Acute disturbances caused by changing environmental conditions are increasingly affecting the structure and function of coral reef ecosystems. Notably, changing rainfall patterns are leading to increasing incidence of hyposalinity. This study explored interannual changes in the overall cover and composition of hard corals (order Scleractinia) in Pioneer Bay, Orpheus Island, which was subject to hyposalinity during unprecedented high rainfall in February 2025. Hard coral cover declined 66.60%, from 41.66% (±1.22 SE) in September 2024 to 13.92% (±0.92 SE) in October 2025, with coral loss mostly apparent on the reef flat and reef crest. Coral loss was not equally apportioned among different coral taxa (genera), possibly reflecting differential susceptibility to hyposalinity based on specific physiology and habitat associations. The most pronounced declines were recorded among Merulinidae, which were the predominant hard corals on the reef flat in 2024. Soft corals were similarly affected and exhibited major declines in abundance on the reef flat. Hyposalinity is rarely considered among the suite of climatic disturbances that impact on coral assemblages and reef ecosystems, but this research shows that the potential ecological effects are very extensive, adding to the diversity of acute disturbances that will influence the structure coral reef ecosystems in the Anthropocene.
Millions of patients benefit from medical imaging every single day. However, large-scale multicenter studies published in the last 6 years have brought new result that allow extrapolation to nationwide or global levels. They have opened a new era wherein millions of patients are receiving cumulative doses in three digits of mGy of organ doses or three digits of mSv of cumulative effective dose (CED) every year. One out of 125 patients can be exposed to an effective dose ≥50 mSv from a single computed tomography (CT) exam, and 3 out of 10,000 patients undergoing CT exams could potentially receive cumulative effective doses ≥100 mSv in a single day. Recurrent imaging with CT, fluoroscopically guided interventions (FGI), and hybrid imaging modalities such as positron emission tomography/computed tomography (PET/CT) are more prevalent today than ever before. Although a major fraction of patients with such high doses is ≥60 years of age, the number of patients <60 years and with diseases that do not substantially shorten life expectancy is estimated to be nearly half a million added every year. Moreover, data from a centre that employs the best form of justification and the best form of optimisation indicate that we have reached a limiting point in providing safer imaging to many patients using currently available imaging machines and justification and optimisation tools. This leads us to an unprecedented era where collective thinking and actions are needed, and it provides a fitting opportunity for the call given by the International Commission on Radiological Protection (ICRP) to develop solutions to achieve safer imaging, a mission that necessitated the creation of ICRP in 1928.
Like other warm-temperate seas around the world, the Mediterranean is becoming tropicalised due to seawater warming and the range expansion of tropical species. This review identifies previous tropical phases of the (ancestor of the) Mediterranean in the geological past, seeking analogies with the present condition: the Mesozoic (from an Indo-Pacific character during the Tethys to a circumtropical character in the Mesogea), the Pliocene (Atlantic affinity), and the Last Interglacial (Senegalese affinity). The ongoing situation is analysed by comparing changes in the chorological spectra of two locations in the NW Mediterranean (Portofino Promontory, Ligurian Sea) and SE Mediterranean (Kos Island, Aegean Sea), before and after the major climatic shift that occurred in the 1990s. The increased occurrence of Indo-Pacific species, introduced through the man-made Suez Canal, may be reminiscent of the Mesozoic situation. These new inhabitants, however, have come to coexist with a background of species of Atlantic origin, including many endemics. Apart from Indo-Pacific species, the Mediterranean biota is becoming similar to that of the Last Interglacial, with little or no coral reef development. In addition, human traffic is introducing, voluntarily or involuntarily, many alien species that are generally tropical. Humans represent a factor that was not present in the geological past, and the anthropogenic influence is so pervasive that the current era has been termed the Anthropocene by some. Thus, knowledge of the past will be of little help in predicting the future biotic configuration of the tropical Mediterranean Sea.
Muscle atrophy occurs during physiological (i.e., fasting) and pathological conditions (i.e., cancer) and anticipates death. Since not all patients will undergo muscle wasting, it would be highly useful to identify them soon to intervene early. We aim to generate a reporter system to follow only pathological, but not physiological, muscle wasting through in vivo imaging. Comparing the upstream non-coding regions of a subset of atrophy-related genes or atrogenes, using the MuRF1 promoter as a backbone, we cloned various promoters upstream of Firefly Luciferase. The best hits selected in vitro were further compared in in vivo imaging if able to sense early atrophy induced by MCG101 sarcoma or sciatic nerve resection through plasmid electroporation or AAV9 injections. The best promoter was used to generate the reporter mouse MyoRep, expressing the cassette in all skeletal and cardiac muscles using the loxP system. Luciferase assays showed that only the newly generated promoters of MuRF1, one containing glucocorticoid-responsive elements or GRE (TWIST) (p ≤ 0.01, 1.7 FC) and a GRE-less promoter (GREDEL) (p ≤ 0.0001, 1.6 FC), discriminated the supernatants from cachectic tumoural cells (C26) from non-cachectic ones (4T1). Comparing both reporters electroporated in leg muscles, we found that GREDEL, but not TWIST, anticipated atrophy by 6 days in MCG101 carriers (p ≤ 0.05) and by 8 days upon denervation (p ≤ 0.05), recapitulating MuRF1 inductions. TWIST, but not GREDEL, drove an undesirable bioluminescent signal in vitro to dexamethasone (p ≤ 0.001, 1.5 FC) and in vivo upon fasting (p = 0.0553, 3 FC). GREDEL-carrying AAV9 injected in the legs of ApcMin/+ mice unraveled sex-different cachexia and anticipated body emaciation by 1 week (p ≤ 0.001, 3.7 FC). GREDEL was then used to generate the MyoRep mouse. Dorsal view of bioluminescent signal of MCG101-carrying MyoRep mice increased already 6 days from tumour injection (p ≤ 0.01, 1.7 FC) when tumour is still unpalpable. Denervated MyoRep mice emitted a signal already 1 day after surgery (p ≤ 0.05, 1.4 FC), anticipating atrophy. Male ApcMin/+ mice display less musclin in their muscles (p ≤ 0.05, 0.4 FC) and plasma (p ≤ 0.01, 0.6 FC). Such mice, when expressing MyoRep in their muscle legs, were given the anti-catabolic myokine musclin. The emitted signal was decreased by 30% 3 weeks after musclin-AAV9 administration (p ≤ 0.05), supporting MyoRep useful to test anti-atrophic drugs. Since MyoRep detects only pathological atrophy anticipating wasting, it represents an unprecedented tool to predict it early in diseases with local or systemic atrophy. It could also be useful to identify early biomarkers of atrophy and new drugs at once.
The increasing frequency and severity of natural hazards, such as floods, wildfires, land degradation, and ground displacement, pose significant challenges to the protection of urban areas worldwide. While traditional monitoring approaches based on a single-source satellite sensor have proved to be reliable, they often fail to provide a holistic representation of the complexity, scale, and rapid evolution of these phenomena. The recent advancement of artificial intelligence (AI), coupled with the unprecedented availability of multi-source satellite imagery, offers new perspectives for enhancing natural hazard monitoring and susceptibility mapping. In this study, we present a novel approach that leverages state-of-the-art Explainable AI (XAI) techniques, particularly SHAP (SHapley Additive exPlanations), to analyze multi-source satellite imagery for natural hazard monitoring and assessment in urban areas. The framework utilizes globally available, open-source satellite data (Sentinel-1/2, COSMO-SkyMed, SAOCOM) to ensure inherent scalability and transferability. XAI is chosen to move beyond black-box prediction, providing transparent attribution of susceptibility to underlying environmental and infrastructural parameters, which is essential for informed intervention. This interpretability is critical for building stakeholder trust and ensuring that automated predictions align with domain knowledge before deployment. Our approach was developed, applied, and validated in two distinct sites located in the Puglia region, southern Italy: the densely populated Bari Urban Region (BUR) and the diverse settlements and land uses within the Gargano Urban Region (GUR). We combined XAI-based models with optical imagery from Sentinel-2, SAR data from Sentinel-1, COSMO-SkyMed, and SAOCOM to extract the key features explaining the occurrence and magnitude of the following hazards: (1) sediment connectivity; (2) land displacement; (3) urban floods; and (4) urban wildfires. Our results demonstrate that the integration of multi-source satellite imagery through AI not only significantly enhances the accuracy and reliability of hazard detection (e.g., F1 scores consistently above 67.5% for three of the four hazards, and high Recall across all modules) but also enables the identification of subtle spatial patterns and crucial interrelationships.
Global biodiversity is facing unprecedented declines, with vulnerable, threatened, endangered, and critically endangered (VTEC) species at disproportionate risk. Among emerging threats, microplastics (MPs, <5 mm) and heavy metals (HMs) are persistent contaminants with high potential for bioaccumulation and biomagnification across ecosystems. This review is the first to synthesize the scarce and fragmented field-based evidence documenting MPs and HMs in VTEC species, highlighting critical gaps in taxonomic, habitat, trophic, and conservation-level coverage. The review evaluates field evidence on microplastics (MPs) and heavy metals (HMs) in vulnerable, threatened, endangered, and critically endangered species listed by the International Union for Conservation of Nature. From 2005 to 2024, only 21 eligible field studies were identified, exposing a serious research deficit relative to conservation urgency. MP studies are dominated by marine taxa while amphibians and freshwater organisms are largely neglected. In contrast, HM research is biased toward terrestrial birds, particularly vultures, with minimal coverage of marine and reptilian species. Overall, contaminant monitoring in high-risk species is fragmented, taxonomically biased, and poorly aligned with proactive conservation planning. Despite extremely limited data, this review underscores the urgent need for integrative, cross-taxa field studies, long-term ecotoxicological monitoring, and conservation strategies.
The unprecedented expansion of human activities has led to increasing global underwater noise pollution, but its effects on fish behavior and cognition, which are fundamental for learning, decision-making, and survival, as well as the underlying physiological mechanisms remain poorly understood. Here, we exposed juvenile black rockfish (Sebastes schlegelii) to four noise levels for 50 days. The results showed that medium and high noise levels (110 and 130 dB re 1 μPa root mean square (RMS)) significantly impaired growth and induced learning and memory-related deficits in T-maze tests, as evidenced by reduced spatial preference and altered swimming patterns. Noise exposure doubled malondialdehyde levels in the brains and livers of fish, indicating severe lipid peroxidation. Moreover, noise exposure induced dysregulation of the hypothalamic-pituitary-interrenal (HPI) axis, leading to a sustained stress-inflammatory state that further propagated systemic disturbances, including significant alterations in gut microbiota and metabolite profiles. Consistently, the level of N-acetyl-L-leucine, a key microbial-derived metabolite, was reduced in the brain and gut microbial metabolites, suggesting impaired autophagy function. Collectively, these effects may have contributed to neuronal injury and ultimately resulted in behavioral deficits. These findings highlight the critical role of the HPI and "microbiota-gut-brain" axes in mediating noise-induced behavioral changes in a marine fish.
Antarctic marginal seas are crucial for the global climate, but direct observations, especially of mesoscale ocean eddies, remain scarce. Here, by analyzing the unprecedented high-resolution sea surface height data provided by the recently launched Surface Water and Ocean Topography (SWOT) satellite, we reveal a widespread presence of mesoscale eddies across the Antarctic continental shelf. The geographic distributions of the observed eddies, along with eddy-resolving model simulations, support the hypothesis that ice shelf basal melting and dense shelf water formation are key processes driving the prevalent eddy activity. Our findings highlight the potential of innovative satellite measurements for monitoring critical Antarctic oceanic processes, and the need to resolve the abundant Antarctic ocean eddies in climate models.
This article proposes a modular platform for m-health devices for police officers and firefighters, considering a sample of professionals from southern Brazil. The methodological approach considers the heterogeneity of potential users' needs by using the stated preference technique to estimate conditional multinomial logit (C-MNL) and latent class logit (LCL) models. The results show that the features for monitoring stress and vital signs were the most significant, meeting the illnesses most reported by police officers and firefighters (mental illnesses and illnesses of the circulatory system). The proposed framework, based on the novel use of the stated preference technique with two models (C-MNL and LCL), paves the way for further analysis of Internet of Things (IoT) device configurations. The results provide substantial detail on implementing m-health devices for public safety agents, consider user requirements and propose a modular architecture based on an unprecedented product development strategy.
Influenza A (H5Nx) highly pathogenic avian influenza viruses of clade 2.3.4.4b were first detected in North America in late 2021, initiating a multi-year outbreak unprecedented in geographic extent, duration, and host range. Surveillance conducted across Canada, the United States, and Mexico has documented widespread detections in wild birds and poultry, and repeated spillover into wild and domestic mammals. Genomic analyses reveal successive lineage replacements and extensive reassortment between Eurasian and North American lineages, with over 100 distinct genotypes identified to date. Recent events, including detection of genotype B3.13 in United States dairy cattle and the emergence of genotype D1.1 across all four North American migratory bird flyways, highlight ongoing viral evolution and cross-species transmission risks. This synthesis provides a continental overview of the outbreak from November 1, 2021, to March 31, 2025, summarizing surveillance results and genomic trends to inform continued One Health preparedness and response efforts.
Due to an increase in media and news attention on anti-Black racism in 2020, the APA declared racism a pandemic as the CDC highlighted the challenges related to the COVID-19 pandemic. Thus, the work described in the current manuscript took place during what is referred to as a double pandemic for Black people in the United States. This paper discusses the impact of this period on a department and its students, the training students advocated for in response to the urgent need for more support for Black communities, and the approaches they used to address racial stress and trauma during this unprecedented time. We outline how one Clinical Psychology program designed and disseminated resources, including a racial trauma guide, public health messaging campaign, podcast, and social media content to increase access to translational research, culturally relevant resources, and psychoeducation to combat racism and discrimination. Analytics and trends demonstrate the impact of the Task Force's initiatives. We summarize the process and recommend clinical-community approaches for healing racial stress and trauma among Black youth, families, and communities.
In response to the COVID-19 pandemic, federal policymakers temporarily lifted long-standing restrictions on telemedicine, resulting in an unprecedented and rapid expansion of virtual care across video, audio, and asynchronous modalities. When integrated into longitudinal care relationships, telemedicine can increase access, reduce patient burden, and support continuity for people facing geographic, mobility, or socioeconomic barriers. However, telemedicine also introduces new clinical, regulatory, equity, and safety challenges that require deliberate policy design. Beyond its clinical considerations, telehealth offers environmental and logistical benefits, including reduced travel time and cost, decreased fuel consumption, lower transportation expenses, and lower greenhouse gas emissions. In this position paper, the American College of Physicians updates its previous policy paper on telemedicine to reflect changes in payment policy, licensure, prescribing authority, and utilization patterns that have occurred over the past decade and accelerated during the COVID-19 public health emergency. This paper focuses on access, payment policy, licensure, prescribing practices, equity, and patient safety across federal and state programs and private payers and emphasizes the conditions under which telemedicine should be integrated into clinical practice. Key developments addressed include the expansion and partial lapse of Medicare telemedicine waivers, evolving U.S. Drug Enforcement Administration rules governing prescribing, increased reliance on interstate practice, and normalization of telemedicine by private payers.
Aggressive subtypes of acute myeloid leukemia (AML) are characterized by increased migratory behavior and poor prognosis prioritizing the need for uncovering relevant mechanisms. While attributed to transcriptional changes, these AMLs manifest dysregulated eIF4E implicating disrupted mRNA metabolism. Here, we observed in AML mouse models, patient specimens, and cell lines that eIF4E drives motility, colonization, engraftment and AML progression. AML cells migrate utilizing Ezrin-positive pseudopods. Unexpectedly, we discovered that eIF4E interacts with Ezrin, that these physically associated factors are required and cooperated to drive an on-demand translation program in pseudopods for motility. Indeed, pseudopods were sites of eIF4E- and Ezrin-dependent translation by implementing the first method to directly mark active ribosomes in situ ( Vis ualizing T ranslation A ctivity using R iboLace, VISTA-R). Biochemically, Ezrin bound eIF4E, ribosomal components, and mRNAs consistent with our observed Ezrin-dependent modulation of protein production. This unprecedented physical coupling of motility and translation provisions migratory sites to sustain AML progression. eIF4E reduction impairs AML cell motility and disease progressioneIF4E-dependent motility requires EzrinEzrin binds eIF4E, transcripts encoding motility factors and active ribosomesVISTA-R enabled visualization of active ribosomes and translationally active pseudopods (T-PODs)T-PODs provide novel on-demand localized translation to sustain mobility at migratory sites.
Spatial transcriptomics (ST) enables the simultaneous measurement of gene expression and spatial context, offering unprecedented insights into tissue architecture and cellular communication. However, existing approaches often fail to jointly capture spatial topology and transcriptional heterogeneity, leading to suboptimal representations and limited biological interpretability. To address this limitation, we propose stCAMBL, a biased multi-view contrastive framework that integrates spatial graph structure modeling with attentive feature masking and partial contrastive regularization. Built upon a variational graph autoencoder backbone, stCAMBL learns biologically informed and noise-robust embeddings by adaptively emphasizing informative molecular features while mitigating confounding patterns across spatial domains. Comprehensive evaluations on multiple 10$\times$ Visium datasets demonstrate that stCAMBL substantially improves clustering accuracy, gene ontology enrichment, and signal restoration, demonstrating strong generalizability for high-fidelity ST analysis.
The exponential increase in biomedical data offers unprecedented opportunities for drug discovery, yet overwhelms traditional data analysis methods, limiting the pace of new drug development. Here we introduce a framework for autonomous artificial intelligence (AI)-driven drug discovery that integrates knowledge graphs with large language models (LLMs). It is capable of planning and carrying out automated drug discovery programs at a massive scale while providing details of its research strategy, progress, and all supporting data. At the heart of this framework lies the focal graph - a novel construct that harnesses centrality algorithms to distill vast, noisy datasets into concise, transparent, data-driven hypotheses. We demonstrate that even small-scale applications of this highly scalable approach can yield novel, transparent insights relevant to multiple stages of the drug discovery process, including chemical structure-based target prediction, and present the implementation of a system which autonomously plans and executes a multi-step target discovery workflow.
This study aimed to understand how children experienced nursing care while staying in the hospital during the COVID-19 pandemic and to explore the feelings they had during this time. A descriptive study was conducted with children receiving inpatient care in pediatric units during the pandemic. Information was gathered through child-friendly interviews and questionnaires that focused on their experiences and perceptions of nursing care. Children generally reported that their basic physical needs were well addressed. However, many felt that emotional support and opportunities to talk about their feelings were limited. A large proportion of children expressed worry and emotional distress related to being hospitalized during the pandemic. The findings reflect children's experiences in a single healthcare setting and do not include the perspectives of nurses or family members. Future research could benefit from including multiple viewpoints and broader healthcare contexts. The results highlight the importance of giving greater attention to children's emotional and psychological needs during hospitalization. Nurses may benefit from using simple communication strategies and supportive activities to help children express their feelings, especially during public health crises. By directly listening to children's voices, this study emphasizes the importance of respecting children's rights in healthcare settings and ensuring that their emotional well-being is considered alongside physical care. This study provides insight into children's own views of nursing care during an unprecedented global health crisis. By focusing on children's lived experiences, it offers valuable guidance for improving child-centered and holistic nursing care in challenging situations.
Partial endoreplication is a prominent developmental feature and poses a significant challenge for whole genome assembly in orchids. This form of cell cycle results in highly unbalanced cell DNA content, with the highly endoreplicated (P) fraction being overrepresented in sequencing data compared to the non-endoreplicated (F) fraction. Here, we report the first genome assembly of Vanilla planifolia into 16 chromosome pairs using axillary buds enriched in non-endoreplicated 2 C-nuclei (55%) as determined by flow cytometry. The assembly was generated using a hybrid approach combining PacBio HiFi sequencing and Omni-C scaffolding generated in this study, together with a GBS-SNP genetic map and Oxford Nanopore Technologies long-read data from the literature. For the first time, we identified P and F regions within reconstructed chromosomes, representing 20.57% and 79.43% of the genome, respectively based on DNA sequencing data from three tissues with varying levels of endoreplicated nuclei. P regions were gene-rich and located at chromosome ends, whereas F regions were SSR-rich and located at central parts of chromosomes. Remarkably, 97.24% of SSRs were found in F regions, predominantly comprising the trinucleotide AAG/CTT motif, which may contribute to the absence of endoreplication in these regions. Protein-encoding genes overrepresented in F regions were associated with negative regulation of flower development, mitotic cycle progression, cell division and histone modification. This accurate high-quality chromosome-scale V. planifolia genome assembly provides unprecedented insights into the structural and molecular characteristics of partial endoreplication in Orchids and represents a major step toward the characterization of this complex genome.
Musculoskeletal magnetic resonance imaging has evolved substantially, driven by advances in hardware, image acquisition, and reconstruction techniques. Improvements in gradient performance and dedicated radiofrequency coils have enhanced spatial resolution and scan efficiency across field strengths. Image acceleration strategies, including parallel imaging, simultaneous multislice acquisition, and compressed sensing, now enable high-quality two-dimensional and three-dimensional magnetic resonance imaging with markedly reduced examination times and facilitate the time-neutral incorporation of advanced metal artifact reduction techniques into clinical magnetic resonance imaging protocols. Deep learning-based reconstruction and super-resolution augmentation methods have further expanded achievable acceleration and image quality. Emerging techniques such as synthetic magnetic resonance imaging, magnetic resonance neurography, kinematic magnetic resonance imaging, and zero echo time magnetic resonance imaging expand the capabilities of musculoskeletal magnetic resonance imaging. At the same time, renewed interest in low-field magnetic resonance imaging provides intriguing opportunities to improve accessibility and sustainability. Ultra-high field magnetic resonance imaging provides unprecedented spatial resolution and quantitative insights in selected applications. These developments are redefining musculoskeletal magnetic resonance imaging practice and broadening its clinical value.
Tumor vaccines are considered a promising approach in immunotherapy, designed to boost the immune system's capacity to identify tumor-associated antigens and subsequently trigger immune responses against tumors. However, the inherent genetic instability of tumor cells frequently results in decreased expression or loss of antigen and/or major histocompatibility complex (MHC) expression and upregulation of immune checkpoint molecule PD-L1, thus evading endogenous immune recognition and surveillance. Herein, we developed a hierarchical self-adjuvanted nanoCRISPR-based vaccine (HEDERA) loaded with LSD1/PD-L1 dual-editing CRISPR/Cas9 system, seeking to reinstate the endogenous immune detection and monitoring mechanisms to enhance adaptive immune reactions. Knockdown of LSD1 increases the presence of tumor-specific antigens and major histocompatibility complex class I molecules on the surface of cancer cells, thereby restoring immune recognition. Simultaneously, silencing PD-L1 alleviates the "exhaustion" of T cells and reactivates their cytotoxic activity. Moreover, LSD1 knockdown activates the type I interferon pathway to induce a self-adjuvant effect that enhances innate immune responses and thereby strengthens T cell-mediated adaptive immunity. This dual strategy achieves unprecedented efficacy, with 90% primary tumor inhibition, and demonstrates an 87.3% and 90.6% inhibition rate for post-surgical metastatic and recurrent tumors, respectively. Overall, HEDERA overcomes the single-action constraint of traditional tumor vaccines, and avoids combined medication-related poor patient compliance, delivering a more efficient, convenient integrated tumor immunotherapy solution.
Covalently fusing multiple B-N units into redox-active polycyclic aromatic hydrocarbons (PAHs) offers a powerful strategy for creating π-extended systems with novel functionalities, but it remains a formidable challenge. Here, we report a facile, one-pot, and lithium-free NH-directed borylation to construct a series of 5,10-dihydro-5,10-diphenylphenazine (DPPA) derivatives fused by two or four B-N covalent bonds. Such a multiple B-N locking is found not only to enforce molecular rigidity and suppress excited-state structural relaxation, but also to profoundly modulate the electronic structure and antiaromaticity of the central DPPA core. Interestingly, the resultant quadruply fused system (4BN-Ph) can function as an unprecedented narrowband orange-red thermally activated delayed fluorescence (TADF) emitter, enabling efficient electroluminescence with a record-high external quantum efficiency of 31.2% and a notably small full-width at half-maximum of 32 nm at an emissive peak of 595 nm. Also, 4BN-Ph displays intriguing redox-controlled properties, since a stepwise oxidation generates near-infrared-absorbing open-shell radical cations and closed-shell dications. This work establishes a modular route to PAHs incorporating multiple B-N covalent bonds, with exceptional optoelectronic and spintronic properties.