J. Runze , A. M. Witte , M. H. van IJzendoorn , and M. J. Bakermans-Kranenburg , "Heritability of Children's Secure Base Script Knowledge in Middle Childhood: a Twin Study With the Attachment Script Assessment," Journal of Child Psychology and Psychiatry 66, no. 6 (2025): 796-804, https://doi.org/10.1111/jcpp.14089. The above article, published online on 17 December 2024 in Wiley Online Library (wileyonlinelibrary.com), has been retracted by agreement between the authors; the journal Editor-in-Chief, Edmund Sonuga-Barke; the Association for Child and Adolescent Mental Health; and John Wiley & Sons Ltd. The retraction was agreed upon following the authors' communication to the journal that errors had been identified in the R code, which resulted in the introduction of duplicated values into the dataset. After reperforming the analyses, the authors determined that these errors affected the main results and conclusions of the study, necessitating an extensive revision of the article. Accordingly, the article has been retracted. The authors have been invited to submit a corrected version of the manuscript for consideration for publication.
F. Taslim, M.U. Ashraf, M. Farooq, A. Mahmood, R.M. Sarfraz, H. Ijaz, N. Shahid, and H.A. Gad, "Development of pH-responsive Hydrogel from Copolymers of Artemisia vulgaris Seed Mucilage, Mucin, and poly(methacrylate) for Controlled Delivery of Acyclovir Sodium," Macromolecular Rapid Communications 45, no. 22 (2024): 2400421, https://doi.org/10.1002/marc.202400421. This Expression of Concern is for the above article, published online on 28 September 2024 in Wiley Online Library (wileyonlinelibrary.com), and has been issued by agreement between the journal Editor-in-Chief, Bo Weng, and Wiley-VCH GmbH, Weinheim. Concerns were raised on PubPeer [1] regarding similar images in Figure 7. Following an investigation, it was not clear if there was any deliberate stretching or resizing of images because of the initial poor quality of the photographic data used. Due to the poor image quality, the publisher was unable to rule out that the images were not manipulated. Therefore, the journal has decided to issue an Expression of Concern to inform and alert readers. References [1] Elisabeth M Bik, "Development of pH-responsive Hydrogel from Copolymers of Artemisia vulgaris Seed Mucilage, Mucin, and poly(methacrylate) for Controlled Delivery of Acyclovir Sodium," PubPeer, 2026, https://pubpeer.com/publications/9E25D43FBD85FFA5112224D2FBB379.
Y. H. Kobayashi , "The Significance of Local Government in Disaster Management for International Migrants: The Case of Minoh City, Osaka Prefecture," Disasters 48, no. S1 (2024): e12636, https://doi.org/10.1111/disa.12636. The above article, published online on 12 June 2024 in Wiley Online Library (wileyonlinelibrary.com), has been retracted by agreement between the author, Yasuko Hassall Kobayashi; the journal Editors-in-Chief, Sara Pantuliano, John Twigg, Matthew Foley and Susanne Jaspars; ODI; and John Wiley & Sons Ltd. The retraction has been agreed due to the journal being informed that the article was submitted and published without obtaining mutual permission from all contributors. The author agrees with the retraction.
K. Grymula, M. Tarnowski, M. Wysoczynski, J. Drukala, F. G. Barr, J. Ratajczak, M. Kucia, and M. Z. Ratajczak, "Overlapping and Distinct Role of CXCR7-SDF-1/ITAC and CXCR4-SDF-1 Axes in Regulating Metastatic Behavior of Human Rhabdomyosarcomas," International Journal of Cancer 127, no. 11 (2010): 2554-2568, https://doi.org/10.1002/ijc.25245. This Expression of Concern is for the above article, published online on 16 February 2010 and available in Wiley Online Library (wileyonlinelibrary.com), and has been published by agreement between the journal Editor-in-Chief, Prof. Christoph Plass; the Union for International Cancer Control; and John Wiley & Sons Ltd. The Expression of Concern was agreed due to concerns raised by a third party after publication regarding the similarity of certain blots in Figures 1c & 1d and the underlying data that they represent. This affects the two T-MAPK 42/44 panels in the c) CW9019 ARMS and d) RD EMRS cell lines. The corresponding author, M. Z. Ratajczak, confirmed the similarity of the two panels in Figure 1 but could not provide the original data given the time that had elapsed. An investigation by the University of Louisville concluded that falsification of the data was likely. However, this could not be confirmed due to the lack of original data. The journal has decided to issue this Expression of Concern to alert the readers to these unresolved concerns regarding the integrity of the data and the results presented. The authors M. Z. Ratajczak, M. Wysoczynski, and F. G. Barr agree to this Expression of Concern. K. Grymula, M. Tarnowski, J. Drukala, J. Ratajczak, and M. Kucia were not reachable.
Z. Li and B. M. Pützer, "Spliceosomal Protein E Regulates Neoplastic Cell Growth by Modulating Expression of Cyclin E/CDK2 and G2/M Checkpoint Proteins," Journal of Cellular and Molecular Medicine 12, no. 6a (2008): 2427-2438. https://doi.org/10.1111/j.1582-4934.2008.00244.x. The above article, published online on 16 December 2008 in Wiley Online Library (wileyonlinelibrary.com), has been retracted by agreement between the journal Editor-in-Chief, Stefan Constantinescu; and John Wiley & Sons Ltd. A third party reported that comments had been made on PubPeer [1] that raised concerns about potential duplication of bands in Figure 2B. Additional investigation by the publisher found evidence of splicing in Figure 1B and duplication of Actin blots between Ad-GFP in Figure 3A and Ad-Sme pre-mRNA splicing in Figure 5A. The investigation also found evidence of duplications of the Ad SmE Actin blot in Figure 3A and the Ad-GFP p-CDC2 (Tyr15)/CDC2 blot in Figure 5A. Additional potential duplicated bands were detected in Figure 5A. The authors responded to an inquiry by the publisher and stated that the Western blots were generated separately for each experiment and were not intentionally duplicated or altered. However, the original data were no longer available due to the time that had elapsed since publication. The retraction has been agreed to because the evidence of highly similar or duplicated bands fundamentally compromises the editors' confidence in the results presented. The authors disagree with the retraction. References [1] Unregistered Submission and Hydroporus ferrugineus, Comments on "Spliceosomal protein E regulates neoplastic cell growth by modulating expression of cyclin E/CDK2 and G2/M checkpoint proteins," PubPeer, May 2016-October 2025. https://pubpeer.com/publications/216D30610A95CE3D109B97FC1CA64D.
Immunization is a primary prevention public health strategy that has saved more lives than any other health service. Achieving the recommended 95% childhood immunization coverage rate remains a challenge in Canada, especially post-COVID-19. This challenge highlights the need to better understand current immunization facilitators and barriers to improve coverage rates. This study aimed to determine: (1) Factors that support and create barriers to childhood immunization for families with children 0-6 years of age in Canada (2) If childhood immunization facilitators and barriers changed from pre-to-post-COVID-19. Using Arksey and O'Malley scoping review framework informed by Levac et al. and JBI Scoping Review Guidelines, seven databases were searched: MedLine (OVID), EMBASE (OVID), Web of Science (Clarivate), CINAHL (EBSCOhost), Cochrane Library (Wiley), APA PsycArticles (OVID), ProQuest Dissertations and Theses (Clarivate) for peer-reviewed literature. Articles were screened against inclusion/exclusion criteria, data extracted and thematically analyzed using the Braun and Clarke framework. Thirty-one studies were included. Five identified themes had a dual role supporting and creating barriers to childhood immunization and included: access to healthcare services, cognitive reasoning, affective influences on decision-making, external influences, and information. Two standalone barriers included: use of alternative medicine and colonial institutional practices. Differences pre-to-post-COVID-19 in factors supporting immunization included: cognitive reasoning and access to healthcare services; barriers included cognitive reasoning, information, access to healthcare services, and colonial institutional practices. This scoping review highlighted factors from caregiver perspectives that support and create barriers to childhood immunization including cognitive reasoning, affective influences on decision-making, and information. Post-COVID-19 considerations noted in our findings were affective influences on decision-making - trust and relationships and access to healthcare services. There appears an immunization information time gap in the prenatal period. Colonial institutional practices create access challenges for Indigenous families. To better understand these gaps, additional research is needed to understand current immunization information practices in the prenatal period, the contextual nuances of immunization service delivery, and Indigenous Peoples' experiences with immunization services. Further exploration of these areas may help to inform strategies to address identified barriers, strengthen immunization services, and improve immunization coverage rates.
Background Though bisphosphonates are the gold standard for the treatment of different metabolic bone disorders including osteoporosis for more than five decades, their safety and tolerability in patients with compromised kidney function are not well known. With age-related bone disorders and renal insufficiency becoming more prevalent worldwide, understanding the effect of bisphosphonates on patients with compromised renal function becomes inevitable. This review aims to analyze the clinical data available on safety of bisphosphonates on patients with different levels of renal function. Methods A broad search of PubMed, Wiley Online and the Cochrane Central Register of Controlled Trials was conducted to select randomized controlled trials and clinical trials that evaluated the safety and tolerability of bisphosphonate in patients with different levels of renal function between 2000 and 2026. Results Out of 1388 titles and abstract reviewed, 17 articles were included in the final analysis using PRISMA 2020 guidelines. Despite one trial showing < 2% increase in serum creatinine from baseline, all the other trials proved that bisphosphonates are safe and well tolerated by the patients with transplanted kidney and with compromised kidney function. Meta analysis of the data provided from eligible clinical trials using RStudio indicated that the proportion of serum creatinine that is increased was < 25% from baseline. Further, random effects model (100% (-0.01)) was performed due to high level of heterogeneity and it indicated that ibandronate 27.93%; alendronate 28.58%; risedronate 27.80% and zoledronate 15.69%. The pooled effect shows that kidney damage by bisphosphonates is not statistically significant. Conclusion The evidence from this review suggests that the bisphosphonates are generally well-tolerated with ten trials registering no drug-related withdrawals and other studies showing only very negligible withdrawals due to adverse effects. Even though bisphosphonates are safer to use in compromised renal function i.e., > 30ml/min/1.73m 2 , more cohort studies are required to identify bisphosphonates effects in end stage renal disease (eGFR < 15ml/min/1.73m 2 ).
Brome grass (Bromus diandrus) is a prevalent weed in southern Australian cropping regions which causes significant economic damage in crops and pastures. Before harvest 2023, two populations (named 6-24 and 7-24) suspected of resistance to imidazolinone herbicides were collected from separate fields. Preliminary screening indicated that these populations were resistant to several different acetolactate synthase (ALS)-inhibiting herbicides. Therefore, further characterisation of the level and mechanism of resistance was carried out. There was high survival of the resistant populations at the maximum tested rates of sulfometuron (600 g ha-1) and imazamox + imazapyr (74 + 34 g ha-1, 2× the label rate for use in imidazolinone-tolerant crops). All examined individuals (15 from each population) carried the same point mutation causing a tryptophan-to-leucine substitution at position 574 in the ALS protein. Application of the cytochrome P450 inhibitor malathion prior to herbicide treatment did not affect survival rates. This is the first study reporting a Trp574-Leu mutation as the basis for cross-resistance to ALS-inhibiting herbicides (sulfonylureas, imidazolinones and triazolopyrimidines) in Australian populations of B. diandrus. Control of these populations will require strategic use of pre-emergence herbicides and herbicide-tolerant crops in combination with harvest weed seed control. © 2026 The Author(s). Pest Management Science published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.
To systematically review and synthesize the evidence between consumption of different drinks in daily life and the risk of Inflammatory bowel disease (IBD). We systematically searched PubMed, Web of Science, SinoMed, Cochrane Library, Embase, Wiley, CNKI, and Wanfang Database for case-control, cohort, and cross-sectional studies investigating the relationship between beverage intake and IBD. A random-effects model was used for the meta-analysis. A total of 27 articles from 16 regions were included. The meta-analysis showed that soft beverage intake was associated with an increased risk of IBD (OR = 1.144, 95% CI: 1.052-1.243, p = 0.002). In contrast, alcohol intake (OR = 0.793, 95% CI: 0.629-0.999, p = 0.049), coffee intake (OR = 0.807, 95% CI: 0.667-0.976, p = 0.027), and tea intake (OR = 0.711, 95% CI: 0.522-0.970, p = 0.031) were associated with a reduced risk of IBD. Dose-response analysis revealed a linear inverse correlation between alcohol (linear trend p = 0.011) and coffee (linear trend p < 0.001) consumption and IBD risk. For tea consumption a significant nonlinear relationship and a downward trend was found between tea consumption frequency (times/week) and IBD risk (nonlinear trend p < 0.001). The risk of IBD showed a slow upward trend within the range of 1.200 to 6.000 times per week. Soft beverage consumption is associated with the risk of IBD. Current evidence suggests that higher intake of coffee, alcohol, and tea is associated with a reduced risk of IBD; however, further prospective studies are needed to confirm these findings, given the limited number of studies for certain beverages, highly heterogeneity, and the predominance of case-control designs in the current literature. https://inplasy.com/, identifier INPLASY (registration number INPLASY2025120094).
Predators suppress pest populations not only through direct consumption but also via non-consumptive effects (NCEs), in which prey perceive predation risk and alter behaviors, physiology, and life-history strategies. Despite the growing recognition of the importance of NCEs in biological control, most studies focus on cues from actively feeding predators, while the role of non-feeding stages, such as predator eggs, remains poorly understood. Here, we investigated whether eggs of the predatory mite Phytoseiulus persimilis function as intensity-dependent risk cues that influence the performance and population growth of the invasive spider mite Tetranychus ludeni. Exposure to P. persimilis eggs significantly altered T. ludeni life-history traits in a density-dependent manner, even in the absence of direct predation. Increasing predator egg density reduced female longevity, reproductive rate, and total fecundity, delayed reproductive onset, but accelerated early egg production. Exposure to predator eggs also generated pronounced transgenerational effects that prolonged egg and female offspring development, reduced egg hatching, and lowered immature survival. These individual-level responses translated into strong population-level consequences, which significantly decreased the net reproductive rate (R0), intrinsic rate of increase (rm), and finite rate of increase (λ), but increased population doubling time (Dt) as predation stress intensified. Our results demonstrate that predator eggs induce intensity-dependent NCEs that significantly suppress spider mite population growth. By extending fear-mediated effects from non-preying predator stages, this study broadens the functional scope of biological control and highlights the ecological significance of early predator cues in regulating pest populations. © 2026 The Author(s). Pest Management Science published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.
The limited penetration of chemotherapeutic agents into solid tumors remains a major obstacle to effective cancer treatment and is strongly influenced by the extracellular matrix (ECM). Three-dimensional (3D) tumor spheroids derived from primary tumor cells (PTCs) represent a valuable in vitro model to study how ECM composition and organization regulate drug distribution and cytotoxicity with accurate physiological relevance. By recapitulating key features of the tumor microenvironment, including endogenous collagen deposition and diffusion-limited drug accessibility, these models enable mechanistic investigation of microenvironment-driven drug resistance. Here, we describe a set of integrated protocols to evaluate the impact of ECM remodeling on chemotherapeutic response in primary breast tumor spheroids. Spheroids are generated from isolated primary tumor cells and subjected to controlled enzymatic degradation of collagen-rich ECM using ultrapure recombinant collagenases. As a model chemotherapeutic agent, doxorubicin is employed thanks to its widespread clinical use, well-characterized cytotoxic mechanism, and intrinsic fluorescence, which allows direct visualization of drug uptake and spatial distribution by confocal microscopy. In parallel, drug-induced cytotoxicity is quantified using a luminescent 3D viability assay. Together, these protocols provide a reproducible and accessible platform for investigating ECM-mediated barriers to drug delivery and toxicity in 3D tumor models. This framework facilitates the implementation of physiologically relevant assays to study drug efficacy and therapeutic resistance in solid tumors. © 2026 The Author(s). Current Protocols published by Wiley Periodicals LLC. Basic Protocol 1: Induction of breast cancer, isolation of tumor primary cells, and generation 3D spheroids Support Protocol: Culture and storage of PTCs Basic Protocol 2: Evaluation of collagen expression and enzymatic degradation in primary tumor spheroids by confocal microscopy Basic Protocol 3: Enzymatic degradation of the endogenous matrix collagen in primary tumor spheroids using recombinant collagenases Basic Protocol 4: Assessment of doxorubicin uptake in spheroids by confocal microscopy Basic Protocol 5: Assessment of cell viability in doxorubicin-treated spheroids using CellTiter-Glo 3D assay.
Mental health problems among undergraduate medical students are a major global public health concern that emerge early during training and are shaped by demanding educational environments, emotional stressors and organisational pressures. Although research has expanded rapidly, the literature remains fragmented across themes, regions and methods. This scoping review aims to map the global quantitative literature on medical students' mental health and identify gaps in scope, geography, methodology and equity. This scoping review will be conducted in accordance with the Joanna Briggs Institute methodological guidance and reported in accordance with PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. We will include quantitative studies assessing mental health among undergraduate medical students. MEDLINE (Ovid), Web of Science (Clarivate), the Cochrane Library (Wiley) and PsycINFO (Ovid) will be searched without date or language restrictions using a keyword-based search strategy. Two reviewers will independently screen titles, abstracts and full texts and extract data using a standardised form. Data will include publication year, country, study design, sample size, mental health measures, thematic domains and patterns of collaboration. Mental health domains will be classified using an a priori thematic framework encompassing psychological symptoms and distress, psychological resources, academic environment, social support and physical health and lifestyle factors. Equity-related variables (sex, gender identity, sexual orientation, race/ethnicity, socioeconomic status) will be operationalised based on analytical use. Results will be synthesised descriptively using tables and visualisations. Ethical approval is not required. Findings will be disseminated through publication and presentations. The dataset and code will be openly available on publication. Protocol registration will be made available online via the Open Science Framework (doi:10.17605/OSF.IO/2EHNU).
Mycotoxins remain a persistent threat to the safety and quality of cereal grains and other agricultural products, and their impact on human health continues to raise global concerns. In many situations, the practices traditionally used to control these toxins are no longer sufficiently effective. They can be costly, difficult to implement on a large scale, and, in some cases, create environmental drawbacks. As cereal products move through the supply chain, the need for faster and more sensitive detection tools, more reliable detoxification options, and practical postharvest preventive measures has become increasingly clear. This review scrutinizes recent advances in biotechnology- and nanotechnology-based approaches, focusing on their superior environmental sustainability compared to classical methods. Specifically, it evaluates how nanoparticle-assisted biosensors and advanced spectroscopic techniques significantly enhance the sensitivity and selectivity of mycotoxin monitoring systems. Biological and nanocatalytic detoxification methods, which provide milder and more environmentally friendly modes of action, are also discussed. In addition, advances in active and smart packaging are considered, especially their potential to limit fungal growth and prevent recontamination during storage and distribution. Taken together, these developments suggest that combining high-performance analytical tools with emerging bio-nano solutions could support more effective and sustainable mycotoxin management throughout the cereal supply chain. © 2026 The Author(s). Journal of the Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.
Bromelain, a complex mixture of proteolytic enzymes primarily extracted from plants of the Bromeliaceae family, has gained prominence because of its broad industrial applicability, particularly in the food, pharmaceutical and cosmetic sectors. Despite its wide use, a systematic understanding of recent scientific advances remains limited, highlighting the importance of bibliometric approaches. A bibliometric analysis was conducted using publications indexed between 2020 and 2024, retrieved from scientific databases, and analyzed through quantitative indicators of scientific production, collaboration networks and research trends. The analysis demonstrated a consistent growth in scientific output, with research leadership by countries such as China, India and Italy, reflecting strong governmental investment and well-established research frameworks. In the food industry, bromelain is applied in meat tenderization, beverage clarification and as a processing aid. Recent studies emphasize its role in the production of protein hydrolysates with bioactive properties, including antioxidant and antihypertensive activities. In the pharmaceutical field, its anti-inflammatory, analgesic and antitumoral effects are explored in the treatment of burns and tumors, as well as its potential neuroprotective applications. In cosmetics, bromelain is used in exfoliating formulations and dentifrices for stain removal. Bromelain research extends across multiple disciplines, promoting advances in biological sciences, medicine and chemical engineering. Recent efforts have focused on identifying alternative sources beyond pineapple, aiming to obtain enzymes with improved stability and functionality under diverse processing conditions. These advances reinforce bromelain's potential as a versatile and sustainable biotechnological resource. © 2026 The Author(s). Journal of the Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.
Infertility affects up to 20% of couples in high-income countries, which has led to an increased use of assisted reproductive technology (ART). While previous studies have linked ART to a higher risk of major congenital heart defects (CHD), less is known about the associated risk of minor CHD. As minor CHD are associated with premature early-onset cardiac morbidity and mortality, this study aimed to evaluate the risk of minor CHD in singleton infants conceived via ART compared with in those conceived spontaneously. The Copenhagen Baby Heart Study (CBHS) is a Danish, prospective, multicenter study of neonates delivered between 1 April 2016 and 31 October 2018. Included in this cohort study based on CBHS data were singleton infants who met the inclusion criteria and had undergone neonatal transthoracic echocardiography (TTE) within 60 days after birth. Infants conceived via ART, defined as either in-vitro fertilization or intracytoplasmic sperm injection, were matched randomly, based on sex and maternal age, in a 1:4 ratio with spontaneously conceived singleton infants, who formed the control group. The primary outcome was the diagnosis of minor CHD, defined as a ventricular septal defect (VSD), bicuspid aortic valve (BAV) and/or atrial septal defect (ASD), detected on neonatal TTE. For analysis of ASD, we assessed a subgroup of the matched infants included within the overall cohort who were evaluated using TTE from 15 May 2017 onwards using an algorithm for the TTE classification of interatrial communications implemented in the CBHS. Using multiple logistic regression analysis, we compared the risk of minor CHD in infants conceived via ART vs those conceived spontaneously, adjusting for maternal age, parental CHD, pregestational diabetes mellitus and maternal body mass index. Of 23 493 infants who met the inclusion criteria, 1630 singletons were conceived by ART. These were matched with 6520 controls who were conceived spontaneously. The subgroup of infants evaluated using the algorithm for TTE classification of interatrial communications comprised 862 infants conceived by ART and 3448 matched infants who were conceived spontaneously. The risk of minor CHD overall (VSD, BAV and/or ASD) in the subcohort evaluated using this algorithm was not significantly different between singleton infants conceived via ART and those conceived spontaneously (adjusted odds ratio, 1.07 (95% CI, 0.83-1.38)). Furthermore, we observed no significant differences in the risk of specific minor CHD subtypes (VSD, BAV and/or ASD) between singleton infants conceived via ART and those conceived spontaneously. Similarly, no significant differences in the risk of minor CHD were observed between ART subtypes, including conception via fresh in-vitro fertilization, fresh intracytoplasmic sperm injection and fresh- and frozen-embryo transfer, or between each ART subtype and infants conceived spontaneously. There was no increased risk of minor CHD in singleton infants conceived via ART compared with singleton infants conceived spontaneously. These findings provide reassuring evidence that ART is unlikely to impose an increased long-term cardiovascular risk attributable to subclinical minor CHD that would otherwise remain undiagnosed in the absence of screening. © 2026 The Author(s). Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
Radiotherapybased bladder-preserving strategies are established alternatives to radical cystectomy for selected patients with muscle-invasive bladder cancer (MIBC), yet survival outcomes remain heterogeneous and prognostic stratification is imprecise. Pretreatment hydronephrosis has shown adverse prognostic associations in cystectomy and trimodality therapy cohorts, but its impact across the broader spectrum of radiotherapy-based bladder preservation is unclear. This systematic review and meta-analysis aimed to quantify the prognostic significance of pretreatment hydronephrosis on survival outcomes in MIBC patients treated with radiotherapy-based bladder-preserving strategies. The study was designed as a systematic review with quantitative synthesis, structured around a predefined PICO framework. The protocol was prospectively registered in PROSPERO (CRD420261305703). Eligible studies included observational cohorts and clinical trials enrolling adults with MIBC treated with definitive radiotherapy-based bladder preservation, including radiotherapy alone, concurrent chemoradiotherapy, or trimodality therapy. Searches of PubMed, ScienceDirect, the Cochrane Library, Google Scholar, and Wiley Online Library were performed from January 2000 to December 2025. Risk of bias was assessed with ROBINS-I and study quality with Newcastle-Ottawa Scale. Time-to-event outcomes were extracted as hazard ratios (HRs) with 95% confidence intervals (CIs), prioritizing multivariable-adjusted estimates. Evidence synthesis was performed using random-effects models with inverse-variance weighting of log-transformed HRs according to the DerSimonian-Laird method. Forty-two studies comprising 8,586 participants met the inclusion criteria. Pretreatment hydronephrosis was significantly associated with inferior overall survival (HR 1.65, 95% CI 1.43- 1.91; I² 29.8%). This adverse effect was consistent across treatment modalities, including definitive chemoradiotherapy (HR 1.74, 95% CI 1.30-2.32; I² 34%), radiotherapy alone (HR 1.65, 95% CI 0.38-7.19; I² 0%), and trimodality therapy (HR 1.64, 95% CI 1.25-2.14; I² 39.6%), with no evidence of subgroup interaction (p = 0.93). Hydronephrosis was also associated with worse cancer-specific survival (HR 2.00, 95% CI 1.68-2.37; I² 8.9%). Disease control endpoints were consistently inferior in patients with hydronephrosis, including disease-free survival (HR 1.83, 95% CI 1.12-3.01; I² 48.7%), progression-free survival (HR 1.59, 95% CI 1.02-2.49; I² 0%), and metastasis-free survival (HR 1.56, 95% CI 1.32-1.84; I² 0%). The overall risk of bias across included studies was predominantly moderate. Pretreatment hydronephrosis is a robust, treatmentindependent adverse prognostic factor in radiotherapy-based bladder-preserving management of muscle-invasive bladder cancer, conferring consistently increased hazards for mortality and disease progression across all major oncologic endpoints. Its presence should be systematically integrated into baseline prognostic stratification, patient counseling, and risk-adapted surveillance strategies in bladder-preserving treatment paradigms.
Artificial intelligence (AI) is increasingly being integrated into various aspects of healthcare delivery, from diagnostics to patient management. While these advancements offer significant benefits, they also raise anxiety among healthcare professionals regarding job security, ethical implications, and changes in clinical decision-making. Despite the growing importance of this issue, there is limited consensus among healthcare professionals regarding the overall level of anxiety about AI. This systematic review and meta-analysis was conducted to assess healthcare professionals' anxiety about AI. This study was conducted in accordance with PRISMA guidelines and registered in the PROSPERO database (CRD420251017693). A comprehensive literature search was conducted in the Web of Science, PubMed, Scopus, EBSCO, ScienceDirect, and Wiley Online Library databases up to April 2025. Studies focusing on healthcare professionals' levels of anxiety about AI were included. Risk of bias was assessed using the JBI critical appraisal tool. In the analyses, effect sizes were calculated using the random effects model, while heterogeneity, sensitivity, and publication bias were assessed via Cochrane's Q, I2, τ2, leave-one-out analysis, funnel plots, and Egger's and Begg's tests. Nine studies involving 1877 healthcare professionals were included in the systematic review, and five studies (n = 926) that met the criteria were included in the meta-analysis. The meta-analysis revealed that the mean score on the AI anxiety scale was 59.26 (95% CI = 40.54-77.97), indicating that healthcare professionals generally experience a moderate level of AI-related anxiety. A statistically significant heterogeneity was observed among the included studies (I2 = 99.1%, τ2 = 224.20, p < 0.0001). While it can be suggested that healthcare professionals experience moderate to high levels of anxiety towards AI technologies, the high heterogeneity observed across the included studies makes it difficult to draw a generalized conclusion. The study highlights the necessity of proactive measures, including education and organizational support, to build healthcare professionals' confidence and readiness for AI adoption.
The MTT [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide] assay is low-cost, widely available, and mainly used to assess cell viability as a function of cellular oxidoreductase enzyme-dependent conversion of the water-soluble tetrazolium salt to insoluble purple formazan. Although MTT is often associated with mitochondrial redox activity, extra-mitochondrial MTT reduction has been identified in several cell types, shaping the assay towards a total oxidoreductase/metabolic activity measurement. Standard MTT protocols were developed for adherent monolayer cells and perform poorly with suspension cells, as medium removal, cell and formazan loss, aggregate formation, and incomplete formazan solubilization result in data with high variability and nonlinearity. To overcome these limitations, here we describe an easy, inexpensive, and optimized MTT protocol for evaluating the metabolic activity in human spermatozoa. Key improvements in cell number optimization, compound and medium non-interference validation, post-assay cell preservation, and homogenous formazan solubilization resulted in a reproducible and linear protocol compatible with conventional microplate readers. This method quantifies spermatozoa metabolic activity with improved precision across technical replicates and can be directly applicable to toxicology screening, spermatozoa quality assessment, and fertility research focused on spermatozoa bioenergetics. Furthermore, although optimized for human spermatozoa, the workflow described in this protocol is readily adaptable to other suspension cell types following simple cell-specific calibration. © 2026 Wiley Periodicals LLC. Basic Protocol: Quantitative evaluation of human spermatozoa metabolic activity using MTT.
The Demographic and Health Surveys (DHS) Program, launched in 1984, provides high-quality population health data that underpins a vast body of global health research. However, the scale and growth patterns of DHS-based publications remain underexplored, particularly as donor funding uncertainties threaten program sustainability. We examine temporal trends in DHS-based research output from 1984 to 2025, quantifying growth patterns and publication delays to inform understanding of the program's global research expansion. A systematic bibliometric review was conducted following PRISMA guidelines across PubMed, Scopus, Web of Science, Dimensions, Wiley, and CINAHL. Eligible peer-reviewed articles using DHS data between 1984 and 2025 were identified. Annual publication counts were analyzed, segmented regression identified growth inflection points, and timeliness was assessed by calculating lag between survey completion and publication. Over 10,000 DHS-based publications were identified. Annual output rose from isolated studies in the 1980s to several hundred annually by the 2010s. Segmentation analysis revealed two rapid growth phases: a 56-publications/year increase from 2004-2012, and a 71-publications/year increase from 2012 to 2024. Despite this growth, median lag from survey completion to publication remained approximately 5 years, with only a modest recent improvement (Kendall's τ =  -0.623, p < 0.001). DHS data have fueled exponential growth in global health research over four decades, confirming their vital role in evidence generation. However, persistent publication delays highlight the need to shorten the pathway from data collection to dissemination through strengthened research capacity in low- and middle-income countries. Sustained funding is essential to maintain this critical evidence source. Main findings: Over 10,000 peer-reviewed studies using Demographic and Health Survey (DHS) data were identified between 1984 and 2025, with publication output increasing markedly after 2004 and accelerating further after 2012. Despite this rapid growth in research output, the median time from survey completion to publication remains about 4 years, although it has improved substantially over time.Added knowledge: This study provides the most comprehensive and up-to-date bibliometric analysis of DHS-based research, documenting four decades of publication growth, identifying key inflection points in output trends, and quantifying improvements in the timeliness of translating DHS data into scientific evidence.Global health impact for policy and action: The findings highlight the critical role of DHS data in generating global health evidence and underscore the need for sustained funding and strengthened research capacity, particularly in low- and middle-income countries to ensure timely translation of survey data into policy-relevant insights.
Internalized stigma negatively impacts recovery outcomes, quality of life, and self-concept among individuals with psychiatric diagnoses. Group-based psychosocial interventions have been proposed as effective stigma-reduction strategies, but their impact across diverse populations remains under-evaluated. This systematic review synthesizes global evidence on the effectiveness of group-based interventions in reducing internalized stigma in adult psychiatric populations, with a focus on studies using the Internalized Stigma of Mental Illness (ISMI) scale. Following PRISMA 2020 guidelines, we searched PubMed, PsycINFO and Web of Science, and additionally screened full-text platforms (SpringerLink, ScienceDirect, SAGE Journals, and Wiley Online Library), for studies published between 2003 and 2025. Inclusion criteria required adult psychiatric populations, group-based interventions, and internalized stigma as a primary outcome. Study selection, risk of bias assessment, and data extraction were performed independently by two reviewers (US and GOC). Ten studies [n= 1,088], across five countries, met inclusion criteria, including randomized controlled trials and pre-post designs. Most studies reported significant reductions in ISMI scores post-intervention, particularly in the domains of stereotype endorsement and social withdrawal. Culturally adapted interventions in China, Poland, and Spain demonstrated feasibility and impact, though subscale reliability varied regionally. Group-based psychosocial interventions may help reduce internalized stigma in psychiatric populations within an ISMI-based evidence base. The ISMI scale is, to this day, among the most frequently used instrument, though cultural adaptation of subscales such as stigma resistance remains a concern.