed this long-standing limitation by employing rigid, tridentate carbodiphosphorane (CDP) and acridine-based pincer ligands. These ligand frameworks not only stabilize low-valent Ge(II) and Sn(II) centers but also promote the crucial reductive elimination step, thereby enabling complete E(II)/E(IV) or E(II)/E(III)/E(IV) (E = Ge or Sn) catalytic cycles. In this Account, we summarize our systematic progress in unlocking the redox potential of germanium and tin. We first describe the synthesis and electronic properties of CDP-ligated Sn(II) and Ge(II) complexes, which exhibit strong nucleophilicity and versatile reactivity toward electrophiles. Building on this foundation, we demonstrate that these complexes serve as efficient redox catalysts for the catalytic activation of both C(sp2)-F and C(sp3)-F bonds. Notably, the Sn(II) platform enables selective defluorination of trifluoromethyl alkenes to either gem-difluoroalkenes or monofluoroalkenes by simply tuning the solvent, temperature and silane loading. Mechanistic studies into the elementary steps validate a Sn(II)/Sn(IV) redox cycle that closely mirrors classical transition metal catalysis, comprising C-F oxidative addition, F/H ligand metathesis and C-H reductive elimination.We further extended this catalytic platform to nitrous oxide (N2O) activation and the chemodivergent reduction of nitroarenes. With PhSiH3 as the reductant, nitroarenes can be selectively converted to either anilines or arylhydroxylamines simply by controlling the reaction temperature. In contrast, switching to the less reactive Et2SiH2 delivers azoxybenzenes or hydrazines, with selectivity again dictated by temperature. These results underline the exceptional tunability of our Sn(II)/Sn(IV) catalytic system. In parallel, a T-shaped stannyliumylidene ion stabilized by an acridine-based PNP pincer ligand exhibits pronounced ambiphilicity and serves as an efficient catalyst for the transfer hydrogenation of azoarenes and imines, operating through an FLP-type concerted mechanism. Finally, we disclosed a distinct mechanistic landscape for the germanium congener. Unlike the Sn(II) system, the Ge(II) catalyst promotes the transfer hydrogenation of azoarenes via a single-electron transfer pathway, involving a Ge(II)/Ge(III)/Ge(IV) redox cycle. The formation of azo radical anions and a germanium radical cation have been unequivocally confirmed by electron paramagnetic resonance spectroscopy and radical trapping experiments. Moreover, the Ge(II) catalyst is also effective in the transfer hydrogenation of imines and N-heteroarenes, proceeding through a Ge(II)/Ge(IV) redox cycle.Collectively, this work establishes divalent group 14 compounds as a new class of main group redox catalysts, offering sustainable and conceptually novel alternatives to transition metals. The mechanistic diversity, which spans two-electron and single-electron transfer pathways, highlights how rational ligand design and element selection can unlock diverse chemical transformations.

Art is integrated into the Mayo Clinic environment. Since the original Mayo Clinic Building was finished in 1914, many pieces have been donated or commissioned for patients and staff to enjoy. Each issue of Mayo Clinic Proceedings features a work of art (as interpreted by the author) that is displayed in a building or on the grounds of Mayo Clinic campuses.

Artificial intelligence (AI)-based decision support systems are increasingly explored in surgical oncology. However, their concordance with multidisciplinary tumor board (MTB) decisions, particularly in complex gastrointestinal malignancies, remains insufficiently characterized. This retrospective observational study included 47 patients who underwent oncological surgery and were discussed at a multidisciplinary tumor board during an eighteen-month period. For each patient, concordance between MTB-established treatment decisions and subsequent AI-generated recommendations (ChatGPT-based) was assessed. Concordance was categorized as discordant (0), partially concordant (1), or fully concordant (2). Discordant cases were further analyzed across predefined domains, including staging discrepancies, resectability assessment, interpretation of metastatic disease burden, and treatment sequencing. Full concordance was observed in 18 cases (38.3%), partial concordance in 22 cases (46.8%), and discordance in 7 cases (14.9%). Overall, 85.1% of cases demonstrated at least partial concordance. Discordance was more frequent among male patients (5 of 19; 26.3%) compared with female patients (2 of 28; 7.1%). Qualitative analysis revealed that discordance most commonly arose from differences in resectability assessment and staging interpretation. AI recommendations tended to favor broader surgical candidacy, whereas MTB decisions more frequently excluded surgery based on nuanced clinical and contextual factors. AI-generated recommendations show substantial overlap with MTB decisions in most cases but diverge at critical surgical decision points, particularly regarding resectability and staging. These findings suggest that AI may serve as a complementary decision-support tool rather than a substitute for multidisciplinary clinical judgment for oncological surgery care.

Lifestyle has a considerable impact on the prevalence and prognosis of noncommunicable diseases, which continue to be the leading causes of morbidity and mortality in the country and around the world. Cardiovascular disease, cancer, chronic lung disease, and diabetes are universally recognized as being significantly related to modifiable behaviors such as tobacco smoking, physical inactivity, and poor diet. Alzheimer's disease, multiple sclerosis, depression, and anxiety disorders have also been linked to lifestyle factors. Interventions to encourage healthy lifestyles and discourage hazardous behaviors among individuals aim to lower the burden of noncommunicable illnesses, improve survival, and improve individuals' and communities' overall quality of life. This Philippine clinical practice guideline (CPG) was developed to provide recommendations on nonpharmacologic approaches to promote healthy lifestyles among adults and adolescents. The Periodic Health Examination 2 (PHEX2) Lifestyle Advice Task Force proceeded through the preparation and prioritization, CPG generation, CPG appraisal, and implementation based on the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach to CPG development recommended by the Department of Health (DOH). Nonpharmacological interventions of interest for this guide-line were clinical interventions that pertain to strategies done or recommended by individual providers to patients, likely in a clinic setting. Evidence review experts systematically reviewed existing clinical practice guidelines, appraised, and summarized the evidence. For questions on specific advice on healthy diet and physical activity, the ADAPTE methodology was applied after appraising existing CPGs with the AGREE II instrument. A multisectoral panel formulated recommendations through a formal consensus based on the evidence summaries. The CPG was externally reviewed prior to publication. In addition to general questions on financial and intellectual conflicts of interest (COI), typically associated with the pharmaceutical industry, specific questions related to lifestyle, such as involvement with weight loss clinics or programs, wellness centers, tobacco, and e-cigarettes, were included. Nineteen (19) recommendations were made by the consensus panel, including adopting the WHO guidelines on physical activity and diet. During the consensus panel meetings, the impact of lifestyle-focused interventions on disease prevention was primarily considered, as well as the effect of these interventions on the prognosis of established diseases. The Philippine Guidelines on PHEX Phase 2 Lifestyle Advice CPG is a systematic synthesis of evidence to address lifestyle or nonpharmacologic interventions in preventing diseases and promoting better health. More evidence on the effectiveness and safety outcomes of lifestyle-related interventions, direct evidence for the prevention of internet addiction and internet gaming disorder, longer follow-ups for effects of electronic nicotine delivery systems (ENDS), and studies on cost-effectiveness, patients' preferences, and health equity impact assessments are needed to make more robust recommendations on a healthy lifestyle.

Prenatal alcohol exposure is a major cause of neurodevelopmental and growth impairments collectively termed fetal alcohol spectrum disorders (FASD). However, the mechanisms by which ethanol disrupts early embryonic development remain incompletely understood; for example, the potential link between ethanol treatment and biomechanical properties of tissues that lead to defects in development is not understood. To address this gap in knowledge, we used zebrafish (Danio rerio), a powerful vertebrate model with optical transparency and rapid development, to investigate ethanol-induced alterations during embryogenesis. Embryos were exposed to varying concentrations of ethanol and assessed using a multimodal imaging approach integrating light sheet fluorescence microscopy, optical coherence tomography, and optical coherence elastography. This platform enabled high-resolution, noninvasive, and parallel visualization of structural, molecular, and biomechanical changes. We found that ethanol exposure disrupts Wnt ligand expression in the nervous system, which correlates with a cascade of morphological abnormalities consistently detected across imaging modalities and consistent with alterations to Wnt / &#x3b2; -catenin signaling activity. These findings highlight the critical role of Wnt / &#x3b2; -catenin signaling in alcohol-induced teratogenesis and underscore the value of zebrafish models and multimodal imaging for advancing our understanding of FASD pathogenesis.

While thermal acclimation refers to the acquisition of thermal tolerance following sublethal pre-exposure under laboratory conditions, acclimatization describes the same plastic process occurring in the field, in response to both thermal and non-thermal cues. This distinction has led to concerns that laboratory experiments may not fully portray the costs and benefits of field acclimatization, particularly regarding overwintering capacity. We studied adult and developmental lab acclimation in Drosophila suzukii, at both constant and fluctuating regimes, as well as field acclimatization at various times of the year. We assessed cold tolerance and metabolomic profiles using targeted and untargeted tools. All acclimatory treatments promoted cold tolerance. Developmental acclimation and acclimatization produced comparable cold tolerance, exceeding that of adult acclimation. In acclimatized flies, cold tolerance rose progressively from September to December. Metabolomic profiles revealed shared cryoprotective compound accumulation, but also treatment-specific differences across acclimation and acclimatization treatments. Although constant laboratory acclimation is often assumed to fail to capture the intricacies of environmental variability and the associated phenotypic changes, our findings show that even this simple approach can serve as a robust predictor of D. suzukii's thermal tolerance mediated by natural acclimatization, thereby validating a broad body of laboratory research conducted on Drosophila and other insects.

The IUCN Red List of Threatened Species, the most widely used global system for assessing species' extinction risk, has become a foundational source of information for conservation management, policy and research. Since the adoption of quantitative extinction risk criteria more than three decades ago, the Red List has expanded substantially in scope and influence, informing decisions ranging from species conservation and protected area designation to international agreements, corporate risk assessments and global biodiversity indicators. Given its central role, maintaining scientific rigour, transparency and trust in the Red List system is essential. Feedback from users, emerging from evolving applications and scientific advances, has shaped the Red List throughout. At the same time, the Red List has been subject to recurring critiques, some of which stem from persistent misconceptions about its purpose, design and appropriate use. To address these, we review the history and development of the Red List system, clarify the strengths of its design, delineate the contexts for which the system was and was not intended, and elucidate the circumstances under which it may be modified. Finally, we outline pathways for researchers and users to contribute to ongoing improvements and discuss potential future directions for evolution of the Red List.

Breast reconstruction (BR) following mastectomy is one component of comprehensive breast cancer care; however, its educational emphasis, accessibility, and cultural context vary across health systems, particularly in middle-income countries. Understanding how future physicians perceive BR within the local epidemiologic and health-system landscape is necessary to guide proportionate and culturally responsive medical education. This study assessed knowledge, awareness, perceptions, and attitudes toward BR among Jordanian medical students, with the aim of identifying educational gaps and barriers to practice. A national cross-sectional study was conducted among clinical-year medical students (years 4-6) from six Jordanian universities using a validated, self-administered questionnaire. A validated, self-administered questionnaire was distributed electronically via institutional mailing lists and verified student communication platforms. The survey was developed following expert review and piloting for clarity and cultural appropriateness. Data were analyzed descriptively to evaluate students' educational exposure, knowledge, confidence, and perceptions regarding BR. Of 391 respondents, 69.6% were female and all universities were represented. While 79% reported prior teaching on breast cancer, only 21% attended lectures specifically on BR, and 20.2% observed a procedure. Most rated their knowledge as basic (58.8%), with only 1.3% reporting advanced knowledge. Confidence in counseling patients was limited, with 7.2% feeling very confident. Awareness of key aspects varied: 42.2% recognized both immediate and delayed reconstruction, 55% knew both implant and autologous options, and 57.3% were unsure about insurance coverage. Reported barriers included financial cost (85.2%), lack of awareness (68.3%), and cultural or religious sensitivity (>&#x2009;60%). Despite this, 88.7% agreed BR improves quality of life, and 75.7% supported greater curricular emphasis, with 68.3% seeking additional training. Jordanian medical students demonstrate supportive attitudes toward BR but significant educational and systemic gaps remain. Strengthening BR education and addressing cultural and financial barriers are essential to empower future physicians in promoting patient-centered cancer care.