Connective tissue disorders (CTDs) frequently cause severe oesophageal dysmotility and medically refractory gastro-oesophageal reflux disease (GERD). Laparoscopic anti-reflux surgery may offer symptom relief, but concerns remain regarding postoperative dysphagia in patients with ineffective or absent peristalsis. This review assesses outcomes of anti-reflux surgery in patients with CTD, focusing on reflux control, dysphagia and the impact of fundoplication type. A PubMed search identified English-language studies reporting outcomes of laparoscopic anti-reflux surgery in patients with CTD. Extracted variables included demographics, preoperative investigations, operative approach, complications and symptom outcomes. Nine studies reporting 129 laparoscopic procedures were included, 109 of which were fundoplications. Scleroderma represented 78% of CTD diagnoses. Partial fundoplication comprised 68% of operations. Reflux symptoms resolved in 87% of patients, and regurgitation improved in 74%. Among the 62 patients with reported data, postoperative dysphagia occurred in 24%, with higher rates in cohorts predominantly undergoing Nissen fundoplication. Studies favouring partial wraps generally demonstrated lower dysphagia rates and sustained symptomatic improvement. Overall complication rates were 12%, with no reported mortality. Limited data on robotic procedures suggested comparable safety. Laparoscopic fundoplication is a safe and effective treatment for GERD in patients with CTD, achieving 74%-87% resolution of presenting symptoms balanced against 24% postoperative dysphagia in the early postoperative period. Overall, 93% of patients were satisfied at 5 years post-surgery. Despite a lack of conclusive data, partial wraps appear to provide the lowest rates of postoperative dysphagia while maintaining effective resolution of reflux. Insufficient data currently exists to compare anterior and posterior partial wraps.
This study investigated elementary teachers' spelling activity and assessment practices and examined how these practices relate to teachers' spelling knowledge, self-efficacy in teaching spelling, and instructional philosophy. Survey responses were collected from 324 K to 5 teachers in a diverse urban district, including open-ended descriptions of spelling activities and scoring methods. Responses were analyzed and categorized into eight instructional activity types and five scoring approaches. Descriptive and multinomial logistic regression analyses revealed that teachers' activity choices were more strongly associated with their self-efficacy and philosophy in teaching spelling than with their formal spelling knowledge. Teachers with stronger philosophical beliefs were more likely to report linguistically informed practices (e.g., Word Sorts), while those with higher self-efficacy tended to favor traditional spelling activities (e.g., worksheet-based tasks). Scoring practices showed a preference for partial-credit approaches, though many still used traditional right/wrong grading. Spelling knowledge showed a marginal association with nuanced scoring that goes beyond mere right-or-wrong evaluations, but all three traits (i.e., spelling knowledge, self-efficacy, and philosophy) did not significantly predict scoring methods. These findings suggest that teacher education should address not only spelling knowledge but also self-efficacy and philosophy to support evidence-based spelling practices.
The discovery of moiré superlattices has introduced a new dimension to twist engineering, enabling structure-level modulation beyond conventional compositional design. However, the electrochemical energy-storage properties of MXene moiré superlattices remain largely unexplored. In this work, we systematically investigate structural stability, electronic band structures, mechanical moduli, and some key electrochemical energy storage properties for representative bilayer Ti3C2O3 moiré superlattices with different twist angles (0°, 21.78°, 27.8° and 38.22°) and interlayer stacking structures (AA-, AB- and AC-stackings) using first-principles calculations. All investigated moiré superlattices are predicted to have negative binding energies with respect to the Ti3C2O2 monolayer and also show high mechanical stiffness (690-723 N m-1 for Young's modulus and 265-286 N m-1 for shear modulus) with Poisson's ratios about 0.27-0.29. The bilayer superlattices retain metallic electronic band dispersions and the robust mechanical integrity with limited in-plane lattice variation (<1.6%) and moderate interlayer expansion (<0.5 Å) upon Li intercalation, indicating excellent structural stability during charge-discharge cycles. The moiré modulation introduces diverse adsorption sites and enhances Li accommodation, leading to high theoretical capacities (300 mAh g-1) and favorable average open-circuit voltages (1.7 V). Meanwhile, the relatively low migration barrier (<0.2 eV) is also obtainable for Li ions in Ti3C2O2 moiré superlattices, suggesting promising rate performance. Notably, the adsorption energy landscape of Li species in the interlayer spacing of bilayer Ti3C2O2 superlattices is mainly modulated by the local atomic registries of moiré spots, while the adsorption energies on the surfaces of bilayer structures are determined by the surface O-terminations and the intercalated Li layer in the interlayer spacing. Overall, our current work highlights the tuning of the electrochemical properties of MXenes through twist engineering, probably offering a new theoretical paradigm to further optimize the performance of moiré superlattices as electrode materials in lithium ion batteries.
Mismatch-repair deficient (dMMR)/microsatellite instability-high (MSI-H) gastroesophageal adenocarcinoma (GEA) is associated with favorable prognosis but limited benefit from perioperative chemotherapy. Although immune checkpoint inhibition (ICI)-based approaches have shown promising activity in early-phase studies, the optimal therapeutic combinations and the feasibility of non-operative management (NOM) in resectable disease remain unclear. This exploratory, retrospective, multicenter, real-world study included 55 patients with resectable dMMR/MSI-H GEA, who were divided into subgroups, characterized and compared according to treatment strategy (chemotherapy, chemoimmunotherapy, immunotherapy and initial resection). Pathological and clinical complete response (pCR, cCR), progression-free (PFS) and overall survival (OS) were evaluated. Patients received chemotherapy (n=10), chemoimmunotherapy (n=16), immunotherapy (n=13), or initial resection without subsequent systemic treatment (n=16). Forty five (82%) patients had surgical resection. The pCR rate was 22% (n=2/9) in the chemotherapy, 27% (n=4/15) in the chemoimmunotherapy, and 100% (n=5/5) in the immunotherapy (i.e., doublet ICI) subgroup, respectively. The overall cCR rate in NOM patients was 33% (n=3/9), with rates of 37.5% (n=3/8) in the immunotherapy subgroup and 0% (n=0/1) in the chemoimmunotherapy subgroup. Complete response rates (pCR/cCR) were significantly associated with PD-L1 CPS ≥10 (p=0.027). This real-world study is, to our knowledge, the first to evaluate a broad spectrum of therapeutic combinations in patients with resectable MSI-H/dMMR GEA, showing meaningful antitumor activity, particularly with doublet ICI. Given the challenges of conducting randomized prospective trials in this setting, such real world data may support clinicians in guiding therapeutic decision-making.
Minimally invasive procedures for pes planovalgus offer a safe alternative to open surgery and reduce postoperative morbidity significantly. The significantly lower risk of wound-healing complications and the markedly reduced need for analgesics are among the factors that favor minimally invasive techniques. Owing to the substantially lower complication rate while maintaining a high correction potential, percutaneous calcaneal displacement osteotomy can now be regarded as the gold standard. Depending on the individual pathophysiology, additional procedures are usually required in adult acquired flatfoot, which can also be performed using minimally invasive techniques. Besides the overview of percutaneous calcaneal osteotomy, this article also provides an overview of endoscopic FDL transfer and the percutaneous reverse Cotton osteotomy, surgical techniques that are frequently combined in the treatment of flexible flatfoot deformity. Minimalinvasive Verfahren beim Pes planovalgus bieten eine sichere Alternative zu offenen Eingriffen und reduzieren die postoperative Morbidität deutlich. Das signifikant geringere Risiko für Wundheilungsstörungen sowie der deutlich reduzierte Bedarf an Schmerzmitteln zählen zu den wesentlichen Faktoren, die minimalinvasive Verfahren begünstigen. Aufgrund des deutlich geringeren Komplikationsrisikos bei gleichzeitig hohem Korrekturpotenzial kann die perkutane Kalkaneus-Verschiebeosteotomie heute als Goldstandard betrachtet werden. Die Behandlung des erwachsenen Knick-Senk-Fußes erfordert, abhängig vom jeweiligen Deformitätsmuster, meist eine Kombination unterschiedlicher operativer Prozeduren, die häufig minimalinvasiv durchgeführt werden können. Dieser Beitrag gibt neben der perkutanen Kalkaneusosteotomie eine Übersicht über den endoskopischen FDL-Transfer sowie die perkutane „Reverse-cotton“-Osteotomie, Verfahren, die im Rahmen der Behandlung des flexiblen Pes planovalgus häufig kombiniert eingesetzt werden.
Preoperative concerns about mesh are common, but their relationship to long-term decision regret after hernia repair (HR) remains unclear. We evaluated long-term decision regret (DR) among patients who previously completed a preoperative mesh perception survey followed by mesh-based hernia repair. Patients who had previously completed a preoperative mesh perception survey and later underwent HR were surveyed to assess DR using the Brehaut Decision Regret Scale (BDRS). The BDRS ranges from 0 (no regret) to 100 (highest regret). Scores ≤ 25 were considered minimal regret, while scores > 25 indicated more than minimal regret. Descriptive analyses were performed. Of 202 patients in the original survey cohort, 97 (48.0%) underwent HR, and 48 (49.5%) completed the follow-up BDRS survey. Mean age was 58.9 ± 12.8 years, 64.6% were male, and 29.2% had history of recurrent hernia. The average time since surgery to survey was 60.2 ± 18.8 months. Overall, mean BDRS was 9.9 ± 14.5, and 95.9% agreed that surgery was the right decision, with 85.4% reporting minimal regret and 52.1% reporting no regret. Ventral hernias comprised 47.9% of cases and had the lowest mean regret (3.9 ± 6.6), with no patients scoring > 25. Inguinal (31.3%) and umbilical (8.3%) hernias had higher mean scores (16.7 ± 17.2 and 23.8 ± 18.9, respectively). Among the 7 (14%) patients with scores > 25, all were primary hernias, and most reported postoperative discomfort or minor wound complications. Correlation analyses comparing preoperative survey with postoperative BDRS scores found very early expectation of recovery and graduate-level education were associated with higher regret scores. Long-term DR following mesh-based HR is uncommon, with most patients reporting minimal or no regret an average of 5 years postoperatively. Ventral hernia repair had the lowest DR, while inguinal and umbilical repair had higher scores. These findings suggest that mesh-based hernia repair is associated with favorable long-term, patient-reported decision satisfaction.
In the absence of head-to-head trial data, a matching-adjusted indirect comparison (MAIC) was conducted to compare the effectiveness, with respect to overall survival (OS) and progression-free survival (PFS), of PET-guided BrECADD versus PET-guided ABVD, BEACOPP, and eBEACOPP in advanced Hodgkin lymphoma. Individual patient data (IPD) from patients in HD21 and aggregate data from the SWOG S0816, RATHL, HD9, and Mondello 2020 studies were utilized. Potential effect modifiers and prognostic variables for advanced Hodgkin lymphoma were identified via literature review, clinician input, and statistical analysis. As there was no common arm between HD21 and the comparator trials, unanchored MAICs were conducted. Data from patients in HD21 were weighted to align with published aggregate characteristics of the comparator trials. BrECADD was associated with significantly improved PFS and OS compared with PET-guided ABVD among patients aged 18-60 (SWOG S0816; PFS HR: 0.24, 95% CI 0.16, 0.35, p < 0.001; OS HR: 0.30, 95% CI 0.14, 0.63, p = 0.004) and patients aged 18 to 75 (RATHL; PFS HR: 0.24, 95% CI 0.16, 0.36, p < 0.001; OS HR: 0.47, 95% CI 0.25, 0.89, p = 0.01). In the comparison of BrECADD versus BEACOPP (per the Mondello et al. 2020 study cohort), there was a trend in PFS improvement [HR = 0.58 (95% CI 0.29, 1.19), p = 0.194)] in favor of BrECADD in adults aged 18-75 years of age. Additionally, a trend was observed among patients aged 66-75, favoring BrECADD for freedom from treatment failure [HR = 0.63 (95% CI 0.28, 1.44), p = 0.260] when compared to BEACOPP (HD9). These findings provide robust evidence and further support for the use of BrECADD in adult patients with advanced Hodgkin lymphoma.
Root exudates, functioning as chemical signaling molecules in the rhizosphere, regulate the structure and function of rhizosphere microbial communities, and play vital roles in plant disease resistance. This study characterized the rhizosphere microecological characteristics of tobacco and its accompanying weed Cyperus rotundus across different disease stages and explored the mechanisms by which C. rotundus root exudates affect Ralstonia solanacearum and its antagonistic strain Bacillus velezensis. The results showed that as soil temperature, humidity, and concurrent increases in R. solanacearum in the tobacco rhizosphere increased, the severity of tobacco bacterial wilt disease intensified. Additionally, the α-diversity of the rhizosphere soil microbial community exhibited a declining trend as the disease progressed. The rhizosphere of C. rotundus was more conducive to the stable enrichment of disease-suppressing bacterial groups such as Actinobacteria and Acidobacteria. In contrast, beneficial bacterial groups in the tobacco rhizosphere, including the phylum Pseudomonadota and the Burkholderia-Caballeronia-Paraburkholderia complex, declined continuously as the disease progressed. The active substances exerted significantly different effects on the two bacterial strains. At 50 μM, ferulic acid and phenylglyoxylic acid promoted the growth, biofilm formation, and motility of R. solanacearum. At 150 μM, phenylglyoxylic acid and 2-methoxycinnamaldehyde promoted the growth and motility of B. velezensis. Pot experiments confirmed that phenylglyoxylic acid and 2-methoxycinnamaldehyde at concentrations above 150 μM exerted certain control effects against bacterial wilt. In conclusion, the combined effects of soil environmental factors and root exudates alter the rhizosphere microbial community structure, creating a favorable microenvironment for R. solanacearum proliferation and thereby accelerating disease progression.IMPORTANCEInteractions between plants and rhizosphere microbial communities are key factors governing plant resistance to pathogen stress. This study investigated the regulatory effects of C. rotundus root exudates on R. solanacearum and its antagonistic bacteria from the perspective of tripartite interactions among weeds, pathogens, and crops, thereby providing new insights into the microecological regulatory mechanisms of tobacco bacterial wilt. Furthermore, C. rotundus exhibited an enrichment effect on R. solanacearum at the early disease stage, while it selectively reshaped the rhizosphere microbiome via recruiting beneficial microbial communities during critical disease development stages. These findings deepen the understanding of the mechanisms by which associated weeds influence crop diseases and provide theoretical support for green prevention and control strategies against bacterial wilt.
Despite the goal of utilization management (UM) to facilitate high-value cancer care, concerns about care denials persist. Evaluating justifications for denied claims can clarify the quality of UM decisions. To examine second-level appeals for denied anticancer medications in Medicare Part D to assess the quality of UM decisions. This cross-sectional study used a large language model (ChatGPT 5 Mini, OpenAI) to analyze texts of second-level appeals decisions on denied Part D medications, rendered by a Medicare-contracted reviewer. Data were analyzed from March 13, 2025, to May 12, 2026. From decision summaries, the reasons for first-level denials (as cited by Part D plans) and the outcomes of second-level appeals (favorable vs unfavorable) were examined. The reasons for unfavorable reviews (clerical vs nonclerical) were also examined. We included 4952 second-level appeals from 2020 to 2024 by beneficiaries with hematological (n = 1155 [23.3%]), prostate (n = 876 [17.7%]), digestive (n = 650 [13.1%]), breast (n = 613 [12.%]), and lung, bronchus, and respiratory (n = 430 [8.7%]) cancers. Most appeals were for targeted therapy (n = 2889 [58.9%]) or hormonal therapy (n = 959 [19.4%]). The most common reasons for initial denial or appeals were "non-medically acceptable" indications (ie, off-label use; 3410 [68.9%]), formulary exceptions (545 [11.0%]), and failure to meet preapproval coverage criteria (mostly on-label prescribing; 463 [9.3%]). Overall, 19.5% (95% CI, 18.4%-20.6%) received favorable reviews, and 55.2% (95% CI, 53.8%-56.6%) and 25.3% (95% CI, 24.1%-26.5%) received unfavorable reviews due to clerical and nonclerical issues, respectively. Favorable reviews were more prevalent among appeals for drugs initially failing to meet preapproval coverage criteria (61.1% [95% CI, 56.7%-65.6%]), but less so among appeals for off-label therapies (16.5% [95% CI, 15.2%-17.8%]). More than 87.9% (95% CI, 86.1%-89.6%) of successfully appealed off-label therapies were for medically acceptable indications supported by Medicare-approved clinical compendia and/or peer-reviewed literature. In this cross-sectional study of second-level appeals for denied anticancer medications in Medicare Part D, a considerable number of successfully appealed claims (especially for therapies prescribed on label) were found, which suggests potentially inappropriate UM decisions by Part D plans. However, the appeal outcomes varied substantially by the nature of the denials. Streamlining the preapproval process for on-label therapies and establishing accessible, transparent criteria for off-label prescribing may optimize UM processes for anticancer medications.
Stroke is a major complication of atrial fibrillation (AF), and risk prediction using the congestive heart failure, hypertension, age, diabetes, stroke, vascular disease, and sex category score (CHA₂DS₂-VASc) remains limited by residual heterogeneity. We aimed to identify plasma proteins associated with post-AF stroke and evaluate whether a protein score provides incremental predictive information beyond CHA₂DS₂-VASc. We analyzed 709 AF participants from the UK Biobank Pharma Proteomics Project, with 76 incident strokes. Stroke-related proteins were identified using multivariable Cox regression, least absolute shrinkage and selection operator (LASSO) Cox regression, and machine-learning approaches. A five-protein score was constructed, and its incremental value beyond CHA₂DS₂-VASc was assessed by discrimination, calibration, reclassification, clinical net benefit, and 1000-bootstrap internal validation. Mendelian randomization served as supportive genetic evidence. Five core proteins were identified: epidermal growth factor receptor (EGFR), V-type proton ATPase subunit D (ATP6V1D), neurotrophin 4 (NTF4), amnionless (AMN), and discoidin, CUB and LCCL domain-containing protein 2 (DCBLD2). Adding the five-protein score to CHA₂DS₂-VASc improved discrimination, increasing the concordance index from 0.681 to 0.768. The combined model had 3-, 5-, and 8-year receiver operating characteristic areas of 0.799, 0.775, and 0.806, respectively, and showed favorable five-year prediction error and calibration, with a Brier score of 0.0347, calibration intercept of -0.068, and calibration slope of 0.968. The score improved continuous net reclassification improvement (0.459; P = 0.028). Mendelian randomization provided supportive genetic evidence for AMN, EGFR, and DCBLD2. The five-protein score provided incremental predictive information beyond CHA₂DS₂-VASc for post-AF stroke risk assessment.
The global rise in obesity is linked to Western dietary patterns (WDPs). The Westernized Diet Index (WDI) was developed to measure adherence to WDPs. This study examined the associations between the WDI and overweight/obesity and constructively validated the findings against inflammatory, oxidative stress, and metabolic biomarkers. A population-based case-control study was conducted on 1605 adults (812 overweight/obese; 793 normal weight), using a 124-item validated food frequency questionnaire to assess dietary intake and calculate WDI-G (global Z-score) and WDI-FG (food group Z-scores). Fully adjusted logistic and linear regression models evaluated associations with BMI and biomarkers. In fully adjusted models, a 1-unit increase in WDI-G (ranging from -1.71 to 1.02) was associated with a 41% decrease in the odds of overweight/obesity (OR = 0.59; p = 0.007), and similarly, a 1-unit increase in WDI-FG (ranging from -1.91 to 1.44) was linked to a 26% decrease in the odds of overweight/obesity (OR = 0.74; p = 0.086). Higher WDI-G scores were also significantly associated with lower waist circumference (-4.6 cm), fasting blood glucose levels (-7.6 mg dL-1), and LDL-c levels (-7.1 mg dL-1) and higher plasma malondialdehyde levels (+0.35 μM). Similarly, higher WDI-FG scores were associated with lower plasma IL-6 (-37.8 pg mL-1), lower triglyceride (-15.3 mg dL-1), and higher HDL-c (+2.37 mg dL-1) levels. Lower adherence to the WDP diet was associated with lower odds of having overweight/obesity and more favorable metabolic, inflammatory, and oxidative stress profiles. These findings support the use of the WDI as a valid and practical nutritional tool for assessing WDPs in clinical nutrition, nutritional epidemiology, and public health research.
Global population ageing is increasing the burden of chronic disease, functional decline, and loss of independence. For most organs, decline in function starts during the 5th decade of life. Micronutrient (MN) insufficiencies/deficiencies are common and may accelerate biological ageing. MNs are required to support multiple physiologic processes, including mitochondrial homeostasis. Age-related declines in organ function are tightly linked to mitochondrial dysfunction, oxidative stress, inflammageing, and immunosenescence. Selected MNs (vitamins B, C, D, E, iron, selenium, zinc) are critical cofactors for mitochondrial function, antioxidant defence, immunity, and resolution of inflammation. Inadequate MN intakes require specific repletion strategies beyond diet for correction. Low intake, (patho)physiological changes, and common medications jointly contribute to compromised MN status. Emerging trials suggest that correcting MN deficiency may restore mitochondrial function and thereby promote healthy ageing. Optimizing intake over the lifespan represents another means to support healthy ageing. Nevertheless, MNs do not work individually but as a web, and may behave differently in different individuals. Further, low status of the n-3 polyunsaturated fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) is common in older adults, which favours inflammation and functional decline. EPA+DHA work in combination with MNs on inflammation containment. Routine risk assessment, selected biomarker measurement from midlife onwards, and well-designed trials are needed to complement an insufficient status. MN and EPA+DHA optimization should be integral to healthy ageing strategies.
Acidic CO2 reduction prevents carbonate loss but is limited by uncontrolled interfacial proton dynamics that trigger hydrogen evolution and favor ethylene. Here, we demonstrate that an adaptive hybrid ionomer interface steers proton-coupled pathways to achieve highly selective ethanol electrosynthesis. Through surface-limited oxidative reconstruction, the interphase evolves into a robust hydrogen-bonding network paired with an intact cationic sublayer. This architecture limits solvated proton diffusion, effectively suppressing the disruptive Eley-Rideal (ER) pathway toward ethylene. Instead, it dynamically shifts the reaction toward the Langmuir-Hinshelwood (LH) mechanism, optimizing surface-bound *H availability within a fixed mildly alkaline microenvironment (pH ≈ 10.5). Consequently, our membrane electrode assembly achieves >64% ethanol Faradaic efficiency at 200 mA cm-2 with >350 h of stability in pH = 1 electrolyte. This elucidates the pivotal role of interfacial hydrogen-bond networks in dictating proton-coupling mechanisms, offering a paradigm for pathway-specific acidic electrosynthesis.
the aim of this study is to evaluate features of acute coronary syndrome (ACS) patients, in Greece, using information from a nationwide registry, the Clinical events and Adherence to Lipid LowerINg therapy In aCUte coronary Syndrome (CALLINICUS)-Hellas registry. CALLINICUS-Hellas Registry is an ongoing, national, multicentre observational registry that aims to evaluate features and incidence of ACS patients in Greece. From January 2022 to December 2025, 2,661 consecutive ACS patients (2,151 males, 60 ± 11 years, 510 females, 63 ± 11 years) were enrolled in the selected collaborating cardiology clinics (15-55% participation rate). Four-point Major Adverse Cardiovascular Event (MACE) including cardiovascular death, myocardial infarction (ST-elevation myocardial infarction [STEMI] and non-STEMI [NSTEMI]), ischaemic stroke and unstable angina (UA) requiring hospitalisation was the outcome of interest at 6-months follow-up. The most common ACS manifestation was NSTEMI (48%) in both sexes, followed by STEMI (37.4%) and UA (13.1%). The male-to-female ratio was approximately 4-to-1. The sex ratio favours males before age 60 years but shifts towards females thereafter. The mean age of ACS was 60 years in males, and 63 years in females. Almost 1 in 4 male and 1 in 6 female ACS patients had a previous cardiovascular event. At 6-months follow-up of 2,068 patients, MACE was observed in 120 patients (5.8%), and the most common manifestation was NSTEMI followed by UA. By addressing the lack of recent registry data, the present study provides an updated description of the demographic, lifestyle, clinical, and healthcare characteristics of ACS patients treated in selected Greek hospitals, offering contemporary insights that may inform future research and healthcare planning.
To overcome challenges in DNA nucleobase Raman analysis, such as strong backbone signals, spectral overlap, and background noise, we propose a surface-enhanced Raman scattering (SERS) method employing a k-space filter-assisted radial vector beam (RVB) coupled with gold nanospheres (AuNPs). A spatial frequency-modulated RVB is tightly focused to excite AuNPs, producing a localized plasmonic field with a strong longitudinal component that spatially overlaps with DNA segments located in the AuNP near-field region. This configuration achieves strong near-field enhancement while suppressing background noise. The orientation-dependent near-field selection is interpreted through the projection between the local plasmonic field and the vibrational polarizability derivatives of DNA modes. Under orientation-favorable configurations, backbone-related modes with weak field projection are relatively suppressed, whereas nucleobase-related modes with larger projection are preferentially enhanced. Experimental results show effective suppression of backbone signals (900-1250 cm-1) and clearer DFT-assisted assignment of nucleobase-related Raman bands (1350-1500 cm-1). Combined with density functional theory (DFT), overlapping peaks were accurately identified and decoupled. This approach provides a physical mechanism for selective enhancement and noise suppression, offering a label-free optical method for specific DNA nucleobase identification.
Cercocebus lunulatus, an endangered primate species, is endemic to three countries in West Africa, including Côte d'Ivoire. In this country, remnant populations of this species have survived in four protected areas including Comoé National Park, which is considered to harbor the largest wild population. However, the park faces significant anthropogenic pressures, including poaching, mining, and agricultural activities in peripheral areas, which hinder sustainable management and conservation efforts. For two decades, updated information on this species' population size, group structure and food availability has been almost non-existent due to non-focused studies. From November 2021 to November 2022, we collected data using camera traps and phenological data in the park's forest habitats. A total of 25 groups of white-naped mangabeys, estimated at about 1396 individuals, were recorded with seasonal variations in group size comprising 10 to 249 and 10 to 192 individuals in dry and rainy seasons, respectively. The mean density is 25.38 individuals /km². Groups comprise 44% juveniles, 27% adult females, 18% infants, and 10% adult males. Food item productivity (TotPI) averaged 2912 items/month in gallery forests and 1756 items/month in forest patches, but the choice of specific habitats is not statistically significant. Relying on phenological features, the group structure, marked by a high rate of juveniles and infants and a sex ratio largely in favor of females, we can assume that despite their endangered status, the viability of this species is not engaged.
Trophically transmitted parasites frequently alter the phenotype of their intermediate host to increase predation by the next host in the life cycle. Still, the degree to which such manipulation is specific to the correct predator varies widely across systems. Some parasites employ mechanisms that selectively increase vulnerability to the next host, whereas others increase predation indiscriminately, exposing the parasite to dead-end predators. Despite growing empirical documentation of this variation, no theoretical model has addressed the evolution of manipulation specificity itself. Here, I develop a general analytical model in which a trophically transmitted parasite evolves two traits simultaneously: manipulation intensity and manipulation leakage-the degree to which parasite-induced changes in host vulnerability extend to non-host predators. The parasite faces three competing outcomes in its intermediate host: predation by the suitable next host (transmission), predation by non-host predators (dead end), and natural non-predation mortality. I derive the condition for manipulation to be favoured, obtain the joint evolutionarily stable strategy for intensity and leakage, and provide an analytical approximation for the equilibrium. The model reveals that although dead-end predation creates the selective incentive for specificity, specificity evolves only when the fecundity costs of achieving it are sufficiently low. This condition is determined by the manipulation pathway, not by the intensity of non-host predation.
Precise control over reaction pathways and product selectivity is critical for advancing electrochemical CO2 reduction reaction (CO2RR). Traditional strategies for promoting multicarbon production mainly rely on compositional tuning and architecture optimization. Here we report lattice chirality as a structural feature that biases reaction selectivity. As a proof of concept, chiral CuO nanoparticles were synthesized through thermal conversion of enantiopure Cu-Cysteine precursors, producing lattice-distorted nanoparticles while preserving the same crystal phase, morphology, and particle size as the achiral counterpart, which lacks lattice distortion. In CO2RR, the chiral-derived nanostructures suppress the hydrogen evolution reaction and promote multicarbon formation, increasing the C2+/C1 product ratio by up to 68.5% relative to the achiral counterpart. In situ spectroscopy combined with density-functional theory calculations indicates that lattice chirality modulates the initial CO2 activation and alters the population and evolution of surface intermediates (e.g., *CO and *OCCO species), favoring C-C coupling toward C2+ products. Furthermore, lattice distortion increases the energetic cost of oxygen removal, contributing to slower reduction and altered structural evolution of the catalysts during operation compared with achiral counterparts. These results demonstrate that lattice chirality in CuO precatalysts biases reaction pathway selectivity in CO2RR, highlighting a potential parameter to modulate chemoselectivity in related multielectron catalytic reactions.
Chronic inflammation is central to the pathogenesis of numerous severe diseases, and current therapeutic approaches are limited by suboptimal efficacy and significant adverse effects. The emergence of mesenchymal stem cells (MSCs) represents a groundbreaking advance, owing to their potent immunomodulatory and tissue-reparative capacities. Among diverse MSC sources, gingival mesenchymal stem cells (GMSCs) exhibit distinct advantages. Since their therapeutic potential was first demonstrated in 2009, GMSCs have shown considerable promise as a cellular therapeutic modality in a range of preclinical models. This review discusses the major immunomodulatory functions of GMSCs and synthesizes preclinical evidence supporting their therapeutic potential in two distinct but complementary domains: (1) chronic inflammatory conditions, including arthritis and periodontitis; and (2) broader regenerative medicine applications, such as nerve injury, bone injury, stroke, and tracheal defect repair. GMSCs attenuate inflammation and promote tissue repair through the secretion of anti-inflammatory factors. These mechanisms have been validated in various animal models, demonstrating promising therapeutic efficacy and favorable safety profiles. Additionally, this article explores innovative strategies-such as three-dimensional (3D) culture systems-to enhance GMSC therapeutic potential, as well as their applications in regenerative medicine. As technological advances continue to evolve, including the use of engineered extracellular vesicles (EVs) to fine-tune GMSC function, the future of precision immunotherapy and regenerative medicine utilizing GMSCs is highlighted. Collectively, fundamental research on GMSC-based therapies has elucidated the multiple immunomodulatory and regenerative pathways employed by these cells to achieve therapeutic effects, underscoring their substantial potential across both chronic inflammation and regenerative medicine applications.
Chronic obstructive pulmonary disease (COPD) remains a leading global health burden, with acute exacerbations accelerating functional decline and impairing quality of life. Reduced inhaler adherence is a well-recognized contributor to exacerbations and poorer outcomes in COPD. While self-management interventions are well established in stable COPD, their initiation during acute exacerbations has been inadequately explored. This randomized controlled trial, conducted in a South Indian tertiary hospital between July 2024 and May 2025, evaluated the effectiveness of a structured self-management program initiated during hospitalization for acute exacerbation of COPD. The intervention included individualized counseling, family engagement, structured telephonic follow-ups (weekly for 3 months, then monthly for 3 months), and scheduled outpatient reviews, while controls received standard care. Primary outcomes were inhaler adherence assessed by the Test of Adherence to Inhalers, health-related quality of life (HRQoL) measured with the St. George's Respiratory Questionnaire (SGRQ), and functional capacity assessed by the six-minute walk test. At six months, good inhaler adherence was observed in 66.7% of the intervention group compared to 10% of controls (p<0.001). The mean between-group difference in six-minute walk distance at six months was 92.8 meters [95% confidence interval (CI): 58.1 to 127.6; p<0.001], favoring the intervention group. HRQoL also improved significantly, with a mean between-group difference in SGRQ score of -38.2 (95% CI: -46.7 to -29.8; p<0.001). These findings indicate that initiating structured self-management during hospitalization for acute exacerbation of COPD results in significant improvements in inhaler adherence, functional capacity, and quality of life. Integrating self-management into acute care pathways may therefore optimize patient-centered outcomes in this high-risk population.