Artificial intelligence (AI) is increasingly being integrated into healthcare systems; however, nurses' knowledge, attitudes, and perceived challenges play a crucial role in its adoption in patient care. This study aimed to assess nurses' knowledge, attitudes, and perceived challenges toward AI, examine the relationships among these variables, and explore their associations with demographic characteristics and prior AI training. A descriptive analytical cross-sectional study was conducted among 107 nurses working in intensive care, medical, and surgical units at Zagazig University Hospital. A purposive sampling technique was used. Data were collected over two months using structured instruments during morning shifts. Most participants were aged 25-34 years (55.1%), male (65.4%; reflecting the accessible sample composition), and held bachelor's degrees (68.2%), with nearly half (49.5%) having 5-10 years of clinical experience. Overall, 68.2% of nurses achieved satisfactory knowledge scores, whereas 88.8% demonstrated positive attitudes toward AI applications. Perceived challenges were mainly related to technical and ethical concerns, particularly the need for continuous system updates, cybersecurity risks, and implementation costs. A statistically significant weak negative correlation was found between nurses' knowledge and attitudes toward AI (r = -0.195, p = 0.044). No significant correlations were observed between knowledge and perceived challenges (r = -0.162, p = 0.095) or between attitudes and perceived challenges (r = 0.142, p = 0.145). Previous AI-related training was significantly associated with more positive attitudes toward AI (p = 0.019), whereas no significant associations were found with knowledge or perceived challenges. Educational level, workplace, and years of experience were not significantly associated with nurses' knowledge, attitudes, or perceived challenges. Nurses demonstrated a satisfactory knowledge and generally positive attitudes toward AI applications in patient care, while perceiving moderate implementation challenges. Although previous AI-related training was associated with more positive attitudes, no significant associations were found with knowledge or perceived challenges. The weak negative correlation between knowledge and attitudes suggests that greater awareness of AI may be accompanied by increased concerns regarding its use. Further educational initiatives are needed to enhance nurses' preparedness for AI integration in clinical practice.
As a detrimental and persistent criminal, social, and health issue, intimate partner violence (IPV) is a severe threat to the well-being of survivors. The healthcare system, specifically the emergency department, has provided access to services and supports for survivors of IPV when seeking healthcare. However, many survivors of IPV are unable to attend the hospital and access the corresponding services. Paramedics, versatile in-community service providers, could play a vital role in linking survivors to healthcare and support services. In-community IPV advocates understand the circumstances of survivors and have expert knowledge of services. To examine how the perspectives of IPV advocates can inform our understanding of paramedic services. Actioning an interpretive description approach in the context of paramedicine, IPV advocates in western Canada participated in semi-structured focus groups. Focus groups were transcribed verbatim and de-identified. De-identified transcripts were inductively analyzed (NVivo) for patterns. N = 17 IPV advocates (all women; age 42 ± 12) participated in focus groups. Participants indicated that primary and emergency healthcare, recognition of and validation for situations involving IPV, and the referral to specialized resources were desirable services paramedics could provide. Challenges for survivors accessing services through paramedics were paramedic conduct, paramedic capacity, paramedic service shortcomings, situational logistics, concurrent conditions, service access, and patient and perpetrator factors. Solutions for these challenges include adopting safe, equitable, and patient-centred practice, establishing and maintaining functional working capacities for paramedics, developing functional infrastructure and supporting policy, providing adaptable and versatile service options, avoiding biases and stereotypes, and considering holistic patient concerns, generating innovative methods to promote service access for all patients, and integrating techniques to facilitate patient engagement and mitigating perpetrator interference. Given the desired services from paramedics and the challenges identified for survivors, it is likely that a practice gap exists among paramedics and paramedic services. IPV advocate-derived solutions may help inform paramedics and paramedic services to address these challenges. If the best available evidence is utilized to develop positive change, paramedics could advance into specialist resources for survivors of IPV.
Artificial intelligence (AI) is increasingly integrated into radiology, but pediatric imaging remains underrepresented in implementation studies. To assess the current status, barriers, and enablers of AI adoption in Pediatric Radiology from a global leadership perspective. A cross-sectional international survey of department leaders and division chiefs from pediatric radiology centers worldwide was conducted. The questionnaire included 14 items across domains of AI deployment, enablers, barriers, ethical concerns, stakeholder involvement, and future directions. Descriptive statistics were used for analysis. Eighteen institutions completed the survey (69% response rate). Sixteen centers (88.9%) reported implementing at least one AI tool, with bone age assessment remaining the most widely used application (44.4%). Other applications included image segmentation and quantification (22.2%), imaging protocol optimization (16.7%), and natural language processing (16.7%). The mean clinical impact rating was 3.56/5, with only 16.7% describing AI as "transformational." The most frequently cited barriers were lack of pediatric-specific datasets (83.3%), integration challenges (66.7%), high cost or unclear return on investment (ROI) (50%), and cybersecurity concerns (44.4%). Enablers were primarily human rather than technical, with vendor maturity and integration (72.2%) and internal champions (66.7%) most frequently highlighted. Regional variation was observed, with NLP/reporting clustered in North America and transformational impact ratings concentrated in the Asia-Pacific centers. A slim majority (55.6%) agreed that pediatric AI research currently overemphasizes model development over clinical integration, ethics, and sustainability. Global pediatric radiology leaders report cautious but growing AI adoption. Addressing pediatric data scarcity, enhancing multicenter collaboration, and prioritizing clinical integration and sustainability will be essential for safe and effective deployment. Question How are leading pediatric radiology centers worldwide implementing AI, and what institutional barriers and enablers determine successful clinical integration? Findings Most centers deploy at least one AI tool, but perceived impact remains modest due to pediatric data scarcity and workflow integration challenges. Clinical relevance Addressing pediatric-specific dataset limitations through multicenter collaboration, empowering institutional AI champions, and prioritizing clinical integration over model development alone will be essential for ensuring AI benefits children as effectively as adults.
Diabetic retinopathy (DR) and diabetic macular edema (DME) are leading causes of vision loss worldwide and represent a growing public health concern in Mexico. Despite the availability of effective treatments, including anti-vascular endothelial growth factor (anti-VEGF) therapies, adherence and persistence remain suboptimal, compromising outcomes. This study, part of the international DR Barometer project, examined the perspectives of patients, healthcare providers, and clinic staff to better understand challenges and opportunities in DR/DME care delivery in Mexico. A cross-sectional, survey-based study was conducted across five high-volume ophthalmology clinics in Mexico. Standardized, paper-based questionnaires were completed anonymously by patients with DR or DME, healthcare providers, and clinic staff. Data were collected between October and November 2023, scanned, and analyzed descriptively. A total of 1151 participants were included: 558 patients with DME, 265 patients with DR, 122 providers, and 206 clinic staff. Key barriers to adherence included financial burden of treatment (reported by 67.4% of patients with DME; emphasized by 97.5% of providers), logistical difficulties such as travel and long waiting times, and emotional concerns about being a burden to family (71.5% of patients with DME; 61.1% of patients with DR). Nonadherent patients were more likely to prioritize competing health issues and report limited support from care teams. While most patients stated that eye treatment was a priority (87-91%), only 61% of providers believed this to be true. Opportunities highlighted across stakeholders included proactive provider-patient communication, continuity of care with the same clinical team, appointment reminders, and financial assistance. Clinic staff emphasized the need for improved educational materials and better coordination of diabetes and eye care services. This study reveals substantial challenges to adherence in DR/DME management in participating Mexican referral centers, rooted in financial, logistical, and psychosocial factors. Strengthening communication, expanding financial support, and integrating coordinated, patient-centered care strategies could improve long-term treatment engagement and outcomes.
Institutional maternal and perinatal outcomes are highly specific to local contextualized conditions and are suited to inform local policy. As institutional delivery increases, maternal health events are more likely to occur in facilities than at home. This was a before-after impact evaluation study through the implementation of a 3-year quality improvement project undertaken in Central Region. The goal was to reduce institutional maternal mortality ratio and perinatal mortality rate over a 3-year period from 2021 to 2023 with 2020 as a baseline year. Baseline assessment was conducted by reviewing 2020 maternal death audit reports to identify key challenges associated with maternal deaths. Interventions were drawn to address identified challenges by key stakeholders. Sensitization meetings were held with stakeholders, health managers and health staff to discuss the interventions and solicited their support. Interventions implemented were life-saving skills and safe motherhood trainings for health staff across the region, introduction of maternal death tracker to improve surveillance on maternal death, clinical supervision of health staff at the peripheral level by specialist through telemedicine using WhatsApp platforms from 2021 to 2023. Baseline indicators were collected from the District Health Information Management System-2 (DHIM2) in 2020. The outcome indicators were improved family planning coverages, increased skilled delivery rates and reduction in maternal mortality ratio and perinatal mortality rates. Process indicators were proportion of practicing midwives and clinicians trained in life saving skills, number of health centers conducting basic emergency obstetric care signal functions, percentage of audited maternal deaths entered DHIMS2. Over the course of the project, 4,800 health staff were trained, skilled birth rate improved from 61.6 to 63.9%, family planning acceptor rate from 28.5 to 45.1% and reported maternal deaths audited improved from 78.7 to 100%. The implementation of institutional audit recommendations also improved from 20 to 72%. Institutional maternal mortality ratio declined by 25.3% and neonatal deaths by 45.2%. Quality improvement methods using the project approach to strengthen maternal health services can lead to improve mother and baby health outcomes. This approach when scaled up nationally may help increase the chances of meeting the sustainable development goal three, I recommend the implementation of the interventions to policymakers such as the Ministry of Health to support in reducing institutional maternal and perinatal mortalities.
Using experience-based co-design (EBCD) methodology, we aimed to co-design and pilot a culturally adapted osteoporosis programme with older people from culturally and linguistically diverse (CALD) communities in Australia. This three-phased study was conducted in one of the most culturally diverse regions in Australia. Twelve end users from three selected language communities with lived experience of osteoporosis and eight subject matter experts were recruited for the first two phases. Phases 1 and 2 utilised interviews and workshops to explore challenges experienced during osteoporosis diagnosis and management and co-designed the key elements for the MultIcultural commuNities co-DeSigned ostEoporosis Toolkit (MINDSET) programme. This programme was piloted with the selected communities (Phase 3) and evaluated for acceptability (participants' satisfaction) and efficacy. The latter was measured by comparing the differences in pre/post Osteoporosis Knowledge Assessment Tool (OKAT) scores among end users. Common challenges identified included (i) lack of access to reliable information, (ii) osteoporosis perceived as a normal part of ageing, and (iii) lack of resources to guide discussions with general practitioners. The programme was piloted with 132 participants (n = 46 Cantonese-speaking, n = 52 Mandarin-speaking and n = 34 Vietnamese-speaking). All participants were highly satisfied with the programme, with 90% of participants stating that they would likely/very likely recommend the programme to others. A significant improvement in pre-post scores on the OKAT was also observed across all groups (mean difference = +2.03, 95% CI 1.42 to 2.63, p < 0.001). MINDSET is an acceptable community-based education programme to improve short-term osteoporosis-specific knowledge for people from selected culturally diverse backgrounds.
Hospital-at-Home (HaH) has been shown to be clinically and cost effective, but many programs struggle to scale. We conducted a systematic review of HaH studies reporting implementation contexts, strategies and outcomes with the primary aim to synthesise the implementation evidence on HaH. Our secondary aim was to develop a framework of HaH implementation outcome indicators for future studies to apply. We searched the literature PubMed, Embase and Scopus, for publications from 2012 to 2022. We included studies related to HaH that included at least one implementation context and at least one implementation outcome variable, excluding clinical outcomes measures. At least two reviewers independently selected studies, abstracted data and assessed quality. We coded the implementation determinants to the Consolidated Framework for Implementation Research (CFIR); implementation strategies to the Expert Recommendations for Implementing Change (ERIC); and implementation outcomes to the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) frameworks. We included 27 studies in the final review, which reported 24 CFIR contextual factors, 25 ERIC strategies, and all domains of the RE-AIM evaluation framework. The most commonly reported implementation determinant, identified in six studies, was information technology infrastructure, which included streamlining documentation processes and improving access to patient records. Five studies described the following implementation factors: (i) work infrastructure, focusing on organising manpower effectively; (ii) capability of innovation deliverers, referring to staff posessing the necessary skills to perform their roles; and (iii) local conditions, such as the geographical challenges associated with HaH. The most frequently referenced implementation strategies were conducting ongoing training (nine studies), creating new clinical teams (eight studies), and promoting adaptability (seven studies). All assessed implementation outcomes were aligned to the RE-AIM framework, with volume of admissions, patient-reported experiences or outcome measures, and home visit frequency being most commonly reported (four studies each). The majority of implementation measures lacked a common denominator, and use of validated tools across studies was lacking. We identified a list of implementation determinants, strategies and outcomes that can be used to inform scale-up of HaH, and have developed a framework for consistent reporting of HaH implementation studies grounded onto RE-AIM.
Plexiform neurofibromas are benign peripheral nerve sheath tumors that typically present in childhood and are most often associated with neurofibromatosis type 1. They usually manifest as diffuse, infiltrative masses involving a single nerve distribution. Adult-onset, multifocal, discrete retroperitoneal plexiform neurofibromas are rare and sparsely reported. This case is presented to expand the known phenotypic spectrum and to emphasize the diagnostic challenges posed by atypical presentations. A 37-year-old Iranian woman presented with a 3-month history of vague, intermittent abdominal pain without bowel or urinary symptoms. Her medical history was notable for long-standing refractory iron deficiency anemia of unknown cause. Physical examination revealed mild bilateral lower abdominal tenderness with no palpable masses or neurological deficits. Laboratory investigations confirmed microcytic anemia. Although anemia has occasionally been reported in patients with neurofibromatosis type 1 due to associated gastrointestinal lesions or chronic disease, no evidence of such an association was identified in our patient, and the anemia was considered an incidental comorbidity. Abdominal ultrasonography demonstrated bilateral hydronephrosis, prompting further imaging. Computed tomography revealed multiple well-defined soft tissue masses along the bilateral paraspinal and psoas muscles, causing ureteral compression. Magnetic resonance imaging showed lesions that were isointense to muscle on T1-weighted sequences and hyperintense on T2-weighted sequences, with persistent signal on fat-suppressed images and contrast enhancement. No osseous involvement or intra-abdominal organ invasion was identified. The imaging findings were highly suggestive of plexiform neurofibromas, and the diagnosis is therefore radiologically favored in the absence of histopathological confirmation. Genetic testing and further management were recommended; however, the patient did not return for follow-up. This case illustrates an unusual adult-onset, multifocal, discrete presentation of plexiform neurofibromas in the retroperitoneum without a prior diagnosis of neurofibromatosis type 1. Recognition of such atypical imaging and clinical features is important to avoid misdiagnosis and unnecessary intervention. The case underscores the value of multimodality imaging in identifying rare variants and highlights the need for heightened clinical awareness of phenotypic variability in plexiform neurofibromas.
A range of mass spectrometry-based proteomic approaches is now employed to characterize the surface proteome-surfaceome-of pathogenic microorganisms, including fungi capable of causing infections in humans. Nevertheless, the preparation of surface-enriched samples remains technically challenging because of the persistent risk of intracellular protein contamination. Cell surface shaving represents a focused sample treatment approach in which proteolytic enzymes act on intact cells to release surface-exposed peptides, thereby enriching this fraction for high-resolution liquid chromatography coupled tandem mass spectrometry (LC-MS/MS) analysis. Optimizing sample preparation for fungal surface proteomics is critical, as reducing sample complexity, enriching surface-exposed components, and ensuring LC-MS/MS compatibility must be achieved while avoiding matrix interferences, partial lysis, and biases toward only trypsin-accessible epitopes. These methodological challenges, as well as strategies for validating sample-treatment selectivity with appropriate controls, are discussed in this chapter.
The increasing prevalence of antifungal resistance necessitates the exploration of novel therapeutic agents from natural reservoirs. Bacteria derived from medicinal plants serve as an underexploited repository of biologically active secondary metabolites. This study investigated the chemical profile and antifungal potential of the cell-free supernatant (CFS) derived from Lactiplantibacillus plantarum (L. plantarum) strain isolated from the medicinal plant Pulicaria jaubertii (P. jaubertii) (Asteraceae) in Yemen. L. plantarum was isolated from surface-sterilized leaves of P. jaubertii and cultured to obtain CFSs. The chemical composition of the CFS was characterized using Fourier-transform infrared (FT-IR) spectroscopy. Antifungal efficacy was evaluated against clinically significant isolates of Aspergillus fumigatus (A. fumigatus) and Candida albicans (C. albicans) using agar incorporation and agar well-diffusion methods, respectively. FT-IR spectroscopy indicated that the CFS is a complex mixture containing functional groups of organic acids, peptides, and carbohydrates. It exhibited dose-dependent antifungal activity, achieving 71.9% and 90.0% growth inhibition against A. fumigatus and C. albicans, respectively, at 30% (v/v). Notably, a sharp increase in efficacy occurred between 20 and 25% (v/v). We hypothesize that this threshold effect may reflect a multi-mechanistic mode of action, potentially driven by the interplay between the acidic and peptidic constituents. These findings underscore the potential of L. plantarum CFS as a promising, sustainable source of multicomponent antifungal agents. This study highlights the value of integrating plant biodiversity with microbial chemistry to develop postbiotic interventions that address critical fungal challenges.
The clinical performance of standard chemotherapeutics is often limited by systemic toxicity and the rapid development of multidrug resistance. To address these challenges, we used an aqueous extract of Justicia adhatoda leaves to develop a sustainable, plant-based method for synthesizing Zinc Oxide (ZnO) and Silver (Ag) nanoparticles. This green approach provides a biocompatible alternative to traditional chemical methods, reducing hazardous waste. We characterized the resulting materials using XRD, FTIR, UV-Vis, FE-SEM, EDX, and Zeta potential analysis. Structural analysis confirmed that the synthesized ZnO nanoparticles formed a crystalline hexagonal wurtzite structure with an average particle size of 72.0 nm. In contrast, the Ag nanoparticles exhibited a face-centered cubic geometry with a mean particle size of 39.46 nm. Zeta potential measurements revealed high surface stability for both nanostructures, showing negative surface charges that prevent agglomeration. In the biological assay, ZnO NPs exhibited broader and more consistent antibacterial efficacy against Staphylococcus aureus and Klebsiella pneumoniae than Ag NPs in standard well diffusion. Time-kill kinetics further substantiated that ZnO NPs demonstrated more rapid, concentration-dependent bactericidal action over a 24-h window compared to Ag NPs. Conversely, MIC and MBC analyses showed that Ag NPs were highly effective against specific strains, such as S. aureus (1.56/3.125 µg/mL). Both nanostructures demonstrated potent, dose-dependent cytotoxicity against HeLa and A549 cancer cell lines. To the best of our knowledge, this is the first comparative study between ZnO and Ag nanoparticles synthesized from Justicia adhatoda under identical conditions. These findings highlight Justicia adhatoda as a powerful reducing and stabilizing agent, supporting the development of a scalable platform for multifunctional nanomaterials in targeted therapeutics.
GAMYBsand TT2 are R2R3-MYB TFs involved in seed dormancy and germination, with GAMYBs mediating GA signaling and TT2 regulating seed-coat proanthocyanidins. The MYB (v-myb avian myeloblastosis viral oncogene homolog) transcription factors (TFs) constitute one of the most diverse and evolutionarily conserved families of plant regulatory proteins, contributing to vegetative reproduction, anthocyanine (ANC) and triterpenoids biosynthesis, abiotic stress responses, immunity process and plant diversification. MYB proteins are ancient regulators, originating approximately one billion years ago in early eukaryotes and subsequently diversifying in plants and animals. The expansion of MYB genes in plants underlies their key role in generating phenotypic variation. Among the existing MYB TFs, the R2R3-MYB subfamily has undergone extensive expansion and diversification in land plants, conferring broad regulatory versatility across developmental, metabolic, and stress-response processes. Collectively, R2R3-MYB TFs are closely linked to phytohormone signalling and play a central role in fine-tuning of plant response networks. Additionally, R2R3-MYB and GAMYB TFs play central and multifaceted roles in regulating seed development, seed-coat pigmentation, dormancy, and germination. Members of the R2R3-MYB, such as MYB56, MYB62, MYB96, and MYB30, and GAMYB-related TFs highlighted here, integrate hormonal cues (ABA, GA, JAs, and NO) with transcriptional networks governing flavonoid biosynthesis, seed size determination, reserve mobilization, and seed-coat architecture. Through transcriptional and post-translational regulation, these TFs balance dormancy maintenance and germination competence. The regulatory roles of R2R3-MYB and GAMYB TFs during the final phase of the seed life cycle (SLC) are reviewed, as this topic has received little attention to date. Notably, this review synthesizes recent advances on the structural, evolutionary, and functional roles of GAMYB and TT2 TFs, including a phylogenetic analysis that highlights lineage-specific gene ascription, conserved clades, and evolutionary relationships within the R2R3-MYB family. Finally, perspectives and challenges are summarized to inform future studies on these important TFs in seed dormancy and germination.
Macrophage lipid accumulation is a hallmark of atherosclerosis and other metabolic diseases. Toll-like receptor 4 (TLR4) signaling and cytoskeletal remodeling have each been implicated in this process, yet the mechanistic connections among these three elements remain incompletely defined. This review synthesizes current evidence for pathways in which TLR4 activation, via bifurcated signaling through MyD88/TRAM, SYK/Src, and integrins, engages small GTPases (Rac, Cdc42, Rho) and downstream effectors including cofilin and paxillin to drive cytoskeletal remodeling. These cytoskeletal changes facilitate lipid internalization through multiple routes, including macropinocytosis, receptor redistribution, and lysosomal synapse formation, and regulate lipid droplet dynamics, ultimately promoting foam cell formation. We also discuss the therapeutic potential and safety challenges of targeting cytoskeletal regulators in diseases such as atherosclerosis. The convergence of TLR4 signaling, cytoskeletal remodeling, and lipid metabolism represents a compelling mechanistic nexus for understanding foam cell formation. Elucidating the molecular details of this pathway-particularly the SYK/Src-cytoskeleton axis-may reveal macrophage-selective therapeutic targets that suppress pathological lipid accumulation while preserving host defense functions.
PARTNERS is a model of care that was co-designed with service users and carers to address the needs of people with severe mental illness to receive better support in primary care. Taking learning from a randomised controlled trial and process evaluation of this complex person-centred goal and coaching-based approach to care, our aim was to understand better the challenges of implementing PARTNERS in complex dynamic service delivery systems. We identified two Integrated Care Systems that were interested in adopting the PARTNERS model of care. We trained practitioners to adopt PARTNERS to their local settings and provided meta-supervision (supervision of supervisors). We examined the implementation period that covered site engagement, training of staff and initial delivery of the new PARTNERS model of care, undertaking a qualitative realist evaluation informed by the Consolidated Framework for Implementation Research (CFIR). Data collection involved semi-structured interviews with 10 System Change Leads, Supervisors, and trained intervention practitioners or 'Care Partners'; augmented by observations of supervision and practice within the systems and collation of documents. Analysis was qualitative informed by a realist approach and the CFIR. Analysis identified complex overlapping configurations of teams and roles within them, leadership, and individual characteristics influenced the systems' ability to implement the PARTNERS model of care. The presence or absence of leadership was instrumental in providing clarity regarding where the delivery of PARTNERS sat within newly emerging systems and was an important indicator of successful implementation. Collaborative leadership and supervision, alongside training tailored to the needs of individual practitioners, increased or decreased perceived self-efficacy amongst individual practitioners and their confidence in delivering the PARTNERS model of care. We identified that both internal and external supervision and system leadership are crucial to the implementation of PARTNERS, backed up by training delivered by a clinician and people with lived experience, to ensure that this new model of care is embedded in everyday practice. It is likely that the absence of any one of these mechanisms could make implementation and sustainability of the PARTNERS model challenging. Not applicable.
Honeybees, Apis mellifera, play a vital role as pollinators in global agricultural ecosystems. Nutrition, particularly dietary protein content, profoundly impacts honeybee health and reproduction. Yet, the molecular mechanisms connecting diet composition and gene expression in honeybee eggs remain underexplored. In this study, we investigate the intricate relationship between diet, gene expression, and honeybee egg development. Using RNA-seq analysis, we explore the effects of different protein-to-carbohydrate (P: C) ratios in honeybee diets on differential gene expression in the eggs laid by the queen and potential associated molecular responses. Our research identifies 1007 differentially expressed genes (DEGs) across various dietary conditions, highlighting the pivotal role of nutritional composition in shaping gene expression during egg development.Cluster analysis revealed two DEG profiles corresponding to low protein diets (LPD) and high protein diets (HPD). LPD conditions upregulate genes linked to protein catabolism, autophagy, and ubiquitin-mediated proteolysis, indicating potential cellular responses to nutritional stress. Conversely, HPD conditions upregulate genes related to RNA processing, spliceosome activity, and the MAPK signalling pathway, suggesting normal cellular development.Notably, the Hippo signalling pathway exhibits distinct gene regulation patterns under LPD and HPD conditions, potentially influencing cellular growth and differentiation in response to nutrient availability.Our findings underscore the critical role of nutrition in honeybee health and reproduction, providing insights into optimizing honeybee diets for colony health and resilience. As honeybee populations confront challenges from changing environmental conditions and resource availability, understanding these molecular responses is crucial for their effective management and conservation as essential pollinators. This study establishes a foundation for further investigations into the functional consequences of these molecular responses at the individual level and their broader implications for honeybee colony development and health.
The remediation of cadmium (Cd)-contaminated agricultural soils poses great challenges. Electrokinetic technology can effectively remediate Cd-contaminated soils, but the electrode polarization effect restricts its remediation efficiency. Therefore, in this study, Cd-contaminated paddy soil samples from northern Guangxi were used as the research object. An L₉(3⁴) orthogonal experimental design was employed to investigate the effects of power supply duration, voltage gradient, power supply mode, and electrolyte type on the remediation efficiency of Cd-contaminated soil via electrogeochemical survey technology, and to determine the optimal electrokinetic remediation parameters. The results indicate that the optimal electrokinetic remediation parameters were a voltage gradient of 0.6 V/cm, a duration of 144 h, continuous power supply, and EDTA-2Na as the electrolyte. Among all experimental runs, the highest measured removal efficiency (49.14%) was achieved in the EK6 group. Statistical analysis revealed that the priority of influence of each factor is electrolyte type > voltage gradient > power supply duration, whereas the effect of the power supply mode was not significant. Mechanistic analysis reveals that EDTA-2Na forms EDTA4- at the cathode, which coordinates with Cd2+ to generate the stable [Cd-EDTA]2- complex. This process effectively mobilizes the recalcitrant Cd fractions, and increases the proportion of the water-soluble fraction of Cd in soil from less than 0.1% to over 35%. Concurrently, the electrogeochemical survey configuration suppressed electrode polarization, and no white film deposition was observed on any of the electrodes. These combined effects resulted in an average Cd removal efficiency of 46.6% with EDTA-2Na, substantially outperforming both citric acid (39.4%) and double deionized water (41.2%). The combined application of electrogeochemical survey with EDTA-2Na forms a synergistic multiphase electrochemical reaction mechanism, significantly improving the overall remediation efficiency of Cd-contaminated soil.
Atopic dermatitis (AD) is a prevalent inflammatory skin disease and a major source of disease burden in children. Biomarker studies in childhood AD span genetic, immune, microbial and metabolic domains, but prior reviews have often focused on single molecular layers, specific sample sites or clinical classification. As a result, the field lacks an integrated, systems-level synthesis that compares and contextualizes biomarkers across domains while clearly distinguishing evidence strength. The rapid growth of literature in this field also poses practical challenges for traditional manual review workflows. To address these gaps, we conducted an AI-augmented, multi-domain review of childhood AD biomarkers. ASReview supported title and abstract screening, while ChatGPT assisted structured data extraction with human validation. Across 526 studies, we identified 141 genome, 95 immunome, 57 microbiome and 75 metabolome childhood AD biomarkers. The most frequently reported biomarkers included Filaggrin, IgE, CCL17, Staphylococcus, Bifidobacterium and vitamin D. Using a structured evidence-grading framework, eight biomarkers were categorized as having strong evidence: IgE, CCL17, CCL27, eosinophil cationic protein, eosinophil, IL-18, IL-31 and Escherichia. By synthesizing evidence across biomarker domains, we developed a systems-level, conceptual AD model in which barrier defects, Th2 inflammation, microbial dysbiosis and metabolic imbalance drive a self-perpetuating cycle of inflammation and barrier dysfunction. We also developed a web app for exploration of the biomarker findings: https://leejw.shinyapps.io/eczema_review_526/. This review provides a broad synthesis of childhood AD biomarkers and frames the evidence within an integrated, multi-domain conceptual model. The findings support the rationale for approaches that consider multiple biological nodes, including barrier repair, immune modulation, microbiome-directed strategies and metabolic factors, while underscoring the need for further validation before clinical implementation. Methodologically, the study illustrates how a hybrid human-AI review workflow can support scalable biomedical evidence synthesis without replacing human oversight.
Multifunctional perovskite nanostructures capable of addressing sustainable energy and biomedical challenges are of great interest to researchers. In this study, BiFeO3 (BFO), Ag-modified BFO (BFO-Ag), fuel-assisted α-BFO, and biofuel-assisted Ag-modified α-BFO (α-BFO-Ag) nanostructures were synthesized via solution combustion using Ravenia spectabilis leaf extract as fuel to investigate the effects of compositional and synthetic modifications on structural, magnetic, anticancer, and electrochemical properties. The evaluated band gap (3.09 and 3.15 eV) suggests effective charge-transport. The formation of rhombohedral BiFeO3 (JCPDS #01-074-2016) was confirmed by PXRD analysis in all samples with distinct diffraction planes. Conversely, the weak secondary reflections of Bi2O3 observed in pristine BFO were significantly diminished in the Ag-modified and fuel-assisted samples, indicating enhanced phase purity. Also, the same was affirmed by conducting Rietveld refinements for the obtained pattern. Morphological analysis revealed densely packed, agglomerated, and polyhedral nanostructures with distinct grain boundaries and compact surface features, characteristic of combustion-derived materials. BET studies revealed the mesoporous feature of the synthesized α-BFO-Ag nanostructure. Magnetic measurements indicated an enhanced magnetic response for α-BFO-Ag compared to the other synthesized samples, which may be associated with Ag incorporation and defect-induced modifications in the magnetic ordering. The nanostructures also exhibited dose-dependent cytotoxicity against MDA-MB-231 triple-negative breast cancer cells, with α-BFO-Ag demonstrating comparatively higher anticancer activity among the investigated samples. Based on electrochemical investigations, the BiFeO3@Ag + Fuel electrode demonstrated low overpotentials of 82 mV at 10 mA cm- 2 and low charge-transfer resistance (11.97 Ω) along with enhanced hydrogen evolution reaction (HER) efficiency. Ag incorporation and fuel-assisted synthesis led to enhanced charge transport, surface activity, and biological response, making these nanostructures promising dual-functional materials for sustainable hydrogen production and anticancer applications.
Psoas abscess is rare in children. Its nonspecific clinical presentation poses diagnostic challenges. This study aimed to evaluate the clinical and demographic characteristics, as well as the diagnostic and therapeutic processes, of 28 pediatric patients diagnosed with psoas abscess, and to provide a broader perspective for the literature. The records of 28 patients treated at a tertiary care hospital between January 1, 2005, and December 1, 2025, were reviewed. Age at admission, presenting complaints, clinical and radiological findings, and treatment regimens were analyzed retrospectively. A total of 28 pediatric patients were included over 20 years. The male-to-female ratio was 1:1. Nine patients (32.1%) were younger than 5 years of age. An underlying condition was identified in 18 patients (64.3%). Hip pain was one of the most common findings and was present in all primary cases. Fever was observed more frequently in secondary cases (54.5%) than in primary cases (16.7%). The most commonly identified microorganisms in cultures were gram-positive pathogens, particularly Staphylococcus species. The median length of hospital stay was 38 (21.0-57.5) days. Surgical intervention was performed in 19 patients (67.9%). No mortality was observed. Psoas abscess is a rare but serious infection that typically presents with nonspecific symptoms. A high index of suspicion is required for diagnosis. Early initiation of antibiotic therapy and timely drainage are among the most important factors influencing prognosis. There are limited studies on this condition in children, and we believe that our study will contribute to the existing literature.
BACKGROUND The coexistence of cardiac myxoma and hypertrophic cardiomyopathy is exceedingly rare and poses diagnostic and therapeutic challenges. While atrial myxomas may cause acute hemodynamic compromise, concomitant left ventricular outflow tract obstruction (LVOTO) due to hypertrophic cardiomyopathy can remain clinically underestimated, raising uncertainty regarding the optimal timing of septal reduction therapy. CASE REPORT A 38-year-old man was admitted with acute dyspnea and hypoxemia. Imaging revealed pulmonary congestion and a large left atrial mass causing functional mitral stenosis. Transthoracic echocardiography demonstrated asymmetric septal hypertrophy (maximum thickness 25 mm) with dynamic LVOTO and a mobile left atrial mass consistent with myxoma. The patient underwent surgical resection of the tumor with concomitant septal myectomy. Histopathology confirmed atrial myxoma and myocardial hyperplasia. Postoperatively, complete atrioventricular block required permanent dual-chamber pacemaker implantation. At short-term follow-up, the patient was asymptomatic with mild residual LVOTO. CONCLUSIONS This case underscores the importance of comprehensive structural and functional assessment in patients with intracardiac tumors. In young patients with favorable prognostic features and significant left atrial dilatation, early septal myectomy performed concomitantly with tumor resection may be justified, even when resting LVOT gradients are below conventional thresholds. This strategy aligns with the latest American and European guidelines on cardiomyopathies and may prevent delayed intervention and disease progression. The case also highlights atrioventricular block as a relevant complication of surgical myectomy, reinforcing the need for careful perioperative planning. Overall, this report provides an instructive example of individualized surgical decision-making in complex cardiomyopathy presentations.