Hidradenitis suppurativa (HS) is a chronic, recurrent inflammatory systemic disease that often leads to extensive, exudative, and painful wound areas. In addition to anti-inflammatory therapy, structured wound care represents a central component of multimodal treatment concepts. Therefore, the aim of this review is to outline specific requirements for pre- and postoperative wound management in HS and to derive practical recommendations. Die Hidradenitis suppurativa (HS) ist eine chronisch-rezidivierende, entzündliche Systemerkrankung, die häufig zu ausgedehnten, stark exsudierenden und schmerzhaften Wundarealen führt. Neben medikamentösen und operativen Therapieansätzen stellt eine strukturierte Wundversorgung einen zentralen Bestandteil des multimodalen Behandlungskonzepts dar. Ziel dieser Übersichtsarbeit ist es daher, spezifische Anforderungen an das prä- und postoperative Wundmanagement bei HS darzustellen und praxisorientierte Empfehlungen abzuleiten.
Empathy and compassion are essential professional values in nursing education; however, evidence on structured longitudinal reflective interventions remains limited. To examine the effects of a longitudinal multimethod reflective learning intervention on nursing students' empathy and compassion. This study was a 2-arm, parallel-group cluster randomized controlled trial. The study included 77 first-year nursing students assigned to intervention (n = 39) and control groups (n = 38). A 14-week structured reflective learning intervention incorporating role-play, guided debriefing, and clinical reflection was implemented during laboratory and clinical training. Linear mixed-model analyses revealed significant main effects of time for empathy and compassion scores (p < .001). However, no significant main effects of group or Time × Group interactions were found for either outcome (p > .05). Empathy and compassion levels increased over time among nursing students. However, the reflective learning intervention did not result in significantly greater improvements than the standard curriculum.
Differences in evidence-based practice (EBP) knowledge, clinical experience, and time availability between nursing students and practicing nurses create the potential for complementary learning, yet interactions are often hierarchical. To explore nurses' experiences in an online collaborative EBP learning model with students and examine how interaction influences engagement and learning. A qualitative descriptive study was conducted. Semi-structured interviews were undertaken with 12 clinical nurses in China. Data were analyzed using Colaizzi's method. A total of 3 themes emerged: perceived benefits, interaction challenges, and optimization strategies. Nurses reported improved EBP knowledge, skills, confidence, and communication. Challenges included knowledge disparities, time constraints, and limited student engagement. Suggested improvements involved structured tasks, better coordination, and stronger facilitation. Online collaborative learning may support nurses' EBP learning by integrating clinical experience with theoretical knowledge. Effective design and facilitation are essential to enhance engagement and outcomes.
We provide a foundation for elucidating the molecular regulatory mechanisms of candidate genes involved in plant architecture and yield related traits. Plant height (PH), leaf angle (LA), ear shank length (ESL), and tassel branch number (TBN) are key plant architecture traits that play crucial roles in improving grain yield in maize. In this study, a genome-wide association study (GWAS) combined with genomic prediction was conducted on these four-plant architecture-related traits in a structured population of 206 inbred lines. Phenotypic data collected over 3 years demonstrated high heritability for all traits. After quality control, a total of 1,191,363 high-quality single-nucleotide polymorphisms (SNP) markers were identified across the 206 inbred lines. The population was divided into four sub-populations, and 830 SNPs exhibited significant associations with the four phenotypic traits. The associated genes were predominantly transcription factors, and functional proteins primarily involved in growth and development, hormone signaling, tissue differentiation, and stress response. Candidate genes associated with TBN and ESL were cloned and identified as Zm00001eb219130 (ZmARM5) and Zm00001eb310680 (ZmNRT1), respectively. RT-qPCR analysis of these genes, along with phenotypic evaluation of transgenic lines, confirmed that ZmARM5 positively regulates TBN, whereas ZmNRT1 negatively regulates ESL. This study provides a foundation for further understanding the genetic control of plant architecture traits in maize and provides valuable molecular insights and genetic resources for efficient transgenic breeding of maize.
Postmenopausal women face increased risks of vascular dysfunction, loss of lean muscle mass, and reduced physical performance due to age-related hormonal and metabolic changes. These factors contribute to heightened cardiovascular risk and physical frailty. L-citrulline, a non-essential amino acid and precursor to nitric oxide (NO), has emerged as a potential therapeutic agent for improving vascular and muscular health. When combined with structured exercise, L-citrulline may enhance NO bioavailability, improve endothelial function, increase muscle perfusion, and potentiate exercise-induced adaptations. This review synthesizes current evidence on the combined impact of L-citrulline supplementation and exercise on endothelial function, arterial stiffness, leg muscle function, lean mass, and strength in postmenopausal women. Findings from preclinical and clinical studies suggest that this combined intervention can reduce arterial stiffness, enhance leg muscle strength, increase lean body mass, and improve overall physical function, potentially via NO-mediated vasodilation, the mechanistic target of rapamycin signaling, improved mitochondrial function, and reduced oxidative stress. These effects are especially relevant in postmenopausal populations at risk for cardiovascular disease and sarcopenia. While early results are promising, further high-quality randomized controlled trials are needed to confirm these benefits, establish optimal dosing strategies, and determine long-term clinical relevance.
Chemical attacks and accidents involving so-called C (chemical)-agents are rare but represent a significant challenge for emergency medical services. More often than classical warfare agents, "dual-use" substances used in industry and everyday settings are involved. Early recognition of a possible exposure is crucial, for example, through clustering of cases or unexplained symptom patterns consistent with a toxidrome. Simple interventions such as undressing and dry decontamination can substantially reduce contamination and help with patient and personnel safety. Initial medical management follows ABCDE (airway, breathing, circulation, disability, and exposure) principles and may be supplemented by targeted antidote therapy. Knowledge of the clinical features, key problems, and management of common substance groups such as organophosphates or cyanides enables a structured and effective approach and is discussed in this article. Anschläge und Unfälle mit chemischen Agenzien (sog. C‑Agents) sind selten, stellen jedoch gerade deshalb eine Herausforderung für den Rettungsdienst dar. Neben klassischen Kampfstoffen kommen häufig „Dual-use“-Substanzen aus der Industrie zum Einsatz. Entscheidend ist das frühzeitige Erkennen einer möglichen Exposition, etwa durch Clusterbildung oder Vorliegen von Toxidromen. Unter Wahrung des Eigenschutzes können einfache Maßnahmen, wie Entkleiden und Trockendekontamination, die Gefahr für Patienten und Rettungsdienst deutlich reduzieren. Die medizinische Versorgung erfolgt symptomatisch nach dem ABCDE-Schema, teilweise ergänzt durch eine gezielte Antidottherapie. Die Kenntnis zur Symptomatik, führenden Probleme und Maßnahmen bei häufigen Substanzgruppen, wie Organophosphaten oder Cyaniden, ermöglicht ein strukturiertes und effektives Vorgehen und wird in diesem Artikel dargestellt.
Bone healing, remodeling, and pathology are strongly regulated by mechanical stimulation. However, conventional two-dimensional (2D) in vitro culture systems fail to reproduce the complex mechanical and biological microenvironment of human bone, limiting their translational relevance. In recent years, bone-on-chip (BoC) platforms, as part of the broader organ-on-chip (OoC) technology, have emerged as advanced microfluidic systems that enable the study of bone biology under dynamic and highly controlled conditions that more closely mimic in vivo physiology. This systematic review aimed to gather the available in vitro evidence on mechanically stimulated BoC models, with a particular focus on osteogenic differentiation outcomes and the technical characteristics underlying these platforms. Following a comprehensive literature search and structured data extraction, biological parameters (cell types, culture conditions, scaffolds), chip design and fabrication strategies, mechanical loading modalities, and assessment assays were systematically analyzed. Across the included studies, fluid shear stress was the most frequently applied mechanical stimulus and was generally associated with enhanced osteogenic differentiation compared with static cultures, although substantial heterogeneity was observed in loading protocols and outcome measures. Overall, this review provides a consolidated technical and biological overview of mechanically stimulated BoC systems and highlights key methodological considerations for future platform development. By integrating microengineering approaches with bone and stem cell biology, BoC models hold significant potential for advancing bone tissue engineering, mechanobiology research, and translational applications, including dentistry-related bone regeneration and biomaterial testing.
This study aims to examine older adults' experiences of laughter yoga and the meanings they attribute to this practice through a phenomenological approach. Data were collected through semi-structured interviews with 14 participants at a retirement center in Türkiye and were analyzed using content and metaphor analyses. The findings reveal that laughter yoga contributes to a holistic improvement in psychological well-being, physical health, and socialization, while the leader's attitude emerges as a critical determinant in this process. Participants reported increased happiness, improved stress management, enhanced life energy, reduced pain, greater breathing awareness, and physical relaxation, as well as strengthened social interaction. Metaphorical analyses further confirmed the multidimensional impact of the intervention through symbolic representations related to psychological transformation, nature experiences, and socialization. This study has shown that laughter yoga in old age is an intervention that supports mental well-being, body awareness, and biopsychosocial health. Integrating laughter yoga into geriatric programs may offer a strategic model for improving quality of life among the aging population by enhancing emotional resilience and strengthening social capital.
Systemic autoimmune rheumatic disease-associated interstitial lung disease (SARD-ILD) represents a heterogeneous group of pulmonary disorders with substantial effects on morbidity and mortality. The clinical course varies according to the underlying rheumatic disease, radiological phenotype, extent of lung involvement and risk of progression. Although interstitial lung disease is particularly frequent in systemic sclerosis and idiopathic inflammatory myopathies, it also significantly contributes to outcomes in rheumatoid arthritis, Sjögren's disease and mixed connective tissue disease. Early recognition is essential, as clinically silent disease may progress to irreversible fibrosis, whereas some patients may present with rapidly progressive or progressive fibrosing phenotypes requiring urgent or intensified treatment. Recent American College of Rheumatology/American College of Chest Physicians (ACR/CHEST) and European Respiratory Society/European Alliance of Associations for Rheumatology (ERS/EULAR) guidelines provide an important framework for screening, monitoring and management of SARD-ILD, but differ in several clinically relevant aspects. ACR/CHEST adopts a largely risk-based and pragmatic approach, whereas ERS/EULAR places greater emphasis on disease-specific assessment, the central role of high-resolution computed tomography in screening and structured monitoring according to progression risk. In treatment, both guidelines support immunosuppression as the main therapeutic strategy, while recognizing the growing role of antifibrotic therapy in selected patients with fibrotic or progressive disease. The available evidence remains strongest for systemic sclerosis-associated interstitial lung disease, with important uncertainties persisting across other SARD subtypes. This narrative review summarizes the epidemiology, clinical and radiological phenotypes, and pathobiological basis of SARD-ILD, and critically discusses recent guideline recommendations from a pulmonary perspective. Particular emphasis is placed on translating the differences between the current guidelines into practical multidisciplinary decisions regarding screening, longitudinal assessment, treatment selection and future research priorities.
Chordoma is a rare malignant bone tumor with high local recurrence, metastatic spread in 40% to 60% of patients over the disease course, and significant morbidity. Because of its rarity, anatomical complexity, and prolonged natural history, high-quality evidence to guide management is limited. International consensus guidelines for localized chordoma were first published in 2015; however, advances in pathology, imaging, surgery, radiotherapy, and supportive care since then necessitate updated multidisciplinary recommendations. To update and expand the 2015 consensus recommendations on the diagnosis, treatment, and follow-up of pediatric and adult patients with primary, localized chordoma. In June 2025, a meeting of the Global Chordoma Consensus Group was held in Milan, Italy, that included experts from all relevant specialties as well as patient representatives. A comprehensive literature review guided structured discussions on the management of primary localized disease. Levels of evidence and grades of recommendation were assigned. A total of 305 articles were included in the literature review. Management strategies were stratified by anatomical site (skull base, mobile spine, and sacrum). The central principal of care was treatment at experienced, multidisciplinary centers, with maximally safe surgery followed by high-dose, highly conformal radiotherapy. Guidance was provided on diagnosis, surgical approaches, and radiotherapy planning for each anatomical site. Systemic therapy options; long-term, risk-adapted follow-up; and supportive, palliative, and rehabilitative care were also addressed. This global consensus statement provided updated multidisciplinary guidance for the management of primary, localized chordoma. It aimed to harmonize clinical practice, support shared decision-making, and identify priorities for future collaborative research in this rare and challenging disease.
Gamification has emerged as a promising pedagogical strategy in medical education, fostering active engagement, collaborative learning, and improved knowledge retention. Clinical enzymology, a core yet conceptually challenging area of biochemistry for medical students and also students majoring in the life sciences and related fields often suffers from poor comprehension and recall when taught using traditional didactic methods. To address these challenges, CARBGAME (CARd and Board GAmes in Medical Education) was developed as a structured gamified approach designed to reinforce enzymology concepts through an interactive board game format. This chapter provides a reproducible methodology for implementing CARBGAME in undergraduate medical and life science/other related disciplines classrooms. The protocol outlines essential materials, step-by-step instructions for designing and conducting the game, strategies for formative assessment, and critical troubleshooting tips. When applied in classroom settings, CARBGAME has been shown to significantly improve both short-term and long-term learning outcomes, enhance student motivation, and create a collaborative environment conducive to deeper learning. The format described here enables educators across institutions to replicate and adapt CARBGAME to different biomedical topics, thereby integrating gamification as an innovative teaching strategy in medical curricula.
Pancreatic masses comprise a broad spectrum of benign, inflammatory, premalignant, and malignant entities with markedly different prognoses and therapeutic implications. Pancreatic ductal adenocarcinoma (PDAC) remains the most lethal solid pancreatic neoplasm, whereas inflammatory conditions such as autoimmune pancreatitis and mass-forming chronic pancreatitis may simulate malignancy on imaging, frequently leading to unnecessary surgical resections. Given the increasing detection of pancreatic lesions through widespread use of high-resolution cross-sectional imaging, radiologists play a central role in lesion characterization, risk stratification, and guidance of further diagnostic steps. This review approaches pancreatic mass evaluation not as a catalogue of entities but as a structured diagnostic problem. A six-step algorithm organized around the central clinical question: is it malignant? is presented as the organizing framework of the manuscript, with each subsequent section addressing a specific diagnostic branch of that algorithm. The algorithm assigns a formal confidence level (high, moderate or indeterminate) at each decision node, defined by explicit imaging and clinical criteria with published accuracy data cited where available.
Faced with increasing suicide rates in the U.S. Army, efforts are underway to bolster noncommissioned officer (NCO) training as suicide prevention gatekeepers and also to support upstream prevention efforts more generally. This qualitative study examined the literature on best practices for non-clinical suicide prevention and training in the skills necessary to have difficult conversations to identify and address suicide risk factors (e.g. financial and relationship issues, mental health and substance use). We reviewed the empirical literature and conducted structured interviews with key Army leaders, trainers, and NCOs about the current Army training efforts. Interviews revealed multiple enhancements to training being made that are in line with best practices, but some gaps were noted as well. Based on our findings, we recommend that the Army increase the availability of training in how to have difficult conversations (especially "soft skills"), enhance support for skills-building after trainings occur through coaching, mentoring, and performance feedback, clarify that this type of soldier support is part of the NCO role, and more strongly promote the concept that soldier well-being is key to a ready and resilient force.
Selective chemical modification of cellulose in lignocellulosic fibers without disrupting the native hierarchical structure remains a central challenge in polysaccharide chemistry. Herein, we report a reactive succinic anhydride-based deep eutectic solvent (SAH-DES) strategy. The SAH-DES system, comprising choline chloride, succinic anhydride, and water (1:1:1 molar ratio), forms a robust hydrogen-bonded network to stabilize anhydride reactivity and suppress hydrolysis. Under optimized conditions (100 °C, 3 h), carboxylated bamboo fibers (C-BFs) achieved a high carboxyl content of 1.01 ± 0.03 mmol/g while retaining excellent tensile strength (2104 ± 237 MPa). The introduced carboxyl groups enabled uniform deposition of conductive materials (Ag/Ni nanoparticles, polypyrrole), resulting in a high electrical conductivity of 34,271 ± 1266 S/m. This study demonstrates that water-regulated reactivity in deep eutectic solvents provides a pathway for selective cellulose esterification, offering mechanistic insight into structure-reactivity relationships of polysaccharides in confined solvent systems.
Protein tyrosine phosphatases (PTPs) are pivotal regulators of cellular signaling and potential therapeutic targets for cancer, metabolic disorders, and autoimmune diseases. However, the development of PTP inhibitors remains challenging due to the highly conserved catalytic pocket, the poor membrane permeability of phosphotyrosine mimetics, and difficulties in achieving subtype selectivity. Multicomponent reactions (MCRs) offer a powerful solution by enabling the rapid and modular synthesis of structurally diverse, medicinally relevant scaffolds in a one-pot manner. Through the flexible combination of building blocks, MCRs facilitate efficient optimization of polarity, topology, conformational rigidity, and secondary-pocket engagement, thereby accelerating the discovery of selective and drug-like PTP inhibitors. This review provides the first systematic overview of MCR-enabled PTP inhibitor discovery. The discussion is organized according to major MCR strategies and PTP target classes, highlighting how MCR chemistry has been applied to rapidly construct focused libraries, identify novel scaffolds, and optimize potency and selectivity. Key design concepts-including phosphotyrosine mimicry, fragment extension, conformational constraint, and stereochemical control-are critically summarized. Current limitations and emerging opportunities, such as AI-assisted design, virtual screening, and dynamic combinatorial chemistry, are also discussed. By positioning MCRs as design-enabling technologies, this review outlines a practical framework for the development of next-generation PTP inhibitors.
This chapter presents a reproducible, cloud-based framework for integrating Python-driven data analysis into a large-enrollment undergraduate biochemistry course. Rapid growth in technologies has transformed biochemistry into a data-intensive discipline, yet most life-science students receive little formal training in computational skills. To address this gap, we developed a set of interactive Jupyter notebooks that embed introductory coding, protein structure visualization, metabolic modeling, and simple multi-omics analysis directly within the core biochemistry curriculum. The workflow is delivered entirely through the CyVerse Discovery Environment, which provides browser-based JupyterLab sessions with preconfigured Python environments, version-controlled notebooks, and standardized datasets. This infrastructure eliminates the need for local installation, supports hundreds of simultaneous users, and ensures consistent execution across diverse student hardware. The notebooks follow a scaffolded learn-apply-reflect design that links biochemical concepts with incremental coding tasks, enabling students with no prior experience to manipulate real datasets, generate visualizations, and interpret quantitative patterns. Assessment using validated pre/post surveys across more than 1000 matched responses demonstrated substantial gains in students' confidence with coding and their ability to interpret omics data. The protocol outlined here offers a scalable, equitable model for incorporating computational literacy into biochemistry education and can be readily adapted for related life-science courses.
What do we know about how the most abundant species of primates in Gorongosa National Park (Mozambique) exploit a highly seasonal and heterogeneous environment? This review examines current knowledge and key gaps in our understanding of Gorongosa's vegetation in relation to the diet and feeding ecology of grey-footed chacma baboons (Papio ursinus griseipes). By synthesising existing literature of Gorongosa's historical context, seasonality, landscape structure, and plant communities, this review provides environmental context for understanding baboon feeding ecology. Baboons appear to be among the most numerous mammals in Gorongosa National Park, inhabiting diverse landscapes and utilising the environment dynamically. Gorongosa National Park provides a useful contemporary system for investigating wild living primates, as it is a highly seasonal area with mosaic environments and a complex history, and it offers a valuable ecological analogue for early hominin environments. In this review, previous work on Gorongosa's chacma baboon ecology and diet is synthesized, highlighting their pronounced dietary flexibility, foraging strategies, and extensive resource use. We also briefly consider their possible ecological role in seed dispersal, vegetation dynamics, and interactions with invasive plants, as these aspects are poorly documented in the park. Overall, this work organises existing data on baboon feeding ecology in Gorongosa, identifies key gaps, and outlines priorities for future integrative research, contributing to broader discussions of primate ecology, conservation, and human evolutionary models.
Soluble epoxide hydrolase (sEH) is a key enzyme regulating the metabolism of epoxidized fatty acids and is involved in various pathological processes, including inflammation, cardiovascular disease, and metabolic disorders; therefore, the development of novel sEH inhibitors is of great significance. In this study, we screened 715,343 natural products using the COCONUT 2.0 natural products database, with the human sEH crystal structure (PDB ID: 3ANS) as the target. Eight representative compounds were selected for in vitro validation. The results showed that Compound 1 (CNP0403849.1) and Compound 3 (CNP0059487.0) exhibited good sEH inhibitory activity, with IC₅₀ values of 0.852 ± 0.014 µM and 2.811 ± 0.243 µM, respectively, while the IC₅₀ value for the positive control AUDA was 0.014 ± 0.003 µM. Enzyme kinetic analysis indicates that these two active compounds inhibit sEH through a non-competitive mechanism. Cell-based experiments indicated that, within the concentration range of 5-40 µM, Compound 1 and Compound 3 exhibited no significant cytotoxicity toward RAW264.7 cells and could inhibit LPS-induced NO production to some extent. 100 ns molecular dynamics simulations revealed that both compounds could maintain stable binding within the active pocket of sEH. This study identified two sEH inhibitors with micromolar activity from natural products, with Compound 1 exhibiting superior in vitro enzyme inhibitory activity. This research provides a new structural basis and research leads for the discovery of sEH inhibitors derived from natural products and the subsequent optimization of lead compounds.
The phytochemical investigation of the root barks of Croton pseudopulchellus Pax yielded two new clerodane-type diterpenoids, crotopseudofurans A (1) and B (2) along with 14 known compounds (3-16). Compounds 2 and 3 were obtained as a mixture of C-12 epimers. Their structures were established by spectrometric and spectroscopic means, single-crystal x-ray diffraction analysis and by comparison with literature data. The single-crystal x-ray diffraction data of 5 is reported for the first time. Minimum inhibitory concentrations (MICs) and minimum bactericidal concentrations (MBCs) of plant constituents were determined against Gram-positive and Gram-negative bacteria by using broth microdilution method. The methanol extract and fractions exhibited moderate broad-spectrum activity, with stronger effects against Gram-positive bacteria. Among the isolates, 7,8-dehydrocrotocorylifuran (6) and vitexin (9) emerged as the most promising candidates (MIC = 16-64 µg/mL) and demonstrated remarkable bactericidal activity against all the tested bacteria. Except compound 6, clerodane-type diterpenoids (1-5) showed weak or no activity. The findings support the ethnomedicinal relevance of Croton pseudopuchellus roots and warrant further mechanistic, toxicological and structure-activity relationship studies aimed at developing new antimicrobial agents.
Molecular dynamics (MD) simulations are widely used in computational and structural biology to study the time-dependent behavior of biological macromolecules at atomic resolution. Over the years, they have become an indispensable tool in the study of biomolecular systems and have been applied to investigate protein folding, conformational change, ligand interaction, protein structure determination, and refinement of X-ray crystallographic models. This chapter presents a practical, end-to-end protocol for performing MD simulations on large biomolecules, using a full-length antibody as a case study. It also introduces foundational software tools commonly used in molecular modeling and MD simulations, including PyMOL, visual molecular dynamics (VMD), nanoscale molecular dynamics (NAMD), MDAnalysis, and others. Additionally, the protocol covers the modeling of antibody-excipient interactions and identifying binding sites from MD trajectories. Together, this accessible and reproducible framework aims to equip researchers with the computational tools and foundational knowledge needed to study the dynamic behavior of complex biomolecular systems and integrate MD simulations into their own biological research.