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In this issue, Webster and colleagues report findings and provide direction following a systematic review and evidence synthesis designed to understand the decisional needs of research participants considering whether to receive biomarker or genetic risk information. The report serves as a foundation for a future of participant-centered approaches to the return of individual results in Alzheimer's disease research. This Ethics Response comments on the authors' terminology choices highlighting the notable absence of references to disclosure. The Response concludes that alternative terms like return or sharing of results offer less stigmatizing and more patient-centered approaches to communicating biomarker and genetic test results.
Academic freedom is under increasing pressure across higher education, yet its erosion in dentistry has remained largely unnoticed. Dentistry rarely features in discussions about academic freedom, despite facing a unique blend of institutional, cultural and political forces that narrow the space for independent thought and inquiry. This guest editorial aimed to highlight the quiet but profound erosion of academic freedom in dentistry. It examines how structural incentives, professional expectations and institutional dynamics are reshaping what can be thought, said and studied within dental schools. Structural incentives and precarious work: The decline of tenure-track positions and the rise of contingent employment undermine the conditions for academic independence. Economic pressures, clinical productivity targets and tuition-driven business models reward conformity over curiosity. Metrics and research agendas: An excessive focus on performance metrics privileges what can be counted over what matters. Research funding structures reinforce this by prioritising clinical and basic sciences while sidelining public health and interdisciplinary perspectives. The 'triple threat' trap: The traditional expectation of excellence in teaching, research and service, now compounded by clinical revenue generation, has become a structural contradiction. It leaves little space for reflection, critical engagement or dissent. Internalized pressures: Political interference compounds the problem, but the deeper erosion comes from within. Institutional risk aversion, reputational control and self-censorship operate silently, narrowing the scope of academic discourse before external pressures even arrive. When academic freedom is curtailed, scholarship contracts. Public engagement becomes riskier, critical enquiry fades, and the profession's ability to interrogate itself diminishes. This weakens dentistry's intellectual and societal role. Academic freedom is not a privilege or a romantic ideal; it is a shared responsibility. It must be practiced, protected and supported through valuing critical engagement, creating institutional space for intellectual risk and recognizing dissent as integral to scholarship. Defending this freedom is essential if dentistry is to remain a space for curiosity, reflection and meaningful contributions to public health.
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Indonesia is a majority Muslim country with a significant influence of religion in public and private life. Islam, alongside the five others officially recognized religions, serves as a crucial moral foundation within the country's diverse cultural and governmental frameworks. However, the role of religion has been subject to debate over the years up to the recent politico-religious polarization observed during the last three presidential elections (2014, 2019, and 2024). Drawing from contemporary secularization theory, this study aims to explore the continuity and change in the societal role of religion in Indonesia over the past two decades. It tests the potential decline of religiosity among the populace amidst the continuing strong state's regulation on religion in the country. The study collects and analyzes secondary data from Badan Pusat Statistik (BPS or the Office of Indonesian National Statistics) and the World Values Survey to investigate continuities and shifts in religious adherence and affiliation, levels of socio-religious participation, and individual religiosity-including belief in God and frequency of daily or weekly prayer. The findings indicate that religious adherence and affiliation remain relatively high, coupled with a decent level of socio-religious participation. However, there is a decline in personal religious belief among the population. The contradiction between those three forms of religiosity-affiliation, participation and belief-might suggest an early stage of long-term secularization. In the last two decades, religion is often viewed as a formal identity marker in Indonesian public life, with more nuanced correlation to individuals' personal religious beliefs and practices.
The associations of stress and negative emotion with alcohol use are well established. These associations are mediated by cognitive and psychological mechanisms that may be sex-dependent. This pilot study examined sex differences in the effects of stress on inhibitory control and alcohol craving in the lab, and of the efficacy of cognitive reappraisal in mitigating stress effects among male and female veterans with alcohol use disorder (AUD). Twenty-six male and twenty-six female military veterans were randomized to the microintervention or control condition and engaged in two sessions. In Session 1, participants in the microintervention condition learned cognitive reappraisal to regulate negative emotion, while those in the control condition received health education. In Session 2, each participant underwent a personalized stress induction; after the induction, participants in the microintervention condition were instructed to use cognitive reappraisal, while those in the control group were asked to sit quietly. Changes in affect, craving, and inhibitory control were measured in response to the stress induction and after using cognitive reappraisal/sitting quietly. At baseline, poorer inhibitory control was associated with higher alcohol craving among women but not associated with men. All participants had increased negative affect and craving in response to the stressor, with larger effect sizes among women. Across sexes, the condition using cognitive reappraisal after the stressor had improved inhibitory control, while the control condition had worsened inhibitory control. Sex further moderated these effects. Men, but not women, had improved inhibitory control after cognitive reappraisal; women had no change in inhibitory control in either condition. Alcohol craving remained elevated after using cognitive reappraisal and sitting quietly in men and women. Pilot findings suggest an association of inhibitory control and alcohol craving specific to women, and a sex-dependent beneficial effect of cognitive reappraisal on stress-modulated inhibitory control for men.
This study examined the effects of nasal and oral breathing routes on genioglossus electromyographic activity (EMG), inspiratory (nadir) epiglottic pressures, and the pressure-dependent reflex regulation of inspiratory genioglossus EMG in awake supine participants. We hypothesized that oral breathing reduces negative pharyngeal pressure swings during inspiration and, via a pressure-dependent reflex mechanism, reduces phasic inspiratory genioglossus EMG. Twenty participants with obstructive sleep apnea (OSA) and 8 people without OSA were recruited into this study. Measurements included multiunit genioglossus EMG via percutaneous bipolar electrodes, airflow via nasal pneumotach, epiglottic pressure, and end-tidal CO2. Participants were studied while in supine position, breathing quietly via nose, then switched to oral breathing for ∼5 min/route, and then repeated the protocol. Oral breathing reduced inspiratory epiglottic negative pressures by ∼50% in all participants [OSA nasal: -4 ± 1.8 (SD) cmH2O; oral: -1.8 ± 0.8 cmH2O; non-OSA nasal: -2.4 ± 1.6 cmH2O; oral: -1.1 ± 0.8 cmH2O]. In people without OSA and a third of people with OSA, oral breathing was associated with reduced phasic inspiratory genioglossus EMG and correlated with reduced inspiratory negative epiglottic pressure swings. Unexpectedly, in the remaining two-thirds of people with OSA, phasic inspiratory EMG was maintained and/or increased with oral breathing, despite reduced inspiratory negative pharyngeal pressure swings. Remarkably, the increased inspiratory genioglossus EMG during oral breathing in these participants with OSA was inversely correlated with epiglottic pressure. The divergent responses in most people with OSA may represent a reflex adaptation to oral breathing, perhaps due, at least in part, to increased and persistent nocturnal oral breathing.NEW & NOTEWORTHY Breathing is supposed to occur through the nose. The switch to oral breathing occurs during exercise, with nasal congestion, or during sleep. This study reports that oral breathing is associated with different patterns of genioglossus muscle activity in individuals with and without obstructive sleep apnea (OSA). A subset of participants with OSA showed increased inspiratory genioglossus muscle activity with oral breathing, despite reduced airway resistance, which was unexpected, and may represent a neural adaptation to increased oral breathing in OSA.
Cervical cancer is a common malignant tumor in the female reproductive system, surgery is the main radical treatment methods. Lymphedema, as a postoperative complication of cervical cancer, affects the prognosis of patients. Identifying the risk factors for lymphedema after surgery is of great clinical significance for reducing its incidence. This study aims to systematically analyze the related risk factors for lymphedema after cervical cancer surgery. Clinical medical data of 701 cervical cancer patients at Meizhou People's Hospital from December 2018 to December 2023 were collected, including age, body mass index (BMI), hypertension, diabetes mellitus, induced abortion, menopause, clinical stage, number of dissected lymph nodes, lymph node metastasis, postoperative complications, postoperative chemotherapy, postoperative radiotherapy, postoperative living habits, and lymphedema. The relationship between lymphedema and clinical features in cervical cancer was analyzed. A total of 220 (31.4%) patients developed lymphedema and 481 (68.6%) did not. The cervical cancer patients with lymphedema had higher proportions of advanced age, hypertension, menopause, number of dissected lymph nodes≥30, postoperative radiotherapy, and sitting quietly> 1 hour every day than patients without lymphedema. Logistic regression analysis showed that advanced age (odds ratio (OR): 2.713, 95% confidence interval (CI): 1.560-4.717, p<0.001), menopause (OR: 1.954, 95% CI: 1.091-3.501, p=0.024), pelvic lymph nodes plus para-aortic lymph nodes plus inguinal lymph nodes were dissected (OR: 2.039, 95% CI: 1.297-3.207, p=0.002), number of dissected lymph nodes (≥30 vs <30, OR: 1.666, 95% CI: 1.105-2.514, p=0.015), postoperative radiotherapy (OR: 3.775, 95% CI: 2.348-6.069, p<0.001), and sitting quietly>1 hour every day (OR: 14.782, 95% CI: 7.926-27.567, p<0.001) were associated with lymphedema in cervical cancer. Advanced age, menopause, pelvic lymph nodes plus para-aortic lymph nodes plus inguinal lymph nodes were dissected, number of dissected lymph nodes, postoperative complications, postoperative radiotherapy, and sitting quietly every day were independently associated with lymphedema in cervical cancer patients.
As health awareness grows, more people are turning to weight loss-yet excessive slimming or dietary imbalance is quietly triggering a wave of fertility problems. Researches show that low BMI or excessive exercise can negatively impact fertility, but its specific cellular mechanism remain unclear. In this study, we investigated how adipose tissue influences ovarian function under energy-restricted conditions by establishing a peri-ovarian adipose tissue (POAT) removal mouse model. We showed that POAT removal resulted in a significant decrease in litter size, impaired follicle development, and an increased apoptosis rate in granulosa cells (GCs). Additionally, the lipid droplets (LDs) content in the ovaries and GCs was significantly reduced. We also observed that Rab14 expression was upregulated in GCs after POAT removal. Functional experiments further showed that Rab14 overexpression significantly enhanced lipophagy activity, reduced the number and volume of LDs, and inhibited the expression of lipid droplet protein PLIN2. Meanwhile, Rab14 overexpression inhibited the phosphorylation level of AKT and induced the apoptosis of granulosa cells, suggesting that Rab14 may activate the cell death pathway mediated by lipophagy. Taken together, POAT may support ovarian function by maintaining lipid homeostasis within GCs. The role of Rab14 in the regulation of lipophagy may link local adipose-derived signaling with GCs survival and female fertility.
Transfusion-dependent β-thalassemia (TDT) has become a chronic, survivable condition, but transfusional iron overload remains a central driver of cardiac, hepatic, and endocrine morbidity. Clinicians increasingly encounter patients whose iron indices 'stall' despite seemingly appropriate chelation, creating uncertainty about whether the problem is correctable (iron balance, adherence, dosing) or reflects a harder biological limitation in iron mobilization. A narrative review of pivotal randomized trials, prospective cohorts, and major observational MRI datasets evaluating deferoxamine, deferiprone, deferasirox, and combination regimens in TDT was performed. Literature was identified via structured searches of PubMed and key hematology/cardiometabolic journals (2000-February 2026), prioritizing primary studies with MRI liver iron concentration (LIC) and cardiac T2* endpoints, and supplemented by regulatory prescribing information for safety monitoring. Many 'plateaus' are predictable steady-state iron balance-ongoing transfusional iron input matches achievable chelator-mediated excretion-and can be addressed by quantifying iron intake, verifying adherence, and rationally intensifying therapy. A second category, a hypothesized 'biological ceiling,' may arise when stored iron becomes less accessible (slow-turnover pools, tissue remodeling, altered export). Clinicians can disentangle these mechanisms by integrating transfusion iron input calculations with serial multi-organ MRI trajectories, then tailoring chelator strategy to the dominant iron compartment and organ risk. People with transfusion-dependent β-thalassemia need regular blood transfusions to live and stay healthy. A major downside is that every transfusion quietly adds iron to the body. Over time, too much iron can damage the heart, liver, and hormone-producing organs. Iron chelation medicines remove iron, but patients and clinicians sometimes notice that iron numbers (especially ferritin) stop improving or improve very slowly, this can feel like “the chelation isn’t working anymore.”In many cases, this “stall” is explainable: the body is still receiving iron from transfusions, and the chelator dose (or how consistently it is taken) may only be enough to match that incoming iron, not remove extra stored iron. Another possibility (still not proven) is that some stored iron becomes harder to access, trapped in slow-turnover storage forms or in remodeled tissues; this could limit how fast iron can be removed even when medicines are taken correctly.The most helpful next step is a structured check: confirm the chelator dose and real-world adherence, calculate how much iron is coming in from transfusions, and use MRI scans (liver iron and heart T2) to see where iron is stored. Treatment can then be adjusted, sometimes by changing dose, switching medicines, or combining chelators, while carefully monitoring side effects.
Anterior cruciate ligament injuries are common in young female athletes, often occurring during landing tasks. Attentional focus instructions may influence landing biomechanics and reduce injury risk, but comparative effects of different external focus (EF) cues remain unclear. Twelve novice female volleyball players (age: 13.6 ± 0.6 years) performed double-leg drop landings from a height of 50  cm under four attentional focus conditions: (1) as quietly as possible, (2) as safely as possible, (3) as softly as possible, and (4) a no-focus control. A Qualisys 3D motion capture system and a Kistler force platform were used to analyze knee joint kinematics and kinetics during initial contact and the first two VGRF peaks, and time-series analysis was conducted to characterize the biomechanical landing pattern across conditions. All EF conditions significantly reduced biomechanical knee joint loading compared with the no-focus condition. Although no significant differences were found among the three EF instructions, the 'soft' landing instruction produced the most pronounced changes, showing the lowest maximal VGRF, increased knee flexion angles, and reduced internal rotation angles, relative to the no-focus condition. EF instructions, particularly those emphasizing a soft landing, can effectively reduce knee joint loading and potentially lower anterior cruciate ligament injury risk in young female athletes. These findings highlight the value of incorporating specific attentional focus cues into injury prevention and training programs.
Smartphones have become an integral part of daily life, yet their impact on the attentional and affective system remains uncertain. This study investigates whether using smartphones during breaks between cognitive tasks influences subsequent performance and mind wandering compared to sitting quietly. Using a within-subjects design, participants completed a 2-back task and took short breaks during which they either used their smartphones or sat quietly without using their smartphones. We measured task performance and mind wandering frequencies during the 2-back task as well as mind wandering during breaks, participants' mood before and after the breaks, and their tendency to check their smartphones spontaneously in daily life. The results revealed no significant differences in mind wandering frequency during the two types of breaks. Additionally, there were no significant differences in subsequent task performance or mind wandering frequency between smartphone and no-smartphone breaks. However, participants felt more positive after smartphone than no-smartphone breaks, and their tendency to check their smartphones spontaneously was positively correlated with this positive mood improvement. These findings suggest that brief smartphone use during breaks may enhance mood, but do not affect performance or mind wandering in a subsequent cognitive task.
Manual support and interpersonal interaction can enhance postural stability during upright standing, yet it remains unclear how tactile and visual interactions influence the temporal organization of postural control. We used a 2 × 2 factorial design manipulating interpersonal touch (Touch vs. No Touch) and partner visibility (Visible vs. Invisible) while participants stood quietly in pairs. Center-of-pressure velocity time series were analyzed using linear and nonlinear methods, including recurrence quantification analysis (RQA) and detrended fluctuation analysis (DFA). Both tactile interaction and partner visibility were associated with reduced sway magnitude, with no significant interaction between modalities. Nonlinear analyses revealed that tactile interaction was associated with reduced recurrence and lower DFA scaling exponents across timescales, indicating altered temporal organization. Visual coupling influenced recurrence measures and longer-timescale structure but did not significantly affect short-timescale scaling. These findings suggest that tactile and visual interactions contribute additively to sway reduction, yet are associated with distinct patterns of temporal organization in postural control.
Whole-body exercise can attenuate postprandial glucose (PPG) excursions, one of the three main components in glucose control. Respiratory muscle endurance exercises (RMEE) based on resisted hyperpnea could offer an alternative or managing postprandial glucose (PPG) excursions in individuals unable or unwilling to perform whole-body exercise. We investigated whether PPG excursions during a 2-h oral glucose tolerance test are attenuated with 5 min (RMEE-5) or 15 min (RMEE-15) of respiratory muscle endurance exercises in 18 younger (age 24 ± 4 years) and 10 older (age 54 ± 7 years) healthy adults. On three separate visits, participants (8-h fasted) ingested 75 g of glucose and, 14min later, performed either RMEE-5, RMEE-15, or sat quietly (control). Blood glucose concentration was monitored periodically for a 2-h period. Neither intervention differed from control in terms of glucose area under the curve (p > 0.53), peak glucose (p > 0.09), time to peak glucose (p > 0.21), or glucose level at 2 h (p > 0.60). Based on the apparent lack of effects regardless of age group and exercise duration, bouts of increased respiratory muscle work do not seem to be effective for the management of PPG.
Assess the impact of different stance variations, body composition and use of shoes among healthy young men and women on postural sway during quiet stance. A repeated-measures study with 123 participants (40 males, 83 females) aged 18-39 years was conducted. Participants stood quietly without shoes on a force plate with hands on hips (also performed with shoes), hands by sides, arms across chest, hands behind head and while isometrically contracting. Postural sway metrics were assessed for each condition. Body composition was assessed using bioelectric impedance analysis. There were no significant differences found between stances involving hands on hips, arms across chest, hands behind head, or hands by sides in the measured variables. Postural sway was greatest during isometric contraction (p < 0.05). Women had greater path length, sway frequency and greater anterior-posterior sample entropy (AP SampEn) compared to men (p < 0.05). Quiet stance postural sway was not influenced by the use of shoes. Variables related to lean body mass are significantly associated with postural sway as assessed by principal component analysis. The assessment of quiet standing postural control in healthy young adults can use a variety of stance variations (with or without shoes) since they yield statistically similar measures of postural sway. Postural sway is significantly increased with muscle contraction. Young women exhibit greater path length, sway frequency and AP SampEn compared to young men. Lean body mass may represent a target for improved postural control since it is associated with postural sway.
This cross-sectional study used functional near-infrared spectroscopy (fNIRS) to explore cerebral cortical activation and functional connectivity in children with Unilateral Cerebral Palsy (UCP) at resting state, during traditional non-virtual reality (non-VR) and single-session VR throwing motor tasks, aiming to clarify the differences in neural responses between VR and non-VR tasks, and provide preliminary neuroimaging evidence for VR application in pediatric cerebral palsy rehabilitation. A total of 35 children with UCP (18 males, 17 females, mean age 9.67 ± 2.4 years; 16 with left hemiplegia, 19 with right hemiplegia; 3 graded MACS Level Ⅰ, 13 Level Ⅱ, 19 Level Ⅲ) were enrolled, with the affected hemisphere standardized to the left. All participants completed fNIRS data acquisition in a randomized order under three conditions: 6-minute resting state (seated quietly with eyes closed), a single-session semi-immersive VR throwing task (8 s per movement cycle, with real-time audio-visual reward feedback for successful hits on horizontally moving virtual targets via ToF 3D motion capture), and a traditional non-VR throwing task with matched movement rhythm but no targets or feedback. fNIRS was used to monitor oxygenated hemoglobin (HbO₂) concentration in 6 regions of interest (ROIs): bilateral prefrontal (LPFC/RPFC), premotor (LPMC/RPMC) and sensorimotor cortices (LSMC/RSMC). One-way repeated measures ANOVA with FDR correction was applied for statistical analysis, which was verified by a professional biostatistician. Cerebral functional connectivity strength analysis showed that after FDR correction, there were significant main effects of task condition on the FCS of LSMC-LPMC [F(2,68) = 16.956, p < 0.001, ηₚ2 = 0.333], LPMC-RPFC [F(2,68) = 16.256, p < 0.001, ηₚ2 = 0.323], and LPMC-LPFC [F(2,68) = 22.725, p < 0.001, ηₚ2 = 0.401], all with large effect sizes (ηₚ2 ≥ 0.14). The FCS of these ROI pairs showed a consistent trend: resting state > single-session VR throwing motor task > non-VR throwing motor task, with significant differences between any two conditions (PFDR < 0.05). No statistically significant differences were observed in FCS between other ROIs (PFDR > 0.05). Cerebral activation level analysis showed that after FDR correction, there were significant main effects of task condition on the activation levels of the affected-side LSMC [F(2,68) = 15.952, p < 0.001, ηₚ2 = 0.319] and affected-side LPFC [F(2,68) = 13.606, p < 0.001, ηₚ2 = 0.286], both with large effect sizes (ηₚ2 ≥ 0.14). Specifically, the activation level of LSMC followed the order: single-session VR throwing motor task > non-VR throwing motor task > resting state; the activation level of LPFC followed the order: single-session VR throwing motor task > resting state > non-VR throwing motor task, with significant differences between any two conditions (PFDR < 0.05). No statistically significant differences were detected in activation levels of other brain regions (PFDR > 0.05). Based on functional near-infrared spectroscopy (fNIRS) technology, this cross-sectional study confirmed that children with unilateral cerebral palsy (UCP) exhibit distinct cerebral cortical neural activity patterns during a single-session VR throwing motor task, compared with the resting state and traditional non-VR throwing motor task. Specifically, the single-session VR motor task was associated with significantly higher activation levels in the left sensorimotor cortex (LSMC) and left lateral prefrontal cortex (LPFC) - the two regions in the affected hemisphere uniformly standardized to the left for all subjects - and modulated the functional connectivity between the premotor cortex and its functionally related brain regions. Compared with the traditional non-VR throwing motor task, the single-session VR throwing motor task elicited greater activation in the above-mentioned motor-related and higher-order cognitive brain regions, and induced a significantly different neural response pattern of the motor-cognitive network. The findings of this study reveal the cortical neural response characteristics of children with UCP during a single-session VR motor task, and provide preliminary neuroimaging evidence for subsequent studies exploring the neural mechanisms of VR-based rehabilitation in children with cerebral palsy.
Growing evidence suggests that age-related declines in balance and gait are major contributors to falls, loss of independence, and reduced quality of life in older adults, yet the underlying neural mechanisms remain incompletely understood. The aim of this scoping review was to provide an overview of electroencephalogram (EEG) power spectrum correlates of balance and gait control when standing or walking quietly, and while responding to sensory, mechanical, or cognitive disturbances, in older adults. This knowledge would be important for developing targeted interventions and rehabilitation strategies aimed at enhancing neural function, improving balance and gait, and ultimately reducing the risk of falls and disability among older adults. We further investigated within the identified studies the types of methods used for EEG signal acquisition, preprocessing, and motion artifact removal. PubMed, Embase, and Web of Science were searched for articles published between 1999 and 2025 using the keywords EEG, brain activity, gait, balance, aging, older adults, and other related search terms. This review followed the Joanna Briggs Institute (JBI) framework and reported according to the PRISMA-ScR for a scoping review. A total of 14 articles were included in this review. This scoping review found that in older adults, increasing the difficulty of standing and walking tasks increased delta, theta, and gamma activity, and decreased alpha and beta activity, in the frontal and central regions of the brain. When compared to younger adults, older adults exhibited greater theta and gamma activity, yet lesser alpha and beta activity, during both standing and walking tasks over sensory and motor areas of the brain. Knowledge synthesized in this review provides insight into the neurobiological mechanisms underlying standing and walking in older adults. The findings of this scoping may lead to developing personalized interventions, such as using non-intensive brain stimulation, to target certain brain activity, which might eventually reduce the risk of falls and disability among older adults.
W. R. Bion's (1950) case of the Imaginary Twin is revisited from different vertices. This paper has remained underappreciated because of two sets of factors: one related to how Bion structured his text in a baffling manner; and the other related to some of the uses to which the paper has been put. In subsequent commentaries on the Twin case (e.g., Bion's own epistemological commentary alongside the questionable thesis of playwright Samuel Beckett as the patient in question), these aspects have distracted from the Twin as a genuine contribution to contemporary psychoanalytic technique. It is a close clinical reading of how Bion went about analyzing a patient who was quite deft in unwittingly hiding in plain sight and illuminates his unique contributions to analytic technique. While accounting for the analytic mentors who inspired his psychoanalytic work, a thesis is maintained that in this first psychoanalytic case study Bion began to craft what would become his defining signature, namely an interactional/emotional focus in his technique of the here and now. The author terms it Bion's implicit method of clinical inquiry. While he adroitly articulated some of Melanie Klein's ideas, he simultaneously and quietly distanced his technical approach from hers.
In the ongoing battle between the immune system and cancer, a unique subset of T cells has quietly emerged as a key player. Tissue-Resident Memory T (TRM) cells, strategically positioned within tissues, are redefining our understanding of localized immune defense and tumor control. This review aims to bridge this knowledge gap by synthesizing current concepts of T cell immune surveillance with foundational aspects of TRM cell biology. We explored clinical evidence supporting the prognostic and therapeutic relevance of TRM cells in various cancer contexts, including their emerging roles in enhancing responses to immunotherapy. Furthermore, we discussed innovative strategies that exploit TRM-phenotype cells for patient stratification, disease staging, and therapeutic development. Key challenges such as the absence of standardized T cell nomenclature and the limited understanding of how TRM markers relate to tumor biology are critically examined. By integrating basic science and clinical observations, this review provides a comprehensive overview of the field and highlights promising avenues for future research to harness TRM cells in precision oncology.
I offer this manuscript as a methodological provocation for qualitative health research at a moment when artificial intelligence (AI)-powered translation is becoming increasingly normalised in cross-language interviewing, transcription, and analysis. Rather than reiterate the now-familiar claim that "AI translation can be risky," I argue that the central problem is epistemic: translation technologies are quietly becoming part of the infrastructure of qualitative knowledge production, yet remain methodologically under-disclosed and analytically under-theorised. Drawing on epistemic injustice and cross-language qualitative scholarship, I show how AI translation can flatten culturally saturated narratives. I then explain why Reflexive Thematic Analysis (RTA) functions as a methodological stress test in this terrain: when researchers rely on AI-mediated translations without robust human verification, the interpretive commitments of RTA become difficult to sustain. In response, I propose a guideline: a Minimum Disclosure Standard for AI-mediated translation (MDS-AIMT) in qualitative health research, specifying considerations for authors regarding the selection and use of translation tools, the languages involved, the verification processes employed, data governance protocols, the alignment of analysis methodologies, and the incorporation of AI-specific reflexivity in their work. Finally, I demonstrate a concrete hybrid "repair" strategy-returning to a vignette in which a culturally dense proverb is flattened into "she feels sad about medicine"-to show how AI can assist with access without becoming an unacknowledged co-author of the data. My aim is to move the field toward an ethic of epistemic accountability: technology as an assistant, not an author, and translation as an interpretive practice rather than a methodological footnote.
Electoral integrity scholarship has made noteworthy progress studying national elections, yet a vital blind spot persists: the governance decisions conducted by political organizations -such as political parties, trade unions, civil society organizations and youth organizations- remain almost entirely beyond its analytical scope. These political actors collectively constitute a vital intermediate layer of democratic life, shaping who leads, whose voices are amplified, and how citizens relate to the political system. This open letter warns that their internal electoral processes are a site of frequent malpractice, that existing regulatory frameworks are wholly inadequate, and that the rapid digitalization of processes has introduced new vulnerabilities requiring urgent attention. We call on researchers, funding bodies, and policymakers to develop a new, interdisciplinary research agenda on electoral integrity within and across all major forms of democratic organization. Every year, millions of people head to the polls to choose their representatives. Scholars, observers, and journalists scrutinize every step of the process: counting, campaigning, rules, etc. But long before any of that happens, quieter elections take place in the meeting rooms and online platforms of political parties, trade unions, civic and youth organizations. These are the moments when leaders are chosen, candidates are selected and the direction of political life is set. This is the blind spot that we are now calling out. Political organizations form the backbone of democratic life. They are the bridge between citizens and the state, the places where political careers begin and collective voices take shape. Yet when these organizations hold their own internal elections, the standards we demand of national votes simply do not apply. There are few rules, little oversight and almost no research. The consequences are real: internal elections within parties and organizations are, by many accounts, frequently manipulated. Also, as organizations rush to digitalize their internal processes, moving votes and decisions online, fresh vulnerabilities are opening up faster than anyone can address them. The risks of hacking, fraud and digital exclusion are growing. We are issuing a challenge: to scholars, to practitioners, to funding bodies and to governments. It is time to treat the internal life of political organizations as a serious subject of study and policy, because democracy is not just what happens on election day. It is built, shaped, and sometimes quietly broken in the everyday decisions of the organizations that sit between citizens and power. Right now, that process is largely in the shadows. It doesn’t have to be.