Assessing departmental scholarly output remains challenging, as traditional bibliometric metrics incompletely capture academic productivity at the department level and are often poorly suited for year-on-year evaluation. The Departmental Scholarly Index (DSI) provides a framework for evaluating aggregate and publication-adjusted departmental academic output over short-term intervals. This study examined year-on-year changes in DSI within an academic plastic surgery department between academic years (AY) 2024 and 2025. Peer-reviewed publications produced by the Department of Plastic Surgery at a tertiary academic center during AY 2024 and 2025 were retrieved from PubMed. Aggregate DSI was calculated as the sum of journal impact factors across departmental publications following outlier handling, with publication-adjusted DSI defined as aggregate DSI divided by total publications. Year-on-year changes were quantified using absolute and relative percentage differences. A total of 57 in AY 2024 and 138 peer-reviewed articles in AY 2025 were included. Aggregate DSI increased from 142.9 to 298.2, representing a 109% year-on-year increase, with increases in basic science research (19.3 to 45.0), clinical research (83.6 to 162.6), and reviews or commentaries (40.0 to 90.6). In contrast, overall publication-adjusted DSI decreased from 2.51 in AY 2024 to 2.16 in AY 2025, with declines observed in basic science research (6.43 to 2.50) and reviews or commentaries (3.08 to 2.27), while clinical research remained relatively stable (2.04 to 2.03). Utilization of the DSI revealed exponential year-on-year growth in overall departmental academic output. The DSI framework offers a practical approach for longitudinal assessment and benchmarking of departmental academic productivity.
This study assessed the societal economic burden in terms of cost of illness and health-related quality of life (HRQoL) of posttraumatic long bone non-unions in the Netherlands. An incidence-based bottom-up approach was used, focusing on adult patients with posttraumatic long bone non-unions. The analysis included healthcare costs, patient and family costs, and productivity losses, measured using the iMCQ and iPCQ questionnaires. Cost evaluations followed Dutch costing guidelines, and productivity losses were calculated using the friction cost method. HRQoL was assessed with the EQ-5D-5L. A deterministic one-way sensitivity analysis varied baseline characteristics by ± 10%. Scenario analyses were conducted from healthcare and patient perspectives, as well as for patient subgroups. Average costs per patient during the three months before the initial visit at a non-union clinic were €8,928 (healthcare, N = 78), €1,360 (patient and family, N = 58), and €4,313 (productivity losses, N = 59), the average of the observed data calculates to 10,831 (N = 44). The mean EQ-5D-5L utility score was 0.390 (± 0.29 SD). Subgroup analysis showed no significant cost increase for patients with infections or open fractures. However, a higher Non-Union Severity Score and a lower HRQoL were significantly associated with higher total costs. Posttraumatic long bone non-unions pose a substantial economic burden on Dutch society and have a tremendous impact on HRQoL. Severe non-unions and a lower quality of life were associated with increased costs, whereas initial fracture characteristics were not. These findings highlight the importance of effective preventive and therapeutic strategies to reduce the burden of posttraumatic long bone non-unions.
More than 50% of physicians currently work for hospital systems compared with 20% in 2010, a shift driven in large part by hospital acquisitions of physician practices. These acquisitions have been linked to higher prices for physician and hospital services, and the evidence regarding their impact on quality of care has been mixed; however, there is little research regarding the perspectives of key stakeholders regarding such acquisitions. To provide systematic evidence on the motivation for and impact of physician practice acquisitions from hospital system leaders and physicians who are directly involved in these transactions. A qualitative research design was used for the study. Data collection occurred between December 2024 and April 2025. A purposive sample of 3 hospital systems that each had experience with physician practice acquisitions was included. Interviews were conducted with hospital system leaders and employed physicians who had been members of an acquired practice. Semistructured interview guides were used covering motivations for acquisitions, implications for patient care, and operational challenges. Coded data were analyzed to identify major themes. A total of 37 interviews were conducted of 18 hospital system leaders and 19 employed physicians (26 male and 11 female). Both hospital leaders and physicians reported that practice acquisitions were most often initiated by physicians because of concerns about the financial viability of their practices. Hospital leaders and physicians also perceived that practice acquisitions improved care for patients, for example by uniting clinicians through a common electronic health record or colocating primary care and behavioral health services. Operationally, hospital leaders expressed frustration with employed physicians' productivity, whereas employed physicians complained of being sidelined in decisions about practice support and work schedules. In this qualitative study of hospital acquisitions of physician practices, acquisitions were largely initiated by physicians seeking to leave independent practice. The acquisitions created opportunities to improve patient care, but efforts to integrate physicians after acquisition were impeded by ongoing tensions over physician productivity and autonomy. Physician practice acquisitions hold promise for improving patient care if various operational challenges on integrating acquired practices can be resolved.
Osteoarthritis (OA) in working-age individuals (aged 30-64 years) adversely affects health and reduces productivity. In this study, the disease burden and economic impact of OA on this demographic are examined, and the trends from 1990 to 2021 are analyzed. Using data from the 2021 Global Burden of Disease Study, incident cases, prevalent cases, years lived with disability (YLDs), and the corresponding age-standardized rates of OA in the working-age population from 1990 to 2021 were examined. To evaluate the changes in trends, the average annual percentage change (AAPC) of these age-standardized rates was calculated. Subgroup analyses based on sex, age, sociodemographic index (SDI) level, and joint site were conducted. The economic burden was assessed by integrating data from the World Health Organization (WHO), the World Bank, and the International Labour Organization (ILO). By 2021, 329 million working-age individuals had OA, a 123% increase over 1990. Age-standardized rates of incidence, prevalence, and YLDs increased globally by 116%, 123%, and 125%, respectively, with the most rapid growth occurring in low-middle-SDI regions. The total economic burden in 2021 was $350 billion, with $165 billion in direct medical costs and $185 billion in productivity losses, representing 0.32% of the global GDP. High-SDI regions bore a greater economic burden, representing approximately 50% of the total. The increasing prevalence of OA and its significant economic impact on the working-age population highlight the need for targeted policies and preventive strategies. The growing burden, especially in low-middle-SDI countries, underscores the importance of sustainable health development.
Coccolithophores are unicellular marine microalgae capable of producing calcium carbonate exoskeletons composed of micrometric scales called coccoliths. Since they require CO₂ for both calcification and biomass production, they are expected to exhibit a potentially higher CO₂ fixation, making them promising candidates for applications in biological carbon capture systems. In addition, coccoliths themselves are considered high-value products due to their potential applications in many fields such as nanobiotechnology. In this study, a high cell density culture of Chrysotila sp. was tested using the CellDEG® technology, with the objective of maximizing both biomass and coccolith production as a function of light intensity, nitrogen and carbon supply, thanks to a design of experiments (DoE) approach. The optimal conditions identified for biomass production were 600 mg L⁻1 of nitrogen and a light intensity of 375 µmol m⁻2 s⁻1, which allowed the system to reach a final biomass productivity of 0.96 g L⁻1 d⁻1. However, coccolith production was found to be very limited under these conditions. Additional experiments assessed the effect of calcium addition and light regime, which did not remarkably affect the PIC:POC ratio. On the other hand, when Chrysotila sp. was cultivated in a semicontinuous system with controlled pH (to maintain the carbonate structure of the coccosphere) with a light bubbling as mixing, a remarkable particulate inorganic carbon versus particulate organic carbon ratio (PIC:POC) of 0.3 was obtained. Semicontinuous feeding was selected for its ability to maintain relatively stable concentrations of nutrients and cells over time. Therefore, semicontinuous cultivation under these conditions is recommended for coccolith production, whereas the CellDEG® system is more suitable for biomass generation. This study allowed us to obtain data on the growth of Chrysotila sp. using semicontinuous and high cell density culture systems, which is innovative given the limited information available in literature regarding the cultivation of this species. KEY POINTS: CellDEG® technology allows high biomass production, but low PIC:POCChanges in calcium concentration or photoperiod cannot increase CellDEG®'s PIC:POCSemicontinuous cultivation yields high PIC:POC but reduces biomass levels.
Gels show potential in soil conditioners to restore soil structure and quality for high crop yield. Herein, we propose a synchronous chemical loading system using oil in deep eutectic solvent (O/DES) high internal phase emulsion as template. By removing the internal phase, the interconnected porous network with high surface area (37.5 m2 g-1) is achieved. Benefiting from the porous structure and hygroscopic skeleton, the eutectogel demonstrates attracting hygroscopicity, super absorbency and water-retention behavior, along with reusability even after five cycles. In this strategy, urea, known as a kind of fertilizer, is constructed into the eutectogel network through hydrogen bonds for urea-releasing. Meanwhile, the eutectogel shows additional adhesion and mechanical properties. Compared with blank soil, the eutectogel-soil shows improved moisture harvesting and water holding capabilities. As a benefit of this water-fertilizer integrated system, Brassica rapa demonstrates enhanced germination rate and growth indicators compared with blank soil group in 40-day plant growth experiment. All of the results demonstrate that the eutectogel, as multifunctional eco-product, ensures to address both water and fertilizer retention issues, with high potential of application for sustainable modern agriculture.
The Haber-Bosch process remains the dominant method for ammonia (NH3) synthesis, but it is highly energy-intensive and environmentally burdensome. Nitrate reduction to ammonia (NRA) presents a promising dual-function alternative, enabling both sustainable NH3 production and environmental remediation. However, current NRA methods, primarily photocatalytic and electrocatalytic, depend heavily on external energy inputs (light or electricity), limiting their deployment in off-grid or distributed settings. Here, we report a mechanoluminescence (ML)-enhanced mechanocatalysis strategy for mechanically driven NRA using Mn-doped CaZnOS (Mn-CaZnOS) as an efficient mechano-catalyst. Under mechanical stimulation, Mn-CaZnOS generates a synergistic cascade of piezoelectric and photoexcitation effects that facilitate the NRA process. This ML-enhanced system achieves a notable NH3 yield rate of 5.4 μmol g-1 h-1 with exceptional stability over 100 h. Mechanistic investigations, including isotope labeling, kinetic isotope effect, and electron spin resonance, confirm the reaction pathway and identify hydrogenation as the rate-limiting step. Kelvin probe force microscopy and density functional theory calculations reveal that mechanical stimuli induce piezopotential, enriching local NO3- concentration and enhancing proton-coupled charge transfer. Additionally, the electronic structure of the active sites is modulated to enhance intermediate adsorption and reduce the energy barrier for NH3 formation. This work establishes ML-assisted mechanocatalysis as a mechanically driven platform for sustainable ammonia synthesis and environmental cleanup.
We report two distinct and complementary synthetic strategies-electrochemical and mechanochemical-for the preparation of diversely functionalized chalcogenated 4-hydroxycoumarins/4-hydroxy-N-methylquinolin-2-one. Each method provides a practical and straightforward route to biologically relevant sulfide- and selenide-functionalized oxygen- and nitrogen-containing heterocycles. The developed protocols offer multiple advantages, including mild and energy-efficient reaction conditions, the elimination of transition-metal catalysts, the use of external heating and additional oxidants, short reaction times, high to excellent yields, a broad substrate scope, gram-scale applicability, operational simplicity, and environmentally friendly execution. Additionally, the synthetic application of the synthesized compounds has been extended.
The electrochemical reduction of CO2 to CH4 in neutral electrolytes represents a compelling route toward carbon-neutral energy systems. Nonetheless, realizing a high Faradaic efficiency (FE) at industrially relevant current densities remains a formidable challenge, primarily due to the intrinsically slow kinetics of the multistep proton-coupled electron transfer (PCET) processes from CO2 to CH4. In this study, we propose an alternative active hydrogen (•H) transfer (AHT) process that significantly facilitates both CO2 activation and subsequent intermediate hydrogenation, thereby markedly enhancing the kinetics of CO2-to-CH4 conversion by designing a multivalent copper-based catalyst comprising Cu(0) nanoparticles and Cu(I) single atoms on an Al-MgO support. This novel catalyst achieved a CH4 Faradaic efficiency of ∼93.5% at a high current density of 350 mA cm-2 in a flow cell, substantially outperforming its monovalent counterpart (Cu(0)/Al-MgO, FE 55.4% at 300 mA cm-2) governed by a PCET-mediated pathway. Experimental studies and theoretical calculations demonstrate that the Cu(I) sites significantly lower the energy barrier for H2O dissociation, generating •H species that subsequently migrate to adjacent Cu(0) sites. These •H species effectively promote the hydrogenation of *CO to *CHO on Cu(0) sites, a key step in CH4 formation. Our findings highlight the critical role of tailoring hydrogenation pathways from traditional PCET to AHT mechanisms for advancing the efficiency and selectivity of electrocatalytic CO2-to-CH4 conversion.
This review article provides a comprehensive overview of lean authoring in the pharmaceutical industry based on the experience of medical writing leaders, emphasizing its importance for efficiently creating clinical study reports (CSRs) and other clinical documents. Lean authoring is defined as an approach focused on delivering unambiguous, clear, concise, and objective content that meets regulatory reviewer expectations. This will better ensure accessibility, eliminating unnecessary details, and tailoring content to meet the following needs of regulatory reviewers during what is essentially a non-linear review process: a) fast navigation to decision-critical information, b) a clear, logical trail from study design to analyses to results, c) low cognitive burden, and d) fewer review questions resulting from ambiguous language and inconsistency. The benefits of lean authoring include improved readability and reusability of content, enhanced efficiency and cost-effectiveness in document preparation, and more efficient regulatory reviews. These benefits have been observed across many industries. And yet, challenges in implementing lean authoring methods, including resistance to change, are common. To help companies counter resistance to change, this article outlines the benefits of lean authoring and a step-by-step approach to adopting lean authoring methods, understanding regulatory reviewers' needs, and developing a robust change management plan. Healthcare agency regulatory reviewers have stated their preference for clear and concise information. Our goal is to influence the pharmaceutical industry to adopt lean authoring to achieve this. By optimizing the authoring process, we aim to increase the efficiency of the process, improve the quality of CSRs, and reduce the burden of regulatory reviews.
This study aimed to evaluate the biofunctional and selective anticancer potential of cell-free supernatants obtained from Lactiplantibacillus plantarum S61 fermented on two carbon sources: glucose (Glu) and xylooligosaccharides (XOS). High-performance liquid chromatography (HPLC) analysis revealed significant production of vitamin B2 (8.66 ± 0.11 and 8.05 ± 0.06 mg/L for Glc and XOS, respectively) and vitamin B12-like compounds (0.47 ± 0.03 and 0.24 ± 0.03 mg/L, respectively). The anti-inflammatory activity was assessed by inhibition of bovine serum albumin (BSA) denaturation, where XOS-fermented supernatants exhibited the strongest effect (88.7 ± 0.1% at 400 µg/mL), comparable to diclofenac (91.44 ± 0.1%), while Glc reached 71.1 ± 0.4%. The anticancer activity was evaluated in vitro using the MTT assay on two breast cancer cell lines (MCF-7 and MDA-MB-231) and normal peripheral blood mononuclear cells (PBMCs). Both fermented supernatants showed a dose-dependent cytotoxic effect against cancer cells while exhibiting markedly lower toxicity toward PBMCs, indicating a selective anticancer activity. XOS-fermented supernatants displayed lower IC₅₀ values against MCF-7 (198.55 ± 14.94 µg/mL) and MDA-MB-231 (200.80 ± 13.61 µg/mL) compared to PBMCs (862.16 ± 169.11 µg/mL), resulting in favorable selectivity index values. Overall, these findings highlight the potential of L. plantarum S61 postbiotic metabolites, particularly those derived from XOS fermentation, as safe and selective natural agents with anti-inflammatory and anticancer properties.
The aggressive and diverse subtype of breast cancer known as triple-negative breast cancer (TNBC) has poor clinical outcomes and few specific therapeutic choices. Tumor-infiltrating lymphocytes (TILs), T-cell receptor-engineered T cells, and chimeric antigen receptor T (CAR-T) cells are examples of adoptive cell therapy (ACT), which has become a promising immunotherapeutic approach. Its clinical application in TNBC is still difficult, nevertheless. This study used bibliometric techniques to thoroughly assess growing hotspots, intellectual structure, and worldwide research trends pertaining to ACT in TNBC. The Scopus database was searched for publications related to ACT in TNBC from 2011 to 2025. There were only original articles and reviews written in English. VOSviewer (version 1.6.20) and Microsoft Excel 2021 were used to analyse bibliometric indicators, such as annual publication output, country and institutional contributions, authorship patterns, citation characteristics, and keyword co-occurrence. To investigate thematic evolution and collaboration patterns, network visualisation and clustering analysis were carried out. With a compound annual growth rate of more than 60%, a total of 8,496 publications were found, indicating an exponential rise in research output, especially beyond 2020. Together, China and the US accounted for over 60% of all publications, dominating the world's research output. The core research network was made up of a few institutions and very productive writers. CAR-T cell therapy, tumor microenvironment manipulation, immunological checkpoint inhibition, metabolic reprogramming, and biomarker-driven methods were among the clinically orientated themes that emerged from foundational and preclinical investigations, according to keyword analysis. The literature shows ongoing translational difficulties with regard to tumor heterogeneity, antigen instability, immunosuppressive microenvironments, and safety concerns in solid tumors, despite increased research activity. Over the past ten years, research on ACT in TNBC has grown significantly, reflecting both unmet clinical need and growing scientific interest. However, continuous efforts to overcome biological and translational constraints are highlighted by the concentration of scientific leadership and the conceptual move towards combination methods and next-generation engineering approaches. This bibliometric analysis offers a thorough picture of the state of the field and could direct future research, teamwork, and the creation of more potent ACT tactics for TNBC.
Understanding the impact of shell structure on the photothermal conversion properties remains a key challenge. Herein, we report the synthesis and characterization of Ag42(SPhF5)24(P(Ph-m-OMe)3)8 (denoted as Ag42) NC, featuring a hollow Ag12 core and an integrated Ag30S24P8 outer shell. Ag42 exhibits remarkable photothermal performance, achieving a temperature rise of 22.4 °C and a photothermal conversion efficiency (PCE) of 75.27% under 450 nm light irradiation in CHCl3 (150 mg/L), significantly outperforming the classical [Ag44(SPhF2)30]4- (denoted as Ag44) with ΔT = 4.5 °C and PCE = 35.27%, while also maintaining higher stability under prolonged irradiation. This enhanced performance is associated with the shell modulation of Ag42 and its photophysical/structural consequences, including a high molar absorption coefficient (ε = 1.36 × 105 L·mol-1·cm-1), favorable metal-to-ligand charge transfer with metal-centered contribution, nearly negligible PLQY (∼0%), and enhanced shell rigidity. These findings provide new insights for designing more efficient photothermal materials.
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Writing is an essential yet often overlooked component of vision rehabilitation for adults with acquired vision loss, receiving less focus than activities such as reading. This study explores the specific challenges older adults encounter when engaging in writing tasks, the types of writing they wish to perform and the factors they associate with successful performance. It also examines the psychological and functional impacts of writing difficulties and evaluates the usability of current assistive tools designed to support writing. A qualitative design was employed using semi-structured interviews with 10 participants aged 67-93 years recruited through vision impairment support groups. Interview data were analysed using content analysis to identify key themes and subthemes related to participants' needs, challenges and adaptive strategies. Analysis identified five themes with 20 subthemes. Participants engaged in diverse writing tasks across daily, personal and occupational contexts, with emails, shopping lists and signatures being reported most frequently. Performance was limited by difficulties with initiation, multisensory coordination, visual focus and physical effort, but mitigated by task familiarity. Success was judged against personal benchmarks of spatial accuracy, legibility, efficiency and error correction, although these were often compromised. Adaptations included changes in modality, use of assistive technologies and reduction in frequency or volume of written output. Impact extended beyond function, contributing to frustration, embarrassment, reduced independence and social isolation. Participants emphasised the distinction between "spot" writing tasks, often retained for procedural familiarity and "fluent" tasks, requiring sustained effort. Success, from the patient perspective, was defined not by completion but by legibility, spatial accuracy, efficiency and self-correction, while preserving independence and identity. These findings highlight that outcome measures must reflect the lived experience of adults with acquired vision loss, capturing the functional, emotional and psychosocial dimensions of writing that matter most to people living with sight loss.
Erythropoietin-producing hepatocellular receptor A2 (EphA2) is overexpressed in various malignancies, including pancreatic ductal adenocarcinoma (PDAC), in which it correlates with poor prognosis. Although EphA2 is considered a promising target receptor for theranostic applications, suitable radiotracers for clinical imaging have been lacking. This study reports first clinical experiences with [68Ga]Ga-BCY18469, a bicyclic peptide radiotracer for EphA2-targeted PET imaging. Seven patients with histologically confirmed PDAC (5 after chemotherapy, 2 at initial staging) underwent PET/CT imaging. Four were scanned at 15, 30, 45, 60 and 180 min. and three at 45 min. after injection of [68Ga]Ga-BCY18469. Dosimetry calculations were performed based on organ-specific time-activity curves from whole-body PET acquisitions. Imaging findings were compared with contrast-enhanced CT or MRI (interval: 9-50 days). No adverse events were observed. The kidneys received the highest absorbed dose (0.31 ± 0.02 mGy/MBq), while the effective dose was 0.017 ± 0.002 mSv/MBq. [68Ga]Ga-BCY18469 demonstrated rapid tumor uptake at 15 min. post-injection with predominantly renal excretion. Of 45 total lesions EphA2-PET detected 36 lesions with tracer uptake suspicious for metastasis. 11 of 45 lesions were detected only on EphA2-PET, whereas 9 of 45 lesions were detected only on CT and/or MRI. The tracer identified 13 liver metastases (SUVmax 6.9 ± 3.4) and 13 lymph node metastases (SUVmax 5.0 ± 1.1), among other findings. Our initial clinical experiences demonstrate that [68Ga]Ga-BCY18469 enables safe, rapid, and high-contrast visualization of EphA2-expressing PDAC lesions. These results strongly support further investigation of [68Ga]Ga-BCY18469 as a diagnostic tool for EphA2-positive malignancies.
The synthesis of branched carbohydrate β-amino esters is described using the Wolff rearrangement of a diazoketone derived from the pyrolysis product (-)-levoglucosenone (LGO). An azide-alkene cycloaddition on LGO catalyzed by methanesulfonic acid directly afforded β-amino diazoketones via the triazoline. A subsequent visible-light-mediated Wolff rearrangement resulted in ring-contraction, giving a series of branched deoxyamino sugars with excellent diastereoselectivity (>20:1). The use of 2,2,2-trifluoroethanol as solvent at subambient temperature improved the yields of the ester relative to reactions performed in methanol or with other alcohol nucleophiles. Amine acylation or sulfonylation prior to the Wolff rearrangement led to the formation of ring-opened chiral 4-aminodihydrofurans in good yields, presumably due to the stabilization of the oxocarbenium ion during ring-opening and elimination.
To investigate the associations between sleep parameters, specifically duration and efficiency, and circadian activity and blue light exposure (BLE) in children and adults within a family environment. In May 2025, a week-long actigraphic study was conducted in Tyumen, Russia, with 177 participants, comprising 88 children (mean age 10.56±2.17 years; 52.3% female) and 89 adults (mean age 37.56±8.14 years; 86.5% female). The study assessed sleep duration (SD), sleep efficiency (SE), relative nonparametric circadian activity amplitude (RA), intra-daily variability of BLE (BLE IV), inter-daily stability of BLE (BLE IS), and the integral index of light hygiene, defined as normalized parametric amplitude BLE (NA CC). Statistical analyses included nonparametric tests, correlation analysis, and linear regression models adjusted for sex and age. Children demonstrated significantly longer sleep duration (by 49 minutes; 8:16±0:57 h vs. 7:27±1:04 h; p<0.001) and higher sleep efficiency (90.70±3.44% vs. 89.01±5.36%; p=0.031) compared to adults. Additionally, children exhibited a higher NA CC (1.48±0.19 vs. 1.42±0.17, p=0.016). Sleep duration and efficiency were positively correlated (r=0.300, p<0.0001). RA was identified as a strong independent predictor of both SD and SE across all groups (p<0.001; η²=0.142-0.276). Among adults, higher SE was significantly associated with greater BLE inter-daily stability (r=0.253, p=0.017; β=0.248, p=0.019) and lower BLE intra-daily variability (r=-0.221, p=0.038; β=-0.257, p=0.016). Children exhibit greater sleep duration and efficiency, as well as more robust circadian rhythmicity, compared to adults. In adults, consistent daily blue light exposure, particularly inter-daily stability, is a key determinant of sleep quality. These findings underscore the significance of circadian light hygiene within the family environment and support the implementation of biodynamic lighting to enhance sleep quality across age groups. Изучить взаимосвязь параметров сна (продолжительность и эффективность) с циркадной активностью и экспозицией синего света (ЭСС) у детей и взрослых в семейной среде. В мае 2025 г. в Тюмени проведена недельная актиграфия у 177 участников: 88 детей (10,56±2,17 года, 52,3% девочек) и 89 взрослых (37,56±8,14 года, 86,5% женщин). Оценены: продолжительность сна (ПС), эффективность сна (ЭС), относительная непараметрическая циркадная амплитуда активности (RA), внутридневная (ЭСС IV) и междневная (ЭСС IS) стабильность ЭСС и интегральный индекс световой гигиены — нормализованная параметрическая амплитуда ЭСС (NA CC). Статистический анализ включал непараметрические тесты, корреляционный анализ и линейную регрессию с контролем пола и возраста. У детей ПС была на 49 мин выше (8:16±0:57 против 7:27±1:04, p<0,001), ЭС — выше (90,70±3,44% против 89,01±5,36%, p=0,031). У детей также был более высокий NA CC (1,48±0,19 и 1,42±0,17, p=0,016). ПС и ЭС положительно коррелировали (r=0,300, p<0,0001). RA была значимым предиктором ПС и ЭС во всех группах (p<0,001; η²=0,142—0,276). У взрослых более высокая ЭС ассоциировалась с более стабильной ЭСС: меньшей ЭСС IV (r=–0,221, p=0,038; β=–0,257, p=0,016) и большей ЭСС IS (r=0,253, p=0,017; β=0,248, p=0,019). Дети демонстрируют более высокую ПС и ЭС, а также более выраженные циркадные ритмы. У взрослых стабильность ЭСС служит ключевым фактором качества сна. Результаты подтверждают важность циркадной световой гигиены в семейной среде и обосновывают применение биодинамического освещения для улучшения сна у всех возрастных групп.
Recurrent pregnancy loss (RPL) is a multifactorial condition with varying definitions across professional societies and is often misunderstood. This review summarizes recent insights into genetic, paternal, anatomic, metabolic, immunologic, and infectious contributors that may explain otherwise unexplained RPL. In most RPL cases, a cause can be identified when standard evaluation is combined with genetic testing of products of conception (POC). When no clear etiology emerges, additional factors should be considered, including the couple's metabolic health, chronic endometritis, adenomyosis, and paternal contributors. Preimplantation genetic testing for aneuploidy appears beneficial, particularly for older patients and those with recurrent aneuploid losses despite normal evaluations. Conversely, emerging evidence suggests that many empiric treatments for unexplained RPL have limited or no benefit. Comprehensive RPL evaluation should include POC genetic testing and assessment of both partners. An individualized, targeted approach improves outcomes while reducing costs, delays, and exposure to ineffective therapies. Paternal factors are increasingly recognized as important and should be included in both evaluation and management strategies when possible.
Glucocorticoid-induced osteonecrosis of the femoral head (GIONFH) is a frequently encountered complication in orthopedic practice, yet its precise pathogenic mechanisms remain incompletely understood. Dysregulation of bone metabolism induced by glucocorticoids (GCs) is considered a key contributing factor. 3,4-Dimethoxychalcone (3,4DC), an organic compound, has shown potential biological activities, but its role in the context of GIONFH has not been elucidated. This study investigates the protective effects and underlying mechanisms of 3,4DC against dexamethasone (Dex)-induced ferroptosis and its therapeutic potential in GIONFH.A rat model of GIONFH was established through intraperitoneal administration of Dex, and in vitro studies were performed by culturing osteoblasts (OBs) under Dex treatment conditions. To evaluate the effects of 3,4DC on Dex-treated OBs, we employed C11-BODIPY and FerroOrange staining, assessed mitochondrial function, and analyzed protein expression via Western blot and immunofluorescence. The impact of 3,4DC on the bone microarchitecture of the femoral head in rats was further examined using micro-CT, H&E staining, as well as immunofluorescence and immunohistochemistry at both imaging and histological levels. Our results indicate that 3,4DC effectively inhibits Dex-induced ferroptosis and attenuates the development of GIONFH. In vitro, 3,4DC treatment significantly increased glutathione (GSH) levels while reducing malondialdehyde (MDA) production, lipid peroxidation, and mitochondrial reactive oxygen species (ROS) accumulation. Furthermore, 3,4DC enhanced STAT3 phosphorylation, upregulated glutathione peroxidase 4 (GPX4) and osteogenesis-related proteins, and promoted bone formation. Mechanistically, 3,4DC activated the STAT3/Nrf2 signaling pathway. Notably, silencing STAT3 with siRNA abrogated the protective effects of 3,4DC in Dex-treated OBs.3,4DC alleviates GIONFH by activating the STAT3/Nrf2 signaling pathway, thereby suppressing ferroptosis and may have potential clinical applications.