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Myocardial viability testing has traditionally been used to guide revascularization decisions in ischemic cardiomyopathy on the assumption that identifying dysfunctional but viable myocardium predicts functional recovery and improved survival following revascularization. Recent trials have challenged this assumption, highlighting the need to re-evaluate the clinical role of viability testing in the context of contemporary revascularization strategies and modern guideline-directed medical therapy. The STICH trial and its extended follow-up demonstrated that CABG improves long-term survival independently of viability status and independently of whether ejection fraction improves, challenging the mechanistic assumption of viability-guided revascularization. REVIVED-BCIS2 showed that PCI may not improve survival benefit, even in patients selected with demonstrated viability. A prespecified imaging substudy of REVIVED identified scar burden, rather than the presence of viable myocardium, as the strongest independent predictor of adverse outcomes, reframing the prognostic question from the detection of viable tissue toward the quantification of irreversible myocardial loss. Viability should be reconceptualized as a continuous spectrum rather than a binary construct. Scar quantification, particularly through late gadolinium enhancement cardiac magnetic resonance (CMR), may offer greater prognostic utility than viability detection alone. A prospective randomized trial integrating contemporary imaging with modern guideline-directed medical therapy is needed to resolve the clinical role of viability-guided revascularization.

A century ago, Wigner's SU(4) symmetry was introduced to explain the properties of atomic nuclei. Despite recent revived interest, its impact on nuclear structure, transitions, and reactions has not been fully explored. Here, we show that a variety of high-fidelity nuclear interactions predict nuclear states that have ≥90% probability of being in a single SU(4) irreducible representation. Meanwhile, our analysis of axial current operators in chiral effective field theory (χEFT) reveals that one-body currents at low momentum transfer act only within SU(4) irreducible representations, while two-body currents connect different representations. These selection rules interfere with the expected convergence pattern of the χEFT expansion and explain key phenomenological observations, e.g., the unnaturally large two-body corrections to the axial-current matrix elements in eight-body nuclei.

This research delivers a comprehensive future-oriented multi-dimensional drought appraisal for Tiruchirappalli District, Tamil Nadu, India, by inter-linking Google Earth Engine (GEE) cloud computing, machine learning algorithms, geospatial analysis, and socioeconomic indicators. Four primary drought dimensions-meteorological, hydrological, agricultural, and socioeconomic vulnerability-are interfaced into a holistic drought evaluation framework during 2014-2025, representing an epoch with intensified climate variability in South India. Meteorological drought is assessed through the Standardized Precipitation Index (SPI), while hydrological drought is assessed through the Standardized Water Level Index (SWI) from the observations of the Public Works Department (PWD) groundwater. Agricultural drought conditions are considered using multi-sensor satellite indices on the GEE platform, namely, Vegetation Condition Index (VCI), Temperature Condition Index (TCI), and Precipitation Condition Index (PCI). Socioeconomic vulnerability parameters, which included population density, literacy, household density, and workforce-related characteristics. These socioeconomic indicators were standardized and weighted separately to derive a socioeconomic vulnerability map, while meteorological, hydrological, and agricultural drought indicators were integrated into Multi-Drought Severity Index. The spatio-temporal assessment shows cyclic drought occurrences, which became stronger in the 2015-2018 period and revived from 2021 onward, particularly in the years 2023-2025. LULC analysis with Random Forest classification for 2014, 2018, and 2025 pointed toward rapid urbanization and consequent land-use change, which increases drought vulnerability. Future drought manifestation for 2035 was done by employing multi-year geospatial trends, historical RF-based LULC spatio-temporal change analysis, ANN-based LULC-2035 predictions, and long-term drought indicators. The integrated ANN-based LULC-2035 and MDSI-2035 analysis predicts extreme drought in Thuraiyur, Omandhur, and Thachankurichi, with varying severity across other regions. This study demonstrates the successful application of multi-indicator drought modelling together with machine-learning-driven land-cover prediction, thereby presenting a scalable framework for regional drought risk assessment and climate-resilient planning.

Dominance has been evolutionarily salient in shaping power relations across species, and recent social-psychological work has revived the concept in the study of human social hierarchies. Yet previous research has produced mixed findings and inconsistent interpretations of the effectiveness of dominance. This article clarifies the role of dominance, particularly in the context of leadership selection. We relax the strict view of dominance as inherently equated with physical aggression and antisociality, often assumed to be inherited from nonhuman primates. Instead, its instrumental value depends on how followers evaluate its capacity to benefit them. We situate this reframing within a unitary evolutionary model of human status, in which diverse traits and behaviours contribute to leadership through a single pathway of competence. We then outline the socio-ecological conditions under which dominance-based leadership emerges. We argue that groups grant leadership to individuals who demonstrate contextually relevant competence, particularly when contexts demand (a) resolving and preventing intragroup conflict, (b) securing and defending resources, and (c) managing external threats. We invite future research to examine how socio-ecological contexts shape diverse forms of leadership, moving beyond explanations focused on a fixed set of individual motives and strategies for status attainment.

Cell culture is a common methodology used in tumor research. However, the manner in which initial tissue conditions, such as storage in the operating theatre, can affect proliferation has not been well‑established. Additionally, there is little information about the behavior of primary cell cultures in meningiomas. Therefore, the present study analyzed the physiology of primary meningioma cultures under different tissue conditions. For the present study, 10 meningioma tissue samples were collected after surgery at Saarland University (Homburg, Germany) between June 2022 and December 2022. Primary cell cultures were separately established on the day of surgery and 1 day later, before the tissues were stored overnight in nutrient solutions. Cultures were split into two flasks, one was used for fluorescence in situ hybridization (FISH), whereas the other was frozen in liquid nitrogen. After 6 months, frozen cultures were thawed and recultivated. The proliferation rates were found to be ≥80% for cell cultures as a minimum. No significant difference was found between cultures established on the surgery day or postoperative day 1 in terms of proliferation rate and growth pattern. FISH revealed loss of the short arm of chromosome 1 (1p) in one meningioma, loss of the long arm of chromosome 22 (22q) in three samples, combined 1p and 22q loss in three samples, and diploid chromosome sets in three samples. In total, 16 out of 17 initially shock‑frozen specimens were successfully recultivated after 6 months of cryopreservation. To conclude, meningioma cultures appeared to proliferate similarly regardless of whether the tissue was processed on the day of surgery or the following day, if viable cells were present. Frozen cultures could be revived after 6 months if cells remained viable. FISH provided evidence that primary meningioma cultures accurately reflected initial chromosomal aberrations of the tumor, even after freezing.

The growing demand for high-specific-energy storage has revived interest in lithium-oxygen batteries (LOBs), whose theoretical energy density far exceeds that of conventional lithium-ion battery systems. However, their practical use is limited by sluggish reaction kinetics, parasitic reactions, high overpotentials, and the buildup of insulating lithium peroxide, all of which hinder reversibility and cycling stability. Manganese oxides (MnOx) have emerged as promising cathode catalysts because of their abundance, low cost, tunable oxidation states, and diverse structural features. Their tunnel, layered, and spinel architecture provide adaptable environments for O2 reduction and evolution, Li+ transport, and the conversion of reaction intermediates. Recent progress demonstrates that structural engineering of MnOx, through pore-structure tuning, surface-site modulation, defect introduction, heteroatom doping, and composite fabrication, can significantly optimize lithium peroxide formation and decomposition. These strategies regulate catalyst electronic structures and reaction pathways, thereby influencing Li2O2 formation/decomposition behavior, reducing side reactions, lowering polarization, and enhancing catalytic activity. This review summarizes recent advances in MnOx-based catalysts for non-aqueous LOBs, emphasizing structure-activity relationships and mechanistic understanding. By outlining remaining challenges and key design guidelines, we aim to support the rational development of next-generation catalysts for practical LOB deployment.

Urban congestion is simultaneously influenced by heterogeneous spatio-temporal travel demands, the topology and spatial characteristics of road networks, and the interplay between multiple travel modes. As a critical component of solutions towards a greener and more sustainable transportation, bike-sharing systems have great potential in reducing carbon emissions, improving public health, and alleviating congestion by substituting short-distance motorized trips. Benefiting from flexible accessibility and usage, dockless bike-sharing has gained wide popularity and revived the fashion of cycling in cities. In this study, we reveal that the widely adopted detour ratio alone cannot effectively reflect congestion levels at the route level. Using large-scale dockless bike-sharing data and taxi trajectory data in Beijing, we quantitatively examine the relationships between cycling flow, motor vehicle traffic and road network structure. In addition, the proposed cycling-traffic-weighted detour ratio can prescreen potentially inefficient cycling routes, which can assist targeted infrastructure optimization and evidence-based urban planning.

Metalloid contamination, notably arsenic (As) toxicity, severely impacts soil, water quality, and plant development. This study evaluated the role of phosphorus (P) supplementation in mitigating As stress in 15-day-old Brassica juncea seedlings. P-deficiency was detrimental across all As concentrations, with As300-P causing the most damage. P-supplementation significantly improved morphology in As150-P seedlings compared to As50-P and As300-P, where the former exhibited rapid recovery while the latter showed limited response. Stress markers, and the activity of antioxidant enzymes increased in As150-P and As300-P treatments, with P-supplementation aiding the restoration of protein-pigment complexes. Although cysteine metabolism was initially impaired by As-P stress, it revived after P-augmentation, peaking in As300-P. Glutathione metabolism also improved with P-enrichment, particularly in As150-P. Thiol and non-protein thiol levels, elevated under stress, declined post-P supplementation, signifying stress relief. These results highlight P-enhanced S-containing detoxification pathways as key to tolerance in mustard seedlings.

The preservation of chicken genetic resources is important to both backup commercial breeds that support egg and meat production worldwide and conserve the genetic diversity of indigenous breeds, which is essential for managing breeding according to future demands. Because chicken embryos are attached to a large yolk, cryopreservation is technically impossible. In chickens, a unique developmental engineering approach based on the manipulation of primordial germ cells (PGCs), the embryonic precursor cells of gametes, has been developed. Cryobanking of PGCs is an innovative strategy for efficiently maintaining chicken genetic resources without breeding live birds. Cryomedia containing dimethyl sulfoxide or propylene glycol (PG) as permeable cryoprotectants, combined with serum as a non-permeable cryoprotectant, have been widely used for the cryopreservation of chicken PGCs. However, because the serum composition varies greatly, performance differences arise between lots. Consequently, there is a demand for serum-free cryomedia with specific known compositions. Here, we investigated the cryoprotective effects of ovalbumin and sericin, as alternatives to serum, on chicken PGCs. Two cryomedia were designed: PO comprising 7.5% PG and 5% ovalbumin and PS comprising 7.5% PG and 2% sericin. Following the culture of PGCs cryopreserved in these cryomedia, viability and cell doubling times recovered to levels comparable to those of an unfrozen control group at 6 and 2 d post-culture, respectively. When frozen-thawed PGCs were transplanted, their gonadal migration ability was significantly lower immediately after thawing, but recovered to levels comparable to those of the unfrozen control group after 4 d of culture. We successfully revived viable offspring from Hinai-dori, designated as a natural monument of Japan, from PGCs cryopreserved in these cryomedia. In conclusion, we developed two serum-free cryomedia that achieved > 60% recovery of viable PGCs after thawing while maintaining germline competency.

Sudden arrhythmic death remains a major clinical risk in ischemic heart disease (IHD), underscoring the need for improved risk stratification. Late gadolinium enhancement cardiac magnetic resonance (LGE-CMR) provides measures of scar burden and heterogeneity, but its incremental prognostic value beyond conventional markers such as left ventricular ejection fraction remains uncertain. We analysed two independent IHD cohorts (Dataset 1: n = 399, 54 events; National Research Ethics Service approvals 07/H0708/83 and 09/H0504/104+5; Dataset 2: n = 424, 50 events; derived from the prospectively registered REVIVED-BCIS2 trial, ISRCTN45979711, registered 20 November 2012)using clinical and LGE-CMR-derived variables to evaluate the contribution of LGE-CMR features, and compare machine learning-based survival modelling approaches. A brute-force feature-selection strategy identified optimal predictor subsets for Cox proportional hazards models, Random Survival Forests, and DeepSurv, evaluated using cross-cohort and pooled validation strategies. Scar entropy consistently emerged as a strong predictor of major arrhythmic events. Non-linear approaches outperformed Cox regression, with DeepSurv demonstrating superior generalization across cohorts and Random Survival Forests showing robust performance in pooled analyses. These findings support scar heterogeneity as an important prognostic marker and suggest that machine-learning survival models may improve arrhythmic risk prediction in patients with IHD.

Uganda faces a rising burden of noncommunicable diseases (NCDs) at a time when pressure to mobilize domestic health financing is increasing. These challenges have become more acute since January 2025, when geopolitical shifts and donor fiscal tightening led to substantial reductions in external health funding. Consequently, policymakers have renewed interest in health taxes as a mechanism both to reduce consumption of harmful products and generate domestic revenue for health. While tobacco taxation has received sustained policy attention, largely due to the influence of the WHO Framework Convention on Tobacco Control, considerably less is known about the political dynamics shaping alcohol and sugar-sweetened beverage (SSB) taxation. This study therefore examines the factors contributing to the relatively low prioritization of alcohol and SSB taxes within Uganda's policy agenda. Guided by the framework on political priority, we conducted 25 semi-structured interviews with stakeholders from government, parliament, civil society, academia, industry, and the media. We also reviewed 22 documents from 2015 to 2025, including policy papers, fiscal records, parliamentary debates, and industry materials. We analyzed the data thematically following an inductive thematic analysis approach. Coding was informed by the framework and strengthened through triangulation across interviews and documentary sources to enhance credibility. We identified three levels of barriers. First, transnational norms promoted health taxes, but regional tax harmonization commitments within the East African community constrained national policy space. Second, domestic advocacy was weakened by fragmented ministerial mandates, limited local evidence, retreating policy entrepreneurs, and industry lobbying. Third, within the national political environment, the multiparty legislative dynamics, the high cost of sponsoring private members' bills, and revenue-centric fiscal framing limited traction. The 2025 donor financing contraction acted as a focusing event that revived debate on health taxes primarily as domestic health financing stabilization instruments rather than NCD prevention tools. While policymakers support health taxes to curb NCDs and increase domestic revenues, taxes on alcohol and SSBs remain underprioritized in Uganda due to institutional fragmentation, political-economic incentives, and legislative resource constraints. As external financing declines, it will be essential to strengthen locally grounded evidence, cross-sector coalitions, and integration of health objectives into fiscal reforms. In this way, health taxes represent a durable policy option for quickly mobilizing financial resources for health and preventing NCDs.

Trichobezoar is a rare gastrointestinal condition typically caused by ingestion of hair, which most often affects adolescent females. Its clinical presentation is frequently nonspecific, with symptoms such as abdominal pain, constipation, or early satiety, which can delay recognition until severe complications such as obstruction or perforation develop. We present the case of a 14-year-old girl who developed a massive trichobezoar resulting in gastric perforation and death. She had a three-month history of intermittent constipation and multiple healthcare visits without definitive diagnosis. On arrival to the emergency department, she was in cardiopulmonary arrest. Computed tomography revealed a large intragastric mass with associated pneumoperitoneum. Emergency laparotomy confirmed a trichobezoar with gastric perforation and diffuse peritonitis. Despite prompt surgical and resuscitative intervention, the patient could not be revived. This case underscores the importance for emergency physicians to maintain clinical vigilance when adolescents present with persistent, unexplained gastrointestinal symptoms. Trichobezoar should be considered in the differential diagnosis, even in the absence of psychiatric history. A low threshold for advanced imaging is warranted, as early recognition and intervention may prevent fatal complications such as gastric perforation and septic shock.

Alzheimer's disease (AD) is a progressive neurodegenerative disorder marked by synaptic dysfunction, glial cell activation, and deterioration of neurons. Multiple pathways contribute to its pathophysiology, including β-amyloid (Aβ) plaque formation, intracellular neurofibrillary tangles, oxidative neuronal damage, and inflammatory responses. While Aβ deposition is considered an early trigger in the disease cascade, clinical symptom progression correlates more strongly with tau pathology and inflammatory responses. Recent concerns over data integrity in several high-profile AD studies have prompted critical re-evaluations of widely accepted hypotheses, emphasizing the urgent need for scientific transparency, reproducibility, and independent validation. In compiling this review, we prioritized findings supported by converging evidence from multiple experimental approaches and replication across independent cohorts. The hypothesis that an imbalance between Aβ42 synthesis and clearance is a central factor in AD has gained support from recent evidence, despite ongoing debate over the amyloid β-protein hypothesis. Dominant mutations associated with early-onset AD are primarily found in the amyloid precursor protein, which serves as the substrate for Aβ production, or in presenilin, the protease responsible for Aβ formation. The identification of presenilin as the catalytic site for β-secretase has provided crucial insights into AD pathogenesis. This review synthesizes current understanding of AD mechanisms, highlights emerging insights from multi-omics and spatial transcriptomic technologies, and discusses the evolving therapeutic landscape. Despite setbacks, the field continues to advance through methodological innovation and a revived interest in AD research integrity, offering hope for early diagnosis, more targeted treatments, and ultimately, disease-modifying therapies.

Coral reef degradation is accelerating globally, yet monitoring efforts remain uneven in scale, accessibility, and resolution. Visual surveys of percent live coral cover offer low-cost but coarse assessments of reef health, while more advanced tools (e.g., autonomous underwater vehicles, airborne LiDAR) often remain inaccessible for many low-income, tropical nations. In this study, we used low-cost, high-resolution Structure-from-Motion (SfM) photogrammetry across 21 sites in Ulithi Atoll, Federated States of Micronesia, spanning a gradient of oceanic and lagoonal exposure, fishing pressure, and human population density, as a community-centered approach to assess reef habitat complexity and its relationships to benthic and fish communities. Habitat complexity was not strongly correlated with live coral cover or coral morphotype composition, two common indicators of reef health, but instead, was most closely associated with overall benthic community composition, including the relative abundance of sponges, macroalgae, and turf algae. Contrary to expectations, habitat complexity did not significantly correlate with total fish abundance but was a stronger predictor of fish and benthic assemblage structure across all reef types and exposure zones. Notably, several sites under active community-led management exhibited higher-than-average structural complexity despite their proximity to human settlements, suggesting that local management practices may help preserve reef architecture. SfM photogrammetry provides a scalable, community-accessible monitoring approach to inform adaptive management, particularly in remote or data-limited reef systems facing compounding climate and human pressures.

We report a state-resolved study of ultrafast vibrational dynamics in the singly ionized heteronuclear dimer Ar-Kr using a femtosecond pump-probe reaction microscope. A linearly polarized pump pulse initiates the dynamics by ionizing the neutral dimer and preparing a coherent superposition of vibrational states on multiple electronic potential energy surfaces of Ar-Kr+. A time-delayed, circularly polarized probe pulse then induces further ionization and dissociation, allowing the evolving nuclear motion to be mapped onto the time-dependent kinetic-energy-release spectra of the fragments. The resulting time- and KER-resolved measurements reveal vibrational revivals at characteristic delays, each serving as a spectroscopic signature of a specific electronic state and exhibiting agreement with numerical simulations. Fourier analysis of the delay-dependent spectra further extracts the vibrational beating frequencies, which are consistent with established spectroscopic constants.

The Vertebrate Genomes Project (VGP) aims to produce complete and near-error-free reference genomes for all ~70,000 extant vertebrate species1. Organized in four phases, it progressively targets all vertebrate orders, families, genera, and eventually all species. Here we present the completion of VGP Phase I, delivering reference genomes for ~95% of vertebrate orders, along with additional lineages within those orders, totaling 816 species and 1.6 trillion base pairs of main haplotype sequence. These genomes were assembled and annotated over an 8-year period (2018-2026) of rapid advances in genome sequencing, assembly, and annotation methods2-4, alongside the growth of associated consortium initiatives and international collaborations5-9. They represent some of the highest-quality vertebrate genomes currently available, and most have become the primary reference for their respective species in public databases. Comparative analyses across a subset of 579 species when we reached a threshold of 85% of orders allowed us to reconstruct the genome of the last common ancestor of all vertebrates 500 million years ago, identify diverse modes of sex chromosome evolution, reveal clade-specific three-dimensional genome architecture, discover methylated epigenetic landscapes across vertebrates, and provide a framework for studying gene and pseudogene evolution, immune loci, cancer-associated genes, and other trait-associated loci. Approximately a quarter of this subset are listed as Vulnerable to Critically Endangered by the IUCN Red List of Threatened Species, and have enabled more advanced genomic investigations of extinction risk. VGP Phase I delivers a reference backbone for vertebrate genomics, enabling discoveries that would otherwise remain out of reach across evolution, conservation, and medicine.

The pig (Sus scrofa) is both an economically important livestock species and a valuable biomedical model . Its genome bears regulatory features shaped by domestication and selection that are often poorly captured by genomic language models (gLMs) trained on human or model organism data. To address these challenges, we developed Porcine MutBERT, a suite of lightweight gLMs with 86 million parameters that employs a probabilistic masking strategy targeting evolutionarily informative single-nucleotide polymorphisms. This design captures population-specific variation while reducing computational cost. We further propose PorcineBench, a benchmark that evaluates gLM performance across porcine functional genomics tasks, including chromatin accessibility (ATAC-seq), CTCF binding, and histone modifications (H3K27ac, H3K4me1, and H3K27me3). Results show that Porcine MutBERT family achieves highly competitive performance on PorcineBench relative to substantially larger models, while providing an explicitly porcine-adapted alternative for downstream functional genomics in pigs. These findings underscore the advantages of species-adapted, efficient architectures in agricultural genomics and demonstrate that compact gLMs can expand accessibility and impact in resource-constrained settings. The code and data are available at https://github.com/ai4nucleome/pigmutbert.

The escalating global prevalence of carbapenem-resistant Gram-negative bacteria has significantly constrained therapeutic options, leading to the revived use of polymyxins. However, this resurgence has been paralleled by an increase in reports of associated adverse effects. No case of drug fever induced by polymyxin B (PMB) has been reported in the literature to date. We report the first case of drug fever (≥39 °C) induced by intravenous PMB in a patient with severe pneumonia caused by carbapenem-resistant Acinetobacter baumannii, accompanied by tachypnea following concomitant nebulized PMB administration. Upon intervention by the clinical pharmacist, which involved discontinuation of PMB and adjustment of the anti-infective regimen, the patient's fever resolved promptly and the infection was successfully controlled. This case highlights a severe and previously unreported adverse drug reaction to PMB, underscoring the necessity for vigilant monitoring and proactive antimicrobial stewardship in managing infections.

This paper divided the history of family doctor renaming into the stages of origin, prosperity, decline and revival by examining its development history for the first time. It documented the changes of family doctor training and the process of its renaming at different times. It clarified the meanings and scope of family doctors and general practitioners and analyzed the differences between the two names in terms of emerging background, disciplinary foundation, training pattern and their main characteristics. It finally put forward some corresponding suggestions on the application of the family doctors and general practitioners in China. 通过对家庭医生的发展史进行梳理，将国外家庭医生的发展历程划分为起源期、繁荣期、衰退期与复兴期，阐述了不同发展时期家庭医生的培养模式转变和更名过程，厘清全科医生和家庭医生这两种称呼所代表的涵义和适用范围，重点从诞生背景、学科基础、培训模式、核心特征等方面分析全科医生和家庭医生的不同。最后，结合中国家庭医生培养模式的发展历程，对中国全科医生和家庭医生名称的适用范围提出了相应建议。.