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Spinal cord injury (SCI) is a life-changing condition resulting in disability, with motor and sensory impairments that impact multiple areas of life and reduce quality of life. Physical rehabilitation can address these limitations, but there is a need to evaluate which interventions are most effective and the outcomes they produce. To evaluate the effectiveness of physical rehabilitation interventions for individuals with complete and incomplete SCI at levels C5-T12, and to inform clinical practice. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews. A comprehensive search of PubMed, Scopus and EBSCOhost identified peer-reviewed studies published between 2013 and 2024. Sixteen studies (n = 327) were included. Effective interventions included functional electrical stimulation, robotic and exoskeleton-assisted training, gait training, upper extremity exercise, balance training, and corporal suspension and pendulum exercises. Reported outcomes included improvements in aerobic capacity, muscle adaptations, gait parameters, cardiopulmonary function, functional capacity and secondary complications. Physical rehabilitation plays a key role in improving functional outcomes in individuals with SCI. However, no single intervention addresses all aspects of recovery, highlighting the need for an individualised approach. This review demonstrates that a range of exercise-based rehabilitation strategies can enhance functional outcomes in individuals with SCI.
This study is to systematically evaluate the efficacy of acupuncture for PHN and provide a visual overview of treatment landscape. A systematic search was conducted in PubMed, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), Chinese Scientific Journals Database (VIP), and Wanfang Database for systematic reviews (SRs) on acupuncture for PHN up to Apr 18, 2025. Studies were included if they were SRs of randomized controlled trials (RCTs) assessing traditional Chinese acupuncture interventions for PHN, and excluded if they involved non-traditional acupuncture, herpes zoster, or PHN prevention research. Two independent reviewers utilized Excel, EndNote 20, and R software for data analysis and assessed the quality of included studies using the AMSTAR2 tool. Of 351 identified records, 40 SRs met inclusion criteria, encompassing 926 RCTs, 63,493 patients, 13 types of acupuncture interventions and 29 outcomes. Acupuncture interventions, particularly fire needling, CPBLC, Fu's subcutaneous needling, plum-blossom needle, multi-acupuncture and multi-acupuncture + pharmacotherapy, showed the most robust benefits in improving effective rate, reducing visual analog scale (VAS) scores, and decreasing adverse reactions in PHN treatment. Despite most SRs reporting positive outcomes, the quality was generally low by AMSTAR2. Acupuncture could be a valuable adjunct to standard PHN treatment, offering benefits in overall efficacy, pain management and treatment safety. However, high-quality clinical trials and systematic reviews are needed to confirm these preliminary results and guide clinical practice.
Exotropia (XT), an outward ocular deviation, commonly affects children. Delayed treatment increases the risk of amblyopia and visual impairment. The aim of this systematic review is to evaluate the evidence on the effectiveness, indications, and clinical outcomes of different treatment modalities for childhood XT. A systematic search was performed in PubMed, Web of Science, ProQuest, Scopus, Google Scholar, EBSCO, and Medline in accordance with PRISMA 2020 guidelines. Articles published between 1997 and 2025 on treatment approaches for childhood XT were included. Treatment success was defined as a post-intervention deviation of ≤10 prism diopters (PD). The review protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) under registration number CRD420251174532. The final review included 34 studies from 11 countries, comprising 3,643 children with a mean age of 5.70 ± 2.24 years. The reviewed studies indicated that part-time occlusion and office-based vergence and anti-suppression therapy (OBVAT) achieved the highest short-term effectiveness rate of 86.8% after follow-up of five months. Overminus lenses therapy achieved a success rate of 80.63% with a follow-up of 2.15 years. Extraocular muscle surgery achieved a success rate of 70.81% with follow-up of 3.68 years, whereas botulinum toxin type A (BTX-A) injection showed a lower effectiveness rate of 66.86% after follow-up of 1.67 years. Multiple surgical and non-surgical options exist for managing childhood XT. Overminus lenses can improve distance control during testing, but deviation typically return to original state with non-overminus lenses, and their use requires monitoring for possible myopic progression. Surgery remains the primary treatment for constant XT, with bilateral lateral rectus recession and unilateral lateral rectus recession and medial rectus resection (R&R) showing similar short-term outcomes and long-term advantages for R&R. BTX-A offers a minimally invasive alternative for selected cases. Part-time occlusion and OBVAT improve short-term control, however durability and optimal protocols remain uncertain.
This article explores the methodological landscape of international university rankings by reconstructing and formalizing the computational pipelines of five widely used global systems (ARWU-ShanghaiRanking, Times Higher Education (THE), U.S. News Best Global Universities, QS World University Rankings, CWUR) and reviews mathematically principled alternatives to fixed-weight composite rank tables. For the major ranking systems, the study details indicator design, normalization and transformation mechanisms and weighted aggregation into final composite scores, highlighting how these design choices encode normative assumptions and drive cross-system discrepancies. Responding to critiques of single-score rank tables, the paper reviews non-aggregative and minimally aggregative paradigms that preserve multidimensionality and reduce misleading ordinal precision, including dominance-based methods (Pareto front, skyline and discriminative skyline ranking), categorical layering (Rainbow Ranking and RR-index), dashboard and group-based multidimensional systems (U-Multirank, CHE-style reporting, and CWTS Leiden Ranking), frontier efficiency models (DEA/FDH), and data-driven latent-dimension approaches (PCA, factor and Bayesian latent-trait models). The article also situates aggregated-ranking voting rules and weighted voting power indices as complementary formal tools for preference aggregation and influence analysis. Overall, it argues that global rankings should be interpreted as algorithmic evaluative frameworks rather than neutral measurements, and that dominance-, profile-, frontier-, and latent-variable approaches offer transparent and conceptually robust complements for multidimensional university evaluation. We aim to identify ranking methods that operate without human-chosen weights or subjective parameter choices, because such choices influence and often distort the resulting rankings.
Anxiety, which involves feelings of tension, worry, and physiological changes in the body, can have significant impacts on patients, including an increased risk of mortality. In ophthalmic surgeries, particularly cataract procedures, anxiety levels tend to be high, often stemming from fears of blindness or surgical failure. This study aimed to determine the best and most effective interventions to reduce anxiety in patients undergoing cataract surgery. Systematic reviews, with or without meta-analysis. Additionally, selected studies were required to meet two mandatory criteria from the Database of Abstracts of Reviewers of Effects and be English-language review articles published between January 2010 and 2025 that met these criteria and focused on anxiety reduction strategies in patients undergoing cataract surgery. Finally, out of 75 relevant papers, 5 review studies with 9638 patients were eligible and included in the study. (1) Non-pharmacological interventions (educational videos, patient education, aromatherapy, relaxation techniques, etc.) significantly reduced mean preoperative anxiety compared to the control group. (SMD: -2.14, 95% CI: -3.48 to -0.79; p < 0.001). (2) Nursing techniques could reduce pain and anxiety during the operation (SMD = - 1.19; 95% (CI): -1.96 to -0.43; p = 0.002). (3) The use of anxiolytics (melatonin) could reduce postoperative anxiety in cataract patients. (SMD = - 0.55; 95% CI: -0.95 to -0.15; p = 0.007). (4) Music therapy. This review study identified techniques and strategies to reduce stress in patients undergoing cataract surgery. These strategies, tailored to patient needs, can be implemented individually or in combination, and prioritizing individual patient needs to enhance patient well-being and lead to several positive clinical outcomes and potentially decrease healthcare costs. Future clinical trials are essential to the integration of new technologies and identifying the most effective methods for widespread implementation.
Traumatic brain injury (TBI) is associated with a range of neuropsychiatric sequelae, including secondary psychotic disorders. Delusional syndromes are a prominent and clinically significant manifestation, often classified as Psychotic Disorder Due to Another Medical Condition.1,2. This narrative synthesis reviews case series, cohort studies, retrospective analyses, and conceptual literature published between 1998 and 2025, focusing on epidemiology, clinical features, pathophysiology, diagnosis, and psychopharmacologic management of post-TBI delusional syndromes. Delusions-commonly persecutory or misidentification types-frequently emerge after a latency of months to years and are more prevalent than schizophrenia-like presentations.1,2,6 Risk factors include moderate-to-severe injury, frontal or temporal lesions (particularly right-sided), post-traumatic epilepsy, and genetic vulnerability.3-6 Compared to primary psychotic disorders, negative symptoms are typically less prominent, though cognitive impairment is nearly universal.6,7,12 Low-dose atypical antipsychotics demonstrate favorable response rates, but tolerability concerns-including sedation, extrapyramidal symptoms, and seizure risk-necessitate cautious use.8,9 Adjunctive anticonvulsants may be beneficial, particularly in patients with comorbid epilepsy.10,15. Post-TBI delusional syndromes highlight the role of structural brain injury in the development of psychosis. Careful diagnostic evaluation and individualized, low-dose psychopharmacologic strategies are essential. Further research is needed to guide evidence-based treatment in this population.
Persons with disabilities are often disproportionately placed in part-time roles, confined to low occupational levels and face a heightened risk of job loss perpetuating a cycle of underemployment, leaving many to earn below the official poverty line. Despite progressive South African employment legislations, many companies still do not meet employment targets for employees with disabilities. The scoping review aimed to summarise the literature and synthesise strategies used to employ and retain persons with disabilities in South African open labour market. Systematic and manual searches of six databases identified relevant primary sources. The first two authors conducted blinded reviews of 2402 titles and abstracts, followed by 482 full-text reviews. Following conflict resolution, 92 sources were included. A content analysis of charted data followed, and the findings were summarised into two categories and 12 codes. Programmes shown to improve the representation of persons with disabilities were demand-side employment, inclusive recruitment, disability disclosure, reasonable accommodation, employee referral, internships and apprenticeships, return-to-work, supported employment, wage subsidy and partnering with disability organisations. Stakeholder support enhanced implementation and reduced barriers. Various programmes were adopted to improve the inclusion of employees with disabilities, but their implementation varied across employers, yielding mixed results. The review highlighted the need for policymakers to strengthen enforcement, for employers to foster inclusive workplace practices and for researchers to expand the scope of inquiry to capture broader dimensions of disability employment. Future research could be conducted under different settings to explore the employment of persons with disabilities.
Off-pump coronary artery bypass (OPCAB) surgery offers distinct advantages over conventional on-pump techniques, including reduced inflammatory response, lower stroke risk, and improved outcomes in high-risk patients. Despite these benefits, concerns persist regarding graft patency, incomplete revascularization, and technical complexity, limiting widespread adoption. A focused literature review was conducted using PubMed-indexed sources published between 2000 and 2025. The medical subject heading term "coronary artery bypass, off-pump" was used in combination with keywords including "hemodynamic optimization," "conversion," "graft patency," and "surgical training." Only peer reviewed randomized trials, meta-analyses, guideline-based reviews, and expert consensus articles were included. Findings were synthesized to define 10 core principles for safe and reproducible OPCAB practice. The "Ten Commandments" address key domains: patient selection, contraindication management, team readiness, stabilization techniques, hemodynamic control, complete revascularization, conversion avoidance, skill acquisition, technical refinement, and evidence-based advocacy. Each principle is supported by clinical data and practical strategies. Innovations, such as intracoronary shunting, advanced stabilizers, and artificial intelligence-guided decision-making, enhance procedural reliability and outcomes. OPCAB can be performed safely and effectively with structured preparation, multidisciplinary collaboration, and adherence to best practices. By embracing these commandments and integrating emerging technologies, surgical teams can overcome barriers to adoption, refine intraoperative techniques, and deliver individualized coronary revascularization with superior long-term outcomes.
Hepatitis B virus (HBV) and hepatitis C virus (HCV) remain public health threats in the WHO European region, where an estimated 29 million people live with chronic infection and viral hepatitis-related deaths now surpass those from HIV/AIDS and tuberculosis combined. Although effective prevention tools and antiviral treatments reduce the risk of complications, overall mortality has not declined. This Series paper reviews models of care (MoC) implemented between 2015 and 2025, drawing on scientific literature and policy documents to assess regional progress. Simplified testing and treatment, childhood and targeted adult HBV vaccination, harm-reduction programmes, and prison-based interventions have advanced elimination efforts. Pragmatic approaches, including point-of-care testing, decentralised services, and integrated models tailored to key populations demonstrate clear benefits. However, major challenges persist: large undiagnosed populations, regional disparities, inadequate healthcare worker knowledge, and inequities affect at-risk groups. Achieving elimination by 2030 will require accelerated case-finding, broader access to simplified treatment, stronger risk-tailored and vaccination strategies, improved data systems, and renewed commitment.
Engaging K-12 science teachers in authentic research experiences has been a promising approach to enhance science teaching and learning. Teacher research experiences aim to bridge the gap between science practices and classroom instruction through immersing teachers in research labs. Building on the previous literature reviews of teacher research experiences, we seek to assess what has changed since previous calls to action in this research area. We report on 39 empirical studies published between 2018 and 2024 that include these types of programs. We have found that while there have been improvements since previous publications, there have also been areas of continued stagnation. We have seen a shift in content areas from natural science to engineering and other STEM fields. The focus areas of many programs include the translation of skills and content gained from these programs into curriculum design, pedagogical knowledge, and classroom instruction. Given the timeframe of the research studies we reviewed, we noted studies where Coronavirus Disease 2019 (COVID-19) impacted the TRE program structure causing the research components to take place online rather than in-person. One major growth area has been the focus of research on underrepresented minority and rural populations. However, despite previous calls to action, there remains a substantial lack of data-driven research about the impacts of these programs on student outcomes. These findings reveal both promising developments and persistent gaps that require further research.
Influenza A virus (IAV) continues to pose a substantial challenge to global health, not merely through primary viral pneumonia but largely due to lethal secondary bacterial complications. Pathogens such as Streptococcus pneumoniae, Staphylococcus aureus, and Haemophilus influenzae capitalize on the physiological "storm" induced by IAV, leading to significantly exacerbated morbidity. This review provides a comprehensive synthesis of the multifaceted mechanisms that dismantle host antibacterial defenses. Beyond the classical understanding of respiratory epithelial damage and the compensatory upregulation of bacterial adhesion receptors, we delve into the sophisticated dysregulation of innate immune signaling, specifically the collateral damage caused by interferon responses and impaired phagocytic function. Furthermore, we examine the complex roles of direct virus-bacterium synergism and the disruption of the respiratory microbiome (dysbiosis). By integrating these established paradigms, we extend the discussion to the rising clinical concern of nosocomial and multidrug-resistant (MDR) infections in critically ill patients. We conclude by identifying critical knowledge gaps and emphasizing the need for targeted strategies to mitigate the host vulnerabilities that permit opportunistic MDR colonization in the wake of viral insult.
Although smoking is a well-established risk factor, lung cancer in never-smokers exhibits distinct epidemiological and biological characteristics. Globally, approximately two-thirds of lung cancer cases in never-smokers occur in females, with a higher prevalence observed in Asian populations. Understanding these epidemiological patterns and specific risk factors holds significant implications for informing effective prevention and control strategies. In addition, low-dose CT screening for never-smoking females remains controversial due to insufficient evidence to support its benefits and unresolved concerns about overdiagnosis. This review provides a comprehensive overview of lung cancer among never-smoking females, synthesizing current evidence on its epidemiology, risk factors, and screening practices, thereby elucidating the multifaceted nature of lung cancer in this population and highlighting its implications for prevention, risk stratification, and future research priorities.
Varicocele is a prevalent cause of male infertility and has been associated with erectile dysfunction in clinical and preclinical studies, characterized by a complex pathophysiological process involving immune-inflammatory responses. This review focuses on the preclinically supported immune-inflammatory interactions between the testicular and penile microenvironments in varicocele patients, systematically summarizing the plausible and partially validated molecular mechanisms mediating erectile dysfunction and spermatogenic impairment. We explore the network relationships among local and systemic inflammatory cytokines, immune cell infiltration, oxidative stress, endothelial dysfunction, and neurovascular injury. By integrating recent omics studies, animal models, and available clinical data, this article elucidates the hypothetical and mechanistically plausible pathological linkage from abnormal varicose veins in the pampiniform plexus to distal impairment of penile cavernous function. The review aims to synthesize and contextualize the systemic impact of varicocele and to establish a theoretical foundation for developing targeted therapies addressing immune-inflammatory pathways.
This systematic review aimed to identify and synthetically evaluate factors asso ciated with work-life balance (WLB) among emergency physicians, emergency nurses, and paramedics. The review was conducted in accordance with the PRISMA 2020 guidelines and was prospectively registered in the PROSPERO database. A comprehensive search of PubMed, Scopus, Web of Science, and CINAHL was performed, encompassing English-language publications from 2015 to 2025. Inclusion criteria were defined using the PICOS framework. Methodological quality was appraised using Joanna Briggs Institute (JBI) critical appraisal tools. Furthermore, the overall certainty and confidence in the evidence were assessed using the GRADE (for quantitative data) and GRADE-CERQual (for qualitative data) frameworks. From 202 identified records, 11 studies met the inclusion criteria: 10 quantitative cross-sectional studies and one qualitative study. The findings indicate that the primary determinants of WLB impairment among emergency personnel include high occupational stress, Effort-Reward Imbalance (ERI), Work-Family Conflict (WFC), shift-work patterns, and adverse organizational characteristics, such as staffing shortages and limited team support. Numerous studies demonstrated robust associations between WLB disturbances and professional burnout, deterioration of somatic and mental health, sleep disorders, and diminished job satisfaction. According to GRADE criteria, the certainty of quantitative evidence was predominantly rated as low or very low; however, the qualitative study provided evidence of moderate-to-high confidence (GRADE-CERQual). The findings underscore the critical necessity of implementing multilevel organizational interventions aimed at enhancing working conditions, mitigating work-family conflict (WFC), and bolstering team-based support. Such strategies are pivotal for safeguarding the occupational well-being of the emergency medicine workforce. Addressing these structural determinants is essential to ensure long-term staff retention and the sustainability of emergency care systems. https://www.crd.york.ac.uk/PROSPERO/view/CRD420251237774, identifier: CRD420251237774.
Sulfoxaflor (SXF), a novel sulfoximine insecticide, has been widely used as a substitute for traditional neonicotinoids (NEOs) to control piercing-sucking pests in agriculture. However, its environmental persistence, high mobility in water and soil, and potential toxicity to non-target organisms (e.g., honeybees, aquatic invertebrates) as well as the toxic risks of its long-lasting metabolites (e.g., X11719474) have raised significant ecological concerns. Biodegradation, as an environmentally friendly and efficient remediation strategy, plays a crucial role in regulating the environmental fate of SXF, and has become a research hotspot in recent years. This review systematically summarizes the environmental behaviors of SXF, including its migration, transformation, and residue characteristics in water bodies, soils, and agricultural products. It focuses on collating the reported SXF-degrading microorganisms (mainly bacteria such as Ensifer, Pseudomonas, Aminobacter, and cyanobacteria like Synechocystis salina) and their degradation efficiencies under different environmental conditions. Moreover, the review elaborates on the core role of nitrile hydratase (NHase) in SXF biodegradation, including the types, structural characteristics, and catalytic mechanisms of SXF-degrading NHases, as well as the key factors (environmental factors, structural residues, chemical modulators) influencing NHase catalytic activity. Additionally, biotechnological optimization strategies for enhancing SXF biodegradation efficiency, such as heterologous expression and immobilization of NHase, are discussed in detail. Finally, the current research gaps and future research directions are prospected, aiming to provide comprehensive theoretical support for the scientific application and environmental risk control of SXF, and offer references for the biodegradation research of novel NEOs and similar insecticides.
Major Depressive Disorder (MDD) represents the classically described episodic depression, with varying degrees of severity and recurrence. With a lifetime prevalence close to 20%, the condition represents a leading cause of disability worldwide. Pharmacotherapy is an option for initial treatment, especially in cases of higher severity. As over half of patients will not experience remission after first antidepressant trial, it is essential for clinicians to understand the vast number of medications available and their unique characteristics. This review provides a comprehensive clinical update on evidence-based pharmacotherapies for MDD, including both established and novel treatment options. Traditional monoaminergic antidepressants remain as important options with comparable efficacy but often distinct side-effect profile. Augmentation strategies are often employed with partial treatment response and are available with a wide range of mechanisms and unique clinical nuances. Fast-acting agents are now a reality in practice, including neuroactive steroids for postpartum depression and agents that target glutamatergic pathways. Relevant aspects for clinical practice are provided for over forty different medications, presenting dose ranges, adverse effects, monitoring requirements, and important patient characteristics to consider when prescribing. We also highlight concepts important for successful pharmacotherapy such as accurate diagnosis and treatment resistance. With the expanding therapeutic arsenal for MDD, ongoing comparative-effectiveness and real-world studies will be crucial for transforming today's advances into accurately personalized care.
Morocco is experiencing rapid demographic aging alongside a rising cancer burden, creating structural challenges for the care of older adults with cancer. This review synthesizes current evidence on geriatric oncology in Morocco and proposes a conceptual framework to guide system-level adaptation. We conducted a structured narrative review of peer-reviewed publications, population-based registry data, national demographic reports, and policy documents published between 2000 and 2025 (last search: January 2026). Evidence was synthesized qualitatively and organized into six predefined analytical domains: (1) demographic transition, (2) cancer epidemiology, (3) health system organization, (4) access to care, (5) workforce capacity, and (6) geriatric assessment and clinical practice. These domains are applied consistently as the organizing framework across the Results sections and are explicitly mapped onto the WHO Health System Building Blocks and the Four-Phase Oncogeriatric Transition framework in the Discussion. In 2024, adults aged ≥60 years accounted for 13.8% of Morocco's population, while individuals aged ≥65 years represented approximately 8%, with projections indicating a marked increase by 2050. Population-based registries report age-standardized cancer incidence rates around 120-137 per 100,000. Available cohorts indicate high vulnerability prevalence (e.g., >80% abnormal G8 in some series), substantial metastatic presentation at diagnosis, limited geriatric workforce capacity, and a strong urban concentration of oncology services. Structured geriatric assessment is not yet consistently implemented in routine oncology care. These findings suggest that Morocco is entering an oncogeriatric transition characterized by a growing mismatch between demographic acceleration and geriatric-integrated oncology capacity. We propose a Four-Phase Oncogeriatric Transition framework to conceptualize this evolution and inform policy, workforce planning, and phased implementation strategies. Early integration of geriatric assessment, registry adaptation, and multidisciplinary coordination will be essential to ensure equitable, age-adapted cancer care in an aging society.
This study conducted a systematic literature review to answer the question: "What is the frequency of post-discharge complications in patients who had bacterial meningitis during childhood and adolescence?" Observational studies assessing post-discharge complications in patients aged 29 days to 18 years with bacterial meningitis were included. Studies on Mycobacterium tuberculosis meningitis or lacking clear diagnostic criteria were excluded. Searches were performed in July 2025 across seven databases (PubMed, EMBASE, Cochrane Library, Scopus, Web of Science, LILACS, and BVS). Evidence certainty was assessed using GRADE. Data on events and total participants were synthesized quantitatively. Thirteen studies were included (sample size range: 51-3623 participants). Age at meningitis diagnosis ranged from 29 days to 18 years, with follow-up periods from 6 months to 35 years. The overall complication rate was 37.3% (95% CI 28.7-46.9). The most frequent sequelae were cognitive impairment (21.6%; 95% CI 13.2-32.8), emotional/behavioural problems (15.3%; 95% CI 8.1-26.8), and hearing loss (14.3%; 95% CI 7.7-25.1). Bacterial meningitis in childhood is associated with a significant and persistent impact on health and development. Despite heterogeneity across studies, a consistently high burden of auditory, motor, cognitive, and behavioural sequelae is observed, underscoring the need for long-term follow-up of affected individuals.
Tumors are highly dynamic diseases characterized by significant heterogeneity. They consist of multiple cellular populations with distinct properties that respond differently to therapeutic pressure. This heterogeneity may arise from spatial variation across tumor regions (spatial heterogeneity) as well as from temporal changes during tumor evolution and treatment (temporal heterogeneity). As a consequence, drug-resistant subclones often emerge under therapy and contribute to treatment failure. Advances in single-cell and spatial multi-omics technologies enable precise quantification of tumor heterogeneity, supporting detailed investigation of how heterogeneity contributes to chemoresistance and informing the development of personalized therapeutic strategies. In this review, we summarize the evolutionary dynamics underlying the emergence of tumor drug resistance and examine the molecular mechanisms responsible for failure of targeted therapies. We highlight how advances in single-cell and spatial multi-omics have significantly improved our ability to elucidate these processes. We further suggest that addressing tumor drug resistance may require a shift from static, single-target approaches toward dynamic, biology-informed personalized strategies. Integrating high-resolution multi-omics monitoring with functional validation could enable identification of subclonal vulnerabilities, support adaptive treatment adjustment, and contribute to more durable clinical responses.